Effect of a post-hatch lipopolysaccharide challenge in Turkey poults and ducklings after a primary embryonic heat stress

The effect of embryonic thermal manipulation on the post-hatch immune response to a lipopolysaccharide (LPS) challenge was studied in Pekin ducklings and turkey poults. Commercial duck and turkey eggs were distributed among four treatments: SS-Control (37.5 °C from embryonic day [ED] 1 to 25); SS-LPS (37.5 °C from ED1 to 25 + LPS at D0 [hatch]); HH-LPS (38 °C from ED1 to 25 + LPS at D0; SH-LPS (37.5 °C from ED1 to 10 and 38 °C from ED 11 to 25 + LPS at D0). At ED16 and ED24, the egg shell temperature of the duck and turkey eggs in the HH and SH treatments were higher (P ≤ 0.01) than the SS treatment. Ducklings and poults in the HH treatment had the lowest yolk free body weight at hatch (P ≤ 0.05). At 24, 48, and 72 h post-LPS injection, ducklings and poults in the HH-LPS treatment had significantly reduced BW compared with the SS-Con treatments (P ≤ 0.05). Ducklings and poults in the SH-LPS and HH-LPS treatments had increased plasma heat shock protein 70 (HSP70) and lower splenic HSP70 mRNA amounts than the SS-LPS treatments at 24, and 48 h post-challenge (P ≤ 0.05). At 48 and 72 h, macrophage nitric oxide (NO) production in ducklings and poults in the SH-LPS and HH-LPS treatments was lower than in the SS-LPS treatments (P ≤ 0.05). Ducklings and poults in the SH-LPS treatment had increased thymocyte proliferation compared to the SS-LPS treatment at 24, 48 and 72 h (P ≤ 0.05). At 24 h, ducklings in the SH-LPS treatment had increased splenic IL-10 and reduced IFNγ and IL-6 mRNA abundance. However, both ducklings and poults in the HH-LPS treatment had increased IFNγ, and IL-10 mRNA abundance compared to the SS-LPS treatment (P ≤ 0.05). At 48 h, SH-LPS ducklings and poults had lower splenic IL-10 mRNA abundance (P ≤ 0.05) while the HH-LPS treatment resulted in comparable splenic IL-10 mRNA compared to the SS-LPS treatment (P ≥ 0.05). Ducklings and poults in the SH-LPS treatment had increased thymic and splenic CD8⁺/CD4⁺ ratios at 24 h versus the SS-LPS treatment (P ≤ 0.05). In conclusion, embryonic thermal manipulation from ED11-25 increased extracellular HSP70 release, thymocyte proliferation and IL-10 but decreased splenic HSP70 and IFNγ mRNA amounts at 24 h post-LPS injection. This suggests that mild heat stress during the later stages of incubation could potentially prime the embryonic immune system thereby enhances the immune response as earlier than 24 h to eliminate the inflammatory response without affecting the growth performance by increase the extracellular release of HSP70 in both ducklings and poults. Continuous exposure to the small increase in temperature from ED 1-25 (HH) caused an imbalance between pro (IFNγ)- and anti-inflammatory cytokines(IL-10) which affects hatchling responses to an inflammatory challenge and increased mortality. The amount of extracellular HSP70 could potentially play an important role in modulating the immune response against inflammatory challenges.

Effect of embryonic thermal manipulation on heat shock protein 70 (HSP70) expression and subsequent immune response to post-hatch lipopolysaccharide challenge in Pekin ducklings

