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Cocoa pulp occurs as a by-product of cocoa bean production and can be repurposed to different food applications, such as jams, fruit preparations and beverages, improving the sustainability of cocoa production, as well as the livelihoods of cocoa farmers. In this work, aroma-active compounds of fresh cocoa fruit pulps from different origins were investigated by applying aroma extract dilution analyses in combination with gas chromatography-mass spectrometry/olfactometry for identification. In total, 65 aroma-active compounds were determined in four different pulps originating from Indonesia, Vietnam, Cameroon, and Nicaragua. Vietnamese pulp showed the highest number of aroma-active regions, while Cameroonian pulp accounted for the lowest. Moreover, Cameroonian cocoa pulp showed the lowest FD factors. Overall, the odorants with the highest FD factors were trans-4,5-epoxy-(E)-decenal, 2- and 3-methylbutanoic acid, 3-(methylthio)propanal, 2-isobutyl-3-methoxypyrazine, (E,E)-2,4-nonadienal, (E,E)-2,4-decadienal, 4-vinyl-2-methoxyphenol, δ-decalactone, 3-hydroxy-4,5-dimethylfuran-2(5H)-one, dodecanoic acid, and linalool. This study provides insights into the aroma composition of fresh cocoa pulp from different origins for future food applications.
Assuntos
Cacau , Aromatizantes/análise , Frutas/química , Compostos Orgânicos Voláteis/análise , Cacau/química , Cacau/crescimento & desenvolvimento , Camarões , Indonésia , VietnãRESUMO
Plant compounds are described to interact with bile acids during small intestinal digestion. This review will summarise mechanisms of interaction between bile acids and plant compounds, challenges in in vivo and in vitro analyses, and possible consequences on health. The main mechanisms of interaction assume that increased viscosity during digestion results in reduced micellar mobility of bile acids, or that bile acids and plant compounds are associated or complexed at the molecular level. Increasing viscosity during digestion due to specific dietary fibres is considered a central reason for bile acid retention. Furthermore, hydrophobic interactions are proposed to contribute to bile acid retention in the small intestine. Although frequently hypothesised, no mechanism of permanent binding of bile acids by dietary fibres or indigestible protein fractions has yet been demonstrated. Otherwise, various polyphenolic structures were recently associated with reduced micellar solubility and modification of steroid and bile acid excretion but underlying molecular mechanisms of interaction are not yet fully understood. Therefore, future research activities need to consider the complex composition and cell-wall structures as influenced by processing when investigating bile acid interactions. Furthermore, influences of bile acid interactions on gut microbiota need to be addressed to clarify their role in bile acid metabolism.
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Ácidos e Sais Biliares/metabolismo , Ácidos e Sais Biliares/fisiologia , Digestão/fisiologia , Adsorção , Animais , Fibras na Dieta/análise , Microbioma Gastrointestinal , Humanos , Compostos Fitoquímicos/metabolismo , Plantas/metabolismo , Solubilidade , Viscosidade , beta-Glucanas/metabolismoRESUMO
OBJECTIVES: This study aimed to develop a method for retrieval of the new meshed nitinol atrial septal defect occluders - Ceraflex and Occlutech. BACKGROUND: The newly developed atrial septal defect occluders have potential benefits considering implantation, but concerns regarding their removal in case of embolisation have been raised. METHODS: Over 21 years, 1449 patients underwent interventional atrial septal defect occlusion in our institution. We reviewed the cases of embolisation of the device, developed a strategy for device removal, and tested it on the benchside and in animal tests. RESULTS: In 11 patients (0.8%), the intended atrial septal defect occlusion was complicated by an embolisation of the device. In contrast to the Amplatzer septal occluders, retrieval of Occlutech devices larger than 16 mm with snare techniques was impossible. In benchside tests, this was confirmed and a new method for removal of large meshed devices was developed. This involved the commercially available Maslanka® biopsy forceps. The feasibility of this technique in vivo was tested in a pig model. During animal tests, using the Maslanka biopsy forceps it was possible to interventionally retrieve embolised Ceraflex and Occlutech devices of different sizes - 10, 16, 30, and 40 mm - into a 12-F sheath. CONCLUSION: It was impossible to retrieve Occlutech and Ceraflex devices larger than 16 mm into a large sheath in vivo and during benchside tests. However, this was feasible on the bench and in vivo using the Maslanka biopsy forceps even with the largest available devices.
