Precision Determination of Pion-Nucleon Coupling Constants Using Effective Field Theory

The pion-nucleon coupling constants determine the strength of the long-range nuclear forces and play a fundamental part in our understanding of nuclear physics. While the charged- and neutral-pion couplings to protons and neutrons are expected to be very similar, owing to the approximate isospin symmetry of the strong interaction, the different masses of the up and down quarks and electromagnetic effects may result in their slightly different values. Despite previous attempts to extract these coupling constants from different systems, our knowledge of their values is still deficient. In this Letter, we present a precision determination of these fundamental observables with fully controlled uncertainties from neutron-proton and proton-proton scattering data using chiral effective field theory. To achieve this goal, we use a novel methodology based on the Bayesian approach and perform, for the first time, a full-fledged partial-wave analysis of nucleon-nucleon scattering up to the pion production threshold in the framework of chiral effective field theory, including a complete treatment of isospin-breaking effects and our own determination of mutually consistent data. The resulting values of the pion-nucleon coupling constants are accurate at the percent level and show no significant charge dependence. These results mark an important step toward developing a precision theory of nuclear forces and structure.

Extraction of the Neutron Charge Radius from a Precision Calculation of the Deuteron Structure Radius

We present a high-accuracy calculation of the deuteron structure radius in chiral effective field theory. Our analysis employs the state-of-the-art semilocal two-nucleon potentials and takes into account two-body contributions to the charge density operators up to fifth order in the chiral expansion. The strength of the fifth-order short-range two-body contribution to the charge density operator is adjusted to the experimental data on the deuteron charge form factor. A detailed error analysis is performed by propagating the statistical uncertainties of the low-energy constants entering the two-nucleon potentials and by estimating errors from the truncation of the chiral expansion as well as from uncertainties in the nucleon form factors. Using the predicted value for the deuteron structure radius together with the very accurate atomic data for the difference of the deuteron and proton charge radii we, for the first time, extract the charge radius of the neutron from light nuclei. The extracted value reads r_{n}^{2}=-0.106_{-0.005}^{+0.007}  fm^{2} and its magnitude is about 1.7σ smaller than the current value given by the Particle Data Group. In addition, given the high accuracy of the calculated deuteron charge form factor and its careful and systematic error analysis, our results open the way for an accurate determination of the nucleon form factors from elastic electron-deuteron scattering data measured at the Mainz Microtron and other experimental facilities.

Délégation de l’évaluation et du traitement de la douleur à l’infirmier de Service mobile d’urgence et de réanimation : étude avant–après monocentrique

Introduction : La prise en charge de la douleur en médecine d’urgence préhospitalière est encore insuffisante. Cette étude a pour objectif d’évaluer les effets d’une délégation de l’évaluation et du traitement de la douleur à l’infirmier diplômé d’État (IDE) en Service mobile d’urgence et de réanimation (Smur) sur le suivi des recommandations de la Société française de médecine d’urgence (SFMU).

Méthode : Étude rétrospective de type avant–après réalisée au Smur du centre hospitalier universitaire (CHU) de Nîmes de janvier à mai 2017. Les IDE ont été formés, entre les deux phases, à un protocole de délégation de l’évaluation et du traitement de la douleur fondé sur les dernières recommandations.

Résultats : Cent quatre-vingt-un patients ont été inclus dans chaque groupe, 74 (40 %) femmes (âge moyen de 60 ± 18 ans). Les groupes étaient comparables à l’exception de la proportion d’interventions traumatologiques (11 % dans le groupe « avant » vs 20 % dans le groupe « après » ; p = 0,02). Les recommandations ont été respectées pour 12 (7 %) patients dans le groupe « avant », 21 (12 %) dans le groupe « après » (p = 0,10). Le seul facteur indépendant de respect des recommandations est le type d’intervention traumatologique (odds ratio = 9,7 ; intervalle de confiance à 95 % : [2,3–53,3] ; p < 0,01). Le nombre de patients ayant bénéficié d’une administration d’antalgique était respectivement de 55 (30 %) dans le groupe « avant » et de 73 (40 %) dans le groupe « après » (p = 0,05). La réévaluation de l’intensité douloureuse en fin de prise en charge a été consignée dans 11 (6 %) cas de la phase avant vs 38 (21 %) dans la phase après (p < 0,01). Dans le sous-groupe des patients n’ayant pas bénéficié de trinitrine, les recommandations ont été respectées respectivement pendant les phases « avant » et « après » chez 7 (6 %) patients vs 17 (14 % ; p = 0,03).

