Impact of N-acetylcysteine on the hepatic microcirculation after orthotopic liver transplantation

Recent observations showed an improvement of hepatic macro- and microhemodynamics as well as survival rates after warm ischemia of the liver following treatment with N-acetylcysteine (NAC). In this study we assessed the influence of NAC on the hepatic microcirculation after orthotopic liver transplantation (OLT) using intravital fluorescence microscopy. OLT with simultaneous arterialization was performed in 16 male Lewis rats following cold storage in University of Wisconsin solution for 24 hr. Within the experimental group (n = 8) donors received NAC (400 mg/kg) 25 min before hepatectomy. In addition, high-dose treatment of recipients with NAC (400 mg/kg) was started with reperfusion. Control animals (n = 8) received an equivalent amount of Ringer's solution. Intravital fluorescence microscopy was performed 30-90 min after reperfusion assessing acinar and sinusoidal perfusion, leukocyte-endothelium interaction, and phagocytic activity. Treatment with NAC reduced the number of nonperfused sinusoid from 52.4 +/- 0.8% to 15.7 +/- 0.5% (p = 0.0001) (mean +/- SEM). Furthermore, we achieved a significant reduction of leukocytes adhering to sinusoidal endothelium (per mm2 liver surface) from 351.9 +/- 13.0 in controls to 83.6 +/- 4.2 in the experimental group (P = 0.0001). In postsinusoidal venules, treatment with NAC decreased the number of sticking leukocytes (per mm2 endothelium) from 1098.5 +/- 59.6 to 425.9 +/- 37.7 (P = 0.0001). Moreover, bile flow was significantly increased after therapy with NAC (4.3 +/- 1.2 vs. 2.2 +/- 0.7 ml/90 min x 100g liver) (P < 0.05). Phagocytic activity was not influenced by application of NAC. We conclude that high-dose therapy with NAC in OLT attenuates manifestations of microvascular perfusion failure early after reperfusion and should be considered as a means to reduce reperfusion injury.     

Functional outcome of Eden-Hybinette-Lange operation in post-traumatic recurrent shoulder dislocation

OBJECTIVE: Post-traumatic recurrent dislocation is a major problem in the operative treatment of shoulder dysfunction in young athletes. This prospectively designed study evaluates the long-term results of a modified Eden-Hybinette procedure in young male athletes. The criteria were: capacity in sports, functional limit, and persistent pain. Genuine disorders of the glenoid or muscular imbalance of the shoulder joint were criteria for exclusion. PATIENTS AND METHODS: From 1982 to 1990, 143 patients underwent surgery. Seventy percent were reevaluated within a minimum period of 18 months after the operation. The functional results were calculated using the ROWE score as well as a visual analog scale (VAS). X-rays were done after the patient had given informed consent. RESULTS: VAS and ROWE score showed excellent/good results in 61%, fair results in 18%, and poor results in 21% of the documented cases. The rate of arthrosis was 25%. Redislocation occurred in 7%, mainly without any relevant trauma. The X-rays showed complete resorption of the bone graft in 30% of the cases. Best functional results and no redislocation were found in the patients who underwent surgery with fewer than 3 dislocations compared to those with more than 4 dislocation episodes. CONCLUSIONS: In cases of post-traumatic recurrent dislocation of the shoulder in young athletes, the modified Eden-Hybinette procedure is a good method of reestablishing sufficient stability of the shoulder. The operation should be performed prior to the 3rd dislocation episode. Four or more dislocation episodes show an increased tendency to redislocate and poor functional results.     

Antibiotic resistance of E. coli in sewage and sludge

The aim of the study is the evaluation of resistance patterns of E. coli in wastewater treatment plants without an evaluation of basic antibiotic resistance mechanisms.Investigations have been done in sewage, sludge and receiving waters from three different sewage treatment plants in southern Austria. A total of 767 E. coli isolates were tested regarding their resistance to 24 different antibiotics. The highest resistance rates were found in E. coli strains of a sewage treatment plant which treats not only municipal sewage but also sewage from a hospital.Among the antimicrobial agents tested, the highest resistance rates in the penicillin group were found for Ampicillin (AM) (up to 18%) and Piperacillin (PIP) (up to 12%); in the cephalosporin group for Cefalothin (CF) (up to 35%) and Cefuroxime-Axetil (CXMAX) (up to 11%); in the group of quinolones for Nalidixic acid (NA) (up to 15%); and for Trimethoprime/Sulfamethoxazole (SXT) (up to 13%) and for Tetracycline (TE) (57%).Median values for E. coli in the inflow (crude sewage) of the plants were between 2.0 x 10(4) and 6.1 x 10(4)CFU/ml (Coli ID-agar, BioMerieux 42017) but showed a 200-fold reduction in all three plants in the effluent. Nevertheless, more than 10(2)CFU E. coli/ml reached the receiving water and thus sewage treatment processes contribute to the dissemination of resistant bacteria in the environment.     

Self-Healing Cs3Bi2Br3I6 Perovskite Wafers for X-Ray Detection

Self-healing of defects imposed by external stimuli such as high energy radiation is a possibility to sustain the operational lifetime of electronic devices such as radiation detectors. Cs₃Bi₂Br₃I₆ polycrystalline wafers are introduced here as novel X-ray detector material, which not only guarantees a high X-ray stopping power due to its composition with elements with high atomic numbers, but also outperforms other Bi-based semiconductors in respect to detector parameters such as detection limit, transient behavior, or dark current. The polycrystalline wafers represent a size scalable technology suitable for future integration in imager devices for medical applications. Most astonishingly, aging of these wafer-based devices results in an overall improvement of the detector performance—dark currents are reduced, photocurrents are increased, and one of the most problematic properties of X-ray detectors, the base line drift is reduced by orders of magnitude. These aging induced improvements indicate self-healing effects which are shown to result from recrystallization. Optimized synthetic conditions also improve the as prepared X-ray detectors; however, the aged device outperforms all others. Thus, self-healing acts in Cs₃Bi₂Br₃I₆ as an optimization tool, which is certainly not restricted to this single compound, it is expected to be beneficial also for many further polycrystalline ionic semiconductors.