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Purpose: Neoadjuvant chemotherapy is now a common first line therapy for breast cancer. International guidelines recommend placement of a clip before commencement of therapy to assist with localizing the tumor bed in the event of excellent response-this takes up time and resources. The microcalcifications associated usually persist after chemotherapy and could serve as an alternative marker. We investigated to determine prognostic criteria to avoid the need for a marker clip before neoadjuvant chemotherapy for breast tumors associated with microcalcifications., Methods: We performed a 7 year single-center bi-site retrospective analytical observational study of 88 women with calcified breast carcinoma treated by neoadjuvant chemotherapy at our bi-site institution between September 2015 and September 2022. This study includied two groups (clip-free tumor localization vs. clip-free tumor non-localization), and investigating quantitative and qualitative predictive factors. The clip-free tumor localization after neoadjuvant chemotherapy was defined by the visibility of residual calcifications on both views of the pre-operative mammogram on the day of or the day prior to surgery., Results: The mean age of the 88 women included in our population was 52.8 years (± 12.7 years standard deviation). Of the 90 tumors with microcalcifications, 64 carcinomas (71.1%) were localizable with no marker clip after neoadjuvant chemotherapy. The main predictive factors significantly associated with clip-free tumor localization were number of calcifications > 10 (P < 0.0001), grade 2 tumor (P = 0.003) with a probability of locating tumor after neoadjuvant chemotherapy of 97.9%, 95% CI [95.6; 99.0]., Conclusion: More than 10 microcalcifications in a grade 2 breast tumor at the initial diagnosis may obviate the need for a marker clip., (© 2024. The Author(s).)

Purpose: The purpose of this study was to propose a deep learning-based approach to detect pulmonary embolism and quantify its severity using the Qanadli score and the right-to-left ventricle diameter (RV/LV) ratio on three-dimensional (3D) computed tomography pulmonary angiography (CTPA) examinations with limited annotations., Materials and Methods: Using a database of 3D CTPA examinations of 1268 patients with image-level annotations, and two other public datasets of CTPA examinations from 91 (CAD-PE) and 35 (FUME-PE) patients with pixel-level annotations, a pipeline consisting of: (i), detecting blood clots; (ii), performing PE-positive versus negative classification; (iii), estimating the Qanadli score; and (iv), predicting RV/LV diameter ratio was followed. The method was evaluated on a test set including 378 patients. The performance of PE classification and severity quantification was quantitatively assessed using an area under the curve (AUC) analysis for PE classification and a coefficient of determination (R²) for the Qanadli score and the RV/LV diameter ratio., Results: Quantitative evaluation led to an overall AUC of 0.870 (95% confidence interval [CI]: 0.850-0.900) for PE classification task on the training set and an AUC of 0.852 (95% CI: 0.810-0.890) on the test set. Regression analysis yielded R² value of 0.717 (95% CI: 0.668-0.760) and of 0.723 (95% CI: 0.668-0.766) for the Qanadli score and the RV/LV diameter ratio estimation, respectively on the test set., Conclusion: This study shows the feasibility of utilizing AI-based assistance tools in detecting blood clots and estimating PE severity scores with 3D CTPA examinations. This is achieved by leveraging blood clots and cardiac segmentations. Further studies are needed to assess the effectiveness of these tools in clinical practice., Competing Interests: Disclosure of Interests The authors declare that they have no competing interest., (Copyright © 2023 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.)

Purpose: In 2022, the French Society of Radiology together with the French Society of Thoracic Imaging and CentraleSupelec organized their 13th data challenge. The aim was to aid in the diagnosis of pulmonary embolism, by identifying the presence of pulmonary embolism and by estimating the ratio between right and left ventricular (RV/LV) diameters, and an arterial obstruction index (Qanadli's score) using artificial intelligence., Materials and Methods: The data challenge was composed of three tasks: the detection of pulmonary embolism, the RV/LV diameter ratio, and Qanadli's score. Sixteen centers all over France participated in the inclusion of the cases. A health data hosting certified web platform was established to facilitate the inclusion process of the anonymized CT examinations in compliance with general data protection regulation. CT pulmonary angiography images were collected. Each center provided the CT examinations with their annotations. A randomization process was established to pool the scans from different centers. Each team was required to have at least a radiologist, a data scientist, and an engineer. Data were provided in three batches to the teams, two for training and one for evaluation. The evaluation of the results was determined to rank the participants on the three tasks., Results: A total of 1268 CT examinations were collected from the 16 centers following the inclusion criteria. The dataset was split into three batches of 310, 580 and 378 C T examinations provided to the participants respectively on September 5, 2022, October 7, 2022 and October 9, 2022. Seventy percent of the data from each center were used for training, and 30% for the evaluation. Seven teams with a total of 48 participants including data scientists, researchers, radiologists and engineering students were registered for participation. The metrics chosen for evaluation included areas under receiver operating characteristic curves, specificity and sensitivity for the classification task, and the coefficient of determination r 2 for the regression tasks. The winning team achieved an overall score of 0.784., Conclusion: This multicenter study suggests that the use of artificial intelligence for the diagnosis of pulmonary embolism is possible on real data. Moreover, providing quantitative measures is mandatory for the interpretability of the results, and is of great aid to the radiologists especially in emergency settings., Competing Interests: Disclosure of Interests The authors declare that they have no known competing financial or personal relationships that could be viewed as influencing the work reported in this paper., (Copyright © 2023 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.)

