[Retrospective evaluation of electronically recorded patient questionnaires of a university outpatient pain clinic with the painDETECT® questionnaire]. / Retrospektive Auswertung elektronisch erhobener Patientenfragebögen einer universitären Schmerzambulanz mit dem painDETECT®-Fragebogen.

BACKGROUND AND OBJECTIVE: Psychometric tests can provide important information for diagnostics and progression in chronic pain patients. Between 2008 and 2018, the electronic system painDETECT® was used in the outpatient pain clinic of the Hannover Medical School (MHH). The aim of this retrospective study was to evaluate the pain symptomatology data recorded using painDETECT® and the treatment procedures used in the patient cohort examined over a period of 15 months. MATERIAL AND METHODS: A statistical analysis of baseline and follow-up data was performed. The analysis comprised pain-related parameters recorded by use of the painDETECT® system as well as outpatient records. RESULTS: Baseline data of 459 patients (66% women) could be evaluated. The most common clinical pictures were spinal pain, headache, facial pain, and somatoform disorders, mostly with many years of previous treatment. Approximately 40% showed evidence of neuropathic pain components or central sensitization. With a mean pain intensity of VAS 6 (0-10), a predominantly high degree of chronicity was present. Approximately one third showed a high degree of pain-related functional impairment. Slightly more than half showed evidence of clinically relevant depression. Approximately 80% showed clinically relevant sleep disturbances. Follow-up data were available for 145 patients (31.6%). The proportion of patients receiving a nonpharmacological form of treatment increased by 44.1% (physical therapy) and by 24.1% (psychotherapeutic procedures) during the observation period. The use of co-analgesics increased by approximately 30% over the course. CONCLUSION: In the outpatient setting, an extension of treatment can be successful for high-grade chronic pain patients. Close structural networking with the clinics for rehabilitation medicine and for psychosomatics and psychotherapy at the MHH can be a favorable prerequisite for this.

Correction to: Biological tumour volumes of gliomas in early and standard 20-40 min 18F-FET PET images differ according to IDH mutation status.

The name of M. Unterrainer was inadvertently presented as M. Unterrrainer in the original article.

Biological tumour volumes of gliomas in early and standard 20-40 min 18F-FET PET images differ according to IDH mutation status.

PURPOSE: For the clinical evaluation of O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) PET images, the use of standard summation images obtained 20-40 min after injection is recommended. However, early summation images obtained 5-15 min after injection have been reported to allow better differentiation between low-grade glioma (LGG) and high-grade glioma (HGG) by capturing the early 18F-FET uptake peak specific for HGG. We compared early and standard summation images with regard to delineation of the PET-derived biological tumour volume (BTV) in correlation with the molecular genetic profile according the updated 2016 WHO classification. METHODS: The analysis included 245 patients with newly diagnosed, histologically verified glioma and a positive 18F-FET PET scan prior to any further treatment. BTVs were delineated during the early 5-15 min and standard 20-40 min time frames using a threshold of 1.6 × background activity and were compared intraindividually. Volume differences between early and late summation images of >20% were considered significant and were correlated with WHO grade and the molecular genetic profile (IDH mutation and 1p/19q codeletion status). RESULTS: In 52.2% of the patients (128/245), a significant difference in BTV of >20% between early and standard summation images was found. While 44.3% of WHO grade II gliomas (31 of 70) showed a significantly smaller BTV in the early summation images, 35.0% of WHO grade III gliomas (28/80) and 37.9% of WHO grade IV gliomas (36/95) had a significantly larger BTVs. Among IDH-wildtype gliomas, an even higher portion (44.4%, 67/151) showed significantly larger BTVs in the early summation images, which was observed in 5.3% (5/94) of IDH-mutant gliomas only: most of the latter had significantly smaller BTVs in the early summation images, i.e. 51.2% of IDH-mutant gliomas without 1p/19q codeletion (21/41) and 39.6% with 1p/19q codeletion (21/53). CONCLUSION: BTVs delineated in early and standard summation images differed significantly in more than half of gliomas. While the standard summation images seem appropriate for delineation of LGG as well as IDH-mutant gliomas, a remarkably high percentage of HGG and, particularly, IDH-wildtype gliomas were depicted with significantly larger volumes in early summation images. This finding might be of interest for optimization of treatment planning (e.g. radiotherapy) in accordance with the individual IDH mutation status.

Aerial measurements of artificial radionuclides in Germany in case of a nuclear accident.

Gamma-ray spectrometric systems carried by helicopters prove to be indispensable for the surveillance of environmental radioactivity. The aerial measurements are an important tool for rapid and large-scale nuclide specific determination of soil contamination after an accidental release of radionuclides from a nuclear facility. Furthermore this technique is also applied for the determination of anomalies of elevated radioactivity of natural radionuclides, the detection of lost radioactive sources and geological mapping. For the measurements the helicopters are equipped with a NaI(Tl)-detector array and a high purity germanium-semiconductor (HPGe) detector. Especially with the HPGe-detector it is possible to clearly identify individual radionuclides. To improve and to guarantee the quality of this method several exercises with different fields of interest have been carried out during the last years. Thereby the main focus is on the improvement of the instrumentation, data handling and data analysis. The results of the airborne radionuclide measurements from the Black Forest which was performed in co-operation with the Swiss National Emergency Operation Centre, are presented here. During this exercise the gamma dose rate, soil contamination due to 137Cs and the specific activities of natural radionuclides in soil were determined.

