Tunnel excavation triggering pulmonary sarcoidosis

Context A definite cause of sarcoidosis has not been identified, however past research suggests that environmental factors may be triggers of the granulomatous response in genetically susceptible individuals. Case Presentation A 22-year-old male non-smoker, presented with progressive exertional dyspnea and cough of 3 months duration. One year before, when he started working in tunnel excavation, he had a normal chest radiograph. Chest imaging revealed bilateral nodules and masses of peribronchovascular distribution plus mediastinal lymphadenomegaly. Histologic lymph node analysis revealed non-caseating confluent granulomas. Sarcoidosis was diagnosed. The patient was treated with corticosteroids and advised to change jobs. Complete remission of the disease was achieved and persisted for at least one year without steroid treatment. Discussion Sarcoidosis is believed to have environmental triggers. The timing of the onset of sarcoidosis in this patient following intensive exposure to tunnel dust suggests an environmental contribution. The recognition that sarcoidosis may have occupational triggers have medical, employment, and legal implications. Am. J. Ind. Med. 55: 390-394, 2012. (C) 2011 Wiley Periodicals, Inc.

Influence of prior 810-nm-diode intracanal laser irradiation on hydrophilic resin-based sealer obturation

Dentin wall structural changes caused by 810-nm-diode laser irradiation can influence the sealing ability of endodontic sealers. The objective of this study was to evaluate the apical leakage of AH Plus and RealSeal resin-based sealers with and without prior diode laser irradiation. Fifty-two single-rooted mandibular premolars were prepared and divided into 4 groups, according to the endodontic sealer used and the use or non-use of laser irradiation. The protocol for laser irradiation was 2.5W, continuous wave in scanning mode, with 4 exposures per tooth. After sample preparation, apical leakage of 50% ammoniacal silver nitrate impregnation was analyzed. When the teeth were not exposed to irradiation, the Real Seal sealer achieved the highest scores, showing the least leakage, with significant differences at the 5% level (Kruskal-Wallis test, p = 0.0004), compared with AH Plus. When the teeth were exposed to the 810-nm-diode laser irradiation, the sealing ability of AH Plus sealer was improved (p = 0282). In the Real Seal groups, the intracanal laser irradiation did not interfere with the leakage index, showing similar results in the GRS and GRSd groups (p = 0.1009).

Temperature changes on the root surfaces of mandibular incisors after an 810-nm high-intensity intracanal diode laser irradiation

Temperature changes caused by laser irradiation can promote damage to the surrounding dental tissues. In this study, we evaluated the temperature changes of recently extracted human mandibular incisors during intracanal irradiation with an 810-nm diode laser at different settings. Fifty mandibular incisors were enlarged up to an apical size of ISO No. 40 file. After the final rinse with 17% ethylenediaminetetraacetic acid, 0.2% lauryl sodium sulfate biologic detergent, and sterile water, samples were irradiated with circular movements from apex to crown through five different settings of output power (1.5, 2.0, 2.5, 3.0, and 3.5 W) in continuous mode. The temperature changes were measured on both sides of the apical and middle root thirds using two thermopar devices. A temperature increase of 7 degrees C was considered acceptable as a safe threshold when applying the diode laser. Results: The results showed that only 3.5-W output power increased the outer surface temperature above the critical value. Conclusion: The recommended output power can be stipulated as equal to or less than 3 W to avoid overheating during diode laser irradiation on thin dentin walls. (c) 2012 Society of Photo-Optical Instrumentation Engineers (SPIE). [DOI: 10.1117/1.JBO.17.1.015006]

Microhardness of Radicular Dentin Treated with 980-nm Diode Laser and Different Irrigant Solutions

