Zyanidvergiftung

Intoxications with cyanide are rare; most of the observed cases are suicides – often committed by persons with professional access to cyanides. Because a variety of different cyanides are used in the industry, they are produced on a large scale and are therefore easier to access than would be expected. Because the signs of cyanide poisoning are nonspecific, such intoxications can be overseen – during the initial emergency room visit as well as during the autopsy. Diagnosis of cyanide intoxication is generally based on 3 observations: evidence from the scene, almond-like odor in the stomach or organs (persons present at autopsy are at risk of poisoning), dark-red color of intestines, particularly the stomach. Under special circumstances, one or all of these signs can be missing. During the interpretation of analytical results, the possible degradation and/or formation of cyanide between death and autopsy, as well as between sampling and analysis, must be considered.     

Initial study of arthropod succession on pig carrion in a central European urban habitat

We conducted a carrion succession study within a restricted urban backyard in the city of Vienna, Austria (16 degrees 22'E, 48 degrees 12'N) from May to November 2001 to analyze sequence and composition of the local carrion visiting fauna. Two medium sized clothed domestic pig carcasses (Sus scrofa Linnaeus), were used as surrogate human models. In total, 42 arthropod species from the families Calliphoridae, Sarcophagidae, Sepsidae, Piophilidae, Muscidae, Fanniidae, Sphaeroceridae, Phoridae, Drosophilidae, Anthomyiidae, and Lauxaniidae (Diptera), Formicidae, Braconidae, Pteromalidae, and Vespidae (Hymenoptera), Silphidae, Staphylinidae, Histeridae, Cleridae, and Dermestidae (Coleoptera), as well as species from the orders Isopoda and Acari were collected during the decomposition of these carcasses. A significant feature in this study was the high abundance of Calliphora vomitoria (L.) and Chrysomya albiceps (Wiedemann). In the experiment conducted May to June, larvae and adults of C. vomitoria outnumbered all other blow fly species, followed by Protophormia terraenovae (Robineau-Desvoidy), C. vicina Robineau-Desvoidy, and Lucilia sericata (Meigen). C. vomitoria is generally considered to be rural in distribution, where it prefers shaded locations. The presence of this species in rural as well as in urban habitats in Austria precludes this species as biogeographic indicator. In the study beginning in August large numbers of female adults of the nonindigeous blow fly C. albiceps began oviposition at day 3 after placement of the cadaver. The predatory second and third instars of C. albiceps larvae subsequently almost monopolized the cadaver. C. albiceps is generally described as tropical and subtropical species. The observed northward expansion of its range beyond southern Europe obviously decreases the value of C. albiceps in estimating place of death, in that it is no longer exclusive to southern regions. Our results clearly show, that caution must be used when drawing conclusions from succession data generated in different geographic areas. Moreover, this study demonstrates, that arthropod mediated decomposition of a 44 kg exposed pig carcass in a central European urban habitat can be completed within 3 wk.     

Pimecrolimus: absorption, distribution, metabolism, and excretion in healthy volunteers after a single oral dose and supplementary investigations in vitro.

The absorption and disposition of pimecrolimus, a calcineurin inhibitor developed for the treatment of inflammatory skin diseases, was investigated in four healthy volunteers after a single oral dose of 15 mg of [(3)H]pimecrolimus. Supplementary information was obtained from in vitro experiments. Pimecrolimus was rapidly absorbed. After t(max) (1-3 h), its blood concentrations fell quickly to 3% of C(max) at 24 h, followed by a slow terminal elimination phase (average t(1/2) 62 h). Radioactivity in blood decreased more slowly (8% of C(max) at 24 h). The tissue and blood cell distribution of pimecrolimus was high. The metabolism of pimecrolimus in vivo, which could be well reproduced in vitro (human liver microsomes), was highly complex and involved multiple oxidative O-demethylations and hydroxylations. In blood, pimecrolimus was the major radiolabeled component up to 24 h (49% of radioactivity area under the concentration-time curve(0-24) h), accompanied by a large number of minor metabolites. The average fecal excretion of radioactivity between 0 and 240 h amounted to 78% of dose and represented predominantly a complex mixture of metabolites. In urine, 0 to 240 h, only about 2.5% of the dose and no parent drug was excreted. Hence, pimecrolimus was eliminated almost exclusively by oxidative metabolism. The biotransformation of pimecrolimus was largely catalyzed by CYP3A4/5. Metabolite pools generated in vitro showed low activity in a calcineurin-dependent T-cell activation assay. Hence, metabolites do not seem to contribute significantly to the pharmacological activity of pimecrolimus.     

