About 40 % of the lesions found in colonoscopy are flat. They are basically involved in de-novo-carcinogenesis. To recognize and evaluate this lesions it may be useful to charactarize the surface with pit pattern classification (Kudo, Japan) during chromoendoscopy. A new classification for micro vessel architecture by NBI was developed from the same group 2009. Japanese studies have shown the prognostic information gained with both methods to be comparable. The aim of the following prospective diagnostic study was to compare both methods in a German setting. Only flat lesions of more than 5 mm in size were included. These are particulary flat adenomas, laterally spreading tumors and sessile serrated adenomas. Altogether, 77 patients were examined and 97 flat polyps were found. Four polyps were excluded because of insufficient documentation. The colonoscopy was realized with Olympus video endoscopes with HD+ and NBI. The polyps were characterized by size, type (paris classification), vessel architecture (NBI) and pit pattern classification (chromoendoscopy with 0.4 % indigo carmine). 93 polyps were evaluated. 57 polyps (61.3%) were tubular adenomas, 8 polyps (8.6 %) were tubular-villous adenomas, 13 polyps (14 %) were sessile serrated adenomas, 6 polyps (6.5 %) were hyperplastic and 9 polyps (9.7%) were malignant. About half of the flat lesions were localized in the cecum and the ascending colon. Both methods (NBI and chromoendoscopy) could poorly evaluate sessile serrated adenomas. This is because of the histologically specific feature that dysplastic changes are localized only in the lower parts of these lesions. For that reason, the sessile serrated adenomas were excluded from the evaluation. Chromoendoscopy and pit pattern classification could accurately recognize 89.3 % of the malignant polyps (sensitivity 89.3 %). 66.7 % of the benign polyps could be accurately identified with this method (specificity 66.7 %). In comparison to that, it was possible to accurately charactarize 76.1% of the malignant polyps with NBI and vessel pattern (sensitivity 76.1%). Only 16,7% of the benign polyps could be classified accurately with NBI and vessel pattern (specificity 16.7 %). Using McNemar Test, we can show significantly (p 0.016) that NBI and vessel architecture pattern is false positive and false negative more often. The Japanese studies which support the benefit of NBI, could not be verified in a German setting. This might be because of the different technical equipment. The Olympus Lucera endoscopy system supports a considerably higher magnification than the Olympus Exera video imaging system.

40% aller colorectalen Neoplasien sind flach. Flache Neoplasien sind schwer zu entdecken und können durch Chromoendoskopie besser erkannt werden. Die Pit-pattern-Klassifikation (Kudo) hat eine histologische Voraussage dieser Läsionen ermöglicht. Kashida (2009) schlug eine Klassifikation der mikrovaskulären Oberflächenstruktur durch Narrow-Band-Imaging vor. Ziel der prospektiven Studie war, Chromoendoskopie (Indigokarmin) und NBI (Narrow Band Imaging) auf ihre Aussagekraft bei flachen Läsionen zu vergleichen

In uncontrolled clinical studies, ursodeoxycholic acid (UDCA) had a beneficial effect on nonalcoholic steatohepatitis (NASH). However, a large controlled trial using UDCA (13‐15 mg/kg/day) was unable to confirm these results. Accordingly, a randomized, placebo‐controlled study was initiated with a high dose of UDCA (23‐28 mg/kg/day). The allocation of patients and the evaluation of liver histology were performed according to a modified Brunt score and the nonalcoholic fatty liver disease activity score (NAS). With the modified Brunt score, 185 patients with histologically proven NASH were randomized [intention to treat (ITT)], and 147 were treated per protocol (PP). With the NAS, 137 patients were confirmed to have NASH, 48 had borderline NASH, and 1 did not have NASH. The treatment time was 18 months. At entry, the treatment groups were comparable. A second biopsy sample was obtained from 139 of 185 patients (NAS: 107/137). The primary criterion for evaluation was a change in the liver histology; the secondary criteria were single histological variables and liver biochemistry. Significant differences in the overall histology could not be detected between the two treatment groups with the modified Brunt score (P = 0.881) or NAS (P = 0.355). Only lobular inflammation improved significantly (P for the modified Brunt score = 0.011, P for NAS = 0.005). In subgroup analyses, significant improvements in lobular inflammation were also observed in males, younger patients up to 50 years of age, slightly overweight patients, and patients with hypertension and an increased histology score. The fibrosis score did not change (P for ITT = 0.133, P for PP = 0.140). With the exception of γ‐glutamyl transferase, UDCA did not improve laboratory data. Conclusion: High‐dose UDCA failed to improve the overall histology in patients with NASH in comparison with placebo. Hepatology 2010

Die Karl Otto Braun KG (KOB) ist ein international agierender Hersteller von Fixierbinden, Stützbinden und Kompressionsbinden (s. auch www.kob.de). Das Unternehmen ist hauptsächlich Original Equipment Manufacturer (OEM) für namhafte Markenunternehmen. Seit 2000 ist die Paul Hartmann AG an KOB beteiligt. Im Stammwerk in Wolfstein beschäftigt KOB etwa 1.100 Mitarbeiter. 2002 erzielte das Unternehmen einen Umsatz von über 80 Mio. Euro.

