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Mohammad Golriz,1,2 Ali Ramouz,1 Sadeq Ali-Hasan-Al-Saegh,1 Saeed Shafiei,1 Ehsan Aminizadeh,1 Ahmed Hammad,1 Markus Mieth,1 Christian Rupp,2,3 Christoph Springfeld,2,4 Katrin Hoffmann,1,2 Markus Büchler,1 Arianeb Mehrabi1,2 1Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany; 2Liver Cancer Center Heidelberg (LCCH), Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany; 3Department of Internal Medicine IV, Gastroenterology & Hepatology, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, Germany; 4National Center for Tumor Diseases, Department of Medical Oncology, Heidelberg University Hospital, Heidelberg, Baden-Württemberg, GermanyCorrespondence: Arianeb Mehrabi, Head of the Division of Liver Surgery and Visceral Transplantation, Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Im Neuenheimer Feld 420, Heidelberg, 69120, Germany, Tel +49– 6221– 5636223, Fax +49– 6221– 567470, Email arianeb.mehrabi@med.uni-heidelberg.dePurpose: Although surgery is associated with an acceptable cure rate, tumor recurrence is still a challenging issue in hepatocellular carcinoma (HCC) patients. Red blood cell distribution width (RDW) is considered an inflammatory marker for predicting overall mortality in a wide spectrum of malignancies. In the current study, the prognostic role of pre- and postoperative RDW in HCC recurrence after liver resection (LRx) is investigated.Patients and Methods: In 395 patients, RDW levels were evaluated preoperatively as well as six and twelve months after curative LRx. The RDW cutoff values were determined using receiver operating characteristic curves (ROCs) according to the recurrence-free survival (RFS). Survival analyses were performed using the Kaplan–Meier, and differences were compared using the Log rank test.Results: The RFS was significantly higher among patients with low RDW at the 6th month and 12th month, postoperatively (P < 0.001 and P = 0.028). RDW levels of higher than 16.15% at the 6th (HR: 2.047, P < 0.001) and higher than 15.85% at 12th (HR: 3.105, P < 0.002) months after liver resection were independent predictors of RFS.Conclusion: Postoperative RDW values seem to be predictive of tumor recurrence in HCC patients. RDW levels at the 6th and 12th months postoperatively were independent predictors of recurrence after LRx.Keywords: hepatectomy, hepatocellular carcinoma, liver resection, red blood cell distribution width

Purpose: Mass spectrometry–based serum peptidome profiling is a promising tool to identify novel disease-associated biomarkers, but is limited by preanalytic factors and the intricacies of complex data processing. Therefore, we investigated whether standardized sample protocols and new bioinformatic tools combined with external data validation improve the validity of peptidome profiling for the discovery of pancreatic cancer–associated serum markers.Experimental Design: For the discovery study, two sets of sera from patients with pancreatic cancer (n = 40) and healthy controls (n = 40) were obtained from two different clinical centers. For external data validation, we collected an independent set of samples from patients (n = 20) and healthy controls (n = 20). Magnetic beads with different surface functionalities were used for peptidome fractionation followed by matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry (MS). Data evaluation was carried out by comparing two different bioinformatic strategies. Following proteome database search, the matching candidate peptide was verified by MALDI-TOF MS after specific antibody-based immunoaffinity chromatography and independently confirmed by an ELISA assay.Results: Two significant peaks (m/z 3884; 5959) achieved a sensitivity of 86.3% and a specificity of 97.6% for the discrimination of patients and healthy controls in the external validation set. Adding peak m/z 3884 to conventional clinical tumor markers (CA 19-9 and CEA) improved sensitivity and specificity, as shown by receiver operator characteristics curve analysis (AUROCcombined = 1.00). Mass spectrometry–based m/z 3884 peak identification and following immunologic quantitation revealed platelet factor 4 as the corresponding peptide.Conclusions: MALDI-TOF MS-based serum peptidome profiling allowed the discovery and validation of platelet factor 4 as a new discriminating marker in pancreatic cancer.

