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In the last few decades, the field of ancient DNA has taken a new direction towards using sedimentary ancient DNA (sedaDNA) for studying human and mammalian population dynamics as well as past ecosystems. However, the screening of numerous sediment samples from archaeological sites remains a time-consuming and costly endeavor, particularly when targeting hominin DNA. Here, we present a novel high-throughput method that facilitates the fast and efficient analysis of sediment samples by applying a pooled testing approach. This method combines multiple extracts, enabling early parallelization of laboratory procedures and effective aDNA screening. Pooled samples with detectable aDNA signals undergo detailed analysis, while empty pools are discarded. We have successfully applied our method to multiple sediment samples from Middle and Upper Paleolithic sites in Europe, Asia, and Africa. Notably, our results reveal that an aDNA signal remains discernible even when pooled with four negative samples. We also demonstrate that the DNA yield of double-stranded libraries increases significantly when reducing the extract input, potentially mitigating the effects of inhibition. By embracing this innovative approach, researchers can analyze large numbers of sediment samples for aDNA preservation, achieving significant cost reductions of up to 70% and reducing hands-on laboratory time to one-fifth., (© 2024. The Author(s).)

Recent excavations at Ranis (Germany) identified an early dispersal of Homo sapiens into the higher latitudes of Europe by 45,000 years ago. Here we integrate results from zooarchaeology, palaeoproteomics, sediment DNA and stable isotopes to characterize the ecology, subsistence and diet of these early H. sapiens. We assessed all bone remains (n = 1,754) from the 2016-2022 excavations through morphology (n = 1,218) or palaeoproteomics (zooarchaeology by mass spectrometry (n = 536) and species by proteome investigation (n = 212)). Dominant taxa include reindeer, cave bear, woolly rhinoceros and horse, indicating cold climatic conditions. Numerous carnivore modifications, alongside sparse cut-marked and burnt bones, illustrate a predominant use of the site by hibernating cave bears and denning hyaenas, coupled with a fluctuating human presence. Faunal diversity and high carnivore input were further supported by ancient mammalian DNA recovered from 26 sediment samples. Bulk collagen carbon and nitrogen stable isotope data from 52 animal and 10 human remains confirm a cold steppe/tundra setting and indicate a homogenous human diet based on large terrestrial mammals. This lower-density archaeological signature matches other Lincombian-Ranisian-Jerzmanowician sites and is best explained by expedient visits of short duration by small, mobile groups of pioneer H. sapiens., (© 2024. The Author(s).)

The Middle to Upper Palaeolithic transition in Europe is associated with the regional disappearance of Neanderthals and the spread of Homo sapiens. Late Neanderthals persisted in western Europe several millennia after the occurrence of H. sapiens in eastern Europe 1 . Local hybridization between the two groups occurred 2 , but not on all occasions 3 . Archaeological evidence also indicates the presence of several technocomplexes during this transition, complicating our understanding and the association of behavioural adaptations with specific hominin groups 4 . One such technocomplex for which the makers are unknown is the Lincombian-Ranisian-Jerzmanowician (LRJ), which has been described in northwestern and central Europe 5-8 . Here we present the morphological and proteomic taxonomic identification, mitochondrial DNA analysis and direct radiocarbon dating of human remains directly associated with an LRJ assemblage at the site Ilsenhöhle in Ranis (Germany). These human remains are among the earliest directly dated Upper Palaeolithic H. sapiens remains in Eurasia. We show that early H. sapiens associated with the LRJ were present in central and northwestern Europe long before the extinction of late Neanderthals in southwestern Europe. Our results strengthen the notion of a patchwork of distinct human populations and technocomplexes present in Europe during this transitional period., (© 2024. The Author(s).)

Ancient DNA recovered from Pleistocene sediments represents a rich resource for the study of past hominin and environmental diversity. However, little is known about how DNA is preserved in sediments and the extent to which it may be translocated between archaeological strata. Here, we investigate DNA preservation in 47 blocks of resin-impregnated archaeological sediment collected over the last four decades for micromorphological analyses at 13 prehistoric sites in Europe, Asia, Africa, and North America and show that such blocks can preserve DNA of hominins and other mammals. Extensive microsampling of sediment blocks from Denisova Cave in the Altai Mountains reveals that the taxonomic composition of mammalian DNA differs drastically at the millimeter-scale and that DNA is concentrated in small particles, especially in fragments of bone and feces (coprolites), suggesting that these are substantial sources of DNA in sediments. Three microsamples taken in close proximity in one of the blocks yielded Neanderthal DNA from at least two male individuals closely related to Denisova 5 , a Neanderthal toe bone previously recovered from the same layer. Our work indicates that DNA can remain stably localized in sediments over time and provides a means of linking genetic information to the archaeological and ecological records on a microstratigraphic scale., Competing Interests: The authors declare no competing interest., (Copyright © 2021 the Author(s). Published by PNAS.)

Despite growing experience with laparoscopic cholecystectomy in up to now 1100 operations lesions of the bile ducts sometimes occur. We therefore decided to perform intraoperative cholangiography obligatorily and increased our rate of intraoperative X-ray control from 30% in the first 500 operations to 98.2% in the last 500 operations. The mean operation time in the radiography group was 44.8 min. After introduction of intraoperative cholangiography no bile duct lesions were encountered, but in 4.6% of all patients with this examination previously unknown choledocholithiasis was diagnosed.

