Incidence of erysipelas in waterfowl in Poland - clinical and pathological investigations.

1. Erysipelas in geese and ducks is an infectious disease causing considerable economic losses in the poultry sector in Poland. The aim of this study was to determine the distribution of erysipelas cases in age groups of geese and in periods of the calendar year and to assess macroscopic lesions in birds infected with Erysipelothrix rhusiopathiae.2. The study used 286 geese and 16 ducks delivered to the laboratory for diagnosis in the years 2019-2021. The birds came from 99 different farms. E. rhusiopathiae from clinical samples were cultured on Columbia blood agar and identified by real-time PCR. Pathological lesions were characterised during anatomopathological examination.3. Distribution of erysipelas cases in age groups of geese and periods of the calendar year differed significantly from the assumed even distribution. Most cases were noted in August and September in birds aged between 11 and 13 weeks. Necropsy of birds infected with E. rhusiopathiae showed anatomopathological lesions characteristic of generalised infection, affecting multiple organs.4. The uneven distribution of erysipelas cases in geese in different age groups and periods of the calendar year suggested that both the age of the birds and climatic conditions are predisposing factors for infection.

Altered expression of CYP17A1 and CYP19A1 in undescended testes of dogs with unilateral cryptorchidism.

Cryptorchidism is the most common disorder of sex development in dogs and testosterone plays a crucial role in the inguinal phase of the testes descending into the scrotum. The molecular background of impaired testosterone synthesis in the testes of cryptorchid dogs is poorly elucidated. In this study, we analyzed the expression of four genes involved in testicular steroidogenesis (CYP17A1, CYP19A1, HSD3B2 and HSD17B3) in undescended and contralateral scrotal testes from inguinal unilateral cryptorchid dogs (n = 13) and from the scrotal gonads of normal males (n = 15). We found that transcript level of CYP17A1 was significantly increased in inguinal gonads, while the level of CYP19A1 was decreased. For these two genes, we analyzed the methylation level of single CpG sites in the promoter region localized within putative target sites for testicular transcription factors (NUR77, CREB, CAR and HSF2). A correlation between decreased methylation in the promoter of CYP17A1 and its increased transcript level in undescended gonads was observed, but the change in protein level was not significant. We also resequenced the 5'-flanking region of both genes and two known polymorphic sites, SNP in CYP17A1 and an indel in CYP19A1, were found. However, the distribution of the variants in affected (n = 80) and control (n = 75) dogs was not associated with cryptorchidism. We tentatively conclude that the altered expression of CYP17A1 and CYP19A1 in undescended testes could be caused by their exposure to increased temperature in the body. Furthermore, we showed that the identified polymorphisms cannot be considered markers associated with a predisposition to cryptorchidism.

Calcium scoring on coronary computed angiography tomography with photon-counting detector technology: Predictors of performance.

INTRODUCTION: Obtaining accurate coronary artery calcium (CAC) score measurements from CCTA datasets with virtual non-iodine (VNI) algorithms would reduce acquisition time and radiation dose. We aimed to assess the agreement of VNI-derived and conventional true non-contrast (TNC)-based CAC scores and to identify the predictors of accuracy. METHODS: CCTA datasets were acquired with either 120 or 140 â€‹kVp. CAC scores and volumes were calculated from TNC and VNI images in 197 consecutive patients undergoing CCTA. CAC density score, mean volume/lesion, aortic Hounsfield units and standard deviations were then measured. Finally, percentage deviation (VNI - TNC/TNC∗100) of CTA-derived CAC scores from non-enhanced scans was calculated for each patient. Predictors (including anthropometric and acquisition parameters, as well as CAC characteristics) of the degree of discrepancy were evaluated using linear regression analysis. RESULTS: While the agreement between TNC and VNI was substantial (mean bias, 6.6; limits of agreement, 178.5/145.3), a non-negligible proportion of patients (36/197, 18.3%) were falsely reclassified as CAC score â€‹= â€‹0 on VNI. The use of higher tube voltage significantly decreased the percentage deviation relative to TNC-based values (ߠ​= â€‹-0.21 [95%CI: 0.38 to -0.03], p â€‹= â€‹0.020) and a higher CAC density score also proved to be an independent predictor of a smaller difference (ߠ​= â€‹-0.22 [95%CI: 0.37 to -0.07], p â€‹= â€‹0.006). CONCLUSION: The performance of VNI-based calcium scoring may be improved by increased tube voltage protocols, while the accuracy may be compromised for calcified lesions of lower density. The implementation of VNI in clinical routine, however, needs to be preceded by a solution for detecting smaller lesions as well.

