Subjective Health Status, Health-Related Behavior, and Health Literacy of Health Professional Students: Results from a Cross-Sectional Study

The importance of health promotion for health professional students is increasingly crucial, as the rising requirements for those students can have a negative impact on their health. Despite this awareness, there is still limited knowledge in Germany about the specific health needs of this group of students. This study's aim was, therefore, to assess the subjective health of first-year students and to identify health needs. Thus, this study is based on an online survey using standardized measurement instruments. First-year students from three degree programs were included. The data were analyzed descriptively. A total of n = 98 (72.6%) participated in the survey. The results showed that a major proportion of participants (80.3%) rated their health positively, but a significant proportion reported weight disorders (24%) and pre-existing health conditions (62.1%) at baseline. Interestingly, a high proportion (59%) reported a high level of mental well-being at the time of the survey. However, worrying findings regarding lifestyle behaviors, including physical inactivity (40.6%), smoking (20%), risky alcohol use (24%), and unhealthy eating habits (37%) were determined. In terms of health literacy, around 45% of students rated their health competencies as problematic. Furthermore, it was found that students with low health literacy had a significantly higher prevalence of low mental well-being (53.3% vs. 30.8%, p = 0.036) and unhealthy eating habits (48.8% vs. 26.5%, p = 0.027) compared to students with sufficient health literacy. Health professional students should be considered a relevant target group for health and health competence promotion from the beginning of their studies. The identified fields of action should be addressed in the context of health promotion. This is of particular importance as they are not only aimed at improving the students' well-being but also will later work directly with patients and, therefore, have a direct influence on the health of others.

[Healthcare for people with rare diseases: recommendations for successful intersectoral collaboration]

BACKGROUND

Rare diseases often present complex symptoms and usually require intersectoral collaboration during diagnostic and therapeutic processes involving inpatient and outpatient care. Hence, smooth interfaces with little loss of information and cooperation are essential to provide appropriate care. Our study, the project ESE-Best, aims at developing recommendations for the design and implementation of intersectoral care for patients with rare diseases using various survey instruments.

METHODS

Using quantitative and qualitative methods, multiple perspectives (primary physicians, expert centers of rare diseases, patients, parents) were assessed. Additionally, two expert workshops were conducted.

RESULTS

Based on findings from our data, we formulated 28 recommendations in the following areas: (1) networking between primary physicians and expert centers, (2) intersections within the expert centers, (3) awareness of rare diseases, structures of expert centers and responsibilities, (4) collaboration between expert centers and patients/caregivers, and (5) further recommendations.

CONCLUSION

Our recommendations provide a basis for a working management of intersectoral care in rare diseases. As the recommendations are based on broad data including multiple perspectives, external validity and feasibility can be assumed. Still, time and human resources as well as organizational structures in single centers or practices and regional structures need to be taken into account as they may impact intersectoral care.

Documentation of psoriasis in routine care - expert consensus on a German data set

BACKGROUND AND OBJECTIVES

Documenting patient data in psoriasis clinical practice can improve care, but standardized and transparent documentation is rare. The current project aimed to develop a data set for the documentation of psoriasis in daily practice.

MATERIAL AND METHODS

In four online Delphi rounds and one in-person meeting, 27 psoriasis experts allocated variables to a standard, an optimal and an optional data set. Most of the questions were standardized. Open questions were included to allow for the provision of reasons and to enlarge the data sets. Furthermore, in the in-person meeting we considered a) patients' attitudes and b) dermatologists' information on the current usage and acceptability in Germany.

RESULTS

The consensus approach resulted in a data set with 69 variables. The standard data set includes 20, the optimal data set 31 and the optional data set 18 variables. In summary, the data set can mainly be grouped into master data, general status and medical history data, medical history of psoriasis, status of psoriasis, diagnostics and comorbidity, therapies and patient-reported outcomes.

CONCLUSIONS

The consensus recommendation of a standard, an optimal and an optional data set for routine care of psoriasis intends to be a decision-making aid and an orientation for both daily practice and further development of documentation systems.