Conclusion : Malgré une augmentation du taux de prescription d’antalgiques et de réévaluation de la douleur, le protocole de délégation IDE n’a pas permis un meilleur respect des recommandations. L’établissement de protocoles spécifiques en fonction du type d’intervention, notamment traumatologique, pourrait être une piste de réflexion.

Le syndrome postgarde de nuit chez les médecins urgentistes : caractéristiques et facteurs influençants

Introduction : Les urgentistes connaissent une privation de sommeil en lendemain de garde. Beaucoup ont des perceptions ou des comportements inhabituels que nous appelons syndrome post-garde de nuit (PGN). L’objectif principal était de caractériser le syndrome PGN des urgentistes. Les objectifs secondaires étaient d’établir une note évaluant le syndrome PGN et de déterminer les facteurs influençant ce syndrome PGN.

Méthode : Étude prospective de cohorte, observationnelle, multicentrique, auprès des urgentistes du Gard et de l’Hérault entre janvier et juin 2017. Deux questionnaires informatiques anonymes étaient diffusés aux structures d’urgences du Gard et de l’Hérault. En journée normale, hors sortie de garde, un questionnaire colligeait les symptômes ressentis habituellement en lendemain de garde, à coter entre 0 et 10. En sortie de garde, un autre questionnaire s’intéressait au ressenti de la garde réalisée et aux caractéristiques de cette garde. Les médecins étaient encouragés à répondre aux deux questionnaires.

Résultats : Cent treize médecins (45 %) ont répondu, 67 (59 %) à distance d’une garde et 46 (41 %) en post-garde immédiat. Le syndrome PGN comprend des symptômes somatiques (échelle visuelle analogique (EVA) = 5 [2–8]), comportementaux (EVA = 7 [3–8]), liés à l’humeur (EVA = 7[5–8]) et psychiques (EVA = 6 [4–8]). Ces symptômes en post-garde immédiat étaient ressentis de manière moins importante que lorsque décrit à distance (respectivement p = 0,001, p <0,001, p < 0,001, p = 0,002). Les gardes de SMUR (service mobile d’urgence et de réanimation) et de traumatologie étaient associées à un syndrome PGN moins marqué (respectivement p =0,035 et p = 0,02) que les gardes des filières médico-chirurgicales.

Conclusion : Il s’agit de la première évaluation du syndrome PGN chez les urgentistes français. Les symptômes en sont moins importants en post-garde immédiat. Les gardes de traumatologie et de SMUR semblent mieux tolérées.

