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Drucken: Moderne Drucker gibt es für die unterschiedlichsten Einsatzgebiete. Bestimmte Fähigkeiten, wie die Netzwerkfähigkeit oder die Ansprechmöglichkeit auch via Smartphone oder Tablet, sind inzwischen bei fast allen Geräten Standard. Von Thomas Jungbluth

Adequate lying times and feed consumption are essential for the welfare and performance of dairy cows. The time budget of cows housed in barns with an automatic milking system (AMS) might be constrained in several ways. Cows with a high milking frequency might also have to visit the AMS at night, possibly interfering with their night-time lying behavior. Moreover, competition for access to the AMS might cause some cows to spend more time waiting in front of the milking unit, resulting in a lower milking frequency. In the present study, the individual total duration of stay and time spent per visit in the feeding, lying and waiting area, as well as lying behavior, was therefore investigated in the daytime and throughout the night in relation to milking frequency. A total of 138 focal cows (day of lactation: 1–200) housed on 4 Swiss working farms with an AMS were automatically tracked for 48 h. Individual lying times were recorded over 7 days with data loggers. The daily milking frequency was calculated from the AMS records and included as a continuous explanatory variable in linear mixed-effects models. Time spent in the waiting area at night increased with increasing milking frequency. In addition, cows with a relatively high milking frequency had shorter daytime lying bouts, and spent less time in the lying area per visit during the daytime as well as at night. The same individuals also visited the feeding area for shorter times during the day, and on average remained longer per visit in the waiting area at night. The daily time budget of cows with a relatively low milking frequency was not adversely affected. Cows with a relatively high milking frequency may face some trade-offs in their time-budget allocation, since the increased time spent by them in the waiting area at night as well as their shorter lying bouts might affect their welfare, health and performance. Nevertheless, the overall daily time budget for lying and feeding, and hence the welfare of cows with both a relatively high or low milking frequency, suffered no obvious adverse effects.

Re-anastomosis after a Hartmann procedure is associated with a higher morbidity and mortality than other elective colorectal operations. The goal of this comparative study was to evaluate whether laparoscopic reversal is a justified operative approach, although the initial operation is most often an emergency laparotomy. A retrospective analysis was conducted on data collected on all 70 patients who underwent laparoscopic and open reversal of a Hartmann procedure at the Department of Surgery, University of Schleswig–Holstein, Campus Lubeck, between January 1999 and December 2011. Together with general demographic data, the analysis included the indication for the initial Hartmann procedure, time to reversal, intraoperative findings, the choice of operative method, operating time, postoperative pain control, return of normal bowel function, length of hospital stay, and peri- and postoperative morbidity and mortality. In most patients, the Hartmann procedure was performed after a perforated sigmoid diverticulitis. We were not able to find any statistically significant differences with respect to gender, body mass index (BMI) and American Society of Anesthesiologists classification between the laparoscopic group (LG) (N = 24 patients) and the open group (OG) (N = 46). In the LG, patients were significantly younger (p = 0.019). The median operating time was 210 min (75–245) in the LG, which was significantly longer than in the OG (166 min; 66–230). The statistical analysis of the duration of postoperative analgesic therapy (LG 7 days [6–10]; OG 12 days [6–30] ), return to normal diet (LG 3 days [2–6]; OG 4 days [2–10] ), return of normal bowel function (LG 3 days [2–4]; OG 4 days [2–9] ) and length of hospital stay (LOS) (LG 10 days [8–13]; OG 15 days [8–163]) detected significant differences in advantage for the LG. Unplanned return to theatre during index admission was only necessary in the OG (N = 7, 15.2 %). With a median follow-up of 8 months (range 1–20), we observed a comparable number of minor complications in both groups but a significantly higher number of major complications in the OG (N = 27, 58.7 %) (p = 0.001). Conversion occurred in three cases (12.5 %). There was no mortality in either of the two groups. This study was able to demonstrate the feasibility of the laparoscopic approach. In terms of postoperative results it should be seen as equivalent to the open procedure. However, the laparoscopic approach requires profound surgical expertise. The indication should be made after a careful risk/benefit analysis for each individual patient.

Biochemical methane potential assays, usually run in batch mode, are performed by numerous laboratories to characterize the anaerobic degradability of biogas substrates such as energy crops, agricultural residues, and organic wastes. Unfortunately, the data obtained from these assays lacks common, universal bases for comparison, because standard protocols did not diffuse to the entire scientific community. Results are usually provided as final values of the methane yields of substrates. However, methane production curves generated in these assays also provide useful information about substrate degradation kinetics, which is rarely exploited. A basic understanding of the kinetics of the biogas process may be a first step towards a convergence of the assay methodologies on an international level. Following this assumption, a modeling toolbox containing an exponential model adjusted with a simple data-fitting method has been developed. This model should allow (a) quality control of the assays according to the goodness of fit of the model onto data series generated from the digestion of standard substrates, (b) interpretation of substrate degradation kinetics, and (c) estimate of the ultimate methane yield at infinite time. The exponential model is based on two assumptions: (a) the biogas process is a two-step reaction yielding VFA as intermediate products, and methane as the final product, and (b) the digestible substrate can be divided into a rapidly degradable and a slowly degradable fraction.

The uptake of essential trace elements by methanogenic bacteria can be obstructed by precipitation in the presence of sulfides and carbonates. The objective of this study was to investigate whether the bioavailability of trace elements, and therefore the methane yield, can be improved through the use of complexing agents. Research showed that the use of EDTA as a complexing agent in the biogas process increases the solubility of essential metals and enhances their bioavailability. If the substrate of a biogas digester has a low content of trace elements, solutions of elements essential for the methanogenic bacteria have to be added to the process. If these metals are complexed with EDTA prior to their supply, the necessary amount can be reduced by up to 75% compared to the non-complexed metals. Therefore, it would be advantageous for environmental and economic reasons to complex trace elements prior to their addition to the biogas process.

