Increased muscle tension and reduced elasticity of affected muscles in recent-onset Graves' disease caused primarily by active muscle contraction

In 3 patients with Graves' disease of recent onset, length-tension diagrams were made during surgery for squint under eyedrop anesthesia. The affected muscles were found to be very stiff when the other eye looked straight ahead. It was expected that these stiff muscles would be able to shorten to some extent but would be unable to lengthen, due to fibrosis of the muscle. We found that the affected muscles did not shorten very much when the other eye looked into the field of action of the muscle. Unexpectedly however, they lengthenend considerably when the other eye looked out of the field of action of the muscle. This finding implies that the raised muscle tension and reduced elasticity of affected muscles in these cases of Graves' disease of recent onset were primarily caused by active muscle contraction, not by fibrosis

Deindustrialization and the Polarization of Household Incomes: The Example of Urban Agglomerations in Germany

The tertiarization, or perhaps more accurately, the deindustrialization of the economy has left deep scars on cities. It is evident not only in the industrial wastelands and empty factory buildings scattered throughout the urban landscape, but also in the income and social structures of cities. Industrialization, collective wage setting and the welfare state led to a stark reduction in income differences over the course of the twentieth century. Conversely, deindustrialization and the shift to tertiary sectors could result in increasing wage differentiation. Moreover, numerous studies on global cities, the dual city, and divided cities have also identified income polarization as a central phenomenon in the development of major cities. Using data from the German Socio-Economic Panel (SOEP), we find an increasing polarization of household income structures since the mid-1990. In agglomerations, this income polarization is even more pronounced than in the more rural regions. The income polarization in Germany is likely to have multiple causes, some of which are directly linked to policies such as the deregulation of the labor market. But extensive deindustrialization is probably also one of the drivers, that has led directly to the weakening of middle income groups

Force-length recording of eye muscles during local-anesthesia surgery in 32 strabismus patients

Abstract. Force-length recordings were made from isolated human eye muscles during strabismus surgery in local, eye-drop anesthesia in 32 adult patients. From each muscle three recordings were made: (1) while the patient looked with the other eye into the field of action of the recorded muscle, (2) looked ahead, and (3) looked out of the field of action of the recorded muscle. Non-innervated eye muscles (state 3) had an approximately exponential relation between force and length. During contraction evoked by letting the patient look ahead or into the field of action of the muscle (states I or 2), the relation between force and length was grossly linear. The approximate spring constants of horizontal rectus muscles that had not been operated on before ranged from 2 to 4 g/mm. In palsies, the degree of muscle paresis could be quantified accurately using this method and, accordingly, cases of true superior oblique palsy could be well differentiated from strabismus sursoadductorius (= upshoot in adduction) that may mimic a superior oblique palsy. In seven patients with Graves' disease of recent onset, affected muscles were found to be very stiff when the other eye looked ahead. It was expected that these stiff muscles would be able to shorten to some extent but would not be able to lengthen, due to fibrosis of the muscle. We found, however, that the affected muscles lengthened considerably when the other eye looked out of the field of action of the muscle. This implies that, in these cases of Graves' disease of recent onset, the raised muscle tension and reduced elasticity of the affected muscles and, hence, the strabismus were primarily caused by active muscle contraction, not by fibrosis

Is There Increasing Regional Specialisation within the General Process of Deindustrialisation?

Trade theory and economic geography suggest that the removal of trade barriers is likely to bring about more economic specialisation and potentially more diverse development paths between countries and regions. Thus, the deepening and extending European integration should be accompanied by an increasing regional specialisation. In contrast, our results for the period from 1995 to 2004 show considerably declining differences in the share of manufacturing in total value added across nations and regions of the EU. The decrease in sectoral specialisation is accompanied by a strong and almost uniform process of deindustrialisation. However, this trend is slowing down and manufacturing shares appear to be gradually approaching lower limits. These bounds are specific according to national affiliation and settlement types of regions

Product Policy and the East-West Productivity Gap: Evidence from German Manufacturing Firms

