Chemical characteristics of wildfire ash across the globe and their environmental and socio-economic implications.

The mobilisation of potentially harmful chemical constituents in wildfire ash can be a major consequence of wildfires, posing widespread societal risks. Knowledge of wildfire ash chemical composition is crucial to anticipate and mitigate these risks. Here we present a comprehensive dataset on the chemical characteristics of a wide range of wildfire ashes (42 types and a total of 148 samples) from wildfires across the globe and examine their potential societal and environmental implications. An extensive review of studies analysing chemical composition in ash was also performed to complement and compare our ash dataset. Most ashes in our dataset had an alkaline reaction (mean pH 8.8, ranging between 6 and 11.2). Important constituents of wildfire ash were organic carbon (mean: 204 g kg-1), calcium, aluminium, and iron (mean: 47.9, 17.9 and 17.1 g kg-1). Mean nitrogen and phosphorus ranged between 1 and 25 g kg-1, and between 0.2 and 9.9 g kg-1, respectively. The largest concentrations of metals of concern for human and ecosystem health were observed for manganese (mean: 1488 mg kg-1; three ecosystems > 1000 mg kg-1), zinc (mean: 181 mg kg-1; two ecosystems > 500 mg kg-1) and lead (mean: 66.9 mg kg-1; two ecosystems > 200 mg kg-1). Burn severity and sampling timing were key factors influencing ash chemical characteristics like pH, carbon and nitrogen concentrations. The highest readily dissolvable fractions (as a % of ash dry weight) in water were observed for sodium (18 %) and magnesium (11.4 %). Although concentrations of elements of concern were very close to, or exceeded international contamination standards in some ashes, the actual effect of ash will depend on factors like ash loads and the dilution into environmental matrices such as water, soil and sediment. Our approach can serve as an initial methodological standardisation of wildfire ash sampling and chemical analysis protocols.

Invasive pulmonary aspergillosis. MRI, CT, and plain radiographic findings and their contribution for early diagnosis.

A prospective study was conducted in 38 patients with nodular lesions on plain chest radiographs and the clinical suspicion of invasive pulmonary aspergillosis (IPA) to assess the diagnostic accuracy of magnetic resonance imaging (MRI) and computed tomography (CT). For early diagnosis of IPA (clinical signs and symptoms < 10 days), CT scans with demonstration of the halo sign had a high sensitivity (16/22) and specificity (8/8). Magnetic resonance imaging performed at the same time revealed a relatively higher sensitivity (22/22), but a very poor specificity (0/8). Gadolinium-diethylene-triamine-pentaacetic acid (Gd-DTPA) enhanced images did not improve specificity. In the later course of infection (clinical signs and symptoms > 10 days), MRIs showed typical nodular target-like lesions with Gd-DTPA enhancement of the rim area that was not seen in the early course of the disease or in patients with Pseudomonas or staphylococcal infection. In conclusion, MRI findings are not as characteristic as the CT halo sign in diagnosing IPA in the early course of the disease, but the MRI target sign with Gd-DTPA enhancement of the rim area and the "reverse target" on T2-weighted images are strongly suggestive of IPA at a later stage of the disease.

[Value of computer tomography in comparison to mediastinoscopy and test thoracotomy in intrathoracic space-occupying lesions with mediastinal involvement]. / Wertigkeit der Computertomographie im Vergleich zu Mediastinoskopie und Probethorakotomie bei intrathorakalen Raumforderungen mit mediastinaler Beteiligung.

The preoperative CT findings in 50 patients out of a total of 144 examined patients with suspected intrathoracal malignant processes with mediastinal involvement were compared to the results obtained by mediastinoscopy and thoracotomy. There was a high diagnostical reliability (95%, n = 40) in assessing lesions in the area, which can be reached by mediastinoscopy. This leads to the conclusion that mediastinoscopy is necessary only in such cases with histologically proven malignant intrathoracal masses, which show lymph nodes of a size from 1 to 2 cm. The evidence of invasive extension into adjacent mediastinal structures as well as the distance from tumour to carina could be assessed well by CT. For follow-up examinations after resection, radiation therapy or chemotherapy, computed tomography is of particular value to detect early mediastinal recurrence.

