[Typical emergencies in otorhinolaryngology-a monocentric analysis of the seasonal course]. / Typische Notfälle in der Hals-Nasen-Ohren-Heilkunde ­ eine monozentrische Evaluation über den jahreszeitlichen Verlauf.

BACKGROUND: The incidence of acute ear, nose, and throat (ENT) diagnoses is influenced by multiple parameters, for example meteorological and seasonal influences. By better understanding the triggering factors, prophylactic approaches can be developed. MATERIALS AND METHODS: A retrospective analysis was performed over 6 years of all patients who presented to the university hospital because of typical and minor ENT emergencies. The diagnoses impacted cerumen, acute otitis media, acute otitis externa, nasal bone fracture, epistaxis, acute tonsillitis, acute rhinosinusitis, and peritonsillar abscess were analyzed. RESULTS: A total of 32,968 cases were analyzed. Epistaxis was the most common of the investigated emergency diagnoses, accounting for 24.5% (8082 cases). Epistaxis, acute otitis media, and acute rhinosinusitis occurred significantly more frequently in the colder half of the year. There was no significant correlation of the incidence of nasal bone fracture with public holidays. Acute otitis externa correlated significantly with the local summer vacations. In calendar week 38, the fewest total emergency presentations occurred, whereas in calendar week 52, the most emergency presentations occurred. CONCLUSION: Seasonal and meteorological factors play a significant role in the pathogenesis of many emergency ENT diagnoses.

Evaluation of the use of a tablet computer with a high-resolution display for interpreting emergency CT scans.

PURPOSE: Evaluation of the potential usability of an iPad 3 with a high-resolution display in CT emergency diagnosis compared to a 3 D PACS workstation. MATERIALS AND METHODS: 3 readers used a 5-point Likert scale to evaluate 40 CCT scans and 40 CTPA scans to determine the detectability of early signs of infarction in CCT or segmental and subsegmental pulmonary embolisms in CT angiography of the pulmonary arteries (CTPA) on the iPad 3 (Apple Inc., USA) using an application for image viewing (Visage Ease, Visage Imaging GmbH, Berlin) and on a 3 D PACS workstation (Visage 7.1, Visage Imaging, Berlin) using a certified monitor for image viewing. The results were compared using the Wilcoxon rank sum test, Spearman's correlation coefficient, and a kappa statistic. RESULTS: There was no significant difference in the median evaluations for the readings of both the CCT scans and the CTPA scans on the iPad 3 and on the workstation (p > 0.05) for all three readers. The mean Spearman's correlation coefficient for CCT and CTPA was 0.46 (± 0.2) and 0.69 (± 0.16), respectively, for the comparison iPad/PACS, 0.41 (± 0.16) and 0.68 (± 0.06), respectively, for the interobserver agreement on the iPad, and 0.35 (± 0.05) and 0.68 (± 0.10), respectively, for the interobserver agreement on the PACS. Mean kappa values for CCT of 0.52 (± 0.17) for the comparison iPad/PACS and 0.33 (± 0.16) and 0.32 (± 0.16), respectively, for the interobserver agreement on the iPad and the PACS were achieved. For CTPA average kappa values of 0.67 (± 0.19) were calculated for the comparison iPad/PACS and 0.69 (± 0.08) and 0.60 (± 0.14), respectively, for the interobserver concordance on the iPad 3 and the PACS. All differences were not statistically significant (p > 0.05). CONCLUSION: The variability of the interpretation of typical emergency scans on an iPad 3 with a high-resolution display and on a 3 D PACS workstation does not differ from the interobserver variability.

Tools for flash-photolysis experiments on voltage-clamped muscle fibre segments.

An experimental set-up is described that allows the combination of rapid transmembrane voltage changes and photometric calcium recording with the fast photochemical turnover of substances applied externally or intracellularly to cut skeletal muscle fibres. It consists of a double-vaseline-gap system, designed for use with a xenon-flash-lamp device and a dual-wavelength microscope photometer. The pools of the vaseline gap chamber that contain the solutions surrounding the cut ends and the voltage-clamped segment of the muscle fibre are closed and have volumes of 20-50 microl. Thin tubes allow rapid solution change or continuous perfusion in the chamber compartments. Accessory tools were constructed to simplify focussing and measuring the flash-light intensity. A pilot light delivered from a red laser diode is used as a guide beam to target the ultraviolet (UV) flash to the preparation. The light distribution in the focal region and the relative changes in flash intensity with increasing numbers of flashes were quantified with an instrument that integrates the photo-current of a UV-sensitive silicon diode. The function of the set-up was demonstrated by measuring the efficiency of Ca2+ release from DM-nitrophen in quartz capillaries using the Ca(2+)-sensitive dye antipyrylazo III and by recording the flash-induced recovery of L-type calcium currents in muscle fibres blocked by the light-sensitive dihydropyridine drug nifedipine.

[The occurrence of enterotoxigenic Clostridium perfringens strains in the feces of dogs and cats]. / Zum Vorkommen enterotoxinbildender Clostridium-perfringens-Stämme im Kot von Hunden und Katzen.

A total of 147 faecal specimen of dogs and cats was examined with cultural method for the occurrence of Cl. perfringens and its enterotoxin by using a reversed passive latex agglutination test (Pet-RPLA). Cl. perfringens could be detected in 77.9% of the samples of dogs (n = 68) and 65.6% of cats (n = 32) with diarrhoea in germ counts of 10(4)-10(10) cfu/g faeces. In the group of non diarrhoeic dogs (n = 39) and cats (n = 8) Cl. perfringens was found in 53.9% and 50% of the samples, the germ counts revealed 10(4)-10(8) cfu/g faeces. The enterotoxin of Cl. perfringens was detected in 48.5% of the samples of dogs and 28.1% of cats with diarrhoea. On the other hand this toxin could not be detected in any faecal specimen of non diarrhoeic animals. The in vitro detection of Cl. perfringens enterotoxin was successful at 65% of 20 strains, that had been isolated from faecal samples with enterotoxin. Also 2 Cl. perfringens strains isolated from faeces of non diarrhoeic dogs proved to be enterotoxigenic. The present test results given reason to believe that enterotoxigenic Cl. perfringens strains are involved in the complex of enteric disease of dogs and cats.