Regional variation in the hedonic evaluation of lamb meat from diverse production systems by consumers in six European countries.

This paper describes the responses of consumers in six European countries (Greece, Italy, Spain, France, Iceland and United Kingdom) tasting meat from twelve different local types of lambs produced in those same six countries. Animals represented 10 breeds and crossbreeds, three sexes, several diets composed of either milk, concentrates and various forages as main ingredients and different slaughter ages, from 1 and 12 months, and carcass weights, from 5.5 to 30.4kg. Tests were conducted by 36 volunteer families in each of the six countries involved in the study. Families were asked to roast the joints using their own cooking criteria, evaluating (from "dislike extremely" to "like extremely") flavour, tenderness, juiciness and overall liking. Also the cook was asked to rate the odour during cooking. Country and lamb type and their interaction were statistically significant for all the variables analysed. Results suggest a link between the assessments of a given lamb type and the consumers' culinary background, showing clear associations between country and lamb type preferences. It was possible to separate, independently of the country, different groups of families with similar preferences. Five family groups, which included 88 families (40.74%), had a clear Mediterranean origin and preferred types of lamb fed either milk or mainly concentrate diets. Seven family groups, which included 93 families (43.06%) with a clear northern origin, preferred types reared on grass or with grass included in the diet. The rest of the groups (four) that included 35 families (16.20%) had no clear composition (northern or Mediterranean), and they had a wider taste preference. It can clearly be seen that there are two categories of consumers of lamb in the analysed European market: those who prefer "milk or concentrate taste" and those who prefer "grass taste".

In situ surface oxidation study of a planar Co/SiO2/Si(100) model catalyst with nanosized cobalt crystallites under model Fischer-Tropsch synthesis conditions.

The oxidation of nanosized metallic cobalt to cobalt oxide during Fischer-Tropsch synthesis (FTS) has long been postulated as a major deactivation mechanism. In this study a planar Co/SiO(2)/Si(100) model catalyst with well-defined cobalt crystallites, close to the threshold value reported for oxidation in the literature (4-10 nm), was prepared by the spin coating method. The planar Co/SiO(2)/Si(100) model catalyst was characterized with atomic force microscopy, X-ray photoelectron spectroscopy, and Rutherford backscattering. The surface oxidation behavior of the nanosized metallic cobalt crystallites of 4-5 nm was studied using in situ near-edge X-ray absorption fine structure under model FTS conditions, i.e., H(2)/H(2)O = 1, P(Total) = 0.4 mbar, and 150-450 degrees C. No surface oxidation of metallic cobalt was observed under these model FTS conditions over a wide temperature range, i.e., 150-400 degrees C.

Perimysial collagen crosslinking and meat tenderness in Belgian Blue double-muscled cattle.

The relationship between intramuscular collagen and five collagen crosslink concentrations, and the tenderness of meat from Belgian Blue normal, heterozygous double-muscled (DM) and homozygous DM cattle was investigated using M. semitendinosus (St) and M. gluteobiceps (Gb). The histidinohydroxymerodesmosine (HHMD) concentration (per mol collagen) in St was less in DM animals than normal animals. Concentrations (per gram of wet meat) of HHMD and Erlich chromogen (EC) in Gb, and HHMD, EC, dihydroxylysinorleucine (DHLNL) and hydroxylysinorleucine (HLNL) in St were also lower in DM animals than normal animals. Shear force of raw meat was significantly greater in normal animals than DM for both muscles; cooked meat shear force was greater in the normal animals for the Gb muscles only, showing a good correlation with sarcomere length. Most correlations between shear force and collagen or crosslink concentrations were not significant and those that were highly significant were generally weak.

Post mortem muscle metabolism and meat quality in three genetic types of turkey.

