Attachment of Respiratory Pathogens and Candida to Denture Base Materials-A Pilot Study.

Denture prostheses are an ideal and extensive reservoir for microorganisms to attach to their surfaces. The aim of the study was to elucidate interactions between materials for the fabrication of denture bases and the attachment of microorganisms, focusing on respiratory pathogens and Candida species. Specimens (6 mm × 1 mm) with a standardized surface roughness (Sa = 0.1 µm) were prepared from heat-pressed polymethyl methacrylate (PMMA), CAD/CAM-processed PMMA, and CAD/CAM-processed polyether ether ketone (PEEK). The specimens were randomly placed in the vestibular areas of complete upper dentures in seven patients and were removed either after 24 h without any oral hygiene measures or after a period of four weeks. The microorganisms adherent to the surface of the specimens were cultivated and subsequently analyzed using mass spectrometry (MALDI-TOF). The means and standard deviations were calculated, and the data were analyzed using a two-way analysis of variance (ANOVA) and Tukey post-hoc test where appropriate (α = 0.05). There was a significant increase (p ≤ 0.004) in the total bacterial counts (CFU/mL) between the first (24 h) and the second (four weeks) measurements. Regarding quantitative microbiological analyses, no significant differences between the various materials were identified. Respiratory microorganisms were detected in all samples at both measurement time points, with a large variance between different patients. Only after four weeks, Candida species were identified on all materials but not in all participants. Candida species and respiratory microorganisms accumulate on various denture base resins. While no significant differences were identified between the materials, there was a tendency towards a more pronounced accumulation of microorganisms on conventionally processed PMMA.

Polypropylene Post-Consumer Recyclate Compounds for Thermoforming Packaging Applications.

Polypropylene (PP) plastic packaging waste consists of a variety of different plastic packaging products with a great span in rheological and mechanical behavior. Therefore, the resulting post-consumer recyclates usually show melt mass-flow rates (MFR) in the region of injection molding grades and intermediate mechanical properties. High-quality packaging applications demand a distinct property profile that is met by tailor-made PP grades and cannot be met by recyclates with intermediate performance. One such application with high market volume is high-stiffness thermoforming trays. The aim of this research was to blend intermediate-performance recyclates with a virgin PP grade to obtain compounds that fulfill the rheological and mechanical demands of this application. Three commercially available PP post-consumer recyclates were acquired and compounded with different blending ratios with a high stiffness, low MFR virgin PP grade. As the pure recyclates show different rheological properties, the blending ratios had to be adapted for each of them to fit into the MFR range of 2-4 g/10 min which is desirable for thermoforming applications. The resulting PP recyclate compounds show a distinct correlation of recyclate content with rheological and mechanical performance. However, the resulting property profile was directly dependent on the performance of the originally used recyclate. The best-performing recyclate could be used in a blending ratio of 65 m% recyclate content while adhering to both property limits, the MFR of 2-4 g/10 min and the lower bound tensile stiffness of 1500 MPa.

Polypropylene Pipe Compounds with Varying Post-Consumer Packaging Recyclate Content.

The high recycling targets set by the European Commission will create an increased availability of polypropylene (PP) post-consumer recyclates (PCRs). However, no regulations mandate the use of recycled PP (rPP), so the industry is challenged to explore possibilities to utilize such materials. One option, as suggested by the European Commission, is the introduction of rPP in pipe applications. According to existing standards, the use of recyclate is not allowed in pressurized gas and drinking water systems. However, many other pipe and underground applications, such as stormwater systems, open the increased use of PCRs. Additionally, even for less-demanding applications, such as non-pressure sewage systems, highly durable solutions are needed to cover the requested lifetime and request an ambitious property profile to fulfill the application needs that cannot be met by PP packaging materials and even less by PCRs thereof. Hence, this work explores the possible use of commercially available PCRs out of polypropylene from packaging applications in compounds together with virgin PP pipe grades to meet the demands for less-demanding applications. Two different commercially available rPPs and one commercially available recycled polyolefin (rPO) from mixed polyethylene and PP waste were acquired and, together with two predefined virgin PP pipe grades, were blended to compounds in the range of 10 m%, 20 m%, and 30 m% recyclate content. The compounds and three virgin PP pipe grades, acting as benchmarks, were tested in terms of short- and long-term mechanical performance as well as for many other physical properties. All of the compounds showed good results regarding fatigue crack (FCG) resistance with virgin polymer as the reference. The factors influencing FCG resistance, such as melt flow rate and polyolefin cross-contamination, were thoroughly investigated as the used virgin grades and recyclates cover a broad range of these properties.