Depending on the ambient pH, ionizable substances are present in varying proportions in their neutral or charged form. The extent to which these two chemical species contribute to the pH-dependant toxicity of ionizable chemicals and whether intracellular ion trapping has a decisive influence in this context is controversially discussed. Against this background, we determined the acute toxicity of 24 ionizable substances at up to 4 different pH values on the embryonic development of the zebrafish, Danio rerio, and supplemented this dataset with additional data from the literature. The LC 50 for some substances (diclofenac, propranolol, fluoxetine) differed by a factor of even >10 3 between pH5 and pH9. To simulate the toxicity of 12 acids and 12 bases, six models to calculate a pH-dependant logD value as a proxy for the uptake of potentially toxic molecules were created based on different premises for the trans-membrane passage and toxic action of neutral and ionic species, and their abilities to explain the real LC 50 data set were assessed. Using this approach, we were able to show that both neutral and charged species are almost certainly taken up into cells according to their logD-based distribution, and that both species exert toxicity. Since two of the models that assume all intracellular molecules to be neutral overestimated the real toxicity, it must be concluded, that the toxic effect of a single charged intracellularly present molecule is, on the average, lower than that of a single neutral molecule. Furthermore, it was possible to attribute differences in toxicity at different pH values for these 24 ionizable substances to the respective deltas in logD at these pH levels with high accuracy, enabling particularly a full logD-based model on the basis of logP ow as a membrane passage descriptor to be used for predicting potential toxicities in worst-case scenarios from existing experimental studies, as stipulated in the process of registration of chemicals and the definition of Environmental Quality Standards (EQS)., Competing Interests: Declaration of Competing Interest The authors have no competing interests to declare, (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Environmental risk assessments of organic chemicals usually do not consider pH as a key factor. Hence, most substances are tested at a single pH only, which may underestimate the toxicity of ionisable substances with a pK a in the range of 4-10. Thus, the ability to consider the pH-dependent toxicity would be crucial for a more realistic assessment. Moreover, there is a tendency in acute toxicity tests to focus on mortality only, while little attention is paid to sublethal endpoints. We used Danio rerio embryos exposed to ten ionisable substances (the acids diclofenac, ibuprofen, naproxen and triclosan and the bases citalopram, fluoxetine, metoprolol, propranolol, tramadol and tetracaine) at four external pH levels, investigating the endpoints mortality (LC 50 ) and heart rate (EC 20 ). Dose-response curves were fitted with an ensemble-model to determine the true uncertainty and variation around the mean endpoints. The ensemble considers eight (heart rate) or twelve (mortality) individual models for binominal and Poisson distributed data, respectively, selected based on the Akaike Information Criterion (AIC). In case of equally good models, the mean endpoint of all models in the ensemble was calculated, resulting in more robust EC x estimates with lower 'standard errors' as compared to randomly selected individual models. We detected a high correlation between mortality (LC 50 ) at 96 hpf and reduced heart rate (EC 20 ) at 48 hpf for all compounds and all external pH levels (r = 0.98). Moreover, the observed pH-dependent effects were strongly associated with log D and thus, likely driven by differences in uptake (toxicokinetic) rather than internal (toxicodynamic) processes. Prospectively, the a priori consideration of pH-dependent effects of ionisable substances might make testing at different pH levels redundant, while the endpoint of mortality might even be replaced by a reliable sublethal proxy that would reduce the exposure, accelerating the evaluation process., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Purpose: The safety and feasibility of early removal of nasogastric tube (NGT) after small bowel obstruction (SBO) surgery have not yet been assessed. Such a practice could allow to implement enhanced recovery after surgery (ERAS) protocols after acute SBO surgery. The aims of this study were to assess the safety of early NGT removal by comparing the short-term outcomes of patients with postoperative NGTs and those with no postoperative NGT., Methods: All patients undergoing surgery for strangulation or adhesive SBO between January the 1st of 2014 and December the 31st of 2017 were retrospectively included., Results: Among the 123 included, NGT was removed immediately after the end of the procedure in 26 cases (21.1%) and 19 patients required NGT replacement (15.4%). In univariate analysis, early removal of NGT was significantly associated with a reduction of overall morbidity, severe morbidity and postoperative ileus occurrence. Multivariate analysis confirmed that NGT left in place was a risk factor for postoperative ileus [Odd Ratio (OR) 4.9, Confidence Interval (CI) 95% 1.3-19.2; p = 0.02], while it has no incidence on severe morbidity., Conclusions: Early NGT removal after ASBO surgery seemed to be feasible, safe and efficient, at least in selected patients. This primary study represents the initial foundations for building the implementation of ERAS protocols after ASBO surgery., (© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.)

Purpose: The objective was to develop a radiological score obtained from multi-detector computed tomography (MDCT) to differentiate between single band adhesion (SBA) and matted adhesions (MA) as the etiology of small bowel obstruction (SBO)., Methods: All consecutive patients who underwent surgery from January 2013 to June 2018 for adhesion-induced SBO were retrospectively included., Results: Among the 193 patients having surgery for SBO, 119 (61.6%) had SBA and 74 (38.4%) had MA surgically proven. In multivariate analysis, the presence of a beak sign (OR = 3.47, CI [1.26; 9.53], p = 0.02), a closed loop (OR = 11.37, CI [1.84; 70.39], p = 0.009), focal mesenteric haziness (OR = 3.71, CI [1.33; 10.34], p = 0.01) and focal and diffuse peritoneal fluid (OR = 4.30, CI [1.45; 12.73], p = 0.009 and OR = 6.34, CI [1.77; 22.59], p = 0.004, respectively) were significantly associated with SBA. Conversely, the presence of diffuse mesenteric fluid without focal fluid (OR = 0.23, CI [0.06; 0.92], p = 0.04) and an increase of the diameter of the most dilated loop (OR = 0.94, CI [0.90; 0.99], p = 0.02) were inversely associated with SBA. Using the significant predictive factors of SBA, we built a composite score to radiologically predict the etiology of SBO. The area under the receiver operating characteristic (ROC) curve of the score was 0.8274. For a cut-off score of -0.523, sensitivity, specificity and the percentage of patients correctly classified were 78.4%, 84.6% and 80%, respectively. If the score is ≥ 7, the probability that the mechanism of SBO is not SBA was 100%., Conclusions: The present score, validated in a different population, could be a significant tool in the decision for surgical management., (© 2021. Springer-Verlag GmbH, DE part of Springer Nature.)

