[Diagnostic value of the determination of total testosterone in the serum and free biologically active testosterone in the saliva in men].

The study was undertaken to provide evidence that the salivary concentration of free testosterone (FT) well correlates with the serum level of unbound testosterone in men. Recent articles demonstrate that the results obtained by the use of especially automatic systems are incorrect. Anew luminescence enzyme immunoassay has been now put into practice. Its high analytical (6.2 pmol/l) and functional (17.3 pmol/l) sensitivities allow the quantification of minor salivary concentrations. In healthy males, the morning salivary concentration was 369 pl/lmo (median) with a range of 263-544 pmol/l, which is statistically higher than that in males with androgen deficiency (215 pl/lmol/I (median) with a range of 51-249 pmol/l. Once-weekly remeasurement of salivary FT during 5 weeks showed the high stability of results over time with a variation coefficient of 9% (range 5-23%). The study indicated that FT in the morning salivary sample well correlates with the calculated FR in the blood of both healthy males (R = 0.754; p = 0.001) and patients with androgen deficiency (R = 0.889; p = 0.0001).

The CardioOP-Data Clas (CDC). Development and application of a thesaurus for content management and multi-user teleteaching in cardiac surgery.

OBJECTIVES: Self-directed and customized medical education programs are gaining importance in health care instruction. We prototypically implemented a repository-driven online computer system (CardioOP) for teleteaching in Heart Surgery. It supports authoring and multiple re-use of multimedia data for different user groups in different instructional applications and therefore requires a process of content management. METHODS: We defined objectives for a terminological system to support semantic, cross-media type annotation and retrieval of learning objects: domain completeness, German (natural) language processing, multi-user concepts, extensibility and maintenance, content based annotation and technical implementation. Existing terminologies (ICD10, READ V3, Snomed III, UMLS 1997, MESH) have been analysed according to these objectives. RESULTS: We found that the analysed terminologies did not meet our criteria sufficiently. Therefore, we developed a domain-specific thesaurus, the CardioOP-DataClas (CDC). The application of the CDC within a database-driven authoring process using specifically developed tools is reported. CONCLUSIONS: Metadata play an important role in the effective discovery and search, access, integration and management of educational multimedia data in medicine but so far, there is no terminology to support content management for instructional multimedia. We prototypically designed and applied a thesaurus for the CardioOP educational system. Additional work is needed to evaluate the system in terms of user-friend-liness, concept coverage and information retrieval performance.

Incidence of malformations of the urinary tract in association with clefts of lip, alveolus, and palate.

Malformation syndromes accompanied by cleft development in the lip-alveolus-palate (LAP) region are sometimes associated with anomalies of the efferent urinary tract. In the present clinical study, 68 children with an LAP-cleft were routinely subjected to radiological examination of the efferent urinary tract. These revealed pathological alterations, in varying degrees, in 26 children. The relationships between cleft type and urinary-tract malformation are analysed. The results show the significance of early interdisciplinary investigations.

[Frequency of urinary tract abnormalities in cleft lip-maxilla-palate patients]. / Die Häufigkeit von Harnwegsanomalien bei Lippen-Kiefer-Gaumenspalten.

Malformations of the urinary tract favour urinary tract infection; on the other hand, a urinary tract infection is often the first indication of a malformation of the urinary tract. Further signs are externally visible malformations, such as cheilognathopalatoschisis. In two years we examined 53 children with schistases urologically and found urinary tract anomalies in 39,6%.

A modified groin flap for reconstruction of oral cavity defects after tumour resection.

21 patients, suffering from carcinoma in the lower part of the oral cavity, were operated on by in-continuity resection of the mandible. The removed bone was replaced by a metal plate. The soft tissue defect was completely repaired by a modified free groin flap, transplanted with microsurgical techniques. 19 patients had a complete flap take, two flaps became necrotic. No metal plate was lost during a follow up period of 1-20 months. The functional results in respect of tongue mobility were in all cases quite favourable. Techniques of flap raising and transplantation are outlined in detail.

[Prevention of cleft palate in animal experiments. Clinical inferences (author's transl)]. / Prävention von Gaumenspalten im Tierexperiment. Ubertragbarkeit auf klinische Belange.

The almost 100% successes with drug prophylaxis of cheilognathopalatoschisis in humans described by some authors are dubious, not only because of the dose level, but particularly because of the fact that the data do not result from controlled studies. In order to clarify the efficacy of cleft prophylaxis, we undertook animal experiments. To produce clefts, NMRI mice were treated with dexamethasone on day 13 of pregnancy. Another group also received a deproteinized hemoderivative in addition from day 11 to day 18 and two other groups were used as controls. It was found on autopsy shortly before birth that the incidence of clefts was significantly lower in the animals treated with additional hemoderivative.