The durability of the intrascaphoid compression of headless compression screws: in vitro study.

PURPOSE: To test a new generation of compression screws: the Acumed Acutrak 2 Mini (AA; Acumed, Hillsboro, OR), the Stryker TwinFix (ST; Stryker, Kalamazoo, MI), and the Synthes 3.0 headless compression screw (SH; Synthes, Solothurn, Switzerland). METHODS: We used 40 fresh-frozen human scaphoids for this study. Bone density was measured. A K-wire was inserted centrally. A perpendicular osteotomy was created in the middle third (Herbert B2 fracture). A custom-made load sensor was placed between the bone fragments. All screws were implanted according to the manufacturers' instructions. The Synthes 2.0 cortical screw (SC), implanted as a lag screw, was used as a reference. The compression force during each experiment was digitally monitored for 12 hours while the data were acquired. The data were analyzed using analysis of variance with the Bonferroni correction. RESULTS: Immediately after screw insertion, ST reached 226 N, followed by AA with 191 N, SH with 137 N, and SC with 72 N. After 12 hours, ST displayed the highest residual compression force, 141 N, followed by AA with 121 N, SH with 78 N, and SC with 32 N. The differences were significant for ST and AA compared to SC. The loss of compression force over 12 hours was 39% for ST, 42% for AA, 49% for SH, and 55% for SC. CONCLUSIONS: The new generation of headless compression screws, especially ST and AA, provided significantly higher compression forces after 12 hours, as well as the least loss of compression force over time, in comparison to a classic cortical lag screw. CLINICAL RELEVANCE: A new generation of headless compression screws, by producing higher compression forces, increase stability at the fracture site and might thereby promote bone healing.

Endovascular abdominal aneurysm repair: trends in Germany.

BACKGROUND: As a minimally invasive technique endovascular aneurysm repair (EVAR) reduces the risk of mortality and should be the preferred technique used in older patients. We analysed trends in endovascular and open surgical procedures in patients hospitalized for abdominal aortic aneurysm (AAA) in Germany. PATIENTS AND METHODS: We used national statistics (DRG statistics) published by the Federal Office of Statistics in Germany to calculate the incidence of patients hospitalised with ruptured (rAAA) and elective (eAAA) AAA. In addition, annual procedure rates of endovascular (EVAR) procedures were calculated. RESULTS: Incidence rates of eAAA per 100,000 males (females) showed a small increase from 2006 to 2007 but remained almost unchanged with 74.8 (8.8) in 2007 and 74.5 (9.8) in 2009. Incidence rates of rAAA per 100 000 males remained unchanged but showed a decreasing trend in females. The rate of people treated by EVAR increased form 2006 to 2009: in males from 24.0 % to 40.3 % and in females from 17.3 % to 31.0 %. In younger males (55 - 60 years) the increase in those who received EVAR was smaller (from 22.1 % to 33.9 %) than in older males (85 - 90 years) (from 20.4 to 41.6 %). Despite a clear increase in the use of EVAR from 2006 to 2009 there is only a small trend in reduction of the death rates which is more pronounced in rAAA. CONCLUSIONS: There has been a relevant increase in EVAR procedures for the treatment of AAA in Germany in recent years. Parallel to this increase of EVAR, aneurysm-related in-hospital deaths seem be declining slightly. A causal relationship between these trends remains to be proven.

