Clinical ergometry in cardio-pulmonary functional disorders--a comparison of the usual ergometric technics]

It is reported on the results of a comparative examination of 18 patients with two usual ergometric methods (team pathophysiology of respiration and research group diseases of heart and circulation of the GDR). Referred to the intake of oxygen as a measure for the stress of the cardiorespiratory system by means of the ergometric methods recommended by the research group diseases of heart and circulation significantly higher minute volumes of the heart rate were established. Principal differences in the evidence of the two methods did not appear.     

Estimation of pulse pressure variation and cardiac output in patients having major abdominal surgery: a comparison between a mobile application for snapshot pulse wave analysis and invasive pulse wave analysis

Pulse pressure variation (PPV) and cardiac output (CO) can guide perioperative fluid management. Capstesia (Galenic App, Vitoria-Gasteiz, Spain) is a mobile application for snapshot pulse wave analysis (PWAsnap) and estimates PPV and CO using pulse wave analysis of a snapshot of the arterial blood pressure waveform displayed on any patient monitor. We evaluated the PPV and CO measurement performance of PWAsnap in adults having major abdominal surgery. In a prospective study, we simultaneously measured PPV and CO using PWAsnap installed on a tablet computer (PPV_PWAsnap, CO_PWAsnap) and using invasive internally calibrated pulse wave analysis (ProAQT; Pulsion Medical Systems, Feldkirchen, Germany; PPV_ProAQT, CO_ProAQT). We determined the diagnostic accuracy of PPV_PWAsnap in comparison to PPV_ProAQT according to three predefined PPV categories and by computing Cohen’s kappa coefficient. We compared CO_ProAQT and CO_PWAsnap using Bland-Altman analysis, the percentage error, and four quadrant plot/concordance rate analysis to determine trending ability. We analyzed 190 paired PPV and CO measurements from 38 patients. The overall diagnostic agreement between PPV_PWAsnap and PPV_ProAQT across the three predefined PPV categories was 64.7% with a Cohen’s kappa coefficient of 0.45. The mean (±?standard deviation) of the differences between CO_PWAsnap and CO_ProAQT was 0.6?±?1.3 L min^??1 (95% limits of agreement 3.1 to ??1.9 L min^??1) with a percentage error of 48.7% and a concordance rate of 45.1%. In adults having major abdominal surgery, PPV_PWAsnap moderately agrees with PPV_ProAQT. The absolute and trending agreement between CO_PWAsnap with CO_ProAQT is poor. Technical improvements are needed before PWAsnap can be recommended for hemodynamic monitoring.

     

Unexplained Appearance of Antibody in an Rhnull Donor

Abstract. A blood donor of the phenotype Rh_null was found at his 6th donation to have an antibody which had not been there before: he had never been transfused. The antibody reacts by the saline, albumin and enzyme methods but not by the antiglobulin (IgG). It reacted with all cells tested except the donor's own and those of two available Rh_null people and, surprisingly, those of three available -D-/-D- people: it is apparently directed at the CcEe part of the Rh antigen complex.
Like other Rh_null propositi the donor has a compensated anaemia and his s and U antigens give some abnormal reactions. His parents are second cousins. Serological and pedigree evidence did not disclose his type of Rh_null, 'regulator' or amorph.     

Bilateral occurrence of pheochromocytoma in patients with the multiple endocrine neoplasia syndrome type 2A (Sipple's syndrome)

Two kindreds with the multiple endocrine neoplasia type 2A syndrome were studied. Of one of these we examined 150 members, 20 of whom were treated with thyroidectomy for medullary carcinoma and nine with bilateral adrenalectomy for pheochromocytoma. Of the second kindred 59 members were examined, seven of whom were thyroidectomized and seven treated with bilateral adrenalectomy. Pheochromocytomas were invariably found on both sides, even in four cases in which the adrenals on one side appeared to be completely normal, not only at preoperative roentgenologic examination but also on inspection during the operation. The microscopic finding of micronodules and a cluster of abnormal medullary cells identical with those found in pheochromocytomas in one of the apparently normal adrenals represents a first stage in the development of diffuse medullary hyperplasia as well as nodular hyperplasia. This is in accordance with the fact that in the MEN type 2A syndrome pheochromocytomas are always multicentric and multiple in origin. On the basis of these findings we conclude that all patients with the MEN 2A syndrome who show symptoms and signs of active pheochromocytoma should be subjected to bilateral adrenalectomy, even when one or both of the adrenals appear to be normal at roentgenologic investigation.     

Effect of Varying Thiophene Units on Charge‐Transport and Photovoltaic Properties of Poly(phenylene ethynylene)‐alt‐poly(phenylene vinylene) Polymers

Poly(phenylene ethynylene)‐alt‐poly(phenylene vinylene)s (PPE‐PPVs) with various thiophene units (thiophene, bithiophene, and 3,4‐ethylenedioxythiophene) at the X position, with the general backbone design (Ph? C?C? X ? C?C? Ph? CH?CH? Ph? CH?CH? ), bearing identical solubilizing side chains at the phenylene rings of the polymers, are synthesized to study the effect of this structural alteration on the properties such as the photophysics, the electrochemical properties, the charge‐carrier mobility, and the morphology of the materials and its impact on their photovoltaic performance. The polymers are obtained in good yields with reasonable molecular weights and show solubility in ordinary organic solvents required for solution‐processing applications. The polymer with a basic thiophene ring at the X positions shows the highest open‐circuit voltage (V_OC of 930 mV) and the polymer with a bithiophene unit at the X position shows the highest short‐circuit current density and charge‐carrier mobility, whereas the polymer with 3,4‐ethylenedioxythiophene shows the lowest photovoltaic performance.

     

Biomarker in der Rheumatologie

The introduction of biologics has continuously increased the demand for biomarkers for early diagnosis and therapeutic stratification. ArthroMark, a research network funded by the Federal Ministry of Education and Research, aims to establish such biomarkers for rheumatoid arthritis and spondyloarthritides. Biobanks and previous work on genotyping, gene expression and autoreactivity profiling build the basis. Bioinformatic networks will help to harmonize the investigations and a clinical study with modern imaging techniques to characterize the functional relevance of the new biomarkers as effectively as possible. To validate the markers for diagnostic application the network aims to expand gradually.