SPECT/CT in der Handgelenkdiagnostik

Zusammenfassung: Klinisches/methodisches Problem: Handgelenkschmerzen sind eine diagnostische Herausforderung für Handchirurgen und Radiologen. Insbesondere chronische Handgelenkschmerzen sind oft nur schwer einer genauen Lokalisation zuzuordnen, eine Schnittbildgebung ist deshalb oft unerlässlich. Radiologische Standardverfahren: Der etablierte Standard zur nichtinvasiven Diagnostik chronischer Handgelenkschmerzen ist die Magnetresonanztomographie. Methodische Innovationen: In den letzten Jahren ist mit der "single photon emission computed tomography"/CT (SPECT/CT) eine neue Modalität zum diagnostischen Spektrum muskuloskelettaler Veränderungen hinzugetreten, welche neben morphologischen Daten auch metabolische Informationen liefert. Leistungsfähigkeit: Die SPECT/CT ermöglicht eine genaue Detektion und präzise anatomische Zuordnung unterschiedlicher Handgelenkpathologien. Dies ist oftmals entscheidend für eine korrekte Therapie. Bewertung: Die SPECT/CT ist bei Patienten mit chronischen Handgelenkschmerzen spezifischer als die MRT. Sie bietet außerdem Vorteile bei Patienten mit posttraumatischen Veränderungen oder Metallimplantaten und kann als problemlösende Methode bei unklaren Fällen eingesetzt werden. Empfehlung für die Praxis: Eine Anwendung der SPECT/CT erscheint aus unserer Sicht immer dann sinnvoll, wenn eine Abklärung mittels MRT unergiebig war bzw. das MRT mehrere Pathologien zeigt, bei denen nicht klar ist, welche die klinisch führende ist. Auch ein primärer Einsatz bei bestimmten ossären Pathologien, bei Patienten mit Metallimplantaten oder bei unklaren Handgelenkschmerzen erscheint gerechtfertig

Characterization of the self-palmitoylation activity of the transport protein particle component Bet3

Bet3, a transport protein particle component involved in vesicular trafficking, contains a hydrophobic tunnel occupied by a fatty acid linked to cysteine 68. We reported that Bet3 has a unique self-palmitoylating activity. Here we show that mutation of arginine 67 reduced self-palmitoylation of Bet3, but the effect was compensated by increasing the pH. Thus, arginine helps to deprotonate cysteine such that it could function as a nucleophile in the acylation reaction which is supported by the structural analysis of non-acylated Bet3. Using fluorescence spectroscopy we show that long-chain acyl-CoAs bind with micromolar affinity to Bet3, whereas shorter-chain acyl-CoAs do not interact. Mutants with a deleted acylation site or a blocked tunnel bind to Pal-CoA, only the latter with slightly reduced affinity. Bet3 contains three binding sites for Pal-CoA, but their number was reduced to two in the mutant with an obstructed tunnel, indicating that Bet3 contains binding sites on its surface

The Direct Testing Effect Is Pervasive in Action Memory: Analyses of Recall Accuracy and Recall Speed

Successful retrieval from memory is a desirably difficult learning event that reduces the recall decrement of studied materials over longer delays more than restudying does. The present study was the first to test this direct testing effect for performed and read action events (e.g., “light a candle”) in terms of both recall accuracy and recall speed. To this end, subjects initially encoded action phrases by either enacting them or reading them aloud (i.e., encoding type). After this initial study phase, they received two practice phases, in which the same number of action phrases were restudied or retrieval-practiced (Exp. 1–3), or not further processed (Exp. 3; i.e., practice type). This learning session was ensued by a final cued-recall test both after a short delay (2 min) and after a long delay (1 week: Exp. 1 and 2; 2 weeks: Exp. 3). To test the generality of the results, subjects retrieval practiced with either noun-cued recall of verbs (Exp. 1 and 3) or verb-cued recall of nouns (Exp. 2) during the intermediate and final tests (i.e., test type). We demonstrated direct benefits of testing on both recall accuracy and recall speed. Repeated retrieval practice, relative to repeated restudy and study-only practice, reduced the recall decrement over the long delay, and enhanced phrases’ recall speed already after 2 min, and this independently of type of encoding and recall test. However, a benefit of testing on long-term retention only emerged (Exp. 3), when prolonging the recall delay from 1 to 2 weeks, and using different sets of phrases for the immediate and delayed final tests. Thus, the direct testing benefit appears to be highly generalizable even with more complex, action-oriented stimulus materials, and encoding manipulations. We discuss these results in terms of the distribution-based bifurcation model

Burgpfeifer. Mitteilungen aus Donaustauf und Sulzbach. Sonderbeilage

Darin u. a.: N. N.: Die Walhalla und ihre Landschaft; Klärschlammdeponie; Bräuberg, Fürstengarten und Altwasser in Donaustauf; Walhalla und Salvatorkirch

Sociocultural Competence Training in Higher Engineering Education: The Role of Gaming Simulation

The present study focuses on competency-based approach in higher engineering education. Today engineers are required to be socially, culturally and communicatively skilled and able to act in constantly changing sociocultural environment. Presently the development of engineers’ sociocultural competency is of great importance, which is seen from the criteria for accrediting engineering programs of numerous international organizations, e.g. ABET. The paper presents some methods of sociocultural competency training based on the techniques of gaming simulation. Here we describe the educational games “Intercultural communication” and “The art of presentation” for the students of Elite Education Department of National Research Tomsk Polytechnic University. The results of incorporating the gaming technologies in education contribute to the effectiveness of engineers’ sociocultural competency training. The paper ends by pointing out gaming simulation which is a cutting-edge pedagogical approach which allows students to participate in realistic scenarios and develop sociocultural competency

