Off-pump compared to minimal extracorporeal circulation surgery in coronary artery bypass grafting.

OBJECTIVE Coronary artery bypass grafting (CABG) using extracorporeal circulation (ECC) is still the gold standard. However, alternative techniques have been developed to avoid ECC and its potential adverse effects. These encompass minimal extracorporeal circulation (MECC) or off-pump coronary artery bypass grafting (OPCAB). However, the prevailing potential benefits when comparing MECC and OPCABG are not yet clearly established. METHODS In this retrospective study we investigated the potential benefits of MECC and OPCABG in 697 patients undergoing CABG. Of these, 555 patients had been operated with MECC and 142 off-pump. The primary endpoint was Troponin T level as an indicator for myocardial damage. RESULTS Study groups were not significantly different in general. However, patients undergoing OPCABG were significantly older (65.01 years ± 9.5 vs. 69.39 years ± 9.5; p value <0.001) with a higher Logistic EuroSCORE I (4.92% ± 6.5 vs. 5.88% ± 6.8; p value = 0.017). Operating off pump significantly reduced the need for intra-operative blood products (0.7% vs. 8.6%; p-value <0.001) and the length of stay in the intensive care unit (ICU) (2.04 days ± 2.63 vs. 2.76 days ± 2.79; p value <0.001). Regarding other blood values a significant difference could not be found in the adjusted calculations. The combined secondary endpoint, major cardiac or cerebrovascular events (MACCE), was equal in both groups as well. CONCLUSIONS Coronary artery bypass grafting using MECC or OPCABG are two comparable techniques with advantages for OPCABG regarding the reduced need for intra-operative blood products and shorter length of stay in the ICU. However serological values and combined endpoint MACCE did not differ significantly in both groups.

Improved relapse-free survival after autologous stem cell transplantation does not translate into better quality of life in chronic lymphocytic leukemia: lessons from the randomized European Society for Blood and Marrow Transplantation-Intergroup study

In chronic lymphocytic leukemia (CLL) medical progress is driven by clinical studies with relapse-free survival (RFS) as the primary endpoint. The randomized EBMT-Intergroup trial compared high-dose therapy and autologous stem cell transplantation (ASCT) to observation and demonstrated a substantial improvement of RFS without showing improved overall survival for the transplant arm. Here we report quality of life (QoL) information of the first 3 years following randomization from that study. The main objective was to assess the impact of treatment on QoL over time. Two secondary analyses were performed to further investigate the impact of ASCT and relapse on QoL. In the primary analysis, we demonstrate an adverse impact of ASCT on QoL which was largest at 4 months and continued throughout the first year after randomization. Further, we demonstrated a sustained adverse impact of relapse on QoL which worsened over time. Despite better disease control by ASCT the side effects thus turned the net effect towards inferior QoL in the first year and comparable QoL in the following 2 years after randomization. This study emphasizes the importance of information concerning QoL impacts when patients are counseled about treatments aimed at improving RFS in the absence of a survival benefit.

Serious Play as a Practice of Paradox

A recent stream of organizational research has used the term serious play to describe situations in which people engage in playful behaviors deliberately with the intention to achieve serious, work-related objectives. In this article, the authors reflect on the ambiguity of this term, and reframe serious play as a practice characterized by the paradox of intentionality (when actors engage deliberately in a fun, intrinsically motivating activity as a means to achieve a serious, extrinsically motivated work objective). This reframing not only extends the explanatory power of the concept of serious play but also helps bridge the concerns of scholars and practitioners: first, by enabling us to understand a variety of activities in organizations as serious play, which can help practitioners address specific organizational challenges; second, by recognizing the potential for emergent serious play, and the creation of the conditions to foster this emergence; third, by pointing toward specific, individual or group-level outcomes associated with the practice; and finally, by uncovering its ethical dimensions and encouraging the understanding of the role of serious play on ethical decision making.

La création de la stratégie en tant que jeu sérieux

Les chercheurs s'efforcent d'élaborer une théorie de la création stratégique. Nous pensons que la difficulté pourrait être réduite en dotant ce domaine d'étude d'une notion d'intentionnalité qui nous permettrait de reconnaître l'émergence du changement. Nous présentons ici le jeu sérieux comme cadre descriptif pour les activités grâce auxquelles les conditions de la possibilité de l'émergence peuvent être créées intentionnellement. Dans ce sens, le but de ce chapitre est d'envisager la création stratégique comme une sorte de jeu sérieux.

Eine Bürger-Krone dem Herrn von Natzmer!! Schon wieder hat die Schlange der Reaktion zwei Opfer verschlungen ...

Welsch (Projektbearbeiter): Der Sturm auf das Zeughaus war ein Werk der Reaktion und Hauptmann Natzmer hat nicht nur k e i n Verbrechen begangen sondern durch seine Tat auch die Monarchie vor dem Untergang gerettet. "Was ... wären die Folgen gewesen, wenn Herr v. Natzmer sich mit bewaffneter Macht ... dem Eindringen in das Zeughaus widersetzt hätte? ... Ströme von Blut wären geflossen, Leichen hätten sich auf Leichen gethürmt - und die Krone wäre verloren gewesen!" Hintergrund: der eigenmächtige militärische Rückzug des Hauptmanns Natzmer angesichts des bevorstehenden Sturms auf das Zeughaus (14. Juni 1848)

Was hot er gesogt? Oestraichsch sollen mer werden hot er gesogt? Waih geschriggen! Hoste gehört, was is gekummen vor a Geschrai in die Zeitungen? ...

