AimCombat-related extremity injuries are regularly associated with long-term complications such as chronic infection, especially osteomyelitis. Clinical examination and laboratory parameters do not usually allow reliable diagnosis. In contrast, imaging techniques enable constructive assertions to be made about the location and extent of an infection of the peripheral musculoskeletal system. The aim of this study was therefore to determine the diagnostic reliability of three-phase bone scanning and antigranulocyte scintigraphy using Tc-99m-sulesomab (Leukoscan) in the diagnostic clarification of infections associated with combat-related extremity injuries.MethodsTwenty-seven male patients (mean age 33.9 years) with suspected combat-associated infections of the extremities were included in this retrospective analysis. All patients underwent three-phase bone scanning using Tc-99m-HDP followed by antigranulocyte scintigraphy with Tc-99m-sulesomab. In 26 of the 27 patients, a CT scan of affected limb was obtained, where the secondary fusion with single photon emission CT data set was possible. The diagnostic reliability of imaging techniques was validated against microbiological samples obtained during surgery and used as gold standard.ResultsThree-phase bone scanning yielded a positive result in all patients, with 18 scans classified as true positive (TP) and nine scans as false positive (FP). This produced a sensitivity of 100%, a specificity of 0% and a positive predictive value (PPV) of 67%. Antigranulocyte scintigraphy recognised 13 patients as TP, 1 patient as FP, 8 patients as true negative (TN) and 5 patients as false negative (FN), which gave a sensitivity of 72%, a specificity of 88%, a PPV of 93%, a negative predictive value (NPV) of 62% and an accuracy of 78%. CT recognised in 7 cases a TP result, in 3 cases an FP, in 5 cases a TN and in 11 cases an FN result. This produced a sensitivity of 39%, a specificity of 63%, a PPV of 70%, an NPV of 31% and an accuracy of 46%.ConclusionsThree-phase bone scanning did not deliver any diagnostic benefit, since no result was able to differentiate unequivocally between infection-related and reactive changes. Antigranulocyte scintigraphy using Tc-99m-sulesomab represented a highly suitable technique for diagnostically clarifying combat-related infections of the extremities. It is superior to CT in sensitivity, specificity, PPV, NPV and accuracy.

The radiobiological properties of the heavy ions of cosmic radiation were investigated on Spacelab 1 by use of biostacks, monolayers of biological test organisms sandwiched between thin foils of different types of nuclear track detectors. Biostacks were exposed to cosmic radiation at several locations with different shielding environments in the module and on the pallet. Evaluations of the physical and biological components of the experiment to date indicate that in general they survived the spaceflight in good condition. Dosimetric data are presented for the different shielding environments.

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Anteil der Bohnen-Trockenmasse an der Gesamt-Trockenmasse in % BlBeg Beginn der Blüte der Stangenbohnen in Tage nach Aussaat BlEnd Ende der Blüte der Stangenbohnen in Tage nach Aussaat EKF Entwicklung der Keimfähigkeit über alle Boniturtermine frBM frühe visuelle Bonitur der Biomasse der Stangenbohnen frSPAD früher Zeitpunkt der SPAD-Messung (ca. 1 Monat vor Erntetermin) KF6 Keimfähigkeit nach 6 Tagen unter suboptimalen Temperaturen KF10 Keimfähigkeit nach 10 Tagen unter suboptimalen Temperaturen KF13 Keimfähigkeit nach 13 Tagen unter suboptimalen Temperaturen KF17 Keimfähigkeit nach 17 Tagen unter suboptimalen Temperaturen RankBeg Beginn des Rankens der Stangenbohnen in Tage nach Aussaat spBM späte visuelle Bonitur der Biomasse der Stangenbohnen zum Erntetermin spSPAD später Zeitpunkt der SPAD-Messung (direkt vor dem Erntetermin) TME-B Bohnen-Trockenmasseertrag in dt/ha TME-G Gesamt-Trockenmasseertrag in dt/ha TME-M Mais-Trockenmasseertrag in dt/ha TnA Tage nach Aussaat TSG-B Bohnen-Trockensubstanzgehalt in % TSG-G Gesamt-Trockensubstanzgehalt in % TSG-M Mais-Trockensubstanzgehalt in % Tabelle 40: Beschreibung der genotypisierten Bohnenakzessionen sowie deren