[Myofascial chronic pelvic pain in women : A retrospective evaluation of the effects of specific diagnostics and therapy]. / Myofaszial bedingte chronische Unterbauchschmerzen bei Frauen : Eine retrospektive Auswertung der Auswirkungen einer spezifischen Diagnostik und Therapie.

BACKGROUND: The prevalence of chronic pelvic pain of 11.8% in the general population underlines the importance of this disease. However, the specific diagnostics and therapy of the muscles of this region are not yet part of the standard examination. The following study examines the effects of specific diagnostics and therapy on myofascial chronic pelvic pain. OBJECTIVES: The effectiveness of targeted diagnostics and multimodal therapy in the context of chronic pelvic pain and the need for a complementary drug adjustment. MATERIALS AND METHODS: This study retrospectively evaluated the data of 59 patients, who were referred to a pain center for treatment-resistant chronic pelvic pain in the period from January 2012 to April 2017. The pain needed to be clearly identified as myofascial. A previous minimum duration of pain as well as previous operations or other treatment procedures did not constitute exclusion criteria. Previous traumatization was a reason for exclusion. Therapy components included manual therapeutic treatment, training in self-stretching exercises, medication with the active ingredients flupirtine or methocarbamol, as well as relaxation procedures. Therapy was evaluated on the basis of the German Pain Questionnaire. RESULTS: After the treatment interval, the following statistically significant improvements were recorded: The average pain intensity decreased by 29.95 points (standard deviation [SD] = 20.61). General quality of life (Marburg questionnaire on habitual well-being, MFHW) increased by 1.1 points (SD = 0.73). The depression and anxiety assessment decreased by 2.56 (SD = 3.99) and 2.63 points (SD = 5.21) respectively. CONCLUSION: A multimodal therapy concept with a manual therapeutic treatment focus can lead to an improvement in pain symptoms and quality of life in patients with myofascial chronic pelvic pain after a treatment period of 120 days. Myofascial syndromes of urogenital muscles must be considered in the assessment of the cause of chronic pelvic pain.

A versatile liquid-jet setup for the European XFEL.

The SPB/SFX instrument of the European XFEL provides unique possibilities for high-throughput serial femtosecond crystallography. This publication presents the liquid-jet sample delivery setup of this instrument. The setup is compatible with state-of-the-art gas dynamic virtual nozzle systems as well as high-viscosity extruders and provides space and flexibility for other liquid injection devices and future upgrades. The liquid jets are confined in a differentially pumped catcher assembly and can be replaced within a couple of minutes through a load-lock. A two-microscope imaging system allows visual control of the jets from two perspectives.

AXSIS: Exploring the frontiers in attosecond X-ray science, imaging and spectroscopy.

X-ray crystallography is one of the main methods to determine atomic-resolution 3D images of the whole spectrum of molecules ranging from small inorganic clusters to large protein complexes consisting of hundred-thousands of atoms that constitute the macromolecular machinery of life. Life is not static, and unravelling the structure and dynamics of the most important reactions in chemistry and biology is essential to uncover their mechanism. Many of these reactions, including photosynthesis which drives our biosphere, are light induced and occur on ultrafast timescales. These have been studied with high time resolution primarily by optical spectroscopy, enabled by ultrafast laser technology, but they reduce the vast complexity of the process to a few reaction coordinates. In the AXSIS project at CFEL in Hamburg, funded by the European Research Council, we develop the new method of attosecond serial X-ray crystallography and spectroscopy, to give a full description of ultrafast processes atomically resolved in real space and on the electronic energy landscape, from co-measurement of X-ray and optical spectra, and X-ray diffraction. This technique will revolutionize our understanding of structure and function at the atomic and molecular level and thereby unravel fundamental processes in chemistry and biology like energy conversion processes. For that purpose, we develop a compact, fully coherent, THz-driven atto-second X-ray source based on coherent inverse Compton scattering off a free-electron crystal, to outrun radiation damage effects due to the necessary high X-ray irradiance required to acquire diffraction signals. This highly synergistic project starts from a completely clean slate rather than conforming to the specifications of a large free-electron laser (FEL) user facility, to optimize the entire instrumentation towards fundamental measurements of the mechanism of light absorption and excitation energy transfer. A multidisciplinary team formed by laser-, accelerator,- X-ray scientists as well as spectroscopists and biochemists optimizes X-ray pulse parameters, in tandem with sample delivery, crystal size, and advanced X-ray detectors. Ultimately, the new capability, attosecond serial X-ray crystallography and spectroscopy, will be applied to one of the most important problems in structural biology, which is to elucidate the dynamics of light reactions, electron transfer and protein structure in photosynthesis.

Calculation factors and reference values for quantitative lipoprotein electrophoresis in childhood.

Agarose gel electrophoresis of lipoproteins combined with quantitative densitometry (Lipidophor) and total cholesterol determination enables the calculation of alpha-, pre-beta-and beta cholesterol. This method is quick, precise and requires less than 100 microliters serum. The calculation factors originally derived from adults were re-evaluated and corrected for children. This was achieved by iterative calculation of the results obtained by quantitative densitometry and by enzymatic determination of the cholesterol contents in electrophoretically separated lipoprotein bands. Thus, calculation factors for children were obtained, which were used for the evaluation of reference values for alpha-, pre-beta- and beta-cholesterol and for the beta/alpha-lipoprotein ratio based on a reference group of 575 healthy children of 5-18 years of age.

Cholesterol fractions and triglycerides in children and adults with Down's syndrome.

