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  • 1
    Electronic Resource
    Electronic Resource
    Kutane Malakoplakie bei einem Patienten mit Psoriasis vulgaris (1996)
    Springer
    Der Hautarzt 47 (1996), S. 763-766 
    Details
    ISSN: 1432-1173
    Keywords: Schlüsselwörter Malakoplakie ; Kutane Manifestation ; Michaelis-Gutmann-Körperchen ; Psoriasis vulgaris ; Key words Malakoplakia ; Cutaneous manifestation ; Michaelis-Gutmann-bodies ; Psoriasis vulgaris
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary A 58 year old patient suffering from psoriasis vulgaris had typical erythematous, scaly plaques for 20 years. In addition, an erosive, therapy-resistant plaque was found in the perianal region. A biopsy was taken to exclude malignancy; it showed intracytoplasmic Michaelis-Gutmann-bodies as a marker for malakoplakia, which rarely occurs in the skin. In further electron microscopic investigation, intracytoplasmatic bacteria could be demonstrated. An underlying malignancy or chronic renal insufficiency with immunosuppression were not found in this patient; both are often associated with malakaplakia.
    Notes: Zusammenfassung Es wird über einen 58jährigen Patienten berichtet, bei dem seit 20 Jahren rezidivierend eine Psoriasis vulgaris mit typischen erythemato-squamösen Plaques an den Prädilektionsstellen besteht. Desweiteren fand sich perianal ein seit ca. 5 Jahren bekannter, therapieresistenter und teils erodierter Plaque. Die zum Ausschluß eines malignen Prozesses durchgeführte Probebiopsie ergab die seltene kutane Manifestation einer Malakoplakie durch den Nachweis der typischen intrazytoplasmatischen Michaelis-Gutmann-Körperchen sowie durch elektronenmikroskopisch nachweisbare intrazytoplasmatische Bakterien. Ein Tumorleiden oder eine Niereninsuffizienz mit entsprechender Immunsuppression, als häufig beobachtete Grunderkrankung der ätiopathogenetisch bisher nicht geklärten Malakoplakie, konnten bei dem hier vorgestellten Fall ausgeschlossen werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001050050505
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  • 2
    Electronic Resource
    Electronic Resource
    CT-gesteuerte Schneid-Saug-Biopsie zur minimal invasiven histologischen Abklärung pathologischer Thoraxbefunde (1999)
    Springer
    Zeitschrift für Herz-, Thorax- und Gefässchirurgie 13 (1999), S. 133-138 
    Details
    ISSN: 0930-9225
    Keywords: Schlüsselwörter Computertomographie – Thorax – Interventionen – Schneid-Saug-Biopsie ; Key words Computer tomography – thorax interventions – carve-suction biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Problem: An investigation into CT-controlled carve-suction biopsy for a histological clarification of indefinite intrathoracic masses. Materials and Method: 143 CT-controlled interventions were performed on 102 patients. For histological evaluation purposes, tissue was taken under application of the carva-suction biopsy method (16–18 gage). The lesions with a diameter of 5–70 mm were located in the mediastinum (25%), were close to the thoracic wall/pleural (40%) and intrapulmonary (35%). Results: 92.2% (94/102) of the interventions provided histologically utilizable material in at least one biopsy specimen. The clinical suspected diagnosis was confirmed 78 times (76.5%), while a different discase was evident 16 times (15.7%). In 8 cases, a diagnosis was not possible (7.8%). The total complication rate was 21.6%. The following were observed: 18 pneumothoraxes, 2 hemothoraxes, and 2 patients who demonstrated a hemoptysis. In 4/102 patients (3.9%) complications arose which had to be treated therapeutically. Two-sided complications were not observed. Conclusions: The CT-controlled carve-suction biopsy can be employed histologically to clarify indefinite intrathoracic findings with a high degree of certainty and justifiable complication rates. In addition to this, the minimally invasive procedure helps to reduce costs.