[Magnetic resonance tomography of so-called transient osteoporosis. Primary diagnosis and follow-up after treatment]. / Magnetresonanztomographie der sogenannten transitorischen Osteoporose. Primärdiagnostik und Verlaufskontrolle nach Therapie.

Transient osteoporosis or transient bone marrow oedema is a rare cause of acute hip pain that predominantly affects adults of middle and younger age. We report on the MR image in 8 patients with transient bone marrow oedema of the hip and in one patient with affection of the knee joint. In three of these, sympathetic nerve blockade has been performed. The MR image after sympathicolysis is discussed.

[Percutaneous sclerotherapy as primary treatment of testicular insufficiency in idiopathic varicocele]. / Die perkutane Sklerotherapie zur primären Behandlung der Testikularisinsuffizienz bei idiopathischer Varikozele.

Among 1217 percutaneous retrograde phlebographies of the left renal/testicular vein 1069 were performed for primary treatment of left-sided idiopathic varicocele. In 989 of these patients (92.5%) an insufficient testicular (internal spermatic) vein with reflux to the pampiniform plexus could be shown phlebographically, in 802 cases percutaneous sclerotherapy could be performed. This amounts 75.0% of patients with varicocele or 81.1% of the cases with a phlebographically proven testicular vein insufficiency. In this group percutaneous sclerotherapy has proven to be a safe and effective treatment of idiopathic varicocele on an outpatient basis and has replaced surgical ligation as method of choice. However, with anatomical and technical obstacles to sclerotherapy, especially in patients with varicocele but without phlebographic evidence of an insufficient testicular vein, surgery remains an essential means of therapy.

[Cyclophosphamide-induced pneumonitis]. / Cyclophosphamid-induzierte Pneumonitis.

Pneumotoxicity of cyclophosphamide is a rare complication of chemotherapy with this drug. 28 cases have so far been reported in world literature. We add one case in whom lung changes had appeared subacutely, after a single dose of cyclophosphamide, and were reversed by corticoids.

[Value of computerized tomography in the diagnosis of recurrence in malignant head and neck tumors]. / Wertigkeit der Computertomographie in der Rezidivdiagnostik bei malignen Tumoren des Gesichtsschädel-/Halsbereichs.

Among 441 CT scans of 303 patients with a malignant tumor of the head or neck 138 scans of 83 patients were performed for evaluation of recurrent tumor. In diagnosing nodal recurrence computed tomography (CT) had a sensitivity of 92% (52 out of 56) and a specificity of 96% (55 out of 57). In diagnosing recurrence at the primary site sensitivity of 72% (56 out of 77) and specificity of 60% (30 out of 50) was lower and clearly inferior to physical examination with 92 and 88% respectively. CT was very useful in delineating advanced recurrencies, especially in regions that were not readily accessible by physical examination or were indurated by flat scarring. In addition to the complete staging of nodal involvement this makes CT the radiologic method of choice in follow-up of patients with malignant tumors of the head and neck. A post-therapeutic baseline scan obtained 6-8 weeks after surgery resp. radiotherapy is expected to further improve results, especially in differentiating scar from recurrent tumor.

[Evaluation of renal artery stenosis: comparison of angiography and invasive blood pressure measurement and Doppler ultrasound]. / Evaluation von Nierenarterienstenosen: Vergleich von Angiographie mit invasiver Blutdruckmessung und Doppler-Sonographie.