Todesursachen bei Hämophilie-Patienten in Deutschland 2006/2007

Seit 1983 (Erhebungszeitraum zurückreichend bis 1978) wird die Untersuchung zur Epidemiologie bei Patienten mit Hämophilie mit der Unterstützung einer Vielzahl von Hämophiliezentren und Behandlungseinrichtungen jeglicher Größe jährlich durchgeführt. Die aktuelle Zusammenstellung beruht auf einer breiten Datenbasis aus inzwischen fast 30 Jahren und vermag sowohl den aktuellen als auch den retrospektiven Morbiditäts- und Mortalitätsstatus gut abzubilden. Abgefragt wurden Informationen ausschließlich zu Patienten mit Hämophilie A, B und von-Willebrand- Erkrankung. Im Einzelnen wurden anonymisierte Daten zur Gesamtzahl an behandelten Patienten, Typ und Schweregrad der Erkrankung, HIV-Status und Todesursachen abgefragt. Diese Datensätze wurden mit den vorhandenen Datensätzen zusammengeführt und statistisch ausgewertet. Insgesamt wurden im Untersuchungszeitraum 2006/2007 eine Gesamtzahl von 8188 Patienten aus 69 Behandlungseinrichtungen gemeldet. Obwohl die Mortalität durch HIV/ AIDS bei Patienten mit Hämophilie weiter abnimmt, bleibt HIV ein wichtiges Problem, insbesondere da eine HIV/HCVKoinfektion das Risiko einer progredienten Lebererkrankung erhöhen kann. Die Altersstruktur unserer Patienten hat sich in im Laufe der vergangenen Jahrzehnte erheblich verändert und nähert sich zunehmend an die der Normalbevölkerung an, so dass dies bei der Beurteilung der Mortalität und Morbidität beachtet werden muss.

Precision Nucleon-Nucleon Potential at Fifth Order in the Chiral Expansion

We present a nucleon-nucleon potential at fifth order in chiral effective field theory. We find a substantial improvement in the description of nucleon-nucleon phase shifts as compared to the fourth-order results utilizing a coordinate-space regularization. This provides clear evidence of the corresponding two-pion exchange contributions with all low-energy constants being determined from pion-nucleon scattering. The fifth-order corrections to nucleon-nucleon observables appear to be of a natural size, which confirms the good convergence of the chiral expansion for nuclear forces. Furthermore, the obtained results provide strong support for the novel way of quantifying the theoretical uncertainty due to the truncation of the chiral expansion proposed by the authors. Our work opens up new perspectives for precision ab initio calculations in few- and many-nucleon systems and is especially relevant for ongoing efforts towards a quantitative understanding of the structure of the three-nucleon force in the framework of chiral effective field theory.

Die Atomverteilung im glasigen roten Phosphor

Using a BRAGG—BRENTANO camera followed by a bent quartz monochromator the scattering intensities of amorphous red phosphorous were determined and converted into the atomic distribution curve. Radiation of various wavelengths (CuKa, MοKa, AgKa) were used. Each phosphorous atom is surrounded by three nearest neighbours at a distance of 2.24 Å and six others at a distance of 3.48 A. At a distance of 3.48 Å one also finds on the average almost two more atoms with the VAN DER WAALS distance. The bond angle is about 102°. The close range order must be related to that in the lattices of the polyphosphid MePbP14.

An improved procedure for normalization and for the elimination of the COMPTON scattering is given and discussed.

Über die Struktur und die Eigenschaften der Halbmetalle

Vor Jahren haben wir die Ansicht ausgesprochen, daß Selen und Schwefel im geschmolzenen hochviskosen sowie im amorph abgeschreckten Zustand vorwiegend ringförmig gebaut sind. Die in der Literatur dagegen angeführten Argumente werden besprochen. Insbesondere werden die nach der paramagnetischen Resonanzmethode durchgeführten Messungen der Radikalkonzentration von GARDENER und FRAENKEL an Hand des Ringmodells diskutiert. Für die Entstehung der verschiedenen amorphen und flüssigen Schwefelformen wird eine molekularkinetische Deutung gegeben.

[Haemophilia patients in Germany 2008/2009. Morbidity and mortality]

Since 1978 an annual multicentric survey regarding the epidemiology of patients suffering of haemophilia is performed with support of hemophilia treating centres of any size. Again the actual compilation is resting upon a broad database returning to over 30 years of inquiry well representing both the actual and retrospective status of mortality. Prompted was exclusively information about patients with haemophilia A, B and von Willebrand disease. In particular anonymous data concerning the last 12 months about number of treated patients, type and severity of illness, HIV-status and detailed information about causes of death was inquired. This data was merged with existing data and analyzed statistically. In the 2008/2009 survey, a total number of 9101 patients with bleeding disorders have been reported from 66 participating centres. Despite mortality from HIV in patients with haemophilia is keeping on decreasing, HIV still remains an important factor as an HIV/HCV coinfection seems to increase risk of progression of severe liver disease. Age structure in our patients has been shifting significantly over the last decades bringing age distribution into line with the entire population. This has to be considered assessing mortality and morbidity.

