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Notes: Abstract The aim of the study was to determine the possibility of establishing a genuine stress urinary incontinence severity grading from the combination of historical clinical and urodynamic parameters. Four hundred and eighty-three patients underwent complete investigation, including a questionnaire, clinical evaluation and multichannel urodynamic testing. They were then divided into four groups on the basis of the presence of only a SUI history (group 1,n=65); positive urine loss with a ‘continent’ stress urethral pressure profile (SUPP) (group 2,n=61); positive urine loss with an ‘incontinent’ SUPP (group 3,n=231); or no urine loss with an ‘incontinent' SUPP (group 4,n=126). Compared to group 1 the severity of incontinence was significantly greater in groups 2 and 3. and maximal urethral closure pressure and pressure transmission ratio were significantly reduced in group 3 and 4. Otherwise, history, clinical and urodynamic parameters showed no significant differences between the four groups. It was concluded that a scoring severity can be established when considering all the parameters of a woman suffering from GSI.

Notes: Zusammenfassung An 25 unfixierten Leichen wurde die Topographie der A. und V. circumflexa ilium superficialis und profunda sowie der A. epigastrica inferior superficialis als axiale Gefäßbündel für Transplantate der Leistenregion untersucht. Durch Farbstoffinjektionen mit Methylenblau wurde das Kapillargebiet der genannten Arterien im Knochen (Beckenschaufel) in der Muskulatur (M. obliquus internus abdominis) und in der Haut (Leistenbeuge und Oberschenkel) dargestellt. Die oberflächliche und tiefe Beckenarterie sind die Hauptversorgungsgefäße der Leistenbeuge und des Oberschenkels. Ihre Vorkommenswahrscheinlichkeit von 96 bzw. 100% ist stabil. Die venöse Entsorgung der Region erfolgt über ein oberflächliches (V. circumflexa ilium superficialis) und tiefes Venensystem (Vv. comitantes der genannten Arterien). Beide Systeme sind immer vorhanden. Die A. circumflexa ilium superficialis versorgt ausschließlich die Haut und ist somit Spendergefäß für Haut-Fett-Transplantate. Die A. circumflexa ilium profunda versorgt den Beckenknochen, die Bauchmuskulatur und ein kleines Hautareal über dem Beckenkamm. Mit diesem Gefäß lassen sich Knochen-, Knochen-Muskel- und Knochen-Muskel-Haut-Transplantate entnehmen. Durch Einbeziehung beider Arterien in das Transplantat kann das Hautareal vergrößert werden. Mit durchschnittlichen Gefäßdurchmessern von 1,5 mm (oberflächliche Beckenarterie) bzw. 3 mm (tiefe Beckenarterie) eignen sich beide Gefäße gut für die Mikrogefäßanastomosierung. Die verschiedenen Gewebekompartments (Muskel, Knochen, Haut) können für Defekte im HNO-Bereich in ausreichender Größe und Form entnommen werden.

Notes: Summary Optimal rehabilitation after injuries has become increasingly important in recent years. In our concept, not only the damaged local structure is treated but supplementary training to improve the general physical performance is recommended. This specific training includes the components of strength, endurance, coordination, flexibility and velocity. We explain in the present article the role of these rehabilitative methods and refer to their importance for the reintegration process following injuries.

