Podcasts about Resorption

Willkommen zu einer neuen Episode unseres Zahnmedizin-Podcasts mit Jöran und mir: In dieser Folge vertiefen wir uns in innovative Entwicklungen der Zahnmedizin und teilen persönliche Einblicke in unsere alltäglichen Herausforderungen. Wir reflektieren wir unsere Erlebnisse von der Fachmesse IDS, wo Jöran ein neues, verbessertes Terminbuchungssystem bei Dr. Flex entdeckte, das die Praxisverwaltung revolutionieren könnte. Ein spannendes Thema war der Austausch über moderne Mikroskope und deren Zubehör, sowie die neuesten Fortschritte im 3D-Druck von Zahnversorgung. Jöran stellt einen Drucker vor, der Kronen blitzschnell erstellen kann, was die Patientenversorgung erheblich verbessert. Wir schließen die Episode mit einer Vorstellung interessanter Produkte ab, die wir auf der IDS fanden. Unsere Diskussionsrunde ist geprägt von Optimismus und wir laden unsere Hörer ein, ihre Eindrücke von der Messe zu teilen. Insgesamt bietet diese Episode wertvolle Einblicke in Fortschritte der Branche und persönliche Erfahrungen, die für Zahnmediziner und Interessierte gleichermaßen relevant sind. Cave Werbung unbezahlt und persönliche Meinungsäusserung

Listen to this podcast to know more about Internal Resorption. Wanna know more about oral diseases? Turn on our notifications here and follow us on instagram: ⁠@doencasdeboca

Bei Patienten mit Erkrankungen der Nieren und der Harnwege können unterschiedliche Schmerzarten auftreten, die sich je nach Art der Erkrankung und ihrem Verlauf unterscheiden. Diese Schmerzen entstehen häufig aufgrund von Entzündungen, Blockaden, Infektionen oder mechanischen Störungen in den Nieren oder im Harntrakt. Ödeme sind eine Ansammlung von Flüssigkeit im Interstitium, also dem Gewebe zwischen den Zellen und in den Körperhöhlen, was häufig bei Erkrankungen der Nieren und des Harntraktes auftreten kann. Diese Flüssigkeitsansammlungen resultieren aus einer gestörten Filtration, Resorption oder Ausscheidung von Flüssigkeit im Körper, die durch eine verminderte Nierenfunktion oder Veränderungen im Kreislaufsystem hervorgerufen wird. Lerne alles Theoretische und Pflegerelevante zu diesen wichtigen Pflegephänomenen und lass dich damit wieder fit machen für deine Prüfungen und die praktische Arbeit auf Station!

Der Dickdarm übernimmt mehrere wichtige Funktionen im Verdauungssystem. Du wirst sehen, dass er eine zentrale Rolle bei der Wasser- und Elektrolytresorption sowie der Bildung und Ausscheidung von Stuhl spielt. Der Dickdarm ist maßgeblich an der Resorption von Wasser und Elektrolyten beteiligt. In diesem Abschnitt des Darms wird der Großteil des Wassers aus dem Darminhalt wieder in den Körper aufgenommen, wodurch der Stuhl eingedickt wird. Elektrolyte wie Natrium und Chlorid werden ebenfalls resorbiert, um den Flüssigkeits- und Elektrolythaushalt des Körpers zu regulieren. Lerne alles wichtige zur Theorie zum Dickdarm und lass dich wieder fit machen für deine Prüfungen!

How long should you wait after a root canal before starting Orthodontics? Should we be scared of orthodontic movement in those taking bisphosphonates? How do you decide if diastemas should be closed restoratively or orthodontically? Dr Daniel Neves answers every one of the questions and several more sent in from the Protrusive Community These questions are the tricky case-specific ones we ponder about and crave guidelines for - straight talking Dr Neves makes it all tangible. https://youtu.be/ZufVChjEJk4 Watch PDP186 on Youtube Protrusive Dental Pearl: Retention is not a ‘one and done' process. It should be customised for the individual and maintained appropriately - including at every routine check up. Highlights of this Episode:04:40 Protrusive Dental Pearl05:53 Introduction to Dr Daniel Neves 12:16 Reducing the Risk of Relapse17:20 Anterior Diastema21:47 Temporary Anchorage Devices (TADs)26:20 Jaw Issues in Adults29:20 Root Resorption34:25 Recession Cases38:00 Timing of Orthodontics after Root Canal Treatment39:39 Bisphosphonates and Orthodontics40:16 Aligners around Implants42:22 Final Thoughts If you liked this episode, you will also like GDP Alignment vs Specialist Orthodontics [STRAIGHTPRIL] – PDP068

Frank und Moritz sind gallig unterwegs und besprechen in einem Fluss die Gallenwege, Gallenblase und die Gallenflüssigkeit selbst. Dabei gibt es für euch zu verdauen, welche intra- und extrahepatischen Abschnitte bei den Gallenwegen vorliegen und was für eine wichtige Funktion die Gallensäuren bei der Resorption von Fetten übernehmen. Außerdem verraten die beiden, welche Formen des Gallenfarbstoffs Bilirubin zu unterscheiden sind und welche prädisponierenden Faktoren für die Entstehung von Gallensteinen man sich merken sollte. Übrigens: Schickt uns eure Fragen und euer Feedback zum Podcast gerne an: podcast@doccheck.com

If you've suffered tooth loss due to decay, an accident, or the effects of disease, Woodbury Dental Arts (651-564-7212) provides dental implant services, with treatment options to help you recover your bright smile and sense of confidence. Visit https://www.woodburydentalarts.com/meet-dr-kamel-woodbury-mn for more details. Woodbury Dental Arts City: Woodbury Address: 237 Radio Drive Website https://www.woodburydentalarts.com/ Phone +1 651 564 7212 Email Mkamel@woodburydentalarts.com

Eine echte Zauberbohne: Über eine Million Nephrone sorgen als kleine Kaffeefilter in der Niere für Filtration und Resorption. Neben Zahlen und Fakten – wie der Menge des produzierten Primärharns und dem Anteil des Herzminutenvolumens, das durch die Niere fließt – erklären Frank und Moritz in dieser Folge, wie die Niere als faules Organ das Gegenstromprinzip für sich arbeiten lässt und welche wichtigen Funktionen die Niere neben Wasserhaushalt und Entgiftung noch übernimmt. Übrigens: Schickt uns eure Fragen und euer Feedback zum Podcast gerne an: podcast@doccheck.com

Ep 68 - Do you have any tips on distinguishing ankylosis from resorption? Love Veterinary Dentistry?

Love Veterinary Dentistry?

Welcome back to the second episode of #AskJaz where I answered questions from the Protruserati - from communication to caries management, I will try my best to help. When I don't know the answer (far too often!) I usually know someone who does! https://youtu.be/Pvt-czUEZ3Q Click Here to watch on YouTube In this #AskJaz I tackled: Picking Courses - Which Year Long Restorative Course? 4:45 Which Facebow should I buy? 10:16 When giving the patient some options goes too far 12:02 Reduce Root Resorption Risk for relapse cases 17:50  Do join our Protrusive Dental Community Facebook Group. It has so many great gems and pearls shared in our little community! Click below for full episode transcript: Opening Snippet: Hello Protruserati, I'm Jaz Gulati and welcome back to the second ever AskJaz Jaz's Introduction: I've just come back from Porto in Portugal. And it was an amazing trip. Let me tell you about it because it's very relevant to the podcast. The way this trip came to be is that in Episode 89, I had Dr. George Andre Cardoso on the podcasts and we were discussing Digital VertiPreps IE, how to scan when you do the BOPT, or the shoulder less technique, they're slightly different, right? So one's shoulder, this one's edgeless. We can talk about that another time. But essentially, this crown preparation or bridge preparation technique, which is pretty much all the rage at the moment, and for good reason. You know, I'm a big believer in vertical preps, they are much more conservative, they help you to gain ferulle, they help you help you to preserve the horizontal ferulle, and their soft tissues. Love it. So I'm a big fan of this prep. I've been doing it for some years now. But I knew that so many dentists in the UK wanted to learn. And so in that episode, Episode 89, Andre says, Hey, why don't you guys come on over and we can do something, we were just chatting. And I was like, Yeah, that sounds great, you know, maybe if anyone's interested if you want to go on his website and register your interest. [Jaz]Fast forward, maybe six to eight months later, and we had enough people interested that I'm actually organized 16 dentists. They happen to be all from the UK. And we flew over to Porto in Portugal, and George Andre Cardoso and his team. Thank you, Catia. Thank you, Joanna. Thank you, Gustavo. They treated us to a fantastic course on vertical preparation hands on. So morning was theory, afternoon hands on. All the dentists that came walked away with their own bur kits. But the best thing about it all was the people, the company because it reminds me very much of being at Andre's dad's restaurant, his dad seafood restaurant in Porto, which is part of a package, you know, you come. We do a course. We include lunch. We include dinner at Andre's Dad's seafood restaurant in Espinho. It was phenomenal. And we're there at dinner. And George Andre Cardoso, he shares some life philosophy, we're talking philosophy. And he says Jaz, you know, I came to realize that life is not about the destination. And I said, Yeah, of course not. We all know it's about the journey. He goes, No, life is not about the destination. Life is not even about the journey. Life is about the company. And at that moment, with this packed restaurant full of all these colleagues, which are some of them I've never met before. They are Protruserati, which I met for the first time, which was amazing. It made me realize, Wow, this is special. You know, when you go away for trips, it reminded me of being at Uni. We just got these ski trips at dental schools and that they were the best. And so the vibe here was just amazing. It was just so much fun. It was a great city tour of Porto. We had great food, Francesinha, if you guys don't know Francesinha is I mean, I'll just wrap this up really quickly because you probably want to get to the AskJaz questions. Francesinha, you can't call it a toasty because Portuguese people will get very upset if you ...

Good morning and welcome to your Friday dose of Your Daily Meds.Bonus Review: Can substances pass freely from blood into the CSF?Answer: Nah. There is a barrier to diffusion of most polar molecules. Naturally, this is called the blood-CSF barrier. In this case, the barrier is due to the tight junctions between the epithelial cells (ependyma) of the choroid plexus. The endothelial cells in the capillaries of the choroid plexus have gaps allowing small molecules to pass between and cross the capillary wall.Paeds Question:Which of the following is NOT one of the primary mechanisms by which foetal lung fluid is cleared at the time of birth?Reduction of fluid secretion in the lungsExpulsion of lung fluid as the foetal chest is compressed during labourLymphatic resorption of lung fluid Resorption of lung fluid via capillariesReduced foetal urine output prior to labourHave a think.Scroll for the chat.Case:A 34-year-old woman, currently at 37 weeks’ gestation in her second pregnancy is reviewed in clinic.She reports headache, some visual disturbances and epigastric pain, although there has been no vomiting.On examination, she is hypertensive to 165/115 mmHg, has a tender abdomen worst over the right upper quadrant and is seen to have brisk reflexes.Which of the following is most suitable to administer given this woman’s clinical presentation?PhenytoinSodium valproateMagnesium sulphateCalcium gluconateCephazolinHave a think.Scroll for the chat.He’s Got Fluid:The foetal lung acts as a secretory organ prior to birth, with approximately 100-150 mL/kg body weight of fluid being produced in the lungs of the normal foetus. This foetal lung fluid, along with foetal urine, are the primary contributors to amniotic fluid volume. Lung fluid is cleared during the time of birth by several mechanisms, including:Reduction of fluid secretion in the lungsExpulsion of lung fluid as the foetal chest is compressed during labourResorption of lung fluid via lung interstitium into pulmonary lymphatics and capillariesOf these, resorption is the main mechanism by which lung fluid is cleared and a failure of this mechanism can lead to transient tachypnoea of the newborn. So a reduction of foetal urine output prior to labour is not one of the primary mechanisms by which foetal lung fluid is cleared at the time of birth.Pre-Nasty:Key to answering this question is recognising the pregnant woman with signs of preeclampsia with severe features.This is evidenced by headache and visual changes, symptoms of central nervous system dysfunction, epigastric pain and right upper quadrant tenderness, potential signs of hepatic abnormality of HELLP (Haemolysis, Elevated Liver enzymes, Low Platelets) syndrome of severe preeclampsia, and brisk reflexes, potentially foreshadowing the seizures of eclampsia. Nasty.Given the features of severe disease in this woman, delivery must occur to minimise the risks of maternal and foetal complications, such as cerebral haemorrhage, hepatic rupture, renal failure, pulmonary oedema, seizure, bleeding of thrombocytopaenia, placental abruption or intra-uterine growth restriction. Of the options listed, magnesium sulphate is the most appropriate medication to administer as it has been shown to reduce the risk of eclampsia, and may be administered intravenously.Phenytoin and sodium valproate are other medications used for seizure prophylaxis, but are inferior to magnesium sulphate in this particular obstetric context. Calcium gluconate may be used to treat magnesium toxicity in the context of seizure prophylaxis with magnesium sulphate. Cephazolin is used as intrapartum antibiotic therapy in those mothers positive for commensal group B streptococcus infection and hypersensitive to penicillins to prevent neonatal streptococcus disease.Bonus: What is the difference between the blood-CSF barrier and the blood-brain barrier?Answer in Monday’s dose.Closing:Thank you for taking your Meds and we will see you Monday for your MANE dose. As always, please contact us with any questions, concerns, tips or suggestions. Have a great day!Luke.Remember, you are free to rip these questions and answers and use them for your own flashcards, study and question banks. Just credit us where credit is due. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit yourdailymeds.substack.com

JAK inhibitors in AA – Bone resorption with hyaluronic acid - The ALT-70: Predicting lower extremity cellulitis – Appreciate the masseter! - We don't have enough pediatric dermatologists https://dermaspherepodcast.com/ Check out Luke and Michelle's other podcast, SkinCast! https://healthcare.utah.edu/dermatology/skincast/ Luke and Michelle report no conflicts of interest.

Resorption cases on mandibular anterior teeth can be challenging!

Risk factors for MBL around implant in function for 4 years

Theresa und ich sprechen heute über die Aspekte zur ökologischen Bestattung. Wie wichtig ist es "Nachhaltig" zu sterben? Spätestens seit "Fridays for future" ist der Trend zu ökologischen Bestattungen auch in der Bestattungsbranche angekommen. Wir wollen aber auch über die Grenzen schauen und besprechen was es an nachhaltigen Formen der Bestattung schon heute gibt (Stichwörter: Prozession, Resorption oder Re-Composing).Hier die Links zur Sendung:Abschied im Rahmen einer Recompose-Bestattung zu https://www.dailymotion.com/video/x6enl40 Jae Rhim Lee TED Talk zu Ihrem Myzelanzug: https://www.ted.com/talks/jae_rhim_lee/transcript?language=deWebsite und Video zur Resomation: https://resomation.comTED Talk von Kathrina Spade zum Recomposing: https://www.ted.com/talks/katrina_spade_when_i_die_recompose_me

Jan Bellows, DVM, DAVDC, DABVP, FAVD, is board certified by American Veterinary Dental College and American Board of Veterinary Practitioner. He is the current president of the Foundation for Veterinary Dentistry. Dr. Bellows practices veterinary dentistry at All Pets Dental in Weston, Florida.  Bellows is also the author of "Small Animal Dental Equipment Materials and Techniques, 2nd Ed" and "Feline Dentistry, 2nd Ed." Check out some awesome insight as he offers helpful tools in improving veterinary dentistry at your practice. 