Abstract60 Jahre nach Ende des Zweiten Weltkriegs, pünktlich zum traurigen Jubiläum des Abwurfs der ersten Atombombe auf Hiroshima, erschien ein Buch, dessen Autor wissen will, dass auch das NS‐Regime kurz davor stand, ein solches Massenvernichtungsmittel einsetzen zu können. Doch in Deutschland gab es weder ein geschlossenes Atomprojekt noch spaltbares Material in ausreichender Menge.

Angewandte ChemieVolume 113, Issue 18 p. 3589-3589 BuchbesprechungFree Access Rutherford – Scientist Supreme. Von John Campbell Günter Herrmann, Günter Herrmann Institut für Kernchemie der Universität MainzSearch for more papers by this author Günter Herrmann, Günter Herrmann Institut für Kernchemie der Universität MainzSearch for more papers by this author First published: 14 September 2001 https://doi.org/10.1002/1521-3757(20010917)113:18<3589::AID-ANGE11113589>3.0.CO;2-7AboutPDF ToolsRequest permissionAdd to favorites ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume113, Issue18September 17, 2001Pages 3589-3589 This is the German version of Angewandte Chemie. Note for articles published since 1962: Do not cite this version alone. Take me to the International Edition version with citable page numbers, DOI, and citation export. We apologize for the inconvenience. RelatedInformation

Background & Aims: Ursodeoxycholic acid (UDCA) is used for treatment of primary biliary cirrhosis. Previous studies showed that, compared with UDCA mono-therapy, bile salts plus prednisolone had no further effect on laboratory data but improved liver histology. Thirty percent of these patients had prednisolone-related side effects. Budesonide is a glucocorticoid with a high receptor affinity and a high first-pass metabolism. In this study we investigated whether budesonide and UDCA are superior to UDCA mono-therapy. Methods: A 2-year prospective, controlled double-blind trial was performed. Twenty patients (mainly with early-stage disease) were treated with UDCA at a dose of 10-15 mg/kg daily in addition to 3 mg budesonide 3 times daily (group A), and 19 patients (1 dropped out for personal reasons) were treated with UDCA plus placebo (group B). Liver biopsy specimens were taken before, after 12 months, and at the end of study. Glucose tolerance tests, serum cortisol levels, and adrenocorticotropin-stimulated cortisol secretion were assessed at regular intervals. Bone mass density was measured by dual-energy photon absorptiometry. Results: Compared with pretreatment values, liver enzyme and immunoglobulin M and G levels decreased significantly in both groups. Improvement in group A was significantly more pronounced (P < 0.05) than in group B. Titers of antimitochondrial antibodies did not change. In group A, the point score of liver histology improved by 30.3%; in group B, it deteriorated by 3.5% (P < 0.001). Changes in bone mineral density after 2 years were -1.747% in group A and -0.983% in group B (P = 0.43). Budesonide had little influence on the hypothalamic-pituitary-adrenal axis. One patient in group A had budesonide-related side effects; in 3 patients in group B, complications of liver disease developed. Conclusions: Combination therapy with UDCA and budesonide is superior to UDCA and placebo.

Angewandte Chemie International Edition in EnglishVolume 36, Issue 21 p. 2384-2385 Book Review Book Review: Table of Isotopes. 8th Edition, Volumes 1 and 2. Edited by R. B. Firestone and V. S. Shirley Günter Herrmann, Günter Herrmann Institut für Kernchemie der Universitat Mainz (Germany)Search for more papers by this author Günter Herrmann, Günter Herrmann Institut für Kernchemie der Universitat Mainz (Germany)Search for more papers by this author First published: November 14, 1997 https://doi.org/10.1002/anie.199723842AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume36, Issue21November 14, 1997Pages 2384-2385 RelatedInformation

SIR -Given the number of scientific conferences held worldwide, and the amount of time physicians and scientists spend attending them, we decided to investigate the fate of abstracts presented at these meetings.We wanted to know how many ultimately became papers published in peer-reviewed journals, and, if published, how closely they resembled the original abstract.• We randomly selected 100 abstracts presented at the 1992 annual scientific meetings of each of four associations: the American Heart Association, the Feder-percentage, if not a majority, of abstracts presented at scientific conferences do not evolve into papers.However, abstracts in general present data in significant advance of any subsequent publication in peerreviewed journals.

