Biodegradable Polymers in Veterinary Medicine-A Review

During the past two decades, tremendous progress has been made in the development of biodegradable polymeric materials for various industrial applications, including human and veterinary medicine. They are promising alternatives to commonly used non-degradable polymers to combat the global plastic waste crisis. Among biodegradable polymers used, or potentially applicable to, veterinary medicine are natural polysaccharides, such as chitin, chitosan, and cellulose as well as various polyesters, including poly(ε-caprolactone), polylactic acid, poly(lactic-co-glycolic acid), and polyhydroxyalkanoates produced by bacteria. They can be used as implants, drug carriers, or biomaterials in tissue engineering and wound management. Their use in veterinary practice depends on their biocompatibility, inertness to living tissue, mechanical resistance, and sorption characteristics. They must be designed specifically to fit their purpose, whether it be: (1) facilitating new tissue growth and allowing for controlled interactions with living cells or cell-growth factors, (2) having mechanical properties that address functionality when applied as implants, or (3) having controlled degradability to deliver drugs to their targeted location when applied as drug-delivery vehicles. This paper aims to present recent developments in the research on biodegradable polymers in veterinary medicine and highlight the challenges and future perspectives in this area.

Fast strain mapping in abdominal aortic aneurysm wall reveals heterogeneous patterns

Abdominal aortic aneurysm patients are regularly monitored to assess aneurysm development and risk of rupture. A preventive surgical procedure is recommended when the maximum aortic antero-posterior diameter, periodically assessed on two-dimensional abdominal ultrasound scans, reaches 5.5 mm. Although the maximum diameter criterion has limited ability to predict aneurysm rupture, no clinically relevant tool that could complement the current guidelines has emerged so far. In vivo cyclic strains in the aneurysm wall are related to the wall response to blood pressure pulse, and therefore, they can be linked to wall mechanical properties, which in turn contribute to determining the risk of rupture. This work aimed to enable biomechanical estimations in the aneurysm wall by providing a fast and semi-automatic method to post-process dynamic clinical ultrasound sequences and by mapping the cross-sectional strains on the B-mode image. Specifically, the Sparse Demons algorithm was employed to track the wall motion throughout multiple cardiac cycles. Then, the cyclic strains were mapped by means of radial basis function interpolation and differentiation. We applied our method to two-dimensional sequences from eight patients. The automatic part of the analysis took under 1.5 min per cardiac cycle. The tracking method was validated against simulated ultrasound sequences, and a maximum root mean square error of 0.22 mm was found. The strain was calculated both with our method and with the established finite-element method, and a very good agreement was found, with mean differences of one order of magnitude smaller than the image spatial resolution. Most patients exhibited a strain pattern that suggests interaction with the spine. To conclude, our method is a promising tool for investigating abdominal aortic aneurysm wall biomechanics as it can provide a fast and accurate measurement of the cyclic wall strains from clinical ultrasound sequences.

Limb graft occlusion after endovascular aneurysm repair with the Cook Zenith Alpha abdominal graft

OBJECTIVE

Prior reports of the low profile Zenith Alpha abdominal graft (Cook Medical Inc, Bloomington, IN) have shown impaired limb graft patency to be the primary causes of reintervention. Special notices from the manufacturer have indicated certain instructions for use (IFU) violations as the main reasons for these complications. In the present study, we assessed the incidence of limb graft occlusion (LGO) and analyzed the effects of the detailed anatomic risk factors for LGO highlighted in the IFU and previously reported studies.

METHODS

A retrospective study was performed of 241 patients treated with the low profile Zenith Alpha at a single institution from October 1, 2015 to September 30, 2018. All computed tomography angiograms were analyzed using three-dimensional software. Data were extracted from the electronic medical records until the end of the study period (December 31, 2020). The cumulative incidence of LGO and LGO-related reinterventions were assessed. A regression analysis was performed to evaluate the possible risk factors associated with the development of LGO at specified time points. These included aortic and iliac diameters, graft component oversizing, iliac tortuosity and calcification, overlap of graft components, proximal alignment of ipsilateral and contralateral legs, and sealing zone in the external iliac artery. Reader agreement of iliac calcification and tortuosity was assessed in patients with LGO.