Hämophilie-Patienten in Deutschland 2008/2009

Since 1978 an annual multicentric survey regarding the epidemiology of patients suffering of haemophilia is performed with support of hemophilia treating centres of any size. Again the actual compilation is resting upon a broad database returning to over 30 years of inquiry well representing both the actual and retrospective status of mortality. Prompted was exclusively information about patients with haemo philia A, B and von Willebrand disease. In particular anonymous data concerning the last 12 months about number of treated patients, type and severity of illness, HIV-status and detailed information about causes of death was inquired. This data was merged with existing data and analyzed statistically. In the 2008/2009 survey, a total number of 9101 patients with bleeding disorders have been reported from 66 participating centres. Despite mortality from HIV in patients with haemophilia is keeping on decreasing, HIV still remains an important factor as an HIV/HCV coinfection seems to increase risk of progression of severe liver disease. Age structure in our patients has been shifting significantly over the last decades bringing age distribution into line with the entire population. This has to be considered assessing mortality and morbidity.

[Morbidity and mortality of patients with haemophilia in Germany 2007/2008]

Since 1978 an annual multicentric survey regarding the epidemiology of patients suffering of haemophilia is performed with support of haemophilia treating centres of any size. Again the actual compilation is resting upon a broad database returning to over 30 years of inquiry well representing both the actual and retrospective status of mortality. Prompted was exclusively information about patients with haemophilia A, B and von Willebrand disease. In particular anonymous data concerning the last 12 months about number of treated patients, type and severity of illness, HIV-status and detailed information about causes of death was inquired. This data was merged with existing data and analyzed statistically. In the 2007/2008 survey, a total number of 8904 patients with bleeding disorders have been reported from 63 participating centres. Despite mortality from HIV in patients with haemophilia is keeping on decreasing, HIV still remains an important factor as an HIV/HCV coinfection seems to increase risk of progression of severe liver disease. Age structure in our patients has been shifting significantly over the last decades bringing age distribution into line with the entire population. This has to be considered assessing mortality and morbidity.

Morbidity and mortality of patients with haemophilia in Germany 2007/2008

Since 1978 an annual multicentric survey regarding the epidemiology of patients suffering of haemophilia is performed with support of haemophilia treating centres of any size. Again the actual compilation is resting upon a broad database returning to over 30 years of inquiry well representing both the actual and retrospective status of mortality. Prompted was exclusively information about patients with haemophilia A, B and von Willebrand disease. In particular anonymous data concerning the last 12 months about number of treated patients, type and severity of illness, HIV-status and detailed information about causes of death was inquired. This data was merged with existing data and analyzed statistically. In the 2007/2008 survey, a total

[Causes of death in patients with haemophilia in Germany 2006/2007]

Since 1983 (survey period returning to 1978) with support of numerous haemophilia treating centres of any size an annual survey regarding the epidemiology of patients suffering of haemophilia is performed. The actual compilation is resting upon a broad database returning to almost 30 years of inquiry well representing both the actual and retrospective status of mortality. Prompted was exclusively information about patients with haemophilia A, B and von Willebrand disease. In particular anonymous data concerning the last 12 months about number of treated patients, type and severity of illness, HIV-status and detailed information about causes of death was inquired. This data was merged with existing data and analyzed statistically. In the 2006/2007 survey, a total number of 8188 patients with bleeding disorders have been reported from 69 participating centres. Despite mortality from HIV in patients with haemophilia is decreasing, HIV still remains an important factor as a HIV/HCV coinfection seems to increase risk of progression of liver disease. Age structure in our patients has been shifting significantly over the last decades bringing age distribution into line with the entire population. This has to be considered in assessing mortality and morbidity.