1. A standard (FG, fast-growing), a black local or 'label', type (SG, slow-growing) turkey line, and the crossbreed between these two lines were compared for muscle post-mortem metabolism and related meat quality traits. 2. Ninety male turkeys (30 of each genetic type) were raised under the same experimental conditions until slaughter at 16 weeks of age. 3. Live weights at 16 weeks of age differed significantly (7.8, 6.0 and 4.2 kg, for the FG, crossbred and SG lines, respectively). Collagen content of Pectoralis superficialis (PS) muscle was higher in SG birds than in the other two types. 4. The rate of post-mortem glycogen depletion and lactate accumulation in PS and Ilio tibialis (IT) muscles were similar in the 3 lines, as were the rate and extent of post-mortem pH fall in PS muscle. In IT muscle, however, SG birds showed a slight but significantly faster pH decline. 5. Colour measurements indicated a paler breast muscle and a higher degree of myoglobin oxidation in SG birds at 24 h post mortem, than in both other lines. But these differences had disappeared after 4 and 7 d post mortem 6. SG birds showed higher drip loss and instrumentally-assessed toughness in breast muscle, compared with crossbred and FG birds. FG birds, however, had the lowest yield of breast meat after curing-cooking. 7. No marked differences in post-mortem metabolism were found between the three lines. However, differences in water-holding capacity of fresh and cured-cooked meat suggest that factors other than the rate and extent of post-mortem pH fall may contribute to the respective characteristics of these lines.

Tenderization of beef by lactic acid injected at different times post mortem.

The potential to tenderize beef muscles by the injection of lactic acid (0.5 M, 10% w/w) was studied using the pectoralis profundus muscle from cull cows. The injection was performed either 1 h (pre rigor) or 24 h (post rigor) post mortem, and the meat was stored for 2 or 14 days post mortem. Both treatments caused a rapid pH drop to around 5.0 within 4 h of injection. Other effects were: (1) an accelerated release of lysosomal enzymes into the cytosol; (2) a greater degradation of myosin heavy chains; (3) ultrastructural alterations of the myofibrils which included a general weakening or rupture in the M-lines and, to a lesser extent, in the I-bands; (4) a decreased heat stability of perimysial collagen indicated by a lower insoluble collagen content, lower differential scanning calorimetry transition temperature, and lower transition temperatures in isometric tension tests on muscle strips. The lactic acid injections improved significantly the textural traits of the meat (shear value, tensile strength, sensory scores) at 2 days post mortem with little further improvement when storage was extended to 14 days post mortem. Changes in texture were of similar amplitude at both post mortem injection times. The tenderization mechanisms of lactic acid injection are discussed.

Relationships between muscle characteristics and meat quality traits of young Charolais bulls.

Charolais bull calves (106) were used to study the variability in meat quality attributes in relation to the variability in muscle characteristics in the Longissimus thoracis (LT) muscle. The variability in traits was adjusted either to constant age or constant weight at slaughter and thus originated only from differences between animals born, reared and fattened in the same location. The following meat quality attributes were measured: the strength of the myofibrillar resistance to a 20% compression strain measured on the raw meat 2, 7 and 21 days post mortem; and taste panel scores of tenderness (initial and overall), flavour and juiciness of steaks grilled to a 55°C core temperature 6 or 15 days post-mortem. The following muscle characteristics were measured 24 h after slaughter: pH, dry matter, protein, lipid, heme iron and collagen contents, collagen solubility, LDH and ICDH activity, the proportion of slow twitch myosin heavy chain, the mean muscle fibre area and the mean sarcomere length. One fourth to one third of the variability of 2 day mechanical strength and 15 day tenderness or flavour scores were related to the variability in muscle characteristics. Tenderness and strength measurements were predominantly related to the muscle fibre area, collagen characteristics and energetic metabolic activity. Dry matter content was the principal muscle characteristic related to flavour.

Effects of high-intensity high-frequency ultrasound on ageing rate, ultrastructure and some physico-chemical properties of beef.