During the course of multi-stage incubation, small locational differences in incubation temperature within a machine are not uncommon and so the goal of this study was to study the immune response of ducklings exposed to thermal manipulation during incubation. Commercial Pekin duck eggs (n = 200) were distributed among four treatment: SS-Control (37.5°C from embryonic day [ED] 1 to 25); SS-LPS (37.5°C from ED1 to 25 + LPS at D0 [hatch]); HH-LPS (38°C from ED1 to 25+ LPS at D0); SH-LPS (37.5°C from ED1 to 10 and 38°C from ED 11 to 25 + LPS at D0). At D0, ducklings received a lipopolysaccharide (LPS) injection. At D1 and D5, the HH-LPS treatment significantly reduced body weight (P ≤ 0.05). At D1 and D3 post-LPS injection, the SH-LPS and HH-LPS treatments significantly reduced splenic and bursal heat shock protein 70 (HSP70), mRNA abundance, and macrophage nitric oxide production compared with the SS-LPS treatment (P ≤ 0.05). At D1, the HH-LPS and SH-LPS treatments had increased splenic IL-10 mRNA and lower MHC I mRNA compared with the SS-LPS treatment (P ≤ 0.05). At D1, the HH-LPS treatment increased splenic IL-6 mRNA and bursal IFNγ mRNA transcription while the SH-LPS treatment reduced splenic IL-6 mRNA compared with the SS-LPS treatment (P ≤ 0.05). The HH-LPS treatment reduced thymocyte proliferation efficiency, while at D1, D3, and D5, the SH-LPS treatment increased thymocyte proliferation efficiency compared with the SS-LPS treatment (P ≤ 0.05). Ducklings in the HH-LPS treatment had a higher splenic CD8+/CD4+ ratio compared to the SS-LPS treatment at D3 post-LPS injection (P ≤ 0.05). In summary, the HH-LPS treatment compromised immunocompetence via decreased NO production and thymocyte proliferation efficiency, while the SH-LPS treatment increased body weight and thymocyte proliferation and reduced IL-6 mRNA abundance. This suggests that an embryonic temperature stress during the latter half of incubation may prime the immune system which may be beneficial during secondary post-hatch inflammatory challenges.

Collagen Gel Immobilisation Provides a Suitable Cell Matrix for Long Term Human Hepatocyte Cultures in Hybrid Reactors

An easy to apply culture technique is presented that protects a monolayer configuration of liver cells within an extracellular matrix. The Immobilising Gel (IG)-Technique not only preserves hepatocyte morphology and supports a variety of differentiated cell functions over long term periods, but also offers higher resistance of IG-culture systems against shear forces of fluids in a hybrid reactor device, as compared to other culture techniques. Human hepatocyte cultures in IG-Technique: DNA-normalised levels for the total production of cholinesterase, albumin, urea and lactate remained high throughout the investigational period (50 days). Glutamic-Pyruvic-Transaminase (GPT) release decreased after peak values during early culture adaptation. Electron Microscopic (EM) findings after the shear forces experiment revealed undisturbed subcellular structures and a preserved intercellular morphology, including bile canaliculi and desmosomes. We conclude that the IG-technique is of considerable advantage as compared to other culture systems, especially in the field of dynamic applications, e.g. hybrid reactors for artificial organ development.

Extracorporeal Artificial Liver: The Influence of a Second Cell Layer on the Morphology and Function of Immobilized Human Hepatocytes

Hepatocytes in long-term cultures represent a promising approach to preserve liver function under standard culture conditions. Hepatocyte cultures as the key components in an extracorporeal artificial liver (EAL) in the treatment of hepatic insufficiency, would be a great advantage. However, one of the numerous unsolved problems is the limitation of the surface area of a future EAL. To decrease the dimensions of same, we modified the cell immobilization technique by placing a second layer of immobilized human hepatocytes onto a layer of pre-immobilized hepatocytes creating a “sandwich immobilization” (SI) system. Immobilization and sandwich immobilization were compared over an investigation period of 30 days: functional performance mirrored by cholinesterase (CHE) and albumin secretion showed remarkable differences only in the course of the first week, whereas we found almost no differences from day 8 on. The total DNA-values on days 0, 1, 7, 14, 21 and 30 varied strongly after the first week but were very similar up to day 30. Finally, it appears disadvantageous to enlarge number/cm2 of (human) hepatocytes in long-term cultures or for application in an EAL by means of sandwich immobilization.

[Cytology of cerebrospinal fluid : Standards, importance and modern methods]

Cytology is an integral part of cerebrospinal fluid (CSF) analysis. It is relevant for the diagnostics and differential diagnosis of inflammatory, hemorrhagic and neoplastic central nervous system (CNS) processes. This article summarizes the recommended procedures and typical clinical patterns. In addition, modern immunocytochemical and flow cytometry methods for CSF cytology are presented. In particular, the diagnostic contribution and clinical relevance in several CNS conditions are discussed.

