Alterations in the mechanical, chemical and biocompatibility properties of low-cost polyethylene and polyester meshes after steam sterilization

Introduction

In Africa and other Low Resource Settings (LRS), the guideline-based and thus in most cases mesh-based treatment of inguinal hernias is only feasible to a very limited extent. This has led to an increased use of low cost meshes (LCMs, mostly mosquito meshes) for patients in LRS. Most of the LCMs used are made of polyethylene or polyester, which must be sterilized before use. The aim of our investigations was to determine changes in the biocompatibility of fibroblasts as well as mechanical and chemical properties of LCMs after steam sterilization.

Material and methods

Two large-pored LCMs made of polyester and polyethylene in a size of 11 x 6 cm were cut and steam sterilized at 100, 121 and 134 °C. These probes and non-sterile meshes were then subjected to mechanical tensile tests in vertical and horizontal tension, chemical analyses and biocompatibility tests with human fibroblasts. All meshes were examined by stereomicroscopy, scanning electron microscopy (SEM), LDH (cytotoxicity) measurement, viability testing, pH, lactate and glycolysis determination.

Results

Even macroscopically, polyethylene LCMs showed massive shrinkage after steam sterilization, especially at 121 and 134 °C. While polyester meshes showed no significant changes after sterilization with regard to deformation and damage as well as tensile force and stiffness, only the unsterile polyethylene mesh and the mesh sterilized at 100 °C could be tested mechanically due to the shrinkage of the other specimen. For these meshes the tensile forces were about four times higher than for polyester LCMs. Chemical analysis showed that the typical melting point of polyester LCMs was between 254 and 269 °C. Contrary to the specifications, the polyethylene LCM did not consist of low-density polyethylene, but rather high-density polyethylene and therefore had a melting point of 137 °C, so that the marked shrinkage described above occurred. Stereomicroscopy confirmed the shrinkage of polyethylene LCMs already after sterilization at 100 °C in contrast to polyester LCMs. Surprisingly, cytotoxicity (LDH measurement) was lowest for both non-sterile LCMs, while polyethylene LCMs sterilized at 100 and 121 °C in particular showed a significant increase in cytotoxicity 48 hours after incubation with fibroblasts. Glucose metabolism showed no significant changes between sterile and non-sterile polyethylene and polyester LCMs.

Conclusion

The process of steam sterilization significantly alters mechanical and structural properties of synthetic hernia mesh implants. Our findings do not support a use of low-cost meshes because of their unpredictable properties after steam sterilization.

Hydration and Dehydration Kinetics: Comparison between Poly( N-isopropyl methacrylamide) and Poly(methoxy diethylene glycol acrylate) Films

Thermoresponsive films of poly( N-isopropyl methacrylamide) (PNIPMAM) and poly(methoxy diethylene glycol acrylate) (PMDEGA) are compared with respect to their hydration and dehydration kinetics using in situ neutron reflectivity. Both as-prepared films present a homogeneous single-layer structure and have similar transition temperatures of the lower critical solution temperature type (TT, PNIPMAM 38 °C and PMDEGA 41 °C). After hydration in unsaturated D₂O vapor at 23 °C, a D₂O enrichment layer is observed in PNIPMAM films adjacent to the Si substrate. In contrast, two enrichment layers are present in PMDEGA films (close to the vapor interface and the Si substrate). PNIPMAM films exhibit a higher hydration capability, ascribed to having both donor (N-H) and acceptor (C═O) units for hydrogen bonds. While the swelling of the PMDEGA films is mainly caused by the increase of the enrichment layers, the thickness of the entire PNIPMAM films increases with time. The observed longer relaxation time for swelling of PNIPMAM films is attributed to the much higher glass transition temperature of PNIPMAM. When dehydrating both films by increasing the temperature above the TT, they react with a complex response consisting of three stages (shrinkage, rearrangement, and reswelling). PNIPMAM films respond faster than PMDEGA films. After dehydration, both films still contain a large amount of D₂O, and no completely dry film state is reached for a temperature above their TTs.

