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Objectives: The occurrence of sudden cardiac death (SCD) in competitive athletes has led to a discussion about appropriate preparticipation screening models. The role of an electrocardiogram (ECG) in routine testing remains controversial in current guidelines. Furthermore, data on cardiac findings and the prognostic utility of screening strategies in young female elite ice hockey is scarce., Methods: Female elite ice hockey players were enrolled in the open prospective "General Evaluation Program for Arrhythmia-Related Death in Athletes" (GEPARD) registry from 2008 to 2018. A staged preparticipation screening was performed. The main goal was to determine the prevalence of SCD conditions and identify effective screening tools. The secondary aim was to study baseline results and follow-ups on a unique subgroup of young female ice hockey players., Results: A total of 88 female ice hockey players, mean age 16 ± 1 years, were prospectively enrolled. The prevalence of conditions potentially leading to SCD during competition was 3.4% (3/88). The 12-lead ECG led to the diagnosis of one congenital long QT and one acute myocarditis and showed a number needed to screen of 44, with a specificity of 98%. One athlete demonstrated a relevant pericardial effusion on echocardiography, which was related to acute toxoplasmosis. No cases of SCD occurred during long-term follow-up., Conclusion: The subgroup of young female ice hockey players showed a notable prevalence of athletes "at risk" of 3.4%, which indicates the importance of preparticipation screening that features a 12-lead ECG as the most important component., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Mohl, Pongratz, Muxel, Berger, Berr, Schneider, Schlichting-Knoob, Platz, Dorwarth, Rogowski, Hoffmann and Straube.)

Low back pain patients often have deficits in trunk stability. For this reason, many patients receive physiotherapy treatment, which represents an enormous socio-economic burden. Training at home could reduce these costs. The problem here is the lack of correction of the exercise execution. Therefore, this feasibility study investigates the applicability of a vibrotactile-controlled feedback system for trunk stabilisation exercises. A sample of 13 healthy adults performed three trunk stabilisation exercises. Exercise performance was corrected by physiotherapists using vibrotactile feedback. The NASA TLX questionnaire was used to assess the practicability of the vibrotactile feedback. The NASA TLX questionnaire shows a very low global workload 40.2 [29.3; 46.5]. The quality of feedback perception was perceived as good by the subjects, varying between 69.2% (anterior hip) and 92.3% (lower back). 80.8% rated the feedback as helpful for their training. On the expert side, the results show a high rating of movement quality. The positive evaluations of the physiotherapists and the participants on using the vibrotactile feedback system indicate that such a system can reduce the trainees fear of independent training and support the users in their training. This could increase training adherence and long-term success.

Background: the successful treatment of spondylodiscitis (SD) and isolated spinal epidural empyema (ISEE) depends on early detection of causative pathogens, which is commonly performed either via blood cultures, intraoperative specimens, and/or image-guided biopsies. We evaluated the diagnostic sensitivity of these three procedures and assessed how it is influenced by antibiotics., Methods: we retrospectively analyzed data from patients with SD and ISEE treated surgically at a neurosurgery university center in Germany between 2002 and 2021., Results: we included 208 patients (68 [23-90] years, 34.6% females, 68% SD). Pathogens were identified in 192 cases (92.3%), including 187 (97.4%) pyogenic and five (2.6%) non-pyogenic infections, with Gram-positive bacteria accounting for 86.6% (162 cases) and Gram-negative for 13.4% (25 cases) of the pyogenic infections. The diagnostic sensitivity was highest for intraoperative specimens at 77.9% (162/208, p = 0.012) and lowest for blood cultures at 57.2% (119/208) and computed tomography (CT)-guided biopsies at 55.7% (39/70). Blood cultures displayed the highest sensitivity in SD patients (SD: 91/142, 64.1% vs. ISEE: 28/66, 42.4%, p = 0.004), while intraoperative specimens were the most sensitive procedure in ISEE (SD: 102/142, 71.8% vs. ISEE: 59/66, 89.4%, p = 0.007). The diagnostic sensitivity was lower in SD patients with ongoing empiric antibiotic therapy (EAT) than in patients treated postoperatively with targeted antibiotic therapy (TAT) (EAT: 77/89, 86.5% vs. TAT: 53/53, 100%, p = 0.004), whereas no effect was observed in patients with ISEE (EAT: 47/51, 92.2% vs. TAT: 15/15, 100%, p = 0.567)., Conclusions: in our cohort, intraoperative specimens displayed the highest diagnostic sensitivity especially for ISEE, whereas blood cultures appear to be the most sensitive for SD. The sensitivity of these tests seems modifiable by preoperative EAT in patients with SD, but not in those with ISEE, underscoring the distinct differences between both pathologies.