[The national GTH haemophilia registry as database within the scope of the German human genome project]

The Committee of Haemophilia of the GTH has established a central registry for all German centers treating patients with haemophilia. The intention was to establish a suitable system for collecting and analyzing epidemiological data relevant to bleeding disorders. The registry provides the database within the scope of the German Human-Genome-Project. The set goal is the complete molecular characterization of the genetic mutations on chromosome X of haemophilia A patients in Germany and subsequent correlation with the phenotype. An electronic network is applied for communication. A Java-application was developed for online electronic data acquirement by the participating centers. Offline data entry and sending encrypted data carriers is possible, too. A high level of security is assured by personalized access. Data are anonymized and scrambled by secure encoding. The concept was confirmed by the official data security offices. A considerable improvement for the epidemiological sciences and a better basis on therapy for patients with bleeding disorders is expected. Furthermore the registry is available for other scientific projects.

Transcatheter closure of muscular ventricular septal defects in two patients after myocardial infarction

Acquired muscular ventricular septal defects (MVSD) after myocardial infarction (MI) can lead to right heart failure and cardiogenic shock with high mortality. Early surgical therapy is often difficult to perform but can reduce the mortality. The closure of congenital septal defects is performed with high safety. Therefore, the interventional closure of an acquired post-MI VSD might be feasible and of potential benefit. To date, experiences with closure of post-MI MVSDs are minimal. We report on two patients with post-MI VSD.

Scanning behavior of rats during eating under stressful noise

Behavioral ecological theories postulate that threatening environments should increase eating speed and vigilance during feeding. In the present experiment, eating speed and scanning behavior during eating were measured in 36 rats in 5 consecutive test sessions under stressful noise (95 dB white noise, n = 18) and control conditions (60 dB, n = 18) after the animals had been habituated to the test environment. Intense noise induced an increase of scanning rate and eating speed. These effects are similar to those reported for novel and light environments.

Respiratory syncytial virus infection: its role in aeroallergen sensitization during the first two years of life

Our aim was to study the influence of infection with the respiratory syncytial virus (RSV) in non-hospitalized infants on sensitization to aeroallergens and the early manifestation of atopy. Six hundred and nine infants from the prospective German Multicenter Cohort Study on Atopy were included, 38% of whom had an elevated atopic risk. RSV IgG and IgM antibodies were tested by ELISA with gradient purified RSV antigen. Specific IgE against mites, cat dandruff, birch and grass pollens and relevant nutritional antigens were tested with CAP-RAST-FEIA (Pharmacia, Sweden). Of the cord sera 99% were positive for RSV-IgG, 44.7% at one year and 64.2% (n = 265) at two years of age. The positivity rate after 12 months varied with the season of birth, the number of siblings and the degree of exposure to tobacco smoke; and correlated closely with attacks of wheezing during infancy. Twenty (2.8%) children were found to be sensitized against at least one aeroallergen at one year, and 28 (10.5%) at two years. By the first birthday, mite sensitization (n = 3) could only be seen in the RSV-infected children; grass pollen sensitization (n = 9) was associated with RSV seropositivity (logistic regression model including the confounders mentioned above: with RSV IgG < p = 0.048 > and IgM < p = 0.0006 >), as was birch sensitization (n = 5) with RSV IgM (p = 0.009). No such differences could be detected at two years. No correlation of RSV seropositivity to any allergic manifestation could be found. We conclude, that it is only in the first year of life, that RSV infection plays a significant role in promoting sensitization against aeroallergens, which do not at this time produce allergic symptoms.

