Interaction of therapeutic12C ions with bone-like targets: physical characterization and dosimetric effect at material interfaces.

Carbon therapy is a promising treatment option for cancer. The physical and biological properties of carbon ions can theoretically allow for the delivery of curative doses to the tumor, while simultaneously limiting risks of toxicity to adjacent healthy structures. The treatment effectiveness can be further improved by decreasing the uncertainties stemming from several sources, including the modeling of tissue heterogeneity. Current treatment plans employ density-based conversion methods to translate patient-specific anatomy into a water system, where dose distribution is calculated. This approach neglects differences in nuclear interactions stemming from the elemental composition of each tissue. In this work, we investigated the interaction of therapeutic carbon ions with bone-like materials. The study concentrated on nuclear interactions and included attenuation curves of 200 and 400 AMeV beams in different types of bones, as well as kinetic energy spectra of all charged fragments produced up to 29 degrees from the beam direction. The comparison between measurements and calculations of the treatment planning system TRiP98 indicated that bone tissue causes less fragmentation of carbon ions than water. Overall, hydrogen and helium particles were found to be the most abundant species, while heavier fragments were mostly detected within 5 degrees from the beam direction. We also investigated how the presence of a soft tissue-bone interface could affect the depth-dose profile. The results revealed a dose spike in the transition region, that extended from the entry channel to the target volume. The findings of this work indicated that the tissue-to-water conversion method based only on density considerations can result in dose inaccuracies. Tissue heterogeneity regions containing bones can potentially produce dose spikes, whose magnitude will depend on the patient anatomy. Dose uncertainties can be decreased by modeling nuclear interactions directly in bones, without applying the tissue-to-water conversion.

Expression of odorant-binding proteins in mouthpart palps of the desert locust Schistocerca gregaria.

Odorant-binding proteins (OBPs) are essential molecular elements of the insect chemosensory system, which is composed of the antennae and the mouthpart palps (maxillary and labial). In this study, we have analysed the expression and the sensilla specificity of 14 OBP subtypes in the palps of the desert locust Schistocerca gregaria. The locust palps comprise only a low number of sensilla basiconica but a high number of sensilla chaetica. Employing a variety of approaches, we found that only a subset of the antennal OBP repertoire was expressed in both palp types. These OBPs were previously shown to be expressed either in sensilla basiconica or sensilla chaetica of the antennae. Comparing the expression pattern in the two chemosensory organs revealed similarities and differences; most remarkably, two OBP subtypes, OBP6 and OBP8, were found in both sensilla types on palps, whereas on the antennae they were solely expressed in one sensillum type. Together, the data indicate a differential, but partly overlapping, expression of OBPs in the two sensilla types of the palps. The differences in the expression pattern of OBP subtypes between antennae and palps might be indicative for distinct functions of the OBPs in the two chemosensory organs.

Discovering and quantifying nontrivial fixed points in multi-field models.

We use the functional renormalization group and the [Formula: see text]-expansion concertedly to explore multicritical universality classes for coupled [Formula: see text] vector-field models in three Euclidean dimensions. Exploiting the complementary strengths of these two methods we show how to make progress in theories with large numbers of interactions, and a large number of possible symmetry-breaking patterns. For the three- and four-field models we find a new fixed point that arises from the mutual interaction between different field sectors, and we establish the absence of infrared-stable fixed-point solutions for the regime of small [Formula: see text]. Moreover, we explore these systems as toy models for theories that are both asymptotically safe and infrared complete. In particular, we show that these models exhibit complete renormalization group trajectories that begin and end at nontrivial fixed points.

Stability of fixed points and generalized critical behavior in multifield models.

We study models with three coupled vector fields characterized by O(N_{1})⊕O(N_{2})⊕O(N_{3}) symmetry. Using the nonperturbative functional renormalization group, we derive ß functions for the couplings and anomalous dimensions in d dimensions. Specializing to the case of three dimensions, we explore interacting fixed points that generalize the O(N) Wilson-Fisher fixed point. We find a symmetry-enhanced isotropic fixed point, a large class of fixed points with partial symmetry enhancement, as well as partially and fully decoupled fixed-point solutions. We discuss their stability properties for all values of N_{1},N_{2}, and N_{3}, emphasizing important differences to the related two-field models. For small numbers of field components, we find no stable fixed-point solutions, and we argue that this can be attributed to the presence of a large class of possible (mixed) couplings in the three-field and multifield models. Furthermore, we contrast different mechanisms for stability interchange between fixed points in the case of the two- and three-field models, which generically proceed through fixed-point collisions.

