Mediterranean springs: Keystone ecosystems and biodiversity refugia threatened by global change.

Mediterranean spring ecosystems are unique habitats at the interface between surface water and groundwater. These ecosystems support a remarkable array of biodiversity and provide important ecological functions and ecosystem services. Spring ecosystems are influenced by abiotic, biotic, and anthropogenic factors such as the lithology of their draining aquifers, their climate, and the land use of their recharge area, all of which affect the water chemistry of the aquifer and the spring discharges. One of the most relevant characteristics of spring ecosystems is the temporal stability of environmental conditions, including physicochemical features of the spring water, across seasons and years. This stability allows a wide range of species to benefit from these ecosystems (particularly during dry periods), fostering an unusually high number of endemic species. However, global change poses important threats to these freshwater ecosystems. Changes in temperature, evapotranspiration, and precipitation patterns can alter the water balance and chemistry of spring water. Eutrophication due to agricultural practices and emergent pollutants, such as pharmaceuticals, personal care products, and pesticides, is also a growing concern for the preservation of spring biodiversity. Here, we provide a synthesis of the main characteristics and functioning of Mediterranean spring ecosystems. We then describe their ecological value and biodiversity patterns and highlight the main risks these ecosystems face. Moreover, we identify existing knowledge gaps to guide future research in order to fully uncover the hidden biodiversity within these habitats and understand the main drivers that govern them. Finally, we provide a brief summary of recommended actions that should be taken to effectively manage and preserve Mediterranean spring ecosystems for future generations. Even though studies on Mediterranean spring ecosystems are still scarce, our review shows there are sufficient data to conclude that their future viability as functional ecosystems is under severe threat.

Exchange-Striction Driven Ultrafast Nonthermal Lattice Dynamics in NiO.

We use femtosecond electron diffraction to study ultrafast lattice dynamics in the highly correlated antiferromagnetic (AFM) semiconductor NiO. Using the scattering vector (Q) dependence of Bragg diffraction, we introduce Q-resolved effective temperatures describing the transient lattice. We identify a nonthermal lattice state with preferential displacement of O compared to Ni ions, which occurs within ∼0.3 ps and persists for 25 ps. We associate this with transient changes to the AFM exchange striction-induced lattice distortion, supported by the observation of a transient Q asymmetry of Friedel pairs. Our observation highlights the role of spin-lattice coupling in routes towards ultrafast control of spin order.

Investigating the electronic structure of confined multiexcitons with nonlinear spectroscopies.

Strong confinement in semiconductor quantum dots enables them to host multiple electron-hole pairs or excitons. The excitons in these materials are forced to interact, resulting in quantum-confined multiexcitons (MXs). The MXs are integral to the physics of the electronic properties of these materials and impact their key properties for applications such as gain and light emission. Despite their importance, the electronic structure of MX has yet to be fully characterized. MXs have a complex electronic structure arising from quantum many-body effects, which is challenging for both experiments and theory. Here, we report on the investigation of the electronic structure of MX in colloidal CdSe QDs using time-resolved photoluminescence, state-resolved pump-probe, and two-dimensional spectroscopies. The use of varying excitation energy and intensities enables the observation of many signals from biexcitons and triexcitons. The experiments enable the study of MX structures and dynamics on time scales spanning 6 orders of magnitude and directly reveal dynamics in the biexciton manifold. These results outline the limits of the simple concept of binding energy. The methods of investigations should be applicable to reveal complex many-body physics in other nanomaterials and low-dimensional materials of interest.

Investigating exciton structure and dynamics in colloidal CdSe quantum dots with two-dimensional electronic spectroscopy.

