[Radiological diagnosis and intervention of cholangiocarcinomas (CC)]. / Radiologische Diagnostik und Intervention von Cholangiokarzinomen (CC).

To present current data on diagnosis, indication and different therapy options in patients with cholangiocarcinoma (CC) based on an analysis of the current literature and clinical experience. The diagnostic routine includes laboratory investigations with parameters of cholestasis and also serum tumor markers CA19 - 9 and CEA. After ultrasound for clarifying a tumor and/or dilated bile ducts, contrast-enhanced magnetic resonance imaging (MRI) should be performed with magnetic resonance cholangiography (MRCP). The accuracy (positive predictive value) for diagnosing a CC is 37-84% (depending on the location) for ultrasound, 79-94% for computed tomography (CT), and 95% for MRI and MRCP. An endoscopic retrograde cholangiography (ERCP) can then be planned, especially if biliary drainage or cytological or histological specimen sampling is intended. A curative approach can be achieved by surgical resection, rarely by liver transplantation. However, many patients are not eligible for surgery. In addition to systemic chemotherapy, locoregional therapies such as transarterial chemoembolization (TACE), hepatic arterial infusion (HAI)--also known as chemoperfusion--, drug eluting beads-therapy (DEB) as well as thermoablative procedures, such as laser-induced thermotherapy (LITT), microwave ablation (MWA) and radiofrequency ablation (RFA) can be provided with a palliative intention.

[Examination to possibilities of a physiological fitting of cochlear implants]. / Untersuchungen zu Möglichkeiten einer physiologischen Anpassung von Cochlea-Implantaten.

BACKGROUND: Cochlear implants (CI) convert acoustic events into electrical pulses. The auditory nerve picks these tiny electrical pulses up and sends them to the brain. The dynamics of the audible sound is compressed considerably. The limits for stimulation are determined with the patient. A map law determines which sound pressure level is assigned to which stimulation level. A sufficient speech understanding requests an allocation of high stimulation levels for weak sound signals. The higher the sound level, the lower the increase. Unfortunately, with such kind of map law unwanted background noise is also presented as well audible stimulation. These stimuli are often annoying to CI users in everyday situations. PATIENTS AND METHOD: The possibility to give an s-shaped course to these map laws was examined in 9 patients. After the fitting procedure their speech understanding were tested. The results were compared with the results of former tests. RESULTS: 8 patients reported definite improvement of their hearing situation. Such map laws seem, therefore, suitable to optimise speech processor programming.

Spray deposits of crop protection products on plants--the potential exposure of non-target arthropods.

Spray deposits of plant protection products on cultivated plants present a potential hazard to non-target arthropods. This hazard is considered in the risk assessment procedure when such products are registered. The results of deposit measurements in the laboratory and field, including mean spray deposits on plant surfaces, their variability and their relation to the delivered dose are presented. Initial deposits expressed as ng/cm2 plant surface were measured on individual leaves of various plant species using a fluorescent tracer. The results show that the mean deposit is plant-specific but with a high degree of variability. Mean deposits on field-grown cereals were 3, 9 (growth stage BBCH 10) and 4, 7-14 ng/cm2 (growth stage BBCH 29-63) at a delivered dose rate of 20 g sodium flourescein (SF) per ha. This is equivalent to 200 ng tracer per cm2 ground area. On apple leaves, mean deposits varied between 18 and 50 ng/cm2 at a rate of 20 g tracer/10,000 m2 fruitwall. Coefficients of variation of leaf deposits ranged between 30% and 90%. In addition to the leaf-to-leaf variability, there was a notable variation of the deposit on individual leaves themselves as shown for wheat. Data from field measurements were supported principally by data from tray-grown plants on a laboratory spray track which gives information on targets positioned in a more or less two-dimensional system.

[Family practice quality circles between goals and reality--an interaction analysis]. / Hausärztliche Qualitätszirkel zwischen Anspruch und Wirklichkeit--eine Interaktionsanalyse.