Effect of weight and storage time of broiler breeders' eggs on morphology and biochemical features of eggs, embryogenesis, hatchability, and chick quality.

The transfer of hatchability results obtained under experimental conditions to the commercial ground with a positive financial effect proves the value and usefulness of these data. On the other hand, finding results on commercial processes of broiler breeders' egg incubation in the literature is challenging. The presented study aimed to determine the effects of egg weight and storage time on the physical, biochemical characteristics of hatching eggs, embryogenesis and hatchability in Ross 308 broiler breeders. On the laying day, the eggs were divided into four weight groups: S - small eggs (57-61 g), M - medium eggs (62-66 g), L - large eggs (67-71 g), and XL - extra-large eggs (72-76 g). The eggs were then stored for 3, 7, 14, and 21 days under controlled conditions. As the egg storage time increased, a decrease in the yolk quality (lower index) was observed. The highest Haugh units were found in eggs from the S and M groups. The cholesterol content of the M, L, and XL groups was lower on days 7, 14, and 21 as compared to that of eggs only stored for 3 days. Egg weight loss during incubation decreased with an increase in the egg weight. An extension of the egg storage time caused an increase in the loss of egg weight. On the 14th and 18th days of hatching, an increase in the eggshell temperature was noted with an increase in the weight of the egg. The eggs stored for 7 days were characterised by the highest shell temperature on each day. The highest hatchability percentage was recorded for the M group. The hatchability rate decreased with the prolongation of the storage time, while the number of crippled chicks after hatching increased. The results confirmed that the increased weight of the eggs and prolonged storage time (14 and 21 days) increased the weight and decreased the length of the newly hatched chicks, respectively. Chicks from the heaviest eggs and those stored for 14 and 21 days showed poor results on the Pasgar score® test. The observations indicate the need to adopt various (of those available) methods to assess the quality of newly hatched chicks in hatcheries in order to produce high-quality broiler chickens. The results also indicate that prolonged egg storing beyond 14 days may affect the thyroid hormone economy during the hatching of chicks, especially in the XL group.

Trends in lower extremity surgical and endovascular revascularization in Germany.

BACKGROUND: We analyzed trends in lower extremity endovascular and open surgical procedures in hospitalized patients in Germany. PATIENTS AND METHODS: We used national statistics (DRG statistics) published by the Federal Statistical Office including data from almost all hospitals in Germany to calculate annual procedure rates of lower extremity endovascular and open surgical procedures in the years 2005 to 2008. Detailed lists of the OPS-codes 8 - 836, 5 - 381, 5 - 393 separated by the 6th number of the code were analyzed regarding procedures representing revascularization of peripheral arteries including the aorta. RESULTS: Between 2005 and 2008 the total number of endovascular procedures increased from 73,584 to 98,664 and the number of surgical procedures from 74,789 to 86,172 a year. Age-adjusted incidence rates of endovascular procedures in people >= 65 years increased from 325 to 432 per 100,000 while the incidence rates of all open surgical procedures increased from 315 to 351 per 100.000. Looking only at bypass surgery the incidence remained unchanged with 177 and 176 per 100,000 in the same period. Endovascular procedures other than balloon angioplasty including percutaneous atherectomy, laser recanalization or usage of cutting balloon, account for less than 1 % in Germany. CONCLUSIONS: The numbers of endovascular procedures overweigh the numbers of open surgical procedures for treatment of lower extremity PAD in Germany today. In contrast to data from the USA we could not demonstrate a decrease of open surgical procedures in Germany in recent years.

[Periprosthetic femoral bone reaction after total hip arthroplasty with preservation of the collum femoris : CT-assisted osteodensitometry 1 and 3 years postoperatively]. / Periprothetische femorale Knochenreaktion nach schenkelhalserhaltender Hüftendoprothetik : CT-gestützte Osteodensitometrie 1 und 3 Jahre postoperativ.