Two-Dimensional Electronic Spectroscopy (2DES) is performed on CdSe colloidal quantum dots. These experiments reveal new observations on exciton structure and dynamics in quantum dots, expanding upon prior transient absorption measurements of excitonics in these systems. The 2DES method enables the separation of line broadening mechanisms, thereby better revealing the excitonic lineshapes and biexcitonic interactions. 2DES enables more information rich spectral probing of coherent phonons and their coupling to excitons. The data show spectral modulations and drifts, with differences based upon whether one monitors the excitation energy (E1) or emission energy (E3). These measurements reveal both homogeneous and inhomogeneous broadenings, as well as static and dynamic line broadening. The longitudinal optical phonon modulates the dynamic absorption spectrum both in energy and linewidth. These experiments enable measurement of hot exciton cooling with improved resolution in energy and time. These 2DES results are consistent with prior excitonic state-resolved transient absorption measurements, albeit with the addition of contributions due to coherent phonons. Finally these 2DES experiments enable disentangling of coupling versus relaxation contributions to the signals, further offering a test of electronic structure theory.

Preeclampsia and gestational weight gain in the Norwegian Fit for Delivery trial.

OBJECTIVE: Excessive gestational weight gain is linked to risk of preeclampsia, but it is not clear whether the association is causal. The purpose of this paper was to examine gestational weight gain in the Norwegian Fit for Delivery study among women who developed preeclampsia compared to those who did not, and to further explore associations between weight gain and preeclampsia by including data on body composition (bioimpedance) assessed in the last trimester of pregnancy. RESULTS: A total of 550 women were eligible for the study. Women who developed preeclampsia gained more weight than women who did not (difference 3.7 kg, p = 0.004), with a 3.5 kg difference in total body water observed in week 36 (p = 0.040). Adjusted for age, education, pre-pregnancy body mass index (BMI), randomization, and fat mass, a one kg increase in GWG was associated with 1.3 times higher odds of preeclampsia (OR: 1.31, 95% CI 1.15-1.49, p < 0.001). An independent inverse association between fat mass in week 36 and odds of preeclampsia was observed (OR: 0.79, 95% CI 0.68-0.92, p = 0.002). Given the observed difference in total body water, these findings point to excess fluid as the component driving the association between gestational weight gain and preeclampsia in the present study. Trial registration The NFFD trial has the Clinical Trials registration: clinicaltrial.gov NCT0100168.

The effect of prenatal lifestyle intervention on weight retention 12 months postpartum: results of the Norwegian Fit for Delivery randomised controlled trial.

OBJECTIVE: To examine the effect of a prenatal lifestyle intervention on postpartum weight retention (PPWR). DESIGN: Randomised controlled trial. SETTING: Healthcare clinics in southern Norway. POPULATION: Healthy, nulliparous women with body mass index ≥19 kg/m2 , age ≥18 years, and singleton pregnancy of ≤20 gestational weeks. METHODS: Women were randomised to intervention (dietary counselling twice by phone and access to twice-weekly exercise groups during pregnancy) or control group (standard prenatal care). Intervention compliance was defined post-factum as attending dietary counselling and ≥14 exercise classes. MAIN OUTCOME MEASURES: PPWR (weight measured postpartum minus self-reported pre-pregnancy weight) and the proportion of women returning to pre-pregnancy weight. RESULTS: Of 606 women randomised, 591 were included in an intention-to-treat analysis of pregnancy outcomes and 391 (64.5%) were analysed 12 months postpartum. Mean PPWR was not significantly different between groups (0.66 kg for intervention versus 1.42 kg for control group, mean difference -0.77 kg, 95% CI -1.81, 0.28; P = 0.149). An increased proportion of intervention participants achieved pre-pregnancy weight (53% versus 43%, OR 1.50, 95% CI 1.003, 1.471; P = 0.045). However, the difference was not statistically significant when we adjusted for missing data (adjusted odds ratio (OR) 2.23, P = 0.067) using logistic mixed-effects models analysis. Women compliant with intervention had significantly lower PPWR than control participants, also after adjusting for potential confounders (adjusted mean diff -1.54 kg, 95% CI -3.02, -0.05; P = 0.039). CONCLUSIONS: The Norwegian Fit for Delivery intervention had little effect on PPWR, although women who were compliant with the intervention demonstrated significantly lower PPWR at 12 months. TWEETABLE ABSTRACT: Norwegian Fit for Delivery RCT: little effect of lifestyle intervention on weight retention 1 year postpartum.