Early intestinal development and mucin transcription in the young poult with probiotic and mannan oligosaccharide prebiotic supplementation

Alternative and adjunctive approaches to decreasing the use of dietary antibiotics are becoming popular areas of study. Supplemental probiotics (commensal microbes) and prebiotics (indigestible complex carbohydrates) are 2 dietary approaches to facilitating the intestinal colonization of beneficial bacteria to compete with potential pathogens, thus creating a healthy mucosal environment. The intestinal mucosa is composed of mucin glycoproteins, which play a key role in preventing the attachment of pathogenic bacteria. At hatch, the neonatal turkey intestine is relatively aseptic and vulnderable to bacterial colonization by both commensal and pathogenic microbes. In the current study, we determined the transcription of MUC2, the primary mucin protein produced by goblet cells within the small intestine, and we also measured intestinal morphology immediately post-hatch through d 11. Poults were fed a conventional starter diet, the starter diet supplemented with one of 2 commercial probiotics (A, B), or a commercial mannan oligosaccharide. MUC2 transcription increased from d zero to d 4 post-hatch (P< 0.05), but there was no effect of probiotic or prebiotic supplementation. Villus height and villus area both increased with Probiotic B and mannan oligosaccharide supplementation (P<0.05) and there was a significant d X treatment interaction effect for crypt depth (P=0.007). These results suggest that probiotic and prebiotic supplementation can positively alter the intestinal microenvironment.

Temporal embryonic transcription of chicken fast skeletal myosin heavy chain isoforms in the single comb white leghorn

There are numerous factors that can significantly influence embryonic development in poultry and thus make simple days of incubation (chronological age) a less than perfect metric for studying embryonic physiology. The developmental fast skeletal muscle myosin (MyHC), the predominant protein in the Pectoralis major (PM), is temporally expressed as a cadre of highly specific developmental isoforms. In the study described herein, a novel molecular technology (NanoString) was used to characterize the myosin isoform transcriptional patterns in the PM of Single Comb White Leghorn (SCWL) embryos. NanoString technology is based on quantitative analysis of the transcriptome through digital detection and quantification of target mRNA transcripts. Total RNA was isolated and gene transcription quantified using NanoString in embryonic muscle samples collected daily from 6 through 19 days of incubation. Data were analyzed using the LOESS smoothing function at a 95% confidence level. The temporal transcription of MyHC isoforms obtained in this study was consistent with the literature at higher specificity and resolution, thus validating NanoString for use in gene transcription analyses. The results support a hypothesis that the transcription patterns of the embryonic MyHC isoforms may be used as molecular clocks to further investigate the developmental relationships underlying embryonic fast skeletal muscle growth and development.

Clinical characteristics of ovarian cancer classified by BRCA1, BRCA2, and RAD51C status

We evaluated homologous recombination deficient (HRD) phenotypes in epithelial ovarian cancer (EOC) considering BRCA1, BRCA2, and RAD51C in a large well-annotated patient set. We evaluated EOC patients for germline deleterious mutations (n = 899), somatic mutations (n = 279) and epigenetic alterations (n = 482) in these genes using NGS and genome-wide methylation arrays. Deleterious germline mutations were identified in 32 (3.6%) patients for BRCA1, in 28 (3.1%) for BRCA2 and in 26 (2.9%) for RAD51C. Ten somatically sequenced patients had deleterious alterations, six (2.1%) in BRCA1 and four (1.4%) in BRCA2. Fifty two patients (10.8%) had methylated BRCA1 or RAD51C. HRD patients with germline or somatic alterations in any gene were more likely to be high grade serous, have an earlier diagnosis age and have ovarian and/or breast cancer family history. The HRD phenotype was most common in high grade serous EOC. Identification of EOC patients with an HRD phenotype may help tailor specific therapies.

[Current cerebrospinal fluid diagnostics for pathogen-related diseases]

Cerebrospinal fluid (CSF) analysis is of utmost importance to establish an early diagnosis of central nervous system (CNS) infections and to start appropriate therapy. The CSF white cell count, lactate concentration and total protein levels are usually available very quickly even from non-specialized laboratories and the combination of these parameters often provides sufficient information for decision-making in emergency cases. It is, however, not always possible to identify the underlying infective agent despite further CSF analyses, such as bacterial and fungal staining, evaluation of the blood-CSF barrier function, intrathecal immunoglobulin synthesis and oligoclonal IgG bands. Therefore, close communication between the laboratory and the clinician is an important prerequisite to specify additional pathogen-related diagnostic measures for successful confirmation of the diagnosis.