PURPOSE: In the procedure of renal artery angioplasty, the angiographically measured degree of stenosis should be compared with the intraarterial transstenotic blood pressure gradient and pre-interventional Doppler findings. METHODS: In a total of 46 renal arteries in 35 patients with renovascular hypertension, the angiographic-morphological parameters: "linear", "geometric" and "densitometric" degree of stenosis are compared with the invasive transstenotic blood pressure gradient and the pre-interventional Doppler ultrasound. RESULTS: All angiographically determined degrees of stenosis ("linear", "geometric" and "densitometric") correlate--moderately--with the transstenotic blood pressure gradient (correlation coefficients: 0.67 ("linear"), 0.65 ("geometric") and 0.49 ("densitometric"), each versus systolic pressure gradient, respectively). Stenoses that are angiographically classified as "low grade" (< 50%) nevertheless have a high number of high transstenotic pressure gradients: 21 of 22 show systolic values > or = 10 mmHg, 13 of 22 even > or = 30 mmHg. All stenoses Doppler sonographically classified as "high or very high grade" (Vmax,syst > or = 3 m/s) are confirmed by angiography and/or pressure measurement. CONCLUSIONS: Angiography has the tendency to underestimate the degree of renal artery stenosis, especially in "low grade" stenoses (< 50%). However, in those > or = 50% a high transstenotic blood pressure gradient can be taken for granted. If the angiographic degree of stenosis seems uncertain, we recommend measurement of blood pressure gradient.

[A technic of magnetic resonance tomographic pelvimetry in obstetrics]. / Technik der kernspintomographischen Beckenmessung in der Geburtshilfe.

Magnetic resonance imaging (MRL) allows for the first time direct determination of maternal pelvic dimensions without ionising radiation. Phantom measurements and the correlation with traditional pelvimetric measurements in 10 patients after Caesarean section have shown mean differences of +/- 2 mm, with a maximum of 5 mm. The evaluation of pelvic configuration is obtained analogous to the conventional roentgenogram. In addition to conventional or digital x-ray pelvimetry, the soft tissues of the maternal pelvis and the presenting part of the foetus is delineated with high contrast. Positioning in the body coil can be accomplished even late in pregnancy or in impending labour, acceptance by the pregnant women being high. Whereas in a given indication after delivery conventional x-ray pelvimetry continues to be performed, antenatally MRI pelvimetry has now been established in our Departments as the method of choice--based on meanwhile 107 examinations. Present drawbacks are the relatively high cost and the limited availability of MR units.

[Epidural empyema and orbital phlegmon. Computerized tomographic diagnosis of rare complications of sinusitis]. / Epidurales Empyem und Orbitaphlegmone. Computertomographische Diagnostik seltener Sinusitiskomplikationen.

Among 4019 computed tomograms of the head performed in 2 years we found 2 epidural empyemas combined with an ipsilateral orbital phlegmon and one periorbital abscess with an incipient orbital phlegmon. In all 3 patients they turned out to be intracranial or orbital complications of an adjacent paranasal sinusitis. The CT diagnosis was a guideline for further therapy and was verified by immediate surgery. The reliable diagnosis of orbital and intracranial space-occupying lesions makes CT the radiological method of choice in case of suspicion of a complicated sinusitis.

[Radiology of gastrointestinal stromal tumors (GIST) and a case of Carney syndrome]. / Radiologie des gastrointestinalen Stromatumors (GIST). Gleichzeitig ein Beitrag zum Carney-Syndrom.

Gastrointestinal stromal tumors (GIST) represent an extremely rare group of tumors, which are mostly of smooth muscle origin like leiomyomas, leiomyosarcomas and leiomyoblastomas. With the introduction of immunohistochemical analysis an epithelioid and an autonomic nerve variant can be distinguished. The purpose of this review is to demonstrate the image morphological appearance of these rare tumors together with the pathology based upon a retrospective analysis of five of our own cases since 1997. There are no pathognomonic imaging findings for characterizing a gastrointestinal stromal tumor; however, it should be included in the differential diagnosis if one or multiple large, round or oval, well-delineated gastrointestinal tumors occur in combination with central necrosis. Carney's syndrome is characterized by the syndromal association of a gastrointestinal stromal tumor (originally: gastric leiomyosarcoma) with an extra-adrenal paraganglioma and a pulmonary chondroma. In this rare syndrome, the radiological approach is important to diagnose or rule out the--simultaneous or consecutive--appearance of at least two of the three tumor entities (GIST, extra-adrenal paraganglioma, pulmonary chondroma).