Angewandte ChemieVolume 108, Issue 16 p. 1993-1993 Bücher J. Robert Oppenheimer. Schöpfer der ersten Atombombe. Von K. Hoffmann. Springer, Berlin, 1995. 307 S., geb. 48.00 DM. – ISBN 3–540–59330–6 Günter Herrmann, Günter Herrmann Institut für Kernchemie der Universität MainzSearch for more papers by this author Günter Herrmann, Günter Herrmann Institut für Kernchemie der Universität MainzSearch for more papers by this author First published: 19. August 1996 https://doi.org/10.1002/ange.19961081634AboutPDF ToolsRequest permissionAdd to favorites ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume108, Issue1619. August 1996Pages 1993-1993 This is the German version of Angewandte Chemie. Note for articles published since 1962: Do not cite this version alone. Take me to the International Edition version with citable page numbers, DOI, and citation export. We apologize for the inconvenience. RelatedInformation

Nur 1012 Atome eines Elements sind nötig, um dessen Ionisationsenergie durch Resonanzionisation mit Laserlicht in einem äußeren elektrischen Feld und nachfolgende Massenspektrometrie zu bestimmen. Das Bild rechts zeigt für die Actinoide Berkelium und Californium die auf diese Art gemessenen Ionisationsschwellen Wth und deren Extrapolation auf die Ionisationsenergie I (49989(2) bzw. 50665(2) cm−1) bei der äußeren Feldstärke E = 0.magnified image

Advanced sequencing techniques allow rapid deduction of individual amino acid sequences of highly related proteins. Due to their quasi-species nature, viral genomes (e.g. HIV-1) represent one of the most common sources of related proteins. Another example of related proteins are immunoglobulins. Local differences in amino acid conservation are useful indicators of potential domain structures and immunological or functional epitopes prior to structural analysis of proteins. Although variability indices can be calculated by several methods, delineation of boundaries between sequence stretches with similar variability indices is left to the user. We use algorithmic scale-space filtering for delineation of conserved and variable sequence stretches within a protein which is performed on an algorithmic basis avoiding arbitrary assignments. Out method correctly identified variable regions for the human immunoglobulin lambda-chain V-regions (subgroup I). Prediction of the variable regions of the HIV-1 gp120 env protein was in agreement with empirical derived definitions. These examples indicate that our method is useful for the regional assignment of protein variability solely on the basis of amino acid sequences.

We present an algorithm to identify potential functional elements like protein binding sites in DNA sequences, solely from nucleotide sequence data. Prerequisites are a set of at least seven not closely related sequences with a common biological function which is correlated to one or more unknown sequence elements present in most but not necessarily all of the sequences. The algorithm is based on a search for n-tuples which occur at least in a minimum percentage of the sequences with no or one mismatch, which may be at any position of the tuple. In contrast to functional tuples, random tuples show no preferred pattern of mismatch locations within the tuple nor is the conservation extended beyond the tuple. Both features of functional tuples are used to eliminate random tuples. Selection is carried out by maximization of the information content first for the n-tuple, then for a region containing the tuple and finally for the complete binding site. Further matches are found in an additional selection step, using the ConsInd method previously described. The algorithm is capable of identifying and delimiting elements (e.g. protein binding sites) represented by single short cores (e.g. TATA box) in sets of unaligned sequences of about 500 nucleotides using no information other than the nucleotide sequences. Furthermore, we show its ability to identify multiple elements in a set of complete LTR sequences (more than 600 nucleotides per sequence).

Trace analysis of long‐lived isotopes of technetium and plutonium requires a very sensitive and selective detection method. A laser ion source (LIS) based on resonance ionization spectroscopy with subsequent mass analysis (RIMS) offers these properties. Measurements with an ion source made of extremely pure pyrolytically coated graphite are discussed. Photoionization of 99Tc has been measured with a LIS efficiency of 4×10−3 leading to an extrapolated detection limite of 5×106 atoms. The elements selectivity depends on the working temperature of the cavity and varies from 1×104 (1860 K) to 8×10−2 (2130 K).