[AKTIN - The German Emergency Department Data Registry - real-time data from emergency medicine : Implementation and first results from 15 emergency departments with focus on Federal Joint Committee's guidelines on acuity assessment]

Hintergrund

Die Notfallversorgung befindet sich im Umbruch. In Notaufnahmen werden Patienten ausgehend von Symptomen und Dringlichkeit versorgt; dies bildet sich jedoch in den etablierten Routinedaten der gesetzlichen Sozialversicherung nicht ab. Ziel des AKTIN-Projekts war der Aufbau einer datenschutzkonformen Registerinfrastruktur zur Nutzung von klinischen Routinedaten aus Notaufnahmen.

Methoden

Über eine standardisierte Schnittstelle werden aus den verschiedenen Dokumentationssystemen kontinuierlich Daten der Notaufnahmebehandlung in ein lokales Data Warehouse exportiert. Dort stehen sie sowohl für lokale Nutzungen, wie interne Berichte und Qualitätsmanagement, als auch gleichzeitig datenschutzkonform für multizentrische Auswertungen zur Verfügung.

Anhand der Registerpopulation wird die Ersteinschätzung sowie die Erhebung von Vitalparametern in Abhängigkeit von Vorstellungsgründen für einen 12-Monats-Zeitraum analysiert.

Ergebnisse

Für den Zeitraum 04/2018 bis 03/2019 wurden 436.149 gültige Fälle aus 15 Notaufnahmen übermittelt. In 86,0 % der Fälle ist eine Ersteinschätzung dokumentiert.

Diese fand in 70,5 % innerhalb von 10 min nach Ankunft des Patienten statt. In 10 Kliniken wird regelhaft (82,3 %) ein Vorstellungsgrund erfasst. Die Erfassung von Vitalparametern variiert plausibel zwischen den Vorstellungsgründen.

Schlussfolgerung

Das AKTIN-Notaufnahmeregister bietet einen zeitnahen Einblick in das Versorgungsgeschehen der Notaufnahmen ohne zusätzlichen Dokumentationsaufwand und unabhängig vom primären IT-System, Kostenträger, Fallart und Abrechnungsmodus. Die Vorgaben des Gemeinsamen Bundesausschusses zur Ersteinschätzung werden weitgehend umgesetzt. Durch die Etablierung von standardisierten Vorstellungsgründen werden symptombasierte Analysen und Gesundheitssurveillance ermöglicht.

Zusatzmaterial online

Die Onlineversion dieses Beitrags (10.1007/s00063-020-00764-2) enthält die Abb. S1 und S2. Beitrag und Zusatzmaterial stehen Ihnen auf www.springermedizin.de zur Verfügung. Bitte geben Sie dort den Beitragstitel in die Suche ein, das Zusatzmaterial finden Sie beim Beitrag unter „Ergänzende Inhalte“.

Interface management concepts in healthcare for rare diseases in Germany: a study protocol for a mixed-methods study to develop best practice recommendations

INTRODUCTION

Patients and families affected by a rare disease are burdened in multiple ways. Functional interface management can unburden patients or relatives from the need to be solely accountable for the navigation through the healthcare system. This study aims at (1) providing an assessment of approaches and interface management concepts in the care of rare diseases, (2) evaluating selected existing approaches and concepts and (3) developing best practice recommendations for interface management.

METHODS AND ANALYSIS

We will conduct a mixed-methods study with three phases. In phase 1, we will develop a tool to assess existing concepts of interface management for rare diseases based on a literature search and an expert workshop. The tool will be applied in a telephone survey with representatives of centres or clinics of expertise for rare diseases (target: n=100) and cooperating practitioners (target: n=60). Based on the results of phase 1, we will select four to six centres of expertise with interface management concepts, which will be evaluated extensively in phase 2. For the evaluation, we will conduct semistructured interviews with practitioners cooperating with centres or clinics for rare diseases (target: n=50), a paper-based survey including patients or parents/legal guardians (target: n=300) from the selected centres or clinics, and semistructured interviews with patients or parents/legal guardians (target: n=50). The final phase of the study will be an integration of results from phases 1 and 2 to develop best practice recommendations for interface management in healthcare of rare diseases. In a concluding expert workshop, recommendations will be presented and finalised.

ETHICS AND DISSEMINATION

This study was approved by the Local Psychological Ethics Committee of the Center for Psychosocial Medicine of the University Medical Center Hamburg-Eppendorf (LPEK-0062). The findings of our study will be presented on national and international conferences and published in scientific, peer-reviewed journals. To assure that centres for rare diseases get access to the study results, centres are invited to send a representative to a final expert workshop in phase 3. Moreover, an executive summary will be provided and sent to relevant stakeholders.

