About 0.2 % of patients undergoing laparoscopic cholecystetomy will suffer from complications caused by lost gallstones. Diagnostic and therapeutic measures are correlated to the symptoms. At different locations, abscesses can arise, which can be treated by direct access through the -abdominal wall, laparotomy or laparoscopy. Two cases are presented with the especially grave sequels of subphrenic abscess, infiltration of the thoracic wall, and pleural empyema, which -respectively needed several successive operations -after ten years. In laparoscopic cholecystectomy, all detected stones should be removed. In the case of a failure, conversion to laparotomy is not essential. The loss of stones has to be formally -documented, the patient and family doctor are to be informed.

About 0.2% of patients undergoing laparoscopic cholecystetomy will suffer from complications caused by lost gallstones. Diagnostic and therapeutic measures are correlated to the symptoms. At different locations, abscesses can arise, which can be treated by direct access through the abdominal wall, laparotomy or laparoscopy. Two cases are presented with the especially grave sequels of subphrenic abscess, infiltration of the thoracic wall, and pleural empyema, which respectively needed several successive operations after ten years. In laparoscopic cholecystectomy, all detected stones should be removed. In the case of a failure, conversion to laparotomy is not essential. The loss of stones has to be formally documented, the patient and family doctor are to be informed.

Bei einem 39-Jährigen ging 4 Jahre nach Cholezystektomie wegen akuter Cholezystitis und wiederkehrender Oberbauchsymptomatik peranal ein Bauchtuch ab. Der klinische Befund war blande. Die bei folgender Diagnostik erhobenen Befunde mit Klinik, Labor, Sonographie, Koloskopie und Abdomen-CT scheinen eine restitutio ad integrum zu belegen. Am Bauchtuch fanden sich nach 4 Jahren in situ histologisch keine strukturellen Veränderungen. Der Krankenhausträger musste Schadensersatzansprüche des Patienten befriedigen. Es werden die Pathologie, die technischen Diagnoseverfahren und die Prognose bei belassenen Mullfremdkörpern dargestellt. Zur Prophylaxe ist das Zählen von Instrumenten und Bauchtüchern sowie die Verwendung nur von je einem Mullmaterial in einer Zange angeraten.

Four years after cholecystectomy and recurrent epigastric pain, a surgical sponge passed per anum in a 39-year-old man. Diagnostic procedures including clinical and laboratory examinations, ultrasound, coloscopy, and abdominal CT did not reveal any noteworthy residual changes by the foreign body. After 4 years in situ, the surgical sponge showed no alterations in structure. The representatives of the hospital concerned had to satisfy the patient's claims for damages. Pathology, technical diagnostic methods, and prognosis in cases of retained gauzes are presented. It is essential to count instruments and towels and advisable to use only single sponges in forceps in order to prevent intraoperative loss.

Four years after cholecystectonny and recurrent epigastric pain, a surgical sponge passed per anum in a 39-year-old man. Diagnostic procedures including clinical and laboratory examinations, ultrasound, coloscopy, and abdominal CT did not reveal any noteworthy residual changes by the foreign body. After 4 years in situ, the surgical sponge showed no alterations in structure. The representatives of the hospital concerned had to satisfy the patient's claims for damages. Pathology, technical diagnostic methods, and prognosis in cases of retained gauzes are presented. It is essential to count instruments and towels and advisable to use only single sponges in forceps in order to prevent intraoperative loss.

