Aspect ratio of nano/microstructures determines Staphylococcus aureus adhesion on PET and titanium surfaces.

AIMS: Joint infections cause premature implant failure. The avoidance of bacterial colonization of implant materials by modification of the material surface is therefore the focus of current research. In this in vitro study the complex interaction of periodic structures on PET and titanium surfaces on the adhesion of Staphylococcus aureus is analysed. METHODS AND RESULTS: Using direct laser interference patterning as well as roll-to-roll hot embossing methods, structured periodic textures of different spatial distance were produced on surfaces and S. aureus were cultured for 24 h on these. The amount of adhering bacteria was quantified using fluorescence microscopy and the local adhesion behaviour was investigated using scanning electron microscopy. For PET structures, minimal bacterial adhesion was identified for an aspect ratio of about 0·02. On titanium structures, S. aureus adhesion was significantly decreased for profile heights of < 200 nm. Our results show a significantly decreased bacterial adhesion for structures with an aspect ratio range of 0·02 to 0·05. CONCLUSIONS: We show that structuring on surfaces can decrease the amount of S. aureus on titanium and PET as common implant materials. SIGNIFICANCE AND IMPACT OF THE STUDY: The study highlights the immense potential of applying specific structures to implant materials to prevent implant colonization with pathogen bacteria.

[Monozygotic multiple pregnancies with acardiac anomalies]. / Monocygote Mehrlingsgraviditäten mit akardischen Anomalien.

The acardiac fetus is a rare anomaly of about 1 percent of monozygotic pregnancies, occurring in approximately 1 in 35,000 pregnancies. The special hemodynamic circumstances of the normal heart having to pump an excessive amount of blood for a long period of time will influence the chance of survival of this fetus. In two case-report with many figures pathologic-anatomical problems and prospective management to improve the outcome of monozygotic multiple pregnancies complicated by acardiac malformation were presented. The pathogenesis of metabolic dysbalance in these pregnancies was discussed.

[Comparison between age-dependent (Wald alpha program) and age-independent (Ulm index) analysis program for prenatal detection of Down's syndrome with serum markers]. / Der Vergleich zwischen altersabhängigem (Alphaprogramm nach Wald) und altersunabhängigem (Ulm-Index) Analysenprogramm zur pränatalen Erfassung von Morbus Down mit Serummarkern.

An age-dependent analytic program (Alpha-Software from Wald) was compared to an age-independent Index (Ulm-Index) in order to determine effectivity of detection in prenatal screening for Down's Syndrome in 7060 pregnant women. The rate of accuracy was similar in both analytic programs (6 from 7), but, the rate of false-positive results was twice as high using the Ulm-Index (14.7 versus 7.7%). The higher rate of amniocentesis necessary using the age-independent Ulm-Index apparently does not justify this method for prenatal screening of Down's Syndrome.

[Noninvasive serum test for prenatal detection of Down syndrome, other chromosome abnormalities and open neural tube defects--a prospective study]. / Nichtinvasiver Serum-Test (NIS) zur pränatalen Erfassung von Morbus Down, anderen chromosomalen Anomalien und offenen Neuralrohrdefekten--Eine prospektive Studie.

Between September 1st 1990 and Juli 31st 1993, 5071 pregnant women were screened prospectively by the "triple-test", including maternal serum alpha-fetoprotein, human chorionic gonadotropin and unconjugated oestriol in order to detect chromosomal anomalies and open neural tube defects. The serum samples were collected in collaboration with the obstetricians of the region of West-Mecklenburg and North-West-Brandenburg. Laboratory testing using radioimmunoassays was performed between weeks 15 and 20 of gestation, all serum specimens being investigated in only one institution. The original alpha-software from Wald et al. was the basis for calculating the statistical risk for Down's syndrome. Pregnant women with a high risk for Down's syndrome (cutoff > or = 1:250) were taken care of in a special outpatient clinic including procedures like amniocentesis and fetal blood sampling. Amongst 5071 pregnant women, 21 fetal anomalies were seen. Five cases of Down's syndrome, three of trisomy 18, one trisomy 13, two cases of triploidy and four cases of open neural tube defects, one 46 xy/45 x mosaic karyotype and one case of gastroschisis could be diagnosed correctly. One case of trisomy 21, one case of trisomy 18 and two open neural tube defects showed false negative results. Using the cutoff of 1:250 for prenatal detection of Down's syndrome and performing ultrasound routinely to determine gestational age, the sensitivity of the "triple-test" was 83.33% having a specificity of 92.68%. The predictive value of a positive test for prenatal diagnosis of Down's syndrome was 1.33%.(ABSTRACT TRUNCATED AT 250 WORDS)

[Quantitative acetylcholinesterase (AChE)--determination in amniotic fluid--potential for differential diagnosis in consistently high AFP levels during general AFP screening for prenatal diagnosis of open neural tube defects]. / Die quantitative Acetylcholinesterase (AChE)--Bestimmung im Fruchtwasser--eine Möglichkeit der Feindiagnostik bei wiederholt erhöhten AFP-Werten im Rahmen eines generellen AFP-Screenings zur pränatalen Erfassung offener Neuralrohrdefekte.