Short- and Long-Term Performance of Pipe Compounds Containing Polyethylene Post-Consumer Recyclates from Packaging Waste.

The polymer industry is pushed to present solutions that lead to a circular plastics economy. High plastic packaging waste recycling targets will eventually lead to a high availability of packaging material recyclates. Although the use of polyethylene terephthalate (PET) recyclates is prescribed by regulations to be used in new PET bottles, no such regulation prescribes the use of polyethylene recyclate (rPE) in new products. One possibility of using rPE, which is considered by the European Union, is the use within pipe materials. Pipe applications demand a certain property profile, most prominently a high slow crack growth (SCG) resistance, which is not met by most packaging materials or recyclates made from it. Hence, this work investigates the use of commercially available post-consumer recyclates out of high-density polyethylene from packaging applications in compounds together with high SCG-resistant virgin PE pipe material with a PE100-RC specification. Two rPEs were acquired from German producers and blended to compounds consisting of 25 m%, 50 m% and 75 m% recyclate. These compounds, together with the pure recyclates and several virgin pipe materials acting as benchmarks were tested in terms of short- and long-term mechanical performance and with other basic characterization methods. Several compounds exceeded the performance of one tested virgin PE pipe material, an injection molding PE80 grade, in several categories. The content of recyclate needed to outperform this benchmark grade was mostly dependent on the resulting melt flow rate (MFR) of the compound and thus also of the MFR of the pure recyclate. Furthermore, different levels of polypropylene contaminations within the recyclates resulted in differently contaminated compounds. This is proved to influence the SCG resistance too, as compounds of similar MFRs but with different SCG resistances were found.

Influence of autoclave sterilization on bond strength between zirconia frameworks and Ti-base abutments using different resin cements.

STATEMENT OF PROBLEM: Zirconia frameworks luted on titanium bases have been increasingly used for implant-supported prostheses. A reliable bond strength between the framework and the base is a key factor for clinical success. Autoclaving of the abutments before clinical use has been strongly suggested since abutments have been classified as class II medical devices. However, comprehensive knowledge on the susceptibility of the composite resin luting agents' adhesion to autoclave sterilization is lacking. PURPOSE: The purpose of this in vitro study was to assess the bond strength between zirconia frameworks and titanium bases using different composite resin luting agents with and without thermocycling and autoclaving. MATERIAL AND METHODS: A total of 200 titanium implants were copy milled and 200 zirconia frameworks (Cercon) were generated by computer-aided design and computer-aided manufacturing (CAD-CAM). They were adhesively luted using Multilink Hybrid Abutment (MHA), Panavia F2.0 (PF2), Panavia V5 (PV5), RelyX Ultimate (RXU), or Panavia SA Cement Plus (PSA). Autoclaving (134 °C, 0.21 MPa, 5.5 minutes) and thermocycling (3000 cycles, 5 °C and 55 °C) were performed. The push out bond strength was tested at a crosshead speed of 1 mm/min. Statistical analysis was performed by using the Mann-Whitney U test (α=.05) and the family-wise error rate method. RESULTS: Median bond strength values (interquartile range) after autoclaving and thermocycling ranged between 33.7 (26.7-41.8) MPa for MHA and 7.6 (7.3-8.5) MPa for PF2. MHA showed significantly higher values than all other composite resin luting agents regardless of thermocycling or autoclaving. PV5 showed equal or higher bond strength values than PSA, RXU, and PF2. Autoclaving had no significant influence on MHA or PV5, but had a negative effect on PSA and RXU. The family-wise error rate method showed that both the composite resin luting agent and autoclave sterilization had an overall influence on bond strength. CONCLUSIONS: MHA and PV5 were not significantly influenced by autoclaving and showed acceptable bond strength values. Because MHA showed significantly higher bond strength than all other materials and is released for autoclaving by the manufacturer, it is the first choice for extraoral bonding of zirconia frameworks to titanium bases. Manufacturers who state the indication of extraoral cementation of frameworks on titanium bases should also indicate whether their composite luting material is affected by autoclaving.