DNA methylation is an early event in carcinogenesis. Testing for DNA methylation has potential in cancer screening. The aim of this study was to investigate the feasibility of methylated DNA detection as a screening tool for squamous cell carcinomas (SCC) and squamous intraepithelial lesions (SIL) in cervical scrapings.A multiplex, nested, methylation-specific polymerase chain reaction approach was used to examine promoter methylation of 12 genes (CDH1, DAPK, GSTP1, HIC-1, HIN-1, hMLH1, MGMT, p16, RAR-β, RASSF1A, SHP-1, and Twist) in biopsy-proven SCC (n = 69), high-grade SIL (HSIL, n = 67), low-grade SIL (LSIL, n = 32), and negative (n = 41) liquid-based cytology samples.The methylation frequency in normal, LSIL, HSIL, and SCC was significantly different (p < 0.01) for eight genes (DAPK, HIC-1, HIN-1, MGMT, RAR-β, RASSF1A, SHP-1, and Twist). There was a trend toward increasing methylation of HIN-1, MGMT, RAR-β, RASSF1A, and SHP-1 with increasing severity of cervical squamous lesions. The number of methylated genes increased with the severity of cervical squamous lesions (p < 0.001). In receiver-operating characteristic analysis, the three-gene combination (RAR-β/Twist/MGMT) showed the best performance to distinguish HSIL/SCC from LCIS/negative samples. The estimated specificity of this three-gene panel for detecting HSIL/SCC was 82.2%, and its sensitivity was 78.7%.Although aberrant DNA methylation has the potential to function as a molecular biomarker of HSIL and SCC in liquid-based cytology tests, additional genes that are selectively methylated in HSIL and SCC are needed to improve clinical performance.

Adverse early life experience is prominent risk factors for numerous psychiatric illnesses, including mood and anxiety disorders. It imposes serious long-term costs on the individual as well as health and social systems. Hence, developing therapies that prevent the long-term consequences of early life stress is of utmost importance, and necessitates a better understanding of the mechanisms by which early life stress triggers long-lasting alterations in gene expression and behavior. Post-weaning isolation rearing of rodents models the behavioral consequences of adverse early life experiences in humans and it is reported to cause anxiety like behavior which is more common in case of females. Therefore, in the present study, we have studied the impact of social isolation of young female mice for 8 weeks on the anxiety like behavior and the underlying molecular mechanism. Elevated plus maze and open field test revealed that social isolation caused anxiety like behavior. BDNF, a well-known molecule implicated in the anxiety like behavior, was up-regulated both at the message and protein level in cerebral cortex by social isolation. CREB-1 and CBP, which play a crucial role in BDNF transcription, were up-regulated at mRNA level in cerebral cortex by social isolation. HDAC-2, which negatively regulates BDNF expression, was down-regulated at mRNA and protein level in cerebral cortex by social isolation. Furthermore, BDNF acts in concert with Limk-1, miRNA-132 and miRNA-134 for the regulation of structural and morphological plasticity. Social isolation resulted in up-regulation of Limk-1 mRNA and miRNA-132 expression in the cerebral cortex. MiRNA-134, which inhibits the translation of Limk-1, was decreased in cerebral cortex by social isolation. Taken together, our study suggests that social isolation mediated anxiety like behavior is associated with up-regulation of BDNF expression and concomitant increase in the expression of CBP, CREB-1, Limk-1 and miRNA-132, and decrease in the expression of HDAC-2 and miRNA-134 in the cerebral cortex.

In this work we systematically investigate thermal transport in opacified monolithic silica aerogels by changing their density and the concentration of infrared opacifier. The goal is to minimize the thermal conductivity of these highly porous inorganic materials. The lowest achieved thermal conductivities at 300 K are about 0.013 W m−1 K−1 for non-evacuated specimens, which have to be compared with values of about 0.020–0.025 W m−1 K−1 for CFC-blown insulating polyurethane foams and with 0.035 W m−1 K−1 for the best fiber insulations. Our investigations allow us to quantitatively determine the gaseous, solid and radiative conductivities λg, λs andλr, respectively. The derived variations with aerogel densityρ are: λg ∝ ρ−0.6, λs ∝ ρ1.5 and λr ∝ (ρ· e)−1 in the range 70 < ρ/kg m−3 < 230. The total conductivity shows a minimum around 120 kg m−3.

The thermal transport in polystyrene (PS) and polyurethane (PU) foam insulations is described, with special emphasis on the radiative transfer. Calorimetric measurements of the total conductivity are performed in a guarded hot-plate device. The radiative properties of the foams are derived from infraredoptical investigations with an FTIR spectrometer. In the case of the PS foam, radiative properties are also extracted from calculations using the Mie scattering theory for infinite cylinders and platelets, representing the struts and walls of the foam cells, respectively. The total thermal conductivity of PU foams, including condensation effects of the blowing agent R 11, is modelled.

