New strategies for a sustainable 99mTc supply to meet increasing medical demands: Promising solutions for current problems

The continuing rapid expansion of ^99mTc diagnostic agents always calls for scaling up ^99mTc production to cover increasing clinical demand. Nevertheless, ^99mTc availability depends mainly on the fission-produced ⁹⁹Mo supply. This supply is seriously influenced during renewed emergency periods, such as the past ⁹⁹Mo production crisis or the current COVID-19 pandemic. Consequently, these interruptions have promoted the need for ^99mTc production through alternative strategies capable of providing clinical-grade ^99mTc with high purity. In the light of this context, this review illustrates diverse production routes that either have commercially been used or new strategies that offer potential solutions to promote a rapid production growth of ^99mTc. These techniques have been selected, highlighted, and evaluated to imply their impact on developing ^99mTc production. Furthermore, their advantages and limitations, current situation, and long-term perspective were also discussed. It appears that, on the one hand, careful attention needs to be devoted to enhancing the ⁹⁹Mo economy. It can be achieved by utilizing ⁹⁸Mo neutron activation in commercial nuclear power reactors and using accelerator-based ⁹⁹Mo production, especially the photonuclear transmutation strategy. On the other hand, more research efforts should be devoted to widening the utility of ⁹⁹Mo/^99mTc generators, which incorporate nanomaterial-based sorbents and promote their development, validation, and full automization in the near future. These strategies are expected to play a vital role in providing sufficient clinical-grade ^99mTc, resulting in a reasonable cost per patient dose.

[Recommendations on treatment of acute appendicitis : Recommendations of an expert group based on the current literature]

The paradigm shift in the treatment concept for acute appendicitis is currently the subject of intensive discussions. The diagnosis and differentiation of an uncomplicated from a complicated appendicitis as well as the selection of an adequate treatment is very challenging, especially since nonoperative treatment models have been published. The laparoscopic appendectomy is still the standard for most cases. Guidelines for the treatment of acute appendicitis do not exist in Germany. Therefore, a group of experts elaborated 21 recommendations on the treatment of acute appendicitis after 3 meetings. After initial definition of population, intervention, comparison and outcome (PICO) questions, recommendations have been finalized through the Delphi voting system. The results were evaluated according to the current literature. The aim of this initiative was to define a basic support for decision making in the clinical routine for treatment of acute appendicitis.

(n,γ) reactions on rare Ca isotopes: Valence-hole - core excitation couplings in 47Ca

Recent results on the structure of 47Ca will be presented. The nucleus of interest was populated via the cold-neutron capture 46Ca(n,γ) reaction, on a rare 46Ca target, during the EXILL experimental campaign at the nuclear reactor of Institut Laue- Langevin in Grenoble. High-resolution γ-ray spectroscopy, performed with a composite array of HPGe detectors, enabled the identification of new transitions deexciting states between the neutron-capture level and the ground state. Experimental data will be compared with a novel microscopic theoretical model, currently under development, specifically designed to describe the low-lying structure of odd-mass nuclei with one valence particle/hole outside a spherical doubly-magic core, using the Skyrme effective interaction self-consistently.

[Patient Satisfaction as a Measure of Quality of Patient Care - Comparison between a University Hospital and a General Hospital]

Objective: The aim of the study was to compare the satisfaction of patients of a general hospital with a university hospital. A patient satisfaction index was calculated based on the assessed levels of satisfaction. In general, higher satisfaction could lead to increased competitiveness and improved cost efficiency for achieving profitability. Methods: The authors developed and administered a questionnaire on distinct parameters presumed to reflect the quality of the hospital stay to patients of a university hospital (University Hospital of Bonn, UKB, 1 224 beds) and a general hospital (Johanniterkrankenhaus, Bonn, JKH, 364 beds). Data were collected anonymously. Patient satisfaction and the relative importance of each parameter were assessed. The quotient of both parameters yields the patient satisfaction index (PZI). In order to account for possible differences in patient demands, statistical analysis was performed. Results: The demands and wishes, satisfaction and importance of the retrieved parameters did not differ significantly between the patients of the hospitals in any of aspects assessed (information, participation, contact and comfort during the hospital-stay). The study showed that communication and the contact to physicians and nurses was significantly more important for the patients than comfort (each p<0.001). The highest PZI were found in the categories entertainment (UKB 1.02; JKH 1.25) and contact to the nursing personnel (PZI UKB 0.94; PZI JKH 0.96). The standard of medical-technical care (UKB 0.93; JKH 0.95) was also highly ranked by patients of both hospitals. Needs for improvement related especially to the communication of errors (UKB 0.33; JKH 0.31). Discussion: Surveillance of patient wishes and criticism may result in a more patient-oriented care on a daily basis. Scrutinizing the resources employed may lead to more efficient use of resources and personnel and thus help cut costs and improve the attractiveness of hospitals.