Aim The increasing experience within the area of laparoscopic procedures has paved the way for technically-complex procedures, such as distal pancreatectomy. In order to avoid complications associated with concomitant splenectomy, these procedures are increasingly performed with spleen preservation. A drawback is the low number of cases, which does not allow for an evidence-based comparison between laparoscopic and open procedures, and spleen-preserving and concomitant splenectomy procedures. Patients and Methods Between 2006 and 2010, all data for patients who underwent a laparoscopic distal pancreatectomy (LDP) at the Department of Surgery, University of Schleswig-Holstein, Luebeck, Germany, were collected are stored in a prospectively-maintained database. Patients with tumours in the pancreatic tail and body that did not exceed the level of the portal vein were included in this database. Results A total of 22 patients who underwent LDP could be included in the evaluation. Ten of those patients underwent a laparoscopic spleen-preserving distal pancreatectomy (LSPDP), while the remaining 12 received an LDP with splenectomy (LDPwS). The median operation time was 155 min (range: 98–253) for the LSPDP group, and 201 min (range: 60–310) for the LDPwS group (P = 0.06). The median hospital stay was 8.5 days (range: 5–23) in the LSPDP group compared to 11 days (range: 4–41) in the LDPwS group (P = 0.06). Pancreatic fistula occurred in two patients from each group. It caused an intraabdominal haemorrhage in one patient of the LSPDP group, which required re-laparoscopy. Two patients experienced subphrenic abscesses in the LDPwS group and were treated interventionally. Histological examination revealed six cystadenomas and five pseudocysts (maximum diameter: 7 cm) in the LDPwS group, and six neuroendocrine tumours (maximum diameter: 2 cm) in the LSPDP group. Conclusion LDP can be performed safely. The optic magnification provided by laparoscopy facilitates LSPDP, as dissection of the splenic vessels can be avoided. Although not significant, there was a trend towards reduced hospital stay and operating time for LSPDP. Oncologic outcomes and morbidity seem to not be inferior to open procedures. The size of the tumours and the peripancreatic, as well as paraneoplastic, tissue alterations determine the indication for splenectomy.

The regular colonisation of the oesophagus with a Candida species can, after oesophageal perforation, result in a contamination of the mediastinum and the pleura with a Candida species. A patient cohort of 80 patients with oesophageal perforation between 1986 and 2010 was analysed retrospectively. The most common sources with positive results for Candida were mediastinal biopsies and broncho-alveolar secretions. Candida species were detected in 30% of the patients. The mortality rate was 41% in patients with positive microbiology results for Candida, whereas it was 23% in the remaining patient cohort. This difference did not reach statistical significance (P = 0.124). Mortality associated with oesophageal perforation was attributed mainly to septic complications, such as mediastinitis and severe pneumonia. During the study period we observed a shift towards non-albicans species that were less susceptible or resistant to fluconazole. In selected patients with risk factors as immunosuppression, granulocytopenia and long-term intensive-care treatment together with the finding of Candida, an antimycotic therapy should be started. A surgical approach offers the possibility to obtain deep tissue biopsies. The antimycotic therapy should start with an echinocandin, as the resistance to fluconazole is growing and to cover non-albicans Candida species, too.

Auch das beste IT-System kann versagen. Problematisch wird es, wenn dabei Praxisdaten verloren gehen. Wie Arzte sich ohne Mehraufwand gegen den Datenverlust absichern konnen, zeigt ein Beispiel aus der Praxis.

Optimal nutrient supply in the digester is essential for efficient biogas production. The aim of this study was to analyze the effects of various micro- and macronutrients on the process stability by a field test. The digestates of 25 biogas plants across the federal state of Baden-Wurttemberg, Germany, were investigated. Collected data including trace elements, macronutrients, and volatile fatty acids (VFA) concentrations, as well as the organic loading rate and hydraulic retention time were subjected to statistical analysis. High variations in the concentrations within the different biogas plants were observed. Statistically significant effects of substrate constituents and process parameters on the stability of the anaerobic digestion process were found. Several micro- and macronutrients and the relationships between these elements, as well as the process parameters propionic acid, acetic acid, and acetic acid equivalent were tested. Ni, Mo, and S had a consistent statistically significant effect, while the organic loading rate and Se only showed an effect limited to the acetic acid concentration and the acetic acid equivalent. No statistically significant effect could be shown for Fe, Co, and Na. Most of the significant interactions between the tested elements contained Ni, Fe, and Co. This shows that a balanced relation between the concentrations of these elements is of greater importance than the presence of individual elements for a digester to be able to operate at high organic loading rates and maintain low VFA concentrations.

This work thoroughly evaluates the electric power consumption of a full scale, 3 × 923 m 3 complete stirred tank reactor (CSTR) research biogas plant with a production capacity of 186 kW of electric power. The plant was fed with a mixture of livestock manure and renewable energy crops and was operated under mesophilic conditions. This paper will provide an insight into precise electric energy consumption measurements of a full scale biogas plant over a period of two years. The results showed that a percentage of 8.5% (in 2010) and 8.7% (in 2011) of the produced electric energy was consumed by the combined heat and power unit (CHP), which was required to operate the biogas plant. The consumer unit agitators with 4.3% (in 2010) and 4.0% (in 2011) and CHP unit with 2.5% (in 2010 and 2011) accounted for the highest electrical power demand, in relation to the electric energy produced by the CHP unit. Calculations show that 51% (in 2010) and 46% (in 2011) of the total electric energy demand was due to the agitators. The results finally showed the need for permanent measurements to identify and quantify the electric energy saving potentials of full scale biogas plants.