Assessment of Commercially Available Polyethylene Recyclates for Blow Molding Applications by a Novel Environmental Stress Cracking Method.

The transition to a circular economy has a major impact on waste management and the reuse of materials. New mandatory recycling targets for plastics will lead to a high availability of recyclates. For these recyclates, useful applications need to be found. One potential application for recyclates is blow molding bottles as packaging for non-food contents. This study investigates commercially available post-consumer high-density polyethylene recyclates together with virgin blow molding grades in terms of their short-term mechanical properties and environmental stress cracking resistance. While the short-term mechanical properties showed only slightly lower performance than the tested virgin grades, the overall environmental stress cracking failure times of the recyclates were much lower compared to virgin materials, even though the crack-growth kinetics could be similar. Although neither the tensile nor the notched impact strength results of the two polyethylene recyclates revealed large differences, the stress intensity-factor-dependent crack-growth rates of both materials were significantly different.

Characterization of Composition and Structure-Property Relationships of Commercial Post-Consumer Polyethylene and Polypropylene Recyclates.

The current efforts in moving closer towards a circular plastics economy puts massive pressure on recycled plastics, especially recycled polyethylene (rPE) and recycled polypropylene (rPP) to enter new markets. Their market penetration remained low so far, despite PE and PP constituting the largest share of plastic wastes. However, with the current imperative of more circularity comes a new focus on performance of recyclates. Hence, a detailed understanding of composition and structure-property relationships of post-consumer recyclates has to be developed. Five recycling companies from the Austrian and German markets were asked to supply their purest high-quality rPE and rPP grades. These were characterized by differential scanning calorimetry (DSC), thermo-gravimetric analysis (TGA), and Fourier-transform infrared (FTIR) spectroscopy, and micro-imaging. Technological characterization included density measurements, determination of the melt flow rate (MFR), and Charpy impact testing. All recyclates contained diverse contaminants and inclusions ranging from legacy fillers like calcium carbonate to polymeric contaminants like polyamides or polyolefin cross-contamination. The overall amount, size, and distribution of contaminants varied significantly among suppliers. Furthermore, first structure-property relationships for polyolefin recyclates that link inorganic content and polymeric purity with density and impact performance could be derived.

Global and Local Aging in Differently Stabilized Polypropylenes Exposed to Hot Chlorinated Water with and without Superimposed Mechanical-Environmental Loads.

The influence of chlorinated water on the global and local aging behavior of polypropylene (PP) was investigated for three differently stabilized PP grades consisting of the same PP base polymer. While one of the PP grades contained only a processing stabilizer (PP-S0), the other two were modified with a primary phenolic antioxidant (PP-S1) and a combination of a primary phenolic antioxidant and a hindered amine stabilizer (PP-S3). To study global aging effects, micro-sized specimens were pre-exposed to chlorinated water (5 mg/L free chlorine) at 60 °C for up to 750 h. Over the entire exposure period, significant material aging was detected by monitoring a continuous decrease in stabilizer content, oxidation induction temperature, mean molar mass, and mechanical strain at break. In terms of aging resistance and ultimate mechanical performance, PP-S1 was found to outperform the other two material formulations under these test conditions. Moreover, superimposed mechanical-environmental fatigue tests with cracked round bar specimens were carried out with the three PP grades in non-chlorinated (0 mg/L free chlorine) and chlorinated (5 mg/L free chlorine) water at 80 °C and 95 °C to study local crack tip aging effects. While the fatigue crack growth resistance substantially deteriorated for all three materials in chlorinated water, a significantly stronger effect was found for the higher temperature, with crack growth rates at a given stress intensity factor range in chlorinated water being ca. 30 to 50 times faster than in non-chlorinated water, depending on the material. Molar mass measurements of material samples taken from various positions of the tested CRB specimens provided clear evidence of enhanced local crack tip aging due to the chlorinated water environment.

Chlorinated Water Induced Aging of Pipe Grade Polypropylene Random Copolymers.