Study Design: A retrospective single center cohort study with prospective collected data from an institutional spine registry., Objectives: To determine whether restoration of lordosis L5/S1 is possible with both anterior lumbar interbody fusion (ALIF) and transforaminal lumbar interbody fusion (TLIF) and to find out which technique is superior to recreate lordosis in L5/S1., Methods: Seventy-seven patients with ALIF and seventy-nine with TLIF L5/S1 were included. Operation time, estimated blood loss), and complications were evaluated. Segmental lordosis L5/S1 and L4/5, overall lordosis, and proximal lordosis (L1 to L4) were measured in X-rays before and after surgery. Oswesery disability index and EQ-5D were assessed before surgery, and 3 and 12 months after surgery., Results: Mean operation time was 176.9 minutes for ALIF and 195.7 minutes for TLIF (p = 0.048). Estimated blood loss was 249.2 cc for ALIF and 362.9 cc for TLIF (p = 0.005). In terms of complications, only a difference in dural tears were found (TLIF 6, ALIF none; p = 0.014). Lordosis L5/S1 increased in the ALIF group (15.8 to 24.6°; p < 0.001), whereas no difference was noted in the TLIF group (18.4 to 19.4°; p = 0.360). Clinical results showed significant improvement in the Oswesery disability index (ALIF: 43 to 21.9, TLIF: 45.2 to 23.0) and EQ-5D (ALIF: 0.494 to 0.732, TLIF: 0.393 to 0.764) after 12 months in both groups, without differences between the groups., Conclusion: ALIF and TLIF are comparable methods for performing fusion at L5/S1, with good clinical outcomes and comparable rates of complications. However, there is only a limited potential for recreating lordosis at L5/S1 with a TLIF., Competing Interests: M. Quante hat einen Beratervertrag mit der Fa. Silony und erhält Honorare für Vorträge von der Fa. Nuvasive Inc. sowie der Fa. Silony. B. Thomsen hat eine Beratungstätigkeit für die Fa. Silony. M. Köszegvary hat einen Beratervertrag mit der Fa. Silony und erhält Honorare für Vorträge von der Fa. Nuvasive Inc. H. Halm hat einen Beratervertrag mit Patentvergütungskomponente mit der Fa. Nuvasive. Die Fa. Silony finanziert darüber hinaus eine Studienleiterin („study nurse“). C. Berlin, N. Bürger, F. Pecsi und U. Platz geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Cement augmentation of pedicle screws is one of the most promising approaches to enhance the anchoring of screws in the osteoporotic spine. To date, there is no ideal cement for pedicle screw augmentation. The purpose of this study was to investigate whether an injectable, bioactive, and degradable calcium sulfate/hydroxyapatite (CaS/HA) cement could increase the maximum pull-out force of pedicle screws in osteoporotic vertebrae. Herein, 17 osteoporotic thoracic and lumbar vertebrae were obtained from a single fresh-frozen human cadaver and instrumented with fenestrated pedicle screws. The right screw in each vertebra was augmented with CaS/HA cement and the un-augmented left side served as a paired control. The cement distribution, interdigitation ability, and cement leakage were evaluated using radiographs. Furthermore, pull-out testing was used to evaluate the immediate mechanical effect of CaS/HA augmentation on the pedicle screws. The CaS/HA cement presented good distribution and interdigitation ability without leakage into the spinal canal. Augmentation significantly enhanced the maximum pull-out force of the pedicle screw in which the augmented side was 39.0% higher than the pedicle-screw-alone side. Therefore, the novel biodegradable biphasic CaS/HA cement could be a promising material for pedicle screw augmentation in the osteoporotic spine.