Measurement of maternal serum alpha-fetoprotein concentration for prenatal detection of open neural tube defects had been introduced into the obstetrical care of pregnant women in the district of Schwerin since 1983. In cases of high risk for presence of an open neural tube defect, noticed by elevated levels of maternal serum alpha-fetoprotein concentration step by step further diagnostic steps are necessary. In addition to special examination by ultrasound and measurement of alpha-fetoprotein concentration in amniotic fluid quantitative analysis of acetylcholinesterase activity in amniotic fluid seems to be valuable. Reliability of detecting open neural tube defects in prenatal care had been proved by quantitative analysis of acetylcholinesterase activity in amniotic fluid. The existing results up to now were very reliable, especially biological transit stages from normal to pathological findings were taken into consideration, too. In these cases further controls are necessary. Levels of acethylcholinesterase activity below the 90th percentile can be considered as normal findings, levels above the 99th percentile must be interpreted as pathological findings. These are our experiences up to date.

[East German percentile values for newborn infants--1985 relation of age, parity, body weight and height of the mother and the birth weight of newborn infants]. / Neugeborenen-Perzentilwerte für die DDR - 1985 Beziehungen zwischen Alter, Parität, Körpergewicht und -länge der Mutter und dem Geburtsgewicht der Neugeborenen.

Based on an analysis of very comprehensive data material multidimensional investigations on connections between age, parity, weight and height of mothers and birth weight of infants have been made. Maternal height as well as maternal weight have a considerable influence on birth weight of infants. At the same maternal height infant birth weight will rise in connection with the rise of maternal weight. Maternal age, parity and weight are correlated variables. The older a woman, the higher on average is not only her parity but at the same her weight, too. The rise of maternal weight per year in the statistic mean amounts to 401 g. Moreover, at the same age like primiparae second and subsequent parae are of higher weights so that partly maternal weight contains indirectly not only maternal age but also maternal parity. The following range of the influencing factors maternal height, weight, parity and age on birth weight can be given: 1. Height and weight as relatively equivalent factors, 2. parity and 3. age.

[The determination of acetylcholinesterase activity in amniotic fluid as a further possibility for the prenatal diagnosis of open neural tube defects]. / Die Bestimmung der Acetylcholinesterase-Aktivität im Fruchtwasser als weitere Möglichkeit der pränatalen Diagnostik offener Neuralrohrdefekte.

A method for the determination of the activity of acetylcholinesterase (AChE) in amniotic fluid is developed. In connection with other AChE-determination methods for blood quinidine sulphate in a concentration of 2.10(-5) mol/l is used as an inhibitor for the serum-cholinesterase (ChE). With amniotic fluid samples of 162 gravidities are established preliminary limits of reference ranges. The hitherto existing experiences showed that values below the 90. percentile can be classified as normally, above the 99. percentile as pathological findings. This method is to consider among the ultrasonographical examination and the measurement of alpha-fetoprotein in serum and amniotic fluid as a further diagnosis confirming part on the suspicion of the presence of open neural tube defects.

[Correlation between some environmental, anamnestic and social markers of pregnant patients and the delivery of eutrophic premature and hypotrophic newborn infants]. / Zusammenhang zwischen einigen peristatischen, anamnestischen und sozialen Merkmalen der Schwangeren und der Geburt von eutrophen Frühgeborenen und hypotrophen Neugeborenen.

12,577 single newborns of 19 hospitals of the northern districts of GDR were classified immediately after birth following the recommendations of WHO from 1971 and the Society of Perinatal Medicine of GDR for classification of newborns. In a prospective study the influence of some different parameters on the relative frequency of deliveries of preterm appropriate-for-gestational-age infants and term small-for-gestational-age infants was proved. To secure the statistical statements u-test was used. A sometimes different efficiency of the proved parameters on the tested groups demonstrated that preterm appropriate-for-gestational-age infants, term small-for-gestational-age infants and other groups of newborns of low birth-weight should'nt be collected as infants of low birth-weight up to 2,499 g in present time. With the provided introduction of new percentiles in GDR an exact classification of newborn infants should be realized all over the country.