TRIAL REGISTRATION NUMBER

German Clinical Trials Registry (DRKS00020488).

Nuevos xenófitos de La Palma (Islas Canarias, España), con énfasis en las especies naturalizadas y (potencialmente) invasoras. Parte 3

Varios meses de trabajos de campo en La Palma (Islas Canarias occidentales) han posibilitado el descubrimiento de nuevas plantas vasculares no nativas. Alstroemeria aurea, A. ligtu, Anacyclus radiatus subsp. Radiatus, Chenopodium album subsp. borbasii, Cotyledon orbiculata, Cucurbita ficifolia, Cynodon nlemfuensis, Datura stramonium subsp. tatula, Digitaria ciliaris var. rhachiseta, D. ischaemum, Diplotaxis tenuifolia, Egeria densa, Eugenia uniflora, Galinsoga quadriradiata, Glebionis segetum, Kalanchoe laetivirens, Lemna minuta, Ligustrum lucidum, Lotus broussonetii, Oenothera fallax, Paspalum notatum, Passiflora caerulea, P. manicata × tarminiana, P. tarminiana, Pelargonium capitatum, Phaseolus lunatus, Portulaca trituberculata, Pyracantha angustifolia, Sedum mexicanum, Trifolium lappaceum, Urochloa mutica, U. subquadripara y Volutaria tubuliflora son xenófitos naturalizados o (potencialmente) invasores o de especial interés florístico, que se citan por primera vez para las Islas Canarias o para la isla de La Palma. Tres táxones adicionales, probablemente casuales, se dan a conocer por primera vez de las Islas Canarias, y siete táxones de la isla de La Palma.

Laparoscopic therapy of the coeliac artery compression syndrome: a critical analysis of the current standard procedure

INTRODUCTION

Median arcuate ligament syndrome has been known anatomically for approximately 100 years and results from a compression of the coeliac axis by fibrous attachment of the diaphragmatic crura. Owing to the rarity of the disease and limited available data, many aspects of treatment are controversial. Currently, laparoscopic decompression is considered by several authors as standard surgical procedure. We present an analysis of the clinical routine of MALS therapy.

METHODS

We conducted a prospective observational trial in patients with MALS between March 2016 and August 2018, in which clinical symptoms, diagnostic evaluation, procedures with complication analysis and follow-up data were recorded.

RESULTS

A total of 18 patients (12 female, 6 male) with MALS, aged between 15 and 65 years, were included in this study. All patients presented with long-standing abdominal pain. Preoperative Doppler ultrasonography showed a flow velocity of the coeliac artery averaging 289.9cm/second in mid-position of the diaphragm, 285.9cm/second in expiration and 199.0cm/second in inspiration. All operated patients underwent laparoscopic decompression; two patients received an angiographic intervention. Postoperatively, a significant decrease of the flow velocity in mid-position of the diaphragm was detected (P = 0.018). At follow-up after 5.2 months, 50.0% of the patients were pain-free, 37.5% reported symptomatic relief and 12.5% showed evidence for a recurrence.

CONCLUSION

MALS is challenging both diagnostically and therapeutically. Laparoscopy with release of the median arcuate ligament is an essential part of the therapy and can be confirmed by Doppler ultrasonography. Disease outcome is also influenced by several predictive factors.

[Gender-specific differences of the early postoperative and oncosurgical long-term outcome in rectal cancer-data obtained in a prospective multicenter observational study]

BACKGROUND

Gender-specific aspects have been increasingly considered in clinical medicine, also in oncological surgery.

AIM

To analyze gender-specific differences of early postoperative and oncological outcomes after rectal cancer resection based on data obtained in a prospective multicenter observational study.

PATIENTS AND METHODS

As part of the multicenter prospective observational study "Quality assurance in primary rectal cancer", data on tumor site, exogenic and endogenic risk factors, neoadjuvant treatment, surgical procedures, tumor stage, intraoperative and postoperative complications of patients with the histological diagnosis of rectal cancer were registered. Data from the years 2005-2006 and 2010-2011 were investigated with respect to gender-specific differences of postoperative morbidity, hospital mortality, local recurrency rate, disease-free and overall survival by univariable and multivariable analyses.

