[Physiotherapy for juvenile idiopathic arthritis]. / Physiotherapie bei der juvenilen idiopathischen Arthritis.

Control of disease activity and recovery of function are major issues in the treatment of children and adolescents suffering from juvenile idiopathic arthritis (JIA). Functional therapies including physiotherapy are important components in the multidisciplinary teamwork and each phase of the disease requires different strategies. While in the active phase of the disease pain alleviation is the main focus, the inactive phase requires strategies for improving motility and function. During remission the aim is to regain general fitness by sports activities. These phase adapted strategies must be individually designed and usually require a combination of different measures including physiotherapy, occupational therapy, massage as well as other physical procedures and sport therapy. There are only few controlled studies investigating the effectiveness of physical therapies in JIA and many strategies are derived from long-standing experience. New results from physiology and sport sciences have contributed to the development in recent years. This report summarizes the basics and main strategies of physical therapy in JIA.

Study on the chiral recognition of the enantiomers of ephedrine derivatives with neutral and sulfated heptakis(2,3-O-diacetyl)-beta-cyclodextrins using capillary electrophoresis, UV, nuclear magnetic resonance spectroscopy and mass spectrometry.

The enantiomers of methylephedrine, pseudoephedrine and ephedrine showed a different migration behavior in capillary electrophoresis in the presence of beta-cyclodextrin (beta-CD), heptakis(2,3-O-diacetyl)-beta-cyclodextrin and heptakis(2,3-O-diacetyl-6-sulfato)-beta-cyclodextrin (HDAS). Utilizing UV, MS and NMR spectroscopy, in particular rotating frame Overhauser experiments, an attempt was made to elucidate the chiral recognition mechanism. In the case of the neutral CDs 1:1 complexes were formed with ephedrine and methylephedrine characterized by the inclusion of the phenyl ring in the cavity and the side chain pointing out of the wider rim. In contrast, manifold complexes were formed with HDAS, which on average are characterized by an upside down inclusion of the phenyl ring in the cavity and the side chain pointing out of the narrow rim. This complex geometry is likely be stabilized by an ion-ion interaction between the positively charged nitrogens of the ephedrine derivatives and the negative charges of HDAS. In addition, an attachment of the ligand to the outside of HDAS and other complex stoichiometries are also possible.

New stationary phase for liquid chromatography with chemically bonded pinane ligand: synthesis and characterization by nuclear magnetic resonance and high-performance liquid chromatographic investigations.

A new bicyclic phase for liquid chromatography was prepared by solution polymerization approaches. To introduce a C4 spacer the starting molecule 3-formylpinane was reduced to the alcohol followed by a substitution of the hydroxy group through a bromide. The obtained halide reacted with magnesium and allyl bromide to the 3-(but-3'-enyl)pinane which was hydrosilylated with trichlorosilane and finally immobilized to silica gels with different pore sizes using the technique of solution polymerization. To elucidate the structure of 3-(but-3'-enyl)pinane high-resolution two-dimensional nuclear magnetic resonance (NMR) spectra were carried out. The new phases were characterized, on the one hand by employing 13C and 29Si solid-state NMR spectroscopy and on the other hand, by separating a standard test mixture consisting of mainly monosubstituted aromatic compounds. The results achieved in chromatography were correlated with the information gained from 29Si CP/MAS NMR measurements.

Characterization of polyalkylvinyl ether phases by solid-state and suspended-state nuclear magnetic resonance investigations.

Pure organic polyalkvlvinyl ether phases were synthesized by suspension polymerization using different ratios and compositions of n-butylvinyl ether (C4VE) and n-octadecylvinyl ether (C18VE) with triethylene glycol divinyl ether or divinylbenzene as crosslinkers, respectively. These phases were investigated by means of solid-state 13C cross-polarization magic angle spinning nuclear magnetic resonance (NMR) spectroscopy and 1H high-resolution magic angle spinning (HR MAS) NMR spectroscopy in suspended-state. A comparison of these two methods showed the substantial advantages of 1H HR MAS NMR measurements. Structure elucidation was achieved using a 2D H,H-COSY NMR experiment performed under MAS conditions enabling full peak assignment of the 1H NMR spectra of these phases. The dynamic behavior of the polyalkylvinyl ether phases was determined by employing temperature-dependent measurements of spin-lattice relaxation times (T1) as well as accumulation of a 2D wide line separation NMR spectrum.

Stationary interphases with extended alkyl chains: a comparative study on chain order by solid-state NMR spectroscopy.