Purpose: The main objective was to evaluate types and predictive factors of incidental findings (IFs) on multidetector computed tomographies (MDCTs) performed for an emergency department (ED). The secondary aim was to analyze additional investigations, their benefits, side effects, costs and the final diagnoses., Method: One thousand consecutive patients over 18 years old who underwent an MDCT in the ED of our institution from January 2011 to November 2011 were retrospectively included, accounting for 300 head MDCTs and 700 other MDCTs. The following criteria were collected in patient electronic medical records: IFs (divided into low and high clinical significance), body areas covered, availability of a prior imaging, radiologist's experience and subspecialty, additional investigations, their outcomes and costs., Results: Among the 1000 included patients, 232 had at least one IF and 122 had at least one IF of high clinical significance (IFCS). There were 340 IFs and 150 IFCSs. A significant association with the presence of at least one IF was noted for older patients, less-experienced radiologists, no subspecialty of the radiologist, the abdominopelvic area, and the absence of prior imaging. Eighteen IFs generated additional investigations in our institution, including five invasive samplings and three surgical operations, with two diagnoses of malignancy (a gastrointestinal stromal tumor and a Bosniak IV cystic renal lesion). One benign iatrogenic complication occurred. Total cost of these investigations was €41,247 (with an average of €2292 per IF investigated)., Conclusion: IFs on emergency MDCTs were frequent, rarely severe, rarely iatrogenic and relatively expensive., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Importance: Intraoperative hypotension is associated with increased morbidity and mortality. A machine learning-derived early warning system to predict hypotension shortly before it occurs has been developed and validated., Objective: To test whether the clinical application of the early warning system in combination with a hemodynamic diagnostic guidance and treatment protocol reduces intraoperative hypotension., Design, Setting, and Participants: Preliminary unblinded randomized clinical trial performed in a tertiary center in Amsterdam, the Netherlands, among adult patients scheduled for elective noncardiac surgery under general anesthesia and an indication for continuous invasive blood pressure monitoring, who were enrolled between May 2018 and March 2019. Hypotension was defined as a mean arterial pressure (MAP) below 65 mm Hg for at least 1 minute., Interventions: Patients were randomly assigned to receive either the early warning system (n = 34) or standard care (n = 34), with a goal MAP of at least 65 mm Hg in both groups., Main Outcomes and Measures: The primary outcome was time-weighted average of hypotension during surgery, with a unit of measure of millimeters of mercury. This was calculated as the depth of hypotension below a MAP of 65 mm Hg (in millimeters of mercury) × time spent below a MAP of 65 mm Hg (in minutes) divided by total duration of operation (in minutes)., Results: Among 68 randomized patients, 60 (88%) completed the trial (median age, 64 [interquartile range {IQR}, 57-70] years; 26 [43%] women). The median length of surgery was 256 minutes (IQR, 213-430 minutes). The median time-weighted average of hypotension was 0.10 mm Hg (IQR, 0.01-0.43 mm Hg) in the intervention group vs 0.44 mm Hg (IQR, 0.23-0.72 mm Hg) in the control group, for a median difference of 0.38 mm Hg (95% CI, 0.14-0.43 mm Hg; P = .001). The median time of hypotension per patient was 8.0 minutes (IQR, 1.33-26.00 minutes) in the intervention group vs 32.7 minutes (IQR, 11.5-59.7 minutes) in the control group, for a median difference of 16.7 minutes (95% CI, 7.7-31.0 minutes; P < .001). In the intervention group, 0 serious adverse events resulting in death occurred vs 2 (7%) in the control group., Conclusions and Relevance: In this single-center preliminary study of patients undergoing elective noncardiac surgery, the use of a machine learning-derived early warning system compared with standard care resulted in less intraoperative hypotension. Further research with larger study populations in diverse settings is needed to understand the effect on additional patient outcomes and to fully assess safety and generalizability., Trial Registration: ClinicalTrials.gov Identifier: NCT03376347.

The study investigated the feasibility of using volatile compound signatures of liver tissues in poultry to detect previous dietary exposure to different types of xenobiotic. Six groups of broiler chickens were fed a similar diet either noncontaminated or contaminated with polychlorinated dibenzo-p-dioxins/-furans (PCDD/Fs; 3.14 pg WHO-TEQ/g feed, 12% moisture), polychlorinated biphenyls (PCBs; 0.08 pg WHO-TEQ/g feed, 12% moisture), polybrominated diphenyl ethers (PBDEs; 1.63 ng/g feed, 12% moisture), polycyclic aromatic hydrocarbons (PAHs; 0.72 μg/g fresh matter), or coccidiostats (0.5 mg/g feed, fresh matter). Each chicken liver was analyzed by solid-phase microextraction - mass spectrometry (SPME-MS) for volatile compound metabolic signature and by gas chromatography - high resolution mass spectrometry (GC-HRMS), gas chromatography - tandem mass spectrometry (GC-MS/MS), and liquid chromatography - tandem mass spectrometry (LC-MS/MS) to quantify xenobiotic residues. Volatile compound signature evidenced a liver metabolic response to PAH although these rapidly metabolized xenobiotics are undetectable in this organ by the reference methods. Similarly, the volatile compound metabolic signature enabled to differentiate the noncontaminated chickens from those contaminated with PBDEs or coccidiostats. In contrast, no clear signature was pointed out for slowly metabolized compounds such as PCDD/Fs and PCBs although their residues were found in liver at 50.93 (±6.71) and 0.67 (±0.1) pg WHO-TEQ/g fat, respectively.

This study was undertaken to investigate the relevance of using the pyrolysis-MS (Py-MS) technique to discriminate the production area of oysters harvested over two years and to assess from the data of the second year of harvest the potential of an alternative MS-based technique, the solid phase microextraction-MS (SPME-MS), to perform this discrimination. Oysters were harvested in various areas of France, and models of discrimination according to harvest season were built from Py-MS fingerprints and from virtual SPME-MS fingerprints obtained by summing the mass spectra generated by the SPME-GC-MS system. The treatment of the Py-MS data by a 21-12-3 artificial neural networks led to a correct classification of only 89.2% of the oyster samples according to shoreline. The misclassifications thus did not allow use of the Py-MS technique as a relevant tool for authentication of oyster origin. The assessment of the potential of the virtual SPME-MS fingerprints to discriminate the production area of oysters was undertaken on a part of the sample set. The virtual SPME-MS data were pretreated according to two methods, filtering of raw data (FRD) and comprehensive combinatory standard correction (CCSC), a recently developed chemometric method used for the correction of instrumental signal drifts in MS systems. The results obtained with the virtual SPME-MS fingerprints are promising because this technique, when the data were pretreated by the CCSC method, led to a successful discrimination of the oyster samples not only according to shoreline but also according to production region. This study confirms that an efficient correction method (CCSC) of instrumental drifts can considerably increase the discriminative information contained in the volatile fraction of food products.