Objective: The aim of this study was to evaluate the microhardness of radicular dentin after treatment with 980-nm diode laser and different irrigant solutions. Background data: There are few reports of the consequences of diode laser irradiation emitted at 980 nm on the mechanical properties of dentin. Methods: Seventy-two single canal, human canines with complete root formation were randomly distributed among three groups (n = 24), according to the irrigant solution used in the biomechanical preparation: distilled water; 1% NaOCl; and, 1% NaOCl + 17% EDTA. These groups subsequently were divided into three subgroups (n = 8), according to the diode laser parameter: no irradiation (control); 1.5W/100 Hz; and 3.0 W/100 Hz. Laser was applied with helicoidal movements for 20 sec. Roots were sectioned in slices and the fragment corresponding to the middle third was submitted to the microhardness test (KHN) at depths of 30, 90, 150, and 300 mu m. Results: ANOVA and Tukey tests showed that the microhardness of the groups irradiated with 1.5 W/100 Hz (49.7 +/- 11.2) and 3.0W/100 Hz (50.6 +/- 11.9) were statistically similar to each other (p > 0.05) and different (p < 0.05) from the non-irradiated group (45.0 +/- 9.7). Higher microhardness values were obtained at 150 mu m (49.2 +/- 11.0) and 300 mu m (52.3 +/- 11.3) which were similar among themselves and different (p < 0.05) only at the depth of 30 mu m (44.4 +/- 10.5). No differences were found among the irrigant solutions (p > 0.05). Conclusions: The microhardness of the radicular dentin increased after irradiation with 980-nm diode laser.

Effectiveness of low-level laser therapy for patients with carpal tunnel syndrome: design of a randomized single-blinded controlled trial

Background: Carpal tunnel syndrome is the most common neuropathy in the upper extremity, resulting from the compression of the median nerve at wrist level. Clinical studies are essentials to present evidence on therapeutic resources use at early restoration on peripheral nerve functionality. Low-level laser therapy has been widely investigated in researches related to nerve regeneration. Therefore, it is suggested that the effect of low-level laser therapy associated with other conservative rehabilitation techniques may positively affect symptoms and overall hand function in compressive neuropathies such as carpal tunnel syndrome. The aim of this study is to evaluate the effectiveness of low-level laser therapy in addition to orthoses therapy and home orientations in patients with carpal tunnel syndrome. Methods/Design: Patients older than 18 years old will be included, with clinical diagnosis of carpal tunnel syndrome, excluding comorbidies. A physiotherapist will conduct intervention, with a blinding evaluator. Randomization will be applied to allocate the patients in each group: with association or not to low-level laser therapy. All of them will be submitted to orthoses therapy and home orientations. Outcome will be assessed through: pain visual analogic scale, Semmes Weinstein monofilaments (TM) threshold sensibility test, Pinch Gauge T, Boston Carpal Tunnel Questionnaire and two point discrimination test. Discussion: This paper describes the design of a randomized controlled trial, which aim to assess the effectiveness of conservative treatment added to low-level laser therapy for patients with carpal tunnel syndrome. Trial registration: Brazilian Clinical Trials Registry (ReBec) - 75ddtf / Universal Trial Number: U1111-1121-5184

Temperature impact on the tunnel fet off-state current components

In this work, the temperature impact on the off-state current components is analyzed through numerical simulation and experimentally. First of all, the band-to-band tunneling is studied by varying the underlap in the channel/drain junction, leading to an analysis of the different off-state current components. For pTFET devices, the best behavior for off-state current was obtained for higher values of underlap (reduced BTBT) and at low temperatures (reduced SRH and TAT). At high temperature, an unexpected off-state current occurred due to the thermal leakage current through the drain/channel junction. Besides, these devices presented a good performance when considering the drain current as a function of the drain voltage, making them suitable for analog applications. (C) 2012 Elsevier Ltd. All rights reserved.

What is the diagnostic value of ultrasonography compared to physical evaluation in patients with idiopathic carpal tunnel syndrome?