RESULTS

A total of 33 limbs (7%) in 27 patients (11%) had become occluded. The cumulative incidence of LGO was 7% (95% confidence interval [CI], 5%-9%) per limb up to 3 years postoperatively. The previously described risk factors for LGO were studied using regression analysis; however, no positive association with LGO was identified. Heavily calcified common iliac arteries (CIAs) and external iliac arteries were protective against LGO compared with noncalcified vessels up to 3 years postoperatively (decreased risk, 17% [95% CI, -27% to -7%]; P = .001; and 15% [95% CI, -26 to -5]; P = .005, respectively). The reader agreement of iliac calcification and tortuosity showed substantial agreement (CIA intrareader kappa = 0.75; CIA interreader kappa = 0.62) and almost perfect agreement (intrareader kappa = 0.85; interreader kappa = 0.84), respectively.

CONCLUSIONS

The cumulative incidence of LGO after endovascular aneurysm repair with the Zenith Alpha graft was 7% per limb up to 3 years postoperatively. None of the analyzed risk factors suggested by the IFUs or current literature were positively associated with LGO.

Effects of Biological and Chemical Degradation on the Properties of Scots Pine Wood-Part I: Chemical Composition and Microstructure of the Cell Wall

Research on new conservation treatment for archaeological wood requires large amounts of wooden material. For this purpose, artificial wood degradation (biological-using brown-rot fungus Coniophora puteana, and chemical-using NaOH solution) under laboratory conditions was conducted to obtain an abundance of similar samples that mimic naturally degraded wood and can serve for comparative studies. However, knowledge about its properties is necessary to use this material for further study. In this study, the chemical composition and microstructure of degraded cell walls were investigated using FT-IR, XRD, helium pycnometry and nitrogen absorption methods. The results show that biological degradation caused the loss of hemicelluloses and celluloses, including the reduction in cellulose crystallinity, and led to lignin modification, while chemical degradation mainly depleted the amount of hemicelluloses and lignin, but also affected crystalline cellulose. These changes affected the cell wall microstructure, increasing both surface area and total pore volume. However, the chemical degradation produced a greater number of mesopores of smaller size compared to fungal decomposition. Both degradation processes weakened the cell wall's mechanical strength, resulting in high shrinkage of degraded wood during air-drying. The results of the study suggest that degraded wood obtained under laboratory conditions can be a useful material for studies on new consolidants for archaeological wood.

Factors That Affect the Mechanical Strength of Archaeological Wood-A Case Study of 18th-Century Wooden Water Pipes from Bóżnicza Street in Poznań, Poland

Large amounts of archaeological wood are often excavated during groundworks in cities and towns. Part of the unearthed artefacts is usually saved, conserved and then presented in museums. However, if the finding contains several similar objects, some of them could potentially be further employed for some other practical purposes. The research aimed to determine the mechanical performance of the remains of wooden water mains excavated at Bóżnicza street in Poznań, Poland and evaluate its potential usefulness for any practical purposes. First, wood density was determined along with its mechanical strength in compression. The density of archaeological wood identified as Scots pine was lower than contemporary pinewood (383 kg × m^-3 vs. 572 kg × m^-3); therefore, its mechanical properties in compression tests were also lower, as expected, making the wood unsuitable for any practical applications. However, the differences in modulus of elasticity and compressive strength were not justified by the differences in wood density. Further infrared spectroscopy and X-ray diffraction analyses revealed additional differences in chemical composition and cellulose crystallinity between archaeological and contemporary wood. The results indicated the decrease in carbohydrate content and cellulose crystallinity in degraded wood, which, in addition to wood density, apparently contribute to the deterioration in mechanical strength of archaeological wood. The case study of the excavated archaeological wooden pipes shows that they have historical value but are not useful for practical purposes. It also revealed that not only wood density but also its chemical composition and cellulose crystallinity level has a substantial impact on the wood mechanical properties, particularly in compression.