Background: In the operative treatment of idiopathic scoliosis, posterior correction and fusion in freehand technique is a proven procedure and is frequently performed. Malpositioned pedicle screws can result in serious neurovascular complications. Intraoperative fluoroscopy and neurophysiological measurements are performed to ensure the correct position of pedicle screws. Newer procedures with fluoroscopic- and computertomographic-assisted navigation are advertised as less dangerous and with a more accurate screw position., Hypothesis: Is the freehand technique used in the surgical treatment of idiopathic scoliosis safer than other methods with regard to complications caused by screw malposition and intraoperative radiation exposure?, Material and Methods: Register data of 34 consecutive idiopathic scoliosis patients with two structural curves (Lenke 3 and 6) were collected prospectively in our scoliosis center and were retrospectively analyzed. The following parameters were evaluated: total radiation product, time of fluoroscopy, number of fused segments, time of operation, blood loss, screw-related complications and number of instrumented pedicle screws. All values were given as mean ± standard deviation and statistically analyzed. Finally, our data were compared on accuracy of screw placement and radiation exposure to data from literature with screw placement under navigation., Results: Average age at the time of surgery was 23.6 ± 12 years. The average thoracic curve was 69.2 ± 14.2° preoperatively and 21.7 ± 12.8° postoperatively (correction 69.9%), the average lumbar curve was 64.3° ± 10.8° preoperatively and corrected to 15.6 ± 10.4° postoperatively (correction 76.2%). The total radiation product per patient was 145.7 ± 86.1 cGy*cm², the time of fluoroscopy 31.7 ± 23.5 s (11.5 segments), the time of operation 267.2 ± 64.1 min and the blood loss 700.4 ± 522.3 ml. A total of 803 pedicle screws were placed. No screw-associated complications were detected in the entire collective. The comparison of our data with freehand placement of pedicle screws to literature data showed a noticeable higher radiation exposure for the patient during fluoroscopic- and computertomographic-assisted navigation., Discussion: The results showed that positioning of pedicle screws with freehand technique in patients with idiopathic scoliosis is accompanied with considerably lower intraoperative radiation exposure compared to fluoroscopic- or computertomographic-assisted navigation. An increased radiation exposure of these typically young patients is associated with an increased long-term risk for the occurrence of radiation-induced malignant diseases. With appropriate surgical experience, placement of pedicle screws in freehand technique is safe and effective and with similar accuracy than screws placed under navigation, but produces significantly less radiation exposure to the patients., Competing Interests: C. Berlin and U. Platz confirm that there are no conflicts of interest. M. Quante has a consultancy contract with the Silony company and receives fees for lectures from Nuvasive Inc. and the Silony company. B. Thomsen does consultancy work for the Silony company. M. Köszegvary has a consultancy contract with the Silony company and receives fees for lectures from Nuvasive Inc. M. Halm has a consultancy contract with, and receives fees for lectures from, Nuvasive Inc. and has a consultancy contract with the Silony company. The Silony company also finances a study leader (study nurse)./C. Berlin und U. Platz geben an, dass kein Interessenkonflikt besteht. M. Quante hat einen Beratervertrag mit der Firma Silony und erhält Honorare für Vorträge von der Firma Nuvasive Inc. sowie der Firma Silony. B. Thomsen hat eine Beratungstätigkeit für die Firma Silony. M. Köszegvary hat einen Beratervertrag mit der Firma Silony und erhält Honorare für Vorträge von der Firma Nuvasive Inc. H. Halm. hat einen Beratervertrag mit Patentvergütungskomponente mit der Firma Nuvasive Inc. sowie einen Beratervertrag mit der Firma Silony. Die Firma Silony finanziert darüber hinaus eine Studienleiterin (study nurse)., (Thieme. All rights reserved.)