Effects of stressful noise on eating and non-eating behavior in rats

Eating and other behaviors were measured in 36 food-deprived rats on 15 consecutive days during 20 min test sessions. During training sessions 1 to 5 all animals were habituated to the test boxes with white noise of 55 dB intensity. For sessions 6 to 10 noise intensity was increased to 95 dB for the experimental rats and to 60 dB for the control rats. The food intake of experimental rats was lower for stress session 1. The duration of eating behavior was lower, and durations of exploring, grooming and resting behaviors were higher for all stress sessions for rats exposed to 95 dB white noise. Speed of eating behavior was higher for all stress sessions in the experimental group. Defecation rate of the experimental rats was higher for all stress sessions. On post-stress sessions 11 to 15 animals were again tested under the stimulus conditions of the training period (55 dB). No significant effects were observed for this period. The results are discussed with respect to models of "stress-induced" eating and behavioral ecology.

[Support in living]

"Lebenshilfe" (help in living) is of crucial importance for the organization of live of persons with a handicap. This help in living, training and social integration, however, requires an image of the handicapped person that unrestrictedly recognizes her right to live and to be a human being with a handicap. But todays hedonistic and preference-utilitarian social trends make other, selecting value judgements. This article comments on these dubious ethical positions critically and develops a paradigmatic, positive point of view. This statement is partly based on the principles of 2 self-help organizations of the same name ("Lebenshilfe für geistig Behinderte") in Germany and in Austria.

Techniques for laparoscopic cholangiography and removal of common duct stones

As laparoscopic cholecystectomy becomes more prevalent, the unexpected finding of common duct stones by operative cholangiography presents a therapeutic dilemma for the surgeon. We present our current techniques for laparoscopic cholangiography and management of choledocholithiasis, including the use of angioplasty balloons for ampullary dilation.

Interdisciplinary rehabilitation of the laryngectomee

It is to be hoped that human aspects have not been forgotten in spite of all these statistics. Behind all these numbers lie the personal fates of approximately 700 laryngectomees in Switzerland. The interview findings reflect their situation in life. In summary, we can say that: --Half of the laryngectomees lose their job and feel restricted in their daily lives; every third one mentions financial problems. --A third of the laryngectomees are totally or partly unsatisfied with the speech rehabilitation program. --There appear to be remarkable differences within the various language regions in Switzerland with regard to preparation for the operation, speech rehabilitation, and the current life situation of laryngectomees. From our study, we conclude that extensive medical, psychological, and social counseling and assistance for those affected is of great importance. Here we must especially mention the preparation of the patients and their relatives for the operation and its consequences. This should be the task not of one person but of an interdisciplinary team, including a logopedist, a social worker, and also another laryngectomee, with whom contact is often very valuable for the patient. Early speech therapy, reintegration into working life, and improvement of financial status are further factors of great importance.

[The significance of individual patient characteristics for loading capacity and deformation of the proximal end of the femur]

The influence of such individual characteristics as age, sex, morphological characteristics (CDD angle, length of femoral neck, total and medullary diameter and score on the Singh osteoporosis index) on the loading capacity and deformation of the proximal end of the femur were determined in this experimental study. In all, 341 femora taken from the cadavers of persons who had died at over 60 years of age were tested under alternating load in up to 4000 cycles and, if no instability occurred, also under static load. The loading capacity and deformation were compared. The loading capacity was significantly higher in male femora with (5441 +/- 257 N) than in female femora (4273 +/- 1850 N). The loading capacity also decreased with increasing age and with decreasing CCD angle and Singh index score (higher degree of osteoporosis). Because of the high standard deviation in each group these differences were not significant.