Profiling abdominal aortic aneurysm growth with three-dimensional ultrasound

BACKGROUND

"Profiling" is a new method based on three-dimensional ultrasound (3D-US) allowing for direct comparison of baseline and follow-up diameters along the AAA length. This study aimed to evaluate the feasibility of profiling to visualize AAA changes at sub-maximum diameters, and to categorize the growth profiles.

METHODS

Retrospective analysis of prospectively and consecutively included patients under AAA surveillance at a tertiary referral centre. 3D-US images of AAAs at baseline and at one-year follow-up were segmented, generating a centerline and a mesh of the aneurysm geometry. The mesh was processed to illustrate diameter changes of a given AAA. Three growth profiles were identified: A) Peak Growth: the largest, significant (≥3.6 mm) diameter difference occurred within a 10 mm margin to either side of the maximum baseline diameter; B) Edge Growth: at least one significant diameter difference and the criteria for Peak Growth did not apply; C) No Growth: all diameter differences were nonsignificant. A centerline length of ≥60 mm was assumed to capture a comparable segment of the wall geometry at baseline and follow-up. Cohen's kappa and Kaplan Meier analysis were used to analyze data.

RESULTS

In total, 186 patients had growth profiles generated. Of these, 28 (15%) were discarded, mainly based on inadequate centerline lengths (n= 21, 11.3%). The remaining patients were categorized into Edge Growth (n=83, 52%), No Growth (n=47, 30%), and Peak Growth (n=28, 18%).

CONCLUSIONS

Profiling interprets AAA growth at sub-maximum diameters. Half of the cohort had Edge Growth. These AAAs risk being classified as stable.

The Viscoelastic Behaviour of Waterlogged Archaeological Wood Treated with Methyltrimethoxysilane

Waterlogged wood treatment with methyltrimethoxysilane (MTMS) proved effective in stabilising wood dimensions upon drying (anti-shrink efficiency of 76-93%). Before the method can be proposed as a reliable conservation treatment, further research is required that includes the evaluation of the mechanical properties of treated wood. The aim of the study was to characterise the effect of the treatment on the viscoelastic behaviour of archaeological waterlogged elm and oak wood differing in the degree of degradation. Dynamic mechanical analysis in the temperature range from -150 to +150 °C was used for the study. To better understand the viscoelastic behaviour of the treated wood, pore structure and moisture properties were also investigated using Scanning Electron Microscopy, nitrogen sorption, and Dynamic Vapour Sorption. The results clearly show that methyltrimethoxysilane not only prevents collapse and distortions of the degraded cell walls and decreases wood hygroscopicity (by more than half for highly degraded wood), but also reinforces the mechanical strength by increasing stiffness and resistance to deformation for heavily degraded wood (with an increase in storage modulus). However, the MTMS also has a plasticising effect on treated wood, as observed in the increased value of loss modulus and introduction of a new tan δ peak). On the one hand, methyltrimethoxysilane reduces wood hygroscopicity that reflects in lower wood moisture content, thus limiting the plasticising effect of water on wood polymers, but on the other hand, as a polymer itself, it contributes to the viscous behaviour of the treated wood. Interestingly, the effect of silane differs with both the wood species and the degree of wood degradation.