Aerial measurements on uranium ore mining, milling and processing areas in Germany.

The paper describes aerial measurements at several sites containing residues from uranium mines, waste rock dumps and tailings ponds of the Wismut company in Saxony and Thuringia. For the measurements, a computerized gamma-ray spectrometer equipped with a HPGe-detector and a NaI(Tl)-detector array with a volume of 121 was used. Radioactive anomalies from natural radionuclides have been detected and mapped. The activity concentrations of 226Ra, 228Th and 40K in areas with elevated radioactivity from natural radionuclides were determined from aerial measurements. Ground-based measurements--as far as available--confirmed these results. The mean 226Ra activity concentrations in the different waste rock dumps were found to be in the range 370 to 1600 Bq kg-1. The highest mean 226Ra activity concentrations were measured for the tailings ponds with values up to 1300 Bq kg-1. For 40K and 208Tl, activity concentrations of 860 and 40 Bq kg-1, respectively, were obtained as averages of all measurements. These values are commonly found in the environment. In general, there is reasonable agreement between the results measured with different detectors and measuring methods.

Measurements of radioactivity in environmental samples from the southern Urals.

A region between Chelyabinsk and Ekaterinburg in the Southern Urals has been heavily contaminated due to operational and accidental releases from the first Soviet plutonium production facility Mayak. In 1992 and 1993, the German Federal Office for Radiation Protection organized a measuring campaign involving two Russian institutes to assist with the validation of former Soviet measurement data. The results of this measuring campaign are reported here. Environmental samples were collected from areas affected by significant radioactive releases into the Techa river, which started in 1948, and by fallout from the explosion of a fission product storage tank in 1957. Soil, sediment, water, milk and food samples were independently analysed for 90Sr, 137Cs and plutonium by the three institutes involved. This paper presents data on the present levels of environmental radioactivity. The highest contamination of areas accessible to the local population was found in the vicinity of the Techa river around Muslumovo. Activity concentration of floodplain samples reached up to 37,000 Bq.kg-1 137Cs, 5,600 Bq.kg-1 90Sr and 9.9 Bq.kg-1 Pu. Milk and potatoes from private farms in Muslumovo showed low activity in the range from 0.7 Bq.kg-1 to 25 Bq.kg-1 90Sr. The results of the three independent measurement teams showed sufficient agreement. One Russian laboratory obtained plutonium activities that exceeded the results of the other laboratories by about 20%. Contrary to the International Chernobyl Project, there was no overestimation of 90Sr activities in the Russian analyses. Therefore, the validity of earlier data sets acquired with same methodology and quality control can be considered a valuable basis for further assessments and for dose reconstruction in epidemiological projects.

First attempts at validation of radiation exposure of the population along the Techa River, southern Urals.

A research programme sponsored by the German Federal Ministry for the Environment, Nature Protection and Nuclear Safety (BMU) was conducted during 1992 and 1993 in the Southern Urals, to provide an initial validation and comparison of results of population exposure arising from the release of radioactive waste from the MAYAK nuclear facility between the years 1948 and 1967. This programme included investigations of the contamination of the soil, of food (milk, drinking-water, potatoes) and whole-body-counter measurements of inhabitants of settlements at the Techa River. The nuclides of interest were plutonium isotopes and the long-lived fission products 137Cs and 90Sr. Results of these investigations, particularly in and around the village of Muslyumovo (78 km downstream from the point of release of the radioactive waste into the Techa River), are shown. These investigations are a first step towards an independent validation of the enormous data base collected by the Russian institutes and of derived values of the doses to the population of the Techa River.

[Importance of blackening of films and conditions of assessment of films for diagnostic decision of X-rays of teeth, the tooth supporting apparatus and adjacent structures of the jaw]. / Die Bedeutung der Filmschwärzung und Filmbetrachtungsbedingungen für die diagnostische Entscheidungsleistung bei Röntgenaufnahmen der Zähne, des Zahnhalteapparates und der angrenzenden Kieferstrukturen.

The influence of blackening of films and conditions of assessment of films for diagnostic decisions had been examined. Various pictures of the Periodontitis apikalis chronica at x-ray pictures had been chosen the subject of examination. It should be ascertained by means of the ROS concept to what extent variations of the above-mentioned parameters will result in false diagnoses. The most favourable result is gained with film blackening of 1.2 SE and a lightness of the film equipment of 12,000 Lx. A reduced lightness of the equipment will reduce the quality of diagnostics in essential manner. Optimum conditions for evaluation of the film are given for pictures over- and under-exposed.