Feed restriction delays developmental fast skeletal muscle myosin heavy chain isoforms in turkey poults selected for differential growth

Genetic selection has been very successful at significantly increasing BW and breast muscle proportion in commercial broiler and turkey strains. The mechanisms of breast muscle growth in poultry and the interactive effects of nutritional status and selection are not fully understood. The hypothesis underlying the current study is that feed restriction, simply as a vehicle for controlling early growth, would delay the temporal expression pattern of neonatal (nMyHC) and adult (aMyHC) fast skeletal muscle myosin heavy chain (MyHC) isoforms in the pectoralis major muscle of turkey poults. The poultry growth model used to evaluate this hypothesis consisted of a randombred control turkey line (RBC2) that represents commercial turkeys of the 1960s and a line developed from the RBC2 by selection for BW at 16 wk of age (F line). The F line has significantly heavier breast muscles than the RBC2 concomitant with increased BW, but the proportion of breast muscle relative to BW is similar. A quantitative indirect ELISA using fast skeletal MyHC isoform specific monoclonal antibodies revealed no significant line differences in the temporal expression of posthatch fast skeletal muscle MyHC in ad libitum fed poults. Feed restriction, however, altered the temporal expression patterns of nMyHC and aMyHC in both F line and RBC2 poults compared with the poults fed ad libitum.

Multivariate evaluation of 1-dimensional sarcoplasmic protein profile patterns of turkey breast muscle during early post-hatch development

Proteins are the main participants in metabolic pathways. However, the analysis of protein abundance patterns associated with those pathways is complicated by the large number of proteins involved. In this study, the objective was to present the application of principal component analysis (PCA) to permit the visualization of developmental proteomic patterns of sarcoplasmic proteins found in breast muscle. Different turkey genotypes and nutritional regimens were used to potentially increase the variability within the sarcoplasmic protein profile. Sarcoplasmic protein fractions from turkey breast muscle samples were collected at 6 ages between 7 to 24 d. Breast muscle samples were collected from 2 distinctly different turkey lines. The poults within each line were either ad libitum or restrict fed. Proteomic PCA plots showed a visual developmental pattern from 7 until 17 d. Multivariate ANOVA highlighted the effect of time point and feeding regimen among profile patterns. The use of different genotypes and feeding regimens influenced variability, which was measured by mean Euclidean distances and ellipses of the PCA plots. These treatment effects, however, did not mask the developmental patterns. After 17 d, the proteomic patterns converged, suggesting that a level of biological stability was achieved regardless of the genotype or treatment. The developmental pattern obtained by the PCA methodology can aid in the planning of more efficient experimental designs so the developmental stage of individuals can be more accurately assessed.

Evaluation of a new computerized analysis system developed for the processing of CT follow-up scans after EVR of infrarenal aneurysm

PURPOSE

The aim of this retrospective study was to present a new computerized analysis system developed for the evaluation of follow-up CT scans after endovascular repair (EVR) of infrarenal aneurysm and to compare it to the conventional evaluation method as regards preciseness and ease of application. The system is based on the extraction of the surface of the stent-graft (SG) and that of the spinal canal and the overlay of surfaces obtained at different points in time.

MATERIALS AND METHODS

A total of 116 CT follow-up data sets obtained from 49 patients after EVR of infrarenal aneurysm were evaluated using both, the conventional method and the new computerized system. Two parameters were analyzed: SG length and the distance between the most ventral point of the SG and the vertebral column. The correlation between the results of the two methods and the correlation between the results obtained by two independent observers (radiologist and lay person) using the new system were assessed by statistical analysis.

RESULTS

Comparison of the two methods yielded a very high correlation for both parameters, (correlation coefficients of around 0.9 and p<0.001). Comparison of the results obtained by the two observers yielded an equally high correlation (correlation coefficients of around 0.9 and p<0.001).

CONCLUSION

Our results show that the new computerized system is as precise and reliable as the conventional method, but allows better visualization and quantification of SG changes by surface overlay. Moreover, it is easier to apply and less time-consuming and can be easily integrated into existing systems.

[Osteoporotic vertebral fractures in the elderly: are conventional radiographs useful? - clinical and radiographic results after kyphoplasty]

AIM

In a retrospective study we examined the reliability of conventional radiographs to detect osteoporotic vertebral fractures. Furthermore, we analysed clinical and radiological results 4 weeks and one year after balloon kyphoplasty.

MATERIAL AND METHODS

Between April 2007 and December 2008, 68 patients with 77 vertebral fractures were allocated to kyphoplasty. All patients could be evaluated 4 weeks after the operation and 50 patients (74%) for the one-year follow-up. In all patients conventional radiographs of the spine were performed. Persisting or increasing pain after one week led to an MRI. Under consideration of the pain situation and the result of the MRI a balloon kyphoplasty was performed.