Welsch (Projektbearbeiter): Kritische Kommentierung der Wahl Erzherzog Johanns zum Reichsverweser (29. Juni 1848): "Vier und draißig Ferschten un noch a Ferscht! ... Vier und draißig Geseires un noch a neue Geseire! Waih geschriggen!" Warnung vor der bevorstehenden Unterordnung Preußens: "Praißen is gewesen der Herr vun Taitschland, nanu soll es werden der Bedienter vun Oestreich."

Effects of Estrogen on Muscle Damage in Response to an Acute Resistance Exercise Protocol

Creatine Kinase (CK) is used as a measure of exercise-induced muscle membrane damage. During acute eccentric (muscle lengthening) exercise, muscle sarcolemma, sarcoplasmic reticulum, and Z-lines are damaged, thus causing muscle proteins and enzymes to leak into the interstitial fluid. Strenuous eccentric exercise produces an elevation of oxygen free radicals, which further increases muscle damage. Muscle soreness and fatigue can be attributed to this membrane damage. Estradiol, however, may preserve membrane stability post-exercise (Brancaccio, Maffulli, & Limongelli, 2007; Carter, Dobridge, & Hackney, 2001; Tiidus, 2001). Because estradiol has a similar structure to Vitamin E, which is known to have antioxidant properties, and both are known to affect membrane structure, researchers have proposed that estrogen acts as an antioxidant to provide a protective effect on the post-exercise muscle of women (Sandoval & Matt, 2002). As a result, it has been postulated that muscles in women incur less damage in response to an acute strenuous exercise as compared to men. PURPOSE: To determine if circulating estrogen concentrations are related to muscle damage, as measured by creatine kinase activity and to determine gender differences in creatine kinase as a marker of muscle damage in response to an acute heavy resistance exercise protocol. METHODS: 7 healthy, resistance-trained, eumenhorrheic women (23±3 y, 169±9.1 cm, 66.4±10.5 kg) and 8 healthy, resistance-trained men (25±5 y, 178±6.7 cm, 82.3±9.33 kg) volunteered to participate in the study. Subjects performed an Acute Resistance Exercise Test (ARET) consisting of 6 sets of 5 repetitions Smith machine squats at 90% of their previously determined 1-RM. Blood samples were taken pre-, mid-, post-, 1 hour post-, 6 hours post-, and 24 hours post-exercise. Samples were stored at -80ºC until analyzed. Serum creatine kinase was measured using an assay kit from Genzyme (Framingham, MA). Serum estradiol was measured by an ELISA from GenWay (San Diego, CA). Estradiol b-receptor presence on granulocytes was measured via flow cytometry using primary antibodies from Abcam (Cambridge, MA) and PeCy7 antibodies (secondary) from Santa Cruz (Santa Cruz, CA). RESULTS: No significant correlations between estrogen and CK response were found after an acute resistant exercise protocol. Moreover, no significant change in estradiol receptors were expressed on granulocytes after exercise. Creatine Kinase response, however, differed significantly between genders. Men had higher resting CK concentrations throughout all time points. Creatine Kinase response increased significantly after exercise in both men and women (p=0.008, F=9.798). Men had a significantly higher CK response at 24 hours post exercise than women. A significant condition/sex/time interaction was exhibited in CK response (p=0.02, F=4.547). Perceived general soreness presented a significant condition, sex interaction (p=0.01, F=9.532). DISCUSSION: Although no estradiol and CK response correlations were found in response to exercise, a significant difference in creatine kinase activity was present between men and women. This discrepancy of our results and findings in the literature may be due to the high variability between subjects in creatine kinase activity as well as estrogen concentrations. The lack of significance in change of estradiol receptor expression on granulocytes in response to exercise may be due to intracellular estradiol receptor staining and non-specific gating for granulocytes rather than additional staining for neutrophil markers. Because neutrophils are the initial cells present in the inflammatory response after strenuous exercise, staining for estrogen receptors on this cell type may allow for a better understanding of the effect of estrogen and its hypothesized protective effect against muscle damage. Furthermore, the mechanism of action may include estradiol receptor expression on the muscle fiber itself may play a role in the protective effects of estradiol rather than or in addition to expression on neutrophils. We have shown here that gender differences occur in CK activity as a marker of muscle damage in response to strenuous eccentric exercise, but may not be the result of estradiol concentration or estradiol receptor expression on granulocytes. Other variables should be examined in order to determine the mechanism involved in the difference in creatine kinase as a marker of muscle damage between men and women after heavy resistance exercise.