    Notes: Zusammenfassung Fragestellung: Bewertet wird die CT-gesteuerte Schneid-Saug-Biopsie zur histologischen Abklärung unklarer intrathorakaler Raumforderungen. Material und Methode: Bei 102 Patienten wurden 143 CT-gesteuerte Interventionen durchgeführt. Zur histologischen Beurteilung wurde Gewebe in Schneid-Saug-Biopsie-Technik (16–18 Gage) entnommen. Die Läsionen waren 5–70 mm groß, 25% lagen mediastinal, 40% thoraxwandnah/pleural und 35% intrapulmonal. Ergebnisse: 92,2% (94/102) der Interventionen erbrachten in mindestens einer entnommenen Gewebeprobe histologisch verwertbares Material. Die klinische Verdachtsdiagnose wurde 78mal (76,5%) bestätigt, 16mal (15,7%) wurde eine andere Erkrankung nachgewiesen. 8mal ließ sich keine Diagnose stellen (7,8%). Die Komplikationsrate betrug 21,6% (18 Pneumothoraces, 2 Hämatothoraces und 2 Patienten mit Hämoptoe). Bei 4/102 Patienten (3,9%) traten therapiebedürftige Komplikationen auf. Schlußfolgerungen: Mit der CT-gesteuerten Schneid-Saug-Biopsie lassen sich unklare intrathorakale Befunde mit hoher Treffsicherheit und vertretbaren Komplikationen abklären.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003980050070
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  • 3
    Electronic Resource
    Electronic Resource
    Synthesis of non-proteinogenic (D)- or (L)-amino acids by asymmetric hydrogenation (1996)
    Springer
    Amino acids 11 (1996), S. 269-282 
    Details
    ISSN: 1438-2199
    Keywords: Amino acids ; Non-proteinogenic optically active amino acids ; D- and L-enantiomers ; Dehydroamino acids ; Chiral rhodium catalysts ; Asymmetric hydrogenation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Non-proteinogenic amino acids play an increasing role in oligopeptide chemistry. Their pharmacological and chemical properties, caused by D-configuration and “unnatural” residues, are more and more used for drug design. Different methods of asymmetric synthesis have been developed during the last decade to prepare “unusual” amino acids. One of them, the asymmetric hydrogenation of dehydroamino aids catalyzed by chiral rhodium (I) complexes, will be described. A series of examples, D- and L-configured, like naphthyl-, thienyl-, furyl-, and pyridylalanines, as well as phenylalanines substituted by chlorine, fluorine, p-nitro, p-methyl, p-trifluoromethyl, p-isopropyl, and p-tert-butyl have been prepared and characterized. Some analytical data like melting points and values of optical rotation are summarized in tables.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00807936
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  • 4
    Electronic Resource
    Electronic Resource
    Generation of Quasiperiodic Structures by Amassment Centres in Multilattices (1998)
    [S.l.] : International Union of Crystallography (IUCr)
    Acta crystallographica 54 (1998), S. 199-202 
    Details
    ISSN: 1600-5724
    Source: Crystallography Journals Online : IUCR Backfile Archive 1948-2001
    Topics: Chemistry and Pharmacology , Geosciences , Physics
    Notes: In this paper, a general method for generating quasiperiodic lattices is given. It is based on point multilattices which may be transformed into quasilattices in a new manner. A rounding operation allows the conversion of amassments of points in the multilattice into single points of a perfect quasicrystalline structure. Several examples are given.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1107/S0108767397012580
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  • 5
    Electronic Resource
    Electronic Resource
    Kann der Notarzt zum Risiko werden? (1999)
    Springer
    Notfall + Rettungsmedizin 2 (1999), S. 3-17 
    Details
    ISSN: 1436-0578
    Keywords: Key words Rescue management ; Quality control ; Standards of emergency medicine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Nevertheless, an increasing number of unnecessary rescue operations have been reported. Therefore the analysis of quality is demanded. For some years the concept of „medical control” has been successfully practised in the United States. To achieve for quality it is necessary to define quality and to fix standards. Several German organizations (DGU, DIVI, DGNC, DGAI) have already listed the standards of emergency medicine. A national standardized protocol could be introduced. In light of these standards it is now necessary to document the preclinical treatment and carry out quality control. Errors in a defined collective of patients are analysed and critical aspects in the management of critical care patients are discussed. As well as repeated insufficient management of trauma patients, the number of invasive techniques performed without indication is increasing.