RESULTS

Overall, data from 10,657 patients were evaluated: 60.9% of the patients were male, who were significantly younger (p < 0.001). Men had a significantly higher rate of alcohol (p < 0.001) and nicotine abuse (p < 0.001) as well as a trend to a higher body mass index (BMI) compared with women. Although, there was no significant difference in the distribution of various tumor stages comparing men and women, neoadjuvant radiochemotherapy was used significantly more often in male patients (p < 0.001). In addition, male patients underwent an abdominoperineal rectum exstirpation more often, whereas creation of an enterostoma and Hartmann's procedure were more frequently used in women (p < 0.001 each). Multivariate analysis revealed that male patients developed a higher overall morbidity (odds ratio, OR: 1.5; p < 0.001) during both study periods and from 2010-2011 a higher hospital mortality (OR: 1.8; p < 0.001). After a median follow-up period of 36 months, gender did not have a significant impact on overall survival, disease-free survival or on the local tumor recurrency. The 5‑year overall survival was 60.5%, disease-free survival 63.8% and local recurrency rate was 5%.

CONCLUSION

Independent of other variables, gender differences were found with respect to early postoperative outcome but not to oncological long-term results after surgery of rectal cancer.

Minimally invasive video-assisted thyroidectomy: a critical analysis of long-term cosmetic results using a validated tool

INTRODUCTION

Since its first publication in 1997, minimally invasive video-assisted thyroidectomy (MIVAT) has developed into the predominant minimally invasive surgery of the thyroid. A major advantage over conventional thyroid surgery is the superior cosmetic result. However, there are still few data comparing the long-term cosmetic results of the two methods. This paper compares the long-term cosmetic results of the two methods, based on follow-up assessments.

METHODS

Between 2004 and 2011, 143 preselected patients underwent a MIVAT in our department. Additionally, 134 patients underwent a conventional thyroidectomy in our hospital in 2011. A total of 117 patients from the MIVAT group and 102 patients from the conventional thyroidectomy group received follow-up assessments after 23.1 and 23.6 months, respectively, using the patient and observer scar assessment scale.

RESULTS

The measurable cervical scar length averaged 1.9 cm in the MIVAT group and 3.9 cm in the conventional group (P < 0.001). Some 11.1% of the patients in the MIVAT group and 7.1% of the patients in the conventional group had developed keloid (P = 0.391). The patient scar assessment score was 10.4 for the MIVAT group compared with 9.9 for the conventional thyroidectomy group (P = 0.691) and the observer scare assessment score was 8.6 for MIVAT compared with 9.9 for conventional thyroidectomy (P = 0.011).

CONCLUSION

In the patient assessment instrument, conventional thyroidectomy had a small advantage over MIVAT in the cosmetic long-term results. This difference between the two groups was, however, not significant. Our result contradicts short-term cosmetic results of published randomized studies with improvement for MIVAT. The Observer Score demonstrates a significant advantage of the MIVAT.

Investigation of a New Version of the Liquid Embolic Agent PHIL with Extra-Low-Viscosity in an Endovascular Embolization Model

BACKGROUND AND PURPOSE

The type and composition of an embolic agent have a relevant influence on the performance of endovascular embolization. The aim of this study was to investigate a new version of the liquid embolic agent precipitating hydrophobic injectable liquid (PHIL) with extra-low-viscosity in an in vivo embolization model.

MATERIALS AND METHODS

Twenty-four embolization procedures were performed in the porcine rete mirabile. Eight embolizations were performed with PHIL 25% low viscosity, Squid 12, and standard PHIL 25%, respectively. Procedure time, required volume of embolic agent, visibility of the embolic agent, embolization control, embolization extent (ie, penetration of the rete mirabile), amount of reflux, and degree of embolization distal to the rete mirabile were assessed.

RESULTS

All embolic agents were adequately visible. The embolization extent was not significantly different among the 3 investigated agents; however, there was a tendency toward a higher embolization extent for PHIL 25% low viscosity (median embolization extent: 88% [PHIL 25% low viscosity]; 65% [Squid 12]; 60% [PHIL 25%]; P = .146). The amount of reflux was significantly lower for the extra-low-viscosity agents PHIL 25% low viscosity and Squid 12 compared with the standard PHIL 25% (median reflux distance: 8 mm [PHIL 25% low viscosity]; 6 mm [Squid 12]; 17 mm [PHIL 25%]; P = .011). All other embolization features did not differ among agents.

