The effects of surface electrical stimulation plus voice therapy in Parkinson's disease.

OBJECTIVE: This study aimed to assess the effects of surface electrical stimulation plus voice therapy on voice in dysphonic patients with idiopathic Parkinson's disease. METHOD: Patients were assigned to 3 treatment groups (n = 28 per group) and received daily treatment for 3 weeks on 5 days a week. All three groups received voice therapy (usual care). In addition, two groups received surface electrical stimulation, either motor-level or sensory-level stimulation. A standardised measurement protocol to evaluate therapeutic effects included the Voice Handicap Index and videolaryngostroboscopy. RESULTS: Voice Handicap Index and videolaryngostroboscopic assessment showed statistically significant differences between baseline and post-treatment across all groups, without any post-treatment differences between the three groups. CONCLUSION: Intensive voice therapy (usual care) improved idiopathic Parkinson's disease patients' self-assessment of voice impairment and the videolaryngostroboscopic outcome score. However, surface electrical stimulation used as an add-on to usual care did not improve idiopathic Parkinson's disease patients' self-assessment of voice impairment or the videolaryngostroboscopic outcome scores any further.

Malnutrition risk and oropharyngeal dysphagia in the chronic post-stroke phase.

Background: Oropharyngeal dysphagia (OD) and malnutrition are associated with poor clinical outcomes after stroke. The present study evaluated (1) malnutrition risk and OD-related characteristics in patients with chronic post-stroke OD, and (2) the relationship between on the one hand OD severity and on the other hand functional oral intake and dysphagia-specific quality of life. Methods: A cross-sectional study was conducted in a Dutch interdisciplinary outpatient clinic for OD. The standardized examination protocol comprised: clinical ear, nose, and throat examination, body mass index, the short nutritional assessment questionnaire (SNAQ), a standardized fiberoptic endoscopic evaluation of swallowing (FEES), the functional oral intake scale (FOIS), and the MD Anderson dysphagia inventory (MDADI). Results: Forty-two consecutive patients with chronic post-stroke OD were included. Mean (±SD) age and BMI of the population were 69.1 (±8.7) years and 26.8 (±4.1) kg/m2 respectively. Seventeen (40.4%) patients presented a moderate to high risk of malnutrition (SNAQ score≥2). The FEES examination showed moderate to severe OD in 28 (66.7%) patients. The severity of OD was significantly related to the FOIS score but not to the MDADI scores. Conclusion: In this specific sample of referred stroke patients, moderate to severe OD and moderate to high risk of malnutrition were common. Despite the use of clinical practice guidelines on stroke and a normal nutritional status at first sight, repeated screening for malnutrition and monitoring the severity and management of OD remain important elements in the care of patients with chronic post-stroke OD.

Swallowing Assessment in Parkinson's Disease: Patient and Investigator Reported Outcome Measures are not Aligned.

This study determines the relationship between patient and investigator reported outcome measures (PROMs versus IROMs) on oropharyngeal dysphagia (OD) in Parkinson's disease (PD). The PROMs used are the MD Anderson Dysphagia Inventory (MDADI) and the Dysphagia Severity Scale (DSS). The IROMs used are fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopy of swallowing (VFS). Ninety dysphagic PD patients were included. Multilayer perceptron (MLP) neural network analysis was used to investigate the relationship between PROMs and IROMs on OD in PD. MLP neural network analysis showed a moderate agreement between PROMs and IROMs, with an area under the curve between 0.6 and 0.7. Two-step cluster analysis revealed several clusters of patients with similar scores on FEES and/or VFS variables, but with significant different scores on MDADI and DSS variables. This study highlights that there are PD patients with similar FEES and/or VFS findings that cannot be lumped together under the same pathophysiological umbrella due to their differences in PROMs. Since the exact origin of these differences is not fully understood, it seems appropriate for the time being to take into account the different dimensions of OD during the swallowing assessment so that they can be included in a patient-tailored treatment plan.

Polyatomic ions from a high current ion implanter driven by a liquid metal ion source.

High current liquid metal ion sources are well known and found their first application as field emission electric propulsion thrusters in space technology. The aim of this work is the adaption of such kind of sources in broad ion beam technology. Surface patterning based on self-organized nano-structures on, e.g., semiconductor materials formed by heavy mono- or polyatomic ion irradiation from liquid metal (alloy) ion sources (LMAISs) is a very promising technique. LMAISs are nearly the only type of sources delivering polyatomic ions from about half of the periodic table elements. To overcome the lack of only very small treated areas by applying a focused ion beam equipped with such sources, the technology taken from space propulsion systems was transferred into a large single-end ion implanter. The main component is an ion beam injector based on high current LMAISs combined with suited ion optics allocating ion currents in the µA range in a nearly parallel beam of a few mm in diameter. Different types of LMAIS (needle, porous emitter, and capillary) are presented and characterized. The ion beam injector design is specified as well as the implementation of this module into a 200 kV high current ion implanter operating at the HZDR Ion Beam Center. Finally, the obtained results of large area surface modification of Ge using polyatomic Bi2+ ions at room temperature from a GaBi capillary LMAIS will be presented and discussed.