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Cateterismo Cardíaco/instrumentação , Remoção de Dispositivo/métodos , Embolia/terapia , Comunicação Interatrial/terapia , Falha de Prótese , Dispositivo para Oclusão Septal , Adolescente , Adulto , Idoso , Angiografia , Animais , Cateterismo Cardíaco/efeitos adversos , Criança , Embolia/etiologia , Feminino , Comunicação Interatrial/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Animais , Estudo de Prova de Conceito , Desenho de Prótese , Suínos , Resultado do Tratamento , Adulto JovemRESUMO
To explain the cholesterol-reducing effects of dietary fibres, one of the major mechanisms proposed is the reduced reabsorption of bile acids in the ileum. The interaction of dietary fibres with bile acids is associated with their viscous or adsorptive effects. Since these fibre characteristics are difficult to investigate in vivo, suitable in vitro methodologies can contribute to understanding the mechanistic principles. We compared the commonly used centrifugal approach with a modified dialysis method using dietary fibre-rich materials from different sources (i.e., barley, citrus, lupin, and potato). Digestion was simulated in vitro with oral, gastric, and small intestinal digestion environments. The chyme was dialysed and released bile acids were analysed by high-performance liquid chromatography. The centrifugation method showed adsorptive effects only for cholestyramine (reference material) and a high-fibre barley product (1.4 µmol taurocholic acid/100 mg dry matter). Alternatively, the dialysis approach showed higher values of bile acid adsorption (2.3 µmol taurocholic acid/100 mg dry matter) for the high-fibre barley product. This indicated an underestimated adsorption when using the centrifugation method. The results also confirmed that the dialysis method can be used to understand the influence of viscosity on bile acid release. This may be due to entrapment of bile acids in the viscous chyme matrix. Further studies on fibre structure and mechanisms responsible for viscous effects are required to understand the formation of entangled networks responsible for the entrapment of the bile acids.
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Ácidos e Sais Biliares/química , Ácidos e Sais Biliares/metabolismo , Fibras na Dieta/metabolismo , Adsorção , Animais , Ácidos e Sais Biliares/análise , Centrifugação , Citrus/química , Diálise , Fibras na Dieta/análise , Hordeum/química , Humanos , Lupinus/química , Saliva/química , Solanum tuberosum/química , Suínos , ViscosidadeRESUMO
PURPOSE: To compare the quantification of pulmonary stroke volume (SV) by phase contrast magnetic resonance (PC-MR) in the main pulmonary artery (MPA) to the sum of SVs in both peripheral pulmonary arteries (PPA) in different right ventricular (RV) outflow pathologies. MATERIALS AND METHODS: Pulmonary SV was determined by PC-MR in the MPA and the PPA in healthy individuals (H, n = 54), patients after correction for tetralogy of Fallot with significant pulmonary regurgitation and without pulmonary or RV outflow tract stenosis (PR, n = 50), and in patients with RV outflow tract or pulmonary valve stenosis (PS, n = 50). Resulting SVs were compared to aortic SV in the ascending aorta. RESULTS: Mean age was similar between the groups: H 28 ± 17 vs. PR 24 ± 11 vs. PS 22 ± 10 years. Bland-Altman analyses revealed in all groups a relatively small systemic (bias) but large random error (limits of agreement) for pulmonary SV determined in the MPA as compared to summed SVs in the PPA. The largest limits of agreement were present in PS patients: H: MPA 3.9% (-11, + 19) vs. PPA 0.4% (-15, + 15); PR: MPA 5.2% (-25, + 36) vs. PPA 0.6% (-24, + 26); PS: MPA 5% (-36; + 46), PPA -0.03% (-34, + 35). CONCLUSION: The accuracy of PC-MR in the MPA is reasonable; however, a large random error (precision) is observed that is most pronounced in PS patients. This potential error should be taken into consideration when interpreting MPA flow measurements. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1839-1845.