This paper describes the responses of consumers in six European countries (Greece, Italy, Spain, France, Iceland and United Kingdom) tasting meat from twelve different local types of lambs produced in those same six countries. Animals represented 10 breeds and crossbreeds, three sexes, several diets composed of either milk, concentrates and various forages as main ingredients and different slaughter ages, from 1 and 12 months, and carcass weights, from 5.5 to 30.4kg. Tests were conducted by 36 volunteer families in each of the six countries involved in the study. Families were asked to roast the joints using their own cooking criteria, evaluating (from "dislike extremely" to "like extremely") flavour, tenderness, juiciness and overall liking. Also the cook was asked to rate the odour during cooking. Country and lamb type and their interaction were statistically significant for all the variables analysed. Results suggest a link between the assessments of a given lamb type and the consumers' culinary background, showing clear associations between country and lamb type preferences. It was possible to separate, independently of the country, different groups of families with similar preferences. Five family groups, which included 88 families (40.74%), had a clear Mediterranean origin and preferred types of lamb fed either milk or mainly concentrate diets. Seven family groups, which included 93 families (43.06%) with a clear northern origin, preferred types reared on grass or with grass included in the diet. The rest of the groups (four) that included 35 families (16.20%) had no clear composition (northern or Mediterranean), and they had a wider taste preference. It can clearly be seen that there are two categories of consumers of lamb in the analysed European market: those who prefer "milk or concentrate taste" and those who prefer "grass taste".

The aim of this study was to investigate the homogeneity of the traditional dry sausages manufactured in small scale facilities from the Massif Central region in France by taking into account the diversity of the production in this area. The homogeneity was estimated by analysis of the physicochemical parameters of 6 types of traditional dry sausages chosen as representatives of the production diversity. The homogeneity was evaluated (i) within the product, (ii) in the production batch and (iii) over 2 different seasons for each type of dry sausage. When heterogeneity was detected, sensory analysis was performed in order to check if the physicochemical differences found were perceived by a sensory panel. The physicochemical results showed that there was no significant heterogeneity within the product nor there was in the production batch. Over the 2 seasons studied, 3 out of the 6 dry sausages were heterogeneous in composition and this feature was perceived by the sensory panel. The possible causes of this heterogeneity (amounts of ingredients added, type and composition of the raw materials used, length of drying) are discussed.

The oxidation of nanosized metallic cobalt to cobalt oxide during Fischer-Tropsch synthesis (FTS) has long been postulated as a major deactivation mechanism. In this study a planar Co/SiO(2)/Si(100) model catalyst with well-defined cobalt crystallites, close to the threshold value reported for oxidation in the literature (4-10 nm), was prepared by the spin coating method. The planar Co/SiO(2)/Si(100) model catalyst was characterized with atomic force microscopy, X-ray photoelectron spectroscopy, and Rutherford backscattering. The surface oxidation behavior of the nanosized metallic cobalt crystallites of 4-5 nm was studied using in situ near-edge X-ray absorption fine structure under model FTS conditions, i.e., H(2)/H(2)O = 1, P(Total) = 0.4 mbar, and 150-450 degrees C. No surface oxidation of metallic cobalt was observed under these model FTS conditions over a wide temperature range, i.e., 150-400 degrees C.

The spatial distribution of the intramuscular connective tissue (IMCT) in four types of beef muscle (Biceps femoris, Infraspinatus, Longissimus thoracis, and Pectoralis profundus) was examined using histology and magnetic resonance imaging (MRI). The surface and the length of the IMCT and the surface of the myofiber bundles were evaluated by image analysis. The texture of the cooked meat from these muscles was measured both instrumentally by a compression test and by sensory analysis. The relationship between muscle structure and meat texture was studied by general discriminant analysis. The models obtained could assign correctly up to 87% of the samples to two tenderness classes. Histology and MRI provided complementary information about the microscopic and macroscopic IMCT structures, respectively. Both were necessary to predict sensory tenderness whereas only the MRI measurements were necessary to predict instrumental toughness. Tough muscles had smaller MRI myofiber bundles (0.7-1 mm radius) than tender muscles.

The relationship between intramuscular collagen and five collagen crosslink concentrations, and the tenderness of meat from Belgian Blue normal, heterozygous double-muscled (DM) and homozygous DM cattle was investigated using M. semitendinosus (St) and M. gluteobiceps (Gb). The histidinohydroxymerodesmosine (HHMD) concentration (per mol collagen) in St was less in DM animals than normal animals. Concentrations (per gram of wet meat) of HHMD and Erlich chromogen (EC) in Gb, and HHMD, EC, dihydroxylysinorleucine (DHLNL) and hydroxylysinorleucine (HLNL) in St were also lower in DM animals than normal animals. Shear force of raw meat was significantly greater in normal animals than DM for both muscles; cooked meat shear force was greater in the normal animals for the Gb muscles only, showing a good correlation with sarcomere length. Most correlations between shear force and collagen or crosslink concentrations were not significant and those that were highly significant were generally weak.