  Atelektasen sind Feinde in der Anästhesie. Sehr böse. Nur Probleme. Oder nicht? Es sind nicht belüftete Areale in der Lunge, das heißt: „zusammengefallenes Lungengewebe“ bzw. kollabierte Alveolen. Es können nur kleine Bereiche kollabiert sein, oder sogar eine gesamte Lunge (Totalatelektase). Die Lunge wird grundsätzlich immer mehr oder weniger perfundiert. Wenn aber perfundierte Bereiche nicht … Weiterlesen

Medikamente oder was ist alles in der Salami Ich will die Chemie nicht zu mir nehmen! Aber du hast keine Scheu vor fastfood, Grillwürstchen und den Nitrosaminen! Du isst gern eine Tüte Chips oder einer Dose Bohnen! Wenn dein Arzt sich nach deinen Befunden zu einer Therapie entscheidet, dann weiß er auf den Mikrogramm genau, was er dir verordnet! Er kann alle Zusatzstoffe einsehen, die für die Resorption oder die Verpackung des Wirkstoffes in deiner Tablette erforderlich sind! Beispiel: Laktoseintolleranz, wenn du Laktose im Medikament hast, kannst du Darmbeschwerden bekommen! So genaue Informationen findest du auf der Salami nicht! Schau mal nach, ob du auf den Hähnchenschnitzeln den Hinweis findest, mit welchem Antibiotikum das Tier im Stall gefüttert wurde!

Sonnenschutzmittel zur Prävention von Hautkrebs sind unumstritten. Sie werden daher sehr breit angewendet - von einige Menschen sogar täglich. Doch bestimmte Bestandteile aus Sonnenschutzmitteln werden systemisch resorbiert. Und zwar in nicht unerheblichen Mengen, wie eine aktuelle Studie zeigt.

This edition of the EVJ on the hoof podcast discusses the paper 'Radiological Prevalence of Equine Odontoclastic Tooth Resorption and Hypercementosis' (http://onlinelibrary.wiley.com/doi/10.1111/evj.12776/full) by S. Rehrl, W. Schröder, C. Müller, C. Staszyk and C. Lischer

In this podcast Imogen Johns discusses histological evaluation of liver biopsies, and Sam Hole discusses equine odontoclastic tooth resorption and hypercementosis. https://onlinelibrary.wiley.com/doi/10.1111/eve.12871 https://onlinelibrary.wiley.com/doi/10.1111/eve.12603  

Audio: Video: Gesund Abnehmen mit der Paleo Low Carb Ernährung Wie du mit richtigem, echten Essen und weniger Zucker dein persönliches, gesundes Körpergewicht findest Du willst Abnehmen, hast aber schon jede Diät probiert und das Gewicht kommt immer wieder? Was ist „zu viel“ Gewicht eigentlich? Fühlst du dich nur aufgebläht und schlapp? Hast du, wie ich früher, immer mit Kreuzweh zu kämpfen? Oft schauen Frauen immer nur auf die Waage und vergessen ganz, dass sie sich die Muskeln weghungern. Ich (Julia Tulipan) helfe dir in diesem Kurs persönlich deine Ernährungsweise zu finden. Essen sollte nicht aus kalorienzählen und Verzicht bestehen. Mit Paleo Low Carb muss das auch nicht sein. Du lernst, warum dein Körper und deine Hormone anders auf Essen reagieren werden. Lebenslangen Zugriff auf die Plattform Zugriff auf alle Erweiterungen und neue Lektionen des Kurs-Paket Folgende Kurse sind enthalten Gesund Abnehmen Vorbereitung und Ablauf Deine Gesundheit (Ales über Cholesterin, Insulin und Blutzucker) Kurs: Ernährungsgrundlagen Kurs: Makronährstoffe Kurs: Essensrevolution 4 Wochen Paleo Low Carb Ernährungsplan mit Rezepten Alle 4 Wochen haben wir eine Live Sitzung in der ich deine Fragen (anonym) beantworte Alle 5 Kurse und lebenslanger Zugriff -10% für Hörer (Komplettpreis € 269,10  statt regulär € 299,-) Hier zum Kurs anmelden Wenn du noch mehr erfahren willst oder in ein paar Vorschau-Lektionen hineinschnuppern willst, dann klicke hier In dieser Folge: Wie Du gesund und effizient ins neue Jahr startest und gesunde Gewohnheiten etablierst Was die 6-Schritte Formel für Deinen Erfolg sein kann Wie Du Deine Ziele realistisch und Schritt für Schritt umsetzen kannst Wie Du die häufigsten Fehler bei der Ernährungsumstellung zu Paleo LCHF vermeidest Das Video der aktuellen Folge direkt auf Youtube öffnen Kurze Zusammenfassung In dieser Folge erfährst Du wie Du gesund und effizient ins neue Jahr startest und gesunde Gewohnheiten etablierst und die häufigsten Fehler vermeidest. Gäste Keine Shownotes Vorsätze In Mexiko kennt man dazu ein altes Sprichwort: „Der gute Vorsatz ist ein Gaul, der oft gesattelt, aber selten geritten wird.“ Statistik Laut Statistik der Universität Scranton in Pennsylvania: nur 8 % der Befragten setzen ihre guten Vorsätze für das neue Jahr wirklich um. | Rank | Top 10 New Years resolutions for 2015 | | 1 | Lose Weight | | 2 | Getting Organized | | 3 | Spend Less, Save More | | 4 | Enjoy Life to the Fullest | | 5 | Staying Fit and Healthy | | 6 | Learn Something Exciting | | 7 | Quit Smoking | | 8 | Help Others in Their Dreams | | 9 | Fall in Love | | 10 | Spend More Time with Family | Tipps: Kleine Schritte gehen, jeden Tag einen Schritt mehr. Jetzt machen, was später zum Erfolg führt. Jetzt pflanzen und später säen. Pawel’s 6 Schritte Formel Finde heraus, was Dir wirklich wichtig ist. Visualisiere es und verbinde es mit Emotionen. Erstelle Dir ein Vision Board und / oder schreibe die Ziele auf. Mache daraus alltäglich realistische umsetzbare und einfache Schritte / kleine Ziele. Erzähle es Bekannten um Dir “Druck” aufzubauen. Fang sofort damit an. JETZT! Belohnung nicht vergessen! Mehr über Pawel’s Erfolg gibt es hier und hier die Tipps und Tricks zum Thema Sport. Fehler Nicht SMART Ziele sind nicht SMART S – specific, significant, stretching M – measurable, meaningful, motivational A – agreed upon, attainable, achievable, acceptable, action-oriented R – realistic, relevant, reasonable, rewarding, results-oriented T – time-based, time-bound, timely, tangible, trackable Gewohnheiten Etabliere gesunde Gewohnheiten in Dein individuelles Leben nutze dazu Mikro-Gewohnheiten jeden Tag 10 Squats für 30 Tage jeden 2. Tag Gemüse essen Morgenrituale Unterschied “gute” und “schlechte” Gewohnheiten 5 Minuten meditieren vs. 5 Minuten rauchen Stelle Deine Umgebung auf gesunde Gewohnheiten um Leg Dir das Buch auf Dein Kopfkissen Verbanne jeglichen Zucker aus der Wohnung Kaufe erst keine schlechten Lebensmittel ein Fahre eine andere Route, die nicht am Fast Food Restaurant vorbeiführt Organisiere Dich Sehr gute Literatur zum Thema Gewohnheiten: Charles Duhigg, Die Macht der Gewohnheit: Warum wir tun, was wir tun Micro Habits: Simple Micro Habits To Get You Started Small And Finishing Big (Habits, Micro Habits, Power Habits, Mini Habits) (English Edition) von Brian Ledger Ernährungsumstellung Fehler Nummer 1: Zu wenig Fett Das mag jetzt vielleicht kontraintuitiv klingen, aber das ist wirklich einer der ganz häufigen Fehler, die man am Anfang einer LCHF Ernährung macht. Die Hintergründe sind natürlich klar. Jetzt hat man Jahrzehnte lang jedes Krümelchen Fett gemieden, wie der Teufel das Weihwasser und nun soll man auf einmal viel davon essen. Das ist kognitiv schwer zu verarbeiten. Wie baut man einfach und unkompliziert langsam mehr Fett in die Ernährung ein? Zu Beginn, ist es einfach einmal wichtig, die natürlich vorkommenden Fette in den Lebensmitteln zu akzeptieren und nicht nach fettreduzierten oder sehr mageren Produkten zu greifen. Milchprodukte in der Vollfettvariante, Schopfbraten und Bauchfleisch statt Karree oder Filet-Steak. Gemüse in Butter schwenken und Olivenöl auf den Salat. Auf diese Art und Weise lässt sich vollkommen natürlich mehr Fett in die Ernährung einbauen. Fehler Nummer 2: Zu viel Eiweiß (Protein) Ein Missverständnis, das mir oft begegnet, sowohl bei Kunden als auch bei „Kritikern“ der LCHF Ernährung, ist die Meinung, dass es sich bei LCHF um eine besonders eiweißreiche Ernährungsform handeln würde. Dies ist überhaupt nicht so, ganz im Gegenteil, bei der LCHF Ernährung sollte man darauf achten nur moderate Mengen an Protein zu sich zu nehmen. Hier komme ich noch einmal auf den Punkt zurück, den ich schon unter Fehler Nummer 1 angesprochen habe. Wählt man tierische Produkte mit einem natürlich hohen Fettgehalt, ist dementsprechend die Menge an enthaltenem Eiweiß reduziert. Ist die Fleischportion zu groß, zu mager oder isst man zu viel Käse, der oft sehr viel Protein enthält, so schießt man leicht über das Ziel hinaus und nimmt zu viel Protein zu sich. Warum ist zu viel Protein ein Problem? Protein ist nicht etwa schädlich für die Nieren oder fördert Gicht[i] [ii]. Diese Annahmen sind veraltet und durch gute klinische Studien wiederlegt. Dies ist also nicht der Grund, warum zu viel Protein ein Problem darstellen kann. Die wirkliche Problematik ist nicht ganz so offensichtlich und mag für viele überraschend sein –  Protein stimuliert Insulin[iii] und zu viel Protein wird zu Zucker (Glucose) umgewandelt. Fehler Nummer 3: Durchfall, Magenbeschwerden und Verstopfung Der Körper produziert nur Dinge, die er auch wirklich benötigt. Wenn man Jahre oder Jahrzehnte lang fettarm isst, dann wird auch die Produktion von Verdauungsenzymen eingeschränkt. Kann das Fett nicht aufgespalten werden, so gelangt es unverdaut in den Dickdarm und führt zu Durchfall und Fettstuhl. Um dies zu vermeiden, kann es, besonders am Anfang, Sinn machen Verdauungsenzyme zu den Mahlzeiten dazu zu nehmen. Bei einer wohl formulierten LCHF Ernährung werden auch jede Menge faserreiche Pflanzen konsumiert. Auch das kann anfänglich den Verdauungstrakt überfordern. Nebenbei haben viele eher zu wenig Magensäure als zu viel. Sowohl ich persönlich, als auch viele meiner Klienten haben mit der zusätzlichen Einnahme von Betain HCl vor den Mahlzeiten, sehr gute Erfolge erzielt. Fehler Nummer 4: Der Carb-Kater oder die Atkins-Flu Insulin erhöht die Resorption von Salz über die Niere[iv]. Wer kohlenhydratereduziert isst, hat weniger Insulin im System und scheidet daher mehr Salz und andere Elektrolyte über die Niere aus. Die Folge sind Symptome wie Kopfschmerzen, Gliederschmerzen und allgemeine Schwäche. Da diese Symptome sehr an einen grippalen Infekt erinnert, bezeichnet man diesen Zustand als Carb-Kater oder auch Atkins—Flu (flu: engl. Grippe). Dem Carb-Kater kann man leicht entgegenwirken. Es empfiehlt sich  allgemein mehr Salz zu verwenden und jeden Tag ein Glas Knochenbrühe zu trinken. Fehler Nummer 5: Das Suchtpotential von Zucker und Getreide unterschätzen „Einmal gepoppt, nie mehr gestoppt“ – was als lässiger Webeslogan einer Cracker-Marke gedacht war, beschreibt äußerst treffend die abhängig machende Natur dieser Lebensmittel. Zucker und Getreide macht nicht nur im übertragenen Sinne süchtig. Aus Versuche mit Tieren und Menschen zeigt sich, dass Süßigkeiten die gleichen Gehirnareale aktivieren wie Heroin. Während Zucker unser Belohnungszentrum aufleuchten lässt wie einen Weihnachtsbaum, wirkt Getreide über einen anderen Mechanismus. Das Glutenprotein in Getreide und euch Casein, ein Protein in Milch, zeigen die Fähigkeit, die Blut-Hirn Schranke zu überwinden und an Opioidrezeptoren im Gehirn zu binden[v]. Dies wird dann besonders zum Problem, wenn die Barrierefunktion des Darms gestört ist (leaky-gut) und diese Proteine ungehindert in den Blutkreislauf übertreten können. Quellen: [i] Landau, Daniel, and Ralph Rabkin. „Effect of Nutritional Status and Changes in Protein Intake on Renal Function.“ Nutritional Management of Renal Disease(2012): 197. [ii] Richette, Pascal, and Thomas Bardin. „Purine-rich foods: an innocent bystander of gout attacks?.“ Annals of the rheumatic diseases 71.9 (2012): 1435-1436. [iii] Nuttall, Frank Q., and Mary C. Gannon. „Metabolic response of people with type 2 diabetes to a high protein diet.“ Nutr Metab (Lond) 1.1 (2004): 6. [iv] Soleimani, Manoocher. „Insulin resistance and hypertension: new insights.“Kidney international 87.3 (2015): 497-499. [v] Lister, Josh, et al. „Behavioral effects of food-derived opioid-like peptides in rodents: Implications for schizophrenia?.“ Pharmacology Biochemistry and Behavior (2015). Statistik: http://www.statisticbrain.com/new-years-resolution-statistics/ Literatur Charles Duhigg, Die Macht der Gewohnheit: Warum wir tun, was wir tun Micro Habits: Simple Micro Habits To Get You Started Small And Finishing Big (Habits, Micro Habits, Power Habits, Mini Habits) (English Edition) von Brian Ledger Practical Paleo: A Customized Approach to Health and a Whole-Foods Lifestyle von Diane Sanfilippo BS NC Abnehmen mit Paleo: Paleo Lifestyle Power For Everyone Pragmatiker Edition Mit Erfahrungsgarantie von Pawel M. Konefal Gehirn-Pflege Guide 2.0: Paleo Brain Power For Everyone Pragmatiker Edition von Pawel M. Konefal Gehirn-Pflege Paleo Rezepte Kochbuch 2.0: Paleo Brainfood Power For Everyone von Pawel M. Konefal Darm S.O.S. Das Taschenbuch von Julia Tulipan Paleo Ernährung für Mama und Baby: Der Ratgeber für gesunde Steinzeiternährung vor, während und nach der Schwangerschaft – Mit mehr als 40 Paleo Beikost und Babybrei Rezepten zum selber machen – 100% glutenfrei und laktosefrei Entpuppt: Mit LCHF in ein leichtes Leben von Annika Rask LowCarb Basics: Glutenfrei. Sojafrei. Pur! von Daniela Pfeifer The Ketogenic Diet: A Complete Guide for the Dieter and Practitioner 1st by McDonald, Lyle (1998) Paperback von Lyle McDonald Keto Clarity: Your Definitive Guide to the Benefits of a Low-Carb, High-Fat Diet (English Edition) Das Paläo-Prinzip der gesunden Ernährung im Ausdauersport von Loren Cordain Dumm wie Brot: Wie Weizen schleichend Ihr Gehirn zerstört von Dr. David Perlmutter Webseiten JULIAS BLOG http://PaleoLowCarb.de/ PAWELS BLOG http://superhumanoid.de  

Today's tip is an excerpt from the Driving Radio Show. Dr. Wendy Ying takes on a equine odontoclastic tooth resorption, both the disease's name and it implications are a real mouthful, .. Listen in...Support the show (https://www.patreon.com/user?u=87421)