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Imageamento por Ressonância Magnética/métodos , Complicações Pós-Operatórias/diagnóstico por imagem , Artéria Pulmonar/diagnóstico por imagem , Artéria Pulmonar/fisiopatologia , Tetralogia de Fallot/cirurgia , Disfunção Ventricular Direita/cirurgia , Adulto , Feminino , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Humanos , Masculino , Complicações Pós-Operatórias/fisiopatologia , Insuficiência da Valva Pulmonar/diagnóstico por imagem , Insuficiência da Valva Pulmonar/fisiopatologia , Estenose da Valva Pulmonar/diagnóstico por imagem , Estenose da Valva Pulmonar/fisiopatologia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Volume Sistólico/fisiologia , Disfunção Ventricular Direita/diagnóstico por imagem , Disfunção Ventricular Direita/fisiopatologia , Adulto JovemRESUMO
We showed that nitric oxide (NO) signaling is decreased in the pulmonary vasculature before the development of endothelial dysfunction in a lamb model of congenital heart disease and increased pulmonary blood flow (Shunt). The elucidation of the molecular mechanism by which this occurs was the purpose of this study. Here, we demonstrate that concentrations of the endogenous NO synthase (NOS) inhibitor, asymmetric dimethylarginine (ADMA), are elevated, whereas the NOS cofactor tetrahydrobiopterin (BH(4)) is decreased in Shunt lambs. Our previous studies demonstrated that ADMA decreases heat shock protein-90 (Hsp90) chaperone activity, whereas other studies suggest that guanosine-5'-triphosphate cyclohydrolase 1 (GCH1), the rate-limiting enzyme in the generation of BH(4), may be a client protein for Hsp90. Thus, we determined whether increases in ADMA could alter GCH1 protein and activity. Our data demonstrate that ADMA decreased GCH1 protein, but not mRNA concentrations, in pulmonary arterial endothelial cells (PAECs) because of the ubiquitination and proteasome-dependent degradation of GCH1. We also found that Hsp90-GCH1 interactions were reduced, whereas the association of GCH1 with Hsp70 and the C-terminus of Hsp70-interacting protein (CHIP) increased in ADMA-exposed PAECs. The overexpression of CHIP potentiated, whereas a CHIP U-box domain mutant attenuated, ADMA-induced GCH1 degradation and reductions in cellular BH(4) concentrations. We also found in vivo that Hsp90/GCH1 interactions are decreased, whereas GCH1-Hsp70 and GCH1-CHIP interactions and GCH1 ubiquitination are increased. Finally, we found that supplementation with l-arginine restored Hsp90-GCH1 interactions and increased both BH(4) and NO(x) concentrations in Shunt lambs. In conclusion, increased concentrations of ADMA can indirectly alter NO signaling through decreased cellular BH(4) concentrations, secondary to the disruption of Hsp90-GCH1 interactions and the CHIP-dependent proteasomal degradation of GCH1.
Assuntos
GTP Cicloidrolase/metabolismo , Proteínas de Choque Térmico HSP70/metabolismo , Cardiopatias Congênitas/metabolismo , Pulmão/irrigação sanguínea , Pulmão/metabolismo , Animais , Antracenos/farmacologia , Arginina/análogos & derivados , Arginina/farmacologia , Velocidade do Fluxo Sanguíneo/efeitos dos fármacos , Modelos Animais de Doenças , Feminino , Proteínas de Choque Térmico HSP90/genética , Proteínas de Choque Térmico HSP90/metabolismo , Cardiopatias Congênitas/patologia , Cardiopatias Congênitas/fisiopatologia , Pulmão/patologia , Pulmão/fisiopatologia , Óxido Nítrico/metabolismo , Óxido Nítrico Sintase/antagonistas & inibidores , Óxido Nítrico Sintase/metabolismo , Propano/análogos & derivados , Propano/farmacologia , Complexo de Endopeptidases do Proteassoma/metabolismo , OvinosRESUMO
For the valorization of oilseed press cakes into food products, extrusion can be used. A common way of applying the protein- and fiber-rich press cakes in directly expanded products is the combination thereof with starch, since starch gives a favourable texture, which correlates directly to expansion. To control product properties like expansion of protein and fiber-rich extruded products, the underlying physicochemical changes of proteins, fibers and starch due to thermomechanical input need to be comprehensively described. In this study, rapeseed press cake (RPC) was extruded and treated under defined thermomechanical conditions in a closed-cavity rheometer, pure and in combination with four starches. The impact of starch type (potato PS, waxy potato WPS, maize MS, high-amylose maize HAMS) and temperature (20/25, 80, 100, 120, 140 °C) on protein solubility, starch gelatinization (Dgel), starch hydrolysis (SH) and fiber solubility of the blends was evaluated. The extrusion process conditions were significantly affected by the starch type. In the extruded blends, the starch type had a significant impact on the protein solubility which decreased with increasing barrel temperature. Increasing barrel temperatures significantly increased the amount of soluble fiber fractions in the blends. At defined thermomechanical conditions, the starch type showed no significant impact on the protein solubility of the blends. Therefore, the observed effects of starch type on the protein solubility of extruded blends could be attributed to the indistinct process conditions due to differences in the rheological properties of the starches rather than to molecular interactions of the starches with the rapeseed proteins in the blends.