Comparison of Contemporary Elm (Ulmus spp.) and Degraded Archaeological Elm: The Use of Dynamic Mechanical Analysis Under Ambient Moisture Conditions

This paper describes dynamic mechanical analysis (DMA) experiments on archaeological and contemporary elm tested under air-dry conditions, to explore the suitability of this technique for increasing understanding of the viscoelastic behaviour of archaeological wood. A strong reduction of storage modulus of archaeological elm (AE) was seen in comparison with contemporary wood (CE), resulting from the high degree of wood degradation, notably the reduction in hemicelluloses and cellulose content of AE, as demonstrated by Attenuated Total Reflection–Fourier Transform Infra-Red spectroscopy (ATR-FTIR). The γ relaxation peak was observed in all samples. The γ peak in AE shifted to a higher temperature, and the activation energy for γ-peak motions was lower in AE (29 kJ/mol) than in CE (50 kJ/mol) indicating that motion is less restricted within the degraded AE cell wall, or possibly a difference in the monomer undergoing rotation. Detection of changes in storage modulus are well known, but the DMA temperature scan technique proved to be useful for probing the degree of wood degradation, relating to the changes in location and intensity of secondary relaxation peaks. The γ peak in loss factor can be used to confirm that cell wall degradation is at an advanced stage, and to improve understanding of the internal spatial structure of the degraded wood cell wall.

Prevention of anastomotic leak following surgical treatment for rectal cancer

INTRODUCTION

Anastomotic leak (AL) is a major complication to surgical treatment of colorectal cancer affecting approximately 12% of patients. AL is associated with a 6-30% mortality. Finding methods that may reduce the incidence of AL is therefore important. In this study, we aimed to examine the effect of mechanical bowel preparation (MBP) and oral antibiotics on the rate of AL.

METHODS

This was a retrospective, single-centre analysis of patients undergoing surgical treatment for rectal cancer. We included 150 consecutive patients treated from July 2014 to October 2018. From June 2017 onwards, 50 patients comprised the study group (receiving MBP and oral antibiotics), while the preceding 100 patients served as a control group (receiving a rectal enema).

RESULTS

Two cases (4%) of AL were found in the study group and 20 cases (20%) in the control group (p lesser-than 0.01). Converting from laparoscopy to open surgery or having a World Health Organization performance score 2-3 were also associated with AL in univariate analysis.

CONCLUSION

Administrating MBP and oral antibiotics prior to surgery seems to reduce the incidence of AL following rectal cancer surgery.

FUNDING

none.

TRIAL REGISTRATION

not relevant.

Moisture-Dependent Strength Properties of Thermally-Modified Fraxinus excelsior Wood in Compression

European ash (Fraxinus excelsior L.) is one of the species commonly used for wood thermal modification that improves its performance. The presented research aimed to investigate a moisture-dependent strength anisotropy of thermally-modified European ash in compression. Wood samples were modified at 180 °C and 200 °C. Their mechanical parameters were determined in the principal anatomical directions under dry (moisture content of 3%) and wet (moisture content above fibre saturation point) conditions. Effect of heat treatment temperature and moisture content on the ash wood mechanical parameters concerning each anatomical direction were determined. The results show that thermal treatment kept the intrinsic anisotropy of wood mechanical properties. It decreased wood hygroscopicity, which resulted in improved strength and elasticity measured for wet wood when compared to untreated and treated samples. Higher treatment temperature (200 °C) increased wood elasticity in compression in all the anatomical directions despite wood moisture content during the measurements. Multivariate analysis revealed that the modification temperature significantly affected the modulus of elasticity perpendicular to the grain, while in the case of compression strength, the statistically significant effect was observed only parallel to the grain. The results obtained can be useful from an industrial perspective and can serve as part of a database for further modelling purposes.

Perigraft seroma penetrating the aortic sac and rupturing into the intraperitoneal cavity

We present a case of a 66-year-old woman who developed perigraft seroma after having undergone elective, open abdominal aortic aneurysm repair with a polytetrafluoroethylene graft 5 years previously. One year after graft implantation, she started to suffer from abdominal discomfort and was therefore offered surgical intervention, which she declined owing to the fear of postoperative complications. Instead, an observational strategy was used. Five years later, the patient presented with sudden severe abdominal pain. Subsequent laparotomy revealed that the pseudomembrane lining the perigraft seroma had penetrated through the native aortic wall and into the intraperitoneal cavity, where it had ruptured. The patient was successfully treated by replacing the polytetrafluoroethylene graft with a polyethylene terephthalate (Dacron) graft.