1. A standard (FG, fast-growing), a black local or 'label', type (SG, slow-growing) turkey line, and the crossbreed between these two lines were compared for muscle post-mortem metabolism and related meat quality traits. 2. Ninety male turkeys (30 of each genetic type) were raised under the same experimental conditions until slaughter at 16 weeks of age. 3. Live weights at 16 weeks of age differed significantly (7.8, 6.0 and 4.2 kg, for the FG, crossbred and SG lines, respectively). Collagen content of Pectoralis superficialis (PS) muscle was higher in SG birds than in the other two types. 4. The rate of post-mortem glycogen depletion and lactate accumulation in PS and Ilio tibialis (IT) muscles were similar in the 3 lines, as were the rate and extent of post-mortem pH fall in PS muscle. In IT muscle, however, SG birds showed a slight but significantly faster pH decline. 5. Colour measurements indicated a paler breast muscle and a higher degree of myoglobin oxidation in SG birds at 24 h post mortem, than in both other lines. But these differences had disappeared after 4 and 7 d post mortem 6. SG birds showed higher drip loss and instrumentally-assessed toughness in breast muscle, compared with crossbred and FG birds. FG birds, however, had the lowest yield of breast meat after curing-cooking. 7. No marked differences in post-mortem metabolism were found between the three lines. However, differences in water-holding capacity of fresh and cured-cooked meat suggest that factors other than the rate and extent of post-mortem pH fall may contribute to the respective characteristics of these lines.

Charolais bull calves (106) were used to study the variability in meat quality attributes in relation to the variability in muscle characteristics in the Longissimus thoracis (LT) muscle. The variability in traits was adjusted either to constant age or constant weight at slaughter and thus originated only from differences between animals born, reared and fattened in the same location. The following meat quality attributes were measured: the strength of the myofibrillar resistance to a 20% compression strain measured on the raw meat 2, 7 and 21 days post mortem; and taste panel scores of tenderness (initial and overall), flavour and juiciness of steaks grilled to a 55°C core temperature 6 or 15 days post-mortem. The following muscle characteristics were measured 24 h after slaughter: pH, dry matter, protein, lipid, heme iron and collagen contents, collagen solubility, LDH and ICDH activity, the proportion of slow twitch myosin heavy chain, the mean muscle fibre area and the mean sarcomere length. One fourth to one third of the variability of 2 day mechanical strength and 15 day tenderness or flavour scores were related to the variability in muscle characteristics. Tenderness and strength measurements were predominantly related to the muscle fibre area, collagen characteristics and energetic metabolic activity. Dry matter content was the principal muscle characteristic related to flavour.

The potential to tenderize beef muscles by the injection of lactic acid (0.5 M, 10% w/w) was studied using the pectoralis profundus muscle from cull cows. The injection was performed either 1 h (pre rigor) or 24 h (post rigor) post mortem, and the meat was stored for 2 or 14 days post mortem. Both treatments caused a rapid pH drop to around 5.0 within 4 h of injection. Other effects were: (1) an accelerated release of lysosomal enzymes into the cytosol; (2) a greater degradation of myosin heavy chains; (3) ultrastructural alterations of the myofibrils which included a general weakening or rupture in the M-lines and, to a lesser extent, in the I-bands; (4) a decreased heat stability of perimysial collagen indicated by a lower insoluble collagen content, lower differential scanning calorimetry transition temperature, and lower transition temperatures in isometric tension tests on muscle strips. The lactic acid injections improved significantly the textural traits of the meat (shear value, tensile strength, sensory scores) at 2 days post mortem with little further improvement when storage was extended to 14 days post mortem. Changes in texture were of similar amplitude at both post mortem injection times. The tenderization mechanisms of lactic acid injection are discussed.

High-intensity and high-frequency ultrasound was tested for its ability to accelerate meat ageing and increase beef tenderness. Samples (≈50g) of semimembranosus muscles from 8 cull cows were assigned to ultrasonic treatment (2.6MHz; 10W/cm(2); 2 ×15s) either pre-rigor (day 0, pH 6.2) or post-rigor (day 1, pH 5.4). When applied pre-rigor, ultrasound induced a slight delay in rigor mortis onset, a stretching (12-15%) of the sarcomeres (p<0.05), an ultrastructural alteration in the Z-line region and an immediate increase (around 30%) in the release of calcium in the cytosol (p<0.05). However, no conclusive effect on meat ageing rate was observed. Post-rigor ultrasonic treatment did not induce any structural modification but slightly improved the ageing index after 6 days (p<0.05). However, no improvement in the final (day 14) ageing index was observed compared to the controls. As ultrasound had also no effect on the thermal stability of collagen, at both postmortem times, no improvement in meat tenderness can be expected under the conditions used.

Meat quality traits were determined in the major muscles of the emu (Dromaius novaehollandiae) at different slaughter ages (6, 10, 14, 17 or ≥20 months). A mean ultimate pH value of 5.5 was reached within around 3 h post mortem, but this value was 6.1 in animals that had suffered a preslaughter stress (transportation and fasting). The collagen and pigment contents varied widely among the muscles. The protein and pigment contents increased with animal age, but this effect was perceptible only between 6 and 14 months. The other chemical constituents were little affected by muscle type or animal age. The intense red colour of emu meat, due to a high pigment content, was very sensitive to oxidation, thus limiting the storage of fresh meat under aerobic conditions to short periods of time. Despite a rapid post-mortem tenderization (≤24 h), the residual myofibrillar strength obtained after extended ageing remained intermediate between those reported for chicken and beef. The tenderness of meat, cooked to 60 °C, differed between muscles and decreased with increasing age, thus reflecting the changes occuring in the concentration and in the heat stability of the intramuscular connective tissue.

In cutaneous melanoma, the standard CD44 molecule is abundantly expressed, whereas the expression of certain splice variants is related to tumour progression and to the metastatic potential of the cell line. In the present study we have investigated the expression of CD44 and the pattern of CD44 alternative splicing in uveal melanoma in relation to the cell type, diameter and invasiveness of the tumour. All uveal melanomas strongly stained with antibodies to the standard portion of CD44. No expression of the CD44 variant (v) exon CD44v7 was found, whereas v5, v6 and v10 were expressed (in 2/12, 5/12 and 8/12 cases, respectively). No correlation was observed between expression of particular splice variants and cell type, tumour diameter or invasion of the sclera or Bruch's membrane. All three uveal melanoma cell lines tested were strongly CD44 positive and expressed low levels of v6-containing isoforms at the cell surface, but v5, v7 and v10 were absent. Our results show that CD44 is strongly expressed in uveal melanoma and that the pattern of CD44 alternative splicing is similar to that observed in cutaneous melanoma. However, in uveal melanoma this alternative splicing does not appear to be related to prognostic parameters.

