In this population based study, 12% of the patients had symptomatic anastomotic leakage after anterior resection of the rectum. Postoperative 30-day mortality was 2.1%. Low anastomosis, pre-operative radiation, presence of intra-operative adverse events and male gender were independent risk factors for symptomatic anastomotic leakage in the multivariate analysis. There was no difference in the use of temporary stoma in patients with or without anastomotic leakage.

Summary. Background: Ximelagatran and its subcutaneous (s.c.) form melagatran are novel direct thrombin inhibitors for the prevention and treatment of thromboembolic disease. Methods: In a double-blind study, 2835 consecutive patients undergoing total hip or knee replacement were randomized to either melagatran/ximelagatran or enoxaparin. Melagatran 2 mg was started immediately before surgery; 3 mg was then administered postoperatively, followed by 24 mg of oral ximelagatran b.i.d. beginning the next day. Enoxaparin 40 mg, administered subcutaneously o.d., was started 12 h before surgery. Both treatments were continued for 8±11 days. The main ef®cacy outcome measures were major venous thromboembolism (VTE); [proximal deep vein thrombosis (DVT), non-fatal and/or fatal pulmonary embolism (PE), death where PE could not be ruled out], and total VTE (proximal and distal DVT; PE; death from all causes). DVT was detected by mandatory bilateral ascending venography at the end of the treatment period or earlier if clinically suspected. The main safety outcome was bleeding.Results: The rates of major and total VTE were signi®cantly lower in the melagatran/ximelagatran group compared with the enoxaparin group (2.3% vs. 6.3%, P 0.0000018; and 20.3% vs. 26.6%, P < 0.0004, respectively). Fatal bleeding, critical site bleeding and bleeding requiring reoperation did not differ between the two groups.`Excessive bleeding as judged by the investigator' was more frequent with melagatran/ximelagatran than with enoxaparin. Conclusions: In patients undergoing total hip or knee replacement, preoperatively initiated s.c. melagatran followed by oral ximelagatran was signi®cantly more effective in preventing VTE than preoperatively initiated s.c. enoxaparin.

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The intraperitoneal lactate/pyruvate ratio and cytokines, IL-6, IL-10, and TNF-alpha, were increased in patients who developed symptomatic anastomotic leakage before clinical symptoms were evident.

SUMMARY BackgroundBowel strictures are a major cause of morbidity, hospitalisation and surgery in Crohn's disease.

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Oral administration of the DTI ximelagatran resulted in a rapid inhibition of both thrombin generation and platelet activation in a concentration-dependent manner using a human shed blood model. The inhibition of thrombin generation by 60 mg ximelagatran was comparable to that observed with doses of r-hirudin and enoxaparin demonstrated to be effective for the treatment of acute coronary syndromes.

A previously presented robust and fast diagnostic NOx model was modified into a predictive model. This was done by using simple yet physically-based models for fuel injection, ignition delay, premixed heat release rate and diffusion combustion heat release rate.The model can be used both for traditional high temperature combustion and for high-EGR low temperature combustion.It was possible to maintain a high accuracy and calculation speed of the NOx model itself. The root mean square of the relative model error is 16 % and the calculation speed is around one second on a PC. Combustion characteristics such as ignition delay, CA50 and the general shape of the heat release rate are well predicted by the combustion model. The model is aimed at real time NOx calculation and optimization in a vehicle on the road.