Publisher Correction: Dimensionally and environmentally ultra-stable polymer composites reinforced with carbon fibres.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Publisher Correction: Dimensionally and environmentally ultra-stable polymer composites reinforced with carbon fibres.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Dimensionally and environmentally ultra-stable polymer composites reinforced with carbon fibres.

The quest to develop materials that enable the manufacture of dimensionally ultra-stable structures for critical-dimension components in spacecraft has led to much research over many decades and the evolution of carbon fibre reinforced polymer materials. This has resulted in structural designs that feature a near-zero coefficient of thermal expansion. However, the dimensional instabilities that result from moisture ingression and release remain the fundamental vulnerability of the matrix, which restricts many applications. Here, we address this challenge by developing a space-qualifiable physical surface barrier that blends within the mechanical properties of the composite, thus becoming part of the composite itself. The resulting enhanced composite features mechanical integrity and a strength that is superior to the underlying composite, while remaining impervious to moisture and outgassing. We demonstrate production capability for a model-sized component for the Sentinel-5 mission and demonstrate such capability for future European Space Agency (ESA) and National Aeronautics and Space Administration (NASA) programmes such as Copernicus Extension, Earth Explorer and Science Cosmic Visions.

[Diagnostic imaging of breast cancer : An update]. / Bildgebende Diagnostik des Mammakarzinoms : Ein Update.

Advances in imaging of the female breast have substantially influenced the diagnosis and probably also the therapy and prognosis of breast cancer in the past few years. This article gives an overview of the most important imaging modalities in the diagnosis of breast cancer. Digital mammography is considered to be the gold standard for the early detection of breast cancer. Digital breast tomosynthesis can increase the diagnostic accuracy of mammography and is used for the assessment of equivocal or suspicious mammography findings. Other modalities, such as ultrasound and contrast-enhanced magnetic resonance imaging (MRI) play an important role in the diagnostics, staging and follow-up of breast cancer. Percutaneous needle biopsy is a rapid and minimally invasive method for the histological verification of breast cancer. New breast imaging modalities, such as contrast-enhanced spectral mammography, diffusion-weighted MRI and MR spectroscopy can possibly further improve breast cancer diagnostics; however, further studies are necessary to prove the advantages of these methods so that they cannot yet be recommended for routine clinical use.

EEG and MEG: sensitivity to epileptic spike activity as function of source orientation and depth.

Simultaneous electroencephalography (EEG) and magnetoencephalography (MEG) recordings of neuronal activity from epileptic patients reveal situations in which either EEG or MEG or both modalities show visible interictal spikes. While different signal-to-noise ratios (SNRs) of the spikes in EEG and MEG have been reported, a quantitative relation of spike source orientation and depth as well as the background brain activity to the SNR has not been established. We investigated this quantitative relationship for both dipole and patch sources in an anatomically realistic cortex model. Altogether, 5600 dipole and 3300 patch sources were distributed on the segmented cortical surfaces of two volunteers. The sources were classified according to their quantified depths and orientations, ranging from 20 mm to 60 mm below the skin surface and radial and tangential, respectively. The source time-courses mimicked an interictal spike, and the simulated background activity emulated resting activity. Simulations were conducted with individual three-compartment boundary element models. The SNR was evaluated for 128 EEG, 102 MEG magnetometer, and 204 MEG gradiometer channels. For superficial dipole and superficial patch sources, EEG showed higher SNRs for dominantly radial orientations, and MEG showed higher values for dominantly tangential orientations. Gradiometers provided higher SNR than magnetometers for superficial sources, particularly for those with dominantly tangential orientations. The orientation dependent difference in SNR in EEG and MEG gradually changed as the sources were located deeper, where the interictal spikes generated higher SNRs in EEG compared to those in MEG for all source orientations. With deep sources, the SNRs in gradiometers and magnetometers were of the same order. To better detect spikes, both EEG and MEG should be used.

Buried under gypsum powder - A rare respiratory complication.