High-intensity and high-frequency ultrasound was tested for its ability to accelerate meat ageing and increase beef tenderness. Samples (≈50g) of semimembranosus muscles from 8 cull cows were assigned to ultrasonic treatment (2.6MHz; 10W/cm(2); 2 ×15s) either pre-rigor (day 0, pH 6.2) or post-rigor (day 1, pH 5.4). When applied pre-rigor, ultrasound induced a slight delay in rigor mortis onset, a stretching (12-15%) of the sarcomeres (p<0.05), an ultrastructural alteration in the Z-line region and an immediate increase (around 30%) in the release of calcium in the cytosol (p<0.05). However, no conclusive effect on meat ageing rate was observed. Post-rigor ultrasonic treatment did not induce any structural modification but slightly improved the ageing index after 6 days (p<0.05). However, no improvement in the final (day 14) ageing index was observed compared to the controls. As ultrasound had also no effect on the thermal stability of collagen, at both postmortem times, no improvement in meat tenderness can be expected under the conditions used.

Meat quality traits in the emu (Dromaius novaehollandiae) as affected by muscle type and animal age.

Meat quality traits were determined in the major muscles of the emu (Dromaius novaehollandiae) at different slaughter ages (6, 10, 14, 17 or ≥20 months). A mean ultimate pH value of 5.5 was reached within around 3 h post mortem, but this value was 6.1 in animals that had suffered a preslaughter stress (transportation and fasting). The collagen and pigment contents varied widely among the muscles. The protein and pigment contents increased with animal age, but this effect was perceptible only between 6 and 14 months. The other chemical constituents were little affected by muscle type or animal age. The intense red colour of emu meat, due to a high pigment content, was very sensitive to oxidation, thus limiting the storage of fresh meat under aerobic conditions to short periods of time. Despite a rapid post-mortem tenderization (≤24 h), the residual myofibrillar strength obtained after extended ageing remained intermediate between those reported for chicken and beef. The tenderness of meat, cooked to 60 °C, differed between muscles and decreased with increasing age, thus reflecting the changes occuring in the concentration and in the heat stability of the intramuscular connective tissue.

Synergy, activity and tolerability of zidovudine and interferon-alpha in patients with symptomatic HIV-1 infection: AIDS Clincal Trial Group 068.

Thirty-four subjects with symptomatic HIV-1 infection, p24 antigenaemia, and CD4 cell counts > 200/mm3 were randomly assigned to receive treatment with either zidovudine (ZDV) orally, interferon-alpha (IFN-alpha) subcutaneously, or both at respective low (200 mg ZDV/ 2 million international units IFN-alpha (MIU)), middle (400 mg/4 MIU) or high (600 mg/6 MIU) daily dose levels for 12 weeks. Thereafter, all patients received combination therapy at the initially assigned dose level to a total of 96 weeks. This design permitted analysis by the combination index (CI) method, which demonstrated antiretroviral synergy between ZDV and IFN-alpha with respect to p24 antigen suppression. Over the first 12 weeks, combination therapy was acceptably tolerated, more so than IFN-alpha monotherapy, and it was significantly more active in suppressing antigenaemia than either of the monotherapies. Similarly, the high-dose combination was the most active dose level over weeks 12 to 96. Combination ZDV/IFN-alpha at the optimal dose level defined by this trial merits further study. In addition, the CI design strategy employed here may be useful for the investigation of new antiretroviral combinations.

Expression of CD44 and the pattern of CD44 alternative splicing in uveal melanoma.

In cutaneous melanoma, the standard CD44 molecule is abundantly expressed, whereas the expression of certain splice variants is related to tumour progression and to the metastatic potential of the cell line. In the present study we have investigated the expression of CD44 and the pattern of CD44 alternative splicing in uveal melanoma in relation to the cell type, diameter and invasiveness of the tumour. All uveal melanomas strongly stained with antibodies to the standard portion of CD44. No expression of the CD44 variant (v) exon CD44v7 was found, whereas v5, v6 and v10 were expressed (in 2/12, 5/12 and 8/12 cases, respectively). No correlation was observed between expression of particular splice variants and cell type, tumour diameter or invasion of the sclera or Bruch's membrane. All three uveal melanoma cell lines tested were strongly CD44 positive and expressed low levels of v6-containing isoforms at the cell surface, but v5, v7 and v10 were absent. Our results show that CD44 is strongly expressed in uveal melanoma and that the pattern of CD44 alternative splicing is similar to that observed in cutaneous melanoma. However, in uveal melanoma this alternative splicing does not appear to be related to prognostic parameters.

