Three by three weeks of robot-enhanced repetitive gait therapy within a global rehabilitation plan improves gross motor development in children with cerebral palsy - a retrospective cohort study

AIM

To assess the improvement in gross motor function following three blocks of a three-week, intensive robot-enhanced treadmill therapy (ROBERT-Program).

METHOD

retrospective chart review in a before-after interventional trial in children with cerebral palsy attending a university hospital outpatient rehabilitation centre. Patients received three blocks of a three-week, 12 sessions ROBERT-Program over a mean period of 24 months. Outcome measures were block specific and cumulative improvement in GMFM 66, D and E. Longterm GMFM 66 improvements were compared to the individuals' expected increment as derived from previously published GMFM-66 percentiles. 95% confidence intervals (CI) and paired t-test were calculated.

RESULTS

20 children (8 GMFCS Level II; 12 GMFCS Level III, mean age 5.9 years (CI: [5.0; 6.7])) were treated. For each block a significant increase in motor performance in similar size could be observed without deterioration between blocks. The cumulative improvement during 21 months observation period was: 6.5 (CI: [4.8; 8.2]) in GMFM 66, which represents a clinically meaningful effect size of 3.6 (CI: [1.4; 5.8]) above the expected improvement.

INTERPRETATION

Progressive clinically meaningful improvement in motor performance for three blocks of ROBERT-Program was observed. Cumulative GMFM 66 improvements exceeded the individuals' age-specific expected course.

[Developmental neurology - networked medicine and new perspectives]

Developmental neurology is one of the major areas of neuropediatrics and is among other things (legally) responsible for monitoring the motor, cognitive and psychosocial development of all infants using standardized monitoring investigations. The special focus is on infants born at risk and/or due to premature birth before 32 weeks of gestation or a birth weight less than 1500 g. Early diagnosis of deviations from normal, age-related development is a prerequisite for early interventions, which may positively influence development and the long-term biopsychosocial prognosis of the patients. This article illustrates the available methods in developmental neurology with a focus on recent developments. Particular attention is paid to the predictive value of general movements (GM). The current development of markerless automated detection of spontaneous movements using conventional depth imaging cameras is demonstrated. Differences in spontaneous movements in infants at the age of 12 weeks are illustrated and discussed exemplified by three patients (healthy versus genetic syndrome versus cerebral palsy).

Quantitative Evaluation of Hyaline Cartilage Disorders Using Flash Sequence

In a prospective clinical study 24 normal volunteers and 106 patients with acute and chronic arthritis, osteoarthritis and post-traumatic alterations of the knee joints were examined. Using the parameters A and M 98 per cent of the pathologic cartilages and 74 per cent of the normal cartilages could be identified. In addition 78.5 per cent were correctly categorized in 5 cartilage classes. The A/M classification proved to be a fast and specific method for evaluation of cartilage disorders with special promise for follow-up examinations during therapy.

Quantitative Evaluation of Hyaline Cartilage Disorders Using Flash Sequence

A method for quantitative evaluation of hyaline cartilage signal intensities has been developed in an experimental study of 6 swine knees with different types of arthritis. A FLASH sequence with TR 50 ms, TE 10 ms and flip angles of 5, 10, 20, 25, 30, 35, 50 and 90° was employed. Two parameters of the signal intensity flip angle curves proved to be useful for tissue characterisation: The initial increase (A) and the maximum (M).

Online monitoring of stable carbon isotopes of methane in anaerobic digestion as a new tool for early warning of process instability

Effective control of anaerobic digestion in biogas plants requires the monitoring of process sensitive and rapid response parameters in order to ensure efficient biogas production and to prevent potential process failure. In this study, stable carbon isotopes of methane (δ(13)CCH4) produced in a full-scale continuous stirred-tank reactor were investigated as a potential new monitoring tool for this purpose. Over a six-month period with variable organic loading rates, δ(13)CCH4-values were measured online by a portable high-precision laser absorption spectrometer. During a stress period of consecutive high organic loading, δ(13)CCH4-values early indicated process changes in contrast to traditionally monitored parameters where a change was observed some five to ten days later. Comparison of the stable isotope values with data from microbial analyses showed a distinct relationship between the quantity of potentially acetoclastic methanogens and δ(13)CCH4-values. This finding indicates an association between dominant methanogenic pathways and carbon isotope values.