Cloning and analysis of a human 86-kDa heat-shock-protein-encoding gene

An 86-kDa heat-shock-protein-encoding (hsp86) cDNA probe permitted to identify, in whole genomic human DNA, two EcoRI fragments of 2.6 and 5.3 kb. These two fragments, as well as an homologous phage lambda VIII1 harboring about 19 kb of human DNA, were isolated from genomic libraries. Sequence analysis revealed that three different genomic hsp86 sequences had been cloned, one of them being the 5' half of a functional gene. This gene contains several introns, as compared to the entire Hsp86-encoding sequence found in lambda VIII1, which represents a processed pseudogene. Cloned hsp86 promoter, with its TATA-box and a heat-shock element upstream at nt positions -25 and -75, respectively, was functional, as verified by fusion to the bacterial chloramphenicol acetyltransferase-encoding gene and its transient expression in vivo. The typical hsp86-type heat-shock regulation was observed, i.e., significant basal activity associated with an inducibility at elevated temperatures. Furthermore, accurate and efficient in vitro transcription was initiated at this hsp86 promoter, resulting in expression of the hsp86 gene, as well as the unrelated sequences.

A rapid DNA probe test for detecting human papilloma virus types 6/11 and 16 in biopsy specimens

A simple, rapid and sensitive non-radioactive in situ hybridization assay for human papillomavirus (HPV) has been developed and used to detect HPV 6/11 and HPV16 DNA in ano-genital biopsy specimens. A comparative study to determine the sensitivity and the specificity of this assay relative to Southern blot hybridization assays was performed using one hundred biopsy specimens. The sensitivity of the in situ hybridization assay was 88% for HPV type 6/11 and 89% for HPV type 16. The specificity of the test was 99% for both virus types. In addition to its high sensitivity and specificity, this in situ hybridization assay for HPV uses a non-radioactive detection system. The assay is faster and easier to perform than the Southern blot method. Also, in situ hybridization assays permit the simultaneous evaluation of the histology, as well as the DNA content of biopsy tissues because they do not result in the destruction of tissue or cell morphology. This prototype HPV DNA assay was developed using DNA probes for HPV 6/11 and HPV 16 DNA in anogenital biopsy specimens. However, the protocol developed in these studies can easily be extended to include the use of probes for detecting other HPV types in a variety of tissues.

[Study of the correlation between early and late changes in the roentgenologic and functional status following conservative and surgical treatment of the head of the tibia]

Between 1976 and 1980 161 patients were admitted to our department with condylar fractures of the tibia. 60% of the patients were treated conservatively, 40% underwent surgery. The patients follow-up was analysed three to seven years after therapy and an examination of a representative group of patients was performed 1983. A direct comparison of therapeutic results between the conservative and operative treatment groups is not possible, since fractures with a particularly poor prognoses including depression and impression fractures of the articular surface were more frequent in the operative treatment group. It is noteworthy, however, that the patients' activity at work and in their leisure time was increased in the operative group. Additionally in this group the remaining complaints were less and the final results more favourable according to the patients' self-judgment. Unchanged irregularities of the joint surface following initial therapy were found in 40.5% of conservatively treated patients and in 6.9% of operated patients respectively. At the time of reassessment, however, differences of radiological findings could not be seen between the two treatment groups. Whereas in the conservative treatment group a difference in length of the two legs of 2 cm or more were observed in 16% of cases, not a single case was found in the operative treatment group. There was a correlation of the functional and the result of the radiological examination, although considerable exceptions from this correlation were also seen. Therefore it is not possible from the individual X-ray findings to predict the functional results of the patient.

[Clinical and mammographic late results following Strömbeck breast reduction-plasties]

Report about 197 breast reductions on 100 patients which were operated by the method of Strömbeck. Indication was mostly macromasty and excessive ptosis. In the mean 740 g were removed on each side, in 18.2% there was removed more than 1000 g on one side. The more tissue was removed, the higher were local complications. The cosmetic result was good to excellent in 80%. The behaviour to the husband was in most cases not changed after the operation. Mammographic studies showed a good interpretation in 80%. After the operation all patients lost their preoperative complaints.

