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Fournier’s gangrene is a necrotizing fasciitis involving the perineal and genital regions. Even today, this often polymicrobial infection still carries a high mortality rate and continues to be a major challenge to the medical community. The purpose of this study was to report our experience with this condition and to compare it with those reported in published studies. We also introduce our approach to treatment. We analyzed data from 33 patients with Fournier’s gangrene who were managed in our hospital from 1996 to 2007, focusing on patient gender, age, etiology, predisposing conditions, comorbidities, bacteriology, sepsis, blood results, mortality, and spread of gangrene. 18 (54.5%) of the 33 patients had been referred to our department by smaller district hospitals. The patient cohort consisted of 23 men and ten women with a median age of 59 years (range 40–79 years). The median time between the onset of symptoms and progression to gangrene was 6 days (range 2–28 days). An underlying cause was identified in 27 patients (81.8%). The commonest etiological events were perianal and perirectal abscesses (n = 13; 39.4%). Predisposing factors included diabetes mellitus in 12 cases (36.4%), chronic alcoholism in ten cases (30.3%), immunosuppression in six cases (18.2%), and prolonged immobilization in five cases (15.2%). 17 patients (51.5%) had a body mass index (BMI) of 25 or higher, and 13 patients (39.4%) had a BMI of 30 or higher. Positive cultures were obtained in 30 cases (90.9%). In 26 cases (78.8%), multiple microorganisms were recovered, including nine cases (27.3%) with both aerobes and anaerobes. Sepsis was present in 26 patients (78.8%). The mortality rate was 18.2%. Fournier’s gangrene remains a major challenge with a high mortality. Our results suggest that women are more commonly affected than has generally been assumed. Contrary to published reports, we found that anorectal sources appear to account for more cases of Fournier’s gangrene than urological sources.

Influences on dust emissions from livestock operations are number, weight, and kind of animals and characteristics of the housing system. Differences between facilities cannot be explained solely by mechanistic input variables. The objective of this study was to characterize the main input variables for modeling emissions of particulate matter with a mass median diameter < or = 10 microm (PM10) from swine facilities using a data-based model. Investigations were performed in mechanically ventilated facilities for weaning, growing-finishing, and sows in Italy and Germany. The measurements included inside and outside concentration of airborne PM10 particles (scatter light photometry), ventilation rate (calibrated measuring fans), indoor air climate at a measuring frequency of 60 s, feeding times, and animal-related data such as weight and animal activity. Dust concentration and emission were simulated using a dynamic transfer function. The results indicated that the average PM10 emission rate was influenced considerably by housing system. The simulation of the PM10 emission rate resulted in a mean percentage error per data set of 21 to 39%, whereas the average simulated and measured emission rate per data set differed by about 4 to 19%. High prediction errors occurred especially during situations in which the absolute level and spatial location of the measured activity peaks did not correspond with the measured dust peaks. Further recommendations of the study were to improve continuous and accurate measurements of input variables, such as the activity level in animal houses, and to optimize the amount of measuring days in relation to the model accuracy.

Especially in hot climate, heat stress decreases feed intake and performance of animals and leads to an increased mortality. 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 effect on indoor humidity. The impact of a high pressure fogging system on ventilation, temperature reduction, indoor humidity, water consumption, and evaporation efficiency was investigated in a research facility for fattening pigs during a total of four fattening periods. Measured reductions of the indoor temperature ranged up to 7°C, ventilation rate was reduced by about 22 %, and water consumption averaged on 4 to 5 liters per pig per day at mean daily outside temperatures above 14°C. Performance of the animals was reduced during hot periods when no cooling was used, but were in general compensated afterwards. Evaporation efficiency for a fixed pressure (7 MPa) did depend mainly on temperature and saturation deficit and was 67 % for cold and wet indoor conditions (13°C; 83 % r. h.) and up to 100 % for indoor temperatures around 28°C. To simulate the effect of the cooling system at different outside conditions, a data-based model was created and used as sub-model part in an established dynamic simulation model. The comparison of indoor temperature-humidity profiles, as well as the consideration of water and energy consumption enabled general recommendations for the settings of ventilation and fogging control, like a reduced maximum ventilation rate combined with shifting the fogging start. Pulse cycles instead of continuously fogging featured minor advantages compared to other changes of settings. An adequate control of a fogging system is generally recommended but depends on the specific outside and facility characteristics.