[Prenatal detection of open neural tube defects in a mass screening program by determination of alpha-fetoprotein concentration in maternal serum]. / Zur pränatalen Erfassung offener Neuralrohrdefekte in einem Massenscreening durch Bestimmung der alpha-Fetoprotein-Konzentration im mütterlichen Serum.

A partially automatized ultramicroencymimmunoassay developed by the GDR and Cuba should be tested in a mass screening for the prenatal detection of open neural tube defects by measurement of maternal alphafetoprotein concentration (MS-AFP). In the screening program 24,271 pregnant women were included (Berlin/District of Schwerin). In 18,144 patients AFP-concentration in maternal serum was measured as a routine procedure in the care for all pregnant women of the district of Schwerin. The time of MS-AFP determination in this connection was limited from 15th to 18th completed gestational week. 1986 already in 84.9 per cent of all pregnant women of the district of Schwerin MS-AFP concentration could be measured in early pregnancy. The detective rate of open neural tube defects among 24,271 tested pregnant women was 86.1 per cent. AFP concentration was expressed in ng/ml and the "cut off" was set at 2.0 MOM. Infants born with open neural tube defects were reduced by 75 per cent under the conditions of MS-AFP screening. Better results are possible in connection with a progress in the qualification of the following diagnostic steps, if MS-AFP-levels are elevated. Not unexpected and unspecific MS-AFP-elevation was found in connection with twin pregnancies and a higher risk of abortion and the delivery of infants with very low birth-weight less than 1,500 g. A general MS-AFP-screening is recommended for prenatal detection of open neural tube defects all over the country.

[The problem of double abnormalities]. / Zur Problematik von Doppelmissbildungen.

Twin monsters are rare obstetrical events. The article reports on the course and the termination of pregnancy of a fetus with epignathus (non separated asymmetrical twin monster) and a fetus with thoracopagus (non separated symmetrical twin monster). In this connection the importance of an early prenatal diagnosis is discussed.

[Analysis of very underweight newborn infants (less than 1,500 g) 1972-1982. Epidemiologic aspects, labor presentation, position and adjustment, method of delivery and mortality]. / Analyse der sehr untergewichtigen Neugeborenen (less than 1500 g) von 1972-1982. Epidemiologische Gesichtspunkte, Geburtslage, -haltung und -einstellung, Entbindungsmodus und Mortalität.

Infants with a very low birthweight (less than 1500 g) have a fundamental influence on perinatal mortality and mortality of babies up to one year also nowadays. The epidemiological role of different signs of risk in the context of the birth of these children is presented. The total mortality of the infants with a very low birthweight (less than 1500 g) was 64,4%. Usually there were combinations of factors, which caused the death of the infants. Complications of secundinae, immaturity and malformations were the substantial factors of lethality of the stillbirths. At the mortality of babies there were intracranial bleedings and immaturity (less than 1000 g, less than 28 completed weeks of pregnancy) in the foreground of the causes of death.

[The effect of various parameters on the incidence of premature births]. / Uber den Einfluss verschiedener Merkmalsgrössen auf die Häufigkeit von preterm infants.

In a retrospective study among about 17,000 newborns the preterm infants were registered. Newborns delivered in the District Hospital of Schwerin between 1969 and 1977 are included in the above figure. The influence of different parameters on the deliveries of preterm infants was proved. In order to exclude the influence of age and parity on the results of the examinations s standardization of age and parity was done. The frequency of the delivery of preterm infants was dependent on age, parity, occupation and case histories of abortion, interruption of pregnancy and delivery of under-weight.

[Some practical aspects of medical examination in sex offenses]. / Einige praktische Aspekte zur ärztlichen Untersuchung bei Sexualstraftaten.

Dispositions are made about some highly important fundamental principles of medical examination and of protection of criminal marks in association with sexual crimes. A model of medical examination is represented. By consideration of these proposals we believe to attain a higher perfection in the evidence of expert opinions.

[Fatal outcome of visceral lupus erythematosus in pregnancy]. / Letaler Ausgang bei Lupus erythematodes visceralis und Gravidität.

After a short presentation of pathogenesis, clinical course of events, diagnosis, treatment and prognosis of lupus erythematodes visceralis in pregnancy a case of maternal death is reported. The relative necessity of avoidance of pregnancy in such cases is demonstrated in the discussion. Irreversible contraception is recommendable.