Über die Löslichkeit der Edelgase in Meerwasser

The solubilities of the inert gases have been measured in pure water and in sea water within the temperature range from 0 to 25°C. Comparison of the values in pure water and of the solubilities of argon in sea water with data obtained by other authors suggests that our measurements are reliable within the quoted limits of error. The behavior of the inert gases is expressed in a series of regularities which are also graphically shown.

Eine neue Methode zur Bestimmung kleinster Uranmengen und ihre Anwendung auf die Urananalyse von Steinmeteoriten

Es wird eine neue Methode zur Bestimmung kleinster Uranmengen in Steinmeteoriten beschrieben, bei welcher das durch die Spaltung des Urans 235 entstandene Xenon 133 gemessen wird. Die Aufarbeitung der bestrahlten Proben und die zur Abtrennung des aktiven Xenons dienende Hochvakuumapparatur werden eingehend erläutert. Es wurden drei Chondrite mit dieser Methode auf ihren Urangehalt untersucht. Zur Standardisierung der Messung dienten Xenon-Bestimmungen von reinem Uranoxyd, das jeweils gleichzeitig mit den Meteoriten bestrahlt wurde. Mögliche Fehlerquellen, wie Verluste an aktivem Xenon oder Schatteneffekte bei der Bestrahlung, wurden berücksichtigt.

Untersuchungen an Steinmeteoriten mit extrem hohem Edelgasgehalt III. Über den Sitz der leichten Uredelgase im Chondriten Pantar

An investigation of the separated dark fraction of the chondrite Pantar has been made. Rare gas analyses of separated minerals show that the main components of the meteorite, i. e. silicates, larger grains of nickel-iron and troilite, contain only very small amounts of primordial helium and neon. The main amounts of these gases have been found in fine-grained nickel-iron and troilite which are supposed to have been newly formed after the crystallisation of the main minerals of the meteorite. Problems related to the variations of the He/Ne-ratios which have been found are discussed.

Eine neue Methode zur Kalium-Argon-Altersbestimmung und ihre Anwendung auf Steinmeteorite

Nach einer neuen Methode wurden an fünf Chondriten und zwei Achondriten Kalium-Argon-Altersbestimmungen durchgeführt. Es handelt sich um eine Neutronenaktivierungsmethode, bei der sowohl Kalium als auch Argon über ein durch die Bestrahlung gebildetes aktives Argonisotop bestimmt werden. So entsteht aus Kalium 39 durch (n, p) -Reaktion Argon 39 und aus Argon 40 durch (n, γ) -Reaktion Argon 41. Da es für die Altersbestimmungen im wesentlichen nur auf das Verhältnis der Aktivitäten von Argon 39 zu Argon 41 ankommt, erscheint diese Methode besonders vorteilhaft, zumal sie nur geringen apparativen Aufwand erfordert. Die Alter der untersuchten Meteorite ergaben sich zu 2,78 · 109 bis 4.25 - 109 Jahren und stimmen, soweit Messungen nach anderen Verfahren bereits vorliegen, mit diesen überein. Nebenbei wurden aus den durch (n, a) -Prozesse entstandenen Argon 37-Aktivitäten Werte für den Calciumgehalt der untersuchten Meteoritproben erhalten.

Uredelgase im Meteoriten Breitscheid

Primordial rare gases have been found in the chondrite Breitscheid, which shows like Pantar light and dark regions. The primordial rare gases are only to be found in the dark portions; they amount to 179·10-6 cm3 STP/g helium and 221·10-8 cm3 STP/g neon. The isotopic compositions of these primordial rare gases have been determined by subtraction of the amounts of the radiogenic and cosmic ray produced rare gases measured in the light portions. Possible alterations of the isotopic abundances of the primordial rare gases in the time interval between the end of the nucleosynthesis and their capture in the meteoritic matter are discussed. The radiogenic helium age has now been determined to be 1.63·109 years.