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BACKGROUND: The aim of this study was to test a CE-certified MR-conditional guidewire to facilitate blood pressure measurement in cardiovascular magnetic resonance (CMR) using fluid-filled catheters in patients with congenital heart disease (CHD). The main purpose was to determine procedural success in a post market clinical follow-up (PMCF) for routine procedure in a diagnostic and interventional workflow. Real-time CMR provides high quality imaging without the risk of exposing the patient to X-rays, especially for patients with irregular heart anatomy and patients who are susceptible to radiation and iodinated contrast media. To date, the assessment of blood pressure gradients is not a common feature of CMR, as these gradients cannot be accurately evaluated in routine CMR. METHODS: Twenty-five CHD patients who were planned for combined clinical CMR and diagnostic and/or interventional catheterization were enrolled in the trial. Prior to inclusion, a specific procedure for catheterization in CMR was defined, encompassing the assessment of pressure and pressure gradients in the heart and great vessels. RESULTS: By the use of an MR-conditional guidewire we successfully measured specific pressure and pressure gradients in up to 92% of cases with liquid-filled catheters which were guided exclusively under CMR guidance. There were no guidewire-related adverse events, and guidewire guidance and manipulation of catheters were successful. CONCLUSIONS: Using a MR-conditional guidewire assists in easily reaching targets in the heart and great vessels and makes the catheter itself visible, so that invasive blood pressure assessment by CMR guidance with liquid-filled catheters can be improved. KEYWORDS: Cardiovascular magnetic resonance (CMR); congenital heart disease (CHD); cardiac catheterization; magnetic resonance; pressure; guidewire.
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Interactions between bile acids and plant-based materials, and the related feedback mechanisms in enterohepatic circulation, have been considered targets for lowering cholesterol. This study aimed to identify lupin compounds that interact with primary bile acids on molecular level. Lupin cotyledons were fractionated and bile acid adsorbing activities were investigated using in vitro digestion, equilibrium dialysis and kinetic analyses. Protein- and fibre-enriched fractions significantly (p ≤ 0.05) adsorbed chenodesoxycholic acids (up to 2.33 µmol/100 g DM). Alcohol purification showed that bile acid adsorption is independent of protein and fibre structures. Moreover, high adsorption was observed with an alcohol extract (6.97 µmol chenodesoxycholic acids/100 g DM) that was rich in phytochemicals, such as flavonoids (1842 mg/100 g DM). These results suggest the formation of hydrophobic interactions between polyphenols and bile acids. Further studies of molecular mechanisms are required to define the contributions of polyphenols to the cholesterol-lowering actions of lupins.
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OBJECTIVE: To evaluate the incidence of cancer within the first 15 years of life in children who underwent cardiac catheterization under the age of one year. METHODS: In this retrospective, single center study, 2770 infants (7.8% with trisomy 21) were studied. All infants underwent cardiac catheterization under one year of age between January 1980 and December 1998. Newly diagnosed cancer in the first 15 years of life was assessed through record linkage to the German Childhood Cancer Registry (GCCR). Cancer risk in study patients was compared to the GCCR population of children less than 15 years. Patients with trisomy 21 were compared to the Danish Cytogenic Register for trisomy 21. Effective radiation doses were calculated for each tumor patient and 60 randomly selected patients who did not develop cancer. RESULTS: In total, 24,472.5 person-years were analyzed. Sixteen children developed cancer, while 3.64 were expected (standardized incidence ratio (SIR) = 4.4, 95% confidence interval (CI): 2.5-7.2, p < 0.001). There was no preferred cancer type. The observed incidence of leukemia and solid tumors in trisomy 21 was only slightly higher (1 in 476 py) than expected (1 in 609 py, p = 0.64). There was no direct relationship between the radiation dose and the incidence of cancer. CONCLUSION: Cardiac catherization in the first year of life was associated with a significantly increased cancer risk in a population with congenital heart disease.
