Synthesis of castor oil/PEG as textile softener

New castor oil/polyethylene glycol (CAO/PEG) hybrids were synthesized by reacting of CAO with PEG 300, 600, 1000, 2000 or 4000, in presence of ammonium per sulfate (APS) as an initiator. The optimum conditions to synthesis such hybrids are: PEG/CAO weight ratio, 35%; APS/PEG weight ratio, 15%; reaction temperature, 80 °C; and reaction time, 60 min. Only the hybrids based on PEG 1000 and 2000 formed oil in water stable emulsions. Treating cotton fabric samples with easy care finishing formulation containing 40 g/L of the synthesized hybrids emulsions results in an enhancement in softness, tensile strength, whiteness index, and stiffness along with a reduction in nitrogen content, wrinkle recovery angle, and wettability properties of treated fabric, compared to that sample finished in absence of that emulsions. The chemical structure of the synthesized CAO/PEG1000 hybrid was confirmed via the FTIR and 1HNMRanalysis whereas the TEM analysis showed that the particles size of that hybrid emulsion is in the range of 27-105 nm. Moreover, such hybrid emulsion treated fabric surface was characterized via SEM and EDX analysis. Furthermore, treating dyed samples with the nominated hybrid emulsion improves the color strength of that samples but keeps the washing fastness, wet rubbing fastness as well as alkaline perspiration fastness of the dyed/finished samples unchanged. The wet rubbing fastness and alkaline perspiration fastness of all the dyed/finished samples were enhanced while the light fastness of such samples decreased.

P5547First results of TranslatiOnal Registry for CardiomyopatHies (TORCH)

Introduction

The cardiomyopathies (CMPs) are a diverse group of cardiac disorders and leading cause of heart failure (HF) and sudden cardiac death (SCD). Clinical courses of CMPs vary considerably even between patients with the same disease entity. The TranslatiOnal Registry for CardiomyopatHies (TORCH) is a comprehensive CMP registry that aims to provide a database and biomaterial bank for basic science and clinical research in this field. The long-term objective of this registry is to increase the understanding of disease pathomechanisms on the way to a better risk stratification as well as identification of new diagnostic and therapeutic approaches in CMP.

Methods

TORCH is a national, prospective, and multicentre registry within the German Centre for Cardiovascular Research (DZHK), which includes 2300 consecutive patients with non-ischemic (primary and secondary) CMP in 20 centres. The minimum follow up time is one year. The DZHK-wide harmonization of datasets and eCRFs (electronic case report form) were performed to ensure a high level of data quality across different study centres.

Results

Seventy percent of the enrolled patients are male. Idiopathic/familial dilated cardiomyopathy (DCM) holds the highest prevalence with 54%, followed by inflammatory DCM/myocarditis with a prevalence of 24%. Hypertrophic cardiomyopathy (HCM) is the third-most prevalent CMP in this registry (16%). Infrequent CMPs such as left ventricular non-compaction (LVNC), arrhythmogenic right ventricular cardiomyopathies (ARVC) are also represented in TORCH with a prevalence of 4% and 2% respectively. Major clinical findings are registered in TORCH. Atrial fibrillation was present with a high prevalence among all CMPs (22%-35%). The highest prevalence of stroke or TIA at baseline was reported in patients with LVNC (15.1%) and the lowest in those with amyloidosis (3.3%). Patients with ARVC had the highest number of ICD implantation and adequate ICD therapy (56.7%, p<0.05; 47.1%, p<0.05). Preliminary data analysis showed higher frequency of therapy refractory heart failure symptoms and worse outcome in patients with familial DCM in comparison to those with inflammatory or idiopathic DCM.

Conclusion and outlook

TORCH represents one of the largest cardiomyopathy registries in Europe. The patients are comprehensively phenotyped through clinical examinations, state-of-the-art imaging modalities, as well as molecular, genetic, and epigenetic investigations. This registry can help researchers design further studies investigating new diagnostic tools or therapeutic strategies in CMPs.