[MR tomography of aneurysmal bone cyst]. / MRT der aneurysmalen Knochenzyste.

The preoperative findings of magnetic resonance imaging (MRI) in six histology-proven aneurysmal bone cysts (ABC) are examined and compared with previous publications concerning MRI of ABC. The signal intensities differ considerably, and not all of our cases conform with the literature data. They can be summarised in three different subheadings: one form that is very inhomogeneous in T1- and T2-weighting, with fluid-fluid levels in the cystic spaces; one intermediate form without fluid-fluid levels, which is inhomogeneous only in T2-weighted images; and finally, an unusual form of ABC that has homogeneous low signal both in T1- and T2-weighting, and which has not been described in literature so far.

[RARE-MR urography: a rapid MR tomographic imaging procedure for the diagnosis of urinary tract malformations in childhood]. / RARE-MR-Urographie: ein kernspintomographisches Schnellbildverfahren zur Diagnostik von Harnwegsfehlbildungen im Kindesalter.

RARE-MR urography (so called "water-pictures") is a fast MR imaging technique that selectively depicts fluid without contrast application. Acquisition time is 6.4 s per slice with 1 excitation, or 23 s per slice with 2 averages respectively. From Sept. 1989 to April 1990 24 children with anomalies of the urinary tract have been examined each by RARE MR urography and one T1-weighted spin-echo sequence. Independent of excretory function, the technique can show dilated calices and renal pelvis, pelviureteric obstruction, renal duplication, and megaureter. However, it cannot distinguish between vesicoureteric reflux and obstructive megaureter. Our first results suggest that RARE MR urography combined with ultrasound, reflux cystography and isotope nephrography, can replace excretory urography in certain circumstances--or at least postpone it to the preoperative phase.

Inflammatory and traumatic lesions of the knee and ankle: comparison of 0.23 T and 2 T MRI.

Fifty-six patients with traumatic and 117 patients with inflammatory lesions of the knee and ankle were examined with a 2 T (69 examinations) or 0.23 T (104 examinations) MR system. The quality of all images was assessed by the consensus of three radiologists on a scale of diagnostic (3+, 2+) and nondiagnostic (1+) image quality. More than 90% of images from both systems were diagnostic. However, the proportion of 3+ quality images was significantly higher (p less than 0.001) at the magnetic field strength of 2 T (81% = 56/69 versus 49% = 51/104 at 0.23 T). Motion artifacts were the main cause of reduced image quality independent of field strength. In patients with traumatic and inflammatory diseases of the knee and ankle, high field imaging at 2 T provided better image quality than low field imaging at 0.23 T.

False-positive diagnosis of a pheochromocytoma with I-123 metaiodobenzylguanidine.

The rare case of a false-positive scintiscan with I-123 labelled metaiodobenzylguanidine (MIBG) in a patient with suspected pheochromocytoma is reported. Focal accumulation of the tracer in the upper right abdomen, primarily thought to represent a right-sided pheochromocytoma, was subsequently proven to be caused by an ampullary renal pelvis. In cases of unexplained MIBG accumulation the possibility of prolonged retention of the tracer, because of an abnormality of the renal pelvis, should be considered and excluded by ultrasound.

[Doppler sonography and phlebography in the detection of hemodynamically different varicocele types]. / Doppler-Sonographie und Phlebographie zum Nachweis hämodynamisch unterschiedlicher Varikozelen-Typen.

Using the bidirectional doppler sonography to evaluate patients with varicocele two haemodynamically different types of varicoceles, pressure-type and shunt-type, can be determined. By means of retrograde phlebography of the internal spermatic vein (testicular vein) in 44 patients with varicocele the pathophysiologic-anatomic equivalent of these two types could be demonstrated. Shunting veins are the cremasteric vein and deferential vein. The two types of varicoceles have a different effect on male fertility.