Background: The decision upper-most instrumented vertebrae (UIV) in a multi-level fusion procedure can dramatically influence outcomes of corrective spine surgery. We aimed to create an algorithm for selection of UIV based on surgeon selection/reasoning of sample cases., Methods: The clinical/imaging data for 11 adult spinal deformity (ASD) patients were presented to 14 spine deformity surgeons who selected the UIV and provided reasons for avoidance of adjacent levels. The UIV chosen was grouped into either upper thoracic (UT, T1-T6), lower thoracic (LT, T7-T12), lumbar or cervical. Disagreement between surgeons was defined as ≥3 not agreeing. We performed a descriptive analysis of responses and created an algorithm for choosing UIV then applied this to a large database of ASD patients., Results: Surgeons agreed in 8/11 cases on regional choice of UIV. T10 was the most common UIV in the LT region (58%) and T3 was the most common UIV in the UT region (44%). The most common determinant of UIV in the UT region was proximal thoracic kyphosis and presence of coronal deformity. The most common determinant of UIV in the LT region was small proximal thoracic kyphosis. Within the ASD database (236 patients), when the algorithm called for UT fusion, patients fused to TL region were more likely to develop proximal junctional kyphosis (PJK) at 1 year post-operatively (76.9% vs . 38.9%, P=0.025)., Conclusions: Our algorithm for selection of UIV emphasizes the role of proximal and regional thoracic kyphosis. Failure to follow this consensus for UT fusion was associated with twice the rate of PJK., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jss-20-598). Dr. SB reports personal fees from K2M, from Medtronic, personal fees from Nuvasive, from Orthofix, personal fees from Stryker, outside the submitted work; Dr. DB reports grants from Bioventus, grants from Depuy, grants from Pfizer, grants from Progenerative Medical, outside the submitted work; Dr. PP reports other from Allosource, personal fees from Globus Medical, personal fees from Medicrea, personal fees from Royal Biologics, personal fees from SpineWave, personal fees from Terumo, personal fees from Zimmer, outside the submitted work; Dr. MG reports grants from Depuy, personal fees from Globus, grants from Innomed, personal fees from Johnson and Johnson, personal fees from Medtronic, other from Proctor and Gamble, personal fees from Wolters Kluwer Health, outside the submitted work; Dr. TP reports other from Altus, personal fees from Globus Medical, personal fees from Medicrea, personal fees from Nuvasive, other from Spine Align, personal fees from Stryker, other from Torus Medical, outside the submitted work; Dr. HJK reports personal fees from Alphatec, other from K2M, other from Zimmer, outside the submitted work; Dr. JSS reports other from Alphatec, personal fees from Carlsmed, personal fees from Cerapedics, grants from Depuy, other from Nuvasive, personal fees from Styker, other from Zimmer, outside the submitted work; Dr. RE reports personal fees from Aesculap, other from Alphatec, personal fees from Baxter, personal fees from Biederman-Motech, personal fees from Carevature, other from Globus, other from Invuity, personal fees from Medtronic, other from Nocimed, personal fees and other from Nuvasive, personal fees from Radius, other from Seaspine, personal fees and other from SI Bone, other from Spine Innovations, outside the submitted work; Dr. KK reports personal fees and other from Depuy, personal fees and other from Orthofix, other from Strykler, outside the submitted work; Dr. GM reports personal fees from Carlsmed, other from K2M, other from Nuvasive, personal fees from Seaspine, personal fees from Stryker, personal fees from Viseon, outside the submitted work; Dr. CS reports grants from Depuy, grants from Globus, grants and other from Medtronic, other from Nuvasive, other from SI Bone, outside the submitted work; Dr. JG reports grants and other from Accuity, other from Cingulate, personal fees from Depuy, grants from Integra, personal fees from Intellirod, personal fees from K2M, personal fees from Mazor, personal fees from Medtronic, grants from Norton Healthcare, other from Nuvasive, personal fees from Pfizer, personal fees from Stryker, outside the submitted work; Dr. VL reports personal fees from Depuy, personal fees from Globus, other from Nuvasive, personal fees from Permanante Medical Group, outside the submitted work; Dr. FS reports grants from Depuy, personal fees from Globus, from K2M, personal fees from Medicrea, grants, personal fees and other from Medtronic, grants from Nuvasive, grants from Styker, grants, personal fees and other from Zimmer, outside the submitted work. The other authors have no conflicts of interest to declare., (2021 Journal of Spine Surgery. All rights reserved.)

Purpose: In surgical correction of scoliosis with pedicle screw dual-rod systems, frequently used freehand technique of screw positioning is challenging due to 3D deformity. Screw malposition can be associated with serious complications. Image-guided technologies are already available to improve accuracy of screw positioning and decrease radiation to surgeon. This study was conducted to measure intraoperative radiation to patients in freehand technique, evaluate screw-related complications and compare radiation values to published studies using navigation techniques., Methods: Retrospective analysis of prospectively collected data of 73 patients with idiopathic scoliosis, who underwent surgical correction with pedicle screw dual-rod system. Evaluated parameters were age, effective radiation dose (ED), fluoroscopy time, number of fused segments, correction and complications. Parameters were compared with regarding single thoracic curve (SC) and double thoracic and lumbar curves (DC), adolescent (10-18 years) or adult (> 18 years) idiopathic scoliosis, length of instrumentation. ED was compared with values for navigation from online database., Results: Average age was 21.0 ± 9.7 years, ED was 0.17 ± 0.1 mSv, time of fluoroscopy was 24.1 ± 18.6 s, 9.5 ± 1.9 fused segments. Average correction for SC was 75.7%, for DC 69.9% (thoracic) and 76.2% (lumbar). No screw-related complications. ED was significantly lower for SC versus DC (p < 0.01), short versus long fusions (p < 0.01), no significant difference for age (p = 0.1). Published navigation data showed 6.5- to 8.8-times higher radiation exposure for patients compared to our results., Conclusion: Compared to navigation procedures, freehanded positioning of pedicle screws in experienced hands is a safe and effective method for surgical correction of idiopathic scoliosis with a significant decrease in radiation exposure to patients.