After 20 years of transition from an economy integrated in an exchange scheme of planned economies towards an open market economy based on the ideas of competition, we ask whether East German firms succeeded in finding their place in the international division of labour. We concentrate on the question, to what extent they have caught up with the productivity level of their Western counterparts of similar size and sector and how this productivity difference is related to changes in their product policy. We analyse these questions with a unique data set provided by Statistics Germany that contains both product policy and productivity information for individual manufacturers from both parts of the country. Using a decomposition approach suggested by Nopo (2008) as a nonparametric extension of the widely-used Oaxaca-Blinder methodology (Blinder 1973; Oaxaca 1973) we find that the time span from 1995 - 2004 has two component periods: a period of adaptation from 1995 to 2001and a period of branding from 2002 to 2004. The initial period is characterized by a smaller share of Eastern firms that modify their product range and by a large productivity gap of Eastern Non-Modifiers if compared to Western Non-Modifiers of comparable size and sector. The evidence for the second period, however, points to a more active and established role of East German manufacturers: more of them alter their product range and step up their productivity performance

Arzthaftungsrecht in der Bundesrepublik Deutschland

[[abstract]]德國醫師責任法分為兩個面向：醫師的診療責任及醫院的住院醫療責任。醫師的診療責任又可分為：依民法特別規定—診療契約所生之債法上責任，以及依民法規定的侵權行為責任。此外，債法上責任依病患身分（私人醫療保險病患、法定醫療保險病患、社會救助受領者）及疏失行為（診療疏失、告知疏失）而有所不同。 在住院醫療方面須區分為：私立醫療院所、公益醫療院所、公立醫療院所。病患於住院之前就必須締結住院醫療契約，其性質原則上為民法的勞務契約。住院醫療契約可分為三種：單一式住院醫療契約、單一式住院醫療附加指定醫師契約、住院醫療與醫師診療分離式契約。在契約責任方面尚可分為醫院及醫師的責任，而侵權行為責任的分類，亦同，且醫院還要為其機關及履行輔助人的行為負侵權行為責任。在公立醫院也一樣分為醫院及醫師的契約責任、侵權行為責任。 在起訴前得就醫師責任爭議提付仲裁。提出請求權之病患須證明存在醫療疏失、法益侵害、受有損害，以及醫療疏失與健康受損之間的因果關係。至於負責診治的醫師須證明已依規定向病患進行告知。發生重大醫療疏失時會產生舉證責任倒置的效果，醫生因此要承擔舉證責任可能帶來的敗訴風險。 Medical malpractice law in Germany ascribe medical liability to doctors and hospitals respectively. The doctor's liability is further categorized as obligation under the special provisions of the treatment contract in the German Civil Code and tort liability under the German Civil Code. Contractual liability differs according to the patients‘ status (private patients, health insurance patients and welfare recipients), treatment errors and incorrect medical advices. With respect to hospitalization, there are options of private hospitals, non-profit hospitals and public hospitals. A hospital contract must be closed prior to hospitalization. The contract is a civil law contract of labor by nature. Hospital contracts are categorized as follows: the complete hospital contracts, the complete hospital contracts with additional physician contracts, and the separate contracts. Contractual liability is assumed by hospitals and/or doctor, and the same with tort liability. The hospital is also liable for their assistants and institutions. Contractual and tort liability is assumed by hospitals and physicians respectively in public hospitals as well. Before an action is brought, the arbitration board may be called for medical liability issues. A patient who submits a liability claim has the responsibility to provide proof of treatment errors, violation of rights, the damages and the causal link between medical malpractice and health damage. The attending physician has to prove that he had explained the medical process to the patient properly. Gross errors in treatment may cause a shift in the burden of proof, and as a result, the physician might run the risk of evidence

Firm wage differentiation in Eastern Germany

In Eastern Germany, wage differentiation between firms has clearly grown, parallel to individual wage differentials. Nevertheless, the wage spread between firms is still much less than in Western Germany. In this paper, a non-parametric decomposition is used to analyze the difference between the wages spread in the two parts of Germany. Only part of the difference can be explained by different economic structures in Eastern Germany. By far, the greater part of the difference in the wage spread between firms in the two parts of the country is due to the fact that differences in wages paid by firms of the same type in Eastern Germany are much less than those of their counterparts in Western Germany. A striking result of the analysis is that the gap in the wage variance between Eastern and Western Germany is increasing. Copyright (c) 2008 The Authors.