Direct Measurement of the Mass Difference of (163)Ho and (163)Dy Solves the Q-Value Puzzle for the Neutrino Mass Determination

The atomic mass difference of (163)Ho and (163)Dy has been directly measured with the Penning-trap mass spectrometer SHIPTRAP applying the novel phase-imaging ion-cyclotron-resonance technique. Our measurement has solved the long-standing problem of large discrepancies in the Q value of the electron capture in (163)Ho determined by different techniques. Our measured mass difference shifts the current Q value of 2555(16) eV evaluated in the Atomic Mass Evaluation 2012 [G. Audi et al., Chin. Phys. C 36, 1157 (2012)] by more than 7σ to 2833(30(stat))(15(sys)) eV/c(2). With the new mass difference it will be possible, e.g., to reach in the first phase of the ECHo experiment a statistical sensitivity to the neutrino mass below 10 eV, which will reduce its present upper limit by more than an order of magnitude.

[CAMIC Recommendations for Surgical Laparoscopy in Non-Obstetric Indications during Pregnancy]

In the operative surgical primary care, the laparoscopic surgical technique has firmly established itself in recent years. Meanwhile, in the normal population over 90 % of all cholecystectomies and over 80 % of all appendectomies are performed in a minimally invasive manner. The proven benefits of the laparoscopic surgical technique, compared with conventional open surgery, are a comparatively rapid early postoperative recovery with early resumption of the general physical and occupational activity. As these benefits are equally applicable for necessary interventions during pregnancy, in recent years laparoscopy has become the preferred treatment for non-obstetric indications in the gravid patient. Overall, it can be assumed that such interventions have to be performed in approximately 2 % of all pregnant patients. Numerous studies have proven here that the use of laparoscopic techniques, in particular for the expectant mother, is safe and not associated with an increased risk. On the other hand, the current pregnancy makes necessary an adapted approach to the solution of surgical problems to ensure the protection of the unborn child. On the basis of currently available data situation, recommendations are formulated which can be used as a decision-making support for a variety of clinical situations.

Nuclear chemistry. Synthesis and detection of a seaborgium carbonyl complex

Experimental investigations of transactinoide elements provide benchmark results for chemical theory and probe the predictive power of trends in the periodic table. So far, in gas-phase chemical reactions, simple inorganic compounds with the transactinoide in its highest oxidation state have been synthesized. Single-atom production rates, short half-lives, and harsh experimental conditions limited the number of experimentally accessible compounds. We applied a gas-phase carbonylation technique previously tested on short-lived molybdenum (Mo) and tungsten (W) isotopes to the preparation of a carbonyl complex of seaborgium, the 106th element. The volatile seaborgium complex showed the same volatility and reactivity with a silicon dioxide surface as those of the hexacarbonyl complexes of the lighter homologs Mo and W. Comparison of the product's adsorption enthalpy with theoretical predictions and data for the lighter congeners supported a Sg(CO)6 formulation.

Theoretical predictions of properties and volatility of chlorides and oxychlorides of group-4 elements. II. Adsorption of tetrachlorides and oxydichlorides of Zr, Hf, and Rf on neutral and modified surfaces

With the aim to interpret results of gas-phase chromatography experiments on volatility of group-4 tetrachlorides and oxychlorides including those of Rf, adsorption enthalpies of these species on neutral, and modified quartz surfaces were estimated on the basis of relativistic, two-component Density Functional Theory calculations of MCl4, MOCl2, MCl6(-), and MOCl4(2) with the use of adsorption models. Several mechanisms of adsorption were considered. In the case of physisorption of MCl4, the trend in the adsorption energy in the group should be Zr > Hf > Rf, so that the volatility should change in the opposite direction. The latter trend complies with the one in the sublimation enthalpies, ΔH(sub), of the Zr and Hf tetrachlorides, i.e., Zr < Hf. On the basis of a correlation between these quantities, ΔH(sub)(RfCl4) was predicted as 104.2 kJ/mol. The energy of physisorption of MOCl2 on quartz should increase in the group, Zr < Hf < Rf, as defined by increasing dipole moments of these molecules along the series. In the case of adsorption of MCl4 on quartz by chemical forces, formation of the MOCl2 or MOCl4(2-) complexes on the surface can take place, so that the sequence in the adsorption energy should be Zr > Hf > Rf, as defined by the complex formation energies. In the case of adsorption of MCl4 on a chlorinated quartz surface, formation of the MCl6(2-) surface complexes can occur, so that the trend in the adsorption strength should be Zr ≤ Hf < Rf. All the predicted sequences, showing a smooth change of the adsorption energy in the group, are in disagreement with the reversed trend Zr ≈ Rf < Hf, observed in the "one-atom-at-a-time" gas-phase chromatography experiments. Thus, currently no theoretical explanation can be found for the experimental observations.