BACKGROUND: Short-stemmed cementless femoral components in total hip arthroplasty have been designed to preserve the proximal femoral bone stock by load transfer to the femoral metaphysis. An in vivo method of computed tomography-assisted (CT) osteodensitometry after total hip arthroplasty is presented which differentiates between cortical and cancellous bone density (BD) changes around uncemented femoral components. PATIENTS AND METHODS: Cortical and cancellous periprosthetic femoral BD (mg Ca HA/ml) was determined prospectively in 31 patients at day 10, 1 year and 3 years after total hip arthroplasty with preservation of the collum femoris (C.F.P.-stem, Link, Hamburg, Germany) using computed tomography-assisted osteodensitometry. Clinical results (Harris hip score) and plain x-rays were assessed in all cases. RESULTS: Progressive proximal cortical BD loss was observed between the 1 year (Ø -8%) and 3 year (Ø -22%) postoperative measurements. Distal to the trochanter minor no significant cortical BD changes were observed. Proximal cancellous BD decreased progressively between the 1 year (Ø -33%) and 3 year (Ø -45%) analyses. The Harris hip score improved from 45 points pre-operatively to 93 points at the 3 year follow-up. All x-rays showed signs of stable ingrowth. CONCLUSION: Periprosthetic CT osteodensitometry has the technical ability to discriminate between cortical and cancellous bone structures with respect to strain-adapted remodeling. Progressive proximal cortical and cancellous BD loss indicates that metaphyseal fixation cannot be achieved with the analyzed C.F.P. stem design. The lack of cortical BD loss below the trochanter minor suggests diaphyseal fixation of the implanted stem.

[Fractures of the distal humerus in the elderly. Pros and cons of endoprosthetic replacement]. / Distale Humerusfraktur beim älteren Menschen. Pro und Contra endoprothetischer Ersatz.

The intraarticular fracture of the distal humerus in an elderly patient remains a challenge for trauma surgeons. In case of severe co-morbidities and/or osteoporosis stable fixation with screws and plates is difficult and in some cases can be impossible. Even if osteosynthesis is feasible the clinical outcome is still incalculable due to delayed or non-union of the fracture fragments. Endoprosthetic replacement of the elbow joint for comminuted distal humerus fractures has been used for almost 20 years. The clinical results are predominantly excellent or good and better predictable than those of osteosynthesis. There still is no guideline when a prosthesis for the elbow joint should be used. We reviewed the literature and outline the current recommendations for diagnostics and surgical therapy for distal humerus fractures in the elderly.

[Chronically progressive occlusive disease of intestinal arteries - short overview from a vascular surgical perspective]. / Chronisch-progrediente Durchblutungsstörungen der Darmarterien - kompakte Kurzübersicht aus gefäßchirurgischer Perspektive.