Elevated LET components in clinical proton beams

This paper assesses the contribution of secondary particles to pencil and passively scattered proton beams, in particular when considering the dose-averaged linear energy transfer (LET(d)) in biological treatment planning. Proton Monte Carlo simulations are performed in water phantoms and for two patients, considering all primary and secondary particles, including recoils from inelastic nuclear interactions. Our results show that secondary protons exhibit LET(d) values up to a factor 10 higher than those of the primary protons at the same depth. Thus, secondary protons have a significant impact on the LET(d). Their contribution increases the LET(d) by ～50% along the central axis and even >200% in the penumbra. Furthermore, the LET maximum after the peak changes from 12 to 15 keV μm(-1) when adding secondary protons to the primary contribution. This is important when modeling LET(d) with analytical methods. The contribution of recoils (A > 3) is observed to be 1.2% in the entrance region considering a prostate case. The degree of biological damage inflicted by recoils remains hard to quantify, but is discussed on the basis of detailed energy spectra. The results highlight the role of secondary protons in LET-based radiobiological effectiveness calculations for proton therapy and when analyzing radiobiological experiments. Furthermore, the findings demonstrate the impact of inhomogeneities on the LET and the subtle changes between the LET distributions of passively scattered and actively scanned beams.     

Vorderes Klaffen der Intervertebralscheiben

Zusammenfassung Es wird ein eigenes Zustandsbild, klinisch-röntgenologisch herausgehoben: Vorderes Klaffen der IVS. Auf den vermutlichen Entstehungsmechanismus wird kurz verwiesen.Mit 4 Textabbildungen (7 Einzelbilder)     

Ichthyotherapy as alternative treatment for patients with psoriasis: a pilot study

Ichthyotherapy (therapy with the so-called 'Doctorfish of Kangal', Garra rufa) has been shown to be effective in patients with psoriasis in the Kangal hot springs in Turkey. This study evaluates the efficacy and safety of ichthyotherapy in combination with short-term ultraviolet A sunbed radiation in the treatment of psoriasis under controlled conditions. We retrospectively analyzed 67 patients diagnosed with psoriasis who underwent 3 weeks of ichthyotherapy at an outpatient treatment facility in Lower Austria between 2002 and 2004. Main outcome measures are as follows: overall relative reduction in Psoriasis Area Severity Index (PASI) score; proportion of patients with an improvement in their PASI score of >/=75% (PASI-75) and >/=50% (PASI-50); patient-reported outcomes assessed with a custom questionnaire; and patient follow-up with a questionnaire sent out in March 2005. Safety was evaluated by reviewing adverse events and vital signs. Overall there was a 71.7% reduction in PASI score compared to baseline (P < 0.0001). Of the 67 patients studied, 31 (46.3%) achieved PASI-75 and 61 patients (91%) achieved at least PASI-50. Patients reported substantial satisfaction with the treatment. The reported mean remission period was 8.58 months [95% confidence interval (CI) 6.05-11.11]. A total of 87.5% of patients reported a more favorable outcome with ichthyotherapy, when asked to compare ichthyotherapy to other previously tried therapies. Sixty-five percent stated that after the relapse their symptoms were less severe than before treatment. There were no significant adverse events. The benefit demonstrated in this study along with the favorable safety profile suggests that ichthyotherapy could provide a viable treatment option for patients with psoriasis.     

Slowing effects of Mg2+ on contractile kinetics of skinned preparations of rat hearts depending on myosin heavy chain isoform content

The effects of changes in Mg²⁺ concentration on the kinetics of stretch activation were investigated on skinned rat heart preparations under maximal Ca²⁺ activation. Muscle strips of hyper- and hypothyroid rat hearts were investigated at 0.5 and 1 mM free Mg²⁺; the total ATP concentration was 8 mM which resulted in saturating MgATP^2– concentrations above 5 mM. Preparations containing exclusively the cardiac -myosin heavy chain (hyper- and hypothyroid atria, hyperthyroid ventricles) showed an acceleration of the kinetics of stretch activation by a factor of about 1.5 (P<0.01, paired t-test) when free Mg²⁺ was decreased from 1 to 0.5 mM. Conversely, preparations containing exclusively the -myosin heavy chain isoform showed only a small acceleration by a factor of 1.05 (P<0.05, paired t-test) under the same conditions. The fact that the Mg²⁺ sensitivity was dependent on the myosin heavy chain isoform excludes the possibility that Mg²⁺ exhibits only unspecific effects on contractile proteins. Several hypotheses for explaining the observed Mg²⁺ effects are discussed. The conditions used in our experiments might be close to the physiological situation and, thus, changes of Mg²⁺ concentration must be considered as possible factors modulating the contractile kinetics especially of atrial muscle tissue.