48Ca+249Bk fusion reaction leading to element Z = 117: long-lived α-decaying 270Db and discovery of 266Lr

The superheavy element with atomic number Z=117 was produced as an evaporation residue in the (48)Ca+(249)Bk fusion reaction at the gas-filled recoil separator TASCA at GSI Darmstadt, Germany. The radioactive decay of evaporation residues and their α-decay products was studied using a detection setup that allowed measuring decays of single atomic nuclei with half-lives between sub-μs and a few days. Two decay chains comprising seven α decays and a spontaneous fission each were identified and are assigned to the isotope (294)117 and its decay products. A hitherto unknown α-decay branch in (270)Db (Z = 105) was observed, which populated the new isotope (266)Lr (Z = 103). The identification of the long-lived (T(1/2) = 1.0(-0.4)(+1.9) h) α-emitter (270)Db marks an important step towards the observation of even more long-lived nuclei of superheavy elements located on an "island of stability."

A comparison between the chemical behaviour of lead-gold and lead-bismuth eutectics towards 316L stainless steel

Lead-gold eutectic (LGE) has been recently proposed as an alternative target material for high power spallation sources. In order to compare the corrosive properties of LGE to the better-studied eutectic of lead-bismuth (LBE), an isothermal twin-loop made of SS 316L was built and operated at the Institute of Physics of the University of Latvia. We have measured the concentration of steel alloying elements dissolved in both alloys at the end of two test campaigns via ICP-OES. In case of LGE, a pronounced concentration increase of Fe, Ni, Mn and Cr is found in the liquid metal, which is significantly higher compared to LBE. Similar results were obtained during complementary investigations on material samples exposed to both alloys in this twin-loop at 400 ◦C and 450 ◦C. These findings indicate that in contact with LGE, SS 316L steel suffers from substantial chemical attack. Detailed investigations using structure materials other than SS 316L have to be undertaken before qualifying LGE as a serious alternative to LBE.

Spectroscopy of element 115 decay chains

A high-resolution α, x-ray, and γ-ray coincidence spectroscopy experiment was conducted at the GSI Helmholtzzentrum für Schwerionenforschung. Thirty correlated α-decay chains were detected following the fusion-evaporation reaction 48Ca + 243Am. The observations are consistent with previous assignments of similar decay chains to originate from element Z=115. For the first time, precise spectroscopy allows the derivation of excitation schemes of isotopes along the decay chains starting with elements Z>112. Comprehensive Monte Carlo simulations accompany the data analysis. Nuclear structure models provide a first level interpretation.

Nuclear structure and reaction studies near doubly magic 270Hs

Fast on-line gas chemical separations of Hs (hassium, element 108) in the form of HsO4 were applied to investigate the reactions 26Mg + 248Cm and 36S + 238U. In an experiment at the gas-filled separator DGFRS the reaction 48Ca + 226Ra was studied. In all cases the product of complete nuclear fusion is 274Hs*. For the first time, the new nuclide 270Hs was produced in the 4n evaporation channel and its decay properties investigated. The nuclide 270Hs was predicted by microscopic-macroscopic calculations to be a deformed doubly magic nucleus and its decay properties are therefore of special interest to theory. Also, much more detailed information was gained on the decay of 269Hs and its daughters, which led to a new assignment of decay properties of the daughter nuclides 265Sg and 261Rf. There is evidence fo r isomeric states in 265Sg and 261Rf, while 266Sg is not an alpha-particle emitter as believed previously, but decays by spontaneous fission (SF) with a rather short half-life. Also, interesting features of the used reaction 26Mg + 248Cm led to the discovery of the nucleus 271Hs in the same experiments. An investigation of the influence of the Q-value on the fusion reaction in relation to the location of the fusion barrier showed, that the high binding energy of 48Ca largely compensates for the lower fusion probability compared to more asymmetric reactions, while 36S is not as promising as a projectile.

Adsorption interaction of astatine species with quartz and gold surfaces

The adsorption interaction of various astatine species with quartz and gold surfaces was investigated by gas chromatography methods. Due to variations of the redox potential of the carrier gas elemental astatine, astatine oxide and hypo-astatic acid have been produced. The identification of the astatine compounds is based on the analogy assumption to the gas phase chemistry of the closest homologues in group 17 of the periodic table, iodine and bromine. The deposition temperatures as well as enthalpies of adsorption have been determined for the astatine species. The enhancement of the metallic character within group 17 towards higher Z is clearly confirmed. Macroscopic properties (sublimation enthalpy) of previously unstudied AtO2 and HAtO were estimated. The determined data for elemental astatine were compared to available literature data. Based on the obtained experimental results possible designs of experiments for studying of chemical properties of the recently discovered element 117 can be suggested.