BACKGROUND: Intestinal ischaemia is quite rare among the cardiovascular diseases. However, it is increasingly diagnosed. The aim of this selective but representative short overview is to assess the impact of intestinal ischaemia in vascular and visceral medicine from a vascularsurgical perspective. MATERIAL AND METHODS: A literature search and selection in relevant online services of the medical scientific literature was performed, in particular, of the last decade on the competent management of intestinal ischaemia combined with the clinical expertise obtained in daily vascular surgical practice including didactically prepared demonstrable cases / case reports related to typical / specific clinical problems and situations. RESULTS AND DISCUSSION: Although the superior mesenteric artery (SMA) is most frequently responsible for the clinical presentation, usually 2 or 3  major arterial trunks are involved for a relevant clinical symptomatology. These disorders of the intestinal circulation are most frequently caused by progressive atherosclerotic occlusive disease. In chronic progressive disease, the visceral arteries show the ability to enlarge typical collateral circulation pathways, which may not always lead to a complete compensation. With a degree of stenosis of more than 70 %, mesenteric ischaemic pain and physical prostration are the major clinical findings. Intestinal infarction with a mortality rate of 60-80 % is the endpoint of the chronically progressive intestinal ischaemia. There-fore, an urgent medical treatment is highly required. CT angiography is the diagnostic procedure of choice in patients with suspected chronic intestinal ischaemia. Mesenteric angiography is subject to specific questions and / or to endovascular arteriographic treatment. Duplex scanning has been advocated as a non-invasive method of pre- and post-interventional screening. Treatment is indicated in symptomatic intestinal vascular disease. Due to the high morbidity of the majority of patients and the enormous invasivity associated with conventional surgery, arteriographic intervention is the treatment of choice, even though quality improvement is required. Surgical reconstructions are highly standardised and should be associated with perioperative mortality less than 3 %. We recommended the reconstruction of 2  vessels, for which antegrade supracoeliacal revascularisation techniques are favourable. In (threatening) septic conditions, autologous reconstructions are required. Intestinal infarction is the most serious complication of all visceral revascularisations. In recurrent occlusions of visceral arteries, it is recommended to favour and finally use a different therapeutic modality. Post-therapeutic care includes second-look operation as well as clinical examination and diagnostic imaging. Antithrombotic therapy should be initiated. The further screening of patients after intestinal revascularisation should be performed by duplex scanning. CONCLUSION: Chronically progressive occlusive disease of intestinal arteries is considered as a complex disease with challenging diagnostic and therapeutic management, in which an interdisciplinary, partly finding- and stage-dependent (also with regard to the frequency and recurrency of the specific local finding) sequential therapeutic approach (e. g., endovascular vs. open procedure; interventionalist / endovascular specialist / vascular surgeon) becomes more and more relevant requiring a competent center of vascular medicine.

Interscalene block using ultrasound guidance: impact of experience on resident performance.

BACKGROUND: We evaluated the weekly progress of anesthesiology residents performing an interscalene block with ultrasound guidance (UG) for block success rates and for the specific time intervals: (i) time to image the brachial plexus and (ii) time from insertion of the block needle until motor stimulation occurred. Our primary objective was to characterize the influence of experience over the course of the regional anesthesia rotation on the performance of a UG interscalene block by anesthesiology residents. METHODS: Residents conducted an interscalene block with UG under the supervision of attending anesthesiologists experienced in this technique. Block efficacy, time intervals required to perform the block, and acute complications were recorded. We compared success rates over the course of the rotation, and analyzed process time data with respect to trainee level of experience, week of the trainee rotation, and patient body habitus. RESULTS: Twenty-one trainees conducted 222 blocks over a consecutive 7-month period. Block success rate was 97.3%, and did not change significantly over the course of the 4-week rotation. Total block time and imaging time significantly decreased over the 4-week rotation, while the needle insertion-to-stimulation time did not change. Slower imaging time was predicted by obesity. CONCLUSION: The success rates for a UG interscalene block provided by supervised residents were initially high, and remained so throughout the 4-week rotation. Trainees required less time to image the nerves and to perform the block over the course of the rotation.

[Amputation of ischaemic extremities--a vascular surgeon's point of view]. / Amputationen an der durchblutungsgestörten Extremität. Die gefässchirurgische Sicht.

The amputation surgery being one of the oldest branches of surgery itself is often times discredited since amputations are frequently considered as a result of failure of alternative therapy options. Worldwide hundreds of thousands amputations are performed annually even though especially in vascular surgery great progress in revascularisation techniques and abilities has been made. Presumably due to rising of life expectancies and increase of diabetes mellitus the number of amputations will in future even rise. Peripheral artery disease and diabetes mellitus which are often associated with a high comorbidity are the most common causes of critical limb ischemia and amputations of the lower extremity. Complications after major amputations like wound infection, development of phantom pain, severe mental distress, myocardial infarction or stroke are frequent. Survival one year after amputation range from 30-50%. The patient collective of amputees is a large group with a high degree of comorbidity in need of special attention and care. The level of amputation ( i.e.: above vs. below knee), postoperative complications, early mobilisation and use of prosthesis are important for the postoperative outcome and the amputees further fate. To regain the independence and mobility in the known social surrounding after amputation is often not to achieve but should be the highest aim of the treating persons.