The widely fluctuating operating conditions in pig husbandry, due to climatic and biological changes (changes in temperature and air flowrate between day and night, as well as between summer and winter, increasing animal mass during the fattening process, etc.) exert a significant influence on the amount of actual odour emission. The project presented here comprised the measurement of seasonal (fattening course), daytime-related, and short-term (feeding) dynamic effects of odour release, as well as the identification of potential factors which influence the amount of odour emitted. In parallel with “classic” olfactometry, an electronic odour sensor with a chemosensor array of ten metal oxide sensors was employed. The highest odour emissions are measured on hot summer days, while the lowest emissions were determined on cold winter days. On the one hand, the sensor signals of the electronic odour sensor exhibited considerable differences on days with large volume flow alterations. On the other hand, continuous measurement with the electronic odour sensor allowed changes in the gas- and odorant composition of the exhaust air during feeding times to be shown. From the measurement results, recommendations for odour sampling, the consideration of seasonal odour emission fluctuations, and the use of electronic odour sensors for the evaluation of odour emissions have been derived.

Experiments on methanogenesis from horse dung were conducted in laboratory-scale batch reactors in order to determine the substrate performance in a solid-phase digestion process, more specifically in terms of potential energy recovery and suitable process technology. Dung from a horse stable with straw bedding was used. The temperature was kept in the mesophilic range. In the percolation process (with process water sprinkled over the stacked biomass) a proportion of 10–20% of solid inoculum (pre-digested horse dung) was found to be suitable. Comparative experiments with both percolation and flooding revealed a higher biogas production per volume for the flooded process, as no addition of solid inoculum was necessary. Methane yield from fresh material was similar in both processes: around 170 L N CH 4 per kg VS added was obtained in six-week cycles with untreated material under optimized conditions. Methane production was increased after chopping the substrate. Pre-aeration resulted in decreased methane production.

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

The intention of this investigation was to optimize biofilters for the use in livestock facilities, considering both economical (costs) and ecological factors (odor and gas reduction). Two different phases were conducted. In phase A five different biofilter materials (biochips, coconutpeat, bark-wood, pellets+bark and compost) were tested with the aim to select 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 it’s high average odor reduction (81 %) in combination with a very low flow resistance. A significant reduction of coarse particles was found for all filter materials. The main factors influencing the filtration characteristic are water vapor condensation, water content of the filter material and hygroscopical properties of the particles. In phase B biochips and coconut fiber peat were tested under different operating conditions (0.5 an 1m bulk layer; down and up flow air supply). The odor emission was in average reduced between 61 and 75 %. The main factor could be found the high of odor concentration in the waste air as well as the homogenous moisture distribution of filter materials. Biofilters were not suitable for a high ammonia reduction (9 up to 26 %). All tested filter materials showed none or only a low reduction potential for CO2 and CH4. Fine structured filter materials can increase the N2O emission, probably due to anaerobic processes. All in all the investigation showed that the efficiency of biofilters can be optimized by using a new filter material and a appropriate operating mode.