Identification and characterization of urinary prenylamine metabolites by means of liquid chromatography-tandem mass spectrometry.

Prenylamine is a vasodilator of phenylalkylamine structure and was used for the treatment of angina pectoris, until reports of undesirable effects including ventricular tachycardia led to a decreasing use of the drug in the 1980s. Metabolic N-dealkylation of orally ingested prenylamine can liberate amphetamine in humans and cause positive findings for amphetamine in doping and forensic analysis. In 2010, the World Anti-Doping Agency (WADA) classified prenylamine as a non-specified stimulant according to the 2010 Prohibited List, thus banning its use in sports in-competition. Supporting the development of a liquid chromatography-tandem mass spectrometry (LC-MS/MS) based detection method, a post-administration urine sample following a single oral prenylamine ingestion (Segontin(®) 60 mg) was analyzed for urinary metabolites. The LC-separated analytes were ionized in positive electrospray ionization (ESI) mode and detected as protonated ions using an AB Sciex TripleTOF 5600 quadrupole-time-of-flight hybrid mass spectrometer. Over 40 phase I metabolites were detected, including previously unknown mono- bis-, tris- and tetra-hydroxylated prenylamine, several hydroxylated and methoxylated prenylamine metabolites and (hydroxylated) diphenylpropylamine. Investigation of the collision-induced dissociation behaviours of the metabolites by high resolution/high accuracy mass spectrometry allowed for the assignment of the nature and the site of observed metabolic transformations. The most abundant phase I metabolite was confirmed as p-hydroxy-prenlyamine by chemical synthesis and stable isotope labelling of reference material. An existing routine screening assay based on direct injection and LC-MS/MS analysis of urine was modified and validated according to common guidelines, in order to allow for the detection of p-hydroxy-prenylamine in sports drug testing. The assay demonstrated the ability to detect the target metabolite at 0.1 ng/ml at intra- and inter-day imprecisions below 10%.

High-throughput screening for various classes of doping agents using a new 'dilute-and-shoot' liquid chromatography-tandem mass spectrometry multi-target approach.

A new multi-target approach based on liquid chromatography--electrospray ionization tandem mass spectrometry (LC-(ESI)-MS/MS) is presented to screen for various classes of prohibited substances using direct injection of urine specimens. With a highly sensitive new generation hybrid mass spectrometer classic groups of drugs--for example, diuretics, beta2-agonists--stimulants and narcotics are detectable at concentration levels far below the required limits. Additionally, more challenging and various new target compounds could be implemented. Model compounds of stimulant conjugates were studied to investigate a possible screening without complex sample preparation. As a main achievement, the integration of the plasma volume expanders dextran and hydroxyethyl starch (HES), commonly analyzed in time-consuming, stand-alone procedures, is accomplished. To screen for relatively new prohibited compounds, a common metabolite of the selective androgen receptor modulator (SARMs) andarine, a metabolite of growth hormone releasing peptide (GHRP-2), and 5-amino-4-imidazolecarboxyamide ribonucleoside (AICAR) are analyzed. Following a completely new approach, conjugates of di(2-ethylhexyl) phthalate (DEHP) metabolites are monitored to detect abnormally high levels of plasticizers indicating for illicit blood transfusion. The assay was fully validated for qualitative purposes considering the parameters specificity, intra- (3.2-16.6%) and inter-day precision (0.4-19.9%) at low, medium and high concentration, robustness, limit of detection (1-70 ng/ml, dextran: 30 µg/ml, HES: 10 µg/ml) and ion suppression/enhancement effects. The analyses of post-administration and routine doping control samples demonstrates the applicability of the method for sports drug testing. This straightforward and reliable approach accomplishes the combination of different screening procedures resulting in a high-throughput method that increases the efficiency of the labs daily work.