Quality circles are considered a key method for quality assurance in health care. However, there is a lack of systematic evaluation for quality circles in general practice, especially regarding the process quality of quality circle work. This article presents the results of an interaction analysis completing the systematic evaluation of quality circles in general practice in a region of south Germany. Using the so-called conference encoding method for interaction analysis we analyzed 7 out of 25 evaluated quality circles and 2348 interactions between the quality circle members. The participation rate of the moderators is high compared to the relative low contribution of the group members to the quality circle work. We could show that quality circles work topic-oriented, there is a wide exchange of experience between the group members and the group climate is positive. However, there were almost no specific activities to develop guidelines for diagnostic and therapeutic procedures. The results showed a significant discrepancy between the aims of quality circles and their practical realisation. Besides improved option for information and training programs for moderators and participants, we recommend further evaluation studies complemented with specific analysis of the process quality for example with the conference encoding method.

Expression of the Escherichia coli pmi gene, encoding phosphomannose-isomerase in Zymomonas mobilis, leads to utilization of mannose as a novel growth substrate, which can be used as a selective marker.

Wild-type Zymomonas mobilis can utilize only three substrates (sucrose, glucose, and fructose) as sole carbon sources, which are largely converted into ethanol and carbon dioxide. Here, we show that although D-mannose is not used as a growth substrate, it is taken up via the glucose uniport system (glucose facilitator protein) with a Vmax similar to that of glucose. Moreover, D-mannose was phosphorylated by a side activity of the resident fructokinase to mannose-6-phosphate. Fructokinase was purified to homogeneity from an frk-recombinant Z. mobilis strain showing a specific activity of 205 +/- 25 U of protein mg-1 with fructose (K(m), 0.75 +/- 0.06 mM) and 17 +/- 2 U mg-1 (relative activity, 8.5%) with mannose (K(m), 0.65 +/- 0.08 mM). However, no phosphomannoseisomerase activity could be detected for Z. mobilis, and this appeared to be the reason for the lack of growth on mannose. Therefore, we introduced the Escherichia coli gene pmi (manA) in Z. mobilis under the control of a lacIq-Ptac system on a broad-host-range plasmid (pZY507; Cmr). Subsequently, in pmi-recombinant cells of Z. mobilis, phosphomannoseisomerase was expressed in a range of from 3 U (without isopropyl-beta-D-thiogalactopyranoside [IPTG]) to 20 U mg-1 of protein in crude extracts (after IPTG induction). Recombinant cells of different Z. mobilis strains utilized mannose (4%) as the sole carbon source with a growth rate of 0.07 h-1, provided that they contained fructokinase activity. When the frk gene was additionally expressed from the same vector, fructokinase activities of as much as 9.7 U mg-1 and growth rates of as much as 0.25 h-1 were detected, compared with 0.34 h-1 on fructose for wild-type Z. mobilis. Selection for growth on mannose was used to monitor plasmid transfer of pZY507pmi from E. coli to Z. mobilis strains and could replace the previous selection for antibiotic resistance.

Functional expression of the glucose transporter of Zymomonas mobilis leads to restoration of glucose and fructose uptake in Escherichia coli mutants and provides evidence for its facilitator action.

The Zymomonas mobilis genes encoding the glucose facilitator (glf), glucokinase (glk), or fructokinase (frk) were cloned and expressed in a lacIq-Ptac system using Escherichia coli K-12 mutants deficient in uptake and phosphorylation of glucose and fructose. Growth on glucose or fructose was restored when the respective genes (glf-glk or glf-frk) were expressed. In E. coli glf+ strains, both glucose and fructose were taken up via facilitated diffusion (Km, 4.1 mM for glucose and 39 mM for fructose; Vmax at 15 degrees C, 75 and 93 nmol min-1 mg-1 [dry weight] for glucose and fructose, respectively). For both substrates, counterflow maxima were observed.