Trotz der Reduzierung der Mortalitat nach Osophagusresektion an Zentren auf unter 5% ist die Chirurgie des Osophagus nach wie vor durch hohe perioperative Morbiditat gekennzeichnet. Die chirurgischen

BACKGROUND: Colorectal cancer is one of the most common malignant diseases in the industrialized nations. Despite advances in research on tumor development and biology, improved therapeutical concepts, and an increasing motivation to undergo screening examinations and surveillance programs the overall mortality remains high. METHODS: PubMed database was used to screen the current literature for the topics of epidemiology, colorectal cancer development, histopathologic features, and diagnosis in colorectal cancer. RESULTS: A general overview of epidemiologic data in terms of incidence, geographic differences in occurrence and risk factors is given. Molecular mechanisms for the formation of colorectal cancer within the adenoma-carcinoma sequence are explained and additional aspects such as ploidy-status of colorectal tumors and microsatellite instability put into perspective. Various variables of routine histopathologic evaluation are summarized, more advanced analyses explained and prognostically relevant features listed. Diagnostic workup and staging of patients with colorectal cancer are based on several different techniques which are discussed for their effectivity, sensibility and sensitivity. CONCLUSIONS: Early detection of colorectal cancer together with a more detailed understanding of tumor heterogeneity and the prospect of tailoring individualized therapeutical concepts constitute essential factors in order to further ameliorate the outcome of colorectal cancer patients.

BACKGROUND: Laparoscopic colorectal procedures for the treatment of benign disorders are increasingly appreciated and have become the standard procedure for e.g. surgical treatment for recurrent diverticulitis. METHODS: Data show that even laparoscopic surgery for left sided colon cancer is seen as oncologically equal to the classic open resection. Laparoscopic resections offer several benefits e.g. minimal impairment of gastrointestinal and pulmonary functions, lower immunosuppression, shorter hospital stay, and faster reconvalescence. RESULTS: However, laparoscopic resections for rectal cancer are still discussed controversially as concerns are raised in terms of oncologic radicality, port-site metastases, autonomic nerve preservation, and completeness of total mesorectal excision especially in obese male patients with a tight pelvis. CONCLUSIONS: The clinical reality and several studies demonstrate that laparoscopic rectal surgery for cancer is oncologically feasible, lymph node dissection is equivalent to open surgery, and the incidence of port-site recurrence is not increased compared to wound recurrence in conventional laparotomy.

This article deals with the digestion of energy crops in a two-phase biogas process based on an anaerobic leach-bed reactor combined with an anaerobic filter. The biogas process is a microbiological conversion of biomass into methane and carbon dioxide. This process is carried out by different microorganisms and can be divided into four steps which normally take place in only one digester. To be able to digest difficult energy crops by mono-digestion and to meet the different needs of the several bacteria, which take part in the four-step process of the methane production, the process was divided into two phases: (i) an anaerobic batch leach-bed phase, where the leachate was produced and (ii) an anaerobic filter, where the organic fraction of the leachate was converted into biogas. Considering the results of the experiments, the two-phase digestion of energy crops exhibited stable digestion behavior. No biological imbalance of the process, e.g. due to a sudden change of substrate, was detected either in the leach bed or in the anaerobic filter. Variation in suitability for two-phase fermentation with an anaerobic batch leach-bed reactor was observed for various substrates. The different substrates varied in their influence on acid formation and concentration as well as an influence on the course of the pH value.Therefore, an effect on the distribution of energy to the phases could be observed.

A life cycle assessment model with eight potential scenarios for the conversion of energy crops into biogas and bioethanol in Germany has been developed, in order to compare energetic output/input relationships and potential environmental effects of the different pathways. The model includes parameter from the literature as well as own data collected at laboratory and semi-industrial scale trials. Corn silage and ripe triticale, both whole plants, were chosen as typical energy crops for the assessment. In addition, steam explosion as a pretreatment technique was examined. Biogas, as well as bioethanol combined with biogas, is potentially helpful to reduce the consumption of nonrenewable energy carriers and its greenhouse gas emission under the investigated scenarios and the scope set. A future task will be the development of differentiated and well-adapted concepts on the basis of a decision on liquid or gaseous fuels versus stationary supply of thermal and electrical energy from biomass.

Background Postoperative surveillance after curative resection for colorectal cancer has been demostrated to improve survival. It remains unknown however, whether intensified surveillance provides a significant benefit regarding outcome and survival. This study was aimed at comparing different surveillance strategies regarding their effect on long-term outcome. Methods Between 1990 and 2006, all curative resections for colorectal cancer were selected from our prospective colorectal cancer database. All patients were offered to follow our institution's surveillance programm according to the ASCO guidelines. We defined surveillance as "intensive" in cases where > 70% appointments were attended and the program was completed. As "minimal" we defined surveillance with < 70% of the appointments attended and an incomplete program. As "none" we defined the group which did not take part in any surveillance. Results Out of 1469 patients 858 patients underwent "intensive", 297 "minimal" and 314 "none" surveillance. The three groups were well balanced regarding biographical data and tumor characteristics. The 5-year survival rates were 79% (intensive), 76% (minimal) and 54% (none) (OR 1.480, (95% CI 1.135-1.929); p < 0.0001), respectively. The 10-year survival rates were 65% (intensive), 50% (minimal) and 31% (none) (p < 0.0001), respectively. With a median follow-up of 70 months the median time of survival was 191 months (intensive), 116 months (minimal) and 66 months (none) (p < 0.0001). After recurrence, the 5-year survival rates were 32% (intensive, p = 0.034), 13% (minimal, p = 0.001) and 19% (none, p = 0.614). The median time of survival after recurrence was 31 months (intensive, p < 0.0001), 21 months (minimal, p < 0.0001) and 16 month (none, p < 0.0001) respectively. Conclusion Intensive surveillance after curative resection of colorectal cancer improves survival. In cases of recurrent disease, intensive surveillance has a positive impact on patients' prognosis. Large randomized, multicenter trials are needed to substantiate these results.

