S. Nitsch

Use of Trichosporon mycotoxinivorans to suppress the effects of ochratoxicosis on the immune system of broiler chicks

1. The objective of this study was to determine whether the dietary inclusion of Trichosporon mycotoxinivorans (TRM) could suppress the detrimental effects of ochratoxin A (OTA) on the immune system of broiler chicks. 2. Six experimental treatments were tested in 300 1-d-old broiler chicks. Treatments included addition to a standard broiler ration of neither OTA nor TRM (Diet 1), OTA alone (500 μg/kg), OTA plus TRM at three inclusion rates (104 CFU/g of feed, 105 CFU/g, 106 CFU/g) and TRM alone at 105 CFU/g of feed. The ration was fed to chicks for 42 d. 3. Blood samples were collected at d 10, 20, 30 and 40 and macrophages and heterophils were isolated. The following variables were determined in macrophages and heterophils activated by phorbol myristate acetate (65 μM): cell viability, total cell-associated urokinase-plasminogen activator (u-PA), membrane-bound u-PA, free u-PA binding sites and superoxide production. 4. There was a decrease in the viability of macrophages and heterophils from chicks receiving OTA-contaminated feed compared to the viability of cells from control birds at d 40. Dietary TRM completely blocked the effect of OTA on cell viability; all three inclusion rates were equally effective. There was a decrease in total cell-associated and membrane-bound u-PA in macrophages and heterophils of chicks receiving OTA-contaminated feed compared to the corresponding values in control birds for heterophils at d 30 and 40 and for the macrophages at d 40. 5. Similarly, dietary TRM abolished the effect of OTA on total cell-associated and membrane-bound u-PA activity. All three inclusion rates of yeast were equally effective. Heterophils, but not macrophages, isolated from chicks receiving OTA-contaminated diet produced less superoxide anion compared to all other diet groups at d 30 and 40. 6. The immune system is a primary target of OTA toxicity in broilers: several functional properties of macrophages and heterophils were depressed in chicks fed OTA-contaminated feed. There was a delay of 30 d before the immunosuppressive effect became apparent. The dietary inclusion of TRM completely blocked the detrimental effects of OTA on several immune properties in broilers.

Role of cytokines in head and neck squamous cell carcinoma

Head and neck squamous cell carcinoma is one of the most frequent cancers and standard treatment has only marginally improved the 5-year survival rate of patients with this disease in the last few decades. It is supposed that cytokine alterations in immune, inflammatory and angiogenetic regulatory routes within the head and neck squamous cell carcinoma microenvironment play a critical role in tumor aggressiveness, its response to chemo- and radiation therapies, as well as the development of immune escape mechanisms.

The Psychosocial Consequences of Reconstruction of Severe Ear Defects or Third-Degree Microtia With Rib Cartilage

BACKGROUND There are few data focusing on the improvement of psychosocial functioning and self-esteem in patients with congenital or acquired severe auricular defects. OBJECTIVE We investigated the satisfaction of patients following auricular reconstruction with rib cartilage. METHODS One hundred patients treated for reconstruction with rib cartilage for congenital or traumatic auricular defects have been evaluated retrospectively for changes in self-esteem, performance ability, and psychosocial attitude using a clinically established questionnaire, Frankfurter Selbstkonzeptskalen (FSKN). In addition, patients were asked to judge the new auricle and the thoracic scar using a new questionnaire. RESULTS Of 68 patients who took part in this study, almost 90% could integrate the new ear into their body concept. If faced with the same decision for surgery again, 75% would again choose a reconstruction with rib cartilage. More than three-quarters rated the thoracic scar as acceptable in relation to the benefits of the new ear, although one-third felt uncomfortable with the pain and cosmetic appearance of the thoracic scar. According to the results of the FSKN questionnaire, values in psychosocial abilities improved postoperatively. There was no clear change in either self-esteem or performance ability. CONCLUSIONS Ear reconstruction with rib cartilage remains, under most circumstances, the procedure of choice for repairing auricular defects. There is a high acceptance of this method among patients, although the impact of the thoracic scar needs to be discussed extensively before surgery. The importance of the surgeons experience cannot be underestimated, because it determines the aesthetic results and the patients satisfaction in this challenging area of plastic surgery.