EXP3174, a metabolite of losartan (MK 954, DuP 753) is more potent than losartan in blocking the angiotensin II-induced responses in vascular smooth muscle cells.

OBJECTIVE: EXP3174 is a metabolite of losartan (previous name DuP753), which is a non-peptide angiotensin II receptor antagonist. DESIGN: The inhibitory potency of these two antagonists on the angiotensin II-induced responses in vascular smooth muscle cells (VSMC) was investigated. METHODS: The effect of angiotensin II on cell growth was determined by [3H]-thymidine incorporation into cell DNA and by cellular protein measurements. Intracellular cytosolic Ca2+ concentration was measured by the fura-2 method. Inositolphosphates were determined by high-performance liquid chromatography after cell labelling with myo-[2-3H]-inositol. The early growth response gene-1 (Egr-1) messenger RNA (mRNA) expression was determined by the Northern blotting method. Binding and displacement studies of the antagonists were performed using [125I]-angiotensin II. RESULTS: An apparent dissociation constant (Kd) of 5.9 nmol/l for [125I]-angiotensin II (maximal binding coefficient 69 fmol/10(6) cells) was found. The specific binding of [125I]-angiotensin II to VSMC was inhibited by losartan, EXP3174 and saralasin with a half-maximal inhibitory concentration (IC50) of 1.0 X 10(-8), 1.1 X 10(-9) and 1.8 X 10(-9) mol/l, respectively. EXP3174 and losartan abolished the angiotensin II-induced formation of inositolphosphates in VSMC. EXP3174 and losartan inhibited the angiotensin II-induced elevation of intracellular cytosolic Ca2+ concentration with an IC50 of 5 X 10(-9) and 5 X 10(-8) mol/l, respectively. EXP3174 was more effective than losartan in blocking the angiotensin II-induced increase in Egr-1 mRNA. EXP3174 and losartan inhibited the angiotensin II-induced cell protein synthesis with an IC50 of 3 X 10(-9) and 4 X 10(-8) mol/l, respectively. CONCLUSIONS: These results indicate that EXP3174 is significantly more potent than losartan in blocking angiotensin II-induced cellular responses.

Angiotensin II induces formation of the early growth response gene-1 protein in rat vascular smooth muscle cells.

The effect of angiotensin II (Ang II) on the early growth response gene-1 (Egr-1) mRNA, on the Egr-1 protein and on the phosphoinositide PI turnover signalling system was investigated in the presence and absence of EXP3174, a potent non-peptide Ang II receptor antagonist. Ang II induced an accumulation of 3.4 kb Egr-1 mRNA and the 80 kDa Egr-1 protein, with a maximum at 30 min and 60 min, respectively. EXP3174 blocked the Ang II-induced increase of inositol phosphates, Egr-1 mRNA and the Egr-1 protein, suggesting the involvement of the PI signalling system by the expression of the Egr-1 gene.

[Long term comparison between atenolol and a depot form of propranolol hydrochloride on the heart rate and blood pressure at rest and during physical work in normal subjects]. / Langzeitwirkungsvergleich zwischen Atenolol und der Retardform von Propranololhydrochlorid auf die Herzfrequenz und den Blutdruck in Ruhe und während körperlicher Belastung bei Normalpersonen.

Atenolol 100 mg and propranolol retard 160 mg were compared by a cross-over trial in 20 male volunteers with respect to their long action on heart rate and blood pressure at rest as well as during ergometric load tests. Both beta-receptor blocking agents showed the following effects 24 h after treatment: 1. The maximal capacity for ergometric load was significantly reduced by atenolol as well as by propranolol retard in comparison to the control. 2. The heart rate was also significantly reduced by both beta-blocking agents after 24 h. 3. The systolic blood pressure during ergometric load as well as the diastolic blood pressure at rest showed significantly lower values 24 h after treatment with both agents.