BACKGROUND: In laparoscopic colon surgery, endostaplers generate 2 parallel rows of staples. The aim of this paper is to analyse whether the introduction of a new endostapler generating a third row of staples influences the rate of anastomotic leakage and bleedings. METHOD: 362 patients of the Department of Surgery, University Clinic of Schleswig-Holstein, Campus Lubeck, were included in this study. All patients underwent colon resection with performance of double-stapling anastomosis. In Group I (n = 148; 7 / 2004 to 12 / 2005), the Endopath® TSB 45 endostapler (2 rows of staples) was used, whereas in Group II (n = 214; 7 / 2006 to 12 / 2007), the Echelon™60 EC60 stapler (3 rows of staples) was used. All further operational steps were identical for both groups. Target parameters were the postoperative anastomotic leakage and anastomotic bleeding rates. RESULTS: Between July 2004 and December 2005, the number of anastomotic leaks (Stapler Endopath®, TSB 45) was n = 4 (2.7 %), for the second period (Stapler Echelon™60 EC60), it was n = 9 (3.7 %) (not significant). Using the Endopath® TSB 45 stapler, the number of anastomotic bleedings was n = 12 (8.1 %), and for the Echelon™60 EC60 stapler, it was n = 8 (3.7 %) (p = 0.074; not significant). Within the 18-month period between July 2006 and December 2007, the number of endoscopic colon operations (n = 214) rose by 44.6 % compared to the 18-month period between July 2004 and December 2005 (n = 148). CONCLUSION: The application of the advanced Echelon endostapler has no impact on the number of anastomotic leaks, and reduces the number of anastomotic bleedings slightly but not significantly. The increased number of endoscopic procedures in the second period results both from the growing number of indications for the application of endoscopic techniques and the positive findings of recent studies carried out by our own and other working groups.

To examine the treatment outcome for patients with acute bleeding from the lower gastrointestinal tract requiring transfusion and acute surgical care as a function of various risk factorsBetween 1999 and 2007, we collected data on 59 patients (39 male and 20 female patients) who received surgical intervention for acute lower intestinal hemorrhage requiring transfusion at our university clinic. Treatment complications and mortality were analyzed retrospectively.The average age of the patients in this study is 70.0 +/- 12.2 years (range, 39 to 97 years) with an overall mortality of 15.3%. Blood transfusions10 U (p = 0.031), postoperative need for ventilation (p = 0.004), necessary reoperations (p = 0.016), and an initial hemoglobin level80 g/L (p = 0.043) proved to be significant risk factors for death. Blood transfusions10 U (p = 0.028), necessary reoperations (p = 0.001), and an initial hemoglobin level80 g/L (p = 0.033) were found to be significant risk factors for postoperative complications. All other parameters have no significant impact.The decisive factors for the outcome of lower gastrointestinal hemorrhage requiring surgery are the severity of bleeding, beginning of treatment (initial hemoglobin level, need for packed red blood cells), and treatment efficiency (necessary reoperation).

In the past, women with Crohn’s disease (CD) as a risk factor in pregnancy were discouraged from becoming pregnant. Today, by contrast, gestation is medically acceptable in these patients despite several severe complications. We present the course of five female patients with CD requiring surgery during pregnancy and giving birth at our institution between 1998 and 2008. These cases as well as our treatment recommendations for patients wishing to have children and our approaches to the management of complications during pregnancy are discussed in the light of the literature. Three of five women had a preterm delivery (26 to 31 weeks’ gestation) with a decreased neonatal weight. Generally, the diagnosis of CD is often delayed and diagnostic errors (four of five women) are not uncommon. The symptoms vary widely and include those typical of pregnancy. Three patients had to have a cesarean and only two patients were able to deliver vaginally. Especially in pregnant patients, the course of the disease is highly variable and difficult to predict. Our experience suggests that patients should be advised to conceive during remission. Indications for surgery in pregnant patients are the same as for nonpregnant women and include perforation, obstruction, hemorrhage, and abscess. The advantages of endoscopic surgery also apply to pregnant patients with acute manifestations. A stoma is not a contraindication to vaginal delivery.

For a more eco-friendly production of energy and chemicals (e.g. lactic acid), green biorefineries are implementing an environmentally conscious technique of using green biomass. To increase the amount of lactic acid in grass and rye silage, different ensiling treatments were conducted. Additionally, after separating the organic juice, the specific methane yield of the remaining solid residue of the ensiled material was determined. The amount of lactic acid was increased by 168.8 % (149.7 ± 20.9 g kg−1 dry matter (DM)) through applying homofermentative lactic acid bacteria together with carbonated lime to the raw material grass. For rye, while having a stable silage, the highest increase in lactic acid was achieved by chopping the raw material to a theoretical length of cut of 1 mm. As a result, an increase of 46.3 % (57.5 ± 0.6 g kg−1 DM) was attained. Taxonomic profiling by 16S amplicon sequencing revealed that the homofermentative species Lactobacillus plantarum was the most dominant species on both substrates with highest lactic acid production rate, though its growth on rye led to unstable silage conditions with butyric acid producing Clostridia. The specific methane yields of the corresponding solid residues were determined to be 335.7 ± 7.2 lN kg−1 organic dry matter (ODM) for grass and at 235.0 ± 2.6 lN kg−1 ODM for rye.