Liquid metal alloy ion source based metal ion injection into a room-temperature electron beam ion source.

We have carried out a series of measurements demonstrating the feasibility of using the Dresden electron beam ion source (EBIS)-A, a table-top sized, permanent magnet technology based electron beam ion source, as a charge breeder. Low charged gold ions from an AuGe liquid metal alloy ion source were injected into the EBIS and re-extracted as highly charged ions, thereby producing charge states as high as Au(60 +). The setup, the charge breeding technique, breeding efficiencies as well as acceptance and emittance studies are presented.

GaBi alloy liquid metal ion source for microelectronics research.

A GaBi alloy liquid metal ion source has been studied. From an analysis of the source mass spectra as a function of emission current, a mechanism is suggested for the production of single- and double-charged ions. There is good agreement with the results of Swanson's investigations of a pure Bi source.

Traceability in fluorometry--Part I: Physical standards.

The inter-instrument, inter-laboratory, and long-term comparability of fluorescence data requires the correction of the measured emission and excitation spectra for the wavelength- and polarization-dependent spectral irradiance of the excitation channel at the sample position and the spectral responsivity of the emission channel employing procedures that guarantee traceability to the respective primary standards. In this respect the traceability chain of fluorometry is discussed from a radiometrist's point of view. This involves, in a first step, the realization of the spectral radiance scale, based on the blackbody radiator and electron storage ring, and the spectral responsivity scale, based on the cryogenic radiometer and their control via key comparisons of the national metrology institutes. In a second step, the characterization including state-of-the art uncertainties of the respective source and detector transfer standards such as tungsten strip lamps, integrating sphere radiators, and trap detectors used to disseminate these radiometric quantities to users of spectroscopic techniques is presented.

Traceability in fluorometry: Part II. Spectral fluorescence standards.

The need for the traceable characterization of fluorescence instruments is emphasized from a chemist's point of view, focusing on spectral fluorescence standards for the determination of the wavelength- and polarization-dependent relative spectral responsivity and relative spectral irradiance of fluorescence measuring systems, respectively. In a first step, major sources of error of fluorescence measurements and instrument calibration are revealed to underline the importance of this issue and to illustrate advantages and disadvantages of physical and chemical transfer standards for generation of spectral correction curves. Secondly, examples for sets of traceable chemical emission and excitation standards are shown that cover a broad spectral region and simple procedures for the determination of corrected emission spectra with acceptable uncertainties are presented. With proper consideration of the respective measurement principle and geometry, these dye-based characterization procedures can be not only applied to spectrofluorometers but also to other types of fluorescence measuring systems and even to Raman spectrometers.

[Work profile of social work in inpatient psychotherapy. Clinical fields and social rights implications]. / Das Tätigkeitsprofil der Sozialarbeit in der stationären Psychotherapie. Klinische Arbeitsfelder und sozialrechtliche Implikationen.

OBJECTIVES: The task profile of social work in (acute) inpatient psychotherapy--unlike psychiatric inpatient treatment--is only fragmentarily described by the so-called Psychiatrie-Personalverordnung (Psych-PV). The aim of the present investigation was, therefore, to provide valid and representative data to define its respective scope of duties. METHODS: During a prospective one-year assessment at the Department of Psychotherapy and Behavioral Medicine at the Philipps-University of Marburg/Germany, we recorded corresponding data of social work referring to three areas of interest, i.e., "education and occupation", "housing and family", and "psychotherapy support". RESULTS: Our data suggest a broad overlap with the corresponding task profile of social work at psychiatric hospitals, which clearly differs, however, from the more therapeutical approach in social work as practiced in Anglo-American countries. CONCLUSIONS: Our findings stress the need for a re-evaluation of social work in inpatient psychotherapy concerning its specific task profile and the respective time values.

[Efficiency criteria and priorities in school age pedodontic care]. / Uber Bewertungskriterien und Schwerpunkte kinderstomatologischer Betreuung im Schulalter.

On the basis of findings in 1200 individuals aged between 7 to 16 years, the authors indicate priorities of dental care in the different age-groups. Apart from other criteria, the readiness for treatment and the disciplined behaviour of the children and adolescents during treatment may be used for assessing the dentist's achievements.

Models for metal-sulfur coordination in copper proteins.