To plan and design dairy housing, several calculations should be made; this requires time and efforts, with the possibility of making mistakes. The objectives of this paper are to develop a tool to assist the designers in planning and designing dairy housing in arid and semi-arid zones, to save time and efforts, and to provide a new design model. Two mathematical models were developed to plan and design corral systems and the required concrete constructions. Subsequently, an electronic spark map (decision tree) was developed for each mathematical model, and then the mathematical models were integrated into the electronic spark maps. Afterwards, C# (C Sharp) programming language was used to develop the software by integrating the electronic spark maps, and making the user interface. The developed software is able to plan and design the housing system (corrals system), specify corrals and house dimensions, and compute the required amounts of construction materials (iron rods, cement, sand, and gravels) to build the required concrete base. Furthermore, it calculates the capital investment and the fixed, variable, and total costs of the construction. Data of 6 dairy farms were used to validate the model, and to evaluate the software. The differences between actual and calculated values were determined, and the standard deviations were calculated. The coefficients of variation (COVs) range between 3% and 7%.

Various leachate recirculation strategies were applied to a batch-wise operated solid-phase digestion system in laboratory-scale tests. Comparative experiments with both continuous and intermittent leachate recirculation revealed no advantages of a continuous flow. Results suggest that leachate recirculation should not be carried out continuously during process initialisation when methanogenesis is the rate-limiting step. Continuous watering resulted in the accumulation of Volatile Fatty Acids (VFA) during process start-up. In addition, no need for continuous water circulation was found for the following digestion process when hydrolysis was rate-limiting. Even in the absence of liquid recirculation, degradation was only slightly retarded when the biomass moisture content was adjusted.

A rare case of hibernoma about the nipple in a 9-year-old boy is presented: the tumour was peculiar not only for the age and region, but also for its superficial, subepidermal site.

In Arztpraxen nimmt der Einsatz digitaler Kameras zu, sei es zur Fotodokumentation von Behandlungsverlaufen oder fur erlauternde Bilder, um den Patienten selbst oder einen Kollegen umfassender zu informieren. Doch worauf ist beim Kauf der Kameras zu achten?

Auch in Arztpraxen nimmt der Einsatz digitaler Kameras zu. Sei es zur Fotodokumentation von Behandlungsverlaufen oder fur erlauternde Bilder, um den Patienten selbst oder einen Facharzt umfassender zu informieren. Doch auf was ist beim Kauf einer solchen Kamera zu achten?

Sei es zur Therapiedokumentation oder fur Bilder, um den Patienten oder einen Facharzt zu informieren: Digitalkameras gehoren heute in vielen Praxen zur Grundausstattung.

Objective In general, chronic pancreatitis (CP) primarily requires conservative treatment. The chronic pain syndrome and complications make patients seek surgical advice, frequently after years of progression. In the past, surgical procedures involving drainage as well as resection have been employed successfully. The present study compared the different surgical strategies. Patients and Methods From March 2000 until April 2005, a total of 51 patients underwent surgical treatment for CP at the Department of surgery, University of Schleswig-Holstein, Campus Lübeck. Out of those 51 patients, 39 (76.5%) were operated according to the Frey procedure, and in 12 cases (23.5%) the Whipple procedure was performed. Patient data were documented prospectively throughout the duration of the hospital stay. The evaluation of the postoperative pain score was carried out retrospectively with a validated questionnaire. Results Average operating time was 240 minutes for the Frey group and 411 minutes for the Whipple group. The medium number of blood transfusions was 1 in the Frey group and 4.5 in the Whipple group. Overall morbidity was 21% in the Frey group and 42% in the Whipple group. 30-day mortality was zero for all patients. During the median follow-up period of 50 months, an improvement in pain score was observed in 93% of the patients of the Frey group and 67% of the patients treated according to the Whipple procedure. Conclusion The results show that both the Frey procedure as well as partial pancreaticoduodenectomy are capable of improving chronic pain symptoms in CP. As far as later endocrine and exocrine pancreatic insufficiency is concerned, however, the extended drainage operation according to Frey proves to be advantageous compared to the traditional resection procedure by Whipple. Accordingly, the Frey procedure provides us with an organ-preserving surgical procedure which treats the complications of CP sufficiently, thus being an alternative to partial pancreaticoduodenectomy if there is no suspicion of malignancy.