Effect of chain architecture on the swelling and thermal response of star-shaped thermo-responsive (poly(methoxy diethylene glycol acrylate)-block-polystyrene)3 block copolymer films

The effect of chain architecture on the swelling and thermal response of thin films obtained from an amphiphilic three-arm star-shaped thermo-responsive block copolymer poly(methoxy diethylene glycol acrylate)-block-polystyrene ((PMDEGA-b-PS)₃) is investigated by in situ neutron reflectivity (NR) measurements. The PMDEGA and PS blocks are micro-phase separated with randomly distributed PS nanodomains. The (PMDEGA-b-PS)₃ films show a transition temperature (TT) at 33 °C in white light interferometry. The swelling capability of the (PMDEGA-b-PS)₃ films in a D₂O vapor atmosphere is better than that of films from linear PS-b-PMDEGA-b-PS triblock copolymers, which can be attributed to the hydrophilic end groups and limited size of the PS blocks in (PMDEGA-b-PS)₃. However, the swelling kinetics of the as-prepared (PMDEGA-b-PS)₃ films and the response of the swollen film to a temperature change above the TT are significantly slower than that in the PS-b-PMDEGA-b-PS films, which may be related to the conformation restriction by the star-shape. Unlike in the PS-b-PMDEGA-b-PS films, the amount of residual D₂O in the collapsed (PMDEGA-b-PS)₃ films depends on the final temperature. It decreases from (9.7 ± 0.3)% to (7.0 ± 0.3)% or (6.0 ± 0.3)% when the final temperatures are set to 35 °C, 45 °C and 50 °C, respectively. This temperature-dependent reduction of embedded D₂O originates from the hindrance of chain conformation from the star-shaped chain architecture.

Thermal glass transition beyond kinetics of a non-crystallizable glass-former

A long-debated problem related to glass formation in amorphous materials is the interplay of thermodynamic, kinetic and α-relaxation processes. For the first time, low-frequency dynamics, as well as kinetic or quasi-static thermal expansion coefficients of a non-crystallizable glass-former are simultaneously measured. Based on the feedback between low-frequency dynamics and morphology, the study supports the viewpoint that glass formation can be observed in internal equilibrium, i.e. beyond kinetics, and might stem from spontaneous local-scale morphological changes.

The Role of Backbone Hydration of Poly(N-isopropyl acrylamide) Across the Volume Phase Transition Compared to its Monomer

Thermo-responsive polymers undergo a reversible coil-to-globule transition in water after which the chains collapse and aggregate into bigger globules when passing to above its lower critical solution temperature (LCST). The hydrogen bonding with the amide groups in the side chains has to be contrasted with the hydration interaction of the hydrophobic main-chain hydrocarbons. In the present investigation we study molecular changes in the polymer poly(N-isopropyl acrylamide) (PNIPAM) and in its monomer N-isopropyl acrylamide (NIPAM) in solution across the LCST transition. Employing Fourier-transform infrared spectroscopy we probe changes in conformation and hydrogen bonding. We observe a nearly discontinuous shift of the peak frequencies and areas of vibrational bands across the LCST transition for PNIPAM whereas NIPAM exhibits a continuous linear change with temperature. This supports the crucial role of the polymer backbone with respect to hydration changes in the amide group in combination with cooperative interactions of bound water along the backbone chain.

[Autopsies for anatomical teaching and training in clinical forensic medicine]

BACKGROUND

Clinical forensic medicine does not only entail examination of patients after physical violence but also the option of clinical autopsies, e.g. after non-notifiable complications of medical interventions, after fatalities closely following medical interventions or fatalities as a result of injuries when the public prosecutor decides not to order a medicolegal autopsy. Based on this routine the Institute of Forensic Medicine at the University of Rostock offers a training course in topographical anatomy to physicians for further training in interventional and surgical disciplines.

METHODS

At the beginning of autopsies the participants can explore the approaches of interventional puncture techniques as well as surgical techniques and the basic topographical anatomy in small groups of 2-4 persons under the supervision of forensic examiners. The format is essentially oriented to the early further training period but fulfils the requirements for the exploration of complex operative techniques. The course was adapted for physicians and offered separately to students. The explorations are performed manually or by support with autopsy instruments.

RESULTS

The courses offer an ideal room for individual, discipline-specific topics and result in a great benefit for all participants. A statistical assessment can only be achieved with a larger number of participants.

CONCLUSION

Making autopsy rooms available for teaching and further training represents an additional feature to the profile of clinical forensic medicine. Lessons in topographical anatomy provide a great benefit for patient safety. It seems to be important to offer the opportunity to address individual interests in a closed meeting to consolidate skills and abilities in a non-judgemental environment. The post-mortem examiners have to ensure that the autopsy is carried out lege artis. Basic ethical principles and all regulations from an accredited scope have to be adhered to.