Stationary interphases with long n-alkyl chains (n = 18, 22, 30, 34) have been examined by solid-state NMR spectroscopy. The determination of the silane functionality and the degree of cross-linking of silane ligands on the silica surface was performed by 29Si CP/MAS NMR spectroscopy. High-speed 1H MAS and 13C CP/MAS NMR spectroscopy were utilized to assess alkyl chain order and mobility of the different bonded phases. For this purpose, 1H NMR line widths and 13C chemical shifts have been evaluated. It is shown that stationary phase order and rigidity increase with alkyl chain length. In addition, the temperature-dependent trans/gauche conformational change occurs at higher temperatures for a polymeric C34 phase compared with a C30 sorbent. This behaviour is discussed in the context of previously reported chromatographic (HPLC) shape selectivity differences.

Direct On-Line Coupling of Capillary HPLC with (1)H NMR Spectroscopy for the Structural Determination of Retinyl Acetate Dimers: 2D NMR Spectroscopy in the Nanoliter Scale.

This paper presents the application of directly coupled capillary high-performance liquid chromatography (capillary HPLC) and proton high-field nuclear magnetic resonance spectroscopy (NMR) for structural elucidation of a so-far unknown kitol isomer. One- and two-dimensional continuous- and stopped-flow NMR spectra were recorded in a 180 µm i.d. capillary, corresponding to a detection volume of only 200 nL. Unequivocal structural assignment on the basis of 1D and 2D stopped-flow capillary HPLC-NMR experiments was performed. The kitol isomer mixture was present in a sample of thermally isomerized retinyl acetate and separated on a capillary column.

[Sonography of the maxillary sinus in children]. / Die Sonographie der Kieferhöhle im Kindesalter.

Ultrasonic diagnosis (A- and B-mode) is a non-invasive alternative without radiation exposure to the radiographic examination of the maxillary sinuses of children. Given the adequate prerequisites (high resolution device, trained examiner) diagnostic mistakes can be reduced to a minimum. Thus sonography becomes the first and frequently the only necessary diagnostic imaging procedure for diagnosing the puerile maxillary sinus.

[Ultrasonic evaluation of the upper abdomen in cystic fibrosis]. / Oberbauchsonographie bei cystischer Fibrose.

Abdominal sonography should compulsory be used in patients with cystic fibrosis (CF). It is not difficult to detect early morphologic changes at liver, gall-bladder, pancreas, spleen, and vessels by ultrasound. As a non-invasive method sonography is a very useful tool for a comprehensive special care of outpatients with CF.

[Kidney sonography in childhood in chronic recurring pyelonephritis without a urinary transport disorder]. / Die Nierensonographie im Kindesalter bei chronisch rezidivierender Pyelonephritis ohne Harntransportstörung.

201 children with healthy kidneys and 61 patients of the paediatric nephrological dispensary with chronically relapsing pyelonephritis without disturbance of the transport of urine were examined sonographically. With the help of an atrophy score was controlled, whether the summation of unspecific parameters is in connection with the length of the kidney. A correlation of the introduced point system with the size of the kidney could be proved. The atrophy score represented shall facilitate the sonographic control of the course of non-obstructive parenchymatous renal diseases.

[Renal sonography in childhood. Normal findings]. / Die Nierensonographie im Kindesalter. Normalbefunde.

In a prospective study 201 children with healthy kidneys were sonographically examined. Apart from the length unspecific parameters in the ultrasound tomogram, such as possibility to delimit the organ, echogenity and differentiation of the fine structure of the kidneys are demonstrated depending on age. The proportion of smoothly delimited kidneys before the 1st year of age was significantly lower than in the following years. With growing age the possibility to delimit mean echocomplex, renal medulla and renal cortex. In the 1st and 2nd trimenon the echo-richness of the kidneys is to be valuated physiologically. The demonstrated dynamics of sonographic signs shall alleviate the age-specific judgement of renal diseases without disturbance of the urine transport.

[To treat or not to treat chronic lymphocytic leukemias with a mild course?]. / Leczyc czy nie leczyc przewlekle bialaczki limfatyczne o lagodnym przebiegu

The study is based on a material of 60 patients with chronic lymphocytic leukaemia of mild course with survival over 4 years. The method used was a comparison of the patients treated from the time of diagnosis establishment with the group of similar patients not treated throughout the whole period of follow-up and with another group of patients treated from the time of exacerbation of the proliferative process. The following data were taken into account: survival length, degree of splenomegaly and lymphadenopathy, leucocyte and platelet counts, haemoglobin level, infectious complications. It was demonstrated that cytostatic and/or hormonal treatment started at the time of diagnosis establishment did not prolong the survival. A statistically significant prolongation of survival time was observed, on the other hand, in cases treated from the time of exacerbation. Cytostatic agents increased the risk of infections and the risk of thrombocytopenia.