We report about a retrospective study of 861 conventional and 812 laparoscopic cholecystectomies (including one coelioscopic choledocholithotomy). In the conventionally operated group reoperation was required in 2.7% (1.4% relaparotomy, 1.3% secondary suture), mortality was 0.5%. After laparoscopic treatment the reoperation rate was 2% (10 relaparoscopies, 5 laparotomies, 2 secondary sutures), no mortality. Growing experience and better definition of contraindications for endoscopic cholecystectomy might improve our results in the future.

Clinical pathology of Ménétrier's disease is reviewed and 3 own cases are presented. All symptoms are unspecific exception made for the enteral protein loss. Roentgenologic and endoscopic appearance contribute to the diagnostic but only histologic examination is decisive. Gastrointestinal bleeding, acute pyloric stenosis, profuse albumin loss are all clear indications for an operation, but also the possibility of malignancy should be kept in mind. Resection should include all abnormal parts of the stomach. Recurrency of the Ménétrier's disease is only known after incomplete resection.

From 1964 to 1974 14 patients affected with a delayed rupture of the spleen, were operated in the Surgical Clinic of the University of Mainz. 12 of these 14 patients had a polytrauma. Head-, brain- and thorax injuries were prevalent. Because of the risk of a delayed spleen rupture each blunt trauma has to be hospitalized and observed under clinical conditions. In unconscious patients and in all doubtful cases a peritoneal lavage should be done. If a spleen rupture is caused by an intraabdominal bleeding, Splenectomy is the therapy of choice as further complications can be avoided by this measure.

A retrospective analysis was made of 235 cases of colectomy, subdivided by age groups, with emphasis being laid on preoperative risk factors and postoperative complications. Lethality accounted for 2.5 per cent, with disorders of wound healing being the most common complications. Advanced age per se does not imply unfavourable prognosis.

The construction and application of a recording desk is described, which is to implant chronically in the abdominal wall of an experimental animal. Potential- und pressure changes can be recorded by this contraction at two different points. Motility can be studied by this method with conscious animals over weeks and month.

Implantation of a small-intestine segment turned 180 degrees has proved good for improving utilization of remaining residues of small intestine. We studied the histological changes after rotation of such a segment in young dogs and young rats. We found an increase in the diameter of the gut in the region of the rotated segment. The height of villi, the number of villi per section and the thickness of the tunica muscularis were substantially increased. Overall, the absorptive surface in the area of the rotated segment had significantly increased at the front and the back.

The food retaining and reservoir-function of the intestinal pouch seems to be characterized by the following mechanism: After being filled with a few foodboli arriving from the oesophagus, segmentary contractions arise and thus continuously propulse the food into the duodenum. In other words the interposed jejunal-loop, due to its decreased motility, rather represents a physiological restraint to the chyme passage, than a real food reservoir. For mixing, predigestion and food-storage the duodenum is more apt, as clinical studies could demonstrate. Furthermore we have shown that any type of surgical manipulation concerning the intestine has severe effects regarding its mechanical activity. This should always be kept in mind when performing Roux-en-Y-anastomosis, correctly intestinal atresia or planning a jejunal by-pass.

52% of recurrences of the group with regular check-up after curative surgery for colonic carcinoma were diagnosed within the first postoperative year compared to 38% of the patients without medical control. Diagnosis of recurrent disease was made in 75% during a regular check-up, i.e. in state of asymptomatic relapse. Patients without postoperative control attended a physician in 96% because of symptomatic recurrence. 31% of the controlled group were free of lymph node involvement or metastases at the time of secondary procedure as compared to 20% of the group without check-up. 37% of secondary operations could be performed curatively for the patients with examinations compared to 17% of the patients without control. Five-year-survival-rate after secondary procedure was 11% for the group with check-up and 0% for the patients without control. Therefore the high personal, financial and temporal expense and the handicap of patients by a regular postoperative check-up seems justified in case of colonic carcinoma.

In this study the incidence of recurrence in radical procedure for carcinoma of colon is more than 37.4%. Of 100 patients undergoing second laparotomy because of recurrence 33% could be resected curatively. The rate of recurrence was independent on sex, negatively correlated with age and positively correlated with tumor stage of former operations. Curative operations located at the ascending colon and hepatic flexure had less recurrences than others. Second operations in curative aims were twice as successful in men than in woman and equally possible in all decades. Results of recurrences of splenic flexure and transverse colon were better than other locations. Tumors of early stages relapsed later. The probability of a radical procedure in recurrence related operations was better in those cases with a long recurrence-free interval. The resectability +/- rate and tumor stage of second-look operation were depending on tumor stage in the first operation. This means further history of tumor disease is determined closely by tumor stage in the first operation.

3 cases of Wernicke's encephalopathy are reported with consecutive death in surgery patients. A long period of vomiting caused by tumors or inflammation in the upper intestinal tract, preceded. This probably causes a deficiency of thiamin. The deficiency was reinforced by high calorie parenteral nourishment. Caused by non-reversible shock and severe destruction of metabolism, only a period of 1-2 days lays between first neurological symptoms and death. in similar cases a sufficient supply of thiamine should be considered.

Slow waves on small intestine are recognized by decreasing frequency from oral to anal direction. By means of an unipolar recording we found in 65,7 percent of our probes the higher frequency on oral side, in 15,7 percent on anal side and 18,6 percent no remarkable difference between both. After the reverse of a segment of small intestine we still found a reverse of the gradient of the frequences in that way, that nearly in the same percentage the higher frequency was now to be found on the anal side. The mechanical activity of the reversed segment remains also permanently reversed. These indicate that the oral-anal frequency gradient is bound causally to the direction of mechanical activity of the small intestinal wall. They further indicate the permanent antiperistalsis of the reversed small intestinal segment.