Influence of Confinement on the Chain Conformation of Cyclic Poly(N-isopropylacrylamide)

In thin and ultrathin supported films, the conformations of flexible linear polymer chains might be considerably confined, in particular, for film thicknesses smaller than a few times the radius of gyration. For ring polymers in solution or in melt, the radii of gyration are significantly reduced as compared to those of their linear counterparts. We study here the influence of geometrical confinement on the chain conformation of cyclic PNIPAM in silicon-supported films. Measurements are performed by grazing incidence small angle neutron scattering (GISANS). For all films, the component of the radius of gyration parallel to the substrate, R_gc∥, is significantly higher than the unperturbed R_gc determined under theta solvent or melt conditions. We attribute this effect to a preferential selection of stretched PNIPAM ring conformations in thin films and a preferential orientation of macromolecules parallel to the film interfaces with the substrate and air.

Sorption of Water and Initial Stages of Swelling of Thin PNIPAM Films Using in Situ GISAXS Microfluidics

The sorption of low-molecular penetrants by thin polymer films, as well as structural changes provoked therein, is of high relevance for many fields of application. Complex permeation, diffusion, swelling, and dissolution processes are often induced within films by solvents or gases. Here, we use a novel in situ microfluidics-grazing incidence small-angle X-ray scattering (GISAXS) setup to examine changes in film thickness and in the surface structure of a thin polymer film that sorbs a good solvent. Thus, this technique is highly complementary to the established techniques on the field of diffusion in polymers. The initial stages of water uptake and swelling are resolved for a 50 nm thin, hydrophilic poly(N-isopropylacrylamide) (PNIPAM) film, before its dissolution sets in. The initial stages of swelling are tentatively described by anomalous swelling induced by a time- and space-dependent diffusion coefficient.

[Inguinal Hernia Repair According to Desarda - Implementation of a Mesh-Free Method in a German University Hospital]

Inguinal hernia repair shows a clear tendency towards mesh-based as well as laparoscopic approaches. This is widely reflected in data-based statistics and guidelines. In contrast we have initiated and hereby illustrate the surgical method according to Desarda using autologous fascia to repair inguinal hernia.

[Loss of domain-a surgeon's challenge. Surgical approach to an enormous scrotal hernia]

We report on the one-stage procedure surgical approach to an enormous scrotal hernia bearing the whole small bowel and part of the large bowel as a loss of domain situation. Using a mesh-based component separation abdominal wall technique according to Ramirez we managed to retrieve the hernia content into the abdominal cavity allowing reduction of the resulting intra-abdominal pressure. We present our surgical approach in detail and report on the postoperative process based on focused intensive care surveillance and specific surgical complication management leading to hospital discharge of the patient on postoperative day 57.

Development of the morphology during functional stack build-up of P3HT:PCBM bulk heterojunction solar cells with inverted geometry

Highly efficient poly(3-hexylthiophene-2,5-diyl) (P3HT):phenyl-C61-butyric acid methyl ester (PCBM) bulk heterojunction solar cells are achieved by using an inverted geometry. The development of the morphology is investigated as a function of the multilayer stack assembling during the inverted solar cell preparation. Atomic force microscopy is used to reveal the surface morphology of each stack, and the inner structure is probed with grazing incidence small-angle X-ray scattering. It is found that the smallest domain size of P3HT is introduced by replicating the fluorine-doped tin oxide structure underneath. The structure sizes of the P3HT:PCBM active layer are further optimized after thermal annealing. Compared to devices with standard geometry, the P3HT:PCBM layer in the inverted solar cells shows smaller domain sizes, which are much closer to the exciton diffusion length in the polymer. The decrease in domain sizes is identified as the main reason for the improvement of the device performance.