Angewandte ChemieVolume 107, Issue 2 p. 202-204 Zuschrift Spurenbestimmung der Radionuclide 90Sr und 89Sr in Umweltproben I: Laser-Massenspektrometrie† Dipl.-Phys. Jörg Lantzsch, Dipl.-Phys. Jörg Lantzsch Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorBruce A. Bushaw, Bruce A. Bushaw Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorProf. Dr. Günter Herrmann, Prof. Dr. Günter Herrmann Institut für Kernchemie der Universität MainzSearch for more papers by this authorM. Sc., Prof. Dr. Heinz-Jürgen Kluge, M. Sc., Prof. Dr. Heinz-Jürgen Kluge Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorDr. Ludwin Monz, Dr. Ludwin Monz Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorDipl.-Chem. Sabine Nieß, Dipl.-Chem. Sabine Nieß Institut für Kernchemie der Universität MainzSearch for more papers by this authorProf. Dr. Ernst W. Otten, Prof. Dr. Ernst W. Otten Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorDipl.-Phys. Richard Schwalbach, Dipl.-Phys. Richard Schwalbach Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorDipl.-Phys. Martin Schwarz, Dipl.-Phys. Martin Schwarz Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorDipl.-Phys. Judith Stenner, Dipl.-Phys. Judith Stenner Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorDr. Norbert Trautmann, Dr. Norbert Trautmann Institut für Kernchemie der Universität MainzSearch for more papers by this authorDr. Klaus Walter, Dr. Klaus Walter Institut für Kernchemie der Universität MainzSearch for more papers by this authorDr. Klaus Wendt, Corresponding Author Dr. Klaus Wendt Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorDipl.-Phys. Klaus Zimmer, Dipl.-Phys. Klaus Zimmer Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this author Dipl.-Phys. Jörg Lantzsch, Dipl.-Phys. Jörg Lantzsch Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorBruce A. Bushaw, Bruce A. Bushaw Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorProf. Dr. Günter Herrmann, Prof. Dr. Günter Herrmann Institut für Kernchemie der Universität MainzSearch for more papers by this authorM. Sc., Prof. Dr. Heinz-Jürgen Kluge, M. Sc., Prof. Dr. Heinz-Jürgen Kluge Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorDr. Ludwin Monz, Dr. Ludwin Monz Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorDipl.-Chem. Sabine Nieß, Dipl.-Chem. Sabine Nieß Institut für Kernchemie der Universität MainzSearch for more papers by this authorProf. Dr. Ernst W. Otten, Prof. Dr. Ernst W. Otten Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorDipl.-Phys. Richard Schwalbach, Dipl.-Phys. Richard Schwalbach Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorDipl.-Phys. Martin Schwarz, Dipl.-Phys. Martin Schwarz Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorDipl.-Phys. Judith Stenner, Dipl.-Phys. Judith Stenner Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorDr. Norbert Trautmann, Dr. Norbert Trautmann Institut für Kernchemie der Universität MainzSearch for more papers by this authorDr. Klaus Walter, Dr. Klaus Walter Institut für Kernchemie der Universität MainzSearch for more papers by this authorDr. Klaus Wendt, Corresponding Author Dr. Klaus Wendt Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this authorDipl.-Phys. Klaus Zimmer, Dipl.-Phys. Klaus Zimmer Institut für Physik der Universität Staudingerweg 7, D-55099 Mainz, Telefax: Int. + 6131/39-2994Search for more papers by this author First published: 18. Januar 1995 https://doi.org/10.1002/ange.19951070211Citations: 10 † Diese Arbeit wurde vom Bundesministerium für Umwelt, Naturschutz und Reaktorsicherheit, vom Bundesamt für Strahlenschutz und vom Umweltzentrum der Universität Mainz gefördert. AboutPDF ToolsRequest permissionAdd to favorites ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume107, Issue218. Januar 1995Pages 202-204 This is the German version of Angewandte Chemie. Note for articles published since 1962: Do not cite this version alone. Take me to the International Edition version with citable page numbers, DOI, and citation export. We apologize for the inconvenience. RelatedInformation