Natural decay of archaeological oak wood versus artificial degradation processes - An FT-IR spectroscopy and X-ray diffraction study

Wood has been extensively used as a material for different applications over the years, therefore the understanding of different degradation processes in various environments is of great importance. In this study, the infrared spectroscopy, X-ray diffraction and chemometric methods were used to evaluate and compare the structure of archaeological and artificially degraded oak wood. The results clearly show that modifications in the structure of archaeological wood are related to the position of the material in the log (sapwood and heartwood), thus the extent of wood degradation. To identify the possible factors influencing these effects, the control wood samples were exposed to artificial white rot biodegradation with Coriolus (Trametes) versicolor and to alkali treatment (with NaOH solution). Due to the structural similarities between biodegraded wood and control or archaeological samples, this type of decay is likely to occur during natural ageing along with degradation produced by other environmental factors. Further, no real similarity was identified between the alkali treated wood and archaeological samples, indicating that such degradation does not affect wood under natural conditions.

Determination of the content of selected elements in medieval waterlogged oak wood from the Lednica Lake-a case study

The content of selected elements: Al, B, Ba, Ca, Cd, Co, Cr, Cu, Fe, K, Li, Mg, Mn, Mo, Na, Ni, P, Pb, Sb, Si, Ti, V and Zn was determined in archaeological waterlogged oak wood from the Lednica Lake by using the inductively coupled plasma optical emission spectrometry (ICP-OES) method. The concentration of metals (especially heavy metals) in wood is typically specified to characterise this material and evaluate the possibility to use it for industrial purposes. In case of waterlogged archaeological wood intended for further research on new methods of conservation, such an analysis is important for other reasons. As it has been confirmed by numerous conservators and researchers, the presence of metal compounds is a serious problem not only due to their destructive influence on wood tissue but also from a conservation/re-conservation perspective. Metal-containing chemicals may influence conservation treatments by reacting with substances used for wood conservation and causing irreversible damage to wooden objects. Therefore, while developing new solutions for wood conservation, a broad knowledge not only on the state of wood preservation and deterioration but also on interacting chemical factors is required. The results of the research clearly show that content of minerals in waterlogged wood excavated from the bottom of the Lednica Lake considerably exceeded the average percentage of these elements in contemporary wood, which is associated with the mineralisation process. Moreover, variability in metal content was observed between waterlogged and contemporary wood. In waterlogged wood, the highest concentrations of Ca, Fe, Mg and P were observed, while in contemporary oak wood the predominant concentrations of K, Ca, Mn and Si were determined. Statistical analysis showed the variability in content of elements between different archaeological wood zones and contemporary wood. On the basis of the results obtained, it could be concluded that the studied waterlogged wood acted as an adsorbent of elements from water and sediments. High content of metal ions can be an impediment in developing new formulations for conservation, while using this wood as an experimental material. Therefore, while planning to use new chemicals as conservation agents, the possible interactions between chemicals and metals must be taken into consideration.

Thermodynamic stability of RNA structures formed by CNG trinucleotide repeats. Implication for prediction of RNA structure

Trinucleotide repeat expansion diseases (TREDs) are correlated with elongation of CNG DNA and RNA repeats to pathological level. This paper shows, for the first time, complete data concerning thermodynamic stabilities of RNA with CNG trinucleotide repeats. Our studies include the stability of oligoribonucleotides composed of two to seven of CAG, CCG, CGG, and CUG repeats. The thermodynamic parameters of helix propagation correlated with the presence of multiple N-N mismatches within CNG RNA duplexes were also determined. Moreover, the total stability of CNG RNA hairpins, as well as the contribution of trinucleotide repeats placed only in the stem or loop regions, was evaluated. The improved thermodynamic parameters allow to predict much more accurately the thermodynamic stabilities and structures of CNG RNAs.