Antimosquito Activity of a Titanium-Organic Framework Supported on Fabrics

Waste swamps, stagnant water, and poor hygiene practices result in the proliferation of mosquitoes that may cause transmissible and infectious diseases such as malaria, typhoid, cholera, and Zika virus sickness. It has been shown that composites of the traditional natural fibers cotton, viscose, and linen and a Ti-bearing metal-organic framework, NH₂-MIL-125, are very effective against mosquitoes in the absence of any conventional insecticides. In our study, prior to coating with NH₂-MIL-125 crystals, the fabrics were modified with 3-glycidyloxypropyltrimethoxysilane. The composite materials were characterized by powder X-ray diffraction, UV-vis spectroscopy, Fourier transform infrared spectroscopy, and scanning electron microscopy with energy-dispersive X-ray spectroscopy analysis. The latter, in particular, has shown the uniform coating of the fabrics with NH₂-MIL-125 crystals. The modified fabrics have excellent antimosquito properties, attracting and killing them.

[The phenomenon of covert self-mutilation in the surgical routine]

Factitious disorders are conditions which are unknown to many physicians but have a prevalence of 1-5 % in outpatient departments and hospitals. In order to avoid prolonged and complicated (false) treatment in surgery this article gives a review of the definition, epidemiology and pathogenesis of factitious disorders as well as clinical symptoms and therapy options. A focus is placed on the identification of patients, treatment strategies and the prevention of malpractice. Additionally, clinical features of the disorder are illustrated with the description of some characteristic cases.

Examination performances of German and international medical students in the preclinical studying-term--a descriptive study

INTRODUCTION

Medical students with a migration background face several specific problems during their studies. International surveys show first indications that this group of students performs worse in written, oral or practical exams. However, so far, nothing is known about the performance of international students in written pre-clinical tests as well as in pre-clinical State Examinations for German-speaking countries.

METHOD

A descriptive, retrospective analysis of the exam performances of medical students in the pre-clinical part of their studies was conducted at the Faculty of Medicine of Heidelberg in for the year 2012. Performance in written tests of the final exams in the second (N=276), third (N=292) and fourth semester (N=285) were compared between German students, students from EU countries and students from non-EU countries. Same comparison was drawn for the performance in the oral exam of the First State Examination in the period from 2009 - 2012 (N=1137).

RESULTS

German students performed significantly better than students with a non-EU migration background both in all written exams and in the oral State Examination (all p<.05). The performance of students with an EU migration background was significantly better than that of students with a non-EU background in the written exam at the end of the third and fourth semester (p<.05). Furthermore, German students completed the oral exam of the First State Examination significantly earlier than students with a non-EU migration background (<.01).

DISCUSSION

Due to its poorer performance in written and oral examinations and its simultaneously longer duration of study, the group of non-German medical students with a country of origin outside of the European Union has to be seen as a high-risk group among students with a migration background. For this group, there is an urgent need for early support to prepare for written and oral examinations.

Severe posttraumatic radiocarpal cartilage damage: first report of autologous chondrocyte implantation

STUDY DESIGN

Case report.

CLINICAL QUESTION

Traumatic articular cartilage defects predispose to secondary osteoarthritis accompanied by impairment or complete loss of function in the corresponding joint. On this account, the timely and correct diagnosis as well as the selection of an appropriate therapy for reconstruction of articular cartilage defects is important.

METHODS

A 22-year-old healthy male patient with history of traumatic intra-articular distal radius fracture is presented with in the course detectable 4° cartilage damage in the fovea scaphoidea and into the fovea lunata. For the first time, autologous chondrocyte implantation by the use of an in situ polymerizable albumin-hyaluronic acid gel was performed to restore the articular cartilage.

RESULTS

The assessment 6 months after autologous chondrocyte implantation using the standard DASH questionnaire for upper extremity pointed out an improvement in the patient outcome (DASH score pre-operative: 10.8 and 6 months post-operative: 7.5). The clinical examination also showed an improvement in the range of movement of the wrist without pain. The radiological control investigation (MRI- examination) of the wrist 6 months after implantation also revealed a good integration of the implant.

CONCLUSION

The case presented here demonstrates the first use of autologous chondrocyte implantation for cartilage reconstruction using an in situ polymerizable albumin-hyaluronic acid gel after traumatic cartilage lesion with 4° cartilage damage of the wrist in a 22-year-old non-smoking, active and healthy man. Initial results are promising in terms of mobility, pain and patient outcome. However, further clinical studies have to be performed with larger number of cases.