Angewandte ChemieVolume 107, Issue 7 p. 891-893 Zuschrift Erste Messung der Ionisationsenergie von Americium und Curium† Dipl.-Chem. Rüdiger Deißenberger, Dipl.-Chem. Rüdiger Deißenberger Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDipl.-Phys. Stefan Köhler, Dipl.-Phys. Stefan Köhler Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDr. Friedhelm Ames, Dr. Friedhelm Ames Institut für Physik der Universität MainzSearch for more papers by this authorDr. Klaus Eberhardt, Dr. Klaus Eberhardt Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDipl.-Phys. Nicole Erdmann, Dipl.-Phys. Nicole Erdmann Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDipl.-Chem. Heike Funk, Dipl.-Chem. Heike Funk Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorProf. Dr. Günter Herrmann, Prof. Dr. Günter Herrmann Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorProf. Dr. Heinz-Jürgen Kluge, Prof. Dr. Heinz-Jürgen Kluge Institut für Physik der Universität MainzSearch for more papers by this authorDipl.-Phys. Martin Nunnemann, Dipl.-Phys. Martin Nunnemann Institut für Physik der Universität MainzSearch for more papers by this authorDr. Gerd Passler, Dr. Gerd Passler Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDr. Joachim Riegel, Dr. Joachim Riegel Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDr. Franz Scheerer, Dr. Franz Scheerer Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDr. Norbert Trautmann, Corresponding Author Dr. Norbert Trautmann Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDr. Franz-Josef Urban, Dr. Franz-Josef Urban Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this author Dipl.-Chem. Rüdiger Deißenberger, Dipl.-Chem. Rüdiger Deißenberger Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDipl.-Phys. Stefan Köhler, Dipl.-Phys. Stefan Köhler Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDr. Friedhelm Ames, Dr. Friedhelm Ames Institut für Physik der Universität MainzSearch for more papers by this authorDr. Klaus Eberhardt, Dr. Klaus Eberhardt Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDipl.-Phys. Nicole Erdmann, Dipl.-Phys. Nicole Erdmann Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDipl.-Chem. Heike Funk, Dipl.-Chem. Heike Funk Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorProf. Dr. Günter Herrmann, Prof. Dr. Günter Herrmann Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorProf. Dr. Heinz-Jürgen Kluge, Prof. Dr. Heinz-Jürgen Kluge Institut für Physik der Universität MainzSearch for more papers by this authorDipl.-Phys. Martin Nunnemann, Dipl.-Phys. Martin Nunnemann Institut für Physik der Universität MainzSearch for more papers by this authorDr. Gerd Passler, Dr. Gerd Passler Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDr. Joachim Riegel, Dr. Joachim Riegel Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDr. Franz Scheerer, Dr. Franz Scheerer Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDr. Norbert Trautmann, Corresponding Author Dr. Norbert Trautmann Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this authorDr. Franz-Josef Urban, Dr. Franz-Josef Urban Institut für Kernchemie der Universität, Fritz-Straßmann-Weg 2, D-55099 Mainz, Telefax: Int. + 6131/394–488Search for more papers by this author First published: 31. März 1995 https://doi.org/10.1002/ange.19951070722Citations: 5 † Diese Arbeit wurde vom Bundesministerium für Umwelt. Naturschutz und Reaktorsicherheit. vom Bundesamt für Strahlenschutz, vom Bundesministerium für Forschung und Technologie sowie von der Deutschen Forschungsgemeinschaft gefördert. AboutPDF ToolsRequest permissionAdd to favorites ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume107, Issue731. März 1995Pages 891-893 This is the German version of Angewandte Chemie. Note for articles published since 1962: Do not cite this version alone. Take me to the International Edition version with citable page numbers, DOI, and citation export. We apologize for the inconvenience. RelatedInformation

Background: Left main coronary artery stenosis is a rare but life-threatening complication after aortic valve replacement because of coronary perfusion-related trauma to the vessel wall with cannulation of the coronary ostia. We investigated whether this complication still occurs in the 1990s despite the use of more advanced catheter materials and modern surgical preservation techniques.Methods: Four years after identification of the first two cases in 1987, five further patients had developed left main coronary artery stenosis after aortic valve replacement (incidence, 0.9%) at the cardiothroacic clinic of the J.W. Goethe University and were studied for contributing factors.Results: Severe coronary ostial stenosis developed within 1 to 6 months after aortic valve replacement. In one such case, intimal proliferation was seen in a biopsy specimen that was comparable to the restenosis induced by coronary angioplasty. The clinical characteristics of the patients developing the complication, the surgical technique, and the intraoperative course did not differ from the other patients. However, five of the seven patients (71%) had a common genetic trait concerning their apolipoprotein E genotype (the epsilon4 allele) that is normally present in only 10% to 15% of patients screened (P < 0.01).Conclusions: These lesions seem to result from a uniform response of the vessel wall to injury. Their incidence is probably related in part to the degree of injury after trauma to the coronary ostia during cannulation for myocardial protection. Patients with the epsilon4 allele might be genetically predisposed for a pathologically increased response of proliferative repair mechanisms after arterial injury. The complication can be avoided by not instrumenting the coronary ostia for direct antegrade cardioplegia but using retrograde delivery as an alternative method of myocardial protection.