Neue Epidemiologie der akuten gastrointestinalen Blutung

Zusammenfassung: Die allgemeinen medizinischen, noch mehr aber die gastroenterologischen Fortschritte der letzten 25Jahre würden erwarten lassen, dass gastrointestinale Blutungen seltener und deren Letalität heute geringer sind. Die publizierten epidemiologischen Daten können dies insgesamt nicht oder nicht im erhofften Ausmaß bestätigen. Die Datenqualität vieler Studien ist aber unbefriedigend. So scheint es beispielsweise, dass fragwürdige Blutungsquellen wie Erosionen im oberen Gastrointestinaltrakt und Kolondivertikel oft wenig kritisch als definitive Ursache der Blutung bezeichnet werden. Klare Hinweise auf Veränderungen finden sich jedoch in Untergruppen. Nach dem Rückgang von H.pylori in der jüngeren Bevölkerung sind bei der Ulkusblutung heute vermehrt ältere Personen mit zusätzlichen Risikofaktoren wie schwerwiegenden Begleiterkrankungen sowie Einnahme von NSAR, Low-dose-Aspirin und Antikoagulantien betroffen. Nicht unerwartet findet sich in dieser Gruppe generell keine Veränderung oder sogar eine Verschlechterung der Prognose bei akuter Blutun

On the kinematics of the cross body abduction and hand behind the back tests to assess osteoarthritis of the acromioclavicular joint

Background: Osteoarthritis of the acromioclavicular joint is one of the most common sources of shoulder pain. One of the current standard clinical physical examination tests is the cross body adduction test which has been shown to signal the presence of osteoarthritis. Another test referred to as the hand behind the back test has been described to provide a more accurate diagnosis than the CBA test for some patients. Through this work, both the CBA and the HBB tests were modeled in order to determine if there is merit for the HBB test to be used as a diagnostic tool for clinicians. Methods: Both tests were modeled using the zygote solid 3D 50th percentile male human anatomy model and MSC-ADAMS Software to compile and run the simulations. Within MSC-ADAMS the bones were outfitted with joints. During simulation, the bones were moved from the anatomical position to the final position for each test and the corresponding minimum distances between the bones at the acromioclavicular joint were then determined. Results: It was found that the distance between the acromioclavicular joint articulating surfaces decreased by 0.3 mm from the anatomical position during the CBA test and by 1.65 mm from the anatomical position during the HBB. This shows that the minimum space decreased from the anatomical position by more than 5 folds during the HBB test than during the CBA test. Conclusions: These results indicate that the HBB test may be a better diagnostic test due to the greater stress and irritation it places upon the acromioclavicular joint

The Test Facility for the Short Prototypes of the LHC Superconducting Magnets

The LHC development program relies on cryogenic tests of prototype and model magnets. This vigorous program is pursued in a dedicated test facility based on several vertical cryostats working at superfluid helium temperatures. The performance of the facility is detailed. Goals and test equipment for currently performed studies are reviewed: quench analysis and magnet protection studies, measurement of the field quality, test of ancillary electrical equipment like diodes and busbars. The paper covers the equipment available for tests of prototypes and some special series of LHC magnets to come

The Measurement Bench for the LHC Spool Corrector Magnets in Industry

The LHC accelerator will be equipped with more than 3500 superconducting spool corrector magnets. CERN has awarded the contract for the series production and testing of these corrector magnets to industry. Magnetic field measurements are done at the factory. Dedicated magnetic measurement benches have been built to test these corrector magnets in the resistive state at room temperature. The benches allow to measure the strength of the main field, normal and skew harmonics, the magnetic axis position and orientation of the main field with respect to the mechanical reference points of the magnet. This paper presents the objectives, a description and the performances obtained with the benches during first measurements at industry

Z-11-TETRADECENYL ACETATE: SEX ATTRACTANT OF AGAPETA ZOEGANA (LEPIDOPTERA: TORTRICIDAE), A POTENTIAL SPECIES FOR THE BIOLOGICAL CONTROL OF KNAPWEED

In Canada, 78 of the most important weed species are introductions from Eurasia (Frankton and Mulligan 1970). Classical biological control aims to reduce the density of alien weeds below the economic threshold through introduction of specific herbivores from the native distribution area (Peschken 1979). During extended field surveys in central and southeastern Europe, the Commonwealth Institute of Biological Control established the root-mining tortricid Agapeta zoegana Haw. as a promising control agent for Centaurea diffusa Lam. and C. maculosa Lam., 2 important ranch weeds in southwestern Canada (Harris and Myers 1984) and the northwestern United States (Maddox 1982). Due to the limited host range and suitable climatic conditions this moth was chosen for introduction into North America (Müller et al. 1982; Müller 1984). We wish to report an attractant that may be used to monitor the establishment of this beneficial species in its new habita

Radical-free hyperpolarized MRI using endogenously occurring pyruvate analogues and UV-induced nonpersistent radicals.