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OBJECTIVES: Existing surgical sealants fail to combine design requirements, such as sealing performance, on-demand activation and biocompatibility. The aim of this study was to compare the effectiveness and safety of the SETALIUM™ Vascular Sealant (SVS), a novel, on-demand activatable sealant, with the commercial sealant, BioGlue®, for the repair of vascular defects. METHODS: In an in vivo porcine model, the use of SVS was compared with BioGlue, for sealing 2-mm defects of the carotid artery and jugular vein. Animals were followed for 7 days and 5 weeks (each time point and per experimental group, n = 4), respectively. The degree of stenosis and flow velocity was determined, and the local tissue response was evaluated. RESULTS: In vivo incision closure succeeded in all cases, and SVS was superior in clinical usability, enabled by its on-demand activation. Unlike BioGlue, SVS use did not induce stenosis and was associated with physiological blood flow in all cases. Moreover, closure with SVS was associated with a low inflammatory reaction and no thrombus formation or intima proliferation, in contrast to BioGlue. CONCLUSIONS: SVS demonstrated effective and rapid sealing of 2-mm vascular defects, with favourable biocompatibility compared to BioGlue. Thus, SVS seems to be an effective and safe vascular sealant.
Assuntos
Materiais Biocompatíveis , Artérias Carótidas/cirurgia , Veias Jugulares/cirurgia , Proteínas/farmacologia , Adesivos Teciduais/farmacologia , Doenças Vasculares/cirurgia , Animais , Modelos Animais de Doenças , SuínosRESUMO
Interference of dietary fibres with the enterohepatic circulation of bile acids is proposed as a mechanism for lowering cholesterol. We investigated how lupin hull and cotyledon dietary fibres interact with primary bile acids using an in vitro model under simulated upper gastrointestinal conditions. Cell wall polysaccharides were isolated and extracted to separate pectin-like, hemicellulosic, and lignocellulosic structures. Lupin hull consisted mainly of structural components rich in cellulose. The viscosity of the in vitro digesta of lupin hull was low, showing predominantly liquid-like viscoelastic properties. On the other hand, lupin cotyledon fibre retarded bile acid release due to increased viscosity of the in vitro digesta, which was linked with high contents of pectic polymers forming an entangled network. Molecular interactions with bile acids were not measured for the hull but for the cotyledon, as follows: A total of 1.29 µmol/100 mg DM of chenodesoxycholic acids were adsorbed. Molecular interactions of cholic and chenodesoxycholic acids were evident for lignin reference material but did not account for the adsorption of the lupin cotyledon. Furthermore, none of the isolated and fractionated cell wall materials showed a significant adsorptive capacity, thus disproving a major role of lupin cell wall polysaccharides in bile acid adsorption.
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Ácidos e Sais Biliares/metabolismo , Parede Celular/metabolismo , Fibras na Dieta/metabolismo , Digestão , Lupinus/metabolismo , Polissacarídeos/metabolismo , Adsorção , Cotilédone/metabolismo , Elasticidade , Interações Hidrofóbicas e Hidrofílicas , ViscosidadeRESUMO
Dietary fibres are reported to interact with bile acids, preventing their reabsorption and promoting their excretion into the colon. We used a method based on in vitro digestion, dialysis, and kinetic analysis to investigate how dietary fibre enriched food ingredients affect the release of primary and secondary bile acids as related to viscosity and adsorption. As the main bile acids abundant in humans interactions with glyco- and tauroconjugated cholic acid, chenodesoxycholic acid and desoxycholic acid were analysed. Viscous interactions were detected for apple, barley, citrus, lupin, pea, and potato derived ingredients, which slowed the bile acid release rate by up to 80%. Adsorptive interactions of up to 4.7 µmol/100 mg DM were significant in barley, oat, lupin, and maize preparations. As adsorption directly correlated to the hydrophobicity of the bile acids the hypothesis of a hydrophobic linkage between bile acids and dietary fibre is supported. Delayed diffusion in viscous fibre matrices was further associated with the micellar properties of the bile acids. As our results indicate changes in the bile acid pool size and composition due to interactions with dietary fibre rich ingredients, the presented method and results could add to recent fields of bile acid research.