[Cost-effectiveness of hernia repair : IPOM versus open sublay mesh technique]

In comparison to the conventional technique of incisional or umbilical hernia repair with sublay mesh augmentation, incisional hernias in obese patients can be surgically treated with minor surgical trauma by laparoscopic intraperitoneal onlay mesh (IPOM) repair. However, although shortened operation time, hospital stay and faster postoperative reconvalescence might be possible with IPOM repair, the economic calculation including mesh costs is significantly higher. In this study the two operation techniques were compared and the perioperative advantages and disadvantages of both methods were analyzed based on the German diagnosis-related groups (DRG) system.

Improved column-based radiochemical processing of the generator produced 68Ga

An improved chemical strategy for processing of the generator produced (68)Ga was developed based on processing of the original (68)Ge/(68)Ga generator eluate on a micro-column. Direct pre-concentration and purification of the eluted (68)Ga is performed on a cation-exchange resin in hydrochloric acid/acetone media. A supplementary step based on a second micro-column filled with a second resin allows direct re-adsorption of (68)Ga eluted from the cation exchanger. (68)Ga is finally striped from the second resin with a small volume of pure water. For this purpose a strong anion exchanger and a novel extraction chromatographic resin based on tetraalkyldiglycolamides are characterized. The strategy allows online pre-concentration and purification of (68)Ga from the original generator eluate. The supplementary column allows transferring (68)Ga with high radionuclide and chemical quality in the aqueous solution with small volume and low acidity useful for direct radiolabeling reactions.

Gas chromatography of indium in macroscopic and carrier-free amounts using quartz and gold as stationary phases

The chemical investigation of E113 is likely to become soon feasible. The determination of chemical properties of carrier-free amounts of the lighter homologues of element 113, especially indium and thallium, allows designing experimental set-ups and selecting experimental conditions suitable for performing these studies. Here, we present investigations of the interaction of indium species with quartz and gold surfaces. Deposition temperatures as well as enthalpies of adsorption were determined for indium T dep=739±20 °C (−ΔH ads(In)=227±10 kJ mol−1) and for indium hydroxide T dep=250±20 °C (−ΔH ads(InOH)= 124±10 kJ mol−1) respectively, on quartz. In case of adsorption of indium on a gold surface only a lower limit of the deposition temperature was established T dep>980 °C (−ΔH ads(In)≥315±10 kJ mol−1). Investigations of macroscopic amounts of indium in thermosublimation experiments at similar experimental conditions were instrumental to establish a tentative speciation of the observed indium species.

Production and decay of element 114: high cross sections and the new nucleus 277Hs

The fusion-evaporation reaction 244Pu(48Ca,3-4n){288,289}114 was studied at the new gas-filled recoil separator TASCA. Thirteen correlated decay chains were observed and assigned to the production and decay of {288,289}114. At a compound nucleus excitation energy of E{*}=39.8-43.9  MeV, the 4n evaporation channel cross section was 9.8{-3.1}{+3.9}  pb. At E^{*}=36.1-39.5  MeV, that of the 3n evaporation channel was 8.0{-4.5}{+7.4}  pb. In one of the 3n evaporation channel decay chains, a previously unobserved α branch in 281Ds was observed (probability to be of random origin from background: 0.1%). This α decay populated the new nucleus 277Hs, which decayed by spontaneous fission after a lifetime of 4.5 ms.

On-line anion exchange of rutherfordium in HF/HNO3 and HF solutions

The fluoride complexation of the group-4 elements Zr, Hf, and Rf, and of the pseudo-homolog Th, was previously investigated in mixed HNO3/HF solutions by studying K d values on both cation-exchange resins (CIX) and anion-exchange resins (AIX) using the automated rapid chemistry apparatus ARCA. On the CIX, the fluoride complexation of Rf was found to be weaker than that of Zr and Hf but stronger than that of Th. On the AIX, the competition for the binding sites by the counter ion NO3 - was found to be stronger for the fluoride complexes of Rf than for those of Zr and Hf. The aim of the present work is to add independent evidence to the latter result by measuring K d values for Rf on the AIX in 0.1 M HNO3/0.5 M HF and in 0.01 M HF without any HNO3. The results are obtained via an activity ratio of the long-lived α-decay descendant of 261mRf, 20-d 253Es, using the multi-column technique (MCT). These experiments corroborate the seemingly much more pronounced competition of NO3 - for the exchanging sites of the AIX with respect to [RfF x ]( x -4)- than with [ZrF x ]( x -4)- and [HfF x ]( x -4)-.

