[Ultrasound artifacts and their diagnostic significance in internal medicine and gastroenterology - part 2: color and spectral Doppler artifacts]. / Artefakte in der Sonografie und ihre Bedeutung für die internistische und gastroenterologische Diagnostik - Teil 2: Artefakte im Farb- und Spektraldoppler.

Artifacts in ultrasonographic diagnostics are a result of the physical properties of the ultrasound waves and are caused by interaction of the ultrasound waves with biological structures and tissues of the body and with foreign materials. On the one hand, they may be diagnostically helpful. On the other hand, they may be distracting and may lead to misdiagnosis. Profound knowledge of the causes, avoidance, and interpretation of artifacts is a necessary precondition for correct clinical appraisal of ultrasound images. Part 1 of this review commented on the physics of artifacts and described the most important B-mode artifacts. Part 2 focuses on the clinically relevant artifacts in Doppler and color-coded duplex sonography. Problems and pitfalls of interpretation arising from artifacts, as well as the diagnostic use of Doppler and colour-coded duplex sonography, are discussed.

[Ultrasound artifacts and their diagnostic significance in internal medicine and gastroenterology - Part 1: B-mode artifacts]. / Artefakte in der Sonografie und ihre Bedeutung für die internistische und gastroenterologische Diagnostik - Teil 1: B-Mode-Artefakte.

Artifacts in ultrasonographic diagnostics are a result of the physical properties of the ultrasound waves and are caused by interaction of the ultrasound waves with biological structures and tissues and with foreign bodies. On the one hand, they may be distracting and may lead to misdiagnosis. On the other hand, they may be diagnostically helpful. Ultrasound imaging suffers from artifacts, because in reality, parameters assumed to be constant values, such as sound speed, sound rectilinear propagation, attenuation, etc., are often different from the actual parameters. Moreover, inadequate device settings may cause artifacts. Profound knowledge of the causes, avoidance, and interpretation of artifacts is a necessary precondition for correct clinical appraisal of ultrasound images. Part 1 of this review comments on the physics of artifacts and describes the most important B-mode artifacts. Pitfalls, as well as diagnostic chances resulting from B-mode artifacts, are discussed.

Incidence of bleeding in 8172 percutaneous ultrasound-guided intraabdominal diagnostic and therapeutic interventions - results of the prospective multicenter DEGUM interventional ultrasound study (PIUS study).

PURPOSE: To analyse the incidence of bleeding after percutaneous ultrasound guided diagnostic and therapeutic intraabdominal interventions in a prospective multicentre study (DEGUM percutaneous interventional ultrasound study). MATERIALS AND METHODS: Within a time period of 2 years diagnostic and therapeutic intraabdominal interventions (with the exclusion of ascites paracentesis) performed percutaneously under continuous ultrasound (US) guidance were prospectively assessed using a pseudonymized standardized web site entry form. Number and type of intervention, operator experience, patient characteristics, medication, lab data as well as technical aspects of the procedure and bleeding complications were analysed according to the interventional radiology standards. RESULTS: 8172 US-guided intraabdominal interventions (liver n = 5903; pancreas n = 501, kidney n = 434, lymph node = 272, biliary system n = 153, spleen n = 63, other abdominal organs and extra-organic targets n = 999) were analysed in 30 hospitals. The majority were diagnostic biopsies including 1780 liver parenchyma, 3400 focal liver lesions and 404 pancreatic lesions. 7525 interventions (92.1 %) were performed in hospitalized patients (mean age 62.6 years). Most operators were highly experienced in US-guided interventions (> 500 interventions prior to the study n = 5729; 70.1 %). Sedation was administered in 1131 patients (13.8 %). Needle diameter was ≥ 1 mm in 7162 punctures (87.9 %) with main focus on core needle biopsies (18 G, n = 4185). Clinically relevant bleeding complications with need of transfusion (0.4 %), surgical bleeding control (0.1 %) and radiological coiling (0.05 %) were very rare. Bleeding complications with fatal outcome occurred in four patients (0.05 %). The frequency of major bleeding complications was significantly higher in patients with an INR > 1.5 (p < 0.001) and patients taking a medication potentially interfering with platelet function or plasmatic coagulation (p < 0.0333). CONCLUSION: This prospective multicentre study confirms the broad spectrum of percutaneous US-guided intraabdominal interventions. However diagnostic liver biopsies dominate with the use of core needle biopsies (18 G). Percutaneous US-guided interventions performed by experienced sonographers are associated with a low bleeding risk. Major bleeding complications are very rare. A pre-interventional INR < 1.5 and individual medication risk assessment are recommended.

Assessment of the oral health status of healthcare-seeking adults living with HIV in Kathmandu Valley, Nepal.