Polypropylene random copolymers (PP-R) are common materials for pressurized hot water pipes. In many pipe systems, potable water is disinfected by chlorine to prevent waterborne diseases. This paper deals with hot chlorinated water induced aging of two PP-R grades with varying morphology. One material had a conventional monoclinic α crystal form (PP-Rα), whereas the other was explicitly beta-nucleated resulting in a trigonal ß crystal form with a fine spherulite structure (PP-Rß). Micro-sized specimens with a thickness of 100 µm were used for aging experiments at 60 °C in chlorinated water with 5 mg/L free chlorine, and aging indicators were monitored for exposure times of up to 2000 h. On the other hand, superimposed mechanical-environmental tests were carried out by using cracked round bar specimens with a diameter of 14 mm to determine the fatigue crack growth (FCG) resistance of both PP-R grades at 60 °C in non-chlorinated and chlorinated water. PP-Rß was found to outperform PP-Rα with an about 30% higher time-to-embrittlement value of 2000 h. Furthermore, PP-Rß exhibited an enhanced FCG resistance in both non-chlorinated and chlorinated water. The effect of chlorine content on the deterioration of the FCG resistances was significantly more pronounced for PP-Rα.

Performance of resin materials for temporary fixed denture prostheses.

This study investigated the handling properties and clinical performance of two commercially available resin materials with slight differences in filler composition for the fabrication of fixed interim restorations. In a dental university setting, patients requiring prosthetic treatment were supplied with fixed interim restorations fabricated from two commercially available resin materials. To clarify the handling properties of the resin materials, dentists and undergraduate students completed a questionnaire. Prior to insertion of the definitive restoration, the interim restorations were analyzed by calibrated examiners using a modification of the United States Public Health Service criteria. Eighty-two fixed interim restorations with a mean clinical service period of 44.5 (±28.3) days were included, including 39 single crowns, 30 fixed denture prostheses, 10 blocked crowns, and 3 partial coverage restorations. No significant differences between the two materials in the rating of their handling properties were identified, with the exception of the parameter "surface". Failures due to fractures were observed in 13% of the interim restorations. No significant differences between the materials in the rating of the clinical performance were identified. These results indicate that slight changes in the filler composition of commercial formulations account for few differences in handling properties and clinical performance.

Influence of Hot Chlorinated Water and Stabilizer Package on the Fatigue Crack Growth Resistance of Glass Fiber Reinforced Polyamide.

To assess the potential use of polyamide (PA) for solar-thermal systems applications, the effect of water with varying chlorine content on the fatigue crack growth (FCG) resistance of two PA formulations differing in their stabilizer packages was investigated at 80 °C. A commercial PA containing 30 wt % glass fibers and a standard stabilization package (PA-0) was used as the reference material. For the other formulation, the reference material PA-0 was compounded with two additional stabilizers (PA-S1). Keeping the specimen geometry and initial loading conditions the same, the total number of cycles to ultimate specimen failure was found to be reduced with an increase in chlorine content for both materials. As to the effect of the chlorine content on crack growth kinetics, the most pronounced effect in enhancing the crack growth rates or decreasing the FCG resistance was determined between 0 ppm and 1 ppm chlorine content. When comparing the relative change of FCG resistance in chlorinated water (10 ppm) to the FCG resistance in non-chlorinated water (0 ppm), the additional stabilization in the material PA-S1 appears beneficial over the stabilization in the reference material PA-0.

Characterization of Irradiation Crosslinked Polyamides for Solar Thermal Applications-Basic Thermo-Analytical and Mechanical Properties.

Polyamide 66 (PA 66) and short glass fiber reinforced versions of PA 66 are widely used for solar-thermal applications, in which thermal and environmental loading of components is from high importance. In this study, the influence of crosslinking via electronic beam irradiation on the morphology and mechanical behavior of unreinforced PA 66 and two types of short glass fiber reinforced PA 66 (30 wt % glass fiber content, 35 wt % glass fiber content) was investigated. In total, five different electronic beam irradiation doses in the range of 0 and 200 kGy were applied. Besides experiments with unconditioned specimens, also preconditioned specimens saturated with water at 80 °C for seven days were investigated. It was found that irradiation causes a shift to lower melting temperatures and lower melting enthalpies, while simultaneously leading to higher glass transition temperatures (TG), increasing small strain modulus values and higher tensile strengths. Also, as expected, preconditioning samples in water at 80 °C to water uptake saturation leads to a shift to lower TG values ('plasticization' effect). In terms of tensile behavior at room temperature, water saturated specimens (being above TG at room temperature) exhibited lower modulus and tensile strength values compared to quasi-dry specimens (being below TG at room temperature).

Influence of proximal box elevation technique on marginal integrity of adhesively luted Cerec inlays.