Notes: Abstract A study was conducted to find out whether in a rear-impact motor vehicle accident, velocity changes in the impact vehicle of between 10 and 15 km/h can cause so-called “whiplash injuries”. An assessment of the actual injury mechanism of such whiplash injuries and comparison of vehicle rear-end collisions with amusement park bumper car collisions was also carried out. The study was based on experimental biochemical, kinematic, and clinical analysis with volunteers. In Europe between DM 10 and 20 billion each year is paid out by insurance companies alone for whiplash injuries, although various studies show that the biodynamic stresses arising in the case of slight to moderate vehicle damage may not be high enough to cause such injuries. Most of these experimental studies with cadavers, dummies, and some with volunteers were performed with velocity changes below 10 km/h. About 65% of the insurance claims, however, take place in cases with velocity changes of up to 15 km/h. Fourteen male volunteers (aged 28–47 years; average 33.2 years) and five female volunteers (aged 26–37 years; average 32.8 years) participated in 17 vehicle rear-end collisions and 3 bumper car collisions. All cars were fitted with normal European bumper systems. Before, 1 day after and 4–5 weeks after each vehicle crash test and in two of the three bumper car crash tests a clinical examination, a computerized motion analysis, and an MRI examination with Gd-DTPA of the cervical spine of the test persons were performed. During each crash test, in which the test persons were completely screened-off visually and acoustically, the muscle tension of various neck muscles was recorded by surface eletromyography (EMG). The kinematic responses of the test persons and the forces occurring were measured by accelerometers. The kinematic analyses were performed with movement markers and a screening frequency of 700 Hz. To record the acceleration effects of the target vehicle and the bullet vehicle, vehicle accident data recorders were installed in both. The contact phase of the vehicle structures and the kinematics of the test persons were also recorded using high-speed cameras. The results showed that the range of velocity change (vehicle collisions) was 8.7–14.2 km/h (average 11.4 km/h) and the range of mean acceleration of the target vehicle was 2.1–3.6 g (average 2.7 g). The range of velocity change (bumper car collisions) was 8.3–10.6 km/h (average 9.9 km/h) and the range of mean acceleration of the target bumper car was 1.8–2.6 g (average 2.2 g). No injury signs were found at the physical examinations, computerized motion analyses, or at the MRI examinations. Only one of the male volunteers suffered a reduction of rotation of the cervical spine to the left of 10° for 10 weeks. The kinematic analysis very clearly showed that the whiplash mechanism consists of translation/extension (high energy) of the cervical spine with consecutive flexion (low energy) of the cervical spine: hyperextension of the cervical spine during the vehicle crashes was not observed. All the tests showed that the EMG signal of the neck muscles starts before the head movement takes place. The stresses recorded in the vehicle collisions were in the same range as those recorded in the bumper car crashes. From the extent of the damage to the vehicles after a collision it is possible to determine the level of the velocity change. The study concluded that, the “limit of harmlessness” for stresses arising from rear-end impacts with regard to the velocity changes lies between 10 and 15 km/h. For everyday practice, photographs of the damage to cars involved in a rear-end impact are essential to determine this velocity change. The stress occurring in vehicle rear-end collisions can be compared to the stress in bumper car collisions.

Notes: Ba6Pr2Fe4O15 (I), Ba5SrPr2Fe4O15 (II) und Ba5CaPr2Fe4O15 (III) wurden mit Hochtemperatur-CO2-LASER-Technik dargestellt. (I)-(III) kristallisieren mit hexagonaler Symmetrie, Raumgruppe C6V4-P63mc, (I): a = 11.808(2), c = 7,036(4) Å; (II): a = 11.689(2), c = 6.954(2) Å; (III): a = 11.602(6), c = 6.894(5) Å, Z = 2. Charakteristische Eigenschaften dieser Kristallstruktur sind flächenverknüpfte MO6-Oktaeder (M = Ba oder Ba/Sr, Ba/Ca) und eine statistische Verteilung von Ba und Pr im Verhältnis 1 : 2 in einem zweifach überkappten trigonalen Sauerstoffprisma. Fe zeigt sowohl tetraedrische als auch oktaedrische Sauerstoffkoordination. Berechnungen der Coulomb-Terme zur Gitterenergie deuten an, daß durch den Ba6Ln2A4O15-Typ Pr3+ neben Fe3+ stabilisiert wird.

Notes: Einkristalle von Ba(VO)Cu4(PO4)4 wurden mit Festkörperreaktionen dicht unterhalb des Schmelzpunktes des Reaktionsgemenges aus BaP2O6, Cu3(PO4)2, CuO, V2O5 und V2O3 in geschlossenen, evakuierten Quarzglasampullen dargestellt. Diese Verbindung kristallisiert tetragonal, Raumgruppe D42—P4212, mit a = 9,560(2), c = 7,160(2) Å, Z = 2. Besondere und neue Eigenschaften der Kristallstruktur sind zueinander isolierte Cu4O12- und (VO)(PO4)4-Gruppen. Die Kristallchemie der Cu4O12-Baugruppen wird mit Blick auf andere Verbindungen, die nicht in Ebenen verknüpfte MO4-Polygone aufweisen, diskutiert.