[Implementation of Work-Related Medical Rehabilitation: A Propensity Score Matched Comparison of Two Cohorts from 2012 and 2014]. / Implementierung medizinisch-beruflich orientierter Rehabilitation: Ein Propensity Score gematchter Vergleich zweier Kohorten aus 2012 und 2014.

AIM OF THE STUDY: We examined if the work-related treatment dose has changed in 2014 than compared to 2012, if the work-related treatment dose differed between common medical rehabilitation (MR) and work-related medical rehabilitation (WMR), and if the therapy recommendations for WMR were met in Northern Germany rehabilitation centres in 2014. MATERIAL AND METHODS: Patients who were treated in WMR or conventional medical rehabilitation in 2014 were matched with patients treated in 2012 by using propensity scores. RESULTS: Patients who were treated in WMR in 2014 received more work-related interventions than comparable patients in 2012 (13.5 vs. 2.5 h) and MR patients in 2014 (13.5 vs. 1.2 h). 30 min of social counselling, 180 min of work-related psychological groups and 360 min of work-related functional capacity training were realised for 93.8, 82 and 41% of the patients participating in WMR in 2014 CONCLUSION: WMR programs in Northern Germany meet the recommendations of the WMR guideline.

Exhaustive mining of EST libraries for genes differentially expressed in normal and tumour tissues.

A four-step procedure for the efficient and systematic mining of whole EST libraries for differentially expressed genes is presented. After eliminating redundant entries from the EST library under investigation (step 1), contigs of maximal length are built upon each remaining EST using about 4 000 000 public and proprietary ESTs (step 2). These putative genes are compared against a database comprising ESTs from 16 different tissues (both normal and tumour affected) to determine whether or not they are differentially expressed (step 3; electronic northern). Fisher's exact test is used to assess the significance of differential expression. In step 4, an attempt is made to characterise the contigs obtained in the assembly through database comparison. A case study of the CGAP library NCI_CGAP_Br1.1, a library made from three (well, moderately, and poorly differentiated) invasive ductal breast tumours (2126 ESTs in total) was carried out. Of the maximal contigs, 139 were found to be significantly (alpha = 0.05) over-expressed in breast tumour tissue, while 13 appeared to be down-regulated.

Compilation of ribosomal 5S ribonucleic acid nucleotide sequences: eukaryotic 5S rRNAs.

5S Ribosomal RNA is the smallest RNA component of the ribosomes. Due to relatively simple isolation and sequencing procedures as well as a potential use of the sequence data in evolutionary analyses, the amount of known nucleotide sequences on both RNA and DNA levels was rapidly growing. In this paper we present the updated (March 1996) compilation of eukaryotic 5D rRNA and 5S rDNA sequences.

Characterization of recombinant human nicotinamide mononucleotide adenylyl transferase (NMNAT), a nuclear enzyme essential for NAD synthesis.

Nicotinamide mononucleotide adenylyl transferase (NMNAT) is an essential enzyme in all organisms, because it catalyzes a key step of NAD synthesis. However, little is known about the structure and regulation of this enzyme. In this study we established the primary structure of human NMNAT. The human sequence represents the first report of the primary structure of this enzyme for an organism higher than yeast. The enzyme was purified from human placenta and internal peptide sequences determined. Analysis of human DNA sequence data then permitted the cloning of a cDNA encoding this enzyme. Recombinant NMNAT exhibited catalytic properties similar to the originally purified enzyme. Human NMNAT (molecular weight 31932) consists of 279 amino acids and exhibits substantial structural differences to the enzymes from lower organisms. A putative nuclear localization signal was confirmed by immunofluorescence studies. NMNAT strongly inhibited recombinant human poly(ADP-ribose) polymerase 1, however, NMNAT was not modified by poly(ADP-ribose). NMNAT appears to be a substrate of nuclear kinases and contains at least three potential phosphorylation sites. Endogenous and recombinant NMNAT were phosphorylated in nuclear extracts in the presence of [gamma-(32)P]ATP. We propose that NMNAT's activity or interaction with nuclear proteins are likely to be modulated by phosphorylation.

Evolution of organisms and organelles as studied by comparative computer and biochemical analyses of ribosomal 5S RNA structure.

