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In head and neck surgery, continuous intraoperative tissue differentiation is of great importance to avoid injury to sensitive structures such as nerves and vessels. Hyperspectral imaging (HSI) with neural network analysis could support the surgeon in tissue differentiation. A 3D Convolutional Neural Network with hyperspectral data in the range of 400 − 1000 nm is used in this work. The acquisition system consisted of two multispectral snapshot cameras creating a stereo-HSI-system. For the analysis, 27 images with annotations of glandular tissue, nerve, muscle, skin and vein in 18 patients undergoing parotidectomy are included. Three patients are removed for evaluation following the leave-one-subjectout principle. The remaining images are used for training, with the data randomly divided into a training group and a validation group. In the validation, an overall accuracy of 98.7% is achieved, indicating robust training. In the evaluation on the excluded patients, an overall accuracy of 83.4% has been achieved showing good detection and identification abilities. The results clearly show that it is possible to achieve robust intraoperative tissue differentiation using hyperspectral imaging. Especially the high sensitivity in parotid or nerve tissue is of clinical importance. It is interesting to note that vein was often confused with muscle. This requires further analysis and shows that a very good and comprehensive data basis is essential. This is a major challenge, especially in surgery.

The titres of indirect anti-Candidahaemagglutination test (C-HAT) and specific immunoglobulins C-IgM, C-IgG and C-IgA in 328 intensive care (IT) patients and 166 non-intensive care (NIT) patients were compared by statistical test methods. Positive correlations were found between values of C-HAT and all threeCandida-specific immunoglobulins. At an interval of≤7 days in the first patient group only, the changes in the course of titres were statistically highly significant. For C-IgM the short-term increase of titres can be interpreted in the sense of happened mycotic infection in connection with the clinical picture. In IT patients we found an average increase of C-IgM at 259.3, C-IgG at 174.7, C-IgA at 59.8 U ml−1 and of three titre steps in C-HAT. In our experience of diagnostics ofCandidainfections in intensive care area with non-neutropenic patients the short-term determination of the anti-Candidaimmunoglobulin subclasses C-IgM and C-IgG and of C-HAT as screening test should not be neglected. [ABSTRACT FROM AUTHOR]

Clinical applications andin vitrostudies show that all antimycotics are most effective against infection when applied as early as possible. An early diagnosis is, therefore, essential. At this time for aspergillosis and particularly candidosis, a statement is only possible by combining several diagnostic methods. Inflammatory parameters like procalcitonin, C-reactive protein and proinflammatory cytokines are most important evidence of infection. Antigen tests are more significant by higher sensitivity. Attention should be focused on the detection of mannan by ELISA test,β-glucan and D-arabinitol. Given the present research level in the field of proteomics, the diagnostic importance of transmembranal receptor proteins or other regulatory proteins seems promising. [ABSTRACT FROM AUTHOR]

The aim was the investigation of fungal colonization and morphological alterations under the influence of voriconazole in an in vitro system. Voriconazole stopped growth and colonization of Candida albicans (wild type SC5314) on cover slips in microtiter plates dependent on drug concentration, the time of Candida growth before the input of voriconazole and oxygen concentration. The direct microscopy by fluorescence staining with the optical brightener Blancophor® showed short bizarrely deformed mycelia looking swollen. The colonization on cover glass was diminished. Microcolonies or starting of biofilm formation as in the control was not observed . The metabolic activity was demonstrated by vital staining with FUN® 1 resulting in red fluorescent structures in the yeast forms and mycelia in the controls. Under voriconazole influence the remaining cells only showed a green or pale yellow fluorescence. Most of the cells lost their metabolic activity. [ABSTRACT FROM AUTHOR]

Discusses an early description of pulmonary aspergillosis in 1847 by medical student Theodor Sluyter. Sluyter's publication of his thesis of the well-documented case of human pulmonary aspergillosis; Classification of the fungi in 1857 as an Aspergillus species.