Molecular versus macroscopic perspective on the demixing transition of aqueous PNIPAM solutions by studying the dual character of the refractive index

The phase separation of aqueous poly(N-isopropyl acrylamide) (PNIPAM) solutions is known to strongly affect their volume expansion behaviour and the elastic moduli, as the latter are strongly coupled to the macroscopic order parameter. On the molecular scale, considerable changes in H-bonding and hydrophobic interactions, as well as in the structure govern the demixing process. However, the relationship between the molecular and macroscopic order parameters is unclear for such complex phase-separating solutions. We contribute to the clarification of this problem by relating optical to volumetric properties across the demixing transition of dilute to concentrated aqueous PNIPAM solutions. Far from the demixing temperature, the temperature dependence of the refractive index is predominantly determined by thermal expansion. In the course of phase separation, the refractive index is dominated by the anomalous behaviour of the specific refractivity, which reflects the spatio-temporally averaged changes in molecular interactions and the structural reorganization of the demixing solutions. Moreover, the presence of relaxation processes is studied by the complex expansion coefficient using the novel technique of temperature modulated optical refractometry.

phase instability and molecular kinetics provoked by repeated crossing of the demixing transition of PNIPAM solutions

The demixing process of aqueous poly(N-isopropylacrylamide) (PNIPAM) solutions can occur either via a nucleation and growth process or via spinodal decomposition. The ensuing self-assembly, leading to heterogeneous morphologies within the PNIPAM solution, is codetermined by kinetic processes caused by molecular transport. By subjecting PNIPAM solutions to cyclic changes in temperature leading to repeated crossing of the demixing transition, we are able to assess the importance of kinetics as well as of overheating and supercooling of the phase transition within the metastable range delimited by the binodal and spinodal lines. First indications about the location of these stability limits for the low- and high-temperature phases, separated by about 1.6 K, could be gained by detailed kinetic studies of the refractive index. These investigations are made possible due to the novel technique of temperature-modulated optical refractometry.

[Treatment of a subsequently detected, iatrogenic colonic perforation via minimal-invasive rendezvous procedure]

Laparoscopic surgery as primary therapeutical option for iatrogenic colonic perforation after colonoscopy can be complemented by intraoparative colonoscopy in order to detect and treat even difficult accessible lesions. Via the presented method minimal invasisve detection and therapy of perforation can be conducted safely and can lead to reduction of morbidity.

From molecular dehydration to excess volumes of phase-separating PNIPAM solutions

For aqueous poly(N-isopropyl acrylamide) (PNIPAM) solutions, a structural instability leads to the collapse and aggregation of the macromolecules at the temperature-induced demixing transition. The accompanying cooperative dehydration of the PNIPAM chains is known to play a crucial role in this phase separation. We elucidate the impact of partial dehydration of PNIPAM on the volume changes related to the phase separation of dilute to concentrated PNIPAM solutions. Quasi-elastic neutron scattering enables us to directly follow the isotropic jump diffusion behavior of the hydration water and the almost freely diffusing water. As the hydration number decreases from 8 to 2 for the demixing 25 mass % PNIPAM solution, only a partial dehydration of the PNIPAM chains occurs. Dilatation studies reveal that the transition-induced volume changes depend in a remarkable manner on the PNIPAM concentration of the solutions. The excess volume per mole of H2O molecules expelled from the solvation layers of PNIPAM during phase separation probably strongly increases from dilute to concentrated PNIPAM solutions. This finding is qualitatively related to the immense strain-softening previously observed for demixing PNIPAM solutions.

Nanocomposite coatings with stimuli-responsive catalytic activity

Stimuli-responsive catalytic coatings are fabricated by in situ-synthesis of metallic nanoparticles in binary poly(N-isopropyl acrylamide)–poly(2-vinyl pyridine) brushes.

For she that hath, to her shall be given…Implications of flowering in Anemone nemorosa L

We looked for life-history trade-offs between flowering, vegetative growth and somatic maintenance in the common woodland herb Anemone nemorosa. A. nemorosa forms a horizontal rhizome system consisting of previously formed annual segments and terminated by a flowering or non-flowering shoot. Resources acquired by the aboveground parts are used for flowering, seed production, storage and growth of the annual segments. Resources stored in the rhizome during the growing period are used for preformation of buds, somatic maintenance between two growing periods and development of aboveground parts in the following spring. We hypothesised that the decision to invest in flower buds depends on the amount of resources stored in the recently formed annual segment. We also hypothesised a trade-off between flowering and segment growth and, finally, as a consequence, we expected individual rhizomes to alternate between the flowering and the non-flowering state. We found that segments producing flower buds were significantly longer than non-flowering segments, indicating that resource level influences the function of the preformed buds. Contrary to our expectations, we found flowering rhizomes produced longer annual segments than non-flowering rhizomes. We suggest the larger leaf area of flowering rhizomes and occasional abortion of flowers or seeds as possible mechanisms behind this pattern. Our study shows that even though the decision to produce a flower bud is taken in another time-frame than that in which the actual flowering and fruiting takes place, an ostensibly inexpedient decision is changed to a neutral or even an advantageous incident.