Supplementary Data from Serum Peptidome Profiling Revealed Platelet Factor 4 as a Potential Discriminating Peptide Associated with Pancreatic Cancer

Pancreatic cancer is one of the most lethal cancers worldwide, most notably in Europe and North America. Great strides have been made in combining the most effective conventional therapies to improve survival at least in the short and medium term. The start of treatment can only be made once a diagnosis is made, which at this point, the tumor volume is already very high in the primary cancer and systemically. If caught at the earliest opportunity (in circa 20% patients) surgical resection of the primary followed by combination chemotherapy can achieve 5-year overall survival rates of 30%–50%. A delay in detection of even a few months after symptom onset will result in the tumor having only borderline resectabilty (in 20%–30% of patients), in which case the best survival is achieved by using short-course chemotherapy before tumor resection as well as adjuvant chemotherapy. Once metastases become visible (in 40%–60% of patients), cure is not possible, palliative cytotoxics only being able to prolong life by few months. Even in apparently successful therapy in resected and borderline resectable patients, the recurrence rate is very high. Considerable efforts to understand the nature of pancreatic cancer through large-scale genomics, transcriptomics, and digital profiling, combined with functional preclinical models, using genetically engineered mouse models and patient derived organoids, have identified the critical role of the tumor microenvironment in determining the nature of chemo- and immuno-resistance. This functional understanding has powered fresh and exciting approaches for the treatment of this cancer.

Chronic inflammation, linked to the presence of bovine milk and meat factors (BMMFs) and specific subsets of macrophages, results in oxygen radical synthesis and induction of mutations in DNA of actively replicating cells and replicating single stranded DNA. Cancers arising from this process have been characterized as indirect carcinogenesis by infectious agents (without persistence of genes of the agent in premalignant or cancers cells). Here, we investigate structural properties of pleomorphic vesicles, regularly identified by staining peritumor tissues of colorectal, lung and pancreatic cancer for expression of BMMF Rep. The latter represents a subgroup of BMMF1 proteins involved in replication of small single-stranded circular plasmids of BMMF, but most likely also contributing to pleomorphic vesicular structures found in the periphery of colorectal, lung and pancreatic cancers. Structurally dense regions are demonstrated in preselected areas of colorectal cancer, after staining with monoclonal antibodies against BMMF1 Rep. Similar structures were observed in human embryonic cells (HEK293TT) overexpressing Rep. These data suggest that Rep or Rep isoforms contribute to the structural formation of vesicles.

In recent years, a wide agreement with respect to the processes associated with cathodic protection (CP) has been reached within the CP industry. The increase of the pH value at the steel surface and the generation of passivating conditions as a result of the CP current are widely accepted as the relevant underlying mechanism. Based on this understanding it was possible to identify the relevant processes with respect to AC and DC interference and explain the empirical observations. This led to the development of ISO 18086 and has significantly influenced the work on ISO/DIS 21857. This paper summarizes present state of knowledge, the more recent developments, and their implications with respect to the CP criteria. It summarizes the relevant aspects in association with interference conditions and highlights possible future approaches with respect to the assessment of the effectiveness of CP.