Na 1 Nachlass Max Horkheimer, 28 - Korrespondenzen mit u.a. Siegfried Kracauer (p. I 14, 115-368)

95 Briefe und Beilagen zwischen Siegfried Kracauer und Max Horkheimer, 1936-1949; 2 Briefe zwischen Else Staudinger vom American Committee for Refugee Scholars, Writers and Artists New York und Max Horkheimer, 10.07.1945, 24.07.1945; 2 Briefe zwischen Meyer Schapiro und Siegfried Kracauer 19.11.1937, 03.12.1937; 2 Briefe von Leo Löwenthal an Schapiro Meyer, 1940, 1941; 1 Brief und 1 Beilage von Max Horkheimer an A. Schütz, 02.08.1940; 1 Brief von Max Horkheimer an Trude Krautheimer, 30.07.1940; 1 Brief von Max Horkheimer an das Hebrew Sheltering and Immigrant Aid New York, 10.06.1940; 2 Briefe ziwschen dem Department of State Washington und Max Horkheimer, 05.04.1939, 1939; 2 Briefe zwischen Betty Drury Max Horkheimer, 05.11.1938, 07.11.1938; 2 Briefe zwischen Margaret Krafft und Max Horkheimer, 1938, 1939; 1 Brief von Gertrud Kurth-Kieslinger an Max Horkheimer, 02.10.1939; 2 Briefe zwischen Werner Kraft und Max Horkheimer, 19.01.1940, 01.03.1940; 1 Brief und 1 Beilage von Friedrich Krause an Max Horkheimer, 05.01.1939; 2 Briefe zwischen Karl Krayl und Max Horkheimer, 201.10.1937, 25.11.1937; 11 Briefe zwischen Ernst Krenek und Max Horkheimer, 1937-1941; 1 Brief von S. Krezel an Max Horkheimer, 12.02.1936; 1 Brief von Charles I. Krieger an Max Horkheimer, 01.08.1940; 1 Brief von H. Kronstein an Max Horkheimer, 20.05.1935; 3 Briefe zwischen Germaine Krull und Max Horkheimer, 1934, 06.09.1937, 1937; 3 Briefe zwischen Lawrence S. Kubie Sekretär der American Psychoanalytic Association, New York und Max Horkheimer, 11.05.1938, 1938; 5 Briefe und Beilagen zwsichen Julius Kühl und Max Horkheimer, 18.10.1939-1940; 1 Brief von Max Horkheimer an Herr Guggenheim, 20.02.1940; 1 Brief von Julius Kühl an die ESKA, 31.03.1945; 4 Briefe zwischen B. Kugelmann und Max Horkheimer, 1934, 1938, 1939; 1 Brief von Georg Kunzel an Max Horkheimer, 01.08.1930;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 390 - Testament

"Date obolum Belisario!Ich, der Endesunterschriebene Dr phil: Arthur Schopenhauer aus Danzig, der ich niemals verehlicht war u. auch in aufsteigender Linie keine Verwandte mehr habe, verordne, mittelst gegenwärtigen Testaments, wie es nach meinem dereinstigen Ableben mit meiner Nachlaßenschaft gehalten werden solle. Zu meinem Universal-Erben setze ich ein den in Berlin errichteten Fonds zur Unterstützung der in den Aufruhr- u. Empörungs-Kämpfen der Jahre 1848 & 1849 für Aufrechterhaltung u. Herstellung der gesetzlichen Ordnung in Deutschland invalide gewordenen Preußischen Soldaten, wie auch der Hinterbliebenen solcher, die in jenen Kämpfen gefallen sind. Herr Arthur Schopenhauer, Dr. phil. gewesener Privat Docent in der Universität Berlin, aus Danzig gebürtig, dahier auf Permission wohnhaft, hat den Inhalt dieses als seinen letzten Willen anerkannt, in Gegenwart der vorstehenden, zu dieser Testamentshandlung besonders erbetenen, vereint versammelten Herrn Zeugen, und meiner, des Notars, hierauf dieses sein Testament mit den Herrn zeugen eigenhändig unterschrieben und besiegelt. Dieses, sowie die eines Thuns, ohne störenden Zwischenakt, überhaupt durchaus nach gesetzlicher Vorschrift vollzogenen Testamentshandlung wird auf Ersuchen hiedurch beglaubigt. So geschehen zu Frankfurt a.M den sechs und zwanzigsten Juni achtzehn hundert zwey und fünfzig. Dr. Johann Valentin Boegner Notar der freien Stadt Frankfurt (L.S.) Nebst einer Beilage vom 4. Februar 1859 eröffnet und publicirt bei dem Stadtgericht II der freien Stadt Frankfurt den 21 September 1860 Dr. Leykauf Secr.";

Zur Kryptogamenflora Preussens

Herr Dr. v. Klinggräff

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 995 - Auskunft von Heimsoeth zu den Kontakten mit Arthur Schopenhauer im Zusammenhang der geplanten Biographie

u.a. Sibylle Mertens-Schaaffhausen; Herr Lampert; Übergabe einer Briefsammlung an die Universitätsbibliothek Bonn; Kopie des Goethe-Albums der Stadt Frankfurt; Johanna und Adele Schopenhauer;