    Notes: Trotzdem wird in den letzten Jahren immer häufiger über unnötige Einsätze und Fehlentscheidungen berichtet, so daß auch hier eine Qualitätsanalyse gefordert wird [32]. Dieses Konzept wird unter dem Begriff „Medical Control” bereits seit Jahren in den Vereinigten Staaten erfolgreich praktiziert [23]. Zielgrößen um die Qualität zu definieren und diese im Sinne der Qualitätssicherung einzusetzen, erfordert die Festschreibung von Standards [32]. Im Rahmen der Notfallmedizin sind Qualitätsstandards bereits von verschiedenen deutschen Organisationen (DGU, DIVI, DGNC, DGAI) zusammengestellt worden. Ein Bundeseinheitliches Notarztprotokoll konnte eingeführt werden [13] (Abb. 1). Es gilt nun die Daten der präklinischen Behandlung unter Berücksichtigung dieser Standards zu dokumentieren und eine Qualitätskontrolle vorzunehmen [12, 23, 32]. Anhand einer Fehleranalyse im eigenen Patientenkollektiv soll auf kritische Punkte der notärztlichen Versorgung von Unfallpatienten hingewiesen werden. Neben der immer wieder zu beobachtenden unzureichenden Versorgung von Traumapatienten, häufen sich in den letzten Jahren auch Fälle in denen nicht indizierte invasive Maßnahmen durchgeführt werden.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s100490050091
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  • 6
    Electronic Resource
    Electronic Resource
    The orientation behaviour of the lesser spearnosed bat, Phyllostomus discolor (Chiroptera) in a model roost (1996)
    Springer
    Journal of comparative physiology 179 (1996), S. 245-254 
    Details
    ISSN: 1432-1351
    Keywords: Bat ; Orientation ; Vision ; Echolocation ; Cumulative navigation error
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract The orientation behaviour of bats (Phyllostomus discolor, Phyllostomidae), flying inside an octagonal “roost-like” chamber (ø: 100cm; h: 150cm) was examined. It has been shown that the bats begin turning manoeuvres during flight by turning their head towards the direction they intend to proceed to. During early phases of the flights, cumulative navigation errors were evident, indicating that endogenous spatial information plays a major role in the orientation of the bats. During later phases of the flight this error is diminished again. So it can be concluded that the bats start to use exogenous spatial information for orientation while approaching the target. In order to investigate the relative importance of vision, echolocation and endogenous spatial information for approaching the roost, the landing lattices inside the test arena were changed for non-grid dummies. We found that: 1. combined visual and endogenous information are more important than echoacoustical cues, 2. the bats learned quickly to switch their orientation behaviour in order to get a better performance in avoiding the dummies, 3. the learning performance was influenced by the visual similarity of dummies and the real landing lattice.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00222791
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  • 7
    Electronic Resource
    Electronic Resource
    A differential-pressure probe for velocity measurements in swirling air flows (1995)
    Springer
    Experiments in fluids 20 (1995), S. 134-135 
    Details
    ISSN: 1432-1114
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mechanical Engineering, Materials Science, Production Engineering, Mining and Metallurgy, Traffic Engineering, Precision Mechanics
    Notes: Abstract For measuring air velocities in swirling flows a differential pressure probe of small axial length was developed. The determination of the velocity is based on measuring the difference between the stagnation pressure and the base pressure of a circular disk whose surface is perpendicular to the main flow direction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00189304
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  • 8
    Electronic Resource
    Electronic Resource
    A differential-pressure probe for velocity measurements in swirling air flows (1995)
    Springer
    Experiments in fluids 20 (1995), S. 134-135 
    Details
    ISSN: 1432-1114
    Source: Springer Online Journal Archives 1860-2000