The impact of neoadjuvant chemotherapy on tumor cells is largely unknown with resistance to therapy remaining a significant challenge. We analyzed 171 chemo-naïve and post-chemotherapy resected patient samples (chemoradiotherapy excluded) using RNAseq and multiplexed immunofluorescence. Neoadjuvant chemotherapy enriched for distinct neoplastic persister phenotypes expressing Classical and Basal-like biomarkers GATA6 and KRT17. The enrichment of GATA6HiClassical-like and KRT17Hi Basal-like cells in post-chemotherapy patient samples was associated with poor survival after mFOLFIRINOX, but not gemcitabine. CYP3A subfamily enzymes (CYP3A4 and CYP3A5) were expressed in GATA6Hi and KRT17Hi persister cells and can degrade mFOLFIRINOX constituent irinotecan. Taken together these data support a model in which pre-existing subpopulations of GATA6Hi (Classical) and/or KRT17Hi (Basal) neoplastic cells emerge after mFOLFIRINOX treatment by expressing CYP3A. The identification of CYP3A-enabled persister cell phenotypes is an important step in the design of effective therapies to overcome drug-tolerance and prevent recurrence after neoadjuvant therapy. Citation Format: Xu Zhou, Roma Kurilov, John P. Neoptolemos, Benedikt Brors, Kai Hu, Teresa Peccerella, Jing-Yu An, Stephanie Roessler, Katrin Pfütze, Angela Schulz, Stephan Wolf, Nicolas Hohmann, Ulrike Heger, Oliver Strobel, Simon T Barry, Christoph Springfeld, Christine Tjaden, Frank Bergmann, Markus Büchler, Thilo Hackert, Franco Fortunato, Peter Bailey. Persister cell phenotypes contribute to poor patient outcomes after neoadjuvant chemotherapy in PDAC [abstract]. In: Proceedings of the AACR Special Conference on Pancreatic Cancer; 2022 Sep 13-16; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2022;82(22 Suppl):Abstract nr A010.

ObjectiveGATA6 is a master regulator of pancreatic differentiation and a key regulator of the classical phenotype in pancreatic ductal adenocarcinoma (PDAC). Low GATA6 expression is associated with poor patient outcome.GATA4is the second most expressed GATA factor in the pancreas. The aim was to assess whether, and how, GATA4 contributes to PDAC phenotype and to analyze the association of expression with clinical outcome.DesignWe analyzed PDAC transcriptomic data, stratifying cases according toGATA4andGATA6expression, and identified differentially expressed genes and pathways. A multicenter TMA study to assess GATA4 and GATA6 expression in PDAC samples (n=745) from patients undergoing tumour resection was performed using immunohistochemistry with antibodies of validated specificity. GATA4 and GATA6 levels were dichotomized into high/low categorical variables; association with outcome was assessed using univariable and multivariable Cox regression models.ResultsSubtype classification using transcriptomic data revealed thatGATA4mRNA is enriched in classical, compared to basal-like tumours. We classified samples in 4 groups as high/low forGATA4andGATA6. Reduced expression ofGATA4did not have a major transcriptional impact. However, concomitant low expression ofGATA4enhanced the transcriptomic effects ofGATA6low expression. Reduced expression of both proteins in tumours was associated with the worst patient survival.GATA4andGATA6expression significantly decreased in metastases and negatively correlated with basal markers.ConclusionsOur analyses uncover a cooperative interaction betweenGATA4andGATA6to maintain the classical PDAC phenotype and provide compelling clinical rationale for assessing their expression as biomarkers of poor prognosis.SUMMARY BOXWhat is already known about this subject?-Patients with classical-type PDAC have a better outcome-Retrospective analyses suggest that classical-type PDAC is more sensitive to 5-FU-based chemotherapy-GATA6 is a surrogate biomarker of classical tumours and its expression is associated with better survival-GATA4 and GATA6 have overlapping and unique functions during pancreatic and gastrointestinal developmentWhat are the new findings?-Tumours displaying only low GATA4 expression have a transcriptomic profile similar to those with preserved expression of both transcription factors-Combined low expression of GATA4 and GATA6 has the highest transcriptomic impact-In a large multicenter tissue microarray study, patients with tumours showing low expression of both GATA4 and GATA6 have the worst overall survival-Low expression of GATA4 and GATA6 is an independent predictor of survival in patients with resectable PDAC-GATA4 levels are down-regulated in liver metastases and are negatively correlated with basal markers such as KRT5/6, KRT14, and TP63How might it impact on clinical practice in the foreseeable future?-The combined assessment of GATA4 and GATA6 expression may improve prognostic stratification of patients with PDAC-Prospective studies should confirm whether GATA4 and GATA6 expression is also predictive of response to chemotherapy in PDAC patients