[Functional results following conservative and surgical therapy of pathologic fractures in malignant diseases]

From 1972-1982 149 pathological fractures in 91 patients were treated. 134 of these were caused by malignant disease. With 78% metastases were the most common cause for fractures. 59% of the patients were women. The most frequent fracture localisation was the femur followed by ribs and humerus. 62% of the fractures but 100% of the leg fractures were treated operatively. The best functional results were achieved after compound osteo-synthesis. The mean survival time of the patients was 10.7 months. The one year survival rate was 24.6% and the two year survival rate was 9.2%. The best survival rates were observed in women, patients with breast cancer metastases, femur shaft- or subtrochanteric fractures. The lowest survival rate was found in male patients, patients with unknown primary tumour and femur neck fractures.

Folding kinetics of mammalian ribonucleases

The folding kinetics of seven different pancreatic ribonucleases are compared both under native conditions and within the unfolding transition. In general, the folding kinetics of these proteins are similar despite numerous amino acid substitutions. Ribonucleases with 4-6 proline residues show 80% slow-folding species. For three ribonucleases with 7 prolines this number increases to 90%. Porcine ribonuclease with a unique Pro 114-Pro 115 sequence folds significantly slower than other ribonucleases which do not show this sequence.

Native-like folding intermediates of homologous ribonucleases

The mechanism of the slow refolding reactions of four different pancreatic ribonucleases from ox, sheep, red deer, and roe deer has been investigated. Refolding kinetics of these proteins were very similar. In particular, a native-like intermediate, IN, was shown to be populated on the slow refolding pathway of all ribonucleases. We conclude that, similar to the stability of the folded proteins, the pathway of slow refolding has been conserved despite the differences in amino acid sequence and the varying number of proline residues.

Decreased serotonin content of embryonic raphe neurons following maternal administration of p-chlorophenylalanine: a quantitative immunocytochemical study

Previous studies from this laboratory have suggested that serotonergic (5-HT) neurons may influence the differentiation of their embryonic target cells in the developing rat brain. The present study was designed to determine whether or not maternal p-chlorophenylalanine (pCPA) administration could deplete serotonin (5-HT) in developing 5-HT neurons during embryonic days 13-15, when the effects of pCPA on neuronal genesis have been observed previously. For this study, pCPA was administered to timed-pregnant rats and embryos were sacrificed at two different gestational ages, embryonic days 13-14 (E13-14) and 14-15 (E14-15). Immunotitration experiments were carried out on tissue sections, using an antiserum to 5-HT-hemocyanin conjugates to obtain a relative estimate of the amount of 5-HT contained within individual 5-HT neurons of embryos from pCPA-treated and control mothers. Diminished immunoreactivity as a consequence of addition of increasing amounts of antigen was then quantitated on a relative scale by comparison with the amount of immunoreactivity present when no antigen was added to the primary antiserum. Two major findings resulted from this study: maternal pCPA treatment depleted 5-HT by approximately 50% in developing 5-HT neurons at embryonic ages E13-14 and E14-15, but depletion appeared to be greatest in the youngest embryos; developing 5-HT neurons increased their content of neurotransmitter by approximately 10-fold during this one day of embryonic development, an effect which could be observed in both pCPA-treated and control animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Folding of homologous proteins. The refolding of different ribonucleases is independent of sequence variations, proline content and glycosylation

The refolding kinetics of four different pancreatic ribonucleases have been compared. Bovine and ovine RNAase contain 4 proline residues, red deer RNAase has 5 prolines, the enzyme from roe deer 6 prolines. Despite the variation in the amount of prolines, all four proteins show a constant value of 20% fast refolding species UF. The extra proline residues of the deer enzymes do not increase the amount of slow refolding species US. Consequently these residues may be non-essential for folding. Despite many differences in the amino acid sequence, the rates if the fast and slow refolding reactions are very similar for all investigated ribonucleases. This indicates that the pathway of refolding has been conserved during evolution, i.e. the positions where amino acid substitutions occur are not critically important for the rate-determining steps of the folding process. A carbohydrate chain attached to ribonuclease does not alter the folding properties of the protein: RNAase A and RNAase B from roe deer show identical refolding kinetics.