Aims: To assess image quality and diagnostic performance of 3.0 Tesla (3T) cardiac magnetic resonance (CMR) myocardial perfusion imaging with a dual radiofrequency source to detect functional relevant coronary artery disease (CAD), using coronary angiography and invasive pressure-derived fractional flow reserve (FFR) as reference standard., Methods and Results: We included 116 patients with suspected or known CAD, who underwent 3T adenosine myocardial perfusion CMR (resolution 2.97 × 2.97 mm) and coronary angiography plus FFR measurements in intermediate lesions. Image quality of myocardial perfusion CMR was graded on a 4-point scale (1 = poor to 4 = excellent). Diagnostic accuracy was assessed by ROC analyses using a 16-myocardial segment-based summed perfusion score (0 = normal to 3 = transmural perfusion defect) and by determining sensitivity, specificity, positive and negative predictive value on the coronary vessel territory and the patient level. Diagnostic image quality was achieved for all stress myocardial perfusion CMR studies with an average quality score of 2.5, 3.1, and 3.0 for LAD, LCX, and RCA territories. The ability of the myocardial perfusion CMR perfusion score to detect significant coronary artery stenosis yielded an area under the curve of 0.93 on ROC analysis. Values for sensitivity, specificity, positive and negative predictive value on a vessel territory level and the patient level were 89, 95, 87, 96% and 85, 87, 77, 92%, respectively., Conclusion: In patients with suspected or known significant CAD, 3T myocardial perfusion CMR with standard perfusion protocols provides consistently high image quality and an excellent diagnostic performance.

In case of an outbreak of a foodborne disease, administrative decisions in the context of crisis management are only efficient if they follow standard practices and are specifically adapted to the outbreak situation in a timely manner. These goals are hard to achieve. The complexity of national and global trade structures obscures a clear view of trade flows and, consequently, it is often impossible to unravel complex trade links quickly. Furthermore, increasing public concerns about possible health hazards caused by global trade put additional pressure on decision makers. The aim of this paper was to unveil the specific trade structures of the German milk supply chain, to highlight how these structures could affect the spatial spread of a hypothetical contaminant, and to quantify the risk of the contaminant reaching the consumer. To achieve this goal, the vertical and horizontal trade links between milk producers, dairies, and consumers were taken into account. The horizontal flow of milk between dairies (inter-dairy trade), which is intended to compensate a temporary over- or undersupply of milk, is of special importance in this respect. We hypothesized that the extent of inter-dairy trade would significantly influence the spatial spread of contaminated milk and the contamination risk. This hypothesis was tested using a computer simulation model that predicts the hypothetical spread of a contaminant via trade of milk. The model parameters were estimated using trade data collected in 2004 and 2010. The results of our study indicate that inter-dairy trade significantly influenced the contamination risk. Compared with a scenario with no inter-dairy trade, the risk that contaminated milk will reach the consumer was up to 4 times higher, even with moderate inter-dairy trade. The contamination risk depended on the extent of inter-dairy trade in a nonlinear way and reached its maximum asymptotically when inter-dairy trade increased. The contamination risk exhibited considerable spatial variation, which could be utilized to implement more accurate food control interventions in times of crisis caused by a foodborne disease., (Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

Cks1 is an activator of the SCF(Skp2) ubiquitin ligase complex that targets the cell cycle inhibitor p27(Kip1) for degradation. The loss of Cks1 results in p27(Kip1) accumulation and decreased proliferation and inhibits tumorigenesis. We identify here a function of Cks1 in mammalian cell cycle regulation that is independent of p27(Kip1). Specifically, Cks1(-/-); p27(Kip1-/-) mouse embryonic fibroblasts retain defects in the G(1)-S phase transition that are coupled with decreased Cdk2-associated kinase activity and defects in proliferation that are associated with Cks1 loss. Furthermore, concomitant loss of Cks1 does not rescue the tumor suppressor function of p27(Kip1) that is manifest in various organs of p27(Kip1-/-) mice. In contrast, defects in mitotic entry and premature senescence manifest in Cks1(-/-) cells are p27(Kip1) dependent. Collectively, these findings establish p27(Kip1)-independent functions of Cks1 in regulating the G(1)-S transition.