In 186 patients with Down's syndrome (age 1-68 yr) total cholesterol and triglycerides were determined, quantitative lipoprotein electrophoresis was performed and cholesterol fractions and beta/alpha-lipoprotein ratios were calculated. A reference group of 51 non-mongoloid mentally handicapped adults living in the same institutions were examined in the same way. Patients' total cholesterol, beta-cholesterol and triglycerides did not differ from the controls. However, alpha-cholesterol was significantly lower and the beta/alpha-lipoprotein ratio significantly higher in patients, findings which are associated in the general population with a high risk for premature atherosclerosis. Interestingly, mortality causes and pathological findings in Down's syndrome show no increased frequency of cardiovascular diseases.

Molybdenum metabolism: stable isotope studies in infancy.

The essential trace element molybdenum (Mo) is bound to and required for the function of molybdoenzymes, e.g. sulfite and xanthine oxidase. Dietary recommendations for early infancy are based on limited knowledge about its metabolism. 100Mo was used as an extrinsic tag to study the absorption and kinetics of excretion in infancy. 10 infants with a gestational age of 35 (30-39) weeks, a birth weight of 2.0 (0.9-2.3) kg and a post-natal age of 20 (10-54) days were studied. They received 25 microg 100Mo/kg with a feed of human milk or formula. Fractional urinary and fecal collections were conducted preceding the 100Mo intake and for 48-72 hours afterwards. The materials were analyzed by atomic absorption spectroscopy and inductively coupled plasma mass spectrometry. The median absorption of 100Mo intake was 97.5 (96.3 to 99.1) %. The retention of nutritive Mo intake and 100Mo in the study period was 11.2 (3.8-15.7) microg Mo/kg, equivalent to 35.7 (12.7-55.6) %. The Mo concentration increased to a peak value in urine within 8 (6-13) hours and in feces within 24 (7-48.5) hours. In addition, increases of copper in feces and urine were observed in 8 of 9 infants studied. Mo given orally is well resorbed in premature infants, and predominantly excreted in the urine. Dietary recommendations should prevent excessive intakes in infancy.

[Visions about a new system of health care]. / Thesen für ein zukünftiges Versorgungskonzept.

The current demographic transition is leading to an ever-growing number of individuals needing assistance and physical care. The current health care system is not structured to manage these increasing demands. The elderly, as well as people with dementia or chronic diseases, will account for a large portion of the population. The new visionary system of health care delivery is a composite of local residents and professionals. This system recruits civic involvement within the society from the generation of the so-called third stage of life, thus making professional care affordable. The new system of care is most likely to be realized in regionally defined neighborhood areas, financed though regional budgets and organized by healthcare professionals.

[The new human mode of being demented]. / Die neue menschliche Seinsweise der Demenz.

Today, for the first time in the history of mankind, the number of demented people is so large that we are compelled to speak of a particular population group and a characteristic human mode of being. Ten perspectives describe which personal and societal changes will enable us to adjust to this new situation. Particular consideration is given to a new, more complete image of man.

Quantitative determination of lactose, maltose, and sucrose in urine.

A simple method for determination of lactose, maltose and sucrose in urine is described. The principle of the method consists of enzymatic splitting of these disaccharides and specific measurement the resulting glucose by the Beckman Glucose-Analyzer. The precision and accuracy of the method have been evaluated and its clinical application is briefly discussed.

[Reference values for plasma amino acids in the course of pregnancy]. / Referenzwerte für Plasmaaminosäuren im Verlauf der Schwangerschaft.

Reference values for 26 plasma amino acids were determined by ion exchange chromatography in 29 healthy pregnant women (1st to 3rd trimenon). The results are given as P50 (P7-P93). In the course of pregnancy the concentrations of amino acids generally decrease. Threonine, however, shows a distinct, statistically significant increase. The interindividual concentration ranges are low and they show little change in the course of pregnancy. The data presented here are relevant for dietary treatment of metabolic disorders, e.g. maternal phenylketonuria in pregnants.

[Reference values for apolipoproteins and HDL-2/HDL-3 in childhood]. / Referenzwerte für Apolipoproteine und HDL-2/HDL-3 im Kindesalter.

It is known from epidemiological studies, that high apolipoprotein B or low HDL-2 concentrations in serum are correlated with an increased risk for premature cardiovascular diseases. It was the aim of this study to generate reference values for apolipoproteins and HDL-cholesterol fractions to accomplish early diagnosis and therapy. All concentrations are age depending, being low at birth and increasing during the first years of life. This rise is more pronounced in apolipoprotein B than in apolipoprotein AI and HDL-2. Apolipoprotein II and HDL-3 reach later childhood values as early as at the end of the first month of life. The ratio of B and AI, which is a very good indicator for an increased risk for premature cardiovascular diseases, moves also distinctively upward during the first year of life.

Trace elements in excavated human hair.

Concentrations of the elements Ca, Sr, Mg, Zn and Cu were determined in excavated hair specimens and adherent, most probably soil remains from two sites in Germany. Though soil contamination obviously has occurred, the two groups could be distinguished by differential trace element contents in the hair samples. The trace element concentrations might be interpreted in terms of nutritional intake, the results being corroborated by preceding bone analyses and the different local and social settings. Hair decomposition is discussed.

In vivo interference of heparin bolus injection with photometric continuous lipase determination.

The new photometric lipase determinations use diacylglycerols as substrates in a micellar solution, whereas the turbidimetric method is based on emulsified triacylglycerols degradation. Extrahepatic lipoprotein lipase, which is well known to be liberated by heparin from the capillar binding sites, may cleave triacylglycerols as well as diacylglycerols. When a heparin bolus injection is given to a patient, the released lipoprotein lipase renders high lipase activities in blood misleading for a pancreatic disorder.