Gypsum is a mineral dust consisting of calcium sulfate and is commonly used in building construction. We here report the first case of an acute calcium sulfate aspiration. An accidental avalanche of fine gypsum powder covered entirely a silo worker. He aspirated a large amount of gypsum powder without loosing consciousness. At admission to the emergency department the patient was breathing spontaneously and directly underwent emergency bronchoscopy. Acute tracheobronchitis was diagnosed. Remaining calcium sulfate was removed by aspiration without rinsing with additional water in order to avoid further exothermic damage to the bronchial mucosa from chemical reactions. He received steroid treatment and antibiotics, as well as bronchodilatative therapy in an attempt to increase mucociliary clearance. Within a month the patient was symptomfree without any residual radiological or functional impairment. This unusual aspiration accident is to our knowledge the first case report of an accidental calcium sulfate aspiration. Our treatment choice left the patient without residual pulmonary impairment.

[Visualisation of bioabsorbable suture anchors with digital projection radiography and magnetic resonance imaging]. / Visualisierung bioresorbierbarer Fadenanker-Implantate mit digitaler Projektionsradiografie und Magnetresonanztomografie.

BACKGROUND: During the last few years bioabsorbable suture anchors have become widely established along side metallic suture anchors in orthopaedic surgery. However, there are still some difficulties in evaluating the postoperative situation after implanting bioabsorbable suture anchors. The aim of this study was to examine the visualisation of bioabsorbable suture anchors with digital projection radiography and magnetic resonance imaging. MATERIALS AND METHODS: Ten Mitek-Anchor-Panalok® suture anchors made of polylactic acid were implanted in an ex-vivo animal study design. After implantation the specimens were examined with digital projection radiography and MRI. The analysis was performed with regard to the bony defects and the anchor material itself. RESULTS: With digital projection radiography and MRI, it was possible to detect the bony defects after implantation of the anchors. The anchor material could not be visualised. CONCLUSION: The results of this study demonstrate that neither digital projection radiography nor MRI is well suited for the detection of the bioabsorbable suture anchors in the postoperative situation. Whereas the bony defects can be well described, the anchors cannot be directly visualised. The visualisation of bioabsorbable anchors remains a clinical problem in orthopaedic surgery.

Magnetoencephalography and magnetic source imaging in epilepsy.

Magnetoencephalograpy (MEG) and Electroencephalography (EEG) provide physicians with complementary data and should not be regarded as mutually exclusive evaluative methods of cerebral activity. Relevant to this edition, MEG applications related to the surgical treatment of epilepsy will be discussed exclusively. Combined MEG/EEG data collection and analysis should be a routine diagnostic practice for patients who are still suffering seizures due to the failure of drug therapy. Clinicians in the field of epilepsy agree that a greater number of patients would benefit from surgery than are currently referred for pre-surgical evaluation. Regardless of age or presumed epilepsy syndrome, all patients deserve the possibility of living seizure-free through surgery. Technological advances in superconducting elements as well as the digital revolution were necessary for the development of MEG into a clinically valuable diagnostic tool. Compared to the examination of electrical activity of the brain, investigation into its magnetic concomitant is a more recent development. In MEG, cerebral magnetic activity is recorded using magnetometer or gradiometer whole-head systems. MEG spikes usually have a shorter duration and a steeper ascending slope than EEG spikes, and variable phase relationships to EEG. When co-registered spikes are compared, it is apparent that EEG and MEG spikes differ. There is agreement among investigators that more interictal epileptiform spikes are seen in MEG than EEG. When MEG is co-registered with invasive intracranial EEG data, the detection rate of interictal epileptiform discharges depends on the number of electrocorticographic channels that record a spike. When patients have a non-localizing video-EEG recording, MEG pinpoints the resected area in 58-72% of the cases.

Micro-bioreactors for fed-batch fermentations with integrated online monitoring and microfluidic devices.

In this study an array of micro-bioreactors based on the format of 48-well microtiter plates (MTP) is presented. The process parameters pH-value and biomass are monitored online by a combination of different sensors, the biolector measurement technology and conductance measurements. A microfluidic device dispenses two fluids individually into each well for controlling the pH-value of fermentations. The micro-bioreactor consists of four wells and two reservoirs. In each well a polyimide foil with platinum electrodes for conductance measurements is integrated. The microfluidic device is fabricated using softlithographic techniques and utilizes pneumatically actuated microvalves. The device is able to dispense volumes below 5nl. Finally, fermentations of Escherichia coli are carried out in the micro-bioreactor system. During the fermentation, the pH-value is measured optically and the biomass development is monitored by the scattered light signal. Meanwhile, the pH-value is controlled by dispensing sodium hydroxide and phosphoric acid. This micro-bioreactor demonstrates the possibility of online monitored and pH-controlled fermentations in micro-scale. The pH-value in the uncontrolled culture varies within the range of 6.46-8.83 whereas the pH-value in the controlled cultures can be kept within 6.85-7.07. This results in an increase in biomass in the pH-controlled culture compared to the nearly completely inhibited pH-uncontrolled culture.