Thermochromatographic studies of mercury and radon on transition metal surfaces

In preparation for the experimental investigation of chemical properties of element 112 model studies were conducted based on the assumed similarity of element 112 to either the noble gas Rn or the transition metal Hg, its supposed lighter homologue in group 12. The adsorption behavior of elemental Hg on the transition metals Ag, Au, Ni, Pd, and Pt were investigated experimentally by off-line gas thermochromatography. The deduced adsorption data of Hg were compared with new values calculated using the Eichler–Miedema model. The observed sequence of increasing Hg-metal-interactions for Ag < Ni < Au < Pd < Pt confirms the predicted trend. The only exception was Pd, on which Hg was calculated to adsorb at a higher temperature than on Pt. Difficulties to obtain reproducible clean surfaces of Ag, Ni, Pd, and Pt led to the choice of Au as the best metal surface suitable to adsorb Hg.

For fast on-line gas thermochromatography studies on metallic surfaces a new set-up was developed based on the In-situ Volatilization and On-line detection technique (IVO). This set-up was tested in on-line thermochromatographic investigations with short-lived Hg isotopes and 219Rn, using Au or Pd as stationary surfaces. An overall efficiency of about 60% and a transportation time less than 25 s was determined for this newly designed IVO. A separation factor of more than 106 was estimated for non-volatile species.

On-line gas chromatographic studies of Rf, Zr, and Hf bromides

The Heavy Element Volatility Instrument (HEVI), an on-line isothermal gas chromatography system, has been used to separate the volatile bromide compounds of the group 4 elements Zr and Hf and the transactinide Rf according to their volatilities, and to provide data on the gas phase chemical properties of very short-lived isotopes in amounts as low as a few atoms. For these studies261Rf was produced via the248Cm(18O, 5n) reaction.165-167Hf was produced via the reactionnatEu(19F, xn), and85Zr was produced via thenatCu(28Si, 3p3n) reaction. The half-life for261Rf was measured to be 75±7 seconds.

A Monte Carlo code was used to deduce the enthalpy of adsorption (ΔHa) from the observed volatility and parameters of the chromatography system. The resulting adsorption enthalpies for the Zr, Hf, and Rf tetrabromides are: -108±5 kJ · mol-1, -113±5 kJ · mol-1 and -87±7 kJ · mol-1, respectively.

Volatilities of the group 4 bromides support the conclusion from previous results for the group 4 chlorides that Rf deviates from the trend expected by simple extrapolation of the properties of its lighter homologs in the periodic table. The group 4 bromides are also observed to be less volatile than their respective chlorides, as predicted by relativistic calculations.

Thermochromatographic studies of berkelium chlorides: BkCl3 and BkCl4

The thermochromatographic behavior of berkelium chlorides in various chlorinating gases was studied. Using Cl2 or a mixture of Cl2/SOCl2, two peaks were observed in a thermochromatographic column. The "high temperature" peak corresponds to BkCl3 and the "low temperature" one corresponds most probably to BkCl4. Using both the model of mobile adsorption and the of Monte Carlo method, the adsorption enthalpies were determined. The possible chemical reactions in a chromatographic column are discussed.

An EC-branch in the decay of 27-s 263Db: Evidence for the isotope 263Rf

27-s 263Db was produced in the 249Bk ( 18O, 4n) reaction at 93 MeV. The activity was transported by a He/KCl-jet to the laboratory where it was collected for 15 min and then subjected to a chemical separation specific for group-4 elements. The activity was dissolved in 0.5 M unbuffered α-HiB and eluted from a cation-exchange column. The effluent was made 9 M in HCl and group-4 tetrachlorides were extracted into TBP/Cyclohexane which was evaporated to dryness on a Ta disc. The Ta discs were assayed for α and SF activity. A SF activity with a half life on the order of 20 min was observed and assigned to the nuclide 263Rf. It is formed by electron-capture decay of 263Db with a decay branch of 3+4 -1%.

Attempts to chemically investigate element 112

Two experiments aiming at the chemical investigation of element 112 produced in the heavy ion induced nuclear fusion reaction of 48Ca with 238U were performed at the Gesellschaft für Schwerionenforschung (GSI), Darmstadt, Germany. Both experiments were designed to determine the adsorption enthalpy of element 112 on a gold surface using a thermochromatography setup. The temperature range covered in the thermochromatography experiments allowed the adsorption of Hg at about 35 °C and of Rn at about -180 °C. Reports from the Flerov Laboratory for Nuclear Reactions (FLNR), Dubna, Russia claim production of a 5-min spontaneous fission (SF) activity assigned to 283112 for the 238U(48Ca,3n) 283112 reaction. Hence, Experiment I was designed to detect spontaneously fissioning (SF) isotopes of element 112 with half-lives (t 1/2) longer than about 20 s. 11 high-energy events were detected. 7 events exhibit a deposition pattern resembling a chromatographic peak in the vicinity of Rn deposition. However, the energy of the events observed in Experiment I was lower than expected for a SF-decay of 283112. Therefore, these events could not be unambiguously attributed to the decay of 283112. In contradiction with earlier publications newer reports from FLNR Dubna claim that 283112 decays by α-particle emission (E α = 9.5 MeV) with t 1/2 = 4 s followed by a SF-decay of 279Ds (t 1/2 = 0.2 s). Therefore, Experiment II was designed to be sensitive to both claimed decay properties of 283112. However, during this experiment neither short α-SF correlations nor SF coincidences were detected. The conclusion is that 283112 was not unambiguously detected, neither in Experiment I nor in Experiment II.