Glial elements contribute to stress-induced torsinA expression in the CNS and peripheral nervous system.

DYT1 dystonia is caused by a single GAG deletion in exon 5 of TOR1A, the gene encoding torsinA, a putative chaperone protein. In this study, central and peripheral nervous system perturbations (transient forebrain ischemia and sciatic nerve transection, respectively) were used to examine the systems biology of torsinA in rats. After forebrain ischemia, quantitative real-time reverse transcriptase-polymerase chain reaction identified increased torsinA transcript levels in hippocampus, cerebral cortex, thalamus, striatum, and cerebellum at 24 h and 7 days. Expression declined toward sham values by 14 days in striatum, thalamus and cortex, and by 21 days in cerebellum and hippocampus. TorsinA transcripts were localized to dentate granule cells and pyramidal neurons in control hippocampus and were moderately elevated in these cell populations at 24 h after ischemia, after which CA1 expression was reduced, consistent with the loss of this vulnerable neuronal population. Increased in situ hybridization signal in CA1 stratum radiatum, stratum lacunosum-moleculare, and stratum oriens at 7 days after ischemia was correlated with the detection of torsinA immunoreactivity in interneurons and reactive astrocytes at 7 and 14 days. Sciatic nerve transection increased torsinA transcript levels between 24 h and 7 days in both ipsilateral and contralateral dorsal root ganglia (DRG). However, increased torsinA immunoreactivity was localized to both ganglion cells and satellite cells in ipsilateral DRG but was restricted to satellite cells contralaterally. These results suggest that torsinA participates in the response of neural tissue to central and peripheral insults and its sustained up-regulation indicates that torsinA may contribute to remodeling of neuronal circuitry. The striking induction of torsinA in astrocytes and satellite cells points to the potential involvement of glial elements in the pathobiology of DYT1 dystonia.

LITHIUM FLUORIDE CRYSTALS AS FLUORESCENT NUCLEAR TRACK DETECTORS.

Radiophotoluminescence signal of LiF crystals was found to be sufficiently strong to visualize tracks of a single charged particle. This was achieved with a wide-field fluorescent microscope equipped with a ×100 objective and LiF single crystals grown with the Czochralski method at IFJ PAN. The tracks of alpha particles, protons, as well as products of 6Li(n,α)3H reaction with thermal neutrons (moderated Pu/Be source), were observed. These encouraging results are the first steps towards practical use of LiF as fluorescent nuclear track detectors. The most promising dosimetric application seems to be neutron measurements.

IMAGING OF PROTON BRAGG PEAKS IN LiF.

Lithium fluoride (LiF) is one of the most common thermoluminescent phosphors routinely used in radiation protection services. Another advantageous property of LiF is radiophotoluminescence, whose occurs after its irradiation due to the creation of color centers. Excitation of LiF samples with a blue light causes the emission of photoluminescence, which spectrum consists of two peaks at ~520 and ~670 nm. The work was focused on imaging of Bragg peaks of proton beams routinely applied at the proton eye radiotherapy facility operating at the Institute of Nuclear Physics Polish Academy of Sciences (IFJ PAN) in Krakow by the measurement of the fluorescence light in LiF crystals excited with a 445 nm blue light after their previous irradiation with the proton beams of energies of 28, 30, 40 and 50 MeV. The range of proton beams in LiF crystals for different energies was calculated by Monte Carlo simulations.

Idiopathic gastroparesis is associated with specific transcriptional changes in the gastric muscularis externa.