Untersuchungen an Steinmeteoriten mit extrem hohem Edelgasgehalt

Large amounts of excessive helium and neon have been found in the veined chondrite Pantar. The absolute amounts as well as the isotopic compositions are similar to those found in Staroye Pesyanoe and Kapoeta.

The meteorite shows light areas which are surrounded by dark regions. The dark color is caused by tiny veins mainly consisting of newly formed troilite, which presumably has been produced during a thermometamorphosis and simultaneous addition of material.

An investigation of the separated fractions shows the excessive helium and neon to be contained almost completely within the dark fraction, i. e. the part of the meteorite which has undergone severe metamorphic changes.

The ammonium content of Pantar is the same as that of other chondrites.

Problems related to the existence of primordial gases in meteorites are discussed in view of the results presented.

Uranbestimmungen an Steinmeteoriten mittels Neutronenaktivierung über die Xenon-Isotope 133 und 135

Nach einer bereits früher veröffentlichten Neutronenaktivierungsmethode zur Bestimmung kleinster Uranmengen, bei welcher die durch die Spaltung des Urans 235 entstandenen Xenon-Isotope 133 und 135 gemessen werden, wurde der Urangehalt von acht Steinmeteoriten, fünf Chondriten und drei Achondriten, bestimmt. Es zeigt sich, daß bis auf eine Ausnahme alle untersuchten Chondriten nahezu konstanten Urangehalt von etwa 1·10-8 g/g Meteorit besitzen, während der Urangehalt der Achondrite stark variiert. Das Verhältnis Thorium/Uran beträgt bei den Steinmeteoriten im Mittel 3,46.

Die relativen Produktionsquerschnitte für 3He und 21Ne aus Mg, Si, S und Fe in Steinmeteorite

With various mineral separation methods, including our newly developed technique of specific solvents, we succeeded in separating very pure fractions of metallic iron, troilite, olivine and pyroxene from the Holbrook meteorite. Helium and neon were extracted from those minerals. The measurements allowed a determination of the relativ production rates of 3He and the neon isotopes by cosmic rays in iron, sulphur, magnesium and silicon. The results enable us to calculate the relative production rates of these isotopes in all kinds of meteorites whatever their chemical composition. The ratio of the relative production rates of 21Ne from Mg and Si is 1.8 ± 0.4. Therefore, we can conclude that the variations of the 3He/21Ne ratio in stone meteorites can not be explained by variations in their chemical composition, at least not for the normal chondrites.

Factor VIII assay mimicking in vivo coagulation conditions

Under certain circumstances, the determination of coagulation factor VIII (FVIII) is hampered by assay discrepancies between clotting and chromogenic approaches. These are observed in certain patients' plasma as well as in certain concentrates. We intended to develop a novel assay for the quantification of coagulation FVIII which reflects the physiological situation better than the established assays. It is based on plasma without chelation of divalent cations and simultaneously minimizes the generation of activated factors which could function as uncontrolled triggers of coagulation. FVIII deficient plasma is prepared with the aid of biotinylated antibodies against FVIII from normal plasma in presence of inhibitors of contact activation. To start the assay only tiny amounts of activated FIX serve as trigger. The FVIII determination is performed in a kinetic experiment and is based on the cleavage of a fluorogenic substrate for activated FX. FVIII concentrations between 0.01 and 1 IU mL(-1) are easily determined. Plasma-derived and recombinant FVIII concentrates were compared. All plasma-derived concentrates were found to contain FVIII activities within the specification of the manufacturer. Recombinant concentrates yielded only 35-50% of the claimed potency. The novel in vivo-like assay avoids the undue advantage or disadvantage of certain product characteristics by eliminating unphysiological assay conditions. Its usefulness could turn out in future experiments with plasma from haemophilia A patients.