Hematite is a low band gap, earth abundant semiconductor and it is considered to be a promising choice for photoelectrochemical water splitting. However, as a bulk material its efficiency is low because of excessive bulk, surface, and interface recombination. In the present work, we propose a strategy to prepare a hematite (&alpha, Fe2O3) photoanode consisting of hematite nanorods grown onto an iron oxide blocking layer. This blocking layer is formed from a sputter deposited thin metallic iron film on fluorine doped tin oxide (FTO) by using cyclic voltammetry to fully convert the film into an anodic oxide. In a second step, hematite nanorods (NR) are grown onto the layer using a hydrothermal approach. In this geometry, the hematite sub-layer works as a barrier for electron back diffusion (a blocking layer). This suppresses recombination, and the maximum of the incident photon to current efficiency is increased from 12% to 17%. Under AM 1.5 conditions, the photocurrent density reaches approximately 1.2 mA/cm2 at 1.5 V vs. RHE and the onset potential changes to 0.8 V vs. RHE (using a Zn-Co co-catalyst).

Background Clinicopathological features and surgical outcomes of patients with fibrolamellar hepatocellular carcinoma (FL-HCC) are underreported. The aim of this study is to describe clinical characteristics and surgical outcomes for patients with this rare tumor to raise awareness among clinicians and surgeons. Methods Retrospective review of records of a tertiary referral center and specialized liver unit was performed. Out of 3623 patients who underwent liver resection, 366 patients received surgical treatment for HCC; of them, eight (2.2%) had FL-HCC and were resected between October 2001 and December 2018. Results Eight patients (3 males and 5 females) with FL-HCC (median age 26 years) underwent primary surgical treatment. All patients presented with unspecific symptoms or were diagnosed as incidental finding. No patient had cirrhosis or other underlying liver diseases. Coincidentally, three patients (37.5%) had a thromboembolic event prior to admission. The majority of patients had BCLC stage C and UICC stage IIIB/IVA; four patients (50%) presented with lymph node metastases. The median follow-up period was 33.5 months. The 1-year survival was 71.4%, and 3-year survival was 57.1%. Median survival was at 36.4 months. Five patients (62.5%) developed recurrent disease after a median disease-free survival of 9 months. Two patients (25.0%) received re-resection. Conclusion FL-HCC is a rare differential diagnosis of liver masses in young patients. Since the prognosis is limited, patients with incidental liver tumors or lesions with suspicious features in an otherwise healthy liver should be presented at a specialized hepatobiliary unit. Thromboembolism might be an early paraneoplastic symptom and needs to be elucidated further in the context of FL-HCC.

By means of numerical modeling and experimental measurements, this work addresses the longstanding controversy of whether or not IR (ohmic) drops need to be considered in on-potential catho...

The well-known Stern–Geary equation was derived on the basis of the theory by Wagner and Traud and relies on the so-called mixed potential of an electrode subject to uniform corrosion. Nevertheless, it is common practice to apply the linear polarization method to determine instantaneous corrosion rates in situations of galvanic corrosion. In the present work, the applicability of the Stern–Geary equation to galvanic corrosion was in detail discussed both with help of theoretical considerations and experimental measurements. The primary reason why the application of the Stern–Geary equation to galvanic corrosion is fundamentally incorrect is the fact that a well-defined mixed potential does for galvanic elements not exist. In this work, equations were derived that allow a correct calculation of the corrosion rate for galvanic cells. However, the required variables can, in usual practical situations, not be measured. Application of the Stern–Geary equation to galvanic cells is in the literature claimed (or assumed) to yield adequate results. An explanation for this apparent applicability was identified in the fact that two major errors have a compensating effect so that they tend to cancel each other out. The extent to which this is possible depends strongly on the actual conditions such as the geometry of the galvanic cell as well as on the position of the counter and the reference electrode (RE). Nevertheless, since this apparent applicability is owing to specific conditions rather than a fundamental applicability of the method, further research is clearly needed to characterize these conditions and their limits in detail.