Lifestyle intervention to limit gestational weight gain: the Norwegian Fit for Delivery randomised controlled trial.

OBJECTIVE: To examine whether a lifestyle intervention in pregnancy limits gestational weight gain (GWG) and provides measurable health benefits for mother and newborn. DESIGN: Randomised controlled trial. SETTING: Healthcare clinics of southern Norway. POPULATION: Healthy, non-diabetic, nulliparous women, aged ≥18 years, with a body mass index of ≥19 kg/m2 , and with a singleton pregnancy at ≤20 weeks of gestation. METHODS: Women were randomised to an intervention group (with dietary counselling twice by telephone and access to twice-weekly exercise groups) or to a control group (with standard prenatal care). Participants were measured three times during pregnancy and at delivery, and newborns were measured at delivery. Hospital records were reviewed for outcomes of pregnancy and delivery. Assessors were blinded to group allocation. Analysis was performed by intention to treat, assessing GWG using the Student's t-test and linear mixed models, and comparing proportions using the chi-square test. MAIN OUTCOME MEASURES: GWG, rates of pregnancy complications and operative deliveries, and newborn birthweight. RESULTS: A total of 606 women were randomised. Of these, 591 were analysed, with 296 in the intervention group and 295 in the control group. At term, the mean GWG from pre-pregnancy was 14.4 kg for the intervention group and 15.8 kg for the control group (mean difference 1.3 kg; 95% confidence interval, 95% CI 0.3-2.3 kg; P = 0.009). There was no significant difference between groups in the frequency of pregnancy complications or operative deliveries. The intervention demonstrated no effect on the mean birthweight of term infants, or on the proportion of large newborns. CONCLUSIONS: The Norwegian Fit for Delivery lifestyle intervention in pregnancy had no measurable effect on obstetrical or neonatal outcomes, despite a modest but significant decrease in GWG. TWEETABLE ABSTRACT: Norwegian Fit for Delivery RCT: reduced gestational weight gain, unchanged birthweight and obstetric outcomes.

Musculoskeletal fitness and balance in older individuals (65-85 years) and its association with steps per day: a cross sectional study.

BACKGROUND: There is limited normative, objective data combining musculoskeletal fitness (MSF), balance and physical activity (PA) among older adults. The aims were therefore to; 1) describe MSF and balance in older Norwegian adults focusing on age- and sex-related differences; 2) investigate the associations among MSF, balance and objectively-assessed PA levels. METHODS: This was part of a national multicenter study. Participants (65-85 years) were randomly selected from the national population registry. We used ActiGraph GT1M accelerometers to measure PA. Balance and MSF were assessed using: one leg standing (OLS), handgrip strength (HG), static back extension (SBE), sit and reach (SR), back scratch right, left arm over (BSR, BSL). Univariate analyses of variance were used to assess sex differences within the different MSF and balance tests and for comparisons among multiple age groups. Linear regression analysis was used to investigate how PA (expressed in 1000 steps increments) was associated with MSF and balance. RESULTS: 85 women and 76 men were included. Mean age (standard deviation (SD)) was 73.2 (5.4) years for women and 72.3 (4.8) years for men. The youngest participants (65-69 years) had significantly better mean OLS- and SBE results compared with older participants. Women (65-85 years) had significantly better mean SR, BSR, BSL and SBE results compared with men (65-85 years). Men had significantly better mean HG results compared with women. No sex differences in mean OLS results were observed. A daily increment of 1000 steps was associated with better mean test scores for OLS- and SBE tests (b = 1.88, 95% CI: 0.85 to 2.90 (p ≤ 0.001) and b = 4.63, 95% CI: 1.98 to 7.29 (p = 0.001), respectively). CONCLUSION: The youngest (65-69 years) had better static balance and muscular endurance in trunk extensors compared with older participants. Older women (65-85 years) had better joint flexibility than older men (65-85 years), whereas older men had better handgrip strength than older women. A higher PA level was associated with better static balance and muscular endurance in trunk extensors in older individuals. This study provides important normative data, and further investigation of trunk endurance and static balance as key foci for PA interventions in elderly is warranted.