Chemical identification and properties of element 112

We present results of the second experiment on the chemical identification of element 112. Similar to the first test in 2000, we aimed at the production of the spontaneously fissioning 283112 nuclei with T 1/2≈3min. A natU3O8 (with some Nd) target, 2mg of U/cm2 thick, was bombarded with 233-MeV 48Ca ions (the energy in the middle of the target layer). The nuclei recoiling from the target were thermalized in flowing helium. The target chamber was connected through a 25m long capillary to detectors of α-particles and fission fragments. All the equipment and detectors were kept at ambient temperature. According to the test experiments, of all the heavy elements produced in the bombardment, only Hg, Rn and At could be transported to the detectors. The first detecting device was similar to that used earlier – an assembly of 8 pairs of PIPS detectors coated with gold. Here one would observe the decay of element 112 atoms if they like Hg adsorbed on gold. The atoms which were not retained and freely passed through the PIPS detectors entered a new, flow-through ionization chamber, 5000 cm3 in volume, optimized for detecting fission fragments. The PIPS detectors and the ionization chamber were placed inside a large assembly of 3He – filled neutron counters to detect prompt neutrons from the fission events. In 22.5 days, a beam dose of 2.8×1018 ions was accumulated. More than 95 of the simultaneously produced α-active 185Hg (T 1/2=49 s) were found deposited already on the first pair of PIPS detectors; meanwhile, all the PIPSs did not detect any fission event. In the ionization chamber, eight fission events were observed in coincidence with neutron counts while the expected background was insignificant. Hence, the spontaneous fissions of the volatile activity can be conclusively attributed to the decay of element 112 produced in the fusion reaction 48Ca+ 238U, and formerly observed in Dubna physical experiments. Evaluation of the experimental data in terms of the adsorption enthalpies indicates much weaker interaction of element 112 with Au than that of Hg. One can conclude that in the given chemical environment, element 112 behaves like Rn rather than like Hg. The formation cross section of 283112 estimated from the data amounts to several pb. The experiments were carried out at the Flerov Laboratory of Nuclear Reactions at JINR in November–December 2001.

Gas phase chemistry of technetium and rhenium oxychlorides

The chloride and oxychloride chemistry of the group 7 elements Tc and Re was investigated in order to develop an experimental approach to a gas chemical characterisation of bohrium (Bh, element 107). In thermochromatography experiments with trace amounts of101,104Tc and183,184Re the formation of one volatile compound was observed in O2/HCl containing carrier gas, which was attributed to MO3Cl (M = Tc, Re). From the measured deposition temperatures the adsorption enthalpies on quartz surfaces ΔHads(TcO3Cl) = -51 ± 3 kJ/mol and ΔHads(ReO3Cl) = -62 ± 3 kJ/mol were evaluated. The sublimation enthalpies were derived using an empirical correlation between Δ Hadsand ΔHsubl: ΔHsubl(TcO3Cl) = 49±10 kJ/mol and ΔHsubl(ReO3Cl) = 67±10 kJ/mol. A fast gas chemical separation technique for highly volatile compounds of short-lived isotopes based on isothermal gas solid adsorption chromatography (OLGA-principle) was developed. With a modified OLGA device, model studies with the short-lived nuclides106,107,108Tc and169,170,174,176Re were carried out in preparation of an experimental gas chemical investigation of bohrium (Bh, element 107). Separation times of less than 3 s were achieved. A good separation of the oxychlorides of group 7 elements from chloride and oxychloride compounds of152-155Er,151-154Ho (as models for actinide elements),98-101Nb,99-102Zr (as models for light transactinide elements),218Po, and214Bi was accomplished in this chemical system.

[Parkinson's disease influences the perioperative risk profile in trauma patients]

AIM

Parkinson's disease (PD) is one of the most common degenerative diseases of the central nervous system affecting elderly patients with increasing demographic prevalence. The aim of this study was to define the perioperative risk profile in trauma patients suffering from Parkinson's disease in order to improve treatment options in these patients.

METHOD

Over a period of 13 years, 16 patients suffering from Parkinson's disease treated in the department of trauma surgery were retrospectively compared using matched-pair analysis with 16 controls not affected by PD. Both groups of patients were assessed regarding morbidity, length of treatment and rehabilitation.

RESULTS

Trauma patients suffering from Parkinson's disease showed an increase in morbidity risk. Postoperative falls occurred significantly, infections of the urinary tract and pneumonia tendentiously more often in PD patients. Postoperative stay and length of treatment were significantly longer in patients with PD. These patients also tended to stay longer preoperatively and remained longer in intensive care. PD patients required on-ward rehabilitation significantly more often.