RESULTS

In 19 patients (25.3%) a cement leakage without any neurological symptoms was observed. After the operation we did not find any neurological disturbances, infection or haematoma. 13 thoracic spine fractures (38%) and 21 lumbar spine fractures (51%) could not be detected with conventional X-rays and could be observed only with the MRI. Preoperatively the kyphosis angle was measured with 13.3°, 4 weeks after the operation it was 5.2° (p = 0.001) and one year after the surgical procedure 4.8°. After kyphoplasty, the compression index was improved with 26% (p ≤ 0.001). Using the visual analogue scale there was a pain reduction of 52.3% (p ≤ 0.001) which was still detectable after one year. We did not find any correlation between the restored height of the vertebra and the reduction of pain. Furthermore, we did not find any correlation concerning pain reduction in the visual analogue scale irrespective of whether the fracture was detected initially with conventional X-rays or later with MRI. In 5 patients (7.3%) there were subsequent vertebral fractures without any trauma. All of these fractures were treated again operatively by a kyphoplasty.

CONCLUSION

Especially in geriatric patients with osteoporosis, vertebral fractures can be underdiagnosed with conventional X-rays. Persisting or increasing pain should lead to an MRI to detect and to determine the age of the fracture. In acute fractures, patients profit very well with a significant long-term pain reduction and as a result with an increased mobility after balloon kyphoplasty.

(-)-Gossypol containing hen sera and a myosin (-)-gossypol conjugate reduces the proliferation of MCF-7 cells

Sera from chickens that consumed a known level of (-)-gossypol (-)-GP) exhibited bioactivity against human breast cancer cells in vitro. Based on this, it is conceivable that similar anti-breast cancer activities of different magnitudes will be exhibited in biological samples harvested from (-)-GP-fed layer hens. The experimental data generated in this study may influence the fundamental thinking regarding the utilization of low cost agricultural commodities such as (-)-GP cottonseed meal to produce value-added chemopreventive animal products.

Distinct mechanistic activity profile of pralatrexate in comparison to other antifolates in in vitro and in vivo models of human cancers

PURPOSE

This study evaluated mechanistic differences of pralatrexate, methotrexate, and pemetrexed.

METHODS

Inhibition of dihydrofolate reductase (DHFR) was quantified using recombinant human DHFR. Cellular uptake and folylpolyglutamate synthetase (FPGS) activity were determined using radiolabeled pralatrexate, methotrexate, and pemetrexed in NCI-H460 non-small cell lung cancer (NSCLC) cells. The tumor growth inhibition (TGI) was assessed using MV522 and NCI-H460 human NSCLC xenografts.

RESULTS

Apparent K ( i ) values for DHFR inhibition were 45, 26, and >200 nM for pralatrexate, methotrexate, and pemetrexed, respectively. A significantly greater percentage of radiolabeled pralatrexate entered the cells and was polyglutamylatated relative to methotrexate or pemetrexed. In vivo, pralatrexate showed superior anti-tumor activity in both NSCLC models, with more effective dose-dependent TGI in the more rapidly growing NCI-H460 xenografts.

CONCLUSIONS

Pralatrexate demonstrated a distinct mechanistic and anti-tumor activity profile relative to methotrexate and pemetrexed. Pralatrexate exhibited enhanced cellular uptake and increased polyglutamylation, which correlated with increased TGI in NSCLC xenograft models.

[Early-onset infection after hemiarthroplasty of the hip: an algorithm for surgical therapy]

BACKGROUND

In a retrospective study, we compared the results of different surgical therapies in 30 patients who had an early-onset infection after implantation of a hip hemiarthroplasty.

MATERIAL AND METHODS

Patients were divided into two groups: In group 1 (n=16, deep infection), we changed the polyethylene inlay as well as the femoral head. In group 2 (n=14, deep infection), an acetabular component was also implanted.

RESULTS

In group 1, successful treatment was achieved in 37.5% of patients 6 months after the last operation, compared with 71.4% in group 2 (p=0.019). All patients were supported with antibiotics. In group 1, three patients died from septic multiorgan failure. Two patients in group 1 and one patient in group 2 received a Girdlestone operation.

CONCLUSIONS

These results suggest that aggressive surgical treatment with soft tissue revision, lavage, and implantation of an acetabular component in combination with antibiotics is a useful technique for treating early-onset infection.