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Ácidos e Sais Biliares/química , Fibras na Dieta/análise , Digestão , Alimentos Fortificados/análise , Adsorção , Interações Hidrofóbicas e Hidrofílicas , Hidroxilação , Cinética , Estrutura Molecular , Relação Estrutura-Atividade , ViscosidadeRESUMO
AIMS: It is commonly believed that pulmonary regurgitation (PR) after surgical repair of tetralogy of Fallot (TOF) leads to progressive right ventricular (RV) enlargement. However, progressive RV dilatation has never clearly been documented in this patient population. Therefore, we studied the size of the RV over time in patients after surgical TOF repair. METHODS AND RESULTS: Fifty-one consecutive patients after surgical TOF repair underwent at least two cardiovascular magnetic resonance (CMR) exams using a single CMR scanner. Patients with RV outflow tract obstruction, interventions other than the initial repair and CMR exams with use of sedation were excluded. Three subgroups with different repair techniques were studied: transannular patch repair [n = 22, age 17 ± 10 years], subvalvular patch repair [n = 15, age 22 ± 8 years], or non-patch repair/infundibulectomy (n = 14, age 28 ± 11 years). Right ventricular end-diastolic volume index (RVEDVI) and PR fraction did not change during the 37 ± 21 months follow-up between first and last CMR in the whole group (RVEDVI: 118 ± 23 mL/m2 vs. 119 ± 23 mL/m2, P = 0.720; PR fraction: 33% (23-40%) vs. 32% (24-39%), P = 0.268). RVEDVI remained stable in all subgroups (transannular patch: 120 ± 21 mL/m2 vs. 122 ± 22 mL/m2, subvalvular patch: 112 ± 23 mL/m2 vs. 111 ± 23 mL/m2, non-patch: 123 ± 28 mL/m2 vs. 123 ± 23 mL/m2, P = 0.827). RVEDVI at last CMR did not differ between groups (P = 0.301). CONCLUSIONS: This study shows no progression of RV dilatation in patients after surgical repair of TOF with moderately dilated RVs and significant PR during a 3-year follow-up. RV dilatation in our patient group seems to be independent from surgical repair techniques.
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Procedimentos Cirúrgicos Cardíacos/métodos , Imagem Cinética por Ressonância Magnética/métodos , Tetralogia de Fallot/diagnóstico por imagem , Tetralogia de Fallot/cirurgia , Função Ventricular Direita/fisiologia , Remodelação Ventricular/fisiologia , Adolescente , Adulto , Fatores Etários , Análise de Variância , Distribuição de Qui-Quadrado , Criança , Estudos de Coortes , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Medição de Risco , Estatísticas não Paramétricas , Fatores de Tempo , Adulto JovemAssuntos
Cistos Ósseos , Doenças Mandibulares , Cistos Ósseos/diagnóstico por imagem , Cistos Ósseos/cirurgia , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/cirurgia , Diagnóstico Diferencial , Humanos , Doenças Mandibulares/diagnóstico por imagem , Doenças Mandibulares/cirurgia , Radiografia PanorâmicaRESUMO
BACKGROUND: To evaluate retrospectively the results of radiotherapy for periarthritis of the shoulder METHODS: In 1983-2004, 141 patients were treated, all had attended at least one follow-up examination. 19% had had pain for several weeks, 66% for months and 14% for years. Shoulder motility was impaired in 137/140 patients. Nearly all patients had taken oral analgesics, 81% had undergone physiotherapy, five patients had been operated on, and six had been irradiated. Radiotherapy was applied using regular anterior-posterior opposing portals and Co-60 gamma rays or 4 MV photons. 89% of the patients received a total dose of 6 Gy (dose/fraction of 1 Gy twice weekly, the others had total doses ranging from 4 to 8 Gy. The patients and the referring doctors were given written questionnaires in order to obtain long-term results. The mean duration of follow-up was 6.9 years [0-20 years]. RESULTS: During the first follow-up examination at the end of radiotherapy 56% of the patients reported pain relief and improvement of motility. After in median 4.5 months the values were 69 and 89%, after 3.9 years 73% and 73%, respectively. There were virtually no side effects. In the questionnaires, 69% of the patients reported pain relief directly after radiotherapy, 31% up to 12 weeks after radiotherapy. 56% of the patients stated that pain relief had lasted for "years", in further 12% at least for "months". CONCLUSION: Low-dose radiotherapy for periarthropathy of the shoulder was highly effective and yielded long-lasting improvement of pain and motility without side effects.