[EN] OBJECTIVE: Our hypothesis is that sonography performed by the rheumatologist in patients with suspected carpal tunnel syndrome (CTS) has higher diagnostic value compared to physical evaluation. METHODS: Adult patients with suspected idiopathic CTS, defined by sensory symptoms over the distribution of the median nerve with or without positive results with the Phalen and/or the Tinel's maneuvers were included. The diagnosis of CTS was indicated by typical symptoms daily for at least 3 months and a positive nerve conduction study. One rheumatologist unaware of the clinical and electrodiagnostic results performed an ultrasound examination of the median nerve for the area ranging from the inlet to the outlet of the carpal tunnel. Mean cross-sectional area at each level, flattening ratio and bowing of flexor retinaculum were obtained. RESULTS: Sixty-eight patients with 105 affected wrists were examined. Tinel's and Phalen's signs had a closer sensitivity (73% and 67% respectively) and specificity (40% and 30% respectively). The best swelling nerve cut-off by sonography was 9.7 mm2 at the tunnel inlet, with a sensitivity of 86%, a specificity of 48% and accuracy of 77%. A 100% positive predictive value was reached with a cross-sectional area of 13 mm2, involving 33 hands (31% of the whole sample). Maximal cross sectional area and the measurement of flexor retinaculum had an accuracy of 72% and 73% respectively. Combination of physical maneuvers and sonography not yielded more accuracy than cross-sectional area itself. CONCLUSION: In patients with clinical history of idiopathic CTS and positive nerve conduction study, sonography performed by the rheumatologist has higher diagnostic value than physical maneuvers.

Usefulness of clinical findings, nerve conduction studies and ultrasonography to predict response to surgical release in idiopathic carpal tunnel syndrome.

[EN] OBJECTIVES: To assess the usefulness of clinical findings, nerve conduction studies and ultrasonography performed by a rheumatologist to predict success in patients with idiopathic carpal tunnel syndrome (CTS) undergoing median nerve release. METHODS: Ninety consecutive patients with CTS (112 wrists) completed a specific CTS questionnaire and underwent physical examination and nerve conduction studies. Ultrasound examination was performed by a rheumatologist who was blind to any patient's data. Outcome variables were improvement >25% in symptoms of the CTS questionnaire and patient's overall satisfaction (5-point Likert scale) at 3 months postoperatively. Success was defined as improvement in both outcome variables. Receiver operating characteristics (ROC) curves and logistic regression analyses were used to assess the best predictive combination of preoperative findings. RESULTS: Success was achieved in 63% of the operated wrists. Utility parameters and area under the ROC curve (AUC) for individual findings was poor, ranging from 0.481 of the nerve conduction study to 0.634 of the cross-sectional area at tunnel outlet. Logistic regression identified the preoperative US parameters as the best predictive variables for success after 3 months. The best predictive combination (AUC=0.708) included a negative Phalen maneuver, plus absence of thenar atrophy, plus less than moderately abnormalities on nerve conduction studies plus a large maximal cross-sectional area along the tunnel by ultrasonography. CONCLUSION: Although cross-sectional area of the median nerve was the only predictor of success after three months of surgical release, isolated preoperative findings are not reliable predictors of success in patients with idiopathic CTS. A combination of findings that include ultrasound improves prediction.

Limited value of ultrasound assessment in patients with poor outcome after carpal tunnel release surgerys

[EN] OBJECTIVE: To determine the value of ultrasonography in the assessment of patients with idiopathic carpal tunnel syndrome (CTS) and poor outcome after carpal tunnel release. METHODS: A total of 88 consecutive patients with CTS (104 hands) underwent open surgical release of the median nerve. Ultrasound (US) examination was performed blind to any patient's data. The median nerve area at tunnel inlet and outlet, the retinaculum distance, and the flattening ratio were measured. The main outcome variable was the patient's overall satisfaction using a five-point Likert scale (1 = worse, 2 = no change, 3 = slightly better, 4 = much better, 5 = cured) at 3 months postoperatively. Pre- and postoperative ultrasonographic findings in relation to clinical outcome were analysed. RESULTS: Improvement (scores 4 or 5 on the Likert scale) was recorded in 75 hands (72%). After carpal tunnel release, the cross-sectional area at tunnel inlet decreased from a mean of 14.2 to 13.3 mm2 in the group with clinical improvement and also from a mean of 12.5 to 11.6 mm2 in the group with no change or slight improvement. No significant changes in the cross-sectional area at tunnel outlet, retinaculum distance, and flattening ratio were observed. CONCLUSION: Reduction of the median nerve cross-sectional area at tunnel inlet at 3 months after carpal tunnel release was similar in patients reporting cure or great improvement and in those with slight or no improvement. Ultrasonography is of limited value in assessment of patients with poor outcome after median nerve release.