Unidentified cells reside in fish skeletal muscle

Cell cultures were established from the skeletal muscle tissue of 6-13 months old rainbow trout and 12-14 months old yellow perch. Approximately 27,000 +/- 5,000 cells/g (trout; N = 5) and 5,000 +/- 1,200 cells/g of tissue (perch; N = 4) were obtained. Isolation and propagation were qualitatively greater for both species when the cells (younger fish producer more cells than older fish) were exposed to DMEM + 15% FBS, rather than L-15 + 15% FBS, at 20 degrees C (trout) and at 24 degrees C (yellow perch). Two morphologically distinct cell types were observed in cultures of both species, some of which eventually formed very small myotubes, which displayed immunocytological reactivity for myogenin, myosin heavy chain, and alpha-actinin; the second population of cells remained unstained. Successful cryopreservation was achieved using a 5% DMSO and 95% serum mixture, but post-thawing viabilities were low 5-27% (trout) and 14-30% (perch). Further research is needed in order to determine cell type specificity of isolated cells.

Polyspecific, antiviral immune response distinguishes multiple sclerosis and neuromyelitis optica

BACKGROUND

A polyspecific, intrathecal humoral immune response against neurotropic viruses such as measles, rubella and varicella zoster virus (MRZ reaction, MRZR) is present in 80-100% of patients with multiple sclerosis (MS), but has not to date been evaluated in patients with neuromyelitis optica (NMO).

AIMS

To evaluate whether MRZR distinguishes NMO and MS.

METHODS

20 patients with NMO and 42 with MS were included. The intrathecal synthesis of antibodies against measles, rubella and varicella zoster virus was detected by calculation of the respective antibody indices (AI).

RESULTS

A positive MRZ reaction, as defined by a combination of at least two positive AIs, was found in 37/42 MS, but in only 1/20 NMO patients (p<0.0001). Median AI values differed significantly between the groups (p<0.0005).

CONCLUSIONS

The polyspecific antiviral humoral immune response characteristic for MS is widely missing in NMO, irrespective of the NMO-IgG status of the patients. Our findings further strengthen the case for NMO being pathologically distinct from MS.

Transmission of methicillin-resistant Staphylococcus aureus among hospital staff in a German trauma centre: a problem without a current solution?

Between October 2001 and February 2002, 324 healthcare workers were screened for methicillin-resistant Staphylococcus aureus (MRSA) by nose and throat swabs. A positive finding led to activation of a standardised control programme for the affected person who was immediately excluded from work. Family members of those who were MRSA-positive were offered screening free of charge. An eradication programme was carried out in the permanent carriers. MRSA was found in 17 (5.3%) healthcare workers, 11 of whom proved to be permanent carriers, and six temporarily colonised. Three children of a positive healthcare worker showed nasopharyngeal MRSA, the acquisition of which occurred within the hospital. The standardised eradication programme for carriers was successful in most cases but failed in two individuals, whereupon systemic antibiotics were used successfully. The decolonised carriers, observed for more than one year, remained MRSA negative. Isolation precautions in hospitals do not always prevent hospital staff and their families from acquiring MRSA. The identification of affected employees is difficult because in most cases only asymptomatic colonisation occurs. Screening and eradication can be complicated and costly, and for the affected employees the occupational consequences can be far-reaching as they have no guaranteed legal protection.

Emerging fermentation technologies: Development of novel sourdoughs

The increasing knowledge of sourdough fermentation generates new opportunities for its use in the bakery field. New fermentation technologies emerged through in depth sourdough research. Dextrans are extracellular bacterial polysaccharides produced mainly by lactic acid bacteria (LAB). These bacteria convert sucrose thanks to an inducible enzyme called dextransucrase into dextran and fructose. The structure of dextran depends on the producing micro-organism and on culture conditions. Depending on its structure, dextran has specific properties which lead to several industrial applications in different domains. The use of dextran is not widely spread in the bakery field even if its impact on bread volume and texture was shown. A new process has been developed to obtain a sourdough rich in dextran using a specific LAB strain able to produce a sufficient amount of HMW dextran assuring a significant impact on bread volume. The sourdough obtained permits to improve freshness, crumb structure, mouthfeel and softness of all kinds of baked good from wheat rich dough products to rye sourdough breads. From fundamental research on dextran technology, a new fermentation process has been developed to produce an innovative functional ingredient for bakery industry.