Evaporation of water to the ambient air is generally a cost-effective solution to alleviate heat stress but is also critically discussed due to its increasing effect on indoor humidity. The objectives of this study were to investigate the impact on indoor temperature, humidity, and ventilation rate using a high-pressure fogging system inside a mechanically ventilated research facility for fattening pigs. Data were sampled quasi-continuously throughout four fattening periods, including information on water consumption and energy use of the fogging system, as well as on the average weight gain of the pigs. It was found that for the pigs, the positive effects of the reduction of sensible indoor temperature exceeded the negative effects of the increased humidity, mirrored e.g. by a reduction of the temperature–humidity index (alert situations were reduced from 15.5% to 0.8%) and an increased weight gain of the animals during hot summer conditions. Main effects were achieved on days with mean daily outside temperatures above 14 °C, during which water consumption of the fogging system averaged 4.9 l d −1 pig −1 . The evaporation characteristics, such as the evaporative fraction as well as the time constant for reaching a steady state, were evaluated using a transfer-function model. Both were influenced largely by temperature and saturation deficit. While the evaporative fraction was 100% during steady state and 63% of steady state was reached within 65 s during warm and dry ambient conditions (28 °C; 53% relative humidity RH), the evaporative fraction dropped to 89% and 65% for moderate (21 °C; 69% RH) and cold/humid (13 °C; 83% RH) indoor conditions, respectively, and the time to reach steady state was nearly doubled for the latter. The information about such evaporation characteristics is crucial for an accurate control of fogging and ventilation.

During hot periods, heat loss from non-sweating animals can be improved by fogging water, in order to cool the ambient air and enhance sensible heat dissipation. A dynamic simulation model was used to test control settings for fogging (turning on the system at 1.5°C and 3°C above setpoint temperature, fogging system duty cycle 30 s and continuous) and ventilation (control range 3°C and 6°C, maximum available ventilation rate 32 and 43 air volume changes per hour). The control settings were evaluated by the number of simulated hours in specific temperature-humidity categories, by maximum temperature-humidity index (THI), as well as by the simulated energy use and water consumption of the control strategies. The validation during four growing-finishing periods resulted in an agreement within the accuracy of the temperature and humidity measurements: the difference between simulated and measured values averaged 0.2°C and 3% RH and 0.6°C and 3% RH with and without evaporative cooling, respectively. The efficacy of the fogging system, as measured by reductions in THI, predicted that alert situations were reduced from 13% to 1%, and all dangerous or emergency situations were eliminated. A year-round simulation resulted in water consumption of 2.5 L pig-1 day-1 if fogging was used on maximum settings and was lowered by about 25% for an optimized ventilation setting, namely a reduced maximum ventilation rate combined with shifting the temperature at which fogging was turned on. The results demonstrate that water and energy consumption can be reduced clearly without considerable negative effects on THI and indoor air climate.

About 60% of the global methane emission is related to anthropogenic activities such as agriculture, fossil fuel use, and waste disposal. A significant part of agricultural methane emissions originates from pig husbandry, with indoor stored pig slurry as the main source. In general, the release of methane from indoor slurry storage can be influenced by availability of oxygen and volatile solids, pH value, substrate temperature, retention time, and presence of inhibiting compounds. Investigations on methane release from a pig house with indoor slurry storage were carried out from October 1999 until February 2001 and from February 2003 until July 2004, respectively. The season, in which the fattening period was accomplished, had a significant influence on the level of the methane emission rate, with increased emissions during summer. However, a clear influence of the indoor temperature – and therefore of the ventilation strategy – on the level of the methane emission rate was only found for mean daily temperatures above 25 °C. Methane emissions were reduced significantly due to complete slurry removal between the fattening periods and subsequent cleaning of the slurry pits.

Perforations of the oesophagus are characterized by a high mortality rate, varying between 7 and 49%. In the analyzed group of patients between the years 1986 and 2003, the mortality rate of 28% was caused by septic complications such as mediastinitis and pneumonia. Microbiological examinations of samples from different locations and various secretions, detected mycoses in 28% of the patients (n = 16). Compared with the total of mycoses, a higher mortality of 50% was calculated. The invasive Candida infection of the oesophagus itself can cause a perforation. In perforations of the oesophagus, simultaneous mycoses arise by fungi invading sterile compartments or by haematogenous and lymphogenous dissemination up to sepsis. Uncomplicated courses do not need antimycotic therapy. At the beginning of the treatment, a microbiological monitoring should be provided, particularly with regard to the intraoperative facts. In relation to the course and the risk factors of the patients, an antimycotic therapy is initiated. Surgical clearing and sufficient drainage of the collateral compartments such as pleural and mediastinal compartments is highly significant.

The two-stage autogenerative high-pressure digestion technique is a novel and promising approach for the production of gaseous fuels or upgraded biogas. This new technique is described in the patent DE 10 2011 015415 A1 and integrates biogas production, its upgrading and pressure boosting in one process. Anaerobic digestion under elevated pressure conditions leads to decreasing pH-values in the digestate due to the augmented formation of carboxylic acid. Model calculations carried out to evaluate the two-stage design showed that the pH-value in the pressurized anaerobic filter has a major influence on the methane content of the biogas produced. Within this study, the influence of the nitrogen content as one of the most important buffering substances on the performance of the system has been tested. The results show that higher NH4 contents lead to higher pH-values in the digester and as a consequence to higher methane contents.