AIMS: This study looks to assess the oral health status in the study subjects and to quantify the prevalence of WHO defined HIV-related oral stage 3 and 4 lesions (HIV-OL) as those conditions are indicating need for treatment independently of CD4 count. METHODS: This quantitative screening study used both structured questionnaire and clinical examination to determine the prevalence of HIV-OL in 83 adults living with HIV randomly selected from a list of service users at a community based HIV organization. RESULTS: The screening revealed a 40 % (95%-CI: 30-51%) prevalence of HIV-OL in this population where 71 are under Antiretroviral Therapy (ART). Most frequent HIV-OL found were persistent oral candidiasis (19% prevalence), and acute necrotizing gingivitis/stomatitis (18% prevalence) Prevalence of HIV-OL was correlating with CD4 count. Patients with multiple HIV-OL have a mean of 133 CD4 cells/µl, patients with a single HIV-OL have 327 CD4 cells/µl and patients without HIV-OL do have a mean of 457CD4 cells/µl (ANOVA-p=0.002). 6 of 12 patients not taking ART yet were found to have stage 3 or 4 HIV-OL. 46 (55%) of the study population had poor or very poor oral hygiene and 29 (35%) had never had an oral examination, 36 (43%) had attended only for extraction. Only 4 of 54 patients who had previously accessed oral health care have revealed their HIV status to the dentist at that time. CONCLUSIONS: Wider access to oral healthcare is required for people living with HIV in Kathmandu Valley/Nepal. In this setting HIV-OL are still an important consideration in assessing patients living with HIV, which can have decisive therapeutic implications. Stage 3 and 4 conditions are, independently of CD4 count, indication to start ART without delay in people living with HIV.

[Contrast-enhanced ultrasound]. / Kontrastmittelsonographie.

Contrast enhanced ultrasound (CEUS) is increasingly accepted in the clinical use for diagnostic imaging. The new guidelines and recommendations provide general advice for the use and procedure of CEUS.

Massive expansion of marine archaea during a mid-Cretaceous oceanic anoxic event.

Biogeochemical and stable carbon isotopic analysis of black-shale sequences deposited during an Albian oceanic anoxic event (approximately 112 million years ago) indicate that up to 80 weight percent of sedimentary organic carbon is derived from marine, nonthermophilic archaea. The carbon-13 content of archaeal molecular fossils indicates that these archaea were living chemoautotrophically. Their massive expansion may have been a response to the strong stratification of the ocean during this anoxic event. Indeed, the sedimentary record of archaeal membrane lipids suggests that this anoxic event marks a time in Earth history at which certain hyperthermophilic archaea adapted to low-temperature environments.

Adrenomedullin and myocardial contractility in the rat.

The effects of adrenomedullin in the regulation of myocardial contractility were investigated in the rat. In papillary muscles (n=6), adrenomedullin (0.1 to 10 nM) failed to show contractile effects. NO (nitric oxide) synthase inhibition with N(G)-nitro-L-arginine (L-NOARG) did not unmask any inotropic effect of adrenomedullin. The positive inotropic effect of isoprenaline (0. 01 nM to 10 microM) was identical after adrenomedullin, after L-NOARG, and after L-NOARG plus adrenomedullin (n=6 each). In field-stimulated rat ventricular myocytes, adrenomedullin (1, 10, and 100 nM; n=4 each) had impact neither on cell shortening nor on Ca(2+) transients. In isolated constant-flow perfused hearts (7.3+/-0.3 ml/min), adrenomedullin (1 nM, n=9; 10 nM, n=7) induced significant coronary vasodilation (-28%, -50%). In conclusion, adrenomedullin is a potent coronary vasodilator, but has no significant effects on myocardial contractility in the rat.

[The influence of chronic exposure of the skin of NMRI*-mice (author's transl)]. / Zum Einfluss einer chronischen UV-Bestrahlung auf die Haut von NMRI*-Mäusen.

The influence of chronic exposure to defined emission spectra within the natural UV global range on the skin of the NMRI-mouse was studied. It was shown that after a period of 15 months under suberythemogenic conditions neither carcinomas of skin nor elastic or collagenous tissue alterations were developed.

[Caries prevention by the use of a Na2FPO3 containing toothpaste, after 7 years]. / Die Karieshemmung einer Na2FPO3-Zahnpasta nach 7 Jahren Applikation.

After 7 years of use of a Na2FPO3 paste, the reduction of DMF surfaces was reduced by 36-38%, relating to the control group. The caries inhibiting effect is statistically ensured. Separate consideration of the first molar shows a caries reduction of 40-42%.

[Caries prevention by means of a Na2FPO3-toothpaste after 7 year's application]. / Die Karieshemmung durch eine Na2FPO3-Zahnpasta nach 7 Jahren Applikation.

After 7 years unsupervised use of a Na2FPO3 paste the number of new DMF-surfaces was 36 to 38% lower than in the control group. The caries-inhibiting effect is statistically significant (P less than 0.001). Separate consideration of the first molar reduced caries of the other teeth to 40--42%.