Hypersensitivity pneumonitis secondary to lovebirds: a new cause of bird fancier's disease.

Hypersensitivity pneumonitis (HP) is an immunologically mediated lung disease due to the repetitive inhalation of antigens. Most new cases arise from residential exposures, notably to birds, and are thus more difficult to recognise. The present authors report a 59-yr-old male who complained of dyspnoea and cough while being treated with amiodarone. Pulmonary function tests revealed restriction and obstruction with low diffusing lung capacity for carbon monoxide and partial pressure of oxygen. A high-resolution computed tomography chest scan and bronchoalveolar lavage showed diffuse bilateral ground-glass attenuation and lymphocytic alveolitis, respectively. Initial diagnosis was amiodarone pulmonary toxicity, but because of a rapidly favourable evolution, this diagnosis was questioned. A careful environmental history revealed a close contact with lovebirds shortly before the onset of symptoms. Precipitins were strongly positive against lovebird droppings, but were negative against other avian antigens. The patient was diagnosed with hypersensitivity pneumonitis to lovebirds. Avoidance of lovebirds and steroid treatment led to rapid improvement. The present observation identifies a new causative agent for hypersensitivity pneumonitis and highlights the importance of a thorough environmental history and of searching for precipitins against antigens directly extracted from the patient's environment. These two procedures should allow a more precise classification of some cases of pneumonitis, and thus might avoid progression of active undiagnosed hypersensitivity pneumonitis to irreversible fibrosis or emphysema.

[Breast cancer imaging]. / Bildgebende Diagnostik des Mammakarzinoms.

Advances in female breast imaging have substantially influenced the diagnosis, therapy, and prognosis of breast cancer in the past few years. Mammography using conventional or digital technique is considered the gold standard for the early detection of breast cancer. Other modalities such as breast ultrasound and contrast-enhanced magnetic resonance imaging of the breast play an important role in diagnostic imaging, staging, and follow-up of breast cancer. Percutaneous needle biopsy is a faster, less invasive, and more cost-effective method than surgical biopsy for verifying the histological diagnosis. New methods such as breast tomosynthesis, contrast-enhanced mammography, and positron emission tomography promise to further improve breast imaging. Further studies are mandatory to adapt these new methods to clinical needs and to evaluate their performance in clinical practice.

[Rapidly progressing cyst of the pancreas as a manifestation of an undifferentiated pancreatic carcinoma with osteoclastic giant cells]. / Rasch progrediente Pankreaskopfzyste als Manifestation eines undifferenzierten Pankreaskarzinoms mit osteoklastären Riesenzellen.

HISTORY AND FINDINGS ON ADMISSION: A 62-year-old woman presented with acute abdominal pain. INVESTIGATIONS AND DIAGNOSIS: Examination revealed a 3 cm large cyst of the pancreatic head accompanied by an acute pancreatitis. TREATMENT AND COURSE: The cystic mass showed rapid increase. After explorative laparatomy a pancreaticoduodenectomy was performed. Pathologic examination revealed an undifferentiated carcinoma with osteoclast-like giant cells. The tumor grew rapidly and the patient died 10 weeks after admission. CONCLUSIONS: An undifferentiated carcinoma with osteoclast-like giant-cells is a very rare cystic tumor of the pancreas. An accurate preoperative diagnosis of cystic tumors is only achieved in about 30 percent. Therefore, surgical exploration should be considered for all cystic neoplasms and cystic tumors that are not clearly defined.

Optimal evaluation of digital electroencephalograms.

Currently available digital EEG equipment provides considerably greater opportunities for clinical data analysis than is generally appreciated especially when appropriate software is used. Data from 7 different laboratories that had been obtained for routine diagnostic evaluations on 7 different EEG instruments and stored on compact disks were investigated. Since the instruments do not filter the data at input, ultra slow activity down to 0.01 Hz is currently being recorded but the attenuation factor is instrument dependent. Nevertheless, relevant clinical information is potentially available in these data and needs to be explored. Several examples in regard to epilepsy are presented. Determination of seizure onset may depend on the frequencies that are examined. The use of appropriate filter settings and viewing windows for the clinical question to be answered is stressed. Differentiation between simple and complex spike wave discharges, as well as spread of spikes, can readily be achieved by expanding the time base to 1 or 2 seconds and placing a cursor on the peak of the negative spike. Latencies in the millisecond range can then become apparent. EEGs co-registered with MEG should be evaluated with the same software in order to allow an adequate assessment of the similarities and differences between electrical and magnetic activity. An example of a comparison of EEG, planar gradiometers and magnetometers for an averaged spike is shown.

