Cold thermopeaking-induced drift of nase Chondrostoma nasus larvae.

Research on how intermittent water releases from hydropower plants affect the early life stages of fish has advanced in the last years, focusing not only on the direct impacts of rapid flow changes (hydropeaking), but also on the short-term fluctuations in water temperature (thermopeaking). Flow and thermal fluctuations caused by hydropeaking may affect fish movement patterns and migration at critical stages of a species' life cycle, e.g., by inducing passive downstream drift. Using two experimental outdoor channels, we investigated how nase (Chondrostoma nasus, Cypriniformes) larvae respond to a rapid drop in water temperature during hydropeaking (simulating a cold thermopeaking event), reaching on average 5.5 °C under peak flow (maximum discharge) conditions, in comparison with a hydropeaking treatment with a constant water temperature regime. Responses of fish larvae were analyzed during acclimation, up-ramping (increase in discharge), peak flow and down-ramping (decrease in discharge) phases. Fish drift increased during peak flow in the cold thermopeaking treatment compared to hydropeaking. Higher drift rates were also negatively associated with pronounced water temperature drops during peak flow conditions. In addition, the starting temperature of the experiment influenced drift during up-ramping. Overall, the results suggest that cold thermopeaking may increase drift in the early life stages of cypriniform fish compared with hydropeaking with stable water temperature. Hence, monitoring and active water temperature adjustments following hydropower releases should be adopted as strategies to mitigate power plant-related impacts on aquatic organisms. Supplementary Information: The online version contains supplementary material available at 10.1007/s00027-023-00955-x.

[Child abuse and violence as reasons for injuries in childhood: results of a monitoring of children and adolescents in South Brandenburg (Germany)]. / Misshandlungen und Gewalt als Verletzungsursachen im Kindesalter: Ergebnisse eines Unfallmonitorings bei Kindern und Jugendlichen in Südbrandenburg (Deutschland).

BACKGROUND: During childhood injuries are one of the most common reasons for a consultation, second only to infectious diseases. Not as rare as aspected these injuries are caused by maltreatment. The aim of this study is to show the frequency of non-accidental injuries (NAI) in the patient group from a pediatric hospital in East Germany. MATERIAL AND METHODS: Over a 12-month period all cases of injured children who needed to be hospitalized for treatment were registered. In a computer based questionnaire various parameters, such as age, sex, social status, and accident details were documented. RESULTS: A total of 573 injured children and adolescents needed inpatient treatment. In 86.7% of the cases injuries resulted from an accident. In 8.6% of all cases a connection to violence could be found mostly in the form of head and soft tissue injuries. CONCLUSION: The findings show the importance of a detailed and specific anamnesis and physical exploration of children with trauma. Recognition of maltreated children does not only apply to pediatricians, but also to physicians of several specializations.

MAP1B is required for axon guidance and Is involved in the development of the central and peripheral nervous system.

Microtubule-associated proteins such as MAP1B have long been suspected to play an important role in neuronal differentiation, but proof has been lacking. Previous MAP1B gene targeting studies yielded contradictory and inconclusive results and did not reveal MAP1B function. In contrast to two earlier efforts, we now describe generation of a complete MAP1B null allele. Mice heterozygous for this MAP1B deletion were not affected. Homozygous mutants were viable but displayed a striking developmental defect in the brain, the selective absence of the corpus callosum, and the concomitant formation of myelinated fiber bundles consisting of misguided cortical axons. In addition, peripheral nerves of MAP1B-deficient mice had a reduced number of large myelinated axons. The myelin sheaths of the remaining axons were of reduced thickness, resulting in a decrease of nerve conduction velocity in the adult sciatic nerve. On the other hand, the anticipated involvement of MAP1B in retinal development and gamma-aminobutyric acid C receptor clustering was not substantiated. Our results demonstrate an essential role of MAP1B in development and function of the nervous system and resolve a previous controversy over its importance.

[The general practitioner's part in the initiation of diagnostic procedures in prostate cancer]. / Die Rolle des Hausarztes bei der Initiierung der Diagnostik des Prostatakarzinoms.

AIM: The aim of the study is the analysis of diagnostic procedures performed by general practitioners (GPs) leading to the detection of prostate cancer (PCA). PATIENTS AND METHODS: A retrospective evaluation was performed on all 406 patients who underwent ultrasound-supported transrectal multibiopsy of the prostate in our department between January 2004 and August 2005. The GPs were interviewed by use of standardised questionnaires concerning the indication for specific examinations, referrals to the specialist, the clinical findings and results, and the GPs own urological qualification. The rate of returned questionnaires was 72.9 % (105 of 144 GPs), therefore a study group (SG) of 295 patients (72.7 %) was formed. The mean age was 67.2 (40 - 90) years. RESULTS: In 190 patients (64.4 %) primary diagnostic measures were performed by the GP herself/himself. All the other patients had already been in urological specialist treatment (n = 43), were either referred directly to an urologist for primary diagnostics (n = 42) or were diagnosed during a hospital stay (n = 3). The reasons for the performed diagnostic measures were not to be found in 17 cases. In 50.8 % of all cases the initiation of preventive medical check-ups or determination of PSA levels was done at the patient's own request. 91 of 176 digital rectal examinations (DRE) performed by GPs showed suspect findings, leading to referral to the urologist in 62 cases. PSA levels of 105 patients measured by the GPs ranged between 0.0 and 1662 ng/mL with a mean level of 29.81 and a median of 6.20 ng/mL. In 75 cases the PSA level led to a referral to the urologist. In the case of 27 patients the referral was decided because of clinical symptoms. In 39.0 % (n = 115) of the SG a PCA was detected by biopsy. In 43.0 % (n = 64) of the patients originally examined by the GPs the suspected diagnosis of a PCA based on a pathological PSA level and/or DRE proved to be correct. The GPs stated in 35.2 % (n = 37) that they had spent a certain period of time in a urological department during their medical training. Concerning referrals and the positive predictive value of DRE, there was no statistically significant different to be found in GPs without urological training. CONCLUSION: Every fifth patient in the study group showed a histologically proven PCA that had initially been suspected by a GP based on a pathological PSA level and/or DRE. This underlines the value of preventive exams in the hands of GPs. In addition, the correct and sensible use of PSA levels controls by GPs as well as a pronounced desire for preventive medical check-ups on the patient's side was shown.