Trans-interfacial polymerization and matter transport processes in epoxy-alumina nanocomposites visualized by scanning Brillouin microscopy

The structural developments in the vicinity of the interface between the reactants of an epoxy are investigated using time- and space-resolved scanning Brillouin microscopy. The hypersonic profile across the phase boundary evolves with strong spatial asymmetry and exhibits erratic behavior within the resin-rich region, which is attributed to a complex interplay between matter transport, dissolution, polymerization, and molecular unravelling process. The presence of alumina nanoparticles in the resin changes the character of these matter transport and reaction processes significantly. On the one hand, the nanoparticles act as transport barriers, hindering the mixing of the reactive components; on the other hand they seem to have a catalytic influence on the epoxy polymerization under certain circumstances. Their transport against gravity is tentatively attributed to gradients in surface tension.

Influence of Leaving-Group Electronic Effect on alpha-Chymotrypsin: Catalytic Constants of Specific Substrates

Rate constants and binding constants for the alpha-chymotrypsin-catalyzed hydrolysis of N-acetyltyrosine, tryptophan, and phenylalanine anilides are presented. Both k(cat) and K(m) are independent of electronic effects in the substrate over a range of 9.8 orders of magnitude (as measured by pK of the leaving group). Similarly, K(m) is independent of charge and orientation about the alpha-carbon for various substrates and pseudo-substrates. These results are not consistent with the pretransition state protonation hypothesis; instead, they are discussed in terms of a tetrahedral intermediate that is thermodynamically less stable than the Michaelis complex.

Unexpectedly high genetic variation in large unisexual clumps of the subdioecious plant Honckenya peploides (Caryophyllaceae)

Honckenya peploides is a subdioecious dune plant that reproduces both sexually and by clonal growth. In northwest Spain this species was found to exhibit an extreme spatial segregation of the sexes, and our objective was to investigate genetic variation in unisexual clumps. Genetic variation was studied in six unisexual clumps of H. peploides, three of them exclusively composed of males and three exclusively female. In total, 193 samples were analysed using isozyme analysis and 80 samples were analysed using two AFLP primer combinations. Both techniques revealed considerably high genetic diversity (average proportion of distinguishable genotypes: 0.22 for isozymes and 0.36 for AFLP; average Simpson's D: 0.65 for isozymes and 0.68 for AFLP). Our results show that, in spite of clonal growth, each unisexual clump consists of different genotypes. Genetic diversity within clumps is similar for both sexual morphs. Reasons for unisexuality of the clumps are discussed.

Concentration and temperature dependence of the refractive index of ethanol-water mixtures: influence of intermolecular interactions

The temperature and concentration dependence of the refractive index, nD(x, T), in ethanol-water mixtures agrees with previous data in the ethanol-rich concentration range. The refractive index versus concentration x determined at 20 degrees C shows the expected maximum at about 41 mol% water (22 mass% water). The temperature derivative of the refractive index, dnD/dT, shows anomalies at lower water concentrations at about 10 mol% water but no anomaly at 41 mol% water. Both anomalies are related to intermolecular interactions, the one in nD seems to be due to molecular segregation and cluster formation while the origin of the second one in dnD/dT is still not clear.

Phase locking of a 1.5 Terahertz quantum cascade laser and use as a local oscillator in a heterodyne HEB receiver

We demonstrate for the first time the closure of an electronic phase lock loop for a continuous-wave quantum cascade laser (QCL) at 1.5 THz. The QCL is operated in a closed cycle cryo cooler. We achieved a frequency stability of better than 100 Hz, limited by the resolution bandwidth of the spectrum analyser. The PLL electronics make use of the intermediate frequency (IF) obtained from a hot electron bolometer (HEB) which is downconverted to a PLL IF of 125 MHz. The coarse selection of the longitudinal mode and the fine tuning is achieved via the bias voltage of the QCL. Within a QCL cavity mode, the free-running QCL shows frequency fluctuations of about 5 MHz, which the PLL circuit is able to control via the Stark-shift of the QCL gain material. Temperature dependent tuning is shown to be nonlinear, and of the order of -16 MHz/K. Additionally we have used the QCL as local oscillator (LO) to pump an HEB and perform, again for the first time at 1.5 THz, a heterodyne experiment, and obtain a receiver noise temperature of 1741 K.