[Feasibility of flat-panel volumetric computed tomography (fpVCT) in experimental small animal imaging of osteoporosis - initial experience]. / Erste Erfahrungen mit einem Flächendetektor-Volumen-CT (fpVCT) in der experimentellen Osteoporosediagnostik am Kleintiermodell.

BACKGROUND: Flat-panel volumetric computed tomography (fpVCT) is a new, noninvasive CT imaging modality with increased isotropic resolution. Technical details, potential applications, and our initial experience with a fpVCT prototype scanner in the imaging of osteoporosis in a rat model are presented. METHODS: To date, 21 rats have been investigated in vivo with fpVCT. Pharmacologic effects on bone mineral density (BMD) and structure were of special interest. Image evaluation focussed on the second lumbar vertebra and the left femoral bone. To validate measurement results, BMD values calculated with fpVCT were correlated with results of BMD measurements from ashing of the second lumbar vertebra and femoral bones. RESULTS: Our initial results show that fpVCT is capable of detecting differences in BMD between ovariectomized rats treated with estradiol and a control group with high statistical significance (p<0.05), corresponding to ashing as the gold standard. CONCLUSIONS: In a rat model, fpVCT imaging is especially useful in longitudinal in vivo investigations of BMD measures. Spatial resolution of up to 150 microm allows imaging of the trabecular structure only in human cadaveric bones.

Cardio-respiratory contributions to the magnetoencephalogram.

Modern MEG technology provides whole head helmet systems which extend posterior to the base of the skull. While this provides better visualization of low temporal structures it also allows the intrusion of activity that is of cardiac origin. This consists not only of the QRS complex of the MCG but a late component (LC) during the SP interval. This tends to consist of a series of waves and has a different topographic distribution from the magnetic QRS complex. The LC is usually most prominent in the low occipital and sub-occipital sensors but can occur also in other areas. When the high pass filter is set to 0.1 Hz it can be seen that the LC rides on a slow wave of about 0.3 Hz, which is linked to respiration. Principal component analysis of cardiac cycles averaged from the ECG separates the MCG from the LC. The physiology of the LC is unknown at this time but it may be related to the ballistocardiogram. Algorhythms designed to remove the cardiac contributions to the MEG will have to take the LC and its marked variability into account.

Electrocardiographic assistance in multidetector CT of thoracic disorders.

ECG-synchronized multislice spiral CT (MSCT) allows a significant reduction of cardiac motion artefacts and as a result a virtually artefact-free display of intrathoracic structures. With their advantages in imaging geometry and continuous spiral image acquisition multislice CT scanners provide superior image quality and spatial resolution in these patients. Possible clinical applications for ECG assistance in MSCT include CT angiography of the coronary arteries, functional cardiac CT imaging and imaging of the cardiac valves, CT angiography of the aorta or pulmonary vascular tree as well as ECG-gated imaging of the lung parenchyma. Prospective ECG triggering and retrospectively ECG-gated image reconstruction comprise the technical corsage for reduction of pulsation artefacts in cardiac and other thoracic CT applications. In addition the development of time-optimised reconstruction algorithms for retrospective cardiac gating in 8- and 16 slice spiral CT scanners have enabled further improvements in temporal resolution. This overview describes the technique, its clinical indications and the merits of electrocardiographic assistance in MSCT of chest disorders.

[Diagnosis and classification of calcaneal fractures in computed tomography]. / Diagnostik und Klassifikation von Kalkaneusfrakturen in der Computertomographie.