Relation between perceived driving disability and scores of vision screening tests

Aim: To determine the relation between perceived driving disability and vision screening tests. Methods: 93 subjects, aged 50 years and over, with binocular visual acuity of at least 20/80. Perceived driving disability (PDD) was assessed by a questionnaire. Subtracting daytime from night-time driving question scores revealed PDD at night (PDDN), subtracting scores of questions for driving in familiar places from those in unfamiliar places revealed PDD at unfamiliar places (PDDU). Results: PDD was strongly related to visual acuity, contrast sensitivity and useful field of view (UFOV). Specific relations existed between PDDN and Nyktotests and Mesotests and between PDDU and UFOV. These associations were enhanced in a subset of subjects with better visual acuities. Conclusions: Vision screening tests correlate well with perceived driving disabilities, especially when a subtraction method is used in the questionnaire to reveal condition dependent disabilities. Additional tests for visual acuity are useful, especially in subjects with better visual acuity.

Decline of Lactate in Tumor Tissue After Ketogenic Diet: In Vivo Microdialysis Study in Patients with Head and Neck Cancer

In head and neck squamous cell carcinoma (HNSCC) aerobic glycolysis is the key feature for energy supply of the tumor. Quantitative microdialysis (μD) offers an online method to measure parameters of the carbohydrate metabolism in vivo. The aim was to standardize a quantitative μD-study in patients with HNSCC and to prove if a ketogenic diet would differently influence the carbohydrate metabolism of the tumor tissue. Commercially available 100 kDa-CMA71-μD- catheters were implanted in tumor-free and in tumor tissue in patients with HNSCC for simultaneous measurements up to 5 days. The metabolic pattern and circadian rhythm of urea, glucose, lactate, and pyruvate was monitored during 24 h of western diet and subsequent up to 4 days of ketogenic diet. After 3 days of ketogenic diet the mean lactate concentration declines to a greater extent in the tumor tissue than in the tumor-free mucosa, whereas the mean glucose and pyruvate concentrations rise. The in vivo glucose metabolism of the tumor tissue is clearly influenced by nutrition. The decline of mean lactate concentration in the tumor tissue after ketogenic diet supports the hypothesis that HNSCC tumor cells might use lactate as fuel for oxidative glucose metabolism.

The role of L-arginine following trauma and blood loss

Purpose of reviewVascular endothelial cells control vascular smooth muscle tone via the release of nitric oxide. Following adverse circulatory conditions, namely trauma and hemorrhage, endothelial cell dysfunction occurs, leading to a decrease in the release of endothelium-derived nitric oxide, which contributes to further alterations in tissue perfusion and organ function. Recent findingsEarly administration of L-arginine (the precursor of nitric oxide) and the substrate for nitric oxide synthase in vascular endothelial cells has been found to restore the depressed organ blood flow and to reduce tissue injury following shock. This improvement in cardiovascular function was associated with restoration of the depressed cell-mediated immune responses and attenuation of the massive inflammatory response encountered under such conditions. Furthermore, the excessive infiltration of the liver with neutrophils following trauma–hemorrhage was decreased by L-arginine administration, thereby reducing hepatic injury. In addition, L-arginine treatment decreased the inflammatory response at the site of trauma and the improved wound-healing process following blood loss. SummaryDespite those promising results in animal models at present, none of the published clinical trials has demonstrated efficacy of L-arginine at doses above standard dietary practices on the outcome in critically ill surgical patients, besides the reduction in infectious complications.

Borderline indications for ear reconstruction.