How RNA viruses exchange their genetic material

One of the most unusual features of RNA viruses is their enormous genetic variability. Among the different processes contributing to the continuous generation of new viral variants RNA recombination is of special importance. This process has been observed for human, animal, plant and bacterial viruses. The collected data reveal a great susceptibility of RNA viruses to recombination. They also indicate that genetic RNA recombination (especially the nonhomologous one) is a major factor responsible for the emergence of new viral strains or species. Although the formation and accumulation of viral recombinants was observed in numerous RNA viruses, the molecular basis of this phenomenon was studied in only a few viral species. Among them, brome mosaic virus (BMV), a model (+)RNA virus offers the best opportunities to investigate various aspects of genetic RNA recombination in vivo. Unlike any other, the BMV-based system enables homologous and nonhomologous recombination studies at both the protein and RNA levels. As a consequence, BMV is the virus for which the structural requirements for genetic RNA recombination have been most precisely established. Nevertheless, the previously proposed model of genetic recombination in BMV still had one weakness: it could not really explain the role of RNA structure in nonhomologous recombination. Recent discoveries concerning the latter problem give us a chance to fill this gap. That is why in this review we present and thoroughly discuss all results concerning nonhomologous recombination in BMV that have been obtained until now.

How RNA viruses exchange their genetic material

One of the most unusual features of RNA viruses is their enormous genetic variability. Among the different processes contributing to the continuous generation of new viral variants RNA recombination is of special importance. This process has been observed for human, animal, plant and bacterial viruses. The collected data reveal a great susceptibility of RNA viruses to recombination. They also indicate that genetic RNA recombination (especially the nonhomologous one) is a major factor responsible for the emergence of new viral strains or species. Although the formation and accumulation of viral recombinants was observed in numerous RNA viruses, the molecular basis of this phenomenon was studied in only a few viral species. Among them, brome mosaic virus (BMV), a model (+)RNA virus offers the best opportunities to investigate various aspects of genetic RNA recombination in vivo. Unlike any other, the BMV-based system enables homologous and nonhomologous recombination studies at both the protein and RNA levels. As a consequence, BMV is the virus for which the structural requirements for genetic RNA recombination have been most precisely established. Nevertheless, the previously proposed model of genetic recombination in BMV still had one weakness: it could not really explain the role of RNA structure in nonhomologous recombination. Recent discoveries concerning the latter problem give us a chance to fill this gap. That is why in this review we present and thoroughly discuss all results concerning nonhomologous recombination in BMV that have been obtained until now.

[Development of a questionnaire for a standard follow-up assessment procedure for inpatient psychosomatic rehabilitation]

The paper establishes a follow-up assessment procedure for inpatient psychotherapy. It is suited for more than one theoretical approach or specific disorder. Using data from a larger follow-up-study, those items are identified that show substantial correlations with health and resource oriented questionnaires. In a second analysis, items are selected that predict therapeutic effects on parameters of health-behavior. This pool of items has to be completed by items constructed by plausibility criteria.

A self-consistent method for X-ray diffraction analysis of multiaxial residual-stress fields in the near-surface region of polycrystalline materials. II. Examples

The application of the formalism for residual-stress gradient evaluation based on the measuring principle of the scattering-vector method, which has been derived in the first paper of this series [Genzel (1999).J. Appl. Cryst.32, 770–778], is demonstrated by practical examples. Depending on the statistical scattering of the experimental data, either biaxial or even triaxial residual-stress states may be analysed; the latter case yields self-consistently the depth profiles of the in-plane stresses, σ11(τ) and σ22(τ), the normal stress component, σ33(τ), as well as the strain-free lattice spacing,d0(hkl). The results obtained by this new evaluation procedure are compared with those obtained by X-ray stress-gradient analysis performed on the basis of the sin2ψ method.

[Combination of methods and integration of methods as standard in psychotherapy?]