[Time limited immunosuppression in allogenic nerve transplant in the rat]. / Die zeitlich begrenzte Immunsuppression am allogenen Nerventransplantat der Ratte.

A rejection response of peripheral nerve allografts eliminates the Schwann cells without destroying the tubular architecture and leads to a regeneration of inferior quality. Under immunosuppression this rejection is prevented, and allogenic Schwann cells persist in the grafts, leading to a better regeneration result. In adult rats of the strains DA and LEW.1W, a 2,5 cm segment of the sciatic nerve was grafted. Under Cyclosporin A regeneration was allowed to take place for 12 weeks. Thereafter, immunosuppression was discontinued in one group and gradually reduced in another. Regeneration quality was compared after an additional six weeks in comparison to an autologous control. Best regeneration was observed in the autologous control; no statistical differences were observed between the two experimental groups. Gradual reduction of immunosuppression did not result in an atraumatic replacement of donor derived Schwann cells by recipient derived ones. Allogenic nerve grafting needs continuous immunosuppression, which to date precludes it from clinical application.

How far is the preoperative Kattan nomogram applicable for the prediction of recurrence after prostatectomy in patients presenting with PSA levels of more than 20 ng/ml? A validation study.

OBJECTIVE: We present an external validation study investigating the applicability of the preoperative Kattan nomogram for predicting recurrence after prostatectomy in a population of patients with serum prostate-specific antigen (PSA) levels exceeding 20 ng/ml. MATERIALS: In the evaluation of clinical parameters pooled from a total of 191 patients presenting with PSA levels ranging between 20.1 and 100 ng/ml, the PSA-free survival rate 60 months after surgery was calculated according to Kattan nomograms. Subsequently, the results were statistically compared with the corresponding actual survival rates obtained from Kaplan-Meier analysis. For this purpose, the patients were assigned to one of four different risk groups according to predictions derived from the Kattan nomograms, enabling a direct comparison of expected (as predicted by Kattan nomogram) versus actual survival of each patient investigated in our study. RESULTS: Predicted PSA-free survival rates were determined to be as follows: 83% (low risk group); 66% (intermediate risk group); 39% (intermediate-high risk group), and 10% (high risk group) in comparison with the actual survival rates determined to be 63, 62, 40 and 21%, respectively. For PSA levels ranging between 20.1 and 30 ng/ml, 30.1 and 50 ng/ml, and 50.1 and 100 ng/dl, PSA-free survival rates were found to be 57, 37, and 27% (p=0.0017), respectively, during a 5-year post-prostatectomy follow-up. CONCLUSIONS: The Kattan nomogram shows good statistical concordance with actual survival rates in the mean risk quadrants, but considerable differences were demonstrated concerning individuals with either a high or with a low risk of cancer progression.

Emergency operation in carcinomas of the left colon: value of Hartmann's procedure.

BACKGROUND: Colonic resection according to the procedure by Hartmann is considered a fast and safe surgical intervention, which has been used for years, in particular, in emergency situations. METHODS: Using data of a prospective multicentre study on the operative treatment of colorectal carcinoma over the time period from 1 January 2000 to 31 December 2002, the value of Hartmann's procedure was investigated in carcinoma of the left colon (n=8825) compared with alternative surgical options under emergency circumstances. The significant impact of independent variables on the type of the selected approach was determined by means of logistic regression. RESULTS: While in total 422 primary Hartmann's procedures (4.8%) were executed under curative intention, 213 (50.5%) of those were carried out in emergency situations. Hartmann's procedure was beneficial in cases with tumour-associated obstruction and perforation of the left colon as it resulted in the lowest mortality (7.5%) of the radical operations. Even under palliative intention, Hartmann's procedure was preferred at the left colon but led to a postoperative mortality (32.7%) very similar to that in creation of a colostoma (33.3%) or segmental colonic resection (38.9%). CONCLUSIONS: Hartmann's procedure has been widely accepted as a curative intervention in emergency cases (oncosurgically adequate R0 resection) for the carcinoma of the left colon. Because of the high postoperative morbidity and mortality in emergency situations with only palliative options (R0 resection not possible), alternative endoscopic treatment should be considered more frequently.