Cell adhesion is crucial in the process of tumour progression. As integrins are important receptor molecules involved in cell adhesion, we studied the distribution of the alpha 1-6, alpha v, alpha IIb, beta 1, beta 3, and beta 4 integrin subunits in tissue sections of common naevocellular naevi (n = 22), dysplastic naevi (16), thin (24) and thick primary cutaneous melanomas (28), and melanoma metastases (25). We found correlated expression of alpha 1/alpha 2, of alpha 4/alpha 5/beta 3, and of alpha 6/beta 4. Decrease of alpha 6 and beta 4, and increase of alpha 4 and alpha v were found to be correlated with melanoma progression. Furthermore, expression of alpha 5 and beta 3 was detected only in primary melanoma and melanoma metastasis. Our findings indicate that during melanoma progression alterations in integrin expression occur, the most striking being emergence of alpha 5 beta 1 fibronectin and alpha v beta 3 vitonectin receptor.

Cardiopulmonary exercise testing (CPX) allows a non-invasive control of the cardiopulmonary exercise capacity. In this study, we wanted to investigate if the CPX can be securely, practicably, and accurately performed in patients with invasively documented coronary heart disease (CHD). Furthermore, we wanted to find out the clinical value of CPX in CHD diagnosis. The CPX measurements (symptom-limited; ramp program with 20 Watts increase/min; semi-supine position; continuous registration of the cardio-circulatory parameters (HR, RR, ECG), of the gas exchange parameters (O2, CO2) and of the ventilation) in 101 patients have shown that CPX is secure, accurate, and practicable. The day-to-day reproducibility is high (r > 0.8). The respiratory anaerobic threshold can be manually evaluated by means of the PET O2 criterion in 95% of the cases. The CCS-classification of angina pectoris could not accurately describe the cardiopulmonary exercise capacity as compared to the Weber-classification. The disadvantage of the Weber-classification is that it does not respect the age-, sex- and weight-dependent differences of the normal values. Our own data and results from the literature demonstrate that the anaerobic threshold, the maximum VO2 and the maximum O2-pulse are the more reduced the more coronary arteries are involved, the more reduced the left ventricular function is. But, nevertheless, the range of values shows large overlaps so that an exact differentiation, based upon these parameters, is not possible. Patients with similar functional results or degree of reduced exercise capacity have different morphological alterations. Most patients demonstrated typical ischemic cascade with anaerobic threshold, ST-segment alterations, angina pectoris and, finally, reduced max. VO2. In conclusion, CPX does not replace the traditional methods of non-invasive and invasive ischemia detection, but enables secure, practicable, and accurate measurements of the individual cardiopulmonary exercise capacity and the interaction between muscles, heart, circulation, and lungs. Possibly, CPX can be used in the near future for identifying CHD patients with low, medium or high risk.

In this study we wanted to investigate if noninvasive cardiopulmonary exercise testing can be securely, accurately applied in patients with acquired cardiac valve disease pre- and postoperatively with any convenience. Furthermore, we looked if the cardiopulmonary exercise capacity (anaerobic threshold, etc.) was improved postoperatively (3 and 6 months) in 15 patients suffering from severe mitral valve disease as compared to the preoperative condition. The symptom-limited cardiopulmonary exercise testing was performed on a bike in a semi-supine position using a ramp program (+20 W/min). The following parameters were continuously monitored, and the breath-by-breath gas exchange values documented: cardiocirculatory parameters (heart rate; blood pressure; surface ECG; exercise capacity in Watts); gas-exchange parameters (O2-uptake VO2; CO2-production VCO2; respiratory anaerobic threshold VO2 AT; gas-exchange ratio VCO2/VO2; O2-pulse VO2/HR; aerobic capacity delta VO2/delta WR) and ventilatory parameters (respiratory rate; tidal volume Vt; minute ventilation VE; equivalent for O2: VE/VO2 and CO2: VE/VCO2). The 155 cardio-pulmonary exercise tests in 115 patients were practicable, safe (no emergency case) and accurate. In 100 patients late postoperatively (68.3 +/- 53.0 -102.9 +/- 41.2 months) after aortic or mitral valve replacement or both without signs of significant hemolysis or prosthetic valve dysfunction the NYHA classification was too imprecise to characterize the actual exercise capacity of the patients (e.g., NYHA class II: Weber class B to E). Patients with aortic valve prosthesis had a significantly better anaerobic threshold (57.4 +/- 19.1% pred. value max. VO2) as compared to those with mitral valve replacement (mean: 35.9% pred. value max. VO2).(ABSTRACT TRUNCATED AT 250 WORDS)

The cardiopulmonary exercise testing (CPX) is a non-invasive method for the evaluation of the cardiopulmonary exercise capacity. Based upon the recent technical progress in gas analysers and personal computers today it is possible to perform CPX with acceptable time consumption, high practicability and high reproducibility of the results in many clinical areas. CPX is realized on a bike or on a treadmill. In bicycle CPX a ramp program (increase of x watts per minute) or a constant workload test (p.e. with 75% of the watts at anaerobic threshold) are performed. Furthermore, an estimation of the cardiac output using CO2-rebreathing method can be realized during a ramp program or a constant workload test. In this paper, also the CPX parameters of the ramp program, the constant workload test and the CO2-rebreathing method are defined and explained. The normal values of CPX are dependent of age, sex, body weight and exercise program. This should be kept in mind in interpreting the measured CPX data. Additionally, the performance of a routine CPX will be reported. Furthermore, the accuracy of the CPX parameters and the potential influences on the data will be discussed. Finally, problems during measurements and their analysis will be clarified.