This study aims to quantify by intravital microscopy and histological wound scoring the effect of radial pressure wave treatment (RPWT) on murine incisional wound healing. The dorsal skinfold chamber in mice was used for intravital microscopy, whereby an incisional wound was created within the chamber. RPWT to the wound was carried out using a ballistic pressure wave source (EMS Swiss DolorClast). Animals received a dose of 500 pulses at an energy flux rate of 0.1mJ/mm(2) and a frequency of 3Hz at day 1, 3, 5, 7, 9, and 11 post wounding. RPW treated and untreated ApoE depleted mice (ApoE(-/-)) were compared to normal healing wild type animals (WT). The microcirculation of the wound was analyzed quantitatively in vivo using epi-illumination intravital fluorescence microscopy. Tissue samples were examined ex vivo for wound scoring and immunohistochemistry. Upon RPWT total wound score in ApoE(-/-) mice was increased by 13% (not significant) on day 3, by 37% on day 7 (P<0.05), and by 39% on day 13 (P<0.05) when compared to untreated ApoE(-/-) mice. Improved wound healing was associated with an increase of functional angiogenetic density by 23% (not significant) on day 5, by 36% on day 7 (P<0.05), and by 41% on day 9 (P<0.05). Following RPWT, on day three we observed enhanced expression of capase-3 (2-fold), proliferating cell nuclear antibody (PCNA, 1,6-fold), and endothelial nitric oxide synthase (eNOS, 2.6-fold), all P<0.05. In conclusion repetitive RPWT accelerated wound healing in ApoE(-/-) mice by increasing functional neovascular density. In addition our findings strongly suggest that RPW may facilitate the linear progression of wound healing phases by fostering apoptosis., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Background: In the era of tissue engineering, the physiologic process of skin graft revascularization remains unclear, preventing the successful development of skin substitutes. Therefore, the authors developed a new in vivo model with which to visualize the process of engraftment and its microvascular architecture. The aim of this study was to specifically investigate the vascular transformations within the skin graft to gain applicable knowledge on how vascular processes during engraftment occur., Methods: Microsurgical preparation of the modified dorsal skinfold chamber including autologous skin grafting was performed in male C57BL/6J mice (n = 10). In addition, immunohistochemistry of angiogenic factors, endothelial cells, and pericytes, and corrosion casting were performed to further characterize the specific mechanisms., Results: The graft exhibited capillary widening starting at day 3, resulting in the temporary formation of spherical protrusions at the graft capillary divisions starting in the center of the graft 24 to 48 hours after revascularization. Confocal microscopy showed the simultaneous expression of CD31 and desmin. Corrosion casting and evaluation by light microscopy and scanning electron microscopy showed the three-dimensional formation of capillaries in the wound bed that connected to the preexisting capillary loops of the skin graft., Conclusions: The authors were able to show for the first time a temporary angiogenic response within the capillaries of the skin graft. This most likely represents a reaction to reperfusion allowing the supply of proangiogenic factors to the hypoxic skin graft. The detection of an angiogenic response within the graft capillaries is for the first time made possible in the newly developed model and is therefore completely novel.

Background and Aims: Cigarette smoking is linked to thromboembolic events; however, a relationship between nicotine exposition and thrombosis has not been established. Thus, we intended to study the effect of acute and chronic nicotine application in an in vivo mouse model., Materials and Methods: In microvessels of the dorsal skin fold chamber, light-dye-induced thrombus formation was analyzed using intravital fluorescence microscopy. Male and female C57BL/6J mice received nicotine chronically via the drinking water (100 microg/ml) for 8 weeks. An additional series of experiments was performed with acute iv nicotine treatment (3 mg/kg body weight)., Results: No significant differences in microvascular thrombus formation were detected after chronic nicotine application in male and female animals when compared with controls. Accordingly, flow cytometric analysis did not show significant effects on platelet activity. Chronic nicotine treatment resulted in a significantly reduced endothelial activation in male, but not in female mice. In contrast, acute iv application of nicotine revealed significantly shorter thrombosis times in arterioles of female mice and a significantly increased endothelial P-selectin expression in mice of both genders., Conclusion: Chronic nicotine application does not promote microvascular thrombus formation in mice of either gender, whereas acute high-dose iv administration caused a significant increase of arteriolar thrombosis in female animals probably via a synergistic effect of increased endothelial P-selectin expression and female hormone levels. A gender-dependency of acute nicotine action can be presumed.