OBJECTIVES: This in vitro study evaluated the marginal quality of Lava Ultimate inlays in deep proximal cavities with and without proximal box elevation (PBE) before and after thermomechanical loading (TML). MATERIALS AND METHODS: Mesio-occluso-distal cavities with proximal boxes beneath the cementoenamel junction (CEJ) were prepared in 24 human molars. Then, one of the proximal boxes was elevated with Filtek Supreme above the CEJ. The specimens were divided into three groups (n = 8). The inlays of group A were adhesively luted to the cavities with Scotchbond Universal and Rely X Ultimate, the inlays of group B with Monobond Plus, Syntac, and Variolink II, and the inlays of group C with Clearfil Ceramic Primer and Panavia SA Cement. Epoxy resin replicas were taken before and after thermomechanical loading (1,200,000 cycles, 55 °C/5 °C, max. load 50 N). Marginal integrity at the different interfaces tooth/PBE, tooth/dentine, inlay/PBE, inlay/dentine was evaluated with scanning electron microscopy (×200). The percentage of continuous margin (% of total proximal margin length) was compared between the groups before and after TML. STATISTICS: Mann-Whitney U test (p = 0.05). RESULTS: No significant differences (p > 0.05) before and after TML were found between the three groups for bonding the inlay to dentine or to PBE composite. CONCLUSIONS: The marginal integrities of bonding inlays directly to dentine are not different from bonding inlays to a proximal box, which has been elevated by a composite filling material. For deep proximal cavities, the PBE technique could be an alternative technique to conventional methods. Clinical research is needed to confirm.

Biofilm formation and Candida albicans morphology on the surface of denture base materials.

Fungal biofilms may contribute to the occurrence of denture stomatitis. The objective of the study was to investigate the biofilm formation and morphology of Candida albicans in biofilms on the surface of denture base materials. Specimens were prepared from different denture base materials. After determination of surface properties and salivary pellicle formation, mono- and multispecies biofilm formation including Candida albicans ATCC 10231 was initiated. Relative amounts of adherent cells were determined after 20, 44, 68 and 188 h; C. albicans morphology was analysed employing selective fluorescence microscopic analysis. Significant differences were identified in the relative amount of cells adherent to the denture base materials. Highest blastospore/hyphae index suggesting an increased percentage of hyphae was observed in mono- and multispecies biofilms on the soft denture liner, which did not necessarily respond to the highest relative amount of adherent cells. For both biofilm models, lowest relative amount of adherent cells was identified on the methacrylate-based denture base material, which did not necessarily relate to a significantly lower blastospore/hyphae index. The results indicate that there are significant differences in both biofilm formation as well as the morphology of C. albicans cells in biofilms on the surface of different denture base materials.

A-Part Gel, an adhesion prophylaxis for abdominal surgery: a randomized controlled phase I-II safety study [NCT00646412].

BACKGROUND: Intra-abdominal surgical intervention can cause the development of intra-peritoneal adhesions. To reduce this problem, different agents have been tested to minimize abdominal adhesions; however, the optimal adhesion prophylaxis has not been found so far. Therefore, the A-Part(®) Gel was developed as a barrier to diminish postsurgical adhesions; the aim of this randomized controlled study was a first evaluation of its safety and efficacy. METHODS: In this prospective, controlled, randomized, patient-blinded, monocenter phase I-II study, 62 patients received either the hydrogel A-Part-Gel(®) as an anti-adhesive barrier or were untreated after primary elective median laparotomy. Primary endpoint was the occurrence of peritonitis and/or wound healing impairment 28 ± 10 days postoperatively. As secondary endpoints anastomotic leakage until 28 days after surgery, adverse events and adhesions were assessed until 3 months postoperatively. RESULTS: A lower rate of wound healing impairment and/or peritonitis was observed in the A-Part Gel(®) group compared to the control group: (6.5 vs. 13.8 %). The difference between the two groups was -7.3%, 90 % confidence interval [-20.1, 5.4 %]. Both treatment groups showed similar frequency of anastomotic leakage but incidence of adverse events and serious adverse events were slightly lower in the A-Part Gel(®) group compared to the control. Adhesion rates were comparable in both groups. CONCLUSION: A-Part Gel(®) is safe as an adhesion prophylaxis after abdominal wall surgery but no reduction of postoperative peritoneal adhesion could be found in comparison to the control group. This may at least in part be due to the small sample size as well as to the incomplete coverage of the incision due to the used application. TRIAL REGISTRATION: NCT00646412.