We investigated the influence of voriconazole and fluconazole in a long term trial of continuous flow culture (cfc) up to 9 days. The effects of these azoles were different in dependence on the growth circumstances. Under anaerobic conditions a fungicidal effect of voriconazole was detectable, defined by an inhibition of 99.9%. This also applied to fluconazole for the majority of tested strains of C. albicans. Under aerobic conditions with an otherwise similar situation we found only a fungistatic reaction (inhibition of 90%). Fluorescence microscopy comparing fungal morphology in biofilms on glass surfaces in the cfc revealed a differentiation into blastospores, germ tubes, pseudomycelia and mycelia in the control trial after a cultivation of 8 days. Under anaerobic conditions with azoles only some single cells could be found, sometimes in cell detritus. The adhesion was clearly reduced. Under aerobic conditions more blastospores but no differentiated mycelia were to be seen. Wir untersuchten den Einfluss von Voriconazol und Fluconazol in kontinuierlicher Langzeitkultur bei einer Zeitdauer bis zu 9 Tagen. Die Wirkung der Azole war unterschiedlich in Abhängigkeit von den Wachstumsbedingungen. Unter anaeroben Verhältnissen zeigte Voriconazol und bei den meisten Teststämmen von Candida albicans auch das Fluconazol eine fungizide Wirkung. Damit wurde eine 99,9%ige Hemmung der C. albicans-Stämme erreicht. Unter aeroben Bedingungen konnte nur eine 90%ige Hemmung festgestellt werden. Fluoreszenzmikroskopisch wurden nach durchschnittlich achttägiger Kulturdauer große Unterschiede in Morphologie und Biofilmbildung der Pilze auf Glasoberflächen beobachtet. In der Kontrolle ohne Azol-Zusatz fand sich eine üppige Aufwuchsflora. Die Candida waren differenziert in Blastosporen, Keimschläuche, echte und Pseudomyzelien. Unter Azol-Einfluss ließ die Besiedlungsdichte deutlich nach. Anaerob waren nur wenige Sprosszellen, selten einmal ein Keimschlauch, häufig nur Zelldetritus nachweisbar. Die Adhäsion war deutlich herabgesetzt. Aerob waren mehr Blastosporen und keine differenzierten Myzelien vorhanden. [ABSTRACT FROM AUTHOR]

Microecology looks for the relationships between microorganisms and their natural environment in definite sites and their physiological and pathological effects. From birth Candida spp. are often but not always detectable in the human gastrointestinal tract. In cases of reduced defense the tract may be a source of infection to the macroorganism. In healthy subjects the incidence of Candida is between 23% and 76% in quantities between 10²-104 CFU/ml or g dependent on site. Evidence is most frequent in oral cavity and faeces. Tolerance for Candida spp. is different in the stomach and duodenum due to differences in acidity. Changes in the occurrence of Candida spp. are possible depending on age, different diseases and exogenous influences as nutrition, stress and drugs. In an endocrine stress model we found no yeasts in the duodenal juices of 7 subjects before and after stress situation, but a clear decrease of yeasts in the faeces. The formation of metabolic products by Candida is secondary to the whole of microbial fermentation in the human orointestinal tract. Colonizing strains of C. albicans are normally present in small or moderate numbers and only they are regarded as part of the resident gastrointestinal microflora [ABSTRACT FROM AUTHOR]

In continuous-flow culture, long generation times and high bacterial counts favour survival of bacteria. A chemotherapeutic agent that achieves a bactericidal effect under these circumstances can therefore be seen as highly effective. In our continuous-flow culture we obtained bactericidal effects with ciprofloxacin 1-2 mg/L, cefotaxime 4 mg/L and mezlocillin 32 mg/L. These effects were seen irrespective of whether conditions were aerobic or anaerobic. There were no significant differences between monocultures and mixed cultures simulating faecal flora with the various Escherichia coli strains tested. Cefotaxime had an initial effect but an increase in counts was then observed as a result of regrowth of E. coli survivor strains in aerobic monoculture and mixed cultures. Mezlocillin was completely bactericidal in monocultures, but regrowth occurred in mixed cultures under anaerobic conditions. Neither the bacterial composition of this culture nor the resistance pattern explained this regrowth. These results were observed in long-term experiments followed for up to 7 days. We conclude that the antibiotics tested are highly effective against E. coli under unfavourable conditions simulating in-vivo situations. [ABSTRACT FROM AUTHOR]

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