Molekulardynamik-Simulationen zu Oberflächeneigenschaften von Siliziumdioxid-Schmelzen

Molekulardynamik-Simulationen zu OberflächeneigenschaftenvonSiliziumdioxid-Schmelzen In der vorliegenden Arbeit werdenMolekulardynamik-Computersimulationenzur Untersuchung der statischen und dynamischenOberflächeneigenschafteneiner Siliziumdioxid (SiO$_2$)-Schmelze durchgeführt.Als Modellpotential verwenden wirein in der Literatur als BKS-Potential bezeichnetesPaarpotential.Wir betrachten in dieser Arbeit zwei Systemgeometrien: zumeinenSysteme aus 432, 1536 und 4608 Atomen ohne periodischeRandbedingungen(Tropfen), zum anderen ein System aus 1152 Atomen mitperiodischen Randbedingungen in zwei Richtungen (dünnerFilm).Für beide Geometrien finden wir im Inneren der Systemekonstante Dichten.Direktan der Oberfläche halten sich ausschließlich Sauerstoffatomeauf.Die Strukturan der Oberfläche erscheint weniger ausgeprägt mit mehrDefekten, als im Inneren des Systems.Es erweist sich,daß viele Eigenschaften statischer Größen, die wir an derOberfläche im Vergleich zum Inneren finden, aufdas Vorhandensein von Zweierringen zurückzuführen sind.Bei der Betrachtung der dynamischen Größen finden wir eineerhöhteBeweglichkeit der Atome an der Oberfläche gegenüber demSysteminneren.

Monte Carlo-Simulationen zum kritischen Verhalten dünner Ising-Filme

Monte Carlo-Simulationen zum kritischen Verhalten dünnerIsing-Filme Dünne Ising-Filme können als vereinfachtes Modell zurBeschreibung von binären Mischungen oder von Flüssigkeitenin schlitzartigen Kapillaren dienen. Infolge dereingeschränkten Geometrie unterscheidet sich das kritischeVerhalten dieser Systeme signifikant von dem einesBulk-Systems, es kommt zu einem Crossover von zwei- zudreidimensionalem kritischen Verhalten. Zusätzlichverschiebt sich der Phasenübergang in den ungesättigtenBereich, ein Effekt, der als 'capillary condensation'bezeichnet wird. In der vorliegenden Arbeit wurden die kritischenEigenschaften von Ising-Filmen im Rahmen einer MonteCarlo-Simulation untersucht. Zur Verbesserung der Effizienzwurde ein Cluster-Algorithmus verwendet, der um einenGhost-Spin-Term zur Behandlung der Magnetfelder erweitertwar. Bei der Datenanalyse kamen moderneMulti-Histogramm-Techniken zur Anwendung. Für alle untersuchten Schichtdicken konnten kritischeTemperatur und Magnetfeld sehr präzise bestimmt werden. DieSkalenhypothese von Fisher und Nakanishi, die dieVerschiebung des kritischen Punktes gegenüber seinesBulk-Wertes beschreibt, wurde sowohl für Systeme mit freienOberflächen als auch für Systeme mit schwachemOberflächenfeld bestätigt. Der Wert des Gap-Exponenten derOberfläche wurde mit $Delta_1$=0.459(13) in Übereinstimmungmit den Literaturwerten abgeschätzt. Die Observablen Magnetisierung und magnetischeSuszeptibilität sowie deren auf die Oberfläche bezogenenEntsprechungen zeigen kein reines zweidimensionaleskritisches Verhalten. Zu ihrer Beschreibung in der Nähe deskritischen Punktes wurden effektive Exponenten für dieeinzelnen Schichtdicken bestimmt.

