Operative Korrektur der distalen Hypospadie und deren Ergebnisse im Kindesalter

In der vorliegenden Arbeit werden zwei Operationsmethoden zur Behandlung unterschiedlich ausgeprägter distaler Hypospadien dargestellt. Retrospektiv wurden 119 Patienten hinsichtlich Operationsdauer, Krankenhausverweildauer, Liegedauer des Harnblasenkatheters, Komplikationen oder Reoperationen und der subjektiven postoperativen Zufriedenheit beobachtet und partiell befragt, die zwischen 1994 und 2009 in der Kinderchirurgie Erfurt operativ versorgt wurden. In Abhängigkeit der Meatuslage erhielten 69 Patienten mit koronarer bzw. glandulärer Hypospadie eine primäre MAGPI-Korrektur mit Präputialplastik und 50 Patienten mit subkoronarer Meatuslage wurden nach der neueren Methode nach Sauvage operiert. Das mittlere Operationsalter betrug 51,59 Monate in der MAGPI Gruppe und 47,94 Monate in der Gruppe nach Sauvage. Die mittlere Operationsdauer lag erwartungsgemäß mit 58,00 Minuten bei der MAGPI-Methode unter der durchschnittlichen Dauer des Eingriffes nach Sauvage mit 74,86 Minuten und spiegelt den erhöhten Aufwand durch die ungünstigeren Voraussetzungen bei der Operation nach Sauvage wider. Die mittlere Verweildauer im Krankenhaus und die mittlere Liegedauer des Harnblasenkatheters lagen bei Patienten, die mit MAGPI versorgt wurden, geringfügig niedriger. Bei 2,90% der Patienten in der MAGPI-Gruppe traten Komplikationen auf, während in der Sauvage-Gruppe in 12,00% Komplikationen, überwiegend leichter Art, festgestellt werden mussten. In allen acht Fällen erfolgte eine Reoperation. Der hinsichtlich des subjektiven Outcome erstellte Fragebogen wurde von insgesamt 58 Patienten bzw. Eltern beantwortet und zeigte keinen Unterschied bezüglich der guten postoperativen Zufriedenheit. Bei richtiger Indikationsstellung und korrekter Wahl der Operationsmethode abhängig der Meatuslage bieten beide Verfahren die Möglichkeit eines guten Outcome für die Behandlung der distalen Hypospadie

Biodegradation of a magnesium alloy implant in the intercondylar femoral notch showed an appropriate response to the synovial membrane in a rabbit model in vivo

Degradable magnesium alloys are promising biomaterials for orthopedic applications. The aim of this study was to evaluate the potential effects on both the synovial membrane (synovialis) and the synovial fluid (synovia) of the degradation products of a MgYREZr-pin implanted in the intercondylar femoral notch in a rabbit model. Thirty-six animals were randomized into two groups (MgYREZr or Ti6Al4V alloy) of 18 animals each. Each group was then divided into three subgroups with implantation periods of 1, 4, and 12 weeks, with six animals in each subgroup. The initial inflammatory reaction caused by the surgical trauma declined after 12 weeks of implantation, and elucidated a progressive recovery of the synovial membrane. Compared with control Ti6Al4V pins, there were no significant differences between the groups. However, after 12 weeks, recovery of the synovial membrane was more advanced in the titanium group, in which 92% showed no signs of synovitis, than in the magnesium group. A cytotoxicity test with L929 cells and human osteoblasts (HOB) was also conducted, according to EN ISO 10993-5/12, and no toxic leachable products were observed after 24 h of incubation. In conclusion, the MgYREZr alloy seems to be a suitable material for intra-articular degradable implants. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav

Naturschutzleistungen des Ökologischen Landbaus: Wiederansiedlung seltener und gefährdeter Ackerwildpflanzen naturräumlicher Herkünfte auf Ökobetrieben