Electronic animal identification is an important technology in modern animal husbandry providing great benefits. Low-frequency applications are state-of-the-art within the radio frequency identification of animals. Quasi-simultaneous detection of several animals and reading of the transponders over longer distances is impossible with low-frequency systems. Ultra-high-frequency (UHF) applications are suitable for this purpose. However, UHF systems have disadvantages through their susceptibility to metallic surfaces and liquids. Thus, the reflection and absorption of electromagnetic radiation in the animals' environment is often problematic. Consequently, an adjustment of the transponder ear tags regarding mechanical stability and functionality close to water (ear tissue) is necessary. In this project, targeted adjustments and a further development of UHF transponder ear tags concerning the resonance frequency were made. Three trials with cattle and two trials with pigs were performed in this study. Cattle were driven through a reader gate for ten rounds and six different types of transponder ear tags designed in-house were tested. The influence of the environment (indoor vs. outdoor), reader orientation at the gate (sideways vs. above) and output power of the readers (1.0 vs. 0.5 W) were tested in two experiments. The average number of readings per round and the reading rates of the transponder ear tag types were taken as target variables. In the trials with pigs, three transponder ear tag types were compared. The animals were driven through the gate for five rounds per repetition, but neither the reader output power nor the reader orientation were varied. The pig experiments were performed indoors. The results of the cattle experiments showed that the average number of readings per round and the reading rates were significantly higher indoors compared to outdoors. The reader output power of 1.0 W achieved significantly better results compared to 0.5 W. The same applied to the reader orientation ‘above’ compared to ‘sideways’. It could also be shown that an improvement of the transponder and, thus, an adjustment to the animal's ear could be achieved during transponder ear tag type development. A maximum reading rate of 100% was reached with the cattle transponder types finally developed (B3-4, B4-4 and B5). In addition, an average reading rate of 100% was achieved for one pig transponder ear tag type (C2). However, these experiments have to be treated with caution due to a very low sample size.

Batch anaerobic dry digestion promises further application in agriculture and for treatment of municipal solid waste, especially with smaller substrate throughputs. As in other anaerobic systems, bacteriological activity is inhibited by lack of moisture and in batch dry digestion liquid is sprinkled over the substrate to encourage biomass degradation and biogas production throughout the process. Laboratory-scale experiments were carried out to investigate individual methane generation from the recirculated liquid phase and from the stacked solid material. Results clearly indicate that methane formation within the recirculated liquid significantly adds to the total methane production of the process. Up to 21% of the total methane generation originated from the recirculated liquid. This suggests that methane generation from the liquid phase is not to be neglected and needs to be recuperated. The process water tank should be equipped with gas collection facilities. Experimental results further indicate that higher ratios of easily hydrolysable substrates increase the proportion of methane from the liquid phase while slowly hydrolysable material encourages biogas generation in the decomposing biomass bed itself. While the amount of easily hydrolysable biomass in the system and the ratio of methane produced in the liquid phase could be positively correlated, no correlation was possible between the volume of liquid in the process water tank and the methane proportion originating from the liquid phase.

A tool was developed to assist the cooling systems designer in designing and installing a microsprinkler and fan cooling system. The tool was developed by integrating a mathematical model into an electronic spark map in order to use the mathematical model practically. The mathematical model was developed using the designs, parameters, variables, and constant values of the microsprinkler and fan cooling system. Subsequently, MS-Excel was used to develop the spark map of the mathematical model and to show the results of the input settings automatically. The spark map, using the mathematical model, assists the designer in making decisions to specify and to calculate the required discharge of cooling system pump, length and diameter of cooling system pipelines, number of cooling fans, and number of microsprinklers. Moreover, this tool calculates the capital investment and the fixed, variable, and total costs of the cooling system. However, the mathematical model of the spark map requires some input data, such as: pressure and discharge of microsprinklers, and some other engineering parameters. Data of 4 cooling systems were used to carry out the model validation. The differences between actual and calculated values were determined, and the standard deviations were calculated. The coefficients of variation were between 2.25% and 4.13%.