Fast identification of wine related lactic acid bacteria by multiplex PCR

The microflora of must and wine consists of yeasts, acetic acid bacteria and lactic acid bacteria (LAB). The latter group plays an important role for wine quality. The malolactic fermentation carried out by LAB leads to deacidification and stabilisation of wines. Nevertheless, LAB are often associated with wine spoilage. They are mainly responsible for the formation of biogenic amines. Furthermore, some strains produce exopolysaccharide slimes, acetic acid, diacetyl and other off-flavours. In this context a better monitoring of the vinification process is crucial to improve wine quality. Moreover, a lot of biodiversity studies would also profit from a fast and reliable identification method. In this study, we propose a species-specific multiplex PCR system for a rapid and simultaneous detection of 13 LAB species, frequently occurring in must or wine: Lactobacillus brevis, Lb. buchneri, Lb. curvatus, Lb. hilgardii, Lb. plantarum, Leuconostoc mesenteroides, Oenococcus oeni, Pediococcus acidilactici, P. damnosus, P. inopinatus, P. parvulus, P. pentosaceus and Weissella paramesenteroides.

A lytic enzyme cocktail from Streptomyces sp. B578 for the control of lactic and acetic acid bacteria in wine

Beside yeasts, lactic acid bacteria (LAB) are the most abundant microbes in must during vinification. Whereas Oenococcos oeni is commercially used as a starter culture for the biological acid reduction in wines, other species are responsible for different types of wine spoilage. Members of the genera Pediococcus, Weissella, Leuconostoc, and Lactobacillus are producers of exopolysaccharide slimes, biogenic amines, acetic acid, and other off-flavors. In order to control microbial growth, different procedures such as heating of must and addition of sulfite or lysozyme from egg white are generally applied. Yet, because of health risks, the application of sulfite should be reduced and lysozyme is not effective against all LAB. In this study, we describe exoenzymes from a Streptomyces sp. strain B578 lysing nearly all wine-relevant strains of LAB and Gram-negative acetic acid bacteria. The lytic enzymes were active under wine-making conditions, such as the presence of sulfite and ethanol, low temperatures, and low pH values. The analysis of the exoenzyme composition revealed a synergistic action of different cell wall hydrolases. In conclusion, the lytic cocktail of Streptomyces sp. B578 is a promising tool for the control of wine-spoiling bacteria.

Bacillus species in the intestine of termites and other soil invertebrates

Soil invertebrates harbour a complex microbial community in their intestinal system. The total number of microbes in the hindgut of soil invertebrates can reach a titre of 10(11) ml(-1). The gut microbes play an indispensable role in the digestion of food and are of ecological importance in the global carbon cycle. The gut microbiota can include a variety of micro-organisms from the three domains Bacteria, Archaea and Eucarya. The bacterial groups from the intestinal systems are mainly affiliated to the proteobacteria, the gram-positive groups Firmicutes and Actinobacteria, the Bacteroides/Flavobacterium branch and the spirochetes. The Archaea are represented by methanogens. The eukaryotic groups consist of protozoa, yeasts and fungi. Intestinal bacteria are involved in the degradation of cellulose, hemicellulose and aromatic compounds as well as nitrogen fixation. They also contribute to the redox status of the gut. Bacilli form a significant portion of the intestinal microbial community of soil invertebrates, especially among cellulose degraders. The diversity and function of bacilli in soil invertebrates will be discussed in this paper.