PURPOSE: To compare image quality of single-slice spiral CT (SSCT) and multislice spiral CT (MSCT) in the diagnosis and classification of calcaneal fractures and to present a rapid and precise algorithm for the classification system of Stuermer. MATERIALS AND METHODS: In 102 patients with 124 calcaneal fractures, spiral CT was performed, in 82 cases as SSCT with a slice thickness (SD) of 3 mm, a table speed (TS) of 3 - 4 mm/rot and an increment of 1.5 mm. In 42 cases, patients were scanned using MSCT (SD of 1.25 mm, increment 0.8 mm). For these examinations, 2 different scan protocols were used, with a TS of 3.75 mm/rot in one group (n = 21) and a TS of 7.5 mm/rot in the other group (n = 21). The image quality of axial sections and reconstructed images was assessed on a scale from 1 to 5 (1 = very good; 5 = insufficient). The fractures were evaluated using a classification system according to Stuermer, which assigns three main groups (A/B/C) and three subtypes (1/2/3). RESULTS: MSCT had substantial advantages over SSCT with respect to scan time and image quality, especially for multiplanar reformatting (median 1.5 versus 4.0). TS showed no significant influence on the image quality. The standardized evaluation of the images enabled a classification of fractures within 5 minutes. All fractures could be assigned to the different types and subtypes. This classification system takes into account the severity of the fracture and the therapeutic approach. The most common type (90 of 124 fractures) were "joint depression" fractures (type C), which were treated by surgery in 92 %. Type A fractures were treated conservatively in 72 %. CONCLUSION: Spiral CT, especially MSCT, allows rapid diagnosis and precise classification of calcaneal fractures, achieved with high quality multiplanar reformatting. The presented classification in different fracture types and subtypes allows an adequate planning of therapy.

Magnetoencephalographic spikes not detected by conventional electroencephalography.

OBJECTIVE: To investigate some of the reasons why magnetoencephalographic (MEG) spikes are at times not apparent in conventional electroencephalograms (EEG) when the data are co-registered, and to explore to what extent modern EEG analysis methods can improve the yield. METHODS: Seventy seconds of MEG-EEG co-registration on a 122 channel Neuromag system were studied in a 10-year-old boy with Landau-Kleffner syndrome. Twenty-six EEG channels were originally recorded with a left ear reference. The EEG data were subsequently reformatted (BESA) to a variety of montages for the 10-20 and 10-10 electrode array. A 10 s data epoch was compared in detail for concordance between MEG and EEG spikes. To detect the characteristics of hidden low voltage EEG spikes, MEG spikes were averaged and compared with the concomitant averaged EEG spike. RESULTS: While there was an abundance of EEG as well as MEG spikes on the left; definite right-sided spikes were not visible in the EEG. Right hemispheric MEG spikes were, however, plentiful with an average strength of 757 fT. When the individual MEG spikes from the right hemisphere were compared with the corresponding EEG events their amplitude ranged between 24 and 31 microV and were, therefore, indistinguishable from background activity. The majority of them became visible, however, with further sophisticated data analysis. CONCLUSIONS: When the relative merits of MEG versus EEG recordings for the detection of epileptogenic spike are investigated the 10-20 system of electrode placement and conventional methods of EEG analysis do not provide optimal data assessment. The use of the 10-10 electrode array combined with modern methods of digital data analysis can provide better concordance with MEG data.

[Diagnostic performance of retrospectively ECG-gated multislice CT of acute pulmonary embolism]. / Diagnostischer Stellenwert der retrospektiven EKG-Triggerung in der Mehrschicht-Spiral-CT der akuten Lungenembolie.

AIM: This study determined the diagnostic performance of ECG-gated MSCT in comparison with conventional MSCT. MATERIALS AND METHODS: Forty-five consecutive patients prospectively underwent ECG-gated (group 1, n = 23) or non-ECG-gated (group 2, n = 22) 8-slice MSCT of the pulmonary arteries. Image data were interactively evaluated by three independent chest radiologists with respect to the presence of emboli at different arterial levels, and with regard to cardiac motion artefacts. Consensus reading by two experienced chest radiologists served as diagnostic gold standard. ROC analysis was carried out for the different vascular sections. RESULTS: Twenty-five patients (56 %) were diagnosed to have pulmonary embolism (13 from group 1, 12 from group 2). Cardiac motion artefacts were significantly more frequent in group 2 (70 % in group 2 versus 13 % in group 1, p < 0.05). There was no significant difference between the two groups in the overall sensitivities (0.92 vs. 0.95) and specificities (0.92 vs. 0.98) or in sensitivities and specificities at any assessed pulmonary arterial level. CONCLUSION: ECG-gated MSCT pulmonary angiography does not significantly influence the diagnostic performance of MSCT in these patients. Therefore no recommendation for routine clinical practice can be given.