CONCLUSIONS

PHIL 25% low viscosity is a promising liquid embolic agent for endovascular embolization, featuring effective distal penetration, adequate visibility, a low amount of reflux, and good flow control.

Nuevos xenófitos de La Palma (Islas Canarias, España), con énfasis en las especies naturalizadas y (potencialmente) invasoras. Parte 2

Varios meses de trabajos de campo en La Palma (Islas Canarias occidentales) han posibilitado el descubrimiento de nuevas plantas vasculares no nativas. Abutilon theophrasti, Agrostis xfouilladeana, Alternanthera brasiliana, Bupleurum salicifolium subsp. salicifolium, Callisia fragrans, Emilia coccinea, Hyparrhenia sinaica, Ipomoea purpurea, Jasminum polyanthum, Macfadyena unguis-cati, Malvastrum coromandelianum subsp. coromandelianum, Misopates calycinum, Nephrolepis cordifolia, Opuntia microdasys, Passiflora subpeltata, Plantago lanceolata, Polygonum aviculare subsp. rurivagum, Pseudogynoxys chenopodioides, Psidium littorale, Robinia pseudoacacia, Rosa micrantha, Rumex bucephalophorus subsp. gallicus, Sorghum bicolor subsp. verticilliflorum, Sphagneticola trilobata, Syzygium jambos, Thunbergia alata y Youngia japonica subsp. japonica son xenófitos naturalizados o (potencialmente) invasores, se citan por primera vez para las Islas Canarias o para La Palma. Se dan a conocer por primera vez 14 t·axones adicionales, probablemente casuales, de las Islas Canarias y 15 taxones de la isla de La Palma.

Nuevos xenófitos de La Palma (Islas Canarias, España), con énfasis en las especies naturalizadas y (potencialmente) invasoras

Varios años de trabajos de campo en La Palma (Islas Canarias occidentales) han posibilitado el descubrimiento de nuevas plantas vasculares no nativas. Amaranthus blitoides, A. deflexus, Aptenia cordifolia, Argemone ochroleuca, Begonia schmidtiana, Capsella rubella, Cardamine hamiltonii, Centratherum punctatum, Cerastium fontanum subsp. vulgare, Chasmanthe floribunda (ampliamente confundida con C. aethiopica y Crocosmia xcrocosmiiflora en Macaronesia), Chenopodium probstii, Commelina latifolia var. latifolia, Dichondra micrantha, Dysphania anthelmintica, Epilobium ciliatum, Erigeron sumatrensis, Erodium neuradifolium, Eucalyptus globulus, Euphorbia hypericifolia, E. maculata, Gamochaeta antillana, Geranium pyrenaicum, Hedychium coronarium, Hypochaeris radicata, Kalanchoe daigremontiana, K. delagoensis, K. xhoughtonii, Kickxia commutata subsp. graeca, K. spuria subsp. integrifolia, Lactuca viminea subsp. ramosissima, Landoltia punctata, Malvastrum coromandelianum subsp. capitatospicatum, Oenothera jamesii, Orobanche nana, Oxalis latifolia, Papaver hybridum, P. setigerum, Pilea microphylla, Podranea ricasoliana, Polygonum arenastrum, Portulaca granulatostellulata, P. nicaraguensis, P. nitida, P. papillatostellulata, Rumex crispus subsp. crispus, R. pulcher subsp. pulcher, R. xpratensis, Sechium edule, Sida spinosa var. angustifolia, Silene nocturna, Solanum abutiloides, S. alatum, S. decipiens, Sonchus tenerrimus, Spergularia marina, Stellaria pallida, Tragopogon porrifolius subsp. australis, Tribulus terrestris y Trifolium repens subsp. repens son xenófitos naturalizados o (potencialmente) invasores, que se citan por primera vez para las Islas Canarias o para la isla de La Palma. 37 táxones adicionales, probablemente casuales, se dan a conocer por primera vez de las Islas Canarias, y 56 táxones de la isla de La Palma.