BACKGROUND: The molecular changes that occur in the stomach that are associated with idiopathic gastroparesis are poorly described. The aim of this study was to use quantitative analysis of mRNA expression to identify changes in mRNAs encoding proteins required for the normal motility functions of the stomach. METHODS: Full-thickness stomach biopsy samples were collected from non-diabetic control subjects who exhibited no symptoms of gastroparesis and from patients with idiopathic gastroparesis. mRNA was isolated from the muscularis externa and mRNA expression levels were determined by quantitative reverse transcriptase (RT)-PCR. KEY RESULTS: Smooth muscle tissue from idiopathic gastroparesis patients had decreased expression of mRNAs encoding several contractile proteins, such as MYH11 and MYLK1. Conversely, there was no significant change in mRNAs characteristic of interstitial cells of Cajal (ICCs) such as KIT or ANO1. There was also a significant decrease in mRNA-encoding platelet-derived growth factor receptor α (PDGFRα) and its ligand PDGFB and in Heme oxygenase 1 in idiopathic gastroparesis subjects. In contrast, there was a small increase in mRNA characteristic of neurons. Although there was not an overall change in KIT expression in gastroparesis patients, KIT expression showed a significant correlation with gastric emptying whereas changes in MYLK1, ANO1 and PDGFRα showed weak correlations to the fullness/satiety subscore of patient assessment of upper gastrointestinal disorder-symptom severity index scores. CONCLUSIONS AND INFERENCES: Our findings suggest that idiopathic gastroparesis is associated with altered smooth muscle cell contractile protein expression and loss of PDGFRα+ cells without a significant change in ICCs.

Dynamic biomechanical analysis of different olecranon fracture fixation devices--tension band wiring versus two intramedullary nail systems: an in-vitro cadaveric study.

BACKGROUND: The aim of this study was to develop a test-setup with continuous angle alteration to imitate joint motion for the evaluation of 3 different olecranon fracture fixation devices. METHODS: Twenty-one fresh cadaver upper extremities underwent olecranon fracture by the means of transverse osteotomy and received 3 different fixation systems. Group 1: Tension band wiring according to Weber. Group 2: XS-nail with 9 holes, all locked with 2mm threaded K-wires. Group 3: Olecranon Nailing System with 90 mm length, locked with 2.7 mm screws, a variable angle locking hole for the proximal fragment and a proximal locking end cap. The servo-pneumatical test stand worked with a rotational angle-adjusted and a linear force-adjusted engine. The fracture model was dynamically tested under cyclic loading imitating elbow motion. There was a continuous angle alteration between 0 degrees and 100 degrees of flexion with continuous changing pull force between 25 N and 150 N. Two steel pins were placed in the proximal, two in the distal olecranon fragment for video analysis of the motion between the two pairs of pins. Displacement in the fracture gap was determined after 4 and 300 cycles. FINDINGS: After 300 cycles the displacement in the fracture fixation model was significantly higher in the tension-band-wiring-group than in the XS-nail group and the olecranon-nailing-system-group. INTERPRETATION: Other studies evaluating biomechanical properties of olecranon-osteosynthesis with joint-involvement did not change the force-direction dynamically. We introduce a test-setup with continuous angle alteration to imitate joint motion. This is an important step for accurate biomechanical evaluation of the treatment of different fixation methods in olecranon fractures. The tested nailing systems showed a higher stability in comparison to tension band wiring.

The allosteric regulation of pyruvate kinase by fructose-1,6-bisphosphate.

BACKGROUND: Yeast pyruvate kinase (PK) catalyzes the final step in glycolysis. The enzyme therefore represents an important control point and is allosterically activated by fructose-1,6-bisphosphate (FBP). In mammals the enzyme is found as four different isozymes with different regulatory properties: two of these isozymes are produced by alternate splicing. The allosteric regulation of PK is directly related to proliferation of certain cell types, as demonstrated by the expression of an allosterically regulated isozyme in tumor cells. A model for the allosteric transition from the inactive (T) state to the active (R) state has been proposed previously, but until now the FBP-binding site had not been identified. RESULTS: We report here the structures of PK from yeast complexed with a substrate analog and catalytic metal ions in the presence and absence of bound FBP. The allosteric site is located 40 A from the active site and is entirely located in the enzyme regulatory (C) domain. A phosphate-binding site for the allosteric activator is created by residues encoded by a region of the gene corresponding to the alternately spliced exon of mammalian isozymes. FBP activation appears to induce several conformational changes among active-site sidechains through a mechanism that is most likely to involve significant domain motions, as previously hypothesized. CONCLUSIONS: The structure and location of the allosteric activator site agrees with the pattern of alternate genetic splicing of the PK gene in multicellular eukaryotes that distinguishes between a non-regulated isozyme and the regulated fetal isozymes. The conformational differences observed between the active sites of inactive and fully active PK enzymes is in agreement with the recently determined thermodynamic mechanism of allosteric activation through a 'metal relay' that increases the affinity of the enzyme for its natural phosphoenolpyruvate substrate.