A series of biofilter materials were tested for performance efficiency in treating ventilation air from pig sheds. Two different phases were conducted. In phase A five different biofilter materials were tested with the aim of selecting the best material regarding the odor reduction and over all efficiency. In conclusion of phase A, biochips, a new filter material, was selected due to its high average odor reduction (81%) in combination with a very low flow resistance (less than 30 Pa for filter volume loads of 600 m3 h−1 m−3). In phase B, biochips and coconut fiber peat were tested under different operating conditions. Biofilters number 3 and 4 each with down-flow air supply could realize a higher average odor reduction than biofilter 5 with up-flow air supply. All three filter materials had the same moisture, however the two biofilters with down-flow air supply showed a more homogenous moisture distribution but they also used approximately three times more water than biofilter 5. Like in phase A the specific odor cleaning efficiency was mainly influenced by the specific odor loading rate and showed only slight differences between the five biofilters differing in bulk layer height (0.5 m and 1.0 m) and air supply mode. All in all the investigation showed that the efficiency of biofilters can be optimized by using an new filter material and a appropiate operating mode.

The dynamics of odour emissions from a pig house was investigated by olfactometry and using an electronic odour sensor. In addition, several suggested influencing factors on the odour emission were measured to get insight into the reasons for the fluctuation of the odour emission. Odour emission tended to increase over the fattening period from August to November 2000 by a factor of two to three, although temperature and air-flow rate decreased according to the seasons. Feeding caused a significant temporary rise in animal activity, dust and odour concentration resulting in an increase of odour emission. The sensor signals of an electronic odour sensor increased simultaneously and showed a good relation to the odour concentration. There is a promising potential of electronic odour sensors to detect the dynamic and the level of odour concentrations. Further investigation will be done, to ensure a standardised measuring protocol and to obtain a calibration of electronic odour sensor signals direct to odour concentrations.

In contrast to ammonia few data about the emissions of CH4, N2O and CO2 from animal houses are yet available. To be reliable, such data should derive from investigations meeting the following minimum requirements: (1) continuous measurement of ventilation rates and gas concentrations; (2) long-term experiments, to cover diurnal and seasonal effects; (3) use of extremely exact measuring equipment. A literature review has shown that reliable data about CH4 emissions are basically only available for cattle housing systems. Data about N2O emissions from animal houses are lacking, because of the difficulties in measuring very low N2O concentrations. However, the results of existing investigations are not comparable and most of them do not meet the minimum requirements mentioned above. Our own experiments have been carried out for dairy cows in loose housing with natural ventilation. The amount of CH4 originating from cows' digestion is about 223 g per livestock unit (1 LU = 500 kg live-weight) per day and varies between 200 and 250 g per LU per day. It mainly depends on the feed intake, which is positively related to animal size, growth rate and production. There is practically no influence of outside conditions on the emission rate. N2O was emitted at about 1.6 g per LU per day.

Long-term measurements were carried out in parallel on two biofilters under practical conditions to test their reduction potential for ammonia and odor emissions. The average efficiency of the ammonia reduction calculated for the first measuring period (6.5-year-old filterbed material) was about 15% at biofilter 1 and 36% at biofilter 2. The average efficiency of the odor reduction calculated for the first measuring period was about 78% at biofilter 1 and 80% at biofilter 2. The efficiency of ammonia reduction was mainly influenced by the air flow rate. The odor reduction was mainly influenced by the odor concentration before the filterbed. The cleaning efficiency of the biofilters could be improved by increasing the moisture content of the filterbed material from 20% to 40%, or from 20% to 50%.

The intention of the research project is to evaluate two housing systems for fattening pigs regarding animal welfare. The project is carried out under field conditions in a special experimental swine house for at least 100 fattening pigs. The swine house is composed of two separate compartments. The first compartment is characterized as a common housing system for fatteners with fully slatted floor and forced ventilation. The second compartment is designed as an alternative housing system with partly slatted floor, separate climatic areas with an insulated, covered lying area (kennels) and natural ventilation. Under summer conditions the natural ventilation can be supported by mechanical ventilation if necessary. The alternative system is adapted to the ethological needs of the swines. The pens are structured to ensure marked functional areas. Both housing systems are equipped with a sensor controlled liquid feeding system and ethologically enriched with occupation techniques. During four fattening periods (two each under summer and winter conditions) animal behavior, animal activity, health and growth performance of the pigs as well as indoor climate (temperature, humidity, gas and dust concentrations) and the surrounding conditions are registered. The animal behavior is observed with 14 parallel running video cameras as well as automatically working activity sensors.

Lameness is a complex economic and welfare problem in dairy cattle which is directly linked to the flooring in loose housing systems. Mobility is the most important prerequisite for the smooth operation of such system. Foot lameness is due to several factors, but the permanent excessive strains on the sole combined with poor horn quality are key issues. In addition, slippery floors impede normal locomotion. This study was based on the working hypothesis that soft rubber mats improve claw health and slip resistance. The elastic rubber mats selected were installed in two freestall dairy houses: the experimental farm of the University of Hohenheim and a commercial farm. Animal behaviour and claw diagnosis were recorded, with biological and ethological parameters, in three steps: firstly, on concrete slatted floors, secondly, on slatted floors covered with rubber mats and thirdly again on concrete slatted floors. The results concerning animal behaviour and claw health confirmed the working hypothesis. Less slipping was detected on soft floors. Step length on the soft slatted floors was similar to that measured on pastures. Activity and walking speed increased on the soft floors, indicating that cows showed confidence on soft floors. Claw diagnosis, divided into 5 severities ranging from 1 (very slight) to 5 (very severe), was the most important parameter for the comparison between hard and soft floors. Claw health was significantly improved on soft slatted floors compared with the usual slatted floors. The experiment showed that soft floors favour the requirements for the correct functioning of the claw and unimpeded cow behaviour.