[Iatrogenic splenic injuries in surgery of colorectal carcinoma: impact on the oncological long-term of outcome]

INTRODUCTION

Iatrogenic lesions of the spleen during surgery of colorectal carcinoma is considered a significant risk factor for a worse early postoperative outcome. With regard to the impact of iatrogenic splenic lesions particularly associated with splenectomy on the oncological long-term outcome, only limited valid data are available.

METHODS

Data obtained in a prospective multicenter observational study were analyzed. The study enrolled 45,265 patients with surgery for colorectal carcinoma in curative and palliative intentions during the study period from 01 January 2000 to 31 December 2004, with regard to the impact of iatrogenic splenic lesions on survival rates.

RESULTS AND CONCLUSION

Follow-up data with corresponding informed consent were obtained from 564 patients with iatrogenic splenic lesions, resulting in a follow-up rate of 99.8 %. The median follow-up period was 50.2 months. The median 5-year overall survival was 4.8 years in group I (splenic lesion with splenectomy) and in group II (splenic lesion with organ preservation) 8.0 years (p = 0.009). Between group II (splenic lesion with organ preservation) and group III (control group with no splenic lesion) there were no significant differences with regard to long-term survival. Using multivariate Cox regression analysis, iatrogenic splenic lesions with splenectomy were identified as an independent risk factor for a worse oncological long-term outcome.

[Surgical treatment of carcinomas of the oesophagogastric junction - results achieved in multicentre studies]

BACKGROUND

Adenocarcinomas of the oesophagogastric junction are increasingly being considered as a separated tumour entity. The prognosis is rather poorer compared with that for distal gastric cancer. Data from a multicentre study as part of research on clinical care aim to reflect the current situation in surgical treatment after inauguration of neoadjuvant modalities.

PATIENTS AND METHOD

As part of the ongoing prospective multicentre observational study QCGC 2 (German Gastric Cancer Study 2), 544 adenocarcinomas of the oesophagogastric junction (AEG 1-3) were registered from 01/01/2007 to 12/31/2009.

RESULTS

Patients underwent surgical intervention in 108 (76.6 %) of the 141 surgical departments which provided data to the study. In 391 patients (82.5 %), R0 resection was achieved. Almost 60 % of the carcinomas of the oesophagogastric junction were approached in departments with no more than 10 of these tumour lesions through the whole study period (3 years). Endoscopic ultrasonography was performed in 283 cases (53 %); the rate of neoadjuvant treatment was 34.4 % (n = 187). Intraoperative fresh frozen section was only included in intraoperative decision-making in 242 patients (60.8 %). In the revealed heterogeneous spectrum of surgical interventions, a limited number of transthoracic approaches (20 %) and a mediastinal lymphadenectomy rate of only 47 % were found. Hospital lethality was 6.6 %. In the adenocarcinomas of the oesophagogastric junction, a significantly lower median survival (25 months) compared with distal gastric cancer (38 months) was observed depending on the tumour stage. In addition, 5-year survival rate of AEG patients (33.1 %) was distinctly lower than for patients with distal gastric cancer (41.4 %). There was no significantly better survival by neoadjuvant treatment in the group of investigated patients.

CONCLUSION

The results in the treatment of carcinomas of the oesophagogastric junction in the multicentre setting including surgical departments of each profile and region even after introduction of multimodal therapeutic concepts are not satisfying. In particular, modern diagnostic and surgical strategies need to be widely used or their percentage has to be increased. In this context, centralisation of the surgical care of this specific tumour entity appears reasonable.

Plasmid DNA in Streptococcus cremoris Wg2: Influence of pH on Selection in Chemostats of a Variant Lacking a Protease Plasmid

Cleared lysates of a proteolytic (Prt) strain and a naturally occurring non-proteolytic (Prt) variant of Streptococcus cremoris Wg2 contain equal amounts of covalently closed circular plasmid DNA. An analysis of this plasmid DNA by agarose gel electrophoresis revealed the presence of at least five different plasmid species in the Prt strain and only three plasmid species in the Prt variant. Curing studies with acriflavine indicated that a 16-megadalton plasmid determined proteolytic activity in the Prt strain. In energy-limited chemostats inoculated with both strains it was observed that the Prt strain was replaced by the Prt variant. This effect was most apparent when the pH of the culture was fixed at a value above 6.3. No selection for the Prt variant was observed at pH 5.9. Since the two types of organisms contain equal amounts of plasmid DNA, it was concluded that the energy gain of the Prt variants at pH values above 6.0 probably has to be found in protein synthesis rather than in plasmid DNA synthesis.