We sought to evaluate the relative value of pure tone audiometry (PTA), extended high-frequency audiometry (EFA) and transiently evoked otoacoustic emissions (OAE) and distortion products when monitoring acute acoustic trauma (AAT).Controlled prospective clinical study.Tertiary referral center.Seventy one active duty soldiers in the same age with normal hearingForty one soldiers suffered assault-rifle-induced acute acoustic traumas with hearing loss and tinnitus. Thirty soldiers served as a control group.Pure tone threshold changes detected by PTA and EFA, amplitude and reproducibility changes in transiently evoked OAE, distortion products, and tinnitus analysis based on a visual analog scale.Assault rifle-induced AAT caused unilateral temporary threshold shifts (TTS) in PTA and bilateral TTS in EFA. Two frequency regions with the largest threshold shifts were identified: one between 3 and 6 kHz and another between 11 and 14 kHz. The reproducibility of transiently evoked OAEs revealed changes related to the acoustic trauma in the 3- to 5-kHz frequency window. The amplitudes of the low stimulation level distortion products at 6 kHz were correlated with the audiometric AAT-induced TTS.Acute acoustic trauma-induced audiometric TTS are predominantly confined to 2 specific frequency regions. PTA and EFA are both necessary to identify the full extent of acute acoustic trauma. PTA and EFA revealed that the TTSs were correlated to with distortion product OAE amplitude shifts at 6 kHz and changes in the reproducibility of transiently evoked OAE in the 3- to 5-kHz frequency window. PTA remains the most important measurement to monitor AAT. It may be useful to complement it with EFA, focusing on the 11 to 14 kHz frequency range. If used, OAE should be analyzed in the frequency range of 3 to 6 kHz.

BackgroundLiving-related liver transplantation has become an excellent treatment method for patients with end-stage liver disease. The anatomical variation is the corner stone for donor and recipient safety.Aim of the studyTo evaluate the impact of anatomical variations of the donor's liver on the p

Die Instandsetzung von korrosionsgeschaedigten Stahlbetonbauwerken ist kosten- und zeitintensiv. Die klassische Vorgehensweise besteht aus dem Abtrag von karbonatisiertem oder chloridbelastetem Beton und anschliessender Reprofilierung. Unter gewissen Umstaenden ist dies nicht moeglich. So kann beispielsweise die hohe Verkehrsauslastung eine Sperrung des Bauwerks praktisch unmoeglich machen. Korrosionsinhibitoren, die durch einfache Spruehapplikation auf die Oberflaeche des Betons aufgetragen werden, stellen eine moegliche Alternative dar. Diese Produkte sind in den meisten Faellen jedoch erst seit wenigen Jahren auf dem Markt, und Erfahrungswerte ueber das Langzeitverhalten liegen noch nicht ausreichend vor. Hinzu kommt, dass bei fehlerhafter Applikation keine genuegende Wirksamkeit erreicht werden kann. Durch Kombination von Anwendung und messtechnischer Ueberwachung der Makroelementstroeme und Potenziale ist es moeglich, die Wirksamkeit der getroffenen Massnahme nachzuweisen. Die langjaehrigen, positiven Ergebnisse einer solchen Inhibierungsmassnahme am Beispiel von Autobahn-Galeriestuetzen werden in diesem Beitrag diskutiert. (A)

The localized corrosion behavior of Al 6061 and cast aluminum was investigated by using fluorescein in combination with fluorescence microscopy and atomic force microscopy in 0.1 M KCl solution. The formation of fluorescent rings around the inclusions can be observed within a short time after open circuit initiation of localized corrosion at open circuit. These fluorescent rings are associated with topographic features formed by precipitated corrosion products which are related to anodic dissolution sites. Hence, even a small number of anodic sites can easily be identified among a large number of inclusions.