Influence of Al(2)O(3) nanoparticles on the isothermal cure of an epoxy resin

The influence of Al(2)O(3) nanoparticles on the curing of an epoxy thermoset based on diglycidyl ether of bisphenol A was investigated using temperature-modulated differential scanning calorimetry (TMDSC) and rheology. Diethylene triamine was used as a hardener. TMDSC not only allows for a systematic study of the kinetics of cure but simultaneously gives access to the evolution of the specific heat capacities of the thermosets. The technique thus provides insight into the glass transition behaviour of the nanocomposites and hence makes it possible to shed some light on the interaction between the nanoparticles and the polymer matrix. The Al(2)O(3) fillers are shown to accelerate the growth of macromolecules upon isothermal curing. Several mechanisms which possibly could be responsible for the acceleration are described. As a result of the faster network growth chemical vitrification occurs at earlier times in the filled thermosets and the specific reaction heat decreases with increasing nanoparticle concentration. Rheologic measurements of the zero-shear viscosity confirm the faster growth of the macromolecules in the presence of the nanoparticles.

Second order elasticity at hypersonic frequencies of reactive polyurethanes as seen by generalized Cauchy relations

The non-equilibrium process of polymerization of reactive polymers can be accompanied by transition phenomena like gelation or the chemical glass transition. The sensitivity of the mechanical properties at hypersonic frequencies-including the generalized Cauchy relation-to these transition phenomena is studied for three different polyurethanes using Brillouin spectroscopy. As for epoxies, the generalized Cauchy relation surprisingly holds true for the non-equilibrium polymerization process and for the temperature dependence of polyurethanes. Neither the sol-gel transition nor the chemical and thermal glass transitions are visible in the representation of the generalized Cauchy relation. Taking into account the new results and combining them with general considerations about the elastic properties of the isotropic state, an improved physical foundation of the generalized Cauchy relation is proposed.

Chemically induced transition phenomena in polyurethanes as seen from generalized mode Grüneisen parameters

Many phenomenological properties of reactive polymers like polyurethanes increase or decrease continuously in the course of the curing process before saturating at the end of the chemical reaction. This holds true for instance for the mass density, the refractive index, the chemical turnover and the hypersonic properties. The reason for this monotone behaviour is that the chemical reaction behaves like a continuous succession of irreversible phase transitions. These transitions are superposed by the sol-gel transition and possibly by the chemically induced glass transition, with the drawback that the latter two highlighted transitions are often hidden by the underlying curing process. In this work we propose generalized mode Grüneisen parameters as an alternative probe for elucidating the polymerization process itself and the closely related transition phenomena. As a model system we use polyurethane composed of a diisocyanate and varying ratios of difunctional and trifunctional alcohols.

Genealogy, morphology and fitness of spontaneous hybrids between wild and cultivated chicory (Cichorium intybus)

Crop species are known to hybridize spontaneously with wild relatives, but few studies have characterized the performance of hybrids at various genealogies, life stages and environments. A group of cultivar-like individuals and potential hybrids were observed in a roadside population of wild chicory plants in Denmark. Seeds were collected from all reproductive plants and grown in a common garden experiment, and their morphological and genetic compositions were analysed. Intermediate plants were identified as hybrids and comprised various backcross and F(n) combinations. A genotypic hybrid index (HI), spanning from wild-like to cultivar-like, was highly correlated to a morphological index. Plant survival, growth and reproduction were evaluated and compared to the genotypic HI. Overall, cultivar-like and intermediate plants grew larger than wild-like plants, flowered longer, and produced more flowers and seeds. The common garden included a nutrient gradient. At higher nutrient levels, intermediate and cultivar-like plants produced more flowers and seeds than wild-like plants, whereas this effect was less pronounced at lower nutrient levels. During winter, small rodents consumed roots of cultivar-like and intermediate plants preferentially. Thus, cultivated and wild chicory are able to hybridize spontaneously, producing hybrid offspring of several generations that may reproduce more effectively than their wild parent, but herbivory and poor environmental conditions may negatively affect their fitness.

[Sacral osteochondrosis dissecans in a Bernese Mountain Dog: diagnosis and treatment]

A 18-month-old female Bernese Mountain Dog with chronic pain at jumping, extension of the right hind leg and paresis of the tail was referred to the Neurological Service of the Veterinary Hospital of the University of Zurich. Upon radiological examination a mineralised fragment at the dorsal aspect of the endplate of S1 was detected. The diagnosis of Osteochondrosis dissecans was confirmed by linear and computed tomography as well as histologic examination of the fragment, which was surgically removed. Preoperative imaging allowed a minimal surgical approach using a unilateral, modified dorsal laminectomy. Outcome was evaluated by neurological reevaluation and a CT scan performed 6 months after surgery.