CONCLUSION

Concomitant Parkinson's disease is a significant factor of perioperative morbidity in trauma patients. Perioperative morbidity in PD patients may be influenced by early diagnostic and therapeutic measures.

Observation of the 3n evaporation channel in the complete hot-fusion reaction 26Mg + 248Cm leading to the new superheavy nuclide 271Hs

The analysis of a large body of heavy ion fusion reaction data with medium-heavy projectiles (6 < or = Z < or = 18) and actinide targets suggests a disappearance of the 3n exit channel with increasing atomic number of the projectile. Here, we report a measurement of the excitation function of the reaction (248)Cm ((26)Mg,xn)(274-x)Hs and the observation of the new nuclide (271)Hs produced in the 3n evaporation channel at a beam energy well below the Bass fusion barrier with a cross section comparable to the maxima of the 4n and 5n channels. This indicates the possible discovery of new neutron-rich transactinide nuclei using relatively light heavy ion beams of the most neutron-rich stable isotopes and actinide targets.

Production of 177Lu at the new research reactor FRM-II: Irradiation yield of 176Lu177Lu

Due to its physical and chemical characteristics, 177Lu is a very attractive radionuclide for use in nuclear medicine. This paper introduces a method for a precise calculation of the irradiation yield of 177Lu produced by neutron activation of 176Lu in a nuclear reactor. The calculation is based on the Westcott convention which requires the knowledge of the neutron flux parameters. In this work, the neutron flux parameters of the new research reactor FRM-II (Garching, Germany) were determined and the stability of thermal neutron flux and thermal neutron flux temperature was monitored. The comparison of theoretically calculated and experimentally determined yield for Lu176(n,gamma)Lu177 reaction is presented.

[Port stapling for simplified port implantation in laparoscopic adjustable gastric banding]

BACKGROUND

The purpose of this study was to evaluate the applicability of a port stapling device to simplify and improve port implantation in laparoscopic adjustable gastric banding (LAGB).

METHODS

From November 2005 to September 2006, a prospective study was conducted on 23 consecutive patients who underwent LAGB with Swedish adjustable gastric banding. Patients were randomized to either conventional titanium-port implantation or port stapling using the "Velocity" device.

RESULTS

No differences in age, body weight, body mass index, fascia depth or incision length were reported between the groups. Port implantation time was significantly less using port stapling (90+/-24 s) compared to conventional port implantation (521+/-138 s). Port related complaints postoperatively and at follow-up were equal in both groups.

CONCLUSIONS

Port stapling is an excellent tool to facilitate port implantation, particularly in massively obese patients with a thick abdominal wall.

Resident macrophages are involved in intestinal transplantation-associated inflammation and motoric dysfunction of the graft muscularis

Gut manipulation and ischemia/reperfusion evoke an inflammatory response within the intestinal muscularis that contributes to dysmotility. We hypothesize that resident macrophages play a key role in initiating the inflammatory cascade. Isogenic small bowel transplantation was performed in Lewis rats. The impact of recovery of organs on muscularis inflammation was investigated by comparing cold whole-body perfusion after versus prior to recovery. The role of macrophages was investigated by transplantation of macrophage-depleted gut. Leukocytes were counted using muscularis whole mounts. Mediator expression was determined by real-time RT-PCR. Contractility was assessed in a standard organ bath. Both organ recovery and ischemia/reperfusion induced leukocyte recruitment and a significant upregulation in IL-6, MCP-1, ICAM-1 and iNOS mRNAs. Although organ recovery in cold ischemia prevented early gene expression, peak expression was not changed by modification of the recovery technique. Compared to controls, transplanted animals showed a 65% decrease in smooth muscle contractility. In contrast, transplanted macrophage-depleted isografts exhibited significant less leukocyte infiltration and only a 19% decrease in contractile activity. In summary, intestinal manipulation during recovery of organs initiates a functionally relevant inflammatory response within the intestinal muscularis that is massively intensified by the ischemia reperfusion injury. Resident muscularis macrophages participate in initiating this inflammatory response.

Doubly magic nucleus (108)(270)Hs162

Theoretical calculations predict 270Hs (Z=108, N=162) to be a doubly magic deformed nucleus, decaying mainly by alpha-particle emission. In this work, based on a rapid chemical isolation of Hs isotopes produced in the 26Mg+248Cm reaction, we observed 15 genetically linked nuclear decay chains. Four chains were attributed to the new nuclide 270Hs, which decays by alpha-particle emission with Qalpha=9.02+/-0.03 MeV to 266Sg which undergoes spontaneous fission with a half-life of 444(-148)(+444) ms. A production cross section of about 3 pb was measured for 270Hs. Thus, 270Hs is the first nucleus for which experimental nuclear decay properties have become available for comparison with theoretical predictions of the N=162 shell stability.