Fusion of the septic knee with external hybrid fixator

Arthrodesis is a well-recognized salvage procedure in patients with septic destruction of knee joints. It offers the opportunity for restoring weight bearing capability and significant pain relief as well as eradication of infection, but at the expense of joint motion. However, arthrodesis in order to joint sepsis may be difficult to achieve because of poor bone stock, persistent infection and soft tissue compromise. From 2000 to June 2004, in 70 consecutive patients arthrodesis of the knee was indicated. Nineteen patients were considered to have external hybrid fixator (EHF) and were therefore included to the prospective study protocol. Forty-three stabilisations of destructed knee joints were done by a modular titanium rod. In these cases bony fusion was very unlikely to be achieved because of devastating defects due to infected total knee arthroplasties. Eight patients were treated by compression nailing. In these situations EHF was not indicated. In three patients minor complication occurred. In two out of 17 patients fusion failed because of primary underestimated bony defects (11.8%). The use of EHF for arthrodeses after septic destruction of knee joints can be recommended according to our results. However, EHF will not be successful or applicable in each case. Therefore, physicians and institutions that offer this special method should have not only experiences with EHF but also with arthrodeses and alternative procedures.

[Polytrauma with severe lung contusion. Early use of extracorporeal membrane oxygenation]

Extracorporeal membrane oxygenation (ECMO) is a technique for sustaining body oxygenation in case of respiratory failure. Since ECMO technology has undergone improvements resulting in better hemo-compatibility and reduced side effects, venovenous ECMO is a mostly accepted treatment of adult respiratory distress syndrome (ARDS). One should discuss the early initiation of ECMO therapy for post-traumatic respiratory failure. We report about a 23-year-old male and a 15-year-old female patient, who suffered polytrauma and received early treatment with ECMO because of severe lung contusion.

[Iliopsoas tendinitis--rare cause of pain following implantation of a total hip endoprosthesis]

Pain following implantation of a total hip endoprosthesis is described in the literature with an incidence of 1-17.6%, depending on the type of prosthesis. The underlying causes are numerous; the primary reasons for such pain are septic and nonseptic loosening of the prosthesis, periarticular heterotopic ossifications, or trochanteric bursitis. Less common reasons are muscular hernia, squeezing of the joint capsule, distal nerve lesions, stress fractures, compartment syndromes, or neoplasia.One can find only a few reports about tendinitis of the iliopsoas muscle as a cause for pain following implantation of an endoprosthesis in total hip arthroplasty. We now report about a female patient with therapy-resistant pain after total hip replacement, caused by tendinitis of the iliopsoas muscle. We introduce the transpositioning of this tendon from the lesser trochanter to the proximal anterior femur and bony refixation with a PDS cord as a new operative treatment.

[Surgical treatment of a displaced femoral head fracture with a cement-free dual-headed prosthesis using a minimally invasive approach. Clinical and radiographic outcome]

One hundred patients treated with a cementless bipolar prosthesis for a displaced subcapital hip fracture were prospectively evaluated for clinical and radiographic outcome. All patients were operated via a minimally invasive approach; in every case we implanted a Zweymuller stem. There were 77 women and 33 men with a mean age of 80 years (29-98 years). The mean duration of the operation was 29 min (20-95 min). Full weight bearing on crutches was allowed 1 day after the operation. The mean follow-up was 2.5 years (6 months to 7 years). Two years after the operation there were 40% of the remaining 65 patients who scored between 90 and 100 on the Harris hip score, 23% between 80 and 89, 20% between 70 and 79, and 17% below 70. No patient complained about thigh pain and up to now there has been no need for femoral revision due to loosening. There was no infection or nerve lesion. In three patients there was a luxation of the prosthesis which could be reduced by closed means. Radiographs from 81 patients showed stress shielding in 97.5% mainly in Gruen zones 1 and 7. Radiolucent lines in two or more Gruen zones were found in two patients. These findings suggest that the noncemented, pressfit, grit-blasted bipolar prosthesis demonstrated similar stability and radiographic results to cemented bipolar prostheses. Stress shielding was common but did not influence longevity of the implant. We did not find any signs of protrusion. Especially in older patients with a history of cardiac disease, the noncemented bipolar prosthesis is a rational alternative to avoid intra- and postoperative complications despite the higher costs for the implant. The minimally invasive approach helps to reduce operation time and intraoperative blood loss.