[Vitamin D for prevention of diseases?]. / Vitamin D zur Prävention von Erkrankungen?

Vitamin D3 shows a multitude of possible preventive effects in various diseases. Calcitriol, the biologically active form of vitamin D3, affects not only bone metabolism but also acts on the renal renin secretion, the pancreatic insulin production in the beta cells, growth and proliferation of smooth and cardiac muscle cells and the function of lymphocytes and macrophages. Although the human body can synthesise vitamin D3 itself, vitamin D deficiency is common in the German population. Numerous trials studied the association between vitamin D deficiency and different diseases. It is known that even mild forms of vitamin D deficiency increase the risk for cardiovascular diseases or diabetes mellitus. Furthermore, an association with cancer such as pancreatic or colorectal cancer was observed. This is attributed to the influence of vitamin D on cell differentiation, angiogenesis, DNA repair mechanisms and the transcription of numerous genes. In addition, effects of vitamin D deficiency in diseases such as Parkinson's disease, multiple sclerosis and autoimmune diseases are discussed. However, up to now the level of evidence of all these observations is low. There are missing confirmatory randomized controlled trials. Noting the possible preventive effects of vitamin D, a moderate exposure to sunlight to increase vitamin D synthesis can be recommended. Even a controlled supplementation of vitamin D in patients with vitamin D deficiency is considered as reasonable. However, an uncritical substitution of high-dose vitamin D should be avoided because of the risk of hypercalcaemia.

[Chronic dizziness in a pain patient--pharmacogenomic identification of tramadol as cause]. / Chronischer Schwindel bei einem Schmerzpatienten--pharmakogenomische Identifizierung von Tramadol als Ursache.

This casuistic reports on a 59-year-old pain patient taking normal dosage Tramadol as analgetic drug, who suffered from chronic dizziness leading to immobilisation for more than 9 months. On admission to inpatient rehabilitation Tramadol was removed in exchange for morphine sulphate with the unexpected result of a prompt and lasting stop of dizziness. A molecular-genetic investigation showed a duplication in the CYP2D6 gene. This genetic situation caused a quick metabolizing-status for substances dependent on CYP2D6 like Tramadol, which is a prodrug. The quick metabolizing-status resulted in an increased rate of active Tramadol-metabolites which caused the chronic dizziness. Under morphine sulphate which is metabolized independently of CYP2D6, a sufficient analgetic outcome could be achieved. Dizziness did not appear in the patient any longer, and he could be mobilised during rehabilitation. Pharmacogenomic knowledge has helped develop a sustainable concept for rehabilitation of this seriously ill patient, and to put it into practise successfully.

[MRSA hygiene in inpatient rehabilitation on the example of oncological rehabilitation--a position paper]. / MRSA-Hygiene in der stationären Rehabilitation am Beispiel der onkologischen Rehabilitation - Ein Positionspapier

Infections and colonizations with methicillin resistant staphylococcus aureus (MRSA) are an increasing problem in German hospitals because they spread there more and more. In homes without predominant nursing care and without hospital-like medical care of the inhabitants, genotypically identical MRSA-strains are rarely found in room neighbours up to now. The recommendations on prevention and control of MRSA published by the Robert Koch-Institut (RKI) therefore are partially discrepant for these two fields. The setting in rehabilitation medical centres, from hygienic points of view, is in many respects similar to a medical practice or a home with predominantly independent inhabitants rather than to a hospital for patients with acute diseases. For an effective and humane stationary rehabilitation of patients with MRSA colonisation it would be desirable to define conditions under which the strict isolation-hygiene prescribed for acute hospitals could be deviated from, following e. g., the RKI recommendations for homes instead. With the input of a summary of the clinical relevance of MRSA and a comparison of both partly identical, partially however very different RKI-recommendations on prevention and control of MRSA the present article seeks to characterize the hygienic setting in (particularly oncological) stationary rehabilitation under the above aspects. A series of recommendations on MRSA hygiene in stationary rehabilitation follows, which depending on the risk profile involved is based partially on the RKI guidelines for hospitals, partially however, on the guidelines for homes. The recommendations have a preliminary character without claiming completeness or the rank of a guideline. They are intended to focus on a problem which arises more and more frequently also in rehabilitation centers. They can, in the individual case, provide a useful help for the practice in stationary rehabilitation particularly as there are no publications on the subject of MRSA hygiene so far which meet the circumstances in stationary rehabilitation in a different manner.