The results documented in this publication demonstrate that for evolutionary studies the ribosomal 5S rRNA is a suitable object for such an investigation and that as many methods as possible should be consulted. In this study the results of biochemical and chemical experiments were combined with those of computer sequence analyses, and they revealed that these methods complement each other nicely. We are currently at a state at which we are able to well define the secondary structures of the 5S rRNAs for eubacteria, organelles, archaebacteria, and eukaryotes and we are even able to propose a secondary structure for a Ur-5S rRNA. It is also clear that in the future the present studies should be continued and extended in such a way that the tertiary structures of these molecules will become known.

The decisive role of the water structure in changes of conformation of nucleic acids.

This review summarizes data on the structure and properties of water under normal conditions, at high salt concentration and under high pressure. We correlate the observed conformational transitions in nucleic acids with changes in water structure and activity, and suggest a mechanism of conformational transitions of nucleic acid involving these changes. We conclude that the Z-DNA form is induced only at low water activity caused by high salt concentrations and/or high pressure.

Effects of clustered drill holes on the breaking strength of the equine third metacarpal bone.

The breaking strength (stress at failure) of equine third metacarpal bones, with and without clustered drill holes, was determined in vitro. Paired ossa metacarpalia II-IV of 39 horses (n = 39) between 2 and 7 years old were tested in palmarodorsal 3-point bending. Four treatments were compared. Clustered 2.7- or 3.5-mm drill holes, in a 4- or 7-hole pattern, were made in the dorsal cortex of the distal diaphysis of the left third metacarpal bone. Undrilled right third metacarpi were used as controls. Bones with clustered drill holes failed by an oblique fracture through 1 or more drill holes, whereas undrilled bones failed with a middiaphyseal transverse fracture. Clustered drill holes acted as a stress concentrator and significantly (P less than 0.05) decreased the stress required for failure. However, differences in breaking strength between treatment groups were not significant (P greater than 0.05).

Pharmacokinetics of metronidazole and its concentration in body fluids and endometrial tissues of mares.

Serum concentrations of metronidazole were determined in 6 healthy adult mares after a single IV injection of metronidazole (15 mg/kg of body weight). The mean elimination rate (K) was 0.23 h-1, and the mean elimination half-life (t1/2) was 3.1 hours. The apparent volume of distribution at steady state was 0.69 L/kg, and the clearance was 168 ml/h/kg. Each mare was then given a loading dose (15 mg/kg) of metronidazole at time 0, followed by 4 maintenance doses (7.5 mg/kg, q 6 h) by nasogastric tube. Metronidazole concentrations were measured in serial samples of serum, synovia, peritoneal fluid, and urine. Metronidazole concentrations in CSF and endometrial tissues were measured after the fourth maintenance dose. The highest mean concentration in serum was 13.9 +/- 2.18 micrograms/ml at 40 minutes after the loading dose (time 0). The highest mean synovial and peritoneal fluid concentrations were 8.9 +/- 1.31 micrograms/ml and 12.8 +/- 3.21 micrograms/ml, respectively, 2 hours after the loading dose. The lowest mean trough concentration in urine was 32 micrograms/ml. Mean concentration of metronidazole in CSF was 4.3 +/- 2.51 micrograms/ml and the mean concentration in endometrial tissues was 0.9 +/- 0.48 micrograms/g at 3 hours after the fourth maintenance dose. Two mares hospitalized for treatment of bacterial pleuropneumonia were given metronidazole (15.0 mg/kg, PO, initially then 7.5 mg/kg, PO, q 6 h), while concurrently receiving gentamicin, potassium penicillin, and flunixin meglumine IV. Metronidazole pharmacokinetics and serum concentrations in the sick mares were similar to those obtained in the healthy mares.

Surgical treatment of sand colic in equids: 48 cases (1978-1985).

Medical records of 48 equids (47 horses, 1 pony) with surgical sand colic were reviewed. The diagnosis of sand colic was made if a sand impaction(s) was palpated during exploratory abdominal surgery or if a large quantity of sand was found during colotomy. Most equids did not experience a previous episode of sand diarrhea or sand colic. Clinical findings and results of clinicopathologic determinations were not diagnostic. Rectal palpation findings in 40 of 46 horses were compatible with large-colon and/or cecal distention. Impactions were palpable per rectum in only 7 horses, but emergency abdominal surgery revealed one or more impactions in 46 of 48 equids. Single impaction most commonly was observed at the pelvic flexure. Twenty-six horses had concurrent large-colon torsion or displacement. Pelvic flexure colotomy was performed in 44 horses. Of 48 equids, 44 survived and were discharged.