Audiovortrag zum Thema Resorption Simple und komplexe Fakten und Meinungen rund um dieses Thema aus dem Yoga Blickwinkel von Sukadev, dem Gründer des gemeinnützigen Vereines Yoga Vidya e.V. Dieser Audiovortrag ist eine Ausgabe des Audiovortrag zum Thema Fastenaufbau Simple und komplexe Fakten und Meinungen rund um dieses Thema aus dem Yoga Blickwinkel von Sukadev, dem Gründer des gemeinnützigen Vereines Yoga Vidya e.V. Dieser Audiovortrag ist eine Ausgabe des Naturheilkunde Podcast. Er ist ursprünglich aufgenommen als Diktat für einen Lexikonbeitrag im Yoga Wiki Bewusst Leben Lexikon. Zum ganzheitlichen Yoga kann man auch die Theorie von Karma und Reinkarnation dazu zählen. In Ayurveda Ausbildungen erfährst du mehr zum Thema Gesundheit und Prävention. Vielleicht magst du ja deine Gedanken dazu in die Kommentare schreiben. Anmerkung: Gesundheitliche Informationen in diesem Podcast sind nicht gedacht für Selbstdiagnose und Selbstbehandlung, sondern Gedankenanstöße. Bei eigener Erkrankung brauchst du einen Arzt oder Heilpraktiker. Hier findest du: Seminare mit Sukadev Seminarübersicht Themenbezogene Seminare Yoga Vidya YouTube Live Kanal Online Seminare Video Seminare Yoga Vidya kostenlose App Yoga Vidya Newsletter Unseren Online Shop Schon ein kleiner Beitrag kann viel bewegen... Spende an Yoga Vidya e.V.! kunde-podcast.podspot.de">Naturheilkunde Podcast. Er ist ursprünglich aufgenommen als Diktat für einen Lexikonbeitrag im Yoga Wiki Bewusst Leben Lexikon. Zum ganzheitlichen Yoga kann man auch die Theorie von Karma und Reinkarnation dazu zählen. In Ayurveda Ausbildungen erfährst du mehr zum Thema Gesundheit und Prävention. Vielleicht magst du ja deine Gedanken dazu in die Kommentare schreiben. Anmerkung: Gesundheitliche Informationen in diesem Podcast sind nicht gedacht für Selbstdiagnose und Selbstbehandlung, sondern Gedankenanstöße. Bei eigener Erkrankung brauchst du einen Arzt oder Heilpraktiker. Hier findest du: » » » » » » » »

Michel Maharbiz & Daniel Cohen. Michel is an Assoc Prof with EECS-UCB. His research is building micro/nano interfaces to cells and organisms: bio-derived fabrication methods. Daniel received his PhD from UCB and UCSF Dept of Bioengineering in 2013.TranscriptSpeaker 1: Spectrum's next. Speaker 2: Okay. Speaker 1: Welcome to spectrum the science and technology show on k a l x Berkeley, a biweekly 30 minute [00:00:30] program bringing you interviews featuring bay area scientists and technologists as well as a calendar of local events and news. Speaker 3: Hi and good afternoon. My name is Brad Swift. I'm the host of today's show. Today we are presenting part one of two interviews with Michelle and Harb is and Daniel Cohen. Michelle is an associate professor with the Department of Electrical Engineering and computer science at UC Berkeley and the Co director of the Berkeley Sensor and actuator center. [00:01:00] His current research interests include building micro and nano interfaces to cells and organisms and exploring bio derived fabrication methods. Daniel Cohen received his phd from the Joint UC Berkeley and UCLA Department of bioengineering program in 2013 his phd advisor was Michelle Ma harvests. Together they have been working on the fronts project and NSF f Free Grant [00:01:30] F re stands for emerging frontiers and research and innovation fronts is the acronym for flexible, resorbable, organic and nanomaterial therapeutic systems. In part one of our interview, we discuss how they came to the challenge of measuring and understanding the so-called wound field. Here's part one, Michelle [inaudible] and Daniel cone. Welcome to spectrum. Thank you. Thanks. How was it that [00:02:00] electrical fields generated by wounds was discovered? So I think Daniel should take this one cause he's the, he's the group historian on this topic. In fact, he gave us a little dissertation during this thesis talk Speaker 4: in the day when electricity was sort of still a parlor trick. There was a lot of work being done to try to figure out where it was coming from. There was a lot of mysticism associated with it. And this is in the mid to late 17 hundreds and so Galvani is a name most people have heard. Galvanism was a term [00:02:30] coined for his work and what he found was all the work with frog legs. So he used to dissect frogs and could show that if you had dissimilar metals in contact with different parts of the muscle and the nerves, the legs with twitch and amputate the frog leg. So his conclusion was that electricity had something to do with life and their living things were made alive by having this spark of life. And this was a really super controversial idea because for a long time there had been a philosophical debate raging about vitalism versus mechanism, which is the idea that all living things are special because of some intrinsic vital force versus the idea [00:03:00] that physical principles explain life. Speaker 4: So the vitalist really liked this idea that electricity is the spark that makes living things special. There's a lot of dispute about this, but eventually Volta who is right after him and who the vault is named after showed that it was really just the movement of ions and things in salt solutions, but it was a little too late and the mystical aspect of this had come along. So the problem then was that this idea prevailed into the early 18 hundreds and so Galvani his nephew Aldini started doing [00:03:30] these experiments in England where he was given permission to take executed criminals and basically play with the corpses and he was able to create a corpus that would go like this. And raise an arm or wink an eye at an audience. And this was the idea of the reanimated corpse. So people were having a lot of fun with this, but it wasn't clear that it wasn't mystical. Speaker 4: And so this is the long answer to the question, but that's the backdrop where the science starts to come in. So the first thing is Frankenstein gets published out of this, and everybody's getting into the whole vitalism idea [00:04:00] at this point. And Frankenstein was written as a part of a horror story competition. It was almost a joke. But the funny thing is Frankenstein. Well, how would you say Frankenstein? The monster came to life to lightning? Like that's a line. It wasn't a Hollywood fabrication and everyone assumed that. But Mary Shelley never wrote anything about lightning or electricity. She in fact, wrote the technology was too dangerous to describe in texts for the average person. But in her preface, she explains that the whole origin of this idea, and this is where the answer to the question comes from, was that [00:04:30] she had writer's block when she was writing the story and she overheard her husband Percy Shelley and Lord Byron having an argument about work done by Erasmus, Darwin and Erasmus. Speaker 4: Darwin was a big natural philosopher or scientist at the time who was a big vitalist. So he's really into the idea of the spark of life and also this idea of spontaneous generation that where does life come from when you have a compost heap, fruit flies appear. There was an idea that be composing garbage produced life, and that was part of spontaneous generation. And he did a lot of experiments where he'd seal things like wet flour into a bell jar [00:05:00] and to show that organisms came out in a sealed environment and they just didn't know about microorganisms and things like that. So he did a famous experiment where he dehydrated some species called Vermicelli all. Sorry, I made the mistake. I'm about to talk about 40 cello, which is a little organism. And when he added water again, they came back to life. Now, Lord Byron and Percy Shelley didn't understand any of this, and the conversation that Mary Shelley eavesdropped on was one where they said that Erasmus Darwin had taken Vermicelli Pasta, put it inside the Bell Jar, sealed [00:05:30] it, and through some magic of his own allowed it to twitch. Speaker 4: So he had essentially given life to pasta. Now Mary Shelley wrote that she didn't believe any of this was actually really what happened. But this idea of animating the inanimate gave her the idea for Frankenstein. Then she writes the one line that links it to electricity, which is, and if any technology would have done this, it would probably have been galvanism, which is this idea of applying electricity to something. And so that's where this whole idea of life and electricity came from. By that point, the scientists had finally [00:06:00] caught up with all the mysticism and started to do more serious experiments, and that's when Carlo met Tucci in 18 and 30 something found that when you cut yourself, there's some sort of electrical signal at the injury source. And that was his main contribution that was called the wound current or the wound field and then after him was the guy who really formalized the whole thing, which was do Bob Raymond, who was a German electrophysiologist who found that if you have any sort of injury, he could actually measure a current flowing at the side of the injury. Speaker 4: He could show that that changed over time. He cut his own thumb and [00:06:30] measured the current flow and they didn't have an explanation for why it happened, but they knew that it had something to do with the electric chemistry there. This was the birth of electrophysiology and then he went off and did all these things with action potentials in neurons, which is why almost no one's heard about this injury side and the fact that electricity's everywhere in the body normally and it's not mystical, it's electrochemical. We're much more familiar with the neural stuff and this other stuff on the wound side sort of languished until maybe the late 19 hundreds because it was rare. It was weird. It wasn't clearly important [00:07:00] and a lot of the players involved were so caught up in all sorts of other things that we tend to forget about this. So that was the whole long winded history of where the wound field came from. But it's a good story. It is a good story. Yeah. Speaker 5: [inaudible] you are listening to spectrum KALX Berkeley. Our guests are Michael ml harvest and and Daniel Colon. They're both bioengineers in the next segment they talk about the genesis of the fronts [00:07:30] project. Speaker 6: Michelle, when you approached the NSF yeah. For a grant for this idea, how long had you been thinking about it? The smart bandage idea, how far down stream were you with the idea? We had been toying with the idea for quite some time and there's a bit of background to this as well. So my group amongst other things builds flexible electrode systems. [00:08:00] You can call them for neuroscience in your engineering, and most of those systems are intended to record electrical signals across many different points across many electrodes usually honor in the brain. And so we had this basic technology lying around. This is sort of a competence that the group has had for quite awhile. The other thing that was beginning to intrigue us, and I have to credit Daniel for sort of beginning of the discussions and kind of pushing this along in the early years, so Daniel and I have like a tube man club of sitting around thinking of crazy things and [00:08:30] one of the things that Daniel had been interested in was the idea of resorbing or having so some of the materials disappear as they do their job in the body and this is a notion that's become very popular recently actually over the last couple of years in into community in the engineering community in general. Speaker 6: Which brings us to another question I had, which is the difference between resorptionSpeaker 4: and absorption. Absorption might imply that you're taking the components up and they're becoming part of the body. Resorption is really just a very strange [00:09:00] semantic term. That means something like the body's breaking it down or it's breaking down in some form and it's not really the same as that material winding up elsewhere in your tissues. It may just get excreted or it may go somewhere else. So really we use it when we don't really know what's going on. Yeah, we had been looking at this general area and then I think the last piece of the puzzle, I think in our minds looking at the extant literature, the idea that we could take meaningful electrical data from a wound began to really interest us. And so the [00:09:30] two parts of this really are one, can you use portable, resorbable systems? Something like a bandage, you know, something that that isn't going to require you to walk around with a handcart. Speaker 4: Can you use systems like this to measure electrical signals that are relevant to wounds? And then the other question is if you can do that, and if you have, you know, you learn about this, and by the way, we're not the first people to try to do this. There are a number of people that have been measuring electrical signals in the wounds as Daniel set for quite some time. If you can do this, is there a value to [00:10:00] trying to control or modulate that electrical information or those fields or those currents in the wound? Is there a therapeutic value? Perhaps there are scientific value. Is there something you can learn about the way the body works or tissue works? Both of those are open questions and you know we can delve into each of those, but those are really kind of how we think about them separately a little bit. Speaker 4: The flip side is that when we do a lot of this kind of design for medical things, you will want to know what's already happening and how the body handles its own injuries. And this field doesn't just arise passively. So they had no way of knowing [00:10:30] this when it was first discovered. But when you get this electric field, there is a navigational effect for incoming cells to the injury. So it actually helps guide things in like a lighthouse to the wound site. And so a lot of my phd work was showing how you can steer ourselves with a controlled electric field so you can really hurt them like sheep based on how the electric field goes. And that means that that was a source of this bio inspired part of it, which is we're not adding something that's not already there. We're taking something that's already there and we're modulating it to maybe improve. Speaker 4: [00:11:00] So evolutionary tools or things that the body has, it just happened to work well enough for us to survive as a species. It doesn't mean it's optimized and this field tends to go away very quickly. Nobody really knows whether extending the duration of the field would improve the healing or if we could shape it. Maybe you can control how scar tissue forms and things like that. So there's this idea of looking at how the body already heals itself and then figuring out where you might start to control it. And electricity is one of the areas that's really been under utilized in medical technology for the sort of thing. Yeah. I think for those of your audience [00:11:30] that are sort of tech junkies, if you will, the resurgence of this type of thing. Occurrent Lee I think arises because we've gotten very good at building very low power, very small electronics, and there's been a whole slew of new polymers and sort of new flexible substrates that are also conductive or can hold conductors. And so those two things together rekindled interest and trying to build gadgets that sit Speaker 6: on the skin. Or in the NSF case, we're not only doing the skin, but we're trying to develop a tool longterm [00:12:00] for surgeons to do something inside the body. So it'd be nice to be able to leave something that will help you heal, but then it'll be resorts so you don't have to reopen. Right. Speaker 5: Spectrum is a public affairs show on k a l x Berkeley. Our guests are Michelle. My heart is in Daniel Cohen of UC Berkeley. They want to build a smart bandage for wounds. In the next segment, they talk about the focus of their research. Speaker 6: [00:12:30] So in your approach to the NSF, was there some sort of focus, there's a technological focus and an application focus? The technological focus for the NSF was to point out that there was a lot of fundamental engineering science that had to be done to produce the type of systems that could do this. You know, we're looking at resorbable batteries are real parts wise, how you would build these systems, what polymers you'd use, what the rates of resorption. There's a lot of just fundamental stuff going on. If you posit that there'll be value to [00:13:00] these kinds of things. That's one focus as the other focus. I would say application wise we're looking at two things. The most ambitious is that you could develop systems that a surgeon could use for internal wounds. So the dream is a surgeon is, for example, let's say you have to resect the part of your intestine. Speaker 6: You then have to fuse the two parts that are left behind. There are methods for doing this and there's still research going on into what we know. The clinical methodology for this. It would be very useful if you could leave behind something that [00:13:30] could tell you, if nothing else, the state of how that is healing but would then go away because you're certainly not going to go back and open somebody's abdomen to take out a little piece of sensor that was doing something to intestine. Right? That'd be a not a good idea, and so that idea, that dream that you could leave behind, very small, very thin things that could take data if nothing else. Take data is really what was one of the applications. The other one is surface wounds. There are lots of surface wounds caused by illness. For example, advanced diabetes produces a [00:14:00] lot of problems in the extremities and wounds that are chronic that don't heal very well. Speaker 6: There's just a lot of ongoing interest in surface wounds and not just the technologies for understanding how they may be healing, but in things that maybe could help heal those surface wounds. Those are our full side view welders. I think of them as there are specific things we want to show we can do with our partners at UCLA, but there's also an entire wealth of engineering science that has to be done to build the fundamental. So the NSF was okay with that broad [00:14:30] a portfolio of research. Well, so that's sort of what their mandate is to go broad like that. Cause that seems like you're, you're doing stuff. Speaker 4: I think their main concern here is that they specifically discourage healthcare applications as NIH can fund those. But the difference is that what engineers have found for a long time now is that we don't actually know how to engineer biology. So any technology brings quantification Speaker 6: and an engineering mindset to solving this, like tissue engineering, growing organs. We don't have a lot of engineering for that. But if we start [00:15:00] to monitor everything we can, that chemical signals mechanical, electrical, we build up a set of stimulus and response type rules. We understand how to perturb these systems. So in the same way that you might build a bridge according to a manual of how you build a bridge and how you look at the loads in it and the ways of building a bridge, we might someday build organs. So if that's the pitch, that's much more fundamental science and that's really where it has a medical application. But we can't do it without science and engineering principles that just don't exist right now. There's two points I should mention. First of all, the key is this work [00:15:30] is really looking at the fundamentals of the engineering and the science. Speaker 6: We certainly have our foot into clinical side because I think it informs some of this, right? So that what you're doing is relevant so that someday you could go down that path so you're not in isolation because if you're not assuming that you're headed in this great direction. Exactly. And then you find clinical guys saying less clinically. Right. So the other were very good. And the second thing is that, um, we're funded under a slightly broader grant mechanism than usual. So we have a, what's called an NSF. Every, I think this is emerging frontiers and research and innovation I think [00:16:00] is what it is and these are sort of headline or marquee type thing. So we're very lucky that we were awarded one of these and so I think the NSF has really looking for this broad, far reaching hard-hitting effort. I think there's a good point to mention that this project is really a big collaboration between a number of us and I'd like to mention who they are because some of the material work has done by very talented people in the department on a rds and the Vec Subramanian are two professors in the ECS department and they're very well known for flexible printed systems and [00:16:30] the materials that go into them and we work also with Shovel Roy at UCF and Mike Harrison and Mike is a sort of brilliant pediatric surgeon and shovel. Speaker 6: Roy's well known for the technologies he builds at the interface with clinical need. It's really the fact that all these people come together that we're building all of these tools. Speaker 7: [inaudible]Speaker 3: spectrum is a science and technology show on KALX Berkeley. We are talking with Michelle Mull Harvest Daniel Cohen. [00:17:00] They are researching the electrical field that is generated by wounds in mammals. Their hope is to collect meaningful data from sensors embedded in bandages placed on wounds. Speaker 6: If you approached interpreting and analyzing the electrical field data that you're getting out of the wounds in an animal right now we're being very cautious. We started a first few experiments with rodents over the last six months. What we've [00:17:30] built is a, is a series of systems. You can think of them as insulators with lots of little electrodes all over them. An array of of little electrodes. They're on order of a centimeter or less in terms of you can think of a postage stamp, maybe a bit smaller. We have different varieties of them. Some are stiff, some are very flexible. You can think of it as contact lenses or transparency paper, that kind of thing. And these arrays are connected to electrical sensing equipment. There's a miniaturize a little board that runs everything [00:18:00] and sends data to a block and all this data is collected and what we're currently looking at as a variety of different signals on both open wounds. Speaker 6: So if I, for example, cut the skin and on pressure wounds, pressure wounds or something that people that don't see clinics very often or hospitals aren't familiar with but in fact are huge, huge problem in hospitals right now. Then we lay these arrays over the tissue and we measure a variety of different things. One thing we measure what's known as electrical impedance between different [00:18:30] points on the array and you can think of electrical impedance as how much resistance to an electric current that tissue might produce. It's not a steady current, it's a time bearing current, so we sort of wiggle the current on and off, on and off negative, positive, negative, a sinusoidal and how quickly that current responds and how much of it there is. That allows us to calculate the impedance and there's a lot you can tell from that. You can tell whether things are very wet and conductive. Speaker 6: You can tell whether the tissue is tight knit, so that doesn't let things through a oily. You can tell whether there [00:19:00] might be changes in from one tissue to another. You can infer things about what tissues are might be underneath. The other thing we measure is actually electric potential when the wounds are immediately after they're made. We try to look at what kind of potentials arise and how they're changing. So right now that's in terms of measurement. That's really what we're looking at it. And another thing I should point out as we do these measurements as a function of frequency across a wide range of frequency spectrum up to hundreds of kilohertz. And that's sort of the rapidity with which we wiggle the signal because different components in the tissue [00:19:30] will respond differently at different legal frequencies. Once we have that complete plot, we can look at the difference between them and by to see whether we can build models that tell us, oh well we've, you see this type of distribution. Speaker 6: There's a in tech skin for example. So the dream, in this case, you put your bandaid on and your doctor checks his eye, his or her iPhone every 12 to 24 hours and just gets a different little map of how it's working without ever having to remove the dressing. How are you doing in understanding what those signals mean in terms of healing? [00:20:00] But we just had a meeting, they're doing great. They've basically collected a great deal of data on the latest set of wounds they did and now they're in fact proposing models and seeing how the data fits. They're fitting their models to the data to try to use those fits as ways of discriminating different types of tissues. So we're in the middle of it right now. I couldn't tell you much. We're still putting all that story together for publication. So, and are you able to leverage the work that other people are doing? Oh, absolutely. Sure. Well, I mean you always do that. Like I said, nothing is in a vacuum, right? So absolutely. We follow [00:20:30] the literature and, and we build off of what other people have found and try to add our own contributions. That's, that's how it works. Maybe these ideas came from discoveries from the 18 hundreds and then later on in the 1980s onwards, a bunch of really good developmental biologists have really pioneered a lot of this and gone down as, as showing that Speaker 4: even in an embryo you can detect changes in electrical potential at the surface of the embryo where limbs will form and things like that. So there's a huge amount of stuff out there that gave us the idea for the original thing, but we're barely scratching the surface. [00:21:00] We were technologist, right? We're engineers. So part of one thing and figure it out. Yeah. So the idea of trying to analyze the wound field data, do you have to solve that problem first before you can take on anything else? Like trying to instigate the healing? Yeah. Yeah, I would say so. You would never put this in the body without knowing, knowing that a real lot works. But on the surface it's a different healing mechanism than say a fracture, but it's still the idea that we don't necessarily know what the cause and [00:21:30] effect is yet. So we have to show that getting a field out relates to some state that we can say the wound is in and that we can intelligently put a field back in that actually helps. So we need some metric of success. And without that metric, that number that says the wound is doing better or worse, we're not confident saying that our stimulation is helping. So that's why getting this data first is really important. Speaker 6: The parameter space is fairly large, right? To number of things you could possibly change. Some of the effects are very subtle. And so just willy nilly going [00:22:00] in there and saying, oh, I applied some fields, you know, likely not gonna be very useful. And then there's another subtlety, which is that there are probably clinical contexts in which this is of limited utility, even if it works. And so that is, uh, something we spend a lot of time thinking about. So let me give you an example. Let's say I told you I can make that little cut on your knees heal 5% faster with a $15 bandaid. I'm pretty sure you're not going to buy a $15 [inaudible] except maybe once for the novelty of it. You know it tickles. But [00:22:30] there are contexts where, and Daniel alluded to this earlier, for example, scar formation is a big deal, right? Speaker 6: How a scar forms and the trajectory of the wound healing for certain load-bearing wounds of really big deal, right? Think of your abdomen if you had to go in there and hurt those muscles or hernia. And there are many things like this and so if, and I want to be very careful to say if if it was founded, electrical interventions can affect that type of healing in a way that produces a useful outcome, right? Much better scar developments so that your load bearing properties are [00:23:00] maybe not as good as the original, but a lot better than just letting it sit around with a dressing. That'll be a very big deal. But that's a very big space, right? Speaker 4: And that's why we split it into this in Vivo work on monitoring the surface and wound properties and in vitro work where we have cells and tissues and culture where we can directly stimulate them in culture in a very controlled environment and watch exactly how they respond to different shapes of fields and types of fields and come up with a way of describing how they behave. That doesn't require the Nvivo work. So we have two parallel tracks [00:23:30] right now and hopefully we can put them together. Speaker 5: [inaudible] be sure to catch part two of this interview with Michelle Maha Urbis and Daniel Cohen on the next spectrum in two weeks. In that interview, Michelle and Daniel talk about the limitations of sensors on or in humans, the ethics of sensing and inputs into living systems and moving research discoveries Speaker 8: into startup companies. Spectrum shows are [00:24:00] archived on iTunes university. We've created a simple link to get you there. The link is tiny url.com/k a l ex spectrum. We hope you can get out to a few of the science and technology events happening locally over the next two weeks. Renee Rao and Rick Karnofsky present the calendar Speaker 9: nerd night east space first show of 2014 will be happening January 27th the show features three great Speakers. [00:24:30] First nerd night, San Francisco alum, Bradley boy tech. We'll guide you through how scientists organize and present some of the vast amounts of data available today. Then the Chabot space centers, Benjamin [inaudible] will discuss the most likely places to find life off of planet earth. Of course, finally KQ Eighties Lisa Allah Ferris will tell you what you need to know about Obamacare. The show will be held this Monday, the 27th at the new Parkway Theater in Oakland. Doors open at seven to get tickets for the HR event. [00:25:00] Go to East Bay nerd night, spelled n I t e.com this February 2nd the California Academy of Sciences will host a lecture on the Ice Age Fonda of the bay area. There's a good chance that wherever you happen to be sitting or standing is a spot where Colombian mamis giants laws direwolves, saber tooth cats and other megafauna. Also Rome during the ice age. Learn about the real giants of San Francisco and how you can embark upon [00:25:30] a local journey to see evidence of these extraordinary extinct animals. The lecture will be held@theacademyonfebruarysecondfromninefortyfiveamtotwelvepmticketsareavailableonlineatcalacademy.orgSpeaker 8: February's East Bay Science cafe. We'll be on Wednesday the fifth from seven to 9:00 PM at Cafe Val Paris, CEO 1403 Solano in Albany, Dr. Harry Green. We'll discuss his book [00:26:00] tracks and shadows field biology as art green, a herpetologist at Cornell blends personal memoir with natural history. He'll discuss the nuts and bolts of field research and teaching how he sees science aiding and in conservation and appreciation of nature, as well as give many tales about his favorite subject. Snakes. For more information about this free event, visit the cafes page on the website of the Berkeley Natural History Museum at BN [00:26:30] h m. Dot berkeley.edu/about/science cafe dot PHP. A feature of spectrum is to present news stories we find interesting. Rick Karnofsky and Rene Rao present our news in a letter published in January 15th nature. James us or would a locomotor biomechanist at the Royal Veterinary College at the University of London and colleagues explain why Birds Migrate In v-shaped [00:27:00] formations. The team fitted several northern bald ibis is with gps trackers and accelerometers to measure wing movement. They found that the birds positioned themselves in optimum positions that agree with their aerodynamic models. Further the birds flap in phase with one another when in such permissions instead of the antifreeze flapping, they performed when following immediately behind each other. This in phase flapping maximizes lifted the plot [00:27:30] and is surprising as a team noted. The aerodynamic accomplishments were previously not thought possible for birds because of the complex flight dynamics and sensory feedback that would be required to perform such a feat. Speaker 9: The tenuous place in the human family tree of artifice guest room, it is a 4.4 million year old African primate has recently been solidified. Fossil remains Ardipithecus Ramidus or rd as a species is known first discovered by UC Berkeley [00:28:00] Professor Tim White and his team in Ethiopia in the 1990s and have proven a consternation to classify ever sense rd displays an unusual mixture of human and ape traits. Fossils reveals small human like teeth and upper pelvis adapted to bipedal motion, but a disproportionately small brain and grasping large toes, best suited for climbing trees. Scientists split over whether rd was our distant relative, essentially an ape that retained a few human features from along a common ancestor [00:28:30] or our close cousin, possibly even an ancestor. Recently Tim white among many others coauthored a paper with Arizona State Universities, William Kimball in which they successfully linked the rd to Australopithecus and thereby to humans. The team examine the basis of rd skulls and found surprising similarities to human and Australopithecines skulls indicating that those had already been may have been small. It was far more similar to a hominids than an apes Speaker 7: in in Speaker 9: [00:29:00] the music heard during the show was written and produced by Alex Simon. Speaker 1: Thank you for listening to spectrum. We are happy to hear from listeners. If you have comments about the show, please send them to us via email. Our email address is spectrum dot k a l ex hate yahoo.com. [00:29:30] Join us in two weeks at this same Speaker 10: hi [inaudible]. Hosted on Acast. See acast.com/privacy for more information.