Background & Aims: Secretions from the exocrine and endocrine pancreas may modulate interdigestive motility. To test this hypothesis in humans, we investigated interdigestive cycling in patients with chronic pancreatitis (CP) as a model of impaired pancreatic function. Methods: Antroduodenal motility, pancreatic enzyme output, and pancreatic polypeptide release were monitored for two consecutive interdigestive cycles in 13 controls and 9 patients with CP. Results: Interdigestive enzyme output was severely impaired in patients with CP (>80% decrease); however, secretory cycling was still evident in most patients. All parameters describing interdigestive motility were similar in controls and patients with CP (duration of the migrating motor complex [MMC] was 107 ± 19 minutes in patients with CP vs. 114 ± 15 minutes in controls). The time between cyclic peaks of enzyme secretion (76 ± 4 minutes vs. 101 ± 4 minutes in controls) and pancreatic polypeptide (63 ± 4 minutes vs. 106 ± 7 minutes in controls) was shortened in patients with CP, and peaks were no longer temporally related to the MMC. Only 56% of phase III activity fronts were associated with a concomitant secretory peak in patients with CP compared with 92% in healthy subjects. Conclusions: CP not only decreases pancreatic secretion but interrupts the coordination among interdigestive cyclic phenomena. Our findings in several animal and human models refute the concept that pancreatic mechanisms exert a major regulatory influence on interdigestive motor activity.

A corrosion sensor newly developed by the Swiss Society for Corrosion, modified for a potential application in the oral cavity, was tested in vitro. By measuring the impedance with a special sensor in the size of a bur handpiece, it allows a quick determination of the corrosion resistance. For the evaluation of the method, measurements were done on six conventional dental alloys (two precious alloys, one Pd-based alloy and three non-precious alloys) which had been tested in crevice corrosion by the authors in an earlier stage. Qualitatively the results are quite in concordance with the ones got with the usual tests. On the base of the present results the use directly in the oral cavity of this corrosion test method appears to be very promising.

BACKGROUND: In tuberculosis (TB), the risk of exposure is determined mainly by the proximity to and the hours of direct contact with an infectious patient. We describe the contact investigation after detection of an infectious form of TB in a military camp using an Interferon-g-Release-Assay (IGRA, QuantiFERON-TB Gold In Tube [QTF-GIT]) eight weeks after detection of the index case. INDEX PATIENT: The index patient presented with fever, cough and weight loss in the military hospital six weeks after entering the camp. TB was suspected and anti-tuberculous therapy given immediately. Subsequently, TB was microbiologically confirmed. METHODS: Four exposure groups were formed a priori based on the proximity and the hours of direct contact to the index case. 168 (95.5%) agreed to be investigated: - Group A: sharing the same dormitory (15 persons) - Group B: same platoon, but not sharing the dormitory (20 persons) - Group C: staff and patients of the military hospital (22 persons) - Group D: other three platoons and senior military staff (111 persons). RESULTS: 34 (20.2%) out of 168 contacts tested positive in the QFT-GIT assay. For the exposure groups, the respective QFT-GIT testing results were: group A, 14/15 (93%); group B, 4/20 (20%); group C, 5/22 (22.7%); and group D, 11/111 (9.9%). No secondary TB cases were identified. CONCLUSIONS: In our study, test results show a correlation with the risk of exposure, suggesting that IGRA may be useful for the assessment of TB infection in TB contacts. The high mobility of recruits reduced traceability of contacts. In this context, QFT-GIT allowed for an efficient screening of contacts at a single time point.

A simple implementation of modulation of the near-field optical signal of near-field probes based on the shear-force feedback system is demonstrated in a reflection-mode near-field optical microscope. The modulation exhibits a derivative type of dependence on the near-field signal and no sensitivity to topography. It is shown that the modulation image can be calculated directly from the derivative of the conventional near-field scattering image. This type of near-field modulation is an excellent way to reject far-field artifacts from the near-field signal.