Molekulardynamik-Simulationen zum Glasübergang in makromolekularen Filmen

Deutsch:
Wir untersuchen durch MD-Simulationen die Dynamik einerunterkühlten Polymerschmelze beschränkt zwischenzwei glatten, undurchdringlichen Wänden. Der Abstandzwischen den Wänden wurde in der Simulation übereinen großen Bereich variiert. Von besonderemInteresse war der Einfluß dieser räumlichenEinschränkung auf die strukturelle Relaxation derunterkühlten Schmelze. Wir stellen eine deutlicheBeschleunigung der Dynamik im Vergleich zum Bulk fest.Unsere Ergebnisse deuten auf eine Abnahme der kritischenTemperatur der Modenkopplungstheorie mit fallender Filmdickehin. Andererseits finden wir aber eine bemerkenswerteÜbereinstimmung zwischen dem Zeitverlauf verschiedenermittlerer Verschiebungsquadrate im Film und im Bulk, wennman sie für den gleichen Abstand von der jeweiligenkritischen Temperatur aufträgt.

English:
Via MD-simulations, we study the dynamics of a supercooledpolymer system confined between two impenetrable andperfectly smooth walls. The wall-to-wall distance was variedin a wide range focusing on the influence of the confinementon the structural relaxation of the supercooled liquid. Weobserve a significant acceleration of the dynamics comparedto that of the corresponding bulk model. Our results suggesta decrease of the mode-coupling critical temperature forstronger confinements, i.e. for smaller wall-to-walldistances. On the other hand, we find a remarkablesimilarity in the time dependence of the mean squaredisplacements in film and in the bulk when compared fortemperatures having the same distance from the criticaltemperature of the corresponding system.

Methoden und Modelle zur Phytoplanktonanalyse am Beispiel einer Restaurierungsmaßnahme an der Bleiloch Talsperre

Methoden und Modelle zur Phytoplanktonanalyse am Beispiel einer Restaurierungsmaßnahme an der Bleiloch Talsperre Zusammenfassung An der hypertrophen Bleiloch Talsperre (Thüringen, BRD) werden die Auswirkungen der 1997 in Betrieb genommenen partiellen Destratifikation (0- 20m) untersucht. Ziel der Maßnahme war die Hemmung des Phytoplanktonwachstums durch Lichtlimitation.Da es nicht gelang, auch die Oberflächenlammelle in die Durchmischung einzubeziehen, wurde auch keine Reduktion des Phytoplanktons beobachtet. Seine zeitliche Dynamik nahm deutlich zu und es traten neben typischen Längsgradienten auch extreme, kleinräumige Konzentrationsunterschiede auf. Die vorher häufigen Cyanobakterien spielten jedoch keine quantitativ bedeutsame Rolle mehr. Es wird diskutiert, wie die Belüftung die Saisonalität des Planktons stört und zu Verschiebungen der Zusammensetzung führt. Der Zusammenhang zwischen der Chlorophyll a Menge und der Stabilität der Wassersäule sowie der Einfluß wachstumsbestimmender Größen werden modelliert. Methodische Schwerpunkte umfassen die Auswertung von Phytoplankton-Pigmentdaten (HPLC-Analyse) und die Entwicklung einer Durchflußzytometer-Methode. Bei letzerer werden an lebenden Phytoplanktern die Vorwärtsstreuung sowie vier Fluoreszenzen (2 Phycoerythrine, Phycocyanin und Chlorophyll a, 514nm Anregungswellenlänge) gemessen. Zur Klassifizierung von Algen anhand von Referenzen werden zwei Methoden entwickelt, Möglichkeiten des Sortierens aufgezeigt und es wird ein Vergleich mit Mikroskopie und HPLC- Pigmentanalyse durchgeführt. Anhand von Modellrechnungen wird demonstriert, wie sich systematische bzw. zufällige Abweichungen der Pigmentstöchiometrien auf die Berechnung von Algengruppenanteilen auswirken. Strategien zur Auswertung von Pigmentdaten werden empfohlen.