Psychotherapy has undergone a relatively brief but nonetheless dramatic development, but this resulted in an enormous variety, extensive diversity, and good treatment possibilities. Can we say at this stage that the combination and integration of different methods in psychotherapy are today's standards? The authors, a psychoanalyst and a behavioural therapist, consider a greater transparency between the various therapeutic schools as a goal that must still be aimed at before methods can be combined. If such a combination is finally achieved, a standard psychotherapeutic treatment may evolve, since patients suffering from eating disorders, compulsive behaviour or anxiety would profit more from such treatment than from a merely "school"-oriented therapy. Initial ideas for achieving an integration of methods are discussed in respect of inherent limitations and risks.

Genetic analysis of colon cancer susceptibility in mice

Mouse models may aid in the identification of genes involved in colon cancer. Our mating scheme involved mouse strains selected for maximum differences in susceptibility to DMH-induced colon tumors. Tumors were found in 40 of 122 progeny from a backcross to the resistant strain. We examined progeny animals for segregation of 177 genetic markers distributed at intervals of 5-30 cM on all mouse chromosomes. Multiple loci contribute to the phenotype, with significant linkage to a novel locus, Ccs1, between D12Mit5 and D12Mit6 on mouse Chr 12. Comparative maps suggest that the human homologue of Ccs1 is near FOS on human chromosome 14q.

[DKPM basic documentation. A uniform basic documentation for inpatient psychosomatic treatment and psychotherapy]

The Arbeitsgemeinschaft Basisdokumentation presents the DKPM-Basisdokumentation, which is conceptualized as a uniform modul of a documentation system for the routine-like use in the in-patient psychosomatic and psychotherapy. We outline possibilities of use, aspects of the data security and the data access as well as some practical presuppositions.

Diagnostic and therapeutic aspects of multiple sclerosis in urology: use of urodynamic methods of investigation

Multiple sclerosis, one of the commonest neurological diseases, is associated in a large number of cases with micturition disorders in both its early stage and its later course. Urological complications play a decisive part in mortality. Urodynamic methods have greatly contributed to the diagnostic spectrum in this disease by permitting to demonstrate and classify neurogenic disorders of bladder function and providing the neurologist with closer information on the sites of the lesion. They are also apt to confirm diagnostic conjectures and may help to adapt the therapeutic measures to the special situation.

[Survey of rehabilitation facilities with psychologic and therapeutic services in the Federal Republic of Germany]

Rehabilitation facilities (N=110) in the Federal Republic of Germany had been surveyed in order primarily to take stock of the psychological/psychotherapeutical services available for treatment in various disorders. The numbers of psychologists employed are shown to vary with the diagnostic groups served by the respective institutions. Facilities in the field of child and adolescent psychiatry, for the care of disabled person, and of persons with dependence problems are much better provided with psychologists than are facilities in the fields of psychiatry, neurology, and internal medicine. The same picture is found as regards the patients/psychologist ratios applicable in the different facilities. Preference of certain psychotherapeutical models (behavioural therapy, client-centered psychotherapy, psychoanalysis) varies with facility type. Especially noteworthy is an apparent predominance of inpatient services as opposed to outpatients models of service delivery. This fact is an indication of insufficient availability of follow-up care. Finally, various curricular aspects of the professional training of psychologists are outlined in relation to the recently established specialty of rehabilitation psychology.

Plastic surgery in hydronephrosis (Indications and follow-up. Isotope nephrographic studies)

Surgical interventions for the reconstruction of the renal pelvis were performed in 108 cases between 1962 and 1974. On follow-up, 3 to 6 months after operation the results were found good or satisfactory in 54 cases (50%). Isotope nephrography revealed a good or satisfactory fall of the curve in the excretion phase in 49 out of the 54 cases (94%), distinct retention curves having been found in the remaining 6%. In 35% of these cases isotope nephrography showed a far more complete urinary drainage than it had been assumed on the ground of radiography. In 63% of the cases the results of the two diagnostic methods were congruent.