The regular colonisation of the oesophagus with a Candida species can, after oesophageal perforation, result in a contamination of the mediastinum and the pleura with a Candida species. A patient cohort of 80 patients with oesophageal perforation between 1986 and 2010 was analysed retrospectively. The most common sources with positive results for Candida were mediastinal biopsies and broncho-alveolar secretions. Candida species were detected in 30% of the patients. The mortality rate was 41% in patients with positive microbiology results for Candida, whereas it was 23% in the remaining patient cohort. This difference did not reach statistical significance (P = 0.124). Mortality associated with oesophageal perforation was attributed mainly to septic complications, such as mediastinitis and severe pneumonia. During the study period we observed a shift towards non-albicans species that were less susceptible or resistant to fluconazole. In selected patients with risk factors as immunosuppression, granulocytopenia and long-term intensive-care treatment together with the finding of Candida, an antimycotic therapy should be started. A surgical approach offers the possibility to obtain deep tissue biopsies. The antimycotic therapy should start with an echinocandin, as the resistance to fluconazole is growing and to cover non-albicans Candida species, too.

Especially in growing stocks, detection of upcoming health problems in individuals when housing pregnant sows in groups is difficult. Madsen and Kristensen (2005) already demonstrated that drinking pattern could be used to detect upcoming health problems with an online-monitoring system. Therefore, the aim of this collaborative research project is to use water intake but also feed intake and animal activity as indicators for monitoring health and behavior of pregnant sows. Animal welfare should be improved by developing, implementing and evaluating an on-line monitoring system using the mentioned indicators. To gain better knowledge about influencing parameters such as drinker types and diversity of individual drinking behavior a preliminary experiment was carried out. Hence within three weeks three different drinker types were tested in a dynamic herd of 50 group housed sows. Water consumption was measured and drinking behavior was observed by a video camera. Daily pattern of drinking events seemed to show a biphasic rhythm, but levels of water flow were different. Sows showed not just different drinking behavior but also volume flow per drinking event differed considerably. Drinker types seemed to have an influence on both water spillage and drinking behavior. The results of this experiment indicate that further research is needed concerning other influences on sows` water intake such as temperature, group structure and management. Nevertheless validation of water intake as an indicator made progress. Hereafter interactions of the three indicators need to be explored and the online-monitoring system needs to be developed, implemented and evaluated.

There is need for research regarding the optimization of air supply and of air cooling systems of livestock houses for fattening pigs. A decision support project for the German Ministry of Agriculture has been established to investigate such technologies on a research farm and under practical conditions. Since January 2011, on the research farm Landesanstalt fur Schweinezucht (LSZ Boxberg) measurements on three air supply and cooling systems have been carried out: Underfloor air inlet and supply, cooling pad and high pressure evaporative indoor air cooling. The present results show differences concerning the parameters: temperature, differential pressure, air velocity and energy consumption .

Background Lymphadenectomy is performed to assess patient prognosis and to prevent metastasizing. Recently, it was questioned whether lymph node metastases were capable of metastasizing and therefore, if lymphadenectomy was still adequate. We evaluated whether the nodal status impacts on the occurrence of distant metastases by analyzing a highly selected cohort of colon cancer patients. Methods 1,395 patients underwent surgery exclusively for colon cancer at the University of Lübeck between 01/1993 and 12/2008. The following exclusion criteria were applied: synchronous metastasis, R1-resection, prior/synchronous second carcinoma, age < 50 years, positive family history, inflammatory bowel disease, FAP, HNPCC, and follow-up < 5 years. The remaining 421 patients were divided into groups with (TM+, n = 75) or without (TM-, n = 346) the occurrence of metastasis throughout a 5-year follow-up. Results Five-year survival rates for TM + and TM- were 21% and 73%, respectively (p < 0.0001). Survival rates differed significantly for N0 vs. N2, grading 2 vs. 3, UICC-I vs. -II and UICC-I vs. -III (p < 0.05). Regression analysis revealed higher age upon diagnosis, increasing N- and increasing T-category to significantly impact on recurrence free survival while increasing N-and T-category were significant parameters for the risk to develop metastases within 5-years after surgery (HR 1.97 and 1.78; p < 0.0001). Conclusions Besides a higher T-category, a positive N-stage independently implies a higher probability to develop distant metastases and correlates with poor survival. Our data thus show a prognostic relevance of lymphadenectomy which should therefore be retained until conclusive studies suggest the unimportance of lmyphadenectomy.

Pain is the main symptom of chronic pancreatitis. However, in addition to an improvement in pain symptoms, an increase in the quality of life also influences therapeutic success. The present paper evaluates the influence of surgery on chronic pancreatitis, and the early and late postoperative quality of life.From March 2000 until April 2005, 51 patients underwent surgical treatment for chronic pancreatitis at our institution.Thirty-nine (76.5%) patients were operated on according to the Frey procedure and, in 12 (23.5%) patients, a Whipple procedure was performed.Patient data were documented throughout the duration of the hospital stay. Postoperative follow-up data were recorded retrospectively.Postoperative follow-up with postoperative pain scores and quality of life were carried out using a standardized questionnaire.During a median follow-up period of 50 months, an improvement in pain scores was observed in 92.3% of the patients in the Frey group and in 66.7% in the Whipple group. The indices for global quality of life and for physical and emotional status increased in both surgical groups.For patients with chronic pancreatitis, the decisive factor is the quality of life, particularly concerning pain and metabolic changes. The Frey procedure seems to offer advantages with respect to long-term freedom of pain and low risk of surgery-induced pancreatic insufficiency.