Acute Rejection in Allogeneic Rodent Small Bowel Transplantation Causes Smooth Muscle Dysfunction via an Inflammatory Response Within the Intestinal Muscularis

INTRODUCTION

Isogeneic intestinal transplantation elicits an inflammatory response within the intestinal muscularis that is associated with dysmotility. Usually the inflammation and the postoperative motor dysfunction resolve within a few days after small bowel transplantation (SBTx). However, the onset of acute rejection in allogeneic SBTx is again associated with dysmotility. We hypothesized that dysmotility during acute rejection is based on coexpression of kinetically active mediators by the alloreactive leucocyte infiltrate.

MATERIALS AND METHODS

Rat SBTx (BN to Lew and BN to BN) was performed without immunosuppression. Animals were sacrificed at 1, 4, and 7 days after SBTx. Leukocyte infiltration was investigated in muscularis whole mounts by immunohistochemistry. Mediator mRNA expression was determined by reverse transcriptase polymerase chain reaction. Muscle contractility was assessed in a standard organ bath.

RESULTS

Transplanted animals showed a significant inflammatory response within the muscularis at day 1 after SBTx. However, allogeneic transplanted animals exhibited a significant second inflammatory peak at day 7 (mRNA induction: iNOS 150-fold; tumor necrosis factor-alpha 18-fold; interferon-gamma 397-fold), parallel to the onset of rejection. This change was associated with a significant leukocyte infiltration. Compared to controls, allogeneic transplanted animals showed a 29% decrease in smooth muscle contractility on days 1 and 4 and a 71% decrease of contractility on postoperative day 7.

CONCLUSIONS

The motor dysfunction of transplanted small bowel during acute rejection is associated with an inflammatory reaction in the intestinal muscularis. The initial unspecific inflammation process immediately after transplantation is reactivated and intensified during acute rejection.

Mechanism and Impact of Organ Harvesting and Ischemia-Reperfusion Injury Within the Graft Muscularis in Rat Small Bowel Transplantation

INTRODUCTION

Inflammatory events within the gut muscularis contribute to dysmotility. We hypothesized that manipulation during organ harvesting initiated an inflammatory response via muscularis macrophages and that this cascade was amplified during reperfusion.

METHODS

Small bowel transplantation was performed in Lewis rats. To investigate the impact of organ harvesting on muscularis inflammation, cold whole-body perfusion was performed after versus prior to organ harvesting. The role of macrophages was investigated by transplantation of the macrophage-depleted gut. Leukocyte infiltration was investigated in muscularis whole mounts. Mediator mRNA expression was determined by real-time reverse transcriptase polymerase chain reaction. Contractility was assessed in a standard organ bath.

RESULTS

Organ harvesting and ischemia-reperfusion induced leukocyte recruitment and mRNA upregulation in the muscularis: interleukin-6 12217-fold, monocyte chemoattractant protein-1 62-fold, ICAM-1 12-fold, cyclooxygenase-2: 8-fold, iNOS: 150-fold. Although organ harvesting with cold ischemia prevented early gene expression, peak expression at 3-hour reperfusion was not changed by modification of the harvesting technique. Compared to controls, transplanted animals showed a 63% decrease in smooth muscle contractility. In contrast, transplanted macrophage-depleted gut exhibited significantly fewer leukocytes and only a 16% decrease in contractility.

CONCLUSIONS

Gut manipulation during organ harvesting initiates an inflammatory response within the muscularis that is massively intensified during reperfusion. This change contributes to muscular dysfunction. Furthermore, the results suggested that resident macrophages play a key role in initiating this process.

[Helical computed tomography in penetrating injury to the torso. Diagnostic value in emergent use]

BACKGROUND

Nontherapeutic laparotomy and thoracotomy rates in penetrating torso trauma remain high. The aim of this study was to define the value of helical computed tomography (CT) in this emergency situation.

MATERIAL AND METHODS

Retrospectively, we studied 11 hemodynamically stable patients with penetrating injury to the torso admitted to our trauma center over a 3-year period who underwent intravenous contrasted helical CT immediately after admission. A positive CT scan was defined as showing any evidence of intrathoracal or intra-abdominal injury necessitating immediate operation. Patients with positive CT underwent laparotomy and/or thoracotomy. Patients with negative CT were observed.

RESULTS

Eleven consecutive patients were studied: nine male, two female; mean age 39 years (range 19-62). Nine stab wounds and two shotgun wounds were seen. Seven patients had positive helical CT findings, and four patients were negative. All patients with positive CT findings were operated on; those with negative scans recovered uneventfully. This imaging method accurately predicted whether thoracotomy or laparotomy was needed in 10/11 cases.

CONCLUSION

In penetrating torso trauma, helical CT can clarify the need for thoracotomy or laparotomy vs nonoperative treatment.