Michel Maharbiz & Daniel Cohen. Michel is an Assoc Prof with EECS-UCB. His research is building micro/nano interfaces to cells and organisms: bio-derived fabrication methods. Daniel received his PhD from UCB and UCSF Dept of Bioengineering in 2013.TranscriptSpeaker 1: Spectrum's next. Speaker 2: Okay. Speaker 1: Welcome to spectrum the science and technology show on k a l x Berkeley, a biweekly 30 minute [00:00:30] program bringing you interviews featuring bay area scientists and technologists as well as a calendar of local events and news. Speaker 3: Hi and good afternoon. My name is Brad Swift. I'm the host of today's show. Today we are presenting part one of two interviews with Michelle and Harb is and Daniel Cohen. Michelle is an associate professor with the Department of Electrical Engineering and computer science at UC Berkeley and the Co director of the Berkeley Sensor and actuator center. [00:01:00] His current research interests include building micro and nano interfaces to cells and organisms and exploring bio derived fabrication methods. Daniel Cohen received his phd from the Joint UC Berkeley and UCLA Department of bioengineering program in 2013 his phd advisor was Michelle Ma harvests. Together they have been working on the fronts project and NSF f Free Grant [00:01:30] F re stands for emerging frontiers and research and innovation fronts is the acronym for flexible, resorbable, organic and nanomaterial therapeutic systems. In part one of our interview, we discuss how they came to the challenge of measuring and understanding the so-called wound field. Here's part one, Michelle [inaudible] and Daniel cone. Welcome to spectrum. Thank you. Thanks. How was it that [00:02:00] electrical fields generated by wounds was discovered? So I think Daniel should take this one cause he's the, he's the group historian on this topic. In fact, he gave us a little dissertation during this thesis talk Speaker 4: in the day when electricity was sort of still a parlor trick. There was a lot of work being done to try to figure out where it was coming from. There was a lot of mysticism associated with it. And this is in the mid to late 17 hundreds and so Galvani is a name most people have heard. Galvanism was a term [00:02:30] coined for his work and what he found was all the work with frog legs. So he used to dissect frogs and could show that if you had dissimilar metals in contact with different parts of the muscle and the nerves, the legs with twitch and amputate the frog leg. So his conclusion was that electricity had something to do with life and their living things were made alive by having this spark of life. And this was a really super controversial idea because for a long time there had been a philosophical debate raging about vitalism versus mechanism, which is the idea that all living things are special because of some intrinsic vital force versus the idea [00:03:00] that physical principles explain life. Speaker 4: So the vitalist really liked this idea that electricity is the spark that makes living things special. There's a lot of dispute about this, but eventually Volta who is right after him and who the vault is named after showed that it was really just the movement of ions and things in salt solutions, but it was a little too late and the mystical aspect of this had come along. So the problem then was that this idea prevailed into the early 18 hundreds and so Galvani his nephew Aldini started doing [00:03:30] these experiments in England where he was given permission to take executed criminals and basically play with the corpses and he was able to create a corpus that would go like this. And raise an arm or wink an eye at an audience. And this was the idea of the reanimated corpse. So people were having a lot of fun with this, but it wasn't clear that it wasn't mystical. Speaker 4: And so this is the long answer to the question, but that's the backdrop where the science starts to come in. So the first thing is Frankenstein gets published out of this, and everybody's getting into the whole vitalism idea [00:04:00] at this point. And Frankenstein was written as a part of a horror story competition. It was almost a joke. But the funny thing is Frankenstein. Well, how would you say Frankenstein? The monster came to life to lightning? Like that's a line. It wasn't a Hollywood fabrication and everyone assumed that. But Mary Shelley never wrote anything about lightning or electricity. She in fact, wrote the technology was too dangerous to describe in texts for the average person. But in her preface, she explains that the whole origin of this idea, and this is where the answer to the question comes from, was that [00:04:30] she had writer's block when she was writing the story and she overheard her husband Percy Shelley and Lord Byron having an argument about work done by Erasmus, Darwin and Erasmus. Speaker 4: Darwin was a big natural philosopher or scientist at the time who was a big vitalist. So he's really into the idea of the spark of life and also this idea of spontaneous generation that where does life come from when you have a compost heap, fruit flies appear. There was an idea that be composing garbage produced life, and that was part of spontaneous generation. And he did a lot of experiments where he'd seal things like wet flour into a bell jar [00:05:00] and to show that organisms came out in a sealed environment and they just didn't know about microorganisms and things like that. So he did a famous experiment where he dehydrated some species called Vermicelli all. Sorry, I made the mistake. I'm about to talk about 40 cello, which is a little organism. And when he added water again, they came back to life. Now, Lord Byron and Percy Shelley didn't understand any of this, and the conversation that Mary Shelley eavesdropped on was one where they said that Erasmus Darwin had taken Vermicelli Pasta, put it inside the Bell Jar, sealed [00:05:30] it, and through some magic of his own allowed it to twitch. Speaker 4: So he had essentially given life to pasta. Now Mary Shelley wrote that she didn't believe any of this was actually really what happened. But this idea of animating the inanimate gave her the idea for Frankenstein. Then she writes the one line that links it to electricity, which is, and if any technology would have done this, it would probably have been galvanism, which is this idea of applying electricity to something. And so that's where this whole idea of life and electricity came from. By that point, the scientists had finally [00:06:00] caught up with all the mysticism and started to do more serious experiments, and that's when Carlo met Tucci in 18 and 30 something found that when you cut yourself, there's some sort of electrical signal at the injury source. And that was his main contribution that was called the wound current or the wound field and then after him was the guy who really formalized the whole thing, which was do Bob Raymond, who was a German electrophysiologist who found that if you have any sort of injury, he could actually measure a current flowing at the side of the injury. Speaker 4: He could show that that changed over time. He cut his own thumb and [00:06:30] measured the current flow and they didn't have an explanation for why it happened, but they knew that it had something to do with the electric chemistry there. This was the birth of electrophysiology and then he went off and did all these things with action potentials in neurons, which is why almost no one's heard about this injury side and the fact that electricity's everywhere in the body normally and it's not mystical, it's electrochemical. We're much more familiar with the neural stuff and this other stuff on the wound side sort of languished until maybe the late 19 hundreds because it was rare. It was weird. It wasn't clearly important [00:07:00] and a lot of the players involved were so caught up in all sorts of other things that we tend to forget about this. So that was the whole long winded history of where the wound field came from. But it's a good story. It is a good story. Yeah. Speaker 5: [inaudible] you are listening to spectrum KALX Berkeley. Our guests are Michael ml harvest and and Daniel Colon. They're both bioengineers in the next segment they talk about the genesis of the fronts [00:07:30] project. Speaker 6: Michelle, when you approached the NSF yeah. For a grant for this idea, how long had you been thinking about it? The smart bandage idea, how far down stream were you with the idea? We had been toying with the idea for quite some time and there's a bit of background to this as well. So my group amongst other things builds flexible electrode systems. [00:08:00] You can call them for neuroscience in your engineering, and most of those systems are intended to record electrical signals across many different points across many electrodes usually honor in the brain. And so we had this basic technology lying around. This is sort of a competence that the group has had for quite awhile. The other thing that was beginning to intrigue us, and I have to credit Daniel for sort of beginning of the discussions and kind of pushing this along in the early years, so Daniel and I have like a tube man club of sitting around thinking of crazy things and [00:08:30] one of the things that Daniel had been interested in was the idea of resorbing or having so some of the materials disappear as they do their job in the body and this is a notion that's become very popular recently actually over the last couple of years in into community in the engineering community in general. Speaker 6: Which brings us to another question I had, which is the difference between resorptionSpeaker 4: and absorption. Absorption might imply that you're taking the components up and they're becoming part of the body. Resorption is really just a very strange [00:09:00] semantic term. That means something like the body's breaking it down or it's breaking down in some form and it's not really the same as that material winding up elsewhere in your tissues. It may just get excreted or it may go somewhere else. So really we use it when we don't really know what's going on. Yeah, we had been looking at this general area and then I think the last piece of the puzzle, I think in our minds looking at the extant literature, the idea that we could take meaningful electrical data from a wound began to really interest us. And so the [00:09:30] two parts of this really are one, can you use portable, resorbable systems? Something like a bandage, you know, something that that isn't going to require you to walk around with a handcart. Speaker 4: Can you use systems like this to measure electrical signals that are relevant to wounds? And then the other question is if you can do that, and if you have, you know, you learn about this, and by the way, we're not the first people to try to do this. There are a number of people that have been measuring electrical signals in the wounds as Daniel set for quite some time. If you can do this, is there a value to [00:10:00] trying to control or modulate that electrical information or those fields or those currents in the wound? Is there a therapeutic value? Perhaps there are scientific value. Is there something you can learn about the way the body works or tissue works? Both of those are open questions and you know we can delve into each of those, but those are really kind of how we think about them separately a little bit. Speaker 4: The flip side is that when we do a lot of this kind of design for medical things, you will want to know what's already happening and how the body handles its own injuries. And this field doesn't just arise passively. So they had no way of knowing [00:10:30] this when it was first discovered. But when you get this electric field, there is a navigational effect for incoming cells to the injury. So it actually helps guide things in like a lighthouse to the wound site. And so a lot of my phd work was showing how you can steer ourselves with a controlled electric field so you can really hurt them like sheep based on how the electric field goes. And that means that that was a source of this bio inspired part of it, which is we're not adding something that's not already there. We're taking something that's already there and we're modulating it to maybe improve. Speaker 4: [00:11:00] So evolutionary tools or things that the body has, it just happened to work well enough for us to survive as a species. It doesn't mean it's optimized and this field tends to go away very quickly. Nobody really knows whether extending the duration of the field would improve the healing or if we could shape it. Maybe you can control how scar tissue forms and things like that. So there's this idea of looking at how the body already heals itself and then figuring out where you might start to control it. And electricity is one of the areas that's really been under utilized in medical technology for the sort of thing. Yeah. I think for those of your audience [00:11:30] that are sort of tech junkies, if you will, the resurgence of this type of thing. Occurrent Lee I think arises because we've gotten very good at building very low power, very small electronics, and there's been a whole slew of new polymers and sort of new flexible substrates that are also conductive or can hold conductors. And so those two things together rekindled interest and trying to build gadgets that sit Speaker 6: on the skin. Or in the NSF case, we're not only doing the skin, but we're trying to develop a tool longterm [00:12:00] for surgeons to do something inside the body. So it'd be nice to be able to leave something that will help you heal, but then it'll be resorts so you don't have to reopen. Right. Speaker 5: Spectrum is a public affairs show on k a l x Berkeley. Our guests are Michelle. My heart is in Daniel Cohen of UC Berkeley. They want to build a smart bandage for wounds. In the next segment, they talk about the focus of their research. Speaker 6: [00:12:30] So in your approach to the NSF, was there some sort of focus, there's a technological focus and an application focus? The technological focus for the NSF was to point out that there was a lot of fundamental engineering science that had to be done to produce the type of systems that could do this. You know, we're looking at resorbable batteries are real parts wise, how you would build these systems, what polymers you'd use, what the rates of resorption. There's a lot of just fundamental stuff going on. If you posit that there'll be value to [00:13:00] these kinds of things. That's one focus as the other focus. I would say application wise we're looking at two things. The most ambitious is that you could develop systems that a surgeon could use for internal wounds. So the dream is a surgeon is, for example, let's say you have to resect the part of your intestine. Speaker 6: You then have to fuse the two parts that are left behind. There are methods for doing this and there's still research going on into what we know. The clinical methodology for this. It would be very useful if you could leave behind something that [00:13:30] could tell you, if nothing else, the state of how that is healing but would then go away because you're certainly not going to go back and open somebody's abdomen to take out a little piece of sensor that was doing something to intestine. Right? That'd be a not a good idea, and so that idea, that dream that you could leave behind, very small, very thin things that could take data if nothing else. Take data is really what was one of the applications. The other one is surface wounds. There are lots of surface wounds caused by illness. For example, advanced diabetes produces a [00:14:00] lot of problems in the extremities and wounds that are chronic that don't heal very well. Speaker 6: There's just a lot of ongoing interest in surface wounds and not just the technologies for understanding how they may be healing, but in things that maybe could help heal those surface wounds. Those are our full side view welders. I think of them as there are specific things we want to show we can do with our partners at UCLA, but there's also an entire wealth of engineering science that has to be done to build the fundamental. So the NSF was okay with that broad [00:14:30] a portfolio of research. Well, so that's sort of what their mandate is to go broad like that. Cause that seems like you're, you're doing stuff. Speaker 4: I think their main concern here is that they specifically discourage healthcare applications as NIH can fund those. But the difference is that what engineers have found for a long time now is that we don't actually know how to engineer biology. So any technology brings quantification Speaker 6: and an engineering mindset to solving this, like tissue engineering, growing organs. We don't have a lot of engineering for that. But if we start [00:15:00] to monitor everything we can, that chemical signals mechanical, electrical, we build up a set of stimulus and response type rules. We understand how to perturb these systems. So in the same way that you might build a bridge according to a manual of how you build a bridge and how you look at the loads in it and the ways of building a bridge, we might someday build organs. So if that's the pitch, that's much more fundamental science and that's really where it has a medical application. But we can't do it without science and engineering principles that just don't exist right now. There's two points I should mention. First of all, the key is this work [00:15:30] is really looking at the fundamentals of the engineering and the science. Speaker 6: We certainly have our foot into clinical side because I think it informs some of this, right? So that what you're doing is relevant so that someday you could go down that path so you're not in isolation because if you're not assuming that you're headed in this great direction. Exactly. And then you find clinical guys saying less clinically. Right. So the other were very good. And the second thing is that, um, we're funded under a slightly broader grant mechanism than usual. So we have a, what's called an NSF. Every, I think this is emerging frontiers and research and innovation I think [00:16:00] is what it is and these are sort of headline or marquee type thing. So we're very lucky that we were awarded one of these and so I think the NSF has really looking for this broad, far reaching hard-hitting effort. I think there's a good point to mention that this project is really a big collaboration between a number of us and I'd like to mention who they are because some of the material work has done by very talented people in the department on a rds and the Vec Subramanian are two professors in the ECS department and they're very well known for flexible printed systems and [00:16:30] the materials that go into them and we work also with Shovel Roy at UCF and Mike Harrison and Mike is a sort of brilliant pediatric surgeon and shovel. Speaker 6: Roy's well known for the technologies he builds at the interface with clinical need. It's really the fact that all these people come together that we're building all of these tools. Speaker 7: [inaudible]Speaker 3: spectrum is a science and technology show on KALX Berkeley. We are talking with Michelle Mull Harvest Daniel Cohen. [00:17:00] They are researching the electrical field that is generated by wounds in mammals. Their hope is to collect meaningful data from sensors embedded in bandages placed on wounds. Speaker 6: If you approached interpreting and analyzing the electrical field data that you're getting out of the wounds in an animal right now we're being very cautious. We started a first few experiments with rodents over the last six months. What we've [00:17:30] built is a, is a series of systems. You can think of them as insulators with lots of little electrodes all over them. An array of of little electrodes. They're on order of a centimeter or less in terms of you can think of a postage stamp, maybe a bit smaller. We have different varieties of them. Some are stiff, some are very flexible. You can think of it as contact lenses or transparency paper, that kind of thing. And these arrays are connected to electrical sensing equipment. There's a miniaturize a little board that runs everything [00:18:00] and sends data to a block and all this data is collected and what we're currently looking at as a variety of different signals on both open wounds. Speaker 6: So if I, for example, cut the skin and on pressure wounds, pressure wounds or something that people that don't see clinics very often or hospitals aren't familiar with but in fact are huge, huge problem in hospitals right now. Then we lay these arrays over the tissue and we measure a variety of different things. One thing we measure what's known as electrical impedance between different [00:18:30] points on the array and you can think of electrical impedance as how much resistance to an electric current that tissue might produce. It's not a steady current, it's a time bearing current, so we sort of wiggle the current on and off, on and off negative, positive, negative, a sinusoidal and how quickly that current responds and how much of it there is. That allows us to calculate the impedance and there's a lot you can tell from that. You can tell whether things are very wet and conductive. Speaker 6: You can tell whether the tissue is tight knit, so that doesn't let things through a oily. You can tell whether there [00:19:00] might be changes in from one tissue to another. You can infer things about what tissues are might be underneath. The other thing we measure is actually electric potential when the wounds are immediately after they're made. We try to look at what kind of potentials arise and how they're changing. So right now that's in terms of measurement. That's really what we're looking at it. And another thing I should point out as we do these measurements as a function of frequency across a wide range of frequency spectrum up to hundreds of kilohertz. And that's sort of the rapidity with which we wiggle the signal because different components in the tissue [00:19:30] will respond differently at different legal frequencies. Once we have that complete plot, we can look at the difference between them and by to see whether we can build models that tell us, oh well we've, you see this type of distribution. Speaker 6: There's a in tech skin for example. So the dream, in this case, you put your bandaid on and your doctor checks his eye, his or her iPhone every 12 to 24 hours and just gets a different little map of how it's working without ever having to remove the dressing. How are you doing in understanding what those signals mean in terms of healing? [00:20:00] But we just had a meeting, they're doing great. They've basically collected a great deal of data on the latest set of wounds they did and now they're in fact proposing models and seeing how the data fits. They're fitting their models to the data to try to use those fits as ways of discriminating different types of tissues. So we're in the middle of it right now. I couldn't tell you much. We're still putting all that story together for publication. So, and are you able to leverage the work that other people are doing? Oh, absolutely. Sure. Well, I mean you always do that. Like I said, nothing is in a vacuum, right? So absolutely. We follow [00:20:30] the literature and, and we build off of what other people have found and try to add our own contributions. That's, that's how it works. Maybe these ideas came from discoveries from the 18 hundreds and then later on in the 1980s onwards, a bunch of really good developmental biologists have really pioneered a lot of this and gone down as, as showing that Speaker 4: even in an embryo you can detect changes in electrical potential at the surface of the embryo where limbs will form and things like that. So there's a huge amount of stuff out there that gave us the idea for the original thing, but we're barely scratching the surface. [00:21:00] We were technologist, right? We're engineers. So part of one thing and figure it out. Yeah. So the idea of trying to analyze the wound field data, do you have to solve that problem first before you can take on anything else? Like trying to instigate the healing? Yeah. Yeah, I would say so. You would never put this in the body without knowing, knowing that a real lot works. But on the surface it's a different healing mechanism than say a fracture, but it's still the idea that we don't necessarily know what the cause and [00:21:30] effect is yet. So we have to show that getting a field out relates to some state that we can say the wound is in and that we can intelligently put a field back in that actually helps. So we need some metric of success. And without that metric, that number that says the wound is doing better or worse, we're not confident saying that our stimulation is helping. So that's why getting this data first is really important. Speaker 6: The parameter space is fairly large, right? To number of things you could possibly change. Some of the effects are very subtle. And so just willy nilly going [00:22:00] in there and saying, oh, I applied some fields, you know, likely not gonna be very useful. And then there's another subtlety, which is that there are probably clinical contexts in which this is of limited utility, even if it works. And so that is, uh, something we spend a lot of time thinking about. So let me give you an example. Let's say I told you I can make that little cut on your knees heal 5% faster with a $15 bandaid. I'm pretty sure you're not going to buy a $15 [inaudible] except maybe once for the novelty of it. You know it tickles. But [00:22:30] there are contexts where, and Daniel alluded to this earlier, for example, scar formation is a big deal, right? Speaker 6: How a scar forms and the trajectory of the wound healing for certain load-bearing wounds of really big deal, right? Think of your abdomen if you had to go in there and hurt those muscles or hernia. And there are many things like this and so if, and I want to be very careful to say if if it was founded, electrical interventions can affect that type of healing in a way that produces a useful outcome, right? Much better scar developments so that your load bearing properties are [00:23:00] maybe not as good as the original, but a lot better than just letting it sit around with a dressing. That'll be a very big deal. But that's a very big space, right? Speaker 4: And that's why we split it into this in Vivo work on monitoring the surface and wound properties and in vitro work where we have cells and tissues and culture where we can directly stimulate them in culture in a very controlled environment and watch exactly how they respond to different shapes of fields and types of fields and come up with a way of describing how they behave. That doesn't require the Nvivo work. So we have two parallel tracks [00:23:30] right now and hopefully we can put them together. Speaker 5: [inaudible] be sure to catch part two of this interview with Michelle Maha Urbis and Daniel Cohen on the next spectrum in two weeks. In that interview, Michelle and Daniel talk about the limitations of sensors on or in humans, the ethics of sensing and inputs into living systems and moving research discoveries Speaker 8: into startup companies. Spectrum shows are [00:24:00] archived on iTunes university. We've created a simple link to get you there. The link is tiny url.com/k a l ex spectrum. We hope you can get out to a few of the science and technology events happening locally over the next two weeks. Renee Rao and Rick Karnofsky present the calendar Speaker 9: nerd night east space first show of 2014 will be happening January 27th the show features three great Speakers. [00:24:30] First nerd night, San Francisco alum, Bradley boy tech. We'll guide you through how scientists organize and present some of the vast amounts of data available today. Then the Chabot space centers, Benjamin [inaudible] will discuss the most likely places to find life off of planet earth. Of course, finally KQ Eighties Lisa Allah Ferris will tell you what you need to know about Obamacare. The show will be held this Monday, the 27th at the new Parkway Theater in Oakland. Doors open at seven to get tickets for the HR event. [00:25:00] Go to East Bay nerd night, spelled n I t e.com this February 2nd the California Academy of Sciences will host a lecture on the Ice Age Fonda of the bay area. There's a good chance that wherever you happen to be sitting or standing is a spot where Colombian mamis giants laws direwolves, saber tooth cats and other megafauna. Also Rome during the ice age. Learn about the real giants of San Francisco and how you can embark upon [00:25:30] a local journey to see evidence of these extraordinary extinct animals. The lecture will be held@theacademyonfebruarysecondfromninefortyfiveamtotwelvepmticketsareavailableonlineatcalacademy.orgSpeaker 8: February's East Bay Science cafe. We'll be on Wednesday the fifth from seven to 9:00 PM at Cafe Val Paris, CEO 1403 Solano in Albany, Dr. Harry Green. We'll discuss his book [00:26:00] tracks and shadows field biology as art green, a herpetologist at Cornell blends personal memoir with natural history. He'll discuss the nuts and bolts of field research and teaching how he sees science aiding and in conservation and appreciation of nature, as well as give many tales about his favorite subject. Snakes. For more information about this free event, visit the cafes page on the website of the Berkeley Natural History Museum at BN [00:26:30] h m. Dot berkeley.edu/about/science cafe dot PHP. A feature of spectrum is to present news stories we find interesting. Rick Karnofsky and Rene Rao present our news in a letter published in January 15th nature. James us or would a locomotor biomechanist at the Royal Veterinary College at the University of London and colleagues explain why Birds Migrate In v-shaped [00:27:00] formations. The team fitted several northern bald ibis is with gps trackers and accelerometers to measure wing movement. They found that the birds positioned themselves in optimum positions that agree with their aerodynamic models. Further the birds flap in phase with one another when in such permissions instead of the antifreeze flapping, they performed when following immediately behind each other. This in phase flapping maximizes lifted the plot [00:27:30] and is surprising as a team noted. The aerodynamic accomplishments were previously not thought possible for birds because of the complex flight dynamics and sensory feedback that would be required to perform such a feat. Speaker 9: The tenuous place in the human family tree of artifice guest room, it is a 4.4 million year old African primate has recently been solidified. Fossil remains Ardipithecus Ramidus or rd as a species is known first discovered by UC Berkeley [00:28:00] Professor Tim White and his team in Ethiopia in the 1990s and have proven a consternation to classify ever sense rd displays an unusual mixture of human and ape traits. Fossils reveals small human like teeth and upper pelvis adapted to bipedal motion, but a disproportionately small brain and grasping large toes, best suited for climbing trees. Scientists split over whether rd was our distant relative, essentially an ape that retained a few human features from along a common ancestor [00:28:30] or our close cousin, possibly even an ancestor. Recently Tim white among many others coauthored a paper with Arizona State Universities, William Kimball in which they successfully linked the rd to Australopithecus and thereby to humans. The team examine the basis of rd skulls and found surprising similarities to human and Australopithecines skulls indicating that those had already been may have been small. It was far more similar to a hominids than an apes Speaker 7: in in Speaker 9: [00:29:00] the music heard during the show was written and produced by Alex Simon. Speaker 1: Thank you for listening to spectrum. We are happy to hear from listeners. If you have comments about the show, please send them to us via email. Our email address is spectrum dot k a l ex hate yahoo.com. [00:29:30] Join us in two weeks at this same Speaker 10: hi [inaudible]. See acast.com/privacy for privacy and opt-out information.