Biofilm formation on the surface of modern implant abutment materials.

OBJECTIVE: To investigate the formation of biofilms on the surface of materials applied for the fabrication of implant abutments. MATERIAL AND METHODS: Specimens were prepared from the implant abutment materials titanium, zirconia, and polyetheretherketone (PEEK); specimens made from polymethylmethacrylate (PMMA) were used for reference. All specimens were polished to high gloss using silicon carbide paper; surface roughness was determined using profilometry, and surface free energy was calculated from contact angle measurements. After the simulation of salivary pellicle formation, multispecies biofilm formation was initiated by exposing the specimens to a suspension of Streptococcus gordonii, Streptococcus mutans, Actinomyces naeslundii, and Candida albicans for either 20 or 44 h. Viable microbial biomass adherent to the specimens (n = 10 per material and incubation time) and the percentage of dead microorganisms in the different biofilms (n = 5, accordingly) were determined. RESULTS: Significantly lower surface roughness was identified for PEEK and PMMA than for zirconia and titanium (P < 0.001); surface free energy was significantly lower for zirconia than for PEEK (P = 0.038). Significantly higher viable biomass and a significantly higher percentage of dead microorganisms were identified after 44 h than after 20 h of biofilm formation (P < 0.001, respectively); after 20 h, PEEK surfaces harbored significantly lower viable biomass than the surfaces of the other materials (P < 0.0125). After 44 h, significant differences were identified in the percentage of dead microorganisms organized in the biofilms on the different materials (P = 0.012). CONCLUSIONS: Within the limitations of a laboratory study, the results suggest that biofilm formation on the surface of PEEK is equal or lower than on the surface of conventionally applied abutment materials such as zirconia and titanium. However, clinical studies are necessary to corroborate these preliminary results.

PVA gel as a potential adhesion barrier: a safety study in a large animal model of intestinal surgery.

BACKGROUND: Intra-abdominal adhesions following surgery are a major source of morbidity and mortality including abdominal pain and small bowel obstruction. This study evaluated the safety of PVA gel (polyvinyl alcohol and carboxymethylated cellulose gel) on intestinal anastomoses and its potential effectiveness in preventing adhesions in a clinically relevant large animal model. METHODS: Experiments were performed in a pig model with median laparotomy and intestinal anastomosis following small bowel resection. The primary endpoint was the safety of PVA on small intestinal anastomoses. We also measured the incidence of postoperative adhesions in PVA vs. control groups: group A (eight pigs): stapled anastomosis with PVA gel compared to group B (eight pigs), which had no PVA gel; group C (eight pigs): hand-sewn anastomosis with PVA gel compared to group B (eight pigs), which had no anti-adhesive barrier. Animals were sacrificed 14 days after surgery and analyzed. RESULTS: All anastomoses had a patent lumen without any stenosis. No anastomoses leaked at an intraluminal pressure of 40 cmH2O. Thus, anastomoses healed very well in both groups, regardless of whether PVA was administered. PVA-treated animals, however, had significantly fewer adhesions in the area of stapled anastomoses. The hand-sewn PVA group also had weaker adhesions and trended towards fewer adhesions to adjacent organs. CONCLUSION: These results suggest that PVA gel does not jeopardize the integrity of intestinal anastomoses. However, larger trials are needed to investigate the potential of PVA gel to prevent adhesions in gastrointestinal surgery.

Effect of sleeve gastrectomy on postprandial lipoprotein metabolism in morbidly obese patients.