Die Intensivierung der Landwirtschaft hat zum Rückgang vieler Ackerwildpflanzen geführt. Der Ökologische Landbau bietet günstige Voraussetzungen für ihren Schutz. Wie entsprechende Populationen etabliert werden können, untersuchte ein Verbundprojekt der Bayerischen Landesanstalt für Landwirtschaft, der Technischen Universität München und der Universität Kassel. Die AG Freising untersuchte drei seltene winterannuelle Arten (Consolida regalis, Legousia speculumveneris, Lithospermum arvense) in mehrfaktoriellen Feldversuchen, in Praxisaus-saaten auf Bio-Betrieben sowie in Gewächshausexperimenten. Messgrößen waren Individuendichte, Samenproduktion und Bodensamenvorrat der Zielarten, zudem wurde der Ertrag der Feldfrüchte bestimmt. Frühe Herbstsaaten und geringe Konkurrenz durch Kulturen brachten beste Erfolge. Zur erfolgreichen Ansiedlung der Ackerwildkräuter wird eine Aussaat in Blanksaat oder in reduziert gesäten Winterungen, wie Dinkel oder Roggen, bis spätestens Mitte Oktober empfohlen. Klee-Gras und Sommerungen wie Erbsen ermöglichten kaum bzw. kein Auflaufen der Zielarten, die jedoch teils im Bodensamenvorrat überdauern. Die AG Witzenhausen untersuchte die Wiederansiedlung von Ackerwildkräutern auf Praxis-betrieben. Dazu wurden artenreiche Spenderflächen identifiziert und autochthones Saatgut gefährdeter Arten entnommen. Samenmischungen wurden in Blühfenster und den benachbarten Getreidebestand ausgebracht. Zudem wurde die Übertragung von Oberboden arten-reicher Flächen getestet. Im Anlagejahr konnte sich bei beiden Verfahren ein Teil der eingebrachten Arten reproduzieren. Dies gelang bei Konkurrenz mit Getreide tendenziell schlechter. In den Folgejahren konnten bei Anbau von Getreide wiederum einige Arten nachgewiesen werden; die meisten Samen gelangten bei Bodenbearbeitung in tiefere Bodenschichten und reicherten die Samenbank an. Praxisempfehlungen zur Wiederansiedlung von Ackerwildkräutern auf ökologisch bewirtschafteten Äckern wurden als Broschüre veröffentlicht

Formation of low- and high-spatial frequency laser-induced periodic surface structures (LIPSSs) in ALD-deposited MoS2

The formation of laser-induced periodic surface structures (LIPSSs) on the atomic layer-deposited (ALD) molybdenum disulfide (MoS2) upon femtosecond laser processing is studied experimentally. Laser-processing parameters such as average laser power and the scan speed at which the formation of the periodic nanostructures takes place are identified. Optical and scanning electron microscopy are applied to identify the parameter regions for the different LIPSS formations and transitions between them. High- and low-spatial frequency LIPSS (HSFL and LSFL) with two distinct periods λLSFL ≈ 1.1 μm and λHSFL ≈ 83 nm can be observed. The HSFL are dominating at higher and the LSFL at lower laser average powers. Formation of LIPSS is found to inhibit laser ablation at lower scan speeds

Pocket depth and bleeding on probing and their associations with dental, lifestyle, socioeconomic and blood variables: a cross-sectional, multicenter feasibility study of the German National Cohort

Background: To investigate the periodontal disease status in a multi-center cross-sectional study in Germany. Associations of dental, socio-economic, blood and biomedical variables with periodontal outcome parameters were evaluated. Methods: From 4 different centers N = 311 persons were included, drawn randomly from the registration offices. Maximal pocket depth (PD) was used as primary indicator for periodontitis. It was classified as: no/mild ≤3 mm, moderate 4-5 mm, severe ≥6 mm. Associations between socioeconomic (household income, education), lifestyle, and biomedical factors and PD or bleeding on probing (BOP) per site (“Yes”/”No”) was analyzed with logistic regression analysis. Results: Mean age of subjects was 46.4 (range 20–77) years. A significantly higher risk of deeper pockets for smokers (OR = 2.4, current vs. never smoker) or persons with higher BMI (OR = 1.6, BMI increase by 5) was found. Severity of periodontitis was significantly associated with caries lesions (p = 0.01), bridges (p < .0001), crowns (p < .0001), leukocytes (p = 0.04), HbA1c (p &lt; .0001) and MCV (p = 0.04). PD was positively correlated with BOP. No significant associations with BOP were found in regression analysis. Conclusions: Earlier findings for BMI and smoking with severity of PD were confirmed. Dental variables might be influenced by potential confounding factors e.g. dental hygiene. For blood parameters interactions with unknown systemic diseases may exist

