[Clinical guidelines and health services research]. / Leitlinien und Versorgungsforschung.

Doctors are bound to ensure and improve the quality of their own work. This is a significant part of medical professionalism and lasts one's entire working life. In this regard clinical guidelines provide valuable and helpful information because they give recommendations on prevention, diagnosis, treatment, and aftercare based on current evidence. However, in their medical work potential users widely ignore such guidelines. Hence it is necessary to discover barriers to compliance with the guidelines and, based on the findings, to investigate more effective strategies for implementing the guidelines. Analyses and evaluation can be performed by using health services research. Undesirable developments in doctors' daily routines, associated with negative consequences for healthy and ill people, as well as for the economics of health care, can be detected and improvements can be identified systematically. This branch of research has become ever more important - even necessary. It ist likely that the increasing demand for assessing the needs, costs, structural conditions, and quality of health care will confirm the significance of such evaluation.

The effect of nigellone and thymoquinone on inhibiting trachea contraction and mucociliary clearance.

NIGELLA SATIVA L. has many effects including those on the gastrointestinal tract and trachea and is, therefore, used in the Mediteranean area and in India/Pakistan. Our aim was to investigate the effect of two main constituents, nigellone and thymoquinone, on trachea (antispasmodic effect) and their influence on respiratory clearance. The effects on Ba (2+)-, carbachol- and leukotriene-induced trachea contractions and the transport of the fluorescence dye rhodamin B concerning ciliary action in the tracheal area were investigated using a microdialysis technique. Nigellone and high concentrations of thymoquinone had a concentration-dependent inhibitory effect on the trachea when being contracted by the depolarizing effect of Ba (2+). The trachea contractions induced by leukotriene-d (4) were inhibited by nigellone and by thymoquinone. The cholinergic system (stimulation by carbachol) was hardly involved. The rate of ciliary clearance (mucociliary transport) was slightly modified by a high thymoquinone concentration (153.0 vs. 505.0 sec/12 mm distance, respectively), and was highly increased by nigellone (217.5 vs. 505.0 sec/12 mm distance). In conclusion, this study provides evidence for an antispasmodic effect and an increase in mucociliary clearance for nigellone but not for thymoquinone. Altogether the data indicate that nigellone but not thymoquinone may be useful in treatment of different respiratory diseases.

Dentocase - open-source education management system in dentistry.

Since 2001, an interdisciplinary project on multimedia education in medicine has been sponsored by the Federal Ministry of Education and Research at the Charité. One part of the project is on dentistry. In the light of the results of a survey of dental students, an Internet-based education management system was created using open-source back-end systems. It supports four didactic levels for editing documentation of patient treatments. Each level corresponds to the learning abilities of the students. The patient documentation is organized to simulate the working methods of a physician or dentist. The system was tested for the first time by students in the summer semester of 2003 and has been used since the winter semester of 2003 as part of the curriculum.

Use of single- and multi-locus and polymerase chain reaction systems for zygosity determination--clinical application in twins with clefts of the lip and palate.

Precision of zygosity determination in twins can be improved by the use of modern methods of DNA analysis. The clinical application of 4 single- (SLS) and 2 multi-locus (MLS), and 6 PCR (polymerase chain reaction) systems for zygosity determination in 12 twin pairs with oral clefts was compared with regard to the quality and quantity of sample material required and the probability of error in monozygosity determination. PCR systems proved to be superior to SLS or MLS, as DNA sampling is much more convenient, while its level of accuracy still fulfils clinical requirements. For this reason, PCR systems should be considered a basic method in modern clinical twin research.

[Possibilities for using bedside cards as secondary comparison in trace element studies with the PCR technique]. / Einsatzmöglichkeiten von bedside-Karten als sekundäres Vergleichsmaterial bei Spurenuntersuchungen mit der PCR-Technik.

When fresh blood is not available as a control in stain investigations extracted teeth, hair, preserved tissue samples, histological slides, cigarette butts or used stamps can also be used. This paper reports on a stain investigation performed 7 months after the death of the victim, where a bedside card from the medical records was successfully employed as a control blood sample. In a series of 10 bedside cards up to 9 years old, the investigation with the PCR method showed recognizable patterns in the STR systems SE 33 and TC 11. Matching patterns could be found from the 4 sections of each card (anti A, anti B, anti AB and anti D). A comparison of the oldest card with a fresh blood sample of the patient also showed matching patterns. AMPFLPs were successful with more recent cards. Using the PCR method typing of bedside cards from medical records up to 10 years old can be used in stain investigations.

DNA extraction from mixtures of body fluid using mild preferential lysis.

A modification to the DNA extraction method "preferential lysis" (Gill et al. 1985) is proposed which can be applied to DNA mixtures of vaginal cells and spermatozoa. In mixtures with a low sperm content the further loss of sperm DNA caused by the extraction can be avoided by using "mild preferential lysis". Amplification by PCR (polymerase chain reaction) then yields sufficient DNA to be able to identify both components in the mixture.

[Evaluation of unusual band patterns in immunochemophoresis]. / Zur Bewertung ungewöhnlicher Bandenmuster in der Immunochemophorese.

The occurrence of unusual band patterns in the protein systems Gc, F XIII B and PLG is described. During the routine investigation of these systems in paternity, identity and criminal cases, several examples of alterations or additions to the normal band patterns have been observed. This was particularly noticeable in post mortem samples, stored liquid blood samples and blood stains. A connection between alterations in the form due to charge changes and changes to the isoelectric point from ageing of blood samples is demonstrated.