First experiences with multidetector CT in traumatized children

INTRODUCTION

The aim of this study was to describe and discuss first experiences with multidetector CT (MDCT) in the assessment of traumatized children.

MATERIAL AND METHODS

Since the implementation of a MDCT scanner in April 2002, 85 children (31 girls, 54 boys with a mean age of 9.2 years) consecutively underwent MDCT (Siemens, Erlangen, Germany) with different protocols depending on age, weight, trauma mechanism and clinical presentation. In all patients in whom pathology was suspected, multiplanar reformations (MPR) in coronal and or sagittal orientation was performed. Examinations were evaluated by two radiologists retrospectively and in consensus.

RESULTS

In 55 (65%) children, a MDCT solely of the head was performed, in 46 there was no pathology found. In six (7%), head and facial bones were scanned. Head and abdomen was examined in two (2%), in two (2%) the abdomen only and in one (1%) the pelvis solely. Scans of the spine were obtained in seven (8%) children. A thorax and abdomen examination only was obtained in one (1%) child each. In 11 (13%) children, a polytrauma protocol was performed. In all patients, the time of examination did not exceed 17 min, including setup time. All children survived at the writing of this report.

CONCLUSION

MDCT was promising in the management of traumatized children and seems to shorten the necessary time to reach diagnosis and to initiate life-saving treatment.

What can morphology and isozymes tell us about the history of the Dryas integrifolia-octopetala complex?

An earlier study of the morphological variation in the circumpolar genus Dryas in Greenland revealed that populations in east Greenland are highly variable and this variation was interpreted as a hybrid zone between D. octopetala and D. integrifolia. It was proposed that populations of Dryas in east Greenland immigrated postglacially from Svalbard. The purpose of our study was to investigate the population structure of the Dryas integrifolia-octopetala complex using a combination of morphological and genetic characters. Populations of Dryas were sampled in Greenland, Svalbard, Iceland and north Scandinavia (Sweden). The morphological traits clearly separated west Greenland from Svalbard, Iceland and north Scandinavia. A large number of individuals from east Greenland and some from north Greenland could be interpreted as hybrids between the morphs. The genetic pattern was, however, partly different as the greatest amount of differentiation among regions was found between west and north Greenland (FRT = 0.65). The highest degree of genetic variation appeared within east Greenland. This was in accordance with the putative hybrid origin of the populations, as concluded based on the morphological results. The total amount of genetic differentiation found among the six regions (FRT = 0.61) was larger than between the two species (FRT = 0.44). The genetic pattern matched the proposed postglacial migration routes.

Flupenthixol versus risperidone: subjective quality of life as an important factor for compliance in chronic schizophrenic patients

OBJECTIVE

The primary aim of this paper was to compare the effects of flupenthixol and risperidone on subjective quality of life and attitude towards medication in chronic schizophrenic patients with mainly negative symptoms. In a spectrum ranging from its typical end "haloperidol" to its atypical end "clozapine", flupenthixol has typical and atypical characteristics.

METHODS

The effects of flupenthixol versus risperidone were investigated in a multicenter, double-blind trial, whereas subjective quality of life was assessed by means of the EuroQuol-Visual Analogue Scale and the patient satisfaction questionnaire. The attitude towards medication was assessed by means of the Drug Attitude Inventory-30 (DAI-30).

RESULTS

Mean daily dose of study medication was 6.6 (SD 2.9) mg/day flupenthixol and 3.6 (SD 1.2) mg/day risperidone. Both groups showed a significant improvement regarding subjective quality of life and positive attitude towards medication. Especially the categories "control of their thoughts", concentration and "feeling better in general" ameliorated in both groups. In the flupenthixol group, the "ability to cope with stress", "feel more relaxed" and the "ability to achieve something" improved significantly more than in the risperidone group.

CONCLUSIONS

(1) The spectrum of schizophrenia can be treated effectively with different neuroleptic treatments. (2) Flupenthixol especially improves the ability to cope with stress, the ability to achieve something and feeling more relaxed. (3) Subjective quality of life significantly increased with no difference between the groups.