Reimbursement for tissue reconstruction by pedicled and free flaps across five European countries. The importance of autologous breast reconstruction

AIM

Case payment mechanisms have become the principle means of remunerating hospitals in many countries. We analysed the reimbursement for different types of autologous tissue transfer in five European countries.

METHODS

We looked at common surgical options for breast reconstruction and flaps at other body regions. The principle diagnosis was systematically modified and processed with national grouper software to identify the relevant Diagnosis-Related Groups.

RESULTS

The mean difference in payment was 4509 € in breast reconstruction versus only 2599 € in other locations. According to the underlying diagnosis for reconstruction, procedures after resection of malignant breast cancer showed higher reimbursement (mean 8319 €) than of other body parts (mean 6454 €). Sweden had the highest mean reimbursement (9589 €) followed by Austria (8032 €), Germany (7259 €), Italy (6667 €) and the UK (6037 €). Austria, Italy and the UK showed significant differences of reimbursement between pedicled flaps of the breast and other parts of the body.

CONCLUSION

International data for the benchmarking and refinement of a national compensation system can be a useful instrument in identifying ways of improving each system. Across a spectrum of European countries, reimbursement for the reconstruction of the breast and other body parts was analysed and characteristics were identified. As rationalisation of healthcare becomes widespread in European countries, the need for individualised reimbursement which correlates accordingly is becoming ever more important.

[Development of DRGs in reconstructive breast surgery]

Diagnosis-Related Groups (DRG) were introduced in Germany in 2004 as a medico-economic classification system. In this analysis, we looked at reconstructive surgery after breast cancer, focusing on changes of the fee-per-case system in the last 6 years. Immediate, delayed, pedicle and free flaps as well as alloplastic reconstructive methods were analysed using data from German reference hospitals. We analysed the length of stay, reimbursements, costs and profits. The biggest profit margin was found in free perforator flaps. These were up to 3 times higher than in alloplastic reconstruction and pedicle flaps. Due to the fact that the underlying costs for the calculation of reimbursement are always retrospective, we accounted for the rate of price increase. In spite of increasing mean profits, foregone profits of up to €574 per case due to inflation were not taken into consideration. Contrary to actual guidelines, neither the immediate reconstruction of the breast by autologous tissue, nor the bilateral reconstruction is taken into account economically. Although a more differentiated reimbursement of breast reconstruction by DRG has taken place in the last years, the subject still remains a classical example for insufficient mapping of new medical standards in our DRG system. As the choice of surgical therapy is increasingly influenced by free market mechanisms, the risk for economic selection in contradiction to clinical recommendations becomes a real problem. Even 9 years after its introduction, the German DRG system is far from being a learning or quick adapting system.

Synthesis and investigation of a new cyclo (N ?-dipicolinoyl) pentapeptide of a breast and CNS cytotoxic activity and an ionophoric specificity

A new acylated cyclopentapeptide namely, Cyclo-( N(alpha)-dipicolinoyl)- bis-[ L-Leu-DL-Nval]- L-Lys OMe (5) was suggested and synthesized. The structural conception of 5 was rationalized by analogy to the structural features of some known cyclodepsipeptides exemplified by the antibiotic and DNA intercalator actinomycin D (NSC: 3053), the ionophore and anti-HIV enniatin B (NSC: 692895) and the ionophore and antibiotic valinomycin (NSC: 630175). The cyclopeptide 5 was chemically synthesized, starting from its linear tetrapeptide ester precursor 2 by coupling L-lysine methyl ester to the prepared tetrapeptide acid 3 or hydrazide 4 via the mixed anhydride or azide method, respectively. A cytotoxic activity (cell killing) in both breast (NCF7) and CNS (SF-268) cell lines NCI, USA) was realized for 5, while less active cytotoxic profile was determined for 2. Moreover, we have recently reported general ionophoric and sensor characteristics particularly, for Pb (II) ions for both 5 and 2. Correlation between the cytotoxic activity and the ionophoric potency is a matter of future investigations.