[Direct costs of diabetes mellitus in Germany: first estimation of the differences related to educational level]. / Direkte Krankheitskosten von Diabetes mellitus in Deutschland: erste Abschätzung der Unterschiede zwischen Bildungsgruppen.

OBJECTIVE: There are many studies on health inequalities, but these are rarely combined with cost-of-illness analyses. If the cost-of-illness were to be calculated for the individual status groups, it would be possible to assess the economic potential of preventive measures aimed specifically at people from low status groups. The objective of this article is to demonstrate for the first time the preventive potential by taking the example of diabetes mellitus (DM) from an economic perspective. METHODS: Based on a systematic literature review, the average direct costs per patient with DM were assessed. Then, the prevalence of DM among adults with different educational levels was estimated based on the nationwide survey 'German Health Update' (GEDA), conducted by the Robert Koch-Institute in Germany in 2009. Finally, the cost and prevalence data were used to calculate the direct costs for each educational level. RESULTS: The direct costs of DM amount to about 13.1 billion € per year; about 35% of these costs can be attributed to patients with a low educational level. Thus, their share of the total costs is about 67% higher than their share of the total population. If the prevalence in the group with 'low educational level' (14.8%) could be reduced to the prevalence in the group with 'middle educational level' (7.9%), this would save about 2.2 billion (about 16.5%) € of direct costs. DISCUSSION: The analysis provides a first estimate of the potential savings from an effective status specific prevention programme. However, the direct costs per patient used were only an average for all people with DM, as a breakdown by educational level was not available. Since education can also affect health behaviour and compliance, which are also determinants of cost, the analyses presented here are probably conservative.

[Risk pregnancies and how to treat them]. / Risikoschwangerschaften und deren Therapie.

UNLABELLED: Recurrent abortions are a common problem. A therapy with low-molecular- weight heparin is usual in deep vein thrombosis with thrombophilia, in woman with recurrent abortions or other risks, like EPH-gestosis or HELLP-Syndrom. PATIENTS, METHOD: The efficacy of a mono-therapy with LMWH (3000-16000 daily) in women with risk pregnancies has been examined prospectively. The dates of 676 pregnant women have been analysed and compared to the current literature about live birth rates without therapy and tot he results of other, similar studies. The live birth rate has been the target variable. RESULTS: We obtained main a live birth rate of 98.6%. There has been no record of serious adverse effects. We obtained a live birth rate of 95.8% if NMH therapy starts early, and a live birth rate of 100% if NMH therapy starts between week 20 and 25. For the live birth rate the existence of thrombophilic gene polymorphisms is irrelevant. CONCLUSION: The high live birth weight is depended on early starting the therapy with NMH. For the late risk it is favourable to start the therapy with heparin between week 20 and 25 week of pregnancy.

Dissection of the intracellular pathways in hepatocytes suggests a role for Jun kinase and IFN regulatory factor-1 in Con A-induced liver failure.

Con A administration results in dose-dependent immune-mediated liver injury. Cytokines are important to determine the outcome of liver failure in this model, and especially TNF-alpha and IFN-gamma directly contribute to hepatocyte damage. The intracellular pathways of these two cytokines, which eventually result in tissue destruction, are not well defined. Here we used anti-IFN-gamma Abs and adenoviral vectors that express molecules inhibiting distinct TNF-alpha-dependent pathways in hepatocytes to better understand the relevance of specific intracellular signaling cascades for Con A-induced liver failure. We show that activation of TNF-alpha- and IFN-gamma-dependent intracellular pathways occurs prior to the influx of immune-activated cells into the liver and that anti-TNF-alpha and anti-IFN-gamma neutralizing Abs cannot block infiltration of these cells. Blocking experiments with Abs and adenoviral vectors showed that NF-kappaB activation and the Fas-associated death domain protein/caspase 8 cascade in hepatocytes during Con A-induced liver failure have no impact on tissue injury. Additionally, STAT1 activation alone after Con A injection in liver cells does not result in liver damage. In contrast, IFN-gamma-dependent expression of IFN regulatory factor-1 and TNF-alpha-dependent activation of c-Jun N-terminal kinase in liver cells correlates with liver cell damage after Con A injection. Therefore, our experiments indicate that 11418690

[Long-time follow-up studies of Isosit composite for conical veneer crowns]. / Nachuntersuchungen zur Langzeitbewährung des Komposites Isosit bei Konusverblendkronen.