Da man sich den negativen Auswirkungen der totalen sowie partiellen Meniskektomie bewusst ist, wird seit mehreren Jahren nach einem geeigneten Ersatzmaterial für geschädigtes Meniskusgewebe gesucht. Bisher konnte allerdings keines der getesteten Materialien das Meniskusgewebe zufriedenstellend ersetzen. Daher war es Ziel der vorliegenden Studie, ein neuartiges Scaffold auf seine Fähigkeit geschädigtes Meniskusgewebe zu ersetzen zu untersuchen. Das getestete Scaffold wurde aus Seidenfibroin, einem Hauptbestandteil der Seide der Seidenspinnerraupe Bombyx mori, hergestellt. Viele Materialien aus Seide konnten bereits in anderen Einsatzgebieten durch ihre gute Biokompatibilität sowie durch hervorragende mechanische Eigenschaften überzeugen. Voruntersuchungen der neuartigen Seidenfibroin-Scaffolds zeigten eine durchschnittliche Porengröße von > 100 μm. Zusätzlich konnten in vitro geeignete mechanische Eigenschaften für den Meniskusersatz sowie eine gute Biokompatibilität der Scaffolds nachgewiesen werden. Daher sollte in der vorliegenden Studie in vivo am Schafmodell getestet werden, ob die Seidenfibroin-Scaffolds auch im Kniegelenk biokompatibel sind, ob sie eine ausreichende mechanische Stabilität aufweisen und ob sie die Entstehung degenerativer Knorpelveränderungen verzögern können. Am medialen Meniskus wurde eine partielle Meniskektomie durchgeführt und die Seidenfibroin-Scaffolds in den Meniskusdefekt implantiert. Es gab zwei Scaffold-Gruppen mit unterschiedlichen Untersuchungszeiträumen. In einer Gruppe betrug die Implantationszeit drei Monate. Das Hauptaugenmerk lag in dieser Gruppe auf möglichen Immunreaktionen gegen das Scaffold. In der anderen Scaffold-Gruppe betrug die Implantationszeit sechs Monate. Als orientierende Vergleichsgruppen wurde eine Tiergruppe shamoperiert, bei einer anderen wurde eine Teilresektion durchgeführt. Der Untersuchungszeitraum dieser beiden Gruppen betrug ebenfalls sechs Monate. Im Vergleich der drei Sechsmonatsgruppen war es möglich die Auswirkungen der Scaffoldimplantation auf die Gelenkgesundheit zu beurteilen. Je Versuchsgruppe wurden 9-10 Tiere operiert. Durch makroskopische, histologische und immunchemische Untersuchungen von Gelenkkapsel, Meniskus und Scaffold sowie Gelenkflüssigkeit wurde die Biokompatibilität der Scaffolds im Kniegelenk überprüft. Die histologischen Untersuchungen der Scaffolds ließen Aussagen über die Bioaktivität und das Einwachsverhalten der Scaffolds zu. Mit makroskopischen, biomechanischen und histologischen Untersuchungsmethoden wurde der Degenerationsgrad des artikulären Knorpels bestimmt, um mögliche chondroprotektive Eigenschaften der Scaffolds zu ermitteln. Zusätzlich wurden Scaffold- und Meniskusproben biomechanisch untersucht. So konnte überprüft werden, ob die Scaffolds vor sowie nach Implantation aus mechanischer Sicht geeignet sind, verletztes Meniskusgewebe adäquat zu ersetzen. Die Ergebnisse dieser Studie zeigen, dass die Seidenfibroin-Scaffolds durchaus Potential für die Anwendung als Meniskusteilersatz haben. Die Biokompatibilität der Scaffolds konnte bestätigt und eine Schädigung des Gelenkknorpels durch die Scaffoldimplantation ausgeschlossen werden. Außerdem scheinen die Scaffolds das Auftreten degenerativer Knorpelveränderungen, wie sie nach partieller Meniskektomie zu beobachten sind, verzögern zu können. Vor Implantation wiesen die Scaffolds eine geringere Steifigkeit auf als das native Meniskusgewebe. Im Laufe der Implantation nahm die Steifigkeit der Scaffolds allerdings zu und unterschied sich nach sechs Monaten nicht mehr signifikant von der Steifigkeit des Meniskus. Auf lange Sicht scheinen die Scaffolds demnach das Meniskusgewebe mechanisch ersetzen zu können. Dies ist besonders wichtig, da die Seidenfibroin-Scaffolds einen dauerhaften Meniskusersatz darstellen und nicht wie andere Materialien einer raschen Resorption und Substitution durch Regenerationsgewebe unterliegen. Allerdings zeigte sich in dieser Studie auch, dass die Fixation der Scaffolds nicht in allen Fällen erfolgreich war. Zudem fand während der Implantationszeit keine Integration der Scaffolds in das Meniskusgewebe statt. Meniskusnah waren zwar einige Scaffoldporen mit Zellen und Bindegewebe gefüllt, eine bindegewebige Verwachsung zwischen Scaffold und Meniskus war hingegen weder nach drei- noch nach sechsmonatiger Implantation zu sehen. Veränderungen der Poreninterkonnektivität, der Porengröße sowie der Fixierbarkeit sind daher vor einem weiteren Einsatz der Scaffolds notwendig. Zudem sollten in einer weiteren in vivo Studie die chondroprotektiven Eigenschaften der Seidenfibroin- Scaffolds über einen längeren Zeitraum untersucht werden.

