[Severe hypertriglyceridemia : Diagnostics and new treatment principles]. / Schwere Hypertriglyzeridämie : Diagnostik und neue Therapieprinzipien.

Severe hypertriglyceridemia is defined at a plasma triglyceride (TG) concentration of >885 mg/dl and may result - in particular when clinical symptoms appear before the age of 40 - from "large variant" mutations in genes which influence the function of the lipoprotein lipase (LPL). For diagnosis, secondary factors have to be excluded and treated before further genetic tests are considered. Typical symptoms in almost all patients are recurrent, sometimes severe abdominal pain attacks, which can result in acute pancreatitis, the most important, sometimes life-threatening complication. To minimize the risk of severe pancreatitis, the aim is to maintain the plasma TG concentration <1000 mg/dl. Other clinical manifestations which can occur and are reversible are eruptive xanthomas, lipemia retinalis, hepatosplenomegaly, dyspnea syndrome, and impaired neurocognitive function. The hyperviscosity syndrome caused by chylomicronemia is seen as the underlying reason for some of the symptoms. Patients with mild-to-moderate hypertriglyceridemia have an increased cardiovascular risk. To lower this is the primary treatment goal here. Treatment mainly consists of a life-long, strict fat- and carbohydrate-restricted diet and the abstention from alcohol. Omega­3-Fatty acids and fibrates can be used to lower plasma TG levels. Recently, new gene therapy approaches for LPL-deficient patients have become available in Germany.

Efficacy and safety of oral alitretinoin in severe oral lichen planus--results of a prospective pilot study.

BACKGROUND: Patients with severe oral lichen planus refractory to standard topical treatment currently have limited options of therapy suitable for long-term use. Oral alitretinoin (9-cis retinoic acid) was never systematically investigated in clinical trials, although case reports suggest its possible efficacy. OBJECTIVES: To assess the efficacy and safety of oral alitretinoin taken at 30 mg once daily for up to 24 weeks in the treatment of severe oral lichen planus refractory to standard topical therapy. METHODS: We conducted a prospective open-label single arm pilot study to test the efficacy and safety of 30 mg oral alitretinoin once daily for up to 24 weeks in severe oral lichen planus. Ten patients were included in the study. Primary end point was reduction in signs and symptoms measured by the Escudier severity score. Secondary parameters included pain and quality of life scores. Safety parameters were assessed during a follow-up period of 5 weeks. RESULTS: A substantial response at the end of treatment, i.e. >50% reduction in disease severity measured by the Escudier severity score, was apparent in 40% of patients. Therapy was well tolerated. Adverse events were mild and included headache, mucocutaneous dryness, musculoskeletal pain, increased thyroid-stimulating hormone and dyslipidaemia. CONCLUSIONS: Alitretinoin given at 30 mg daily reduced disease severity of severe oral lichen planus in a substantial proportion of patients refractory to standard treatment, was well tolerated and may thus represent one therapeutic option for this special group of patients.

An equine cadaver study investigating the relationship between cervical flexion, nuchal ligament elongation and pressure at the first and second cervical vertebra.

Pressure in the atlanto-axial region due to hyperflexion ('rollkur') may influence the development of a nuchal bursa, as adventitious bursae may be caused by pressure. Investigating the pressure between the nuchal ligament and atlas/axis in a flexed position may provide information on the pathogenesis of nuchal bursitis. In this study, ten equine head and neck specimens with one side of the soft tissues over the cervical vertebral spine removed were placed in lateral recumbency on a table in neutral, mildly flexed, and hyperflexed head and neck positions. Angulations of the neck were measured using markers placed on the nuchal ligament and drilled into the skull, vertebrae and withers. In six specimens, the pressure between the nuchal ligament and the atlas and the axis was measured using an inflatable air pouch. Hyperflexion was associated with the highest nuchal ligament length and with the highest pressure values at the site of the nuchal bursa over the atlas (99±24mmHg, more than four times the pressure in the neutral position) and over the axis (77±30mmHg, more than twice the pressure values of the neutral position). Also, over the three head and neck positions, neck flexion angles were highly correlated with pressure values and with nuchal ligament length. This marked increase in pressure at the level of atlas and axis caused by head and neck hyperflexion should be considered during training of horses at risk of, or diagnosed with, nuchal bursitis.

[Comparative studies on the accuracy of fit of upper complete dentures with plastic or cast metal bases]. / Vergleichende Untersuchungen der Passgenauigkeit oberer Totalprothesen mit Kunststoff- und Modellgussbasen.

The conclusion was reached on the basis of statistically significant results that the tendency to cleft formation is significantly less in cast plates than in plastic plates, particularly in the region of the critical dorsal border zone.

Size-dependent melting of self-assembled indium nanostructures.

We have measured the melting temperature of nanoscale indium islands on a WSe(2) substrate using perturbed angular correlations combined with scanning tunneling microscopy. The indium islands are self-assembled nanostructures whose diameter can vary between about 5 and 100 nm, depending on deposition conditions. The melting point decreases due to surface energies as the islands get smaller. This decrease depends on the faceting of the crystalline nanostructures and interactions between the islands and the substrate.