[The classification of newborn infants with reference to length of gestation and birth weight]. / Praktische Erfahrungen mit der Klassifikation von Neugeborenen unter Berücksichtigung von Gestationsdauer und Geburtsgewicht.

Classification of newborns by birth weight and length of gestation has proved to meet both clinical and scientific demands. Classification by these criteria was applied to 16,888 newborns at the Regional Hospital of Schwerin, Department of Gynaecology and Obstetrics, between 1969 and 1977. Particular attention was given to statistical treatment of the inhomogeneous group of infants of low birth weight. Analysis of this kind is proposed at national level, depending on improvement of postpartum diagnosis.

[Are unmarried pregnant women candidates for high risk delivery regarding low birth weight? (author's transl)]. / Sind ledige Schwangere eine Risikogruppe hinsichtlich der Geburt untergewichtiger Neugeborener?

Evidence has been produced to higher risk for unmarried pregnant women to deliver children with low birth weight, with reference being made to the files of the Gynaecological Hospital of the Region of Schwerin and, more particularly, to single live births, between 1969 and 1977. That higher risk was found to depend on other factors, as well, with particular emphasis on residence and occupation. The risk, however, was found to be lowered, when it came to second births and decline in the rate of low birth weight, in the context of unmarried mothers. Yet, the decline was less strong, as compared to married mothers, and the risk associated with unmarried women, consequently, remains to be regularly 60 per cent above average. These findings are considered by the authors as being relevant to supervision and guidance of women during pregnancy.

[Relationships between interruption abortion, and premature birth and low birth weight (author's transl)]. / Zusammenhänge zwischen Interruptio-, Abortus- und Frühgeburtenanmnese und der Geburt von "Kindern mit niedrigem Geburtsgewicht".

Polydimensional retrospective studies were conducted into correlations between interruption of pregnancy, abortion, and premature birth of infants weighing less than 2,501 g, on the one hand, and the general phenomenon of low birth weight, on the other. Reference was made to parity. The studies were undertaken over a period between 1969 and 1977. The birth total investigated was 17,076, stillbirths and twins excluded.-The impact of all factors involved as well as the statistical significance were tested and verified by calculation of information measure 2-I, followed by an approximative chi 2-test. The results suggested that the parameters studied were of somewhat staggered impact upon low birth weight. Premature birth, interruption of pregnancy, and abortion was the order of impact at all parity levels studied.

[Multidimensional investigations to elucidate relationships between case histories of interruption of pregnancy and premature deliveries and low birth weight (author's transl)]. / Mehrdimensionale Untersuchungen zur Prüfung von Zusammenhängen zwischen Interruptioanamnese und Frühgeburtenanamnese und der Geburt von "Kindern mit niedrigem Geburtsgewicht".

Multidimensional retrospective studies were conducted into possible correlations between case histories of induced abortion and premature deliveries, on the one hand, and deliveries of "children with low birth weight", on the other, with reference being made to the ordinal number of birth. Included were 13,287 single newborns, after mothers with twins, stillbirths, and abortion records had been excluded. "Children with low birth weight" up to 2,500 g accounted for 5.4 per cent of these newborns. The investigation was complete, in that all newborns were examined in the obstetric department of the Regional Hospital of Schwerin, between 1969 and 1977. Records of premature delivery and induced abortion were found to play a great epidemiological role in the context of "children with low birth weight" up to 2,500 g, but the general trend for such children for the period under review had remained unaffected by the Free Medical Abortion Act of 1972. Nevertheless, mothers with previous abortions during the period studied contributed to a moderate rise of the total number of "newborns with low birth weight".

PIP: Multidimensional retrospective studies were conducted into possible correlations between case histories of induced abortion and premature deliveries on the 1 hand and deliveries of children with low birthweight on the other. Reference was made to the ordinal number of birth. Included were 13,287 childrne who were single newborns, after mothers with twins, stillbirths, and abortion histories had been excluded. Children with low birthweight up to 2500 g accounted for 5.4% of these newborns. The investigation was complete in that all newborns were examined in the obstetric department of the Regional Hospital of Schwerin between 1969-77. Records of premature delivery and induced abortion were found to play a great epidemiological role in the context of children with low birthweight up to 2500 g but the general trend for such children for the period under review has remained unaffected by the free Medical Abortion Act of 1971. Nevertheless, mothers with a history of previous abortions during the period studied contributed to a moderate rise in the total number of newborns with low birthweight. (Authors' modified)