Subchondral cyst-like lesions in the distal portion of the radius of four horses.

Four horses with subchondral cyst-like lesions in the medial radial facet of the distal portion of the radius were examined. Joint effusion and signs of pain from flexion of the antebrachiocarpal joint were not observed, but lameness was observed in 3 of the 4 horses. Regional nerve blocks and intra-articular anesthesia were used to localize the lesions, and conservative treatment resulted in soundness for performance.

Vacuum phenomenon in the metatarsophalangeal joint of a horse.

Vacuum phenomenon was induced inadvertently during radiographic examination of a metatarsophalangeal joint of a lame horse. The phenomenon was recreated in a sound horse when a metacarpophalangeal joint was radiographed in a stress-flexed position. Distraction of apposing articular surfaces may induce the vacuum phenomenon, which could result in misdiagnosis of an osteochondral defect or fracture.

Skin pustules and nodules caused by Actinomyces viscosus in a horse.

A 12-year-old Arabian stallion was evaluated for a refractory skin problem of 2 years' duration. Skin nodules and pustules, which would rupture, had developed over the right lumbar muscles. Anaerobic culturing from the pustules yielded Actinomyces viscosus, and histologic examination of biopsy specimens revealed globular eosinophilic structures. Concomitant treatment with isoniazid (8 mg/kg of body weight, q 24 h for 8 weeks), trimethoprim-sulfadiazine (30 mg/kg, q 24 h for 8 weeks), and sodium iodide solution (66 mg/kg, every 1, 2, or 4 weeks, for 32 weeks) resolved the condition.

Hemoperitoneum caused by rupture of a juvenile granulosa cell tumor in an equine neonate.

A neonatal foal was examined because of apparent abdominal pain and distention, anemia, and hemoperitoneum. Exploratory laparotomy was performed, and a large spherical mass, which had ruptured, was found in the area of the left ovary. Left salpingo-oophorectomy was performed. The mass was determined to be a juvenile granulosa cell tumor.

Ethmoidal hematoma in nine horses.

Ethmoidal hematoma was diagnosed in 9 horses by results of physical examination, endoscopy, radiography, and histologic examination of tissues. The horses had stertorous breathing (n = 4) or intermittently sanguineous nasal discharge (n = 7). All horses underwent sinusotomy and extirpation of the lesion. At reexamination 15 to 104 months after surgery (mean, 61 months), 3 horses had recurrence of ethmoidal hematoma, and 1 horse had ethmoidal hematoma involving the contralateral ethmoturbinates. One of the horses with recurrence of ethmoidal hematoma also developed a contralateral lesion; both lesions recurred and additional surgeries were performed.

A light probe adapted for use in training the blind.

The application of modern electronics technology has produced a number of new sensory aids for the blind. Serious limitations are presented, however, by the high cost and sophisticated training and maintenance requirements some of the new aids demand. This paper describes the design and development of an economical light sensor. Construction notes, including complete parts requirements, are given. Prototype applications to blind rehabilitation training and suggested uses as a personal sensory aid are discussed and critically evaluated.

Influence of anxiety on the course of heart disease after acute myocardial infarction - risk factor or protective function?

BACKGROUND: There is a lack of clarity concerning the effect of anxiety on the course of cardiac events following myocardial infarction. Some studies have identified anxiety as a risk factor for further cardiac events. However, it is also considered to be a protective factor, as a higher level of anxiety may improve patient compliance and regular medical checkups. METHODS: A group of 76 patients with myocardial infarction underwent physical examination and had their anxiety levels assessed within the first week, and 31 months after myocardial infarction. Cardiac events were documented during the follow-up period. We investigated the predictive value for the occurrence of cardiac events of sociodemographic, psychological and physical parameters when evaluated within the first week after myocardial infarction. Compliancy and regularity of medical checkups were registered. RESULTS: Cardiac events occurred in 24 patients during a mean follow-up period of 31 months. The group of anxious patients not only suffered more often from cardiac events, these events also occurred earlier than in nonanxious patients. Age, gender, partner status, level of anxiety and comorbid diabetes at the time of first assessment proved to be discriminatory variables between patients suffering further cardiac incidents and those free of further events. Anxious patients were more likely to continue smoking, whereas less anxious patients were more likely to give up smoking.