Vitamin C and E supplementation blunts increases in total lean body mass in elderly men after strength training.

The aim of this study was to investigate the effects of vitamin C and E supplementation on changes in muscle mass (lean mass and muscle thickness) and strength during 12 weeks of strength training in elderly men. Thirty-four elderly males (60-81 years) were randomized to either an antioxidant group (500 mg of vitamin C and 117.5 mg vitamin E before and after training) or a placebo group following the same strength training program (three sessions per week). Body composition was assessed with dual-energy X-ray absorptiometry and muscle thickness by ultrasound imaging. Muscle strength was measured as one-repetition maximum (1RM). Total lean mass increased by 3.9% (95% confidence intervals: 3.0, 5.2) and 1.4% (0, 5.4) in the placebo and antioxidant groups, respectively, revealing larger gains in the placebo group (P = 0.04). Similarly, the thickness of m. rectus femoris increased more in the placebo group [16.2% (12.8, 24.1)] than in the antioxidant group [10.9% (9.8, 13.5); P = 0.01]. Increases of lean mass in trunk and arms, and muscle thickness of elbow flexors, did not differ significantly between groups. With no group differences, 1RM improved in the range of 15-21% (P < 0.001). In conclusion, high-dosage vitamin C and E supplementation blunted certain muscular adaptations to strength training in elderly men.

Gene-PUFA interactions and obesity risk.

Although there are indications for modulatory effects of PUFA on associations between SNP and obesity risk, scientific evidence in human subjects is still scarce. The present analyses investigated interaction effects between SNP in candidate genes for obesity and PUFA in erythrocyte membranes on obesity risk. Within the second Bavarian Food Consumption Survey (cross-sectional, population-based), 568 adults provided blood samples. Fatty acid composition of erythrocyte membranes was analysed by means of GC. Genotyping was performed for twenty-one genes, including cytokines, adipokines, neurotransmitters and transcription factors. In addition, plasma IL-6 concentrations were analysed. For the statistical analysis, a logistic regression model assuming additive genetic effects was chosen. About 20 % of the study participants were classified as obese (BMI ≥ 30 kg/m(2)). Several significant gene-PUFA interactions were found, indicating regulatory effects of PUFA by gene variants of IL-2, IL-6, IL-18, TNF receptor family member 1B and 21, leptin receptor and adiponectin on obesity risk. After stratification by genotype, the strongest effects were found for rs2069779 (IL-2) and all tested PUFA as well as for rs1800795 (IL-6) and linoleic or arachidonic acid. The obesity risk of minor allele carriers significantly decreased with increasing fatty acid content. The genetic PUFA-IL-6 interaction was also reflected in plasma IL-6 concentrations. If replicated in a prospective study with sufficient statistical power, the results would indicate a beneficial effect of high PUFA supply for a substantial proportion of the population with respect to obesity risk.

Depression, comorbidities and the TNF-alpha system.

Depression has frequently been reported to be associated with other physical diseases and changes in the cytokine system. We aimed to investigate associations between a medical history of depression, its comorbidities and cytokine plasma levels in the Bavarian Nutrition Survey II (BVS II) study sample and in patients suffering from an acute depressive episode. The BVS II is a representative study of the Bavarian population aged 13-80years. The disease history of its 1050 participants was assessed through face-to-face interviews. A sub-sample of 568 subjects and 62 additional acutely depressed inpatients of the Max Planck Institute of Psychiatry participated in anthropometric measurements and blood sampling. Tumor necrosis factor-alpha (TNF-alpha) and soluble TNF receptor (sTNF-R) p55 and sTNF-R p75 plasma levels were measured using enzyme-linked immunosorbent assays. A history of depression was associated with a higher incidence of high blood pressure, peptic ulcer, dyslipoproteinemia, osteoporosis, allergic skin rash, atopic eczema and thyroid disease. Within the BVS II sample, participants with a history of depression differed from subjects who had never had depression with regard to sTNF-R p55 and sTNF-R p75 levels even when controlling for age, BMI and smoking status. Acutely depressed inpatients showed even higher levels of sTNF-R p55 and sTNF-R p75 than subjects in the normal population. TNF-alpha levels were also significantly elevated in acutely depressed patients. These results confirm earlier studies regarding the comorbidities of depression and support the hypothesis that activation of the TNF-alpha system may contribute to the development of a depressive disorder.