It was recently demonstrated that nonpersistent radicals can be generated in frozen solutions of metabolites such as pyruvate by irradiation with UV light, enabling radical-free dissolution dynamic nuclear polarization. Although pyruvate is endogenous, the presence of pyruvate may interfere with metabolic processes or the detection of pyruvate as a metabolic product, making it potentially unsuitable as a polarizing agent. Therefore, the aim of the current study was to characterize solutions containing endogenously occurring alternatives to pyruvate as UV-induced nonpersistent radical precursors for in vivo hyperpolarized MRI. The metabolites alpha-ketovalerate (αkV) and alpha-ketobutyrate (αkB) are analogues of pyruvate and were chosen as potential radical precursors. Sample formulations containing αkV and αkB were studied with UV-visible spectroscopy, irradiated with UV light, and their nonpersistent radical yields were quantified with electron spin resonance and compared with pyruvate. The addition of <sup>13</sup> C-labeled substrates to the sample matrix altered the radical yield of the precursors. Using αkB increased the <sup>13</sup> C-labeled glucose liquid-state polarization to 16.3% ± 1.3% compared with 13.3% ± 1.5% obtained with pyruvate, and 8.9% ± 2.1% with αkV. For [1- <sup>13</sup> C]butyric acid, polarization levels of 12.1% ± 1.1% for αkV, 12.9% ± 1.7% for αkB, 1.5% ± 0.2% for OX063 and 18.7% ± 0.7% for Finland trityl, were achieved. Hyperpolarized [1- <sup>13</sup> C]butyrate metabolism in the heart revealed label incorporation into [1- <sup>13</sup> C]acetylcarnitine, [1- <sup>13</sup> C]acetoacetate, [1- <sup>13</sup> C]butyrylcarnitine, [5- <sup>13</sup> C]glutamate and [5- <sup>13</sup> C]citrate. This study demonstrates the potential of αkV and αkB as endogenous polarizing agents for in vivo radical-free hyperpolarized MRI. UV-induced, nonpersistent radicals generated in endogenous metabolites enable high polarization without requiring radical filtration, thus simplifying the quality-control tests in clinical applications

NDM-504: MULTI-PLATFORM TORNADO DAMAGE SCENE PRESERVATION

A severe tornado system produced damage to engineered metal buildings at an industrial facility outside Pampa, TX and toppled several nearby center-pivot irrigation structures. Rapid remote-sensing preservation of this overall damage scene was of particular necessity: access to the industrial facility was prohibited, and the overall size of the center-pivot irrigation system disallowed rapid direct measurement of member displacements. Engineers and architects from West Texas A&M University, University of Nebraska-Lincoln, and Texas Tech University collaborated to acquire and preserve the damage scene for future study, using a suite of existing and emerging platforms: including 3D point clouds derived from aerial FoDAR, aerial drone imaging, terrestrial laser scanning, and terrestrial digital photogrammetry as well as two-dimensional, four-band satellite imaging. Data collection using these various platforms offers guidance for the future remote-sensing preservation of damage scenes, the validation of estimated wind speeds currently employed in the Enhanced Fujita Scale of tornado intensity, and the further development of techniques for automated remote-sensing-based wind damage assessments

Childhood onset of Scheie syndrome, the attenuated form of mucopolysaccharidosis I

Scheie syndrome is the most attenuated and rarest form of mucopolysaccharidosis type I (MPS I), an inherited lysosomal storage disorder. Only small patient series have previously been reported. Using natural history data from the uniquely large population of 78 Scheie patients enrolled in the MPS I Registry, we characterized the onset and prevalence of clinical manifestations and explored reasons for delayed diagnosis of the disease. Median patient age was 17.5 years; 46% of the patients were male, and 88% were Caucasian. Of 25 MPS I-related clinical features, cardiac valve abnormalities, joint contractures, and corneal clouding were each reported by >80% and all three by 53% of patients. Carpal tunnel syndrome, hernia, coarse facial features, and hepatomegaly were each reported by >50% of patients. Age at onset of the clinical features varied widely between individuals, but the median age at onset was 3 years for hernia and between 5 and 12 years for most features, including coarse facial features, hepatomegaly, joint contractures, bone deformities, cardiac valve abnormalities, cognitive impairment, and corneal clouding. Carpal tunnel syndrome, cardiomyopathy, and myelopathy arose more commonly during adolescence or adulthood. Delays up to 47 years intervened between symptom onset and disease diagnosis, and the longest delays were associated with later age at symptom onset and symptom onset before 1980. In summary, Scheie syndrome usually emerges during childhood, and recognition of attenuated MPS I requires awareness of the multisystemic disease manifestations and their diverse presentation. Given the availability of etiologic treatment, prompt diagnosis is important

Diagnosis and treatment trends in mucopolysaccharidosis I: findings from the MPS I Registry

Our objective was to assess how the diagnosis and treatment of mucopolysaccharidosis I (MPS I) have changed over time. We used data from 891 patients in the MPS I Registry, an international observational database, to analyze ages at symptom onset, diagnosis, treatment initiation, and treatment allocation (hematopoietic stem cell transplantation, enzyme replacement therapy with laronidase, both, or neither) over time for all disease phenotypes (Hurler, Hurler–Scheie, and Scheie syndromes). The interval between diagnosis and treatment has become shorter since laronidase became available in 2003 (gap during 2006–2009: Hurler—0.2 year, Hurler–Scheie—0.5 year, Scheie—1.4 years). However, the age at diagnosis has not decreased for any MPS I phenotype over time, and the interval between symptom onset and treatment initiation remains substantial for both Hurler–Scheie and Scheie patients (gap during 2006–2009, 2.42 and 6.71 years, respectively). Among transplanted patients, an increasing proportion received hematopoietic stem cells from cord blood (34 out of 64 patients by 2009) and was also treated with laronidase (42 out of 45 patients by 2009). Conclusions: Despite the availability of laronidase since 2003, the diagnosis of MPS I is still substantially delayed for patients with Hurler–Scheie and Scheie phenotypes, which can lead to a sub-optimal treatment outcome. Increased awareness of MPS I signs and symptoms by primary care providers and pediatric subspecialists is crucial to initiate early treatment and to improve the quality of life of MPS I patients