[Chronic mesenteric ischemia with consecutive ischemic colitis. Suggestions for diagnosis and therapy]. / Chronische mesenteriale Ischämie mit konsekutiver ischämischer Kolonstenose. Vorschläge für diagnostisches und therapeutisches Vorgehen.

The incidence of acute mesenteric ischaemia has decreased over the last few years. However, cases of chronic mesenteric ischaemia have grown in number, as this disease is the most frequent disorder of the large intestine in the elderly. The typical clinical presentation of ischaemic colitis develops gradually and only becomes recognisable in the late stage of the disease. We present a 51-year-old woman with a history of unexplained abdominal pain. Multislice CT demonstrated an irregular stenosis of the truncus coeliacus and superior mesenteric artery. A Riolan's anastomosis was present and showed excellent perfusion. After a hemicolectomy 6 years previously, different radiologic procedures and endoscopy revealed a structural tumour at the colon transversum we suspected to be malignant. A sequential procedure was conducted. In a first vascular intervention, the truncus coeliacus was reconstructed with a vein patch, and the mesenteric superior artery was replanted. The second laparotomy was performed for revision of the superior mesenteric artery and resection of the intestinal tumour. However, no carcinoma was found in histological examination. In fact, the individual multidisciplinary considerations play an important role in determining the best treatment strategy, if intervention is warranted. Based on our experience, sequential intervention with a common clinical pathway is the safest and most suitable and economic procedure for curing complex pathologies.

Peri-infarct depolarizations during focal ischemia in the awake Spontaneously Hypertensive Rat. Minimizing anesthesia confounds in experimental stroke.

Anesthesia profoundly impacts peri-infarct depolarizations (PIDs), but only one prior report has described their monitoring during experimental stroke in awake animals. Since temporal patterns of PID occurrence are model specific, the current study examined PID incidence during focal ischemia in the awake Spontaneously Hypertensive Rat (SHR), and documented the impact of both prior and concurrent isoflurane anesthesia. For awake recordings, electrodes were implanted under isoflurane anesthesia 1day to 5weeks prior to occlusion surgery. Rats were then subjected to permanent or transient (2h) tandem occlusion of the middle cerebral and ipsilateral common carotid arteries, followed by PID monitoring for up to 3days. Comparison perfusion imaging studies evaluated PID-associated hyperemic transients during permanent ischemia under anesthesia at varied intervals following prior isoflurane exposure. Prior anesthesia attenuated PID number at intervals up to 1week, establishing 2weeks as a practical recovery duration following surgical preparation to avoid isoflurane preconditioning effects. PIDs in awake SHR were limited to the first 4h after permanent occlusions. Maintaining anesthesia during this interval reduced PID number, and prolonged their occurrence through several hours following anesthesia termination. Although PID number otherwise correlated with infarct size, PID suppression by anesthesia was not protective in the absence of reperfusion. PIDs persisted up to 36h after transient occlusions. These results differ markedly from the one previous report of such monitoring in awake Sprague-Dawley rats, which found an extended biphasic PID time course during 24h after both permanent and transient filament occlusions. PID occurrence closely reflects the time course of infarct progression in the respective models, and may be more useful than absolute PID number as an index of ongoing pathology.