Posttraumatic anterior-inferior instability of the shoulder: arthroscopic findings and clinical correlations.

INTRODUCTION: The main purpose of our study was to evaluate intra-articular lesions in glenohumeral-instability with arthroscopy and correlate them with clinical findings as well as history of instability. MATERIAL AND METHODS: In this prospective multi-centre study, we evaluated arthroscopic findings in 303 patients with posttraumatic anterior-inferior instability of the shoulder. The study cohort was divided into 2 groups: patients with a history of one dislocation (Group 1, n=61, 20.1%) and patients with a history of more than one dislocation (Group 2, n=242, 79.9%). RESULTS: In Group 1, 37 patients had an IGHL-lesion, 31 a MGHL-lesion and 41 a Hill-Sachs lesion. In Group 2, 182 patients had an IGHL-lesion, 172 a MGHL-lesion and 203 a Hill-Sachs lesion. The percentage of lesions in Group 2 (IGHL-75.2%, MGHL-71.1%, Hill-Sachs-83.9%) was significantly higher than in Group 1 (IGHL-60.7%, MGHL-50.8%, Hill-Sachs-67.2%, P=0.0233, P=0.0026, and P=0.0033, respectively). Within Group 2 we found significantly more Hill-Sachs-lesions with a history of an increasing number of recurrences (P=0.0436). We also found an increase of IGHL- and MGHL-lesions with an increasing number of recurrences, but this difference was not significant. The distribution of lesion types of the anterior labrum-ligament complex showed no significant difference between the two groups, apart from a higher incidence of ALPSA-lesions within Group 2 (34.7% versus 18.0% in Group 1). The results of this study show that recurrences after primary posttraumatic anterior-inferior shoulder dislocation cause increasing ligamental damage as well as increasing Hill-Sachs lesions within the gleno-humeral joint. CONCLUSION: Thus we conclude that early surgical stabilization after posttraumatic anterior-inferior shoulder dislocation is necessary to prevent increasing damage within the shoulder joint.

Allergic sensitisation and allergic rhinitis are associated with n-3 polyunsaturated fatty acids in the diet and in red blood cell membranes.

OBJECTIVE: Due to inconsistent results based on dietary intake data, unsaturated fatty acids in red blood cell (RBC) membranes and diet were used to investigate their association with allergic sensitisation and allergic rhinitis. DESIGN: Cross-sectional, population-based study. SETTING: Bavarian Nutrition Survey II (2002-03), Germany. SUBJECTS: A total of 568 adult participants, 325 women and 243 men. METHODS: By means of logistic regression models, the relation of fatty acids to (i) allergic sensitisation as defined by means of specific serum immunoglobulin E analysis (CAPSX1 class > or = 2), and (ii) self-reported allergic rhinitis was examined. RESULTS: A high cell membrane level of eicosapentaenoic acid (EPA, 20:5 n-3) was inversely associated with allergic sensitisation, the adjusted odds ratio (OR) and 95% confidence interval (95% CI) were 0.52 (0.30-0.90) for the highest (vs lowest) quartile. A similar effect was observed for allergic rhinitis with an OR (95% CI) of 0.50 (0.24-1.03; P = 0.027 for trend). A higher dietary intake of alpha-linolenic acid (ALA, 18:3 n-3) was associated with a decreased risk of allergic sensitisation and allergic rhinitis with ORs (95% CIs) of 0.51 (0.28-0.93) and 0.43 (0.20-0.93), respectively, in the highest quartiles. No other dietary or cell membrane unsaturated fatty acid was significantly associated with the outcome variables, nor was the n-6/n-3 ratio. The strongest effects were observed among subjects under the age of 40 y. CONCLUSIONS: In this cross-sectional study among adults, a high content of n-3 fatty acids in RBC membranes (EPA) or in the diet (ALA) is associated with a decreased risk of allergic sensitisation and allergic rhinitis.