    Topics: Mechanical Engineering, Materials Science, Production Engineering, Mining and Metallurgy, Traffic Engineering, Precision Mechanics
    Notes: Abstract For measuring air velocities in swirling flows a differential pressure probe of small axial length was developed. The determination of the velocity is based on measuring the difference between the stagnation pressure and the base pressure of a circular disk whose surface is perpendicular to the main flow direction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01061592
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  • 9
    Electronic Resource
    Electronic Resource
    Nucleation and growth of Ni-LIGA layers (1996)
    Springer
    Microsystem technologies 3 (1996), S. 10-16 
    Details
    ISSN: 1432-1858
    Source: Springer Online Journal Archives 1860-2000
    Topics: Electrical Engineering, Measurement and Control Technology , Technology
    Notes: Abstract  The quality of a Ni-LIGA layer and its adhesion to TiO2 depend crucially on interface morphology and chemistry. The unique combination of ARXPS (angle resolved photo electron spectroscopy), STM (Scanning tunnel microscopy) and DTS (distance tunnel spectroscopy) yield new insights in morphology and stoichiometry on the porous TiO2 plating ground, on the TiO 2-x (OH) y NiO z Ni interface, and on the Ni-nucleation and growth. Aside TiO2-pore dimension, we identified graphite hillocks, with retarded Ni coverage, the adhesion promoting interface oxide TiO 2-x (OH) y Ni z and the Ni nuclei and their expansion.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005420050047
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  • 10
    Electronic Resource
    Electronic Resource
    Injuries of the cervical spine in children (1998)
    Springer
    Der Unfallchirurg 101 (1998), S. 590-612 
    Details
    ISSN: 1433-044X
    Keywords: Key words Spinal injuries in children • Synchondrosis • Atlantooccipital dislocation • Odontoid fractures in children • Atlantoaxial dislocation • Pseudosubluxation • Discoligamentous instability • Operative treatment ; Schlüsselwörter Wirbelsäulenverletzungen bei Kindern • Entwicklung der Wirbelsäule • Diagnostik • Synchondrosen • Atlantookzipitale Dislokation • Densfrakturen bei Kindern • Atlantoaxiale Dislokation • Pseudosubluxation • Operative Behandlung • Diskoligamentäre Instabilitäten
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Verletzungen der Wirbelsäule sind bei Kindern extrem selten. Man kann davon ausgehen, daß sie etwa 0,2 % aller kindlichen Brüche und Verrenkungen und zwischen 1,5 und 3 % aller Wirbelsäulenläsionen ausmachen. Je jünger ein verletztes Kind, desto wahrscheinlicher liegt eine Läsion der oberen HWS vor. Dieser Abschnitt der Wirbelsäule ist im Vergleich zu Erwachsenen mit 50 % der HWS-Verletzungen überproportional häufig betroffen. Die meisten Unterschiede zwischen der Wirbelsäule des Erwachsenen und der des Kindes bestehen nur bis zum 10. Lebensjahr. Danach entsprechen Diagnostik, Klassifikation und Behandlung von Verletzungen weitgehend denen beim Erwachsenen. Bei Unkenntnis des normalen Aussehens und der normalen Entwicklung sind Fehlinterpretationen von Röntgenaufnahmen häufig. Typische Beispiele sind die Verwechslung von Synchondrosen mit Frakturen oder von Pseudosubluxationen des Atlas sowie des zweiten Halswirbels mit „echten“ Instabilitäten. Relevante Läsionen gehen immer auch mit eindeutigen klinischen Befunden einher. Besondere Verletzung der wachsenden Wirbelsäule sind Lösungen der Epiphysenplatten sowie „Frakturen“ der knorpeligen Zwischenzonen, der Synchondrosen. Atlantookzipitale Dislokationen (AOD) kommen besonders oft bei Kindern vor. Nach unseren Erfahrungen mit 16 AOD schlagen wir je nach Dislokationsrichtung der Okzipitalkondylen eine Einteilung in vordere, hintere und vollständig instabile AOD vor. Bei einem Jungen unseres Krankenguts konnte die Läsion durch eine temporäre interne Stabilisierung zur Ausheilung gebracht werden. Er zeigte eine weitgehende Erholung der anfangs hochgradigen neurologischen Ausfallserscheinungen. Verletzungen der Synchondrose des Dens axis stellen eine weitere typische Verletzung im Kindesalter dar. Vier von fünf Kindern aus dem eigenen Krankengut verunglückten bei Verkehrsunfällen. Drei saßen in Kindersitzen in Fahrtrichtung und waren mit einem 4-Punktgurt-System angeschnallt. Wir verwenden einen Halo-Ring mit Gipsweste für die konservative Behandlung. Operationsindikationen bestehen bei nicht retinierbaren sowie hochgradig instabilen Läsionen. Die operative Technik entspricht in allen Einzelheiten der beim Erwachsenen. 