Eine ausreichende Versorgung mit wichtigen Nährstoffen, besonders im Kindesalter, ist von großer Bedeutung für die Gesundheit und die Leistungsfähigkeit. Bei Kindern und anderen Bevölkerungsgruppen bestehen immer noch Nährstoffdefizite, vor allem bei den essentiellen Spurenelementen Eisen und Jod. Eine ungenügende Zufuhr kann zu körperlichen und intellektuellen Schädigungen und Einschränkungen der betroffenen Personen führen. Somit kommt einer adäquaten Eisen- und Jodaufnahme über die Nahrung eine wichtige Bedeutung zu. Die folgende Untersuchung hat zum Ziel in einer Querschnittsuntersuchung die Versorgungslage mit den Mikronährstoffen Eisen und Jod bei 6-7jährigen Schulanfängern in Raum Erlangen zu dokumentieren. Neben der Erfassung der alimentären Jodzufuhr, wird anhand von laborchemischen Parametern überprüft, ob die verbesserte Gesetzgebung für die Verwendung von Jodsalz bei der Herstellung und Verarbeitung von Lebensmitteln sowie jodierten Futter-Mineralstoffmischungen und dadurch stetig zunehmenden Gehalt an Jod in der Nahrung sowie nationale Aufklärungsmaßnahmen zur Schließung der Bedarfslücke und Deckung des Jodbedarfes auch in dieser Region führen. Ein weiterer Schwerpunkt stellt auch die Qualität der Eisenversorgung sowie die Auswirkungen familiärer Gewohnheiten im Hinblick auf den Verzehr von Jodsalz und mit Jodsalz hergestellten Brot und Backwaren dar. Bislang liegen nicht genügend Daten für die Beurteilung der Bedeutung der sTfR als Indikator für einen Eisenmangel bei Kindern vor. Deshalb wird diagnostische Bedeutung der Rezeptoren zur Ermittlung der Prävalenz möglicher Eisendefizite in einer gesunden Population von Schulanfängern im Vergleich zu konventionellen Eisenparametern untersucht. Altersspezifische Referenzwerte werden sowohl für sTfR als auch für den Quotienten sTfR:Ferritin erstellt. Im Schuljahr 1997/98 wurden an 16 Erlanger Grundschulen 427 Schulanfänger im Alter von 6 und 7 Jahren sowie ein Teil deren Familienangehörige rekrutiert. Anthropometrische Daten zu Körpergröße und Körpergewicht sowie zur Körperzusammen-setzung wurden im nüchternen Zustand von 408 Schülern ermittelt. Zur Erfassung der täglichen Energie- und Nährstoffzufuhr wurde von 168 Schulanfängern bzw. durch deren Eltern ein auswertbares 3-Tage-Wiegeprotokoll (Sonntag bis Dienstag) angefertigt sowie der Fragebogen zu den Ernährungsgewohnheiten von 278 Familien beantwortet. Zur Validierung des Ernährungserhebunginstruments wurde von 28 Kindern eine Duplikatsammlung durchgeführt. Für die Analyse der Konzentrationen verschiedener biochemischer Serum-parameter der Eisen- und Jodversorgung wurde auf freiwilliger Basis bei 181 Kindern venöses Blut im nüchternen Zustand entnommen. 207 Kinder gaben eine Spontanurinprobe im nüchternen Zustand zur Bestimmung der Jodidausscheidung ab. Die Bestimmung der Eisen- und Jodstoffwechselparameter erfolgte nach standardisierten Analysenmethoden. Die löslichen Transferrinrezeptoren (sTfR) wurden mittles partikel-verstärktem Immuno-nephelometrischem Assay „N Latex sTfR“ automatisch analysiert. Nach dem Body Mass Index sind 7 % der Erlanger Schulanfänger als übergewichtig und ca. 4,2 % als stark übergewichtig einzustufen. Die mittlere Energiezufuhr der Erlanger 6-7jährigen liegt im Mittel bei den Jungen um – 6,3 %, bei den Mädchen um – 3,9 % unterhalb der Richtwerte für die Nährstoffzufuhr der Deutschen Gesellschaft für Ernährung (DACH 2000). Während die Versorgung mit Vitamin C und B12 durchschnittlich die Empfehlungen der DACH überschreitet, liegen Jod, Folat-Äquivalent und Calcium (vor allem bei den Mädchen) deutlich unterhalb der Empfehlungen. Dies resultiert aus einer durchschnittlich zu niedrigen Zufuhr an Milch und Milchprodukten sowie durch eine zu geringe Zufuhr an Gemüse und Obst. Die Serumkonzentrationen für Folat und Vitamin B12 liegen noch im Bereich der Norm. Die Zufuhr von Eisen trifft im Mittel mit 9,4 mg den täglichen Bedarf. Die kalkulierte mittlere Resorption von Eisen aus tierischen und pflanzlichen Lebensmitteln beträgt im Durchschnitt 0,84 mg. Davon sind ca. 21 % Hämeisen und 79 % Nicht-Hämeisen. Die wichtigsten Quellen für resorbierbares Eisen stellen mit ca. 20 % Brot und Backwaren dar, gefolgt Teigwaren und Eier (13 %), Fleisch und Wurstwaren (11 %) sowie Gerichten, die überwiegend aus tierischen Menükomponenten (11 %) bestehen. Auch Gemüse (8 %) und Gerichte mit überwiegend pflanzlichen Menükomponenten (8 %) tragen zur Eisenversorgung bei. Ein Anteil von 51 % der Jungen und Mädchen liegt dennoch unterhalb der Eisen-Richtwerte der DACH. Zwischen Jungen und Mädchen bestehen keine signifikanten Unterschiede hinsichtlich der mittleren Eisenzufuhr sowie hinsichtlich der Höhe der Zufuhr von Lebensmittelgruppen, die für die Eisenversorgung relevant sind. Die alimentäre Versorgung mit Jod stellt sich bei den Schulanfängern im Gegensatz zur Eisenaufnahme im Mittel als mangelhaft dar, denn die mittlere Zufuhr liegt in etwa 50 % unterhalb der Sollzufuhr. 96 % der Familien verwenden zwar jodiertes Speisesalz, dagegen kaufen nur knapp 32 % der Familien regelmäßig Brot und Backwaren, die mit jodiertem Speisesalz hergestellt wurden. Die wichtigste Quelle für die Jodzufuhr stellen mit 31 % Milch und Milchprodukte dar, gefolgt von Teigwaren und Eiern sowie Getränke mit 12 %. Brot und Backwaren tragen dagegen nur zu mit 6 % und Fisch nur mit 3 % zur täglichen Jodversorgung bei. Geschlechtsspezifische Differenzen bestehen hinsichtlich der mittleren Serum-Ferritin-Konzentrationen sowie der anderen biochemischen Marker des Eisenstoffwechsels nicht. Die mittleren Konzentrationen aller Parameter liegen innerhalb physiologischer Grenzwerte. Von 174 Schulanfänger haben 23,6 % (25 Mädchen, 16 Jungen) der eine Serum-Ferritinkonzentration  20 ng/ml und somit eine marginale Eisenversorgung. Ein Anteil von 2,9 % (4 Mädchen, 1 Junge) der Kinder hat einen latenten Eisenmangel mit Serum-Ferritinkonzentrationen  12 ng/ml. 1,7 % der Schulanfänger (1 Mädchen, 2 Jungen) haben einen Hb-Wert < 11,5 g/dl. Ein Anhaltspunkt für das Vorliegen einer manifesten Eisenmangelanämie liegt nicht vor. Neben dem Serum-Ferritin wurden zur Beurteilung hinsichtlich eines prävalenten Eisenmangels sowie zur eindeutigeren Differenzierung zwischen einem möglichen Eisenmangel und sich entwickelnder Eisenmangel-Erythropoese zusätzlich die löslichen Transferrinrezeptoren (TfR) sowie der Transferrinrezeptor:Ferritin-Quotient (sTfR:Ferritin) bestimmt. Die ermittelten Referenzbereiche liegen für das Kollektiv von Schulanfängern bei den löslichen TfR zwischen 0,93 bis 1,98 mg/l (MW ± SD: 1,46 ± 0,27) und für log sTfR:Ferritin zwischen 1,25 – 2,15 (MW ± SD: 1,70 ± 0,23). Nach den löslichen TfR befinden sich 5,9 % (n=10) der Schulanfänger oberhalb des oberen Referenzwertes, wobei hier von einem Eisenmangel auszugehen wäre. Es kann aber nur ein Kind mit einer Serum-Ferritin-Konzentration von 12 ng/ml mit einem latenten Eisenmangel identifiziert werden. Vier weitere Kinder mit einer Serum-Ferritin-Konzentration von  12 ng/ml werden dagegen falsch negativ klassifiziert. Im Gegensatz dazu werden durch sTfR:Ferritin 3,4 % (n = 6) der Schulanfänger mit latentem Eisenmangel identifiziert. Ein Kind liegt hier mit einer Serum-Ferritin-Konzentration von 13 ng/ml zwar im Grenzbereich, wird aber auch unter Berücksichtigung der Eisen-Transferrin-Sättigung (< 10 %) richtig positiv klassifiziert. Ein signifikant positiven Zusammenhang zeigt sich mit r = 0,21 (p < 0,05) für das untersuchte Gesamtkollektiv (n = 115) nur zwischen der Zufuhr aller getreidehaltigen Lebensmittel (wie Brot und Backwaren, Nährmittel) und dem Serum-Ferritin. Eine Korrelation zwischen der Eisenzufuhr aus tierischen Nahrungsmitteln zu den untersuchten biochemischen Markern besteht nicht. Ebenfalls kein Zusammenhang wird zwischen der Eisenzufuhr und dem SE, dem SF, der TS, den sTfR sowie dem Hb beobachtet. Eine Beziehung zum ermittelten resorbierbaren Anteil von Hämeisen aus tierischen Lebensmitteln zu den hämatologischen Parametern ist nicht zu erkennen. Die mittleren Konzentrationen aller analysierten Parameter für den Jodstoffwechsel liegen Normbereich. Die durchschnittlich ermittelte Jodidausscheidung liegt in Grad 0 der WHO-Einteilung. Hinsichtlich der Jodausscheidung pro g Kreatinin sind nach den Kriterien der Weltgesundheitsorganisation (WHO) (Jodausscheidung < 100 µg/g Kreatinin/d) knapp 43 % der 6-7jährigen in die Jodmangelschweregrade I bis III einzustufen. Knapp 25 % der Kinder scheinen eine ausreichende Versorgung > 150 µg Jod pro g Kreatinin zu haben. Nach der Jodkonzentration weisen 2,9 % der FIT-Schulanfänger einen schweren Jodmangel ( 20 µg/l), 9,2 % einen mäßigen ( 50 µg/l) und 31,9 % der Kinder einen milden Jodmangel ( 100 µg/l) auf. 56 % der Schulanfänger scheinen ausreichend versorgt zu sein. Anhand der Hormone fT4 und TSH lässt sich nur bei einem Jungen eine Hypothyreose nachweisen, eine latente Unterfunktion besteht bei 3,3 % (2 Mädchen, 4 Jungen) der 6-7jährigen Kinder. Geschlechts-pezifische Unterschiede hinsichtlich der mittleren Jodzufuhr und Jodausscheidung sowie der Hormonkonzentrationen bestehen, außer beim TSH (p < 0,05), nicht. Im Gesamtkollektiv besteht mit r = 0,31 (p < 0,001) nur ein signifikanter Zusammenhang zwischen dem Verzehr von Milch und Milchprodukten und der Jod-Kreatinin-Quotienten sowie mit r = 0,19 (p < 0,05) zur Jodidkonzentration. In keiner der nach der WHO definierten Jodmangelgruppen besteht ein Zusammenhang zwischen der Jodurinkonzentration und dem TSH oder dem fT4 oder auch der Jodausscheidung pro g Kreatinin und den Serum-Parametern. Die Ergebnisse der FIT-Studie lassen bei Schulanfängern eine suboptimale Nährstoff-versorgung für Eisen erkennen, während die Versorgung mit Jod weiterhin als unzureichend angesehen werden kann. Eine Verbesserung der alimentären Eisenzufuhr durch die Aufnahme eisenreicher Lebensmittel sowie durch geeignete Lebensmittelkombinationen zur Steigerung der Eisenresorption sollte erzielt werden. Weiterhin sollten verstärkte Bemühungen seitens der verbraucheraufklärenden Institutionen auch dahingehend erfolgen, den täglichen Konsum von mit Jodsalz hergestellten Lebensmitteln oder anderen jodhaltigen Grundnahrungsmitteln noch weiter zu erhöhen. Die Analyse der löslichen TfR scheint bei gesunden Kindern nur wenig zusätzliche Informationen zu den konventionellen biochemischen Parametern des Eisenstoffwechsels, vor allem dem Serum-Ferritin, zu liefern. STfR:Ferritin ist dagegen ein sensitiverer Indikator für Probanden mit bestehendem Eisenmangel und teilweiser beginnender Eisenmangel-Erythropoese. Die Identifikation von Grenzfällen zwischem prä- und latentem Eisenmangel scheint durch TfR:Ferritin eher gewährleistet als durch die Bestimmung von Serum-Ferritin allein. Mögliche Vorteile der Bestimmung von löslichen TfR und der Ermittlung des TfR:Ferritin zur Beurteilung der breiten Spanne des Eisenstatus für eine gesunde Schülerpopulation, aber auch für Kinder dieser Altersgruppe generell, bleibt anhand verschiedener Studienkonzepte zu überprüfen. Weiterhin sollten unbedingt altersspezifische international gültige Referenzwerte für sTfR zur besseren Beurteilung der Prävalenz von Eisenmangel und Eisenmangelanämie erstellt werden. Es wird als unbedingt erforderlich angesehen, primärpräventive Maßnahmen vom Kindesalter an zu fördern, um das Risiko einer Mangelversorgung sowie der möglichen Folgen für Gesundheit, Wohlbefinden und Leistungsfähigkeit zu reduzieren. Eine intensivierte Aufklärungs- und Öffentlichkeitsarbeit sowie ggf. gezielte Untersuchungen im Einzelfall oder auch Vorsorgeuntersuchungen könnten zur Verbesserung der Nährstoffsituation in der Bevölkerung beitragen.