DNA aneuploidy has been identified as a prognostic factor in the majority of epithelial malignancies. We aimed at identifying ploidy-associated protein expression in endometrial cancer of different prognostic subgroups. Comparison of gel electrophoresis-based protein expression patterns between normal endometrium (n = 5), diploid (n = 7), and aneuploid (n = 7) endometrial carcinoma detected 121 ploidy-associated protein forms, 42 differentially expressed between normal endometrium and diploid endometrioid carcinomas, 37 between diploid and aneuploid endometrioid carcinomas, and 41 between diploid endometrioid and aneuploid uterine papillary serous cancer. Proteins were identified by mass spectrometry and evaluated by Ingenuity Pathway Analysis. Targets were confirmed by liquid chromatography/mass spectrometry. Mass spectrometry identified 41 distinct polypeptides and pathway analysis resulted in high-ranked networks with vimentin and Nf-κB as central nodes. These results identify ploidy-associated protein expression differences that overrule histopathology-associated expression differences and emphasize particular protein networks in genomic stability of endometrial cancer.

In this pilot study, we tested whether a soft mat (foam covered with a heat-sealed thermoplastic) reduces alterations and injuries at the skin and the leg joints.The soft mat in the lying area of partly slatted pens was compared to a lying area consisting of either bare or slightly littered (100 g straw per pig and day) concrete flooring. In this study we focused on skin lesions on the legs of finishing pigs as indicators of impaired welfare. Pigs were kept in 19 groups of 8-10 individuals and were examined for skin lesions around the carpal and tarsal joints either at a weight of35 kg, or at close to 100 kg. The likelihood of hairless patches and wounds at the tarsal joints was significantly lower in pens with the soft lying mat than in pens with a bare concrete floor. Pens with a littered concrete floor did not differ compared to pens with a bare concrete floor. The soft lying mat thus improved floor quality in the lying area in terms of preventing skin lesions compared to bare and slightly littered concrete flooring. Such soft lying mats have thus the potential to improve lying comfort and welfare of finishing pigs.

A variety of surgical strategies have been suggested and many surgical techniques, both abdominal and perineal, have been introduced for treatment of rectal prolapse. All these techniques and approaches are based on the attempt to restore the normal anatomy and physiologic function. In 1992, Berman et al. published the first laparoscopically performed rectopexy. Meanwhile, many different minimally invasive procedures have been described. Throughout the past century, more than 100 different surgical techniques have been introduced to treat patients with rectal prolapse. Unfortunately, there is still lack of one generally accepted standard technique for the surgical treatment of rectal prolapse. Our current data strongly supports laparoscopic resection rectopexy to be a safe, fast, and very effective procedure to improve function in patients with rectal prolapse. More evaluations of long-term outcome are needed that focus on each particular laparoscopic procedure to adequately compare different techniques. The indication to perform a laparoscopic resection rectopexy in patients with a previous perineal procedure and a recurrent prolapse should be stated critically because these patients seem to have a high risk to develop yet another recurrence.

Many different techniques to treat rectal prolapse have been introduced. Laparoscopic resection rectopexy has been shown to entail benefits regarding both perioperative results and short-term outcome, whereas data for long-term outcome are scarce. Between 1993 and 2008, all laparoscopic resection rectopexies for rectal prolapse II° or III° were selected from a prospective laparoscopic colorectal surgery database. We analyzed demographic, perioperative, and follow-up results. We defined two periods (1993–2000 and 2001–2008) for comparison of data. Long-term follow-up was obtained by sending questionnaires to all patients. Evaluation included constipation, incontinence, and recurrence of prolapse. Between January 1993 and November 2008, we performed 152 laparoscopic resection rectopexies for rectal prolapse. Median age was 64.1 years (±14.6). Conversion rate was 0.7% (1), mean operation time was 204 (±65.3) min, and was significantly shorter in the second period compared with the first (P

Fournier's gangrene is a necrotizing fasciitis that affects the perineal, genital, or perianal regions. The objective of this study was to highlight this uncommon condition with a particular focus on the disease course in females.From 1996 to 2008, we prospectively collected data from 38 patients with Fournier's gangrene (12 women, 26 men) and retrospectively analyzed relevant parameters.The mean age was 60.9 +/- 11.3 years for females (group I) and 56.2 +/- 11.7 years for males (group II). In both groups, the main predisposing factors were diabetes mellitus and obesity (body mass index of 30 or higher). Twelve men (46.2%), but no women, had chronic alcoholism. The most commonly isolated agents were Escherichia coli (n = 22), streptococcal species (n = 18), Pseudomonas aeruginosa (n = 9), and Staphylococcus aureus (n = 7). Mortality was significantly higher among females (50%) than males (7.7%; p = 0.011). Peritonitis was present in seven group I patients (58.3%) and in two group II patients (7.7%). The retroperitoneum was involved in seven female patients (58.3%) and four male patients (15.4%).The female gender is a risk factor for mortality in patients with Fournier's gangrene and is associated with a higher incidence of inflammation of the retroperitoneal space and abdominal cavity. Differences in male and female genital anatomy may be the reason for the rapid spread of infection to the retroperitoneum and the fatal outcome in women. Fournier's gangrene as a high-risk disease in females should attract exceeding attention.