While the indication for an ear reconstruction with rib cartilage is clear in pediatric patients and patients without previous surgery, there are borderline cases in which neither a reconstruction nor a prosthesis seems to be first choice. Within the last 6 years, approximately 120 patients were treated with a reconstruction with rib cartilage and 20 with a prosthesis at our hospital. Patients without extensively scarred periauricular tissue clearly benefit by a reconstruction with cartilage. The classic indication for an ear prosthesis is status post-malignant tumor resection. In borderline cases presenting with heavy scars, the most favorable repair method has to be decided upon individually. Under these circumstances, one of the main criteria for a reconstruction with rib cartilage is a viable temporoparietal fascia flap. A consideration that is important to note is that an unfavorable ear reconstruction can be converted almost always into a prosthesis repair but very rarely vice versa.

Influence of silicone gel on standardized postoperative scars.

Silicone gel is one therapeutic approach in the treatment and prevention of excessive scarring. The likely mechanism of action is the hydration of the tissue. This should lead to reduced angiogenesis and capillary blood flow. The efficacy is still controversial and the evidence base, insufficient. The aim of this prospective and standardized study is to investigate silicone gel in the preventive treatment of scars.

Ein neues Straylightmeter im klinischen Test

ZusammenfassungHintergrundFür die Fahreignungs-begutachtung ist neben der Überprüfung des Visus und des Gesichtsfeldes, auch die Prüfung des Blendungssehens bei bestimmten Indikationen vorgesehen. Derzeit stehen hierfür verschiedene Messmethoden zu Verfügung, welche meist den Visus oder die Kontrastsensitivität in Anwesenheit einer Blendungsquelle messen. Ziel dieser Studie war die Evaluierung eines neu entwickelten Straylightmeters in Bezug auf Reproduzierbarkeit, Wertigkeit und Diskriminationsfähigkeit, und der Vergleich mit derzeit zur Messung der Blendempfindlichkeit eingesetzten Geräten.Patienten und MethodenInsgesamt wurden an den drei europäischen Kliniken (Salzburg, Amsterdam, Tübingen) 112 Probanden untersucht, welche in 3 Gruppen aufgeteilt wurden: Junge Patienten (20 bis 40 Jahre) ohne Augenerkrankungen, ältere Patienten (über 50 Jahre) ohne Augenerkrankungen und Patienten über 50 Jahre mit einer Katarakt auf mindestens einem Auge. Folgende Untersuchungen wurden durchgeführt: Blendungssehen, intraokuläres Streulicht, Kontrastsensitivität, Visus, Refraktion und LOCS-III-Katarakt-Klassifikation.ResultateDie besten Ergebnisse in Bezug auf Wertigkeit, Reproduzierbarkeit und Diskriminationsfähigkeit wurden mit dem konventionellen und dem neuen Straylightmeter erreicht.SchlussfolgerungenAufgrund der besten Testergebnisse und der Vorteile gegenüber dem Konventionellen, ist das neue, computerisierte Straylightmeter die derzeit am besten geeignete Methode, um intraokuläres Streulicht zu messen, welches die Blendempfindlichkeit und Kontrastsensitivität maßgeblich beeinflusst.SummaryBackgroundBeside testing of visual acuity and visual field, the measurement of straylight and glare is important for testing of drivers. Over the past years, many glare testers have been developed. Most of these measure either visual acuity or contrast sensitivity in the presence of a glare source. The aim of this study was to evaluate a new computer implemented straylight meter in regard to repeatability, validity and discriminative ability, and to compare the results with those of other devices currently used for measuring straylight and glare.Patients and methodsIn the three participating European clinics a total of 112 subjects has been recruited and divided into 3 groups: Young subjects (20 to 40 years of age) without any eye disease, elderly subjects (over 50 years) without any eye disease and elderly subjects (over 50 years) with a cataract in at least one eye. All subjects underwent a battery of glare and straylight tests, measurement of visual acuity, contrast sensitivity, refraction and LOCS III cataract classification.ResultsRepeatability, validy and discriminative ability were all superior for both straylight meters.ConclusionDue to the best test results and the advantages over the conventional, the new computer implemented straylight meter is currently the best method for measuring intraocular straylight that mainly affects glare and contrast sensitivity.