Biochemical markers of bone metabolism have become a common form of analysis for bone metabolism. A number of factors, however, cause fluctuations in these parameters such as day-to-day changes, seasonal changes and age. In women, studies have confirmed parameter fluctuations during the menstrual cycle (Zittermann et al., 2000). Up until now, the coherence hormone status and bone marker activity have been scanty in animal models. The objective of this study was to examine the dependence of bone marker activity on the estrous cycle in the Dresdner miniature pig. The present study included the bone formation marker osteocalcin, and bone resorption marker serum crosslaps. The estrous cycle dependency was determined by comparing the development of marker concentrations with progesterone and estradiol in the respective cycle stages of each pig after synchronisation and at particular sampling points of time. Furthermore the behaviour of biochemical markers, osteocalcin and crosslaps were examined at and after ovariohysterectomy (OVX) to determine the effect of OVX on these specific bone markers. Another aspect of this study was to determine the influence of calcium content in the diet on bone metabolism before and after castration. Sixteen animals were divided into three groups, two control groups and a OVX group. One control group received a 0.99% calcium diet, while the OVX and the second control group received a 0.7% calcium diet. The animals in the OVX group were ovariohysterectomised, while the pigs in the control and the second control groups were not manipulated. The trial consisted of two periods; the pre-castration period, lasting 65 weeks and a post-castration period lasting 8 weeks. Blood samples were drawn and analysed at selected extraction times. The bone marker development pre-castration showed age-related and cycle-related changes. Osteocalcin showed definite increased concentrations, at the age of 9-13 months. If 10 months were seen as a late prepubal stage (Tanner stage) in the minipig, osteocalcin reacts more slowly in minipigs as it does in humans. Assuming that female minipigs in the present study can be compared with female humans during puberty, the present study shows that osteocalcin concentrations are still high at late puberty, unlike those in humans, which are high at midpuberty. Crosslaps increased up until the age of 10 months and then showed a constant decrease in concentrations. This would be the equivalent reaction of resorption markers in humans. Osteocalcin concentrations increased with an increase in estradiol concentrations, so estradiol stimulates bone formation in miniature pigs. The resorption marker serum crosslaps also showed cyclic fluctuations. High crosslaps concentrations were found in the estrus cycle stage or late follicular cycle stage; whereas low crosslaps were found in the luteal phase. As was often the case in other studies, the effect of a calcium reduced diet was not evident between the control and second control group. Resorption and formation markers showed changes post-castration in the OVX group, which shows that this is a calcium diet that can be used in further studies where induced osteopenia is required. Osteocalcin showed a definite concentration increase 4 weeks after castration. Serum crosslaps increased 2 weeks post operation. These increased concentrations were not significant, which could be due to the small animal numbers included in this study. Both markers reacted within a short time after ovariohysterectomy, which is a useful aspect for further osteoporosis research. This study portrayed the usefulness of the minipig as an animal model, not only for further studies on postmenopausal osteoporosis, but also verified the use of osteocalcin and serum crosslaps as biochemical parameters of bone metabolism in this species, to have age-related and cycle-related fluctuations, which should be considered in further studies.

Knochenaufbau mittels Biomaterialien und Transplantaten gehört zur Standardmethodologie in vielen chirurgischen Fachgebieten. Dampfsterilisiertes Knochenmaterial zeigt, trotz Attraktivität der Entkeimungsmethode überwiegend ein Verknöcherungsversagen bei stark verminderter Steifigkeit. Es wurde in dieser dreigeteilten Studie ein neues Knochentransplantatmaterial untersucht, Powerpore® duro, welches seine Steifigkeit bei einer Dampfsterilisierung nicht verliert,. Das Material zeigte eine primäre Osseointegration und eine lamelläre Knochenneubildung. In einer geschlossenen Tierversuchsstudie an 17 Kanninchen wurde am Patellagleitlagermodell das Einwachsverhalten des neuen Materials untersucht. Nicht entkalkte Knochenhistologien zeigen nach 30 (n=5) und 100 (n=12) Tagen eine regelrechte Osseointegration in allen untersuchten Proben. Hierbei waren die allogenen Powerpore® duro Transplantate im Vergleich zur allogenen, unbehandelten Kontrollgruppe (frischer Knochen) adäquat im Hinblick auf Einwuchstiefe, Resorption und Remodelling. Die Technologie ist eine Möglichkeit, Knochenmaterial einfach und kostengünstig zu sterilisieren, und bietet eine alternative Möglichkeit zum Führen einer Knochenbank.

Das Ziel der vorliegenden Arbeit war es, herauszufinden in wieweit die Therapie einer metabolischen Azidose bei Durchfallkälbern durch die orale Verabreichung von Natriumbikarbonat per Kälberschlundsonde möglich ist und ob der Pansensaft-pH-Wert Einfluss auf die Resorption des in den Pansen eingegebenen Puffers hat. Es sollte festgestellt werden, ob es eine bestimmte für alle Kälber mit einer gering- bis mittelgradigen metabolischen Azidose geltende Menge an Natriumbikarbonat gibt, die oral verabreicht in der Lage ist diese Durchfallkälber zu therapieren, ohne dass Nebenwirkungen des Natriumbikarbonats auftreten. Das Patientengut bestand aus 32 bis zu vier Wochen alten Kälbern, die infolge eines Durchfallgeschehens eine metabolische Azidose aufwiesen. 50 g Natriumbikarbonat oral verabreicht war eine Puffermenge, die den Blut-pH-Wert und den BE-Wert der Kälber zumindest vorübergehend ausgeglichen hat, ohne dass deutliche Nebenwirkungen auftraten. Bei einigen Tieren dieser Untersuchung mussten weitere Pufferbehandlungen durchgeführt werden. Es gibt aber keinen eindeutigen Befund, der bereits im Voraus die Vermutung zulässt, welche Tiere eine weitere Pufferbehandlung benötigen. Bei Kälbern, die nach der Behandlung eine gute Tränkeaufnahme zeigen, ist eine ausreichende Wirkung der einmaligen Pufferbehandlung anzunehmen. Ein Einfluss des Pansensaft-pH-Wertes auf die Resorption des Natriumbikarbonats im Pansen konnte nicht festgestellt werden.