The long-term resistance of veneers in conical-crowns is a predominant fact of ästhetics in using this system of anchorage. 158 concical-crowns, veneered by composite ISOSIT were tested and measured after wearing 3 and 12 years. The results are: repeadings 3.2%, insufficient colour 8.9%, borderlinespace 12.1%, visible skeleton 7.6% and gross damages only 3.2%. This results may confirm the hitherto existing clinically experience in veneering conical-crowns by composites ISOSIT.

[Dorsal border of denture base after SR-Ivocap polymerization]. / Dorsale Randspaltbildung an Gaumenplatten nach Polymerisation im SR-Ivocap-Verfahren.

The amount of dorsal borderspace of upper-plates after polymerisating in different dental laboratories has been measured and compared by statistically methods. This result showed a conspicuously small deviation. The overall average was to be found in the range of only 227 microns +/- 10.5 microns after water-laging for 4 weeks. This amount is conformable to the results of Marx. There is no interpretation of the high values measured by Peroz recently. This present results confirm on the contrary the clinically verification of the SR-Ivocap-polymerisating equipment.

[Accuracy of fit of the denture base depending on various jaw geometries. Biotechnical analysis]. / Passgenauigkeit der Prothesenbasis in Abhängigkeit unterschiedlicher Kieferkammformen. Eine biotechnische Analyse.

Good function of full dentures is closely related to an accurate fit of the denture bases. The shape of these bases depend again on the polymerization technique applied. Methods of biotechnical analysis were employed to determine the effects of the alveolar ridge, defined as an angle with the vertical plane, on the accuracy of fit. Both the expansion of castings and the curing contraction of acrylics were taken into consideration in this analysis. The relationships between an increase or reduction of the full denture base and the mechanism of adhesion to the denture-bearing area were computed and their practical implications are discussed.

Angled side wall microarteriotomy scissors: a new end-to-side microvascular anastomosis instrument.

Creation of a smooth side wall arteriotomy for an end-to-side microsurgical anastomosis can at times be difficult and time consuming. To facilitate this maneuver, a new end-to-side microarteriotomy scissor was designed for creation of recipient vessel openings from 0.5-2 mm in size. These new scissors and their recommended use are described.

[Primary accuracy limits of Isosit 10 composite after laboratory preparation]. / Die primäre Genauigkeitsgrenze von Isosit 10 Komposit nach labortechnischer Herstellung.

A modern technique of restoring the anatomical shape of teeth by composite-onlays (Isosit-IO) has been investigated by electronic equipments and the results has been described. The border crevice produced by shrinkage due to polymerisation was found to be extremely small. Significant differences were found in the occlusal and vertical plane with 30 microns as average measuring value. Consequently the high clinically importance of this technique results of the material quality.

[Breaking susceptibility of Ultralite-foil crowns for molars]. / Bruchsicherheit der Ultralite-Folienkrone für Kauflächenzähne.

Proceeding on the assumption that the use of massive cast gold constructions is an important factor in the question of economical dentistry a new technique of crownwork construction is presented. Ultralight construction is a method used in engineering for the production of load-bearing elements from embossed metal foils. Based on the new Ultralite-foil-crown the mechanical strength of the Ultralite-molar-crown is tested. Following the principles in construction with this new technique the results of breaking load tests of the ceramometallic Ultralite-molar-crown are discussed.

Use of small-caliber polytetrafluoroethylene (Gore-Tex) grafts in microsurgical training.

We present the use of polytetrafluoroethylene (PTFE) graft material as a microsurgical training model that better simulates live vessel repairs. PTFE grafts have mechanical advantages over polyethylene or silicone tubing in that they better mimic the "feel" of an arterial vessel wall, thus allowing the student to perfect counterpressor maneuvers before attempting live vessel repairs. Saving the PTFE "repairs" for later comparison and study provides the student with positive feedback that is not possible with living models. This cost-effective model has helped to shorten our directed teaching program and has reduced the use of laboratory animals.

Use of leeches in plastic and reconstructive surgery: a review.

Leeches possess properties that make them uniquely able to assist with venous compromised tissue. Their saliva contains an anticoagulant and a histamine-like vasodilator that promote local bleeding, a local anesthetic, and hyaluronidase that promotes the local spread of the other leech salivary secretions into the wound/bite. In addition, active pharyngeal peristalsis further promotes the egress of venous blood. Resurgence in the use of leeches has been stimulated by Upton in the United States and Mahaffey in Europe. Currently, leeches are used at many microsurgical centers to provide critical venous outflow for compromised tissue replantations and transfers that might otherwise be unsalvageable. As the use of leeches becomes more widespread, knowledge of leech biology and physiology is important. This review reports on Hirudo medicinalis, the species used most often medically in Europe and the United States.