The fluvial architecture of buried floodplain sediments of the Weiße Elster River (Germany) revealed by a novel method combination of drill cores with two‐dimensional and spatially resolved geophysical measurements

The complex and non-linear fluvial river dynamics are characterized by repeated periods of fluvial erosion and re-deposition in different parts of the floodplain. Understanding the fluvial architecture (i.e. the three-dimensional arrangement and genetic interconnectedness of different sediment types) is therefore fundamental to obtain well-based information about controlling factors. However, investigating the fluvial architecture in buried floodplain deposits without natural exposures is challenging. We studied the fluvial architecture of the middle Weiße Elster floodplain in Central Germany, an extraordinary long-standing archive of Holocene flooding and landscape changes in sensitive loess-covered Central European landscapes. We applied a novel systematic approach by coupling two-dimensional transects of electrical resistivity tomography (ERT) measurements and closely spaced core drillings with spatially resolved measurements of electromagnetic induction (EMI) of larger floodplain areas at three study sites. This allowed for (i) time and cost-efficient core drillings based on preceding ERT measurements and (ii) spatially scaling up the main elements of the fluvial architecture, such as the distribution of thick silt-clay overbank deposits and paleochannel patterns from the floodplain transects to larger surrounding areas. We found that fine-grained sand and silt-clay overbank deposits overlying basal gravels were deposited during several periods of intensive flooding. Those were separated from each other by periods of reduced flooding, allowing soil formation. However, the overbank deposits were severely laterally eroded before and during each sedimentation period. This was probably linked with pronounced meandering or even braiding of the river. Our preliminary chronological classification suggests that first fine-grained sedimentation must have occurred during the Early to Middle Holocene, and the last phase of lateral erosion and sedimentation during the Little Ice Age. Our study demonstrates the high archive potential of the buried fluvial sediments of the middle Weiße Elster floodplain and provides a promising time and cost-effective approach for future studies of buried floodplain sediments

The additional value of CT images interpretation in the differential diagnosis of benign vs. malignant primary bone lesions with 18F-FDG-PET/CT

Objective: To evaluate the value of a dedicated interpretation of the CT images in the differential diagnosis of benign vs. malignant primary bone lesions with 18fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT). Materials and methods: In 50 consecutive patients (21 women, 29 men, mean age 36.9, age range 11-72) with suspected primary bone neoplasm conventional radiographs and 18F-FDG-PET/CT were performed. Differentiation of benign and malignant lesions was separately performed on conventional radiographs, PET alone (PET), and PET/CT with specific evaluation of the CT part. Histology served as the standard of reference in 46 cases, clinical, and imaging follow-up in four cases. Results: According to the standard of reference, conventional 17 lesions were benign and 33 malignant. Sensitivity, specificity, and accuracy in assessment of malignancy was 85%, 65% and 78% for conventional radiographs, 85%, 35% and 68% for PET alone and 91%, 77% and 86% for combined PET/CT. Median SUVmax was 3.5 for benign lesions (range 1.6-8.0) and 5.7 (range 0.8-41.7) for malignant lesions. In eight patients with bone lesions with high FDG-uptake (SUVmax ≥ 2.5) dedicated CT interpretation led to the correct diagnosis of a benign lesion (three fibrous dysplasias, two osteomyelitis, one aneurysmatic bone cyst, one fibrous cortical defect, 1 phosphaturic mesenchymal tumor). In four patients with lesions with low FDG-uptake (SUVmax < 2.5) dedicated CT interpretation led to the correct diagnosis of a malignant lesion (three chondrosarcomas and one leiomyosarcoma). Combined PET/CT was significantly more accurate in the differentiation of benign and malignant lesions than PET alone (p = .039). There was no significant difference between PET/CT and conventional radiographs (p = .625). Conclusion: Dedicated interpretation of the CT part significantly improved the performance of FDG-PET/CT in differentiation of benign and malignant primary bone lesions compared to PET alone. PET/CT more commonly differentiated benign from malignant primary bone lesions compared with conventional radiographs, but this difference was not significan

Hodgkin's lymphoma in remission after first-line therapy: which patients need FDG-PET/CT for follow-up?

Background: The purpose of the study was to evaluate the impact of 2-[fluorine-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/computed tomography (CT) during follow-up of patients with Hodgkin's lymphoma. Patients and methods: Patients in complete remission or an unconfirmed complete remission after first-line therapy who received FDG-PET/CT during their follow-up were analyzed retrospectively. Confirmatory biopsy was mandatory in case of recurrence. Results: Overall, 134 patients were analyzed. Forty-two (31.3%) patients had a recurrence. The positive predictive value of FDG-PET/CT was 0.98. Single-factor analysis identified morphological residual mass [P = 0.0005, hazard ratio (HR) 3.4, 95% confidence interval (CI) 1.7-6.6] and symptoms (P 24 months). Conclusions: Asymptomatic patients without morphological residues and an early stage of disease do not need a routine FDG-PET/CT for follow-up. Asymptomatic patients with morphological residues should receive routine follow-up FDG-PET/CT for the first 24 months. Only patients with advanced initial stage do need a routine follow-up FDG-PET/CT beyond 24 month