Inverse temperature dependent lifetimes of transient S(N)2 ion-dipole complexes

The association and collisional stabilization of the S(N)2 entrance channel complex [Cl(-)...CH3Cl]* is studied in a low-temperature radiofrequency ion trap. The temperature dependence of the ternary rate coefficient is measured and a much stronger inverse temperature dependence than expected from a simple statistical calculation is found. From these data the lifetime of the transient S(N)2 complex has been derived as a function of temperature. It is suggested that the inverse temperature dependent rates of nonsymmetric S(N)2 reactions are related to the observed inverse temperature dependence of the transient ion-dipole complexes.

Nonstandard behavior of a negative ion reaction at very low temperatures

We have studied the negative ion reaction NH2-+H_{2}-->NH_{3}+H- in the temperature range from 300 to 8 K. We observe a strongly suppressed probability for proton transfer at room temperature. With decreasing temperature, this probability increases, in accordance with a longer lifetime of an intermediate anion-neutral complex. At low temperatures, a maximum in the reaction rate coefficient is observed that suggests the presence of a very small barrier at long range or a quantum mechanical resonance feature.

[Stereotactic Mammotome breast biopsy: routine clinical experience and correlation with BI-RADS--classification and histopathology]

BACKGROUND

Stereotactic breast biopsy using the Mammotome system allows minimal invasive tissue sampling of suspicious lesions of the breast cancer, e.g. clustered microcalcifications BI-RADS type 3 and 4, and has widely replaced open surgical biopsies. The aim of this retrospective study was to review the results of these biopsies in regard of technical feasibility and complications as well as to correlate initial BI-RADS assessment with histopathology.

METHODS

One hundred thirty-five vacuum-assisted breast biopsies in 124 patients were evaluated. Before biopsy, the mammograms were classified according to the Breast Imaging Reporting and Data System (BI-RADS). All mammograms were reviewed with knowledge of the final histologic diagnosis. Patients with benign diagnoses underwent mammographic follow-up. Excisional biopsy was recommended for diagnoses of in-situ or invasive carcinoma.

RESULTS

No serious complications of the biopsies were observed. Histopathology revealed 105 (78%) benign lesions. Benign lesions were classified as BI-RADS 3 in 49 (36%) and as suspicious (BI-RADS 4) in 56 (41%). Thirty lesions (22%) were malignant, of which 26 (87%) were classified BI-RADS 4 or 5. The frequency of malignancy in BI-RADS 4 and 5 was 19 of 75 (25%) and 7 of 7 (100%), respectively. Of the 53 BI-RADS 3 lesions, 4 (8%) were malignant.

CONCLUSIONS

Mammotome biopsy was shown to be a safe and well-tolerated technique for the work-up of mammographic lesions. The frequency of malignant histopathologic findings in BI-RADS 3 lesions was higher than expected, reflecting the difficulties in the mammographic differentiation of benign and malignant clustered microcalcifications.

Photodetachment of cold OH- in a multipole ion trap

The absolute photodetachment cross section of OH- anions at a rotational and translational temperature of 170 K is determined by measuring the detachment-induced decay rate of the anions in a multipole radio-frequency ion trap. In comparison with previous results, the obtained cross section shows the importance of the initial rotational-state distribution. Using a tomography scan of the photodetachment laser through the trapped ion cloud, the derived cross section is model-independent and thus features a small systematic uncertainty. The tomography also yields the column density of the OH- anions in the 22-pole ion trap in good agreement with the expected trapping potential of a large field free region bound by steep potential walls.

Quantitative high resolution transmission electron microscopy of nanostructured semiconductors

Peak-finding procedures and the geometric phase method of quantitative high resolution electron microscopy (qHRTEM) were applied to determine the local strain and the chemical composition of nanostructured semiconductor materials. The growth of the structures investigated was induced by minimization of strain energy. The analysis of strain distribution is necessary for the understanding of the self-organized formation of nanostructures. The possibilities and limitations of the methods are discussed in detail by analysing HRTEM images of (Si,Ge) islands and of a double layer of stacked quantum dots of (In,Ga)As and Ga(Sb,As).