Polyphasic identification of wild yeast strains isolated from Greek sourdoughs.

A total of forty-five wild yeast strains were isolated from five traditional Greek wheat sourdoughs. Strains were identified using the classical identification technique along with the sodium dodecyl sulfate-polyacrylamide gel electrophoresis of whole cell proteins (SDS-PAGE), Fourier transform-infrared spectroscopy (FT-IR) and the randomly amplified polymorphic DNA-polymerase chain reaction analysis (RAPD-PCR). The latter methods confirmed the classical identification. According to the results obtained, fourteen strains were identified as Saccharomyces cerevisiae strains, twenty-five as Pichia membranaefaciens strains and six as Yarrowia lipolytica.

Quantification of micro-organisms in binary mixed populations by Fourier transform infrared (FT-IR) spectroscopy.

Fourier Transform Infrared (FT-IR) spectroscopy was used for the first time to determine the ratios of different microorganisms in mixtures. Exemplarily, systems composed of two food-associated yeast species (Saccharomyces cerevisiae/Hanseniaspora uvarum) and two yoghurt lactic acid bacteria (Lactobacillus acidophilus/Streptococcus salivarius ssp. thermophilus) were investigated. Determination of the cell number ratio in the lactic acid bacteria system was possible with a minimal prediction accuracy of +/- 16 ratio percentage points while the minimum accuracy of prediction in the yeast two-component system was +/- 4% (both at a 95% confidence level). These results show that FT-IR spectroscopy is potentially a rapid method for the quantification of cell ratios in mixtures of two different microorganisms, provided that the cell ratio does not drop below a certain, system-specific threshold.

[The upper ankle joint. Biomechanics and functional anatomy]. / Das obere Sprunggelenk. Biomechanik und funktionelle Anatomie.

Dorsoplantar motion in the upper ankle joint is around one "transverse" rotational axis. In relation to the lower leg this axis is oblique joining the tips of the malleoli. Talocrural motion is highly precise compared to other human joints. Most of the stability and undisturbed motion in the loaded joint is afforded by the intimate osteocartilagineous contact. The rule of the collateral ligaments is secondary stabilisation, buffering of abnormal stresses and centering the talus in the extremes of motion. The posterior talofibular ligament is the universal lateral stabilizer, the deep portion of the deltoid ligament is the predominant medial ligament structure. Ligament tension without strain and under valgusabduction load as a rule makes only a difference in a quantitative way. Under varusadduction-stress load patterns are usually changed. Fibula and the distal syndesmotic ligaments, in the presence of valgusabduction- and external rotation stress, predominate over the medial joints structures. Remaining joint steps, especially in Volkmanns triangle (posterior malleolus) are prearthritic deformities. Nevertheless primary traumatic lesion of the cartilage has a major prognostic meaning. In cadaver joints as in vivo permanent lesions of only a singular fasciculus of the deltoid or lateral collateral ligament result in clearly detectable motion abnormalities. Concerning clinical therapy at present as in the past complete reconstruction of all that damaged singular structures must be claimed for. There is generally only a small tolerance against instability and malposition in the upper ankle joint. Even after one hundred years of research today factors defining the individual breadth of tolerance are not fully understood. In the presence of treatment regimes, that stood the test of time, it is therefore difficult to recommend treatment alternatives, relaying on individual biomechanical tolerance.

Biomechanics and functional anatomy of the upper ankle.