The thermal properties of monolithic aerogels were investigated by changing their density, the gas pressure and the temperature. Results show that opacified SiO2-aerogels and organic aerogels at room temperature in air have a total thermal conductivity as low as 0.013 W/m K and 0.012 W/m K, respectively, and show a flat minimum on variation of density. Aerogels have a very low solid thermal conductivity due to their extremely high porosity. Nanosize pores are responsible for partial suppression of gaseous conduction. A low radiative conductivity caused mainly by absorption is observed for organic aerogels. In the case of SiO2-aerogels, the radiative transport can be reduced by integrating an opacifier such as carbon black in the SiO2-skeleton.

The thermal conductivity and the elasto-mechanical behavior of a fibrous glass paper insulation and of a fibrous alumina fleece were investigated as a function of external pressure load. The main findings are: (1) at an external load p e x t = 1 bar the solid thermal conductivity λ s of the glass fiber paper is about 1.5.10 - 3 W/(m.K) and for the fleece is 3.10 - 3 W/(m.K); and (2) the variation of λ s with p e x t is weak for the paper and pronounced for the fleece. Three models were employed to study the correlation between λ s and the elasto-mechanical behavior: Kaganer's model, percolation theory, and the phonon diffusion model.

The thermal losses of a monolithic low-density SiO2 aerogel tile (thickness d = 9 mm, density ϱ = 80 kg/m3) have been determined in our evacuable guarded hot plate system LOLA II. The measurements were performed for two values of boundary emissivities (ϵ ≈ 0.05 and 0.9) under variation of temperature and of gas pressure for several types of gases. From our results we conclude that low-density silica aerogel tiles about 10 mm thickness provide excellent thermal insulation with overall loss coefficients k ≲ 0.7 W/(m2 · K) at ambient temperatures (10°C or 283 K) and pressures ≲ 10 mbar. Their use in window systems and covers for passive use of solar energy thus is extremely promising. From the change of thermal losses with gas pressure, a mean free path within the (evacuated) skeleton of about 120 nm can be derived.

At ambient temperatures, transparent silica aerogels as well as translucent granular fillings are excellent superinsulating spacers if evacuated. Thus their use in windows and covers for passive solar systems is extremely promising. Thermal loss coefficients under variation of radiative temperature, sample density, boundary emissivity and internal gas pressure are presented. Furthermore, the scaling of the solid conductivity with density is discussed.

Evacuated silica aerogel layers 15– 20 mm thick have thermal less coefficients of only about 0.5 W m−2 K−1 at ambient temperatures. These layers are either transparent (in the case of monolithic aerogels) or translucent (in the case of granular fillings) and provide a solar transmission of about 50 to 60 %. Aerogel layers could be used to reduce heat losses in all kinds of window systems. Furthermore, translucent thermal insulations are well suited for passive use of solar energy. The excellent thermal insulation of aerogel is due to the high porosity (up to 98 %) of the silica skeleton and to the effective attenuation (absorption) of arrbient thermal infrared radiation. Measurements with monolithic, granular, and segmented aerogel spacers are presented. The following parameters were investigated: surface emissivity, density, internal gas pressure, and external load on the spacers.

The production of highly transparent silica aerogel tiles has been strongly motivated by high-energy physicists who wanted to use this material with low index of refraction in Cerencov counters [1]. Today tiles of excellent optical quality with densities between about 75 and 300 g/l corresponding to indices of refraction between 1.015 and 1.060 and with sizes of 20 × 20 cm2 are available [2]. Though these tiles might also have a potential as transparent superinsulating spacers in window systems in the future [3],right now we consider them primarily as indispensable systems for investigations of the thermal transport in highly porous monolithic materials, which allow the optimization of cheaper granular aerogel fillings.

The apparent thermal conductivity λ of evacuated SiO2-aerogel tiles was measured with our small guarded hot plate vacuum system LOLA II. In order to study the influence of the boundary emissivity on λ the plates (20 × 20 cm2) were either used with their plasma-sprayed surfaces (ε ≈ 0.5) or with low-emissivity aluminum (ε ≈ 0.05) foils as covers. The difference in the apparent conductivity already showed at room temperature and rose to about 50% for radiative temperatures Tr = 570 K. An important consequence is that superinsulating SiO2-aerogel systems should always be provided with low-emissivity boundaries around the aerogel. The calorimetric results for λ are compared with radiative conductivity values derived from spectral i.r. transmission measurements.