BACKGROUND: Obesity is associated with abnormal fasting and postprandial lipids, which may link obesity with atherosclerosis. We explored fasting and postprandial lipids in morbidly obese patients treated with sleeve gastrectomy and in control subjects. METHODS: After fasting for 12 h 15 morbidly obese patients (BMI 51.4±6.5 kg/m2, 43.7±12.6 years) received a standardized oral fat load before and 3 months after bariatric surgery (sleeve gastrectomy). Controls (n=9, BMI 23.1±1.4 kg/m²) were studied once. Plasma was obtained fasting and then postprandially every 2 h for 8 h. Triglycerides (TG), chylomicron-TG (CM-TG), VLDL/chylomicron-remnant (VLDL/CR)-TG, cholesterol, LDL-cholesterol, VLDL/CR-cholesterol and HDL-cholesterol were isolated by ultracentrifugation at each time point. Postprandial values were expressed as area under the curve (AUC) and incremental area under the curve (iAUC). In addition, fasting glucose and insulin values and HOMA-IR-Index was measured (n=14). RESULTS: Compared to controls morbidly obese patients had elevated TG and slightly altered postprandial lipids. Following surgery (weight loss 23.4 kg±6.2 kg; p<0.001) fasting TG (-19.1%; p=0.04), VLDL/CR-TG (-20.0%; p=0.05) decreased significantly, while fasting cholesterol, VLDL-, HDL- and LDL-cholesterol did not change. AUC and iAUC decreased significantly for VLDL/CR-TG (-20.4%, p=0.04 and -38.5%, p=0.04, respectively). Neither fasting nor postprandial changes correlated with the change in weight. In patients with preoperatively elevated TG (>150 mg/dl) a similar pattern was observed. Fasting insulin and HOMA were reduced significantly (-51.9%; p=0.004 and -47.9%; p=0.011). CONCLUSIONS: Three months after sleeve gastrectomy fasting and postprandial lipoprotein metabolism and glucose metabolism is improved in morbidly obese patients. The potential mechanisms may relate to decreased caloric intake but also to hormonal changes.

CT fluoroscopy guided percutaneous gastrostomy or jejunostomy without (CT-PG/PJ) or with simultaneous endoscopy (CT-PEG/PEJ) in otherwise untreatable patients.

PURPOSE: Percutaneous endoscopic gastrostomy (PEG) or percutaneous endoscopic jejunostomy (PEJ) are substantial for patients with swallowing disorders to maintain enteral nutrition or to decompress palliatively intractable small bowel obstruction. Endoscopic placement can be impossible due to previous (gastric) operation, obesity, hepato-splenomegaly, peritoneal carcinosis, inadequate transillumination, or obstructed passage. Computed tomography (CT)-fluoroscopic guidance with or without endoscopy can enable placement of CT-PG/CT-PJ or CT-PEG/CT-PEJ if endoscopically guided placement fails. In this retrospective study, we will evaluate the feasibility and safety of this method. METHODS: A total of 101 consecutive patients were referred to our department for feeding support (n = 87) or decompression (n = 14). Reasons were: ENT tumor (n = 51), esophageal cancer (n = 19), mediastinal mass (n = 2), neurological disorder (n = 15). Decompression tubes were placed because of cancer (n = 13) or Crohn's disease (n = 1). The following approaches were chosen: CT fluoroscopy and simultaneous gastroscopy (n = 61), inflation of the stomach via nasogastric tube (n = 29), and direct puncture under CT-fluoroscopic guidance (n = 11). RESULTS: CT fluoroscopy-guided gastrostomy was feasible in 89 of 101 patients. No procedure-related mortality was observed. One tube was misplaced into the colon in a patient with a history of gastrectomy. No complication was seen after removal. Minor complications: dislodgement (n = 17), peristomal leakage (n = 7), wound infection (n = 1), superficial skin infection (n = 6), tube obstruction (n = 2). CONCLUSIONS: CT fluoroscopy-guided PG/PJ or PEG/PEJ is feasible and safe and provides adequate feeding support or decompression. It offers the benefits of minimally invasive therapy even in patients with contraindications to established endoscopic methods, combining the advantages of both techniques. Long-term complications-mainly tube-related problems-are easily treated.

Characterization of gloss properties of differently treated polymer coating surfaces by surface clarity measurement methodology.

With one measurement configuration, existing gloss measurement methodologies are generally restricted to specific gloss levels. A newly developed image-analytical gloss parameter called "clarity" provides the possibility to describe the perceptual result of a broad range of different gloss levels with one setup. In order to analyze and finally monitor the perceived gloss of products, a fast and flexible method also for the automated inspection is highly demanded. The clarity parameter is very fast to calculate and therefore usable for fast in-line surface inspection. Coated metal specimens were deformed by varying degree and polished afterwards in order to study the clarity parameter regarding the quantification of varying surface gloss types and levels. In order to analyze the correlation with the human gloss perception a study was carried out in which experts were asked to assess gloss properties of a series of surface samples under standardized conditions. The study confirmed clarity to exhibit considerably better correlation to the human perception than alternative gloss parameters.