3 unserer 5 Kinder mit dieser Verletzung wurden erfolgreich operativ stabilisiert. Atlantoaxiale Dislokationen (AAD) werden in translatorische und rotatorische unterteilt. Sagittale Verschiebungen des Atlas bedürfen auch bei Kindern einer Fusion zwischen C1 und C2. Rotatorische Fehlstellungen lassen sich im frischen Stadium leicht reponieren und im Halo-Fixateur ausbehandeln. Auch bei veralteten Läsionen ist nach unseren Erfahrungen bei zwei Patienten teils durch offene, teils durch geschlossene Reposition eine Ausheilung in anatomischer Stellung möglich. Im Bereich der unteren HWS stellen neben Verletzungen mit Einengung des Spinalkanals vor allem solche mit ligamentärer oder diskoligamentärer Beteiligung– also Typ B- und C-Läsionen eine Operationsindikation dar. Sie heilen nämlich nach geschlossener Behandlung genauso wenig stabil aus wie bei Erwachsenen.
    Notes: Summary Injuries of the spine in children rarely occur. They amount to about 0.2 % of all fractures and dislocation and to 1.5 to 3 % of all lesions of the spine. The younger an injured child is, the more likely it has sustained a lesion of the upper cervical spine. This spinal segment in comparison to adults is concerned more often and accounts for 50 % of all C-spine injuries. Important differences between the adult spine and the spine in the child disappear with the age of 10 years. Later diagnostics, classification and treatment correspond widely with the principles valid in adults. The knowledge of the normal shape and development of the spine are crucial in avoiding misinterpretations of X-ray films. Typical examples include the confusion of synchondrosis with fractures or of subluxations of the atlas and the C2/C3 segment with “true” instabilities. Relevant lesions always are accompanied by clear clinical symptoms. Specific injuries of the growing axial skeleton are lesions of the cartilaginous endplates and “fractures” of the synchondrosis. Atlantooccipital dislocations (AOD) occur typically in children. According to our experiences with 16 AOD we propose – dependent on the direction of dislocation of the occipital condyles – a simplified classification in anterior, posterior and completely unstable AOD. In one boy in our series we treated the lesion successfully by temporary interal fixation. He presented a massive improvement of initially subtotal neurologic symptoms. Injuries to the synchondrosis of the dens represent another typical lesion in childhood. Four out of 5 children treated in our clinic were involved as back seat passengers in head-on motor vehicle accidents. Three of them were restrained by 4 point children's seat harnesses. For conservative treatment we prefer a halo and plaster-vest for 12 weeks after closed reduction. We recommend operative treatment in cases of major dislocation with greater instability where it may be impossible to maintain alignment with halo fxation. Surgical equipment and techniques correspond in detail to those used in adults. Three of the five children mentioned have been stabilized successfully by anterior screw fixation. Atlantoaxial dislocations (AAD) are devided into translatory and rotatory instabilities. Sagittal dislocations of the atlas in children also need to be fixed by a fusion between C1 and C2. Rotatory instabilities in the acute phase are easy to reduce and are treated with a halo-fixator. According to our experiences in two delayed cases anatomical reduction is also possible after months partly by open, partly by closed means. For the lower C-spine lesion with encroachment of the spinal canal and above all ligamentous injuries represent a clear indication for operative treatment because, similar to the adult spine, they do not become stable after close management.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001130050313
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