a cross-sectional, multicenter feasibility study of the German National Cohort

Background To investigate the periodontal disease status in a multi-center cross-sectional study in Germany. Associations of dental, socio-economic, blood and biomedical variables with periodontal outcome parameters were evaluated. Methods From 4 different centers N = 311 persons were included, drawn randomly from the registration offices. Maximal pocket depth (PD) was used as primary indicator for periodontitis. It was classified as: no/mild ≤3 mm, moderate 4-5 mm, severe ≥6 mm. Associations between socioeconomic (household income, education), lifestyle, and biomedical factors and PD or bleeding on probing (BOP) per site (“Yes”/”No”) was analyzed with logistic regression analysis. Results Mean age of subjects was 46.4 (range 20–77) years. A significantly higher risk of deeper pockets for smokers (OR = 2.4, current vs. never smoker) or persons with higher BMI (OR = 1.6, BMI increase by 5) was found. Severity of periodontitis was significantly associated with caries lesions (p = 0.01), bridges (p < .0001), crowns (p < .0001), leukocytes (p = 0.04), HbA1c (p < .0001) and MCV (p = 0.04). PD was positively correlated with BOP. No significant associations with BOP were found in regression analysis. Conclusions Earlier findings for BMI and smoking with severity of PD were confirmed. Dental variables might be influenced by potential confounding factors e.g. dental hygiene. For blood parameters interactions with unknown systemic diseases may exist

Metabolic Reprogramming of Clostridioides difficile During the Stationary Phase With the Induction of Toxin Production

The obligate anaerobe, spore forming bacterium Clostridioides difficile (formerly Clostridium difficile) causes nosocomial and community acquired diarrhea often associated with antibiotic therapy. Major virulence factors of the bacterium are the two large clostridial toxins TcdA and TcdB. The production of both toxins was found strongly connected to the metabolism and the nutritional status of the growth environment. Here, we systematically investigated the changes of the gene regulatory, proteomic and metabolic networks of C. difficile 630Δerm underlying the adaptation to the non-growing state in the stationary phase. Integrated data from time-resolved transcriptome, proteome and metabolome investigations performed under defined growth conditions uncovered multiple adaptation strategies. Overall changes in the cellular processes included the downregulation of ribosome production, lipid metabolism, cold shock proteins, spermine biosynthesis, and glycolysis and in the later stages of riboflavin and coenzyme A (CoA) biosynthesis. In contrast, different chaperones, several fermentation pathways, and cysteine, serine, and pantothenate biosynthesis were found upregulated. Focusing on the Stickland amino acid fermentation and the central carbon metabolism, we discovered the ability of C. difficile to replenish its favored amino acid cysteine by a pathway starting from the glycolytic 3-phosphoglycerate via L-serine as intermediate. Following the growth course, the reductive equivalent pathways used were sequentially shifted from proline via leucine/phenylalanine to the central carbon metabolism first to butanoate fermentation and then further to lactate fermentation. The toxin production was found correlated mainly to fluxes of the central carbon metabolism. Toxin formation in the supernatant was detected when the flux changed from butanoate to lactate synthesis in the late stationary phase. The holistic view derived from the combination of transcriptome, proteome and metabolome data allowed us to uncover the major metabolic strategies that are used by the clostridial cells to maintain its cellular homeostasis and ensure survival under starvation conditions

Immune signatures predict development of autoimmune toxicity in patients with cancer treated with immune checkpoint inhibitors.

BACKGROUND Immune checkpoint inhibitors (ICIs) are among the most promising treatment options for melanoma and non-small cell lung cancer (NSCLC). While ICIs can induce effective anti-tumor responses, they may also drive serious immune-related adverse events (irAEs). Identifying biomarkers to predict which patients will suffer from irAEs would enable more accurate clinical risk-benefit analysis for ICI treatment and may also shed light on common or distinct mechanisms underpinning treatment success and irAEs. METHODS In this prospective multi-center study, we combined a multi-omics approach including unbiased single-cell profiling of over 300 peripheral blood mononuclear cell (PBMC) samples and high-throughput proteomics analysis of over 500 serum samples to characterize the systemic immune compartment of patients with melanoma or NSCLC before and during treatment with ICIs. FINDINGS When we combined the parameters obtained from the multi-omics profiling of patient blood and serum, we identified potential predictive biomarkers for ICI-induced irAEs. Specifically, an early increase in CXCL9/CXCL10/CXCL11 and interferon-γ (IFN-γ) 1 to 2 weeks after the start of therapy are likely indicators of heightened risk of developing irAEs. In addition, an early expansion of Ki-67+ regulatory T cells (Tregs) and Ki-67+ CD8+ T cells is also likely to be associated with increased risk of irAEs. CONCLUSIONS We suggest that the combination of these cellular and proteomic biomarkers may help to predict which patients are likely to benefit most from ICI therapy and those requiring intensive monitoring for irAEs. FUNDING This work was primarily funded by the European Research Council, the Swiss National Science Foundation, the Swiss Cancer League, and the Forschungsförderung of the Kantonsspital St. Gallen