The clinician who uses cardio-pulmonary exercise testing (CPX) systems relies on the technical informations from the device producers. In this paper, the practicability, the accuracy and the safety of four different, available CPX systems are compared in the clinical area, using clinically orientated criteria. The exercise tests were performed in healthy subjects, in patients with cardiac and/or pulmonary disease as well as in young or old people. The comparison study showed, that there were partially large differences in device design and measurement accuracy. Furthermore, our investigation demonstrated that beneath repetitive calibrations of the CPX systems a frequent validation of the devices by means of a metabolic simulator is necessary. Problems in calibration can be caused by an inadequate performance or by unclean calibration gases. Problems in validation can be due to incompatibility of the CPX device and the validator. The comparison study of the four different systems showed that in the future standards for CPX testing should be defined.

VVI-pacemaker patients with high-grade atrioventricular block were subjected to cardiopulmonary exercise testing. An interindividual comparison was made between patients with intermittent intrinsic rhythm (n = 9) and patients with permanent VVI-stimulation (n = 15). Patients with intermittent sinus rhythm on exercise had no significant increase in exercise capacity as quantified by the O2-uptake at the anaerobic threshold. An intermittent sinus rhythm is of no relevance to therapeutic decisions, such as choosing the appropriate pacing mode. Exercise capacity is determined by multiple, partly peripheral factors.

Purpose: During the process of metastasis, changes in cell-cell and cell-matrix contacts occur; therefore, expression of integrins, a superfamily of adhesion molecules, may be important. Expression of integrins has been studied extensively in cutaneous melanoma. Because it is known that uveal melanoma has a metastatic behavior different from cutaneous melanoma, the authors investigated integrin expression in uveal melanoma., Methods: The authors used monoclonal antibodies recognizing integrin subunits alpha 1-6, alpha v, beta 1, and beta 4 and integrins alpha v beta 3 and alpha v beta 5 on frozen sections of 32 human primary uveal melanomas and 4 metastases, followed by an avidin-biotin-peroxidase complex-immunoperoxidase technique., Results: As in cutaneous melanoma, alpha 4 expression was rare, but most lesions expressed alpha 3 and alpha 6. In contrast to cutaneous melanoma, in which alpha 2 is well expressed in most lesions and alpha 5 is expressed only in a small percentage of lesions, alpha 2 expression was rare in uveal melanoma and alpha 5 expression was found in all lesions. A major difference was observed with regard to the alpha v beta 3 vitronectin receptor. In contrast to cutaneous melanoma, in which alpha v beta 3 is expressed in advanced primary melanomas and metastases, alpha v beta 3 was not detected in any of the primary uveal melanomas, but all lesions strongly expressed alpha v beta 5., Conclusions: Integrin expression in uveal melanoma cannot be correlated with cell type or invasiveness. In contrast to cutaneous melanoma, it seems that determination of the integrin expression profile is not suitable for categorizing uveal melanomas as less malignant and highly malignant lesions.

Autologous blood donation is an established method for an effective reduction of the blood-transfusion-associated infectious diseases (hepatitis, HIV infections, etc.) in elective surgical procedures. The aim of the study was to investigate the effects of a blood donation of 450 ml on the cardiopulmonary exercise capacity in 16 apparently healthy young subjects. The 24 cardiopulmonary exercise tests were performed on a bicycle ergometer (Ergoline 900) in a semisupine position, using a ramp program (+20 watt/min) 1-7 days before and 2 days after blood donation. By means of continuous breath-by-breath measurements of the gas exchange (VO2, VCO2) and ventilation parameters (minute ventilation VE), as well as of the routine parameters (heart rate, blood pressure, work rate) during incremental exercise the respiratory anaerobic threshold VO2AT, the maximum VO2 (VO2max and the maximal working capacity (max. WR) were determined. Serum hemoglobin concentration was significantly (p < 0.0005) reduced from 14.5 +/- 1.0 to 13.0 +/- 1.4 g/dl after blood donation. The ventilatory anaerobic threshold (before: 68.5 +/- 17.0; after: 52.0 +/- 20.3% pred. max. VO2), the max. VO2 (before: 124.2 +/- 21.3; after: 110.2 +/- 23.2% pred. max. VO2) and max. WR (before: 287.1 +/- 75.6; after 265.5 +/- 76.2 watt) fell significantly (VO2AT: p < 0.0005; max. VO2: p < 0.0005; max. WR: p < 0.025). Heart rate and minute ventilation showed a steeper increase (dHR/dWR: before: 0.31 +/- 0.06; after: 0.34 +/- 0.05 beats/min/watt; dVE/dWR: before: 0.29 +/- 0.05; after: 0.31 +/- 0.05 l/watt) in relation to the increase in WR after blood donation as compared to the test before.(ABSTRACT TRUNCATED AT 250 WORDS)

Over a period of 30 months (1. 1. 89-30. 6. 91) 3516 patients who had either a diagnostic (2718) or therapeutic (798) heart catheterization were followed for local vascular complications. 774 patients were investigated prospectively. The following complications were observed in declining frequency: 1. relevant haematoma, 2. pseudoaneurysm, 3. arteriovenous fistula, 4. arterial thrombosis/dissection, 5. venous thrombosis, 6. rupture of the vessel, 7. local infection. The total complication rate was 2.22%. With prospective investigation it was significantly higher (3.23%) than with retrospective investigation (1.93%). The complication rate was also significantly higher in therapeutical procedures (3.76%) than in diagnostic catheterizations (1.76%). Factors associated with a significantly higher incidence of local vascular complications were age (p < 0.01), female gender (p < 0.025), manifest arterial hypertension (p < 0.005), aortic regurgitation (p < 0.1), peri-interventional medication with acetylsalicylic acid and full dose heparin (p < 0.001), full dose heparin alone (p < 0.001) or fibrinolysis-therapy (p < 0.025). Relevant technical factors were: duration of the procedure, duration of the placement of the catheter-sheath, French size of the catheter, left femoral access, arterial and venous access at one extremity. In about half of the cases the treatment of the complications was conservative, in the other half it was surgical (51%). In relation to all surgically treated patients the percentage of emergency operations was 25%, the percentage of reoperations was 15%.