Fri, 10 Feb 2006 12:00:00 +0100 https://edoc.ub.uni-muenchen.de/5467/ https://edoc.ub.uni-muenchen.de/5467/1/Lutz_Katharina.pdf Lutz, Katharina ddc:500, ddc:590, Tierärztliche Fakultät

Fri, 10 Feb 2006 12:00:00 +0100 https://edoc.ub.uni-muenchen.de/5078/ https://edoc.ub.uni-muenchen.de/5078/1/Lambrecht_Kirstin.pdf Lambrecht, Kirstin ddc:590, ddc:500, Tierärztlich

Die Rekonstruktion des rupturierten vorderen Kreuzbandes ist eine der häufigsten Knieoperationen. Viele Operationsmethoden und verschiedenste Implantatmaterialien wurden beschrieben und dennoch gibt es in der medizinischen Fachwelt keine Einigkeit über ein Operationsverfahren. Aufgrund der komplexen Anatomie konnte bis heute noch kein gleichwertiger Kreuzbandersatz gefunden werden. Eine Methode der Rekonstruktion stellen die autologen Sehnentransplantate dar, unter denen das Patellarsehnentransplantat als Goldstandard zählt. Jedoch birgt diese Methode Nachteile wie Verlust der sensomo torischen Funktion, Nachdehnung des Transplantates und reduzierte Reißfestigkeit. Die alleinige Primärnaht wird aufgrund unbefriedigender Ergebnisse nicht mehr empfohlen. Dies führte zur Verwendung von Augmentationen, die das heilende Ligament vor mechanis cher Überlastung schützen sollen. Unter den vielen Augmentationsmaterialien haben sich resorbierbare Kordeln durchgesetzt. In der vorliegenden Arbeit wurde eine neu entwickelte resorbierbare Augmentationskordel für die temporäre Verstärkung einer Kreuzbandnaht im Tiermodell Schaf untersucht. Die Untersuchung sollte Aufschluss über die klinische Anwendbarkeit dieser langsam resorbierenden Augmentation aus Polylactid geben. Das Ziel war festzustellen, ob ihre Verwendung zu einer höheren Kniegelenkstabilität und damit zu einem besseren Operationsergebnis führt als die Implantation der bisher erhältlichen, schneller resorbierenden Kordel aus Polydioxanon. Im experimentellen Teil der Studie wurden insgesamt 32 Schafe in drei Gruppen eingeteilt. Bei den Gruppen I und II wurde das VKB an seinem femoralen Ursprung durchtrennt, um einen proximalen Riß zu simulieren. Anschließend wurde es mit transkondylären Nähten reinseriert. Gruppe I erhielt die neue PLA-Kordel als Augmentation. Gruppe II erhielt die bereits in der Klinik verwendete PDS-Kordel als Augmentation und diente als Vergleichsgruppe zu Gruppe I. Bei den Tieren der Gruppe III wurde eine Totalresektion des VKB vorgenommen und ein autologes Patellarsehnentransplantat eingesetzt. Diese Gruppe diente als Kontrollgruppe zu den Gruppen I und II. Die Standzeiten betrugen sechs Monate für die Gruppen I und II und zwölf Monate für die Gruppe III. Die makroskopische Untersuchung ergab, dass die operierten Kniegelenke aller Gruppen im Vergleich zur nicht operierten Kontrollseite vermehrt Knorpelschäden höheren Grades zeigten. Beim Gruppenvergleich hatte die PDS-Gruppe mehr Knorpelschäden als die PLAGruppe, die wenigsten Schäden traten bei der PT-Gruppe auf. Zusammenfassung 73 Die Schwerpunkte der biomechanischen und histologischen Untersuchungen waren Einfluss von mechanischem Schutz auf die Heilung und Reißfestigkeit des genähten VKB, Heilungsrate und Belastbarkeit der primären Kreuzbandnaht, In-vivo-Degradation der Augmentation und funktionelle Rekonstruktion des Kniegelenkes. Schubladentest und Reißtest ergaben, dass die Sehnentransplantate die besten Ergebnisse erzielten. Die Schubladen der Kniegelenke der PLA-augmentierten Gruppe waren größer als die der PDS-augmentierten Gruppe. Die vorderen Kreuzbänder der PLA-Gruppe zeigten eine geringfügig höhere Reißfestigkeit als die der PDS-Gruppe, erreichten aber nur 44 % der Reißkraft der Sehnentransplanate und nur 17 % der Reißkraft der nicht operierten Kontrollbänder. Keine der angewandten Operationsmethoden konnte eine Kniegelenkstabilität erreichen, die der Stabilität der nicht operierten kontralateralen Kniegelenke nahe kam. Die PLA-Kordel selbst hatte in neun von elf Fällen eine Teil- oder Totalruptur erfahren. Dies wurde auf die hohe mechanische Belastung an den Bohrkanaleingängen zurückgeführt, die durch Abrieb, Reibung und Biegung entsteht. Histologisch zeigte die PLA-Augmentation eine gute Gewebeverträglichkeit, gute Knochenintegration in den Bohrkanälen und eine langsame Resorption. Die Organisationsstruktur der reinserierten Kreuzbänder war nicht mehr vorhanden. Sie zeigten eine höhere Zelldichte und mehr Blutgefäße als die nicht operierten Kontrollen. Die Studie hat gezeigt, dass eine weitere Verbesserung der mechanischen Eigenschaften der PLA-Kordel notwendig ist, um ihr frühzeitiges Reißen zu vermeiden. Erst dann ist es möglich, eine Aussage über die Auswirkung einer langsam resorbierenden Augmentation auf ein genähtes Kreuzband zu machen. Momentan stellt diese Art der VKB-Reparatur keine Alternative zum Sehnentransplantat dar.

To date, mesenchymal cells have only been associated with bone resorption indirectly, and it has been hypothesized that the degradation of bone is associated exclusively with specific functions of osteoclasts. Here we show, in aseptic prosthesis loosening, that aggressive fibroblasts at the bone surface actively contribute to bone resorption and that this is independent of osteoclasts. In two separate models ( a severe combined immunodeficient mouse coimplantation model and a dentin pit formation assay), these cells produce signs of bone resorption that are similar to those in early osteoclastic resorption. In an animal model of aseptic prosthesis loosening (i.e. intracranially self-stimulated rats), it is shown that these fibroblasts acquire their ability to degrade bone early on in their differentiation. Upon stimulation, such fibroblasts readily release acidic components that lower the pH of their pericellular milieu. Through the use of specific inhibitors, pericellular acidification is shown to involve the action of vacuolar type ATPases. Although fibroblasts, as mesenchymal derived cells, are thought to be incapable of resorbing bone, the present study provides the first evidence to challenge this widely held belief. It is demonstrated that fibroblast-like cells, under pathological conditions, may not only enhance but also actively contribute to bone resorption. These cells should therefore be considered novel therapeutic targets in the treatment of bone destructive disorders.

Die vorliegende Arbeit beschäftigte sich mit verschiedenartigen Aspekten zum Thema Opiatentzug. Dabei wurde die Funktionalität µ-Opioidrezeptor-gekoppelter G-Proteine in der intrazellulären Signaltransduktionskaskade im Entzug und unter chronischer Opiatverabreichung untersucht. Als Ergebnis dieser Studie, die mittels einer in situ [S35]-GTPγSAutoradiographie durchgeführt wurde, konnte die Erkenntnis bestätigt werden, nach der eine Adaption auf extern zugeführte Opioide nicht auf einer Veränderung von Rezeptoren oder deren Interaktion mit G-Proteinen beruht (Kapitel 2). Vielmehr scheinen intrazelluläre, durch Genexpression gesteuerte Mechanismen für eine erfolgreiche Adaption an veränderte Umweltbedingungen ausschlaggebend zu sein. Hierbei spielt eine veränderte Transkription von CREB und somit in Folge eine erhöhte Transkription der Adenylatcyclase eine tragende Rolle. Eine weitere Studie beschäftigte sich mit einem neuartigen Konzept zur Verstärkung von opioidagonistischen Wirkungen durch die Zugabe von Opioidantagonisten in geringer Dosierung (low dose Naloxon-Konzept, Kapitel 3). Hier konnte in verhaltensbiologischen Untersuchungen kein Effekt nachgewiesen werden. Insbesondere konnte nicht nachgewiesen werden, dass die Koverabreichung von low dose Naloxon während der Abhängigkeitsentwicklung Entzugserscheinungen moduliert. Beide Studien beschäftigen sich direkt und indirekt mit der in der Wissenschaft intensiv diskutierten Frage der Existenz von Gs-Proteingekoppelten Opioidrezeptoren, die neben den bereits bekannten Gi/o-Protein-gekoppelten Opioidrezeptoren in der Zellmembran lokalisiert sind. Ein autoradiographischer Nachweis hierzu steht bislang aus. Abhilfe könnte eine weiterentwickelte [S35]-GTPγSAutoradiographie schaffen, in der durch selektive Blockade der Gi/o-Protein-gekoppelten Opioidrezeptoren durch Pertussistoxin ein Nachweis Gs-Protein-gekoppelter Opioidrezeptoren in situ möglich sein müsste. Ein direkter Nachweis dieser Kopplung eröffnet völlig neuartige Perspektiven in der modernen Opioidpharmakologie, da durch selektive Liganden dieser Gs-Protein-gekoppelten Rezeptoren die Opiatwirkung in der klinischen Anwendung verstärkt werden könnte. Möglicherweise findet dieses Wirkprinzip bereits unbeabsichtigt seit Jahren Anwendung: der Opiatagonist Tilidin (Valoron N) kommt bei der Behandlung mittelschwerer bis schwerer Schmerzen zum Einsatz. Als Besonderheit ist diesem Präparat der Opiatantagonist Naloxon im Verhältnis 1:12,5 (Einzeldosis: 4 mg Naloxon/50 mg Tilidin) beigemischt, um eine missbräuchliche Anwendung zu unterbinden. Bei normaler therapeutischer Dosierung unterliegt der Naloxonanteil einem intensivenhepatischen Abbau, so dass Tilidin voll wirksam ist. Bei missbräuchlicher Einnahme hoher Dosen durch Opiatabhängige wird der Naloxonanteil nicht vollständig metabolisiert; Entzugssymptome werden provoziert oder bereits bestehende werden verstärkt. Tilidin selbst wird in der Leber zu Nortilidin und Binortilidin metabolisiert, wobei Nortilidin als der eigentliche Opiatagonist am Rezeptor angesehen wird (Schulz et al. 1978). Möglicherweise passieren aber geringste Spuren von Naloxon bei normalem therapeutischen Einsatz die Leber und könnten folglich im low dose -Bereich wirksam werden. Über die Wirkungsweise low dose Naloxon-vermittelter Verstärkung der analgetischen Wirkung von Opiaten können nur rein hypothetische Ansätze formuliert werden. Neben den bereits diskutierten Gs-Protein gekoppelten Opioidrezeptoren könnte auch ein Einfluss auf die Internalisierung von Opioidrezeptoren möglich sein. Hier steht, neben dem dringend nötigen Nachweis Gs-Protein gekoppelter Opioidrezeptoren, ein völlig neuartiges Forschungsgebiet der Opioidpharmakologie offen. Im letzten Teil der vorliegenden Arbeit konnte erstmals das Phänomen konditionierter Opiatentzug näher charakterisiert werden (Kapitel 4). Auch wenn es nicht gelang, aus der Vielzahl an Entzugserscheinungen die wichtigsten Kardinalsymptome zu konditionieren, so besteht dennoch kein Zweifel, dass Entzugssymptome ausreichend konditioniert werden können und dass diese konditionierten Symptome mit einer Aktivierung von Stressmechanismen verbunden sind. Darüber hinaus konnte gezeigt werden, dass mit der Präsentation des konditionierten Stimulus eine massive neuronale Aktivität im Locus coeruleus ausgelöst wird. Dieses Kerngebiet ist seit Jahren ohne Zweifel für die Ausbildung der meisten körperlichen Entzugssymptome während eines Opiatentzugs verantwortlich (Aghajanian, 1978; Maldonado et al., 1992b). Gerade in den letzten Jahren kommt dem konditionierten Entzug die Aufmerksamkeit zu, die ihm möglicherweise in seiner Bedeutung im Rückfallverhalten zusteht. Neueste Studien (Schulteis et al., 2000) zeigen deutlich, dass konditionierte Entzugserscheinungen mit dem Kerngebiet assoziiert werden, die für die hedonistische Beurteilung eines Ereignisses ausschlaggebend sind. Obwohl in frühen Studien durch Befragung von Abhängigen kein Einfluss konditionierter Entzugserscheinungen auf Rückfallverhalten nachgewiesen werden konnte (McAuliffe, 1982), stellt sich berechtigterweise die Frage, ob von Drogensüchtigen bzw. entzogenen Patienten der Reflexbogen, der zum Rückfall führte, überhaupt als solcher erkannt und benannt werden kann. Gerade das stereotype Ablaufen suchtrelevanter Konditionierungs- und Sensibilisierungsmechanismen entzieht sich oftmals dem Bewusstsein des Suchtkranken (Zieglgänsberger und Spanagel, 1999). In frühen tierexperimentellen Studien waren Versuchstiere nicht in der Lage, die im konditionierten Entzug auftretenden Entzugserscheinungen durch Trinken von opioidagonistischer Lösung zu lindern (Stewart et al., 1984). Dabei stellt gerade die orale Verabreichung von z.B. Morphin auf Grund der schlechten Resorption aus dem Gastrointestinaltrakt eine schlechte Art der Verabreichung von Opiaten dar (Gellert und Holtzman, 1978). In einem konditionierten Entzugsgeschehen kommt daher der schnellen intravenösen Verabreichung von Opiaten tragende Bedeutung zu. Opiatsucht stellt sich als komplexes Krankheitsbild dar, zumal die Patienten nicht nur von einem Opiat abhängig sind, sondern meist Polytoxikomanen sind. Dennoch erscheint gerade der konditionierte Entzug als ein wichtiges Element im Rückfallverhalten, möglicherweise eben nur im Zusammenspiel anderer suchtrelevanter Parameter. Aufschluss inwieweit hier konditionierte Entzugs-erscheinungen eine tragende Rolle spielen, könnte ein Tierexperiment darstellen, in dem auf Entzug konditionierte Versuchstiere gelernt haben, sich über eine intracerebroventriculare Injektion Morphin zuzuführen. Nur ein schneller, unmittelbarer Wirkungseintritt von Morphin greift in den Reflexbogen ein, der von den meisten Patienten im Rückfall nicht kognitiv wahrgenommen wird. Kein anderer Stoff begleitet die Menschheit so lange wie der Saft der Kapseln des Schlafmohns und bei keinem anderen Stoff liegen Wohl und Wehe so eng beisammen. Opium und seine in der modernen Medizin angewandten Derivate stellen nach wie vor die potentesten Schmerzmittel dar. Bis heute gibt es keine vergleichbaren Analgetika. Die erstaunliche Kongruenz zwischen speziellen Rezeptoren im Gehirn und einem sekundären Pflanzenalkaloid bringt die moderne Opioidpharmakologie immer wieder in den Konflikt zwischen maximaler Schmerzlinderung und den fatalen Folgen dieser Therapie, die in Toleranz, Abhängigkeit und Entzug münden kann. Dennoch bemühten sich seit Menschengedenken Ärzte und Wissenschaftler um die Vorteile dieses Prinzips und so sollte es eines Tages gelingen, die schmerzlindernde Komponente der Opiate von den negativen Auswirkungen abzukoppeln.

Aufgrund schlechter Erfahrungen mit der Resorption von Knochentransplantaten benutzte Jacques Joseph in geeigneten Fällen Elfenbeinspäne für die Sattelnasenkorrektur. Vor dem Hintergrund, dass sicher nicht mehr viele von Joseph so operierte Patienten am Leben sind, berichten die Autoren über Langzeitergebnisse von 3 Fällen, bei denen 42, 43 und 63 Jahre zuvor Elfenbeinspäne in den Nasenrücken implantiert worden waren. Die Langzeitprognose aus heutiger Sicht und Josephs eigene Beobachtungen zu diesem Material sowie einige auch heute noch nicht allseits geklärte Umstände des Wirkens dieses genialen Operateurs werden besprochen.