The oxidation state of copper in several model compounds containing copper coordinated to sulfur, some of which are suggested model compounds for naturally occurring Cu-S chromophores, was determined employing x-ray photoelectron spectrometry. Copper was found to be present in a 3d10 state, which is characteristic for Cu(I). An initial photoreduction is excluded, as Cu(ethylenediamine)2 (SCN)2, in which a Cu-S bond is also present, was found to contain Cu(II) (3d9). As was the case with native parsley plastocyanin, the model compounds reacted effectively with superoxide anion radicals. We suggest that the electrons of the metal-sulfur chromophore in blue copper proteins are delocalized and that an equilibrium: RS--Cu(II) in equilibrium or formed from RS.Cu(I) exists.

[Fluorescence microscopic studies on the beginning of the mineralization of rat incisors]. / Fluoreszenzmikroskopische Untersuchungen des Mineralisationsbeginns von Rattennagezähnen.

Histologic and fluorescence microscopic studies were performed on labelled calcium complexes to determine the beginning of the mineralization of rat incisors. The period of the first indications of tooth mineralization at the end of the 20th day of embryonic life is described in detail, special attention being paid to single hard tissue components.

[Rapid diagnosis of carbon monoxide poisoning and quantitative determination of CO-Hb in blood]. / Schnelldiagnose von "Kohlenmonoxidvergiftungen" und Quantitative Bestimmung von CO-Hb in Blut.

A quick diagnosis of carbon monoxide poisoning is a very difficult clinical problem. This paper describes a photometric method which permits a reliable diagnosis in a time of 7 to 10 minutes. Only 0.3 ml whole blood are necessary for the total procedure. Carboxyhemoglobin changes in absorption maximum slightly after reduction, whereas Oxyhemoglobin shows a significant change in extinction. Measurement of the hemolysate at the same wave length before and after alkaline reduction results in large differences in the extinctions (very large for Oxyhemoglobin and very small for Carboxyhemoglobin). Calibration curves are prepared by calibrating rest-extinction defined as: (formula: see text) to percent Carboxyhemoglobin. This curve can also be produced in mathematical way (as control e.g.). In practice there are the following steps: blood collecting (from fingerpad), hematolysis, first photometric measurement, reduction, second measurement, then reading the result from the calibration curve. The method can be automated (as demonstrated with the "Gilford System") providing the same results as with the manual method. All steps of quality control are given in full detail; as is the preparation of the hemolysates with various percentages of Carboxyhemoglobin.

[Changes in microhardness of hard dental tissues of rabbits after internal medication of antibiotics (author's transl)]. / Vernderungen der Mikrohärte der Zahnhartgewebe des Kaninchens nach internen Antibiotikagaben.

Comparative Vickers hardness measurements on hard dental tissues mineralized under normal conditions and under the influence of antibiotic substances showed substance-and dose-dependent variations in quality of superficial enamel and dentine. They were found to correlate with other physicochemical properties (acid solubility) and must be considered as belonging to what is generally referred to as structural anomalies. - Consequently, the administration of antibiotics to babies and young children should be reexamined because of possible late effects.

[On the acid solubility of the dental enamel of rabbits after internal administration of various antibiotic substances (author's transl)]. / Uber die Säurelöslichkeit der Zahnhartgewebe des Kaninchens nach interner Applikation verschiedener Antibiotika.

Sections of etched enamel and dentinal surfaces were examined to compare the acid solubility of normal hard tissue and determine the effects of various antibiotic substances. Considerable differences were observed, of which the correlation with cariogenesis and with the progression of caries are being discussed in detail. The results of this study show that treatment with antibiotics may lead to reductions in quality in infants, young children, and nursing mothers.

[Does dental care influence the progression of caries in children and adolescents?]. / Beeinflusst die Gebisssanierung den Karieszuwachs bei Kindern und Jugendlichen?

The caries-statistical date from 1.500 subjects aged between 7 and 16 years showed that the caries incidence in children and adolescents who had received complete dental treatment was by 31% lower, after two years, than that in children and adolescents who had not received complete dental treatment. Thus, the restorative functions of single fillings are completed by a complex preventive aspect.

[Studies of the permeability of human dentin Part I: Basic studies of constant physiological parameters and experimental variables (author's transl)]. / Permeabilitätsstudien am menschlichen Dentin I. Teil: Basisuntersuchung physiologisch konstanter Parameter und experimenteller Variabler.

Diffusion processes proceeding in the dentin are of fundamental scientific interest and of major importance to numerous therapeutical measures, with the permeability of dentin playing an essential role. Their exact quantitative determination is possibly in vitro only and depends upon various factors. Relevant investigative results obtained using standardized parameters and the methods employed are subjected to a critical analysis and interpreted with regard to the possibility of using them for specific comparative studies. The results reported in this paper are only indirectly applicable to clinical studies. However, they can considered a useful starting point for further studies.