The yeast PRD1 gene, encoding proteinase yscD, was cloned by complementation of the prd1-6 point mutation. Sequencing of the gene revealed an open reading frame of 2.136 kb, encoding a protein of 712 amino acids with a calculated molecular mass of 81.8 kDa. The sequence HEGLG beginning at residue 501 represents the HEXXH motif, unique for the zinc metallo-peptidases. Sequence comparison revealed complete identity of the proteinase yscD gene with a recently published open reading frame of yeast chromosome III. We found 34.8% identity between proteinase yscD and rat metalloendopeptidase (thimet oligopeptidase, EP 24.15). Proteinase yscD hydrolyzes several chromogenic and fluorogenic peptides that are substrates of thimet oligopeptidase. N-[1-(RS)-carboxy-3-phenylpropyl]-Ala-Ala-Phe-p-aminobenzoic acid, a compound designed as specific inhibitor of EP 24.15, is also a strong inhibitor of the yeast enzyme. Proteinase yscD is a non-vacuolar enzyme. 3–5% of the total enzyme activity can be detected in the intermembrane space of mitochondria. In a mutant carrying a deletion of the PRD1 gene no proteinase yscD activity is detectable in the cytoplasm and in mitochondria of these cells. They do not show any grossly altered phenotype but exhibit a decrease in the intracellular degradation of peptides. This suggests a function of proteinase yscD in the late stages of protein degradation.

New methods of assessment of enzyme activity - do they help to optimize enzyme treatment?, G. Adler et al fate of pancreatic enzymes in the human intestinal lumen in health and pancreatic insufficiency, P. Layer and G. Groger effect of exogenous pancreatic enzymes on gastrointestinal and pancreatic hormone release and gastrointestinal motility, P. Malfertheiner and J.E. Dominguez-Monoz enzyme treatment of exocrine pancreatic insufficiency in chronic pancreatitis, P.G. Lankisch pancreatic pain - is there a place for pancreatic enzymes in the treatment of pain in chronic pancreatitis?, I. Ihse et al acute pancreatitis - when is enzyme treatment indicated?, M.J. McMahon indication for pancreatic enzyme treatment in non-pancreatic digestive diseases, L. Gullo enzyme treatment after gastrointestinal surgery, H. Friess et al.

The localized corrosion behavior of Al 2024 was investigated by using a fluorescent dye in combination with conventional fluorescence microscopy and near-field scanning optical microscopy. The fluorescent rings that mark the first steps of corrosion attack were associated with topographic features. The topographic rings were also observed in the absence of the dye, demonstrating that the observed rings are not artifacts. Anodic polarization in the absence of oxygen yielded fluorescent and topographic features similar to those observed under open-circuit conditions, indicating that the dye marks anodic sites.

A 57-yr-old male presented with hyperthyroidism (serum T4, 18 μg/dl) intractable by subtotal thyroidectomy. Workup 1 yr after thyroid surgery showed elevated values of plasma TSH (480 /μU/ml), αTSH (68 ng/ml), T4 (15.9 μg/dl), T3 (230 ng/ml), and thyroid function index (1.25) as well as an enlarged sella. A large pituitary tumor (8.4 g) was partially removed by frontal craniotomy. Postoperatively, plasma TSH was 81 juU/ml and a-TSH was 13.5 ng/ml, whereas /β-TSH rose from 0.5 to 8.0 ng/ml. However, hyperthyroidism persisted and had to be controlled by methimazole. It ceased after reoperation (TSH, 2.1 /μU/ml; T4, ¼1 μg/dl). Plasma TSH concentration was unresponsive to TRH (400 fig, iv), T3 (25 jug, four times daily), bromocryptine (10 mg, orally), metoclopramide (10 mg, orally), and iv somatostatin (500 /μg/h). TRH-induced PRL release was normal, but it was suppressed by bromocryptine and somatostatin. Six fractions of tumor TSH (TSHT) were found by electrofocussing, with isoelectric points at pH 4.8, 5.2...