Denervation facilitates neuronal growth in the motor cortex of rats in the presence of behavioral demand.

This study tests the hypothesis that degeneration of a neocortical pathway may facilitate behaviorally-induced growth of neurons in a connected region of the cortex. Degeneration of trancallosal afferents to the motor cortex and changes in forelimb use were independently manipulated in adult rats. The combination of degeneration and behavioral change resulted in the growth of layer V pyramidal neuron dendrites which was not found as a result of either denervation or behavioral manipulation alone. These results indicate that mild degeneration in the adult brain can facilitate neuronal growth when accompanied by appropriate behavioral demand, a finding which has implications for rehabilitative therapy after brain damage.

Reactive astrocytic responses to denervation in the motor cortex of adult rats are sensitive to manipulations of behavioral experience.

Recent research has suggested that mild denervation of the neocortex of adult rats may facilitate neuronal growth in response to behavioral changes. Astrocytes react to denervation, produce growth-promoting factors and are a potential mediator of this denervation-facilitated growth. The present study assessed whether astrocytic reactions to denervation vary dependent upon post-injury behavioral experience. Denervation of the transcallosal afferents to the motor cortex was induced via partial transections of the corpus callosum. Transected- or sham-operated rats were then either forced to use the opposite forelimb (via limb-restricting vests) or permitted to use both forelimbs normally for 8 days. In the motor cortex, the surface density of glial fibrillary acidic protein (GFAP)-immunoreactive (IR) astrocytic processes and the density of basic fibroblast growth factor (FGF-2)-IR glial cells was significantly increased as a result of transections alone and as a result of forced forelimb-use alone in comparison to controls. The combination of transections and forced-use significantly enhanced GFAP-IR in comparison to all other groups, but did not further enhance FGF-2-IR. These findings are consistent with behavior and denervation having interactive influences on astrocytic reactivity in the motor cortex. These results also raise the possibility that astrocyte-mediated support of neural restructuring after brain injury might be enhanced with appropriate post-injury behavioral manipulations.

[Sicca symptoms and hearing loss in Behçet's syndrome]. / Sicca-Symptomatik und Hörverlust beim Behçet-Syndrom.

HISTORY AND ADMISSION FINDINGS: A 39-year-old woman sustained an irreversible hearing loss in the left ear, followed 6 months later by a left facial paresis. Oral aphthous ulcers frequently recurred with fever of up to 39.5 degrees C. Her general condition was noticeably poor. INVESTIGATIONS: An inflammatory disease was suggested by an increased erythrocyte sedimentation rate (70/100 mm), leucocytosis (18,500/microliter), decreased haemoglobin (10.2 g/l) and leftward shift of the neutrophil granulocytes. Diagnostic tests for an infectious, autoimmune or haemato-oncological disease were negative. TREATMENT AND COURSE: Antibiotic and antimycotic treatment failed to bring lasting improvement. Thrombophlebitis and venous thrombosis developed in both upper limbs and acute episcleritis (scleritis) in the left eye. Behçet's disease with oral, ocular, neurological, cutaneous and vascular involvement was diagnosed and treated with chlorambucil (variable dosage around 7 mg/d orally), with rapid regression of symptoms. 3 months later joint pains set in, and another 18 months later she developed sicca symptoms (xerostomia with dry eyes): both responded to symptomatic treatment. CONCLUSION: The combination of loss of hearing, sicca syndrome and Behçet's syndrome has not been previously reported.

Activity of new macrolides against Bordetella pertussis and Bordetella parapertussis.

MICs and MBCs of four new macrolides (azithromycin, clarithromycin, dirithromycin and roxithromycin) and two older macrolides (erythromycin and josamycin) for Bordetella pertussis and Bordetella parapertussis were determined. The activity of the new macrolides was as good as that of erythromycin, while josamycin was slightly less active. Bordetella parapertussis was more resistant than Bordetella pertussis.