Dorsoplantar motion in the upper ankle joint is around one "transverse" rotational axis. In relation to the lower leg this axis is oblique joining the tips of the malleoli. Talocrural motion is highly precise compared to other human joints. Most of the stability and undisturbed motion in the loaded joint is afforded by the intimate osteocartilagineous contact. The rule of the collateral ligaments is secondary stabilisation, buffering of abnormal stresses and centering the talus in the extremes of motion. The posterior talofibular ligament is the universal lateral stabilizer, the deep portion of the deltoid ligament is the predominant medial ligament structure. Ligament tension without strain and under valgusabduction load as a rule makes only a difference in a quantitative way. Under varusadduction-stress load patterns are usually changed. Fibula and the distal syndesmotic ligaments, in the presence of valgusabduction- and external rotation stress, predominate over the medial joints structures. Remaining joint steps, especially in Volkmanns triangle (posterior malleolus) are prearthritic deformities. Nevertheless primary traumatic lesion of the cartilage has a major prognostic meaning. In cadaver joints as in vivo permanent lesions of only a singular fasciculus of the deltoid or lateral collateral ligament result in clearly detectable motion abnormalities. Concerning clinical therapy at present as in the past complete reconstruction of all that damaged singular structures must be claimed for. There is generally only a small tolerance against instability and malposition in the upper ankle joint. Even after one hundred years of research today factors defining the individual breadth of tolerance are not fully understood. In the presence of treatment regimes, that stood the test of time, it is therefore difficult to recommend treatment alternatives, relaying on individual biomechanical tolerance.

Rapid and reliable identification of food-borne yeasts by Fourier-transform infrared spectroscopy.

Computer-based Fourier-transform infrared spectroscopy (FT-IR) was used to identify food-borne, predominantly fermentative yeasts. Dried yeast suspensions provided the films suitable for FT-IR measurement. Informative windows in the spectrum were selected and combined to achieve optimal results. A reference spectrum library was assembled, based on 332 defined yeast strains from international yeast collections and our own isolates. All strains were identified with conventional methods using physiological and morphological characteristics. In order to assess identification quality, another 722 unknown yeast isolates not included in the reference spectrum library were identified both by classical methods and by comparison of their FT-IR spectra with those of the reference spectrum library. Ninety-seven and one-half percent of these isolates were identified correctly by FT-IR. Easy handling, rapid identification within 24 h when starting from a single colony, and a high differentiation capacity thus render FT-IR technology clearly superior to other routine methods for the identification of yeasts.

[Replantation of a leg after hip para-articular amputation]. / Replantation eines Beins nach hüftgelenksnaher Abtrennung.

Of all macroreplantations, reattachment of a leg amputated at the proximal thigh presents the biggest difficulty. A patient with no other injuries was treated in this way. A critical discussion of indications in general, the technique in the acute setting, and reconstructive procedures, including the ilizarov distraction technique, is presented. The outcome after 2.5 years is gratifying. The results obtainable in proximal thigh replantation can justify the risk of potentially lethal general complications.

[Spinal stabilization in extradural metastatic disease. Indications and follow-up of 32 cases]. / Wirbelsäulenstabilisierung bei extraduraler Metastasenkrankheit Indikation und Verläufe bei 32 Patienten.

Over 4.5 years, 32 patients with spinal epidural metastases were decompressed and stabilized. Median survival was 9.5 months. Myelopathy was the predominant indication (41%) for the operation, intractable pain (microinstability) the second most important. The type of tumor spreading and biomechanics necessitated ventral decompression and stabilization in 65%. Corporectomy or extensive laminectomy was always combined with internal fixation and bone cement. With the exception of six patients (5 early deaths), all patients were able to walk after surgery. The Karnofsky index was improved significantly from 35 to 66%. The longest survival time was found in breast carcinomas and myelomas. Preoperative radiological embolization was a keystone in the treatment. Indication for surgery in spinal metastases is critical and needs an interdisciplinary approach. When the patient is suffering from higher degrees of paresis or even paralysis, he/she is no longer an ideal candidate for the operation. The same applies in the presence of uncontrolled primary tumors and neoplastic disease of the GI tract and the bronchus.