The effect of clenbuterol administration on performance, muscle composition and meat texture was studied in veal calves. Three groups, of ten animals each, were assigned to the three following treatments for 27 days: control, administration of 0·3 and 1·0 ppm in the feed (dry matter basis). After a 14-day withdrawal period, the animals were slaughtered, and three muscles were sampled (M. longissumus thoracis; M. triceps brachii caput longum; M. rectus abdominis). During the period of clenbuterol administration, the treated calves exhibited a higher daily liveweight gain (DLWG) and a higher feed conversion efficiency (FCE) compared to those of the control calves, but these effects were reversed during the subsequent withdrawal period. At slaughter, the overall DLWG, FCE and carcass weight were similar in the three treatments, but the dressing percentage in the clenbuterol-treated calves was up to 5·7 points higher than that of the control calves. In the muscles studied, the clenbuterol had little effect on pH, sarcomere length, dry matter and nitrogen contents, collagen heat stability (solubility, isometric tension) or cooking loss; but it markedly reduced the content of lipids, collagen and haem pigments. The clenbuterol also affected myofibrillar strength after ageing, measured either on raw meat or on cooked meat. This was particularly evident in cooked meat which showed up to a two-fold increase in mechanical parameters (maximum stress, compression modulus) after the clenbuterol treatment. No dose effect was detected except for the mechanical parameters. It was concluded that clenbuterol administration affects, meat in two opposite ways, viz. a marked toughening effects, due to a reduction in the muscle ageing rate, that is not compensated by a concomitant tenderizing effect (through a decrease in the intramuscular collagen content)., (Copyright © 1992. Published by Elsevier Ltd.)

Forty-five Charolais steers were fed one of four experimental regimes containing maize silage and maize grain supplemented with either protected soyabean-rapessed meal or linseed meal. The first three regimes were formulated to supply the same energy and different protein levels with soyabean-rapessed meal: low (L-SRM), medium (M-SRM) and high (H-SRM). The fourth regime consisted in feeding the same amount (kg/day) of linseed meal as that of soyabean-rapessed meal in the H-SRM regime (LSM). As the protein level increased from L-SRM to H-SRM, the daily weight gain of steers increased and the carcass composition was changed towards higher muscle and lower fat proportions. Though the actual supply of feed protein by regime LSM was close to that achieved with M-SRM, the effect of linseed meal supplementation on weight gain and carcass composition was comparable to that obtained by feeding the high protein level (H-SRM). The dry matter content increased and the heme pigments and lipids contents decreased in longissimus thoracis muscle as the protein supply increased from the low to the high level. Again the amplitude of the differences in meat quality with L-SRM were similar in H-SRM and LSM. Muscle colour, connective tissue and mechanical strength remained practically unaffected by the protein treatments. However, meat was scored less tender in H-SRM and less juicy in treatment LSM than in treatment L-SRM. The results obtained with linseed meal suggest a specific effect of type of feed protein on beef carcass composition and meat quality., (Copyright © 1993. Published by Elsevier Ltd.)

Cytomegalovirus (CMV) is the most common viral agent causing congenital infection in humans, affecting 0.2 to 2.4% of all live births. Symptomatic congenital CMV infection has previously been shown to cause low birth weight and prematurity. Whether or not asymptomatic congenital CMV infection, which represents the majority of cases (90 to 95%), affects intrauterine growth or gestational duration is unknown. Using a population of 146 infants with asymptomatic congenital CMV infection and 1419 controls from two socioeconomically diverse populations (biracial low income and white mid- to upper income), determinants of body size (birth weight and crown-heel length) were investigated using multiple regression techniques. We found that congenital infection following the transmission of maternal primary and "unknown" CMV infection resulted in a significant mean birth weight deficit of 163 g (P less than 0.04) for the low income term infants (blacks and whites), but not in the mid- to upper income white infants. Newborns with congenital infection following the transmission of maternal reactivated (recurrent) CMV infection were significantly shorter by a mean of 1 cm (P less than 0.03) than controls, a finding that was consistent regardless of socioeconomic status or race.

Sialyltransferase (ST) activity was examined in tumor and control tissues. Within each group of control tissues a wide variation in the levels of ST activity was observed. Only in 20% of the tumors was the ST activity above the range of enzyme activity of the corresponding group of control tissues. Compared with its corresponding normal counterpart from the same individual, ST was elevated in tumor tissue by a factor of 2.1 on average. The distribution function indicates an increase in enzyme activity in 74% of the tumors. Other tumor markers were also determined for comparison. The ratio of the lactate dehydrogenase (LDH) subunits (M/H) was increased in tumors by a factor of 1.3 on average; the frequency of increase was 75%. From the distribution function of our data it follows that a decrease in the ratio of the creatine kinase (CK) subunits (B/M) occurs in 56% of tumors, the average factor being 0.8. The Regan isoenzyme of the alkaline phosphatase (AP) could be demonstrated in 13% of the tumors. In serum and in tissues ST was found to be composed of multiple forms. However, an isoenzyme of higher tumor specificity has not yet been established.

The activity of sialyltransferase in human serum was determined by a radiochemical assay with desialylized fetuin as acceptor. The precision of this method proved to be low. The effect of storage, temperature, concentration of hydrogen ions and other substances was investigated. As at least 5 pH-optima were found, multiple forms of sialyltransferase may well exist in serum.

Serum-sialyltransferase activity was measured in serum samples of 116 patients with malignant tumors of various origins and different clinical stages using asialo-fetuin as the acceptor and cytidine-5'-mono-phospho[14C]sialic acid as the donor. Only patients with metastatic tumors had significantly elevated serum-sialyltransferase levels. Increased enzyme activity was also associated with rheumatoid arthritis and with acute hepatitis, whereas no significant alteration of enzyme activity was observed in cystic fibrosis patients. In a group of tumor patients, various additional tumor markers were determined (carcinoembryonic antigen, alkaline phosphatase: Regan isoenzyme, creatinekinase: BB-isoenzyme, lactatedehydrogenase: isoenzyme 5) and the data compared to the clinical diagnoses. The sensitivity and specificity of serum-sialyltransferase as a tumor marker is assessed.