Transformation of 2,4,6-trinitrotoluene (TNT) by Raoultella terrigena

Manufacture of nitroorganic explosives generates toxic wastes leading to contamination of soils and waters, especially groundwater. For that reason bacteria living in environments highly contaminated with 2,4,6-trinitrotoluene (TNT) and other nitroorganic compounds were investigated for their capacity for TNT degradation. One isolate, Raoultella terrigena strain HB, removed TNT at concentrations between 10 and 100 mg l(-1) completely from culture supernatants under optimum aerobic conditions within several hours. Only low concentrations of nutrient supplements were needed for the cometabolic transformation process. Radioactivity measurements with ring-labelled (14)C-TNT detected about 10-20% of the initial radioactivity in the culture supernatant and the residual 80-90% as water-insoluble organic compounds in the cellular pellet. HPLC analysis identified aminodinitrotoluenes (2-ADNT, 4-ADNT) and diaminonitrotoluenes (2,4-DANT) as the metabolites which remained soluble in the culture medium and azoxy-dimers as the main products in the cell extracts. Hence, the new isolate could be useful for the removal of TNT from contaminated waters.

["Fatigue" in multiple sclerosis. Development and and validation of the "Würzburger Fatigue Inventory for MS"]

BACKGROUND

Fatigue is one of the most common, yet poorly defined, disabling symptoms in patients with multiple sclerosis (MS). Several fatigue scales have been developed, but rigorous psychometric methods have not always been applied and validation was mainly based on small numbers of patients. We therefore assembled a new fatigue scale from a set of widely used scales and assessed its psychometric properties in a large sample of MS patients.

PATIENTS AND METHODS

Fatigue was assessed in 158 MS patients by four published quantitative scales: the Fatigue Severity Scale (FSS), Modified Fatigue Impact Scale (MFIS), MS-specific Fatigue Severity Scale (MFSS), and Visual Analogue Scale. From these a new fatigue scale, the Würzburg Fatigue Inventory for Multiple Sclerosis (WEIMuS), was assembled. It contains 17 items with values from 0 to 4. The WEIMuS scale was validated in a subgroup of 67 patients and a control group of 68 patients.

RESULTS

The MFIS and FSS but not the MFSS showed high internal consistency and split-half reliability. After applying factor analysis within the scales, fairly reliable and valid items originally found in the MFIS and FSS were selected to construct the final 17-item WEIMuS scale, which showed a high degree of reliability. In the validation study, varimax rotated factor analysis extracted two main factors corresponding to both cognitive and physical fatigue.

CONCLUSION

The new, two-dimensional WEIMuS showed good psychometric properties, is easy to use, and may therefore be a useful tool for the assessment of MS-associated fatigue. Multiple sclerosis patients suffer from different types of fatigue which could be attributed to cognitive and physical fatigue. Thus, MS-associated fatigue is different from common tiredness.

Fast microscopic method for large scale determination of structure, morphology, and quality of thin colloidal crystals

We present a novel fast microscopic method to analyze the crystal structures of air-dried or suspended colloidal multilayer systems. Once typical lattice spacings of such films are in the range of visible light, characteristic Bragg scattering patterns are observed. If in microscopic observations these are excluded from image construction, a unique color coding for regions of different structures, morphologies, and layer numbers results. Incoherently scattering defect structures, however, may not be excluded from image construction and thus remain visible with high resolution.

Continuous complete hematological and cytogenetic remission with molecular minimal residual disease 9 years after discontinuation of interferon-alpha in a patient with Philadelphia chromosome-positive chronic myeloid leukemia

Interferon-alpha has been used as standard therapy for patients with Philadelphia-positive chronic myeloid leukemia (CML) for more than 20 years. Recently randomized trials have shown a superiority of the tyrosine kinase inhibitor imatinib in respect to its efficacy to induce complete hematological and cytogenetic remissions and more importantly in overall survival. Although follow-up is much shorter for imatinib than for interferon-alpha, this data changed the treatment algorithms in this disease. At the end of the era of interferon-alpha as a single-drug first-line treatment for most patients we present a case report which exemplifies a rare but exciting property of interferon-alpha in CML: the induction of complete hematological and cytogenetic remissions which can persist over years after discontinuation of the drug. Hence, the enrollment of CML patients in clinical trials which explore a combination treatment of imatinib and interferon-alpha is warranted.