Emergence of alpha 5 beta 1 fibronectin- and alpha v beta 3 vitronectin-receptor expression in melanocytic tumour progression.

Cell adhesion is crucial in the process of tumour progression. As integrins are important receptor molecules involved in cell adhesion, we studied the distribution of the alpha 1-6, alpha v, alpha IIb, beta 1, beta 3, and beta 4 integrin subunits in tissue sections of common naevocellular naevi (n = 22), dysplastic naevi (16), thin (24) and thick primary cutaneous melanomas (28), and melanoma metastases (25). We found correlated expression of alpha 1/alpha 2, of alpha 4/alpha 5/beta 3, and of alpha 6/beta 4. Decrease of alpha 6 and beta 4, and increase of alpha 4 and alpha v were found to be correlated with melanoma progression. Furthermore, expression of alpha 5 and beta 3 was detected only in primary melanoma and melanoma metastasis. Our findings indicate that during melanoma progression alterations in integrin expression occur, the most striking being emergence of alpha 5 beta 1 fibronectin and alpha v beta 3 vitonectin receptor.

[Cardiopulmonary capacity in patients before and after prosthetic valve replacement]. / Kardiopulmonale Leistungsfähigkeit bei Patienten vor und nach prothetischem Klappenersatz.

In this study we wanted to investigate if noninvasive cardiopulmonary exercise testing can be securely, accurately applied in patients with acquired cardiac valve disease pre- and postoperatively with any convenience. Furthermore, we looked if the cardiopulmonary exercise capacity (anaerobic threshold, etc.) was improved postoperatively (3 and 6 months) in 15 patients suffering from severe mitral valve disease as compared to the preoperative condition. The symptom-limited cardiopulmonary exercise testing was performed on a bike in a semi-supine position using a ramp program (+20 W/min). The following parameters were continuously monitored, and the breath-by-breath gas exchange values documented: cardiocirculatory parameters (heart rate; blood pressure; surface ECG; exercise capacity in Watts); gas-exchange parameters (O2-uptake VO2; CO2-production VCO2; respiratory anaerobic threshold VO2 AT; gas-exchange ratio VCO2/VO2; O2-pulse VO2/HR; aerobic capacity delta VO2/delta WR) and ventilatory parameters (respiratory rate; tidal volume Vt; minute ventilation VE; equivalent for O2: VE/VO2 and CO2: VE/VCO2). The 155 cardio-pulmonary exercise tests in 115 patients were practicable, safe (no emergency case) and accurate. In 100 patients late postoperatively (68.3 +/- 53.0 -102.9 +/- 41.2 months) after aortic or mitral valve replacement or both without signs of significant hemolysis or prosthetic valve dysfunction the NYHA classification was too imprecise to characterize the actual exercise capacity of the patients (e.g., NYHA class II: Weber class B to E). Patients with aortic valve prosthesis had a significantly better anaerobic threshold (57.4 +/- 19.1% pred. value max. VO2) as compared to those with mitral valve replacement (mean: 35.9% pred. value max. VO2).(ABSTRACT TRUNCATED AT 250 WORDS)

[Methodologic aspects of modern, computerized ergospirometry (CPX): ramp program, constant workload test and CO2 rebreathing method]. / Methodische Aspekte der modernen, computerisierten Ergospirometrie (CPX): Rampenprogramm, konstanter Belastungstest und CO2-Rückatmungsmethode.

The cardiopulmonary exercise testing (CPX) is a non-invasive method for the evaluation of the cardiopulmonary exercise capacity. Based upon the recent technical progress in gas analysers and personal computers today it is possible to perform CPX with acceptable time consumption, high practicability and high reproducibility of the results in many clinical areas. CPX is realized on a bike or on a treadmill. In bicycle CPX a ramp program (increase of x watts per minute) or a constant workload test (p.e. with 75% of the watts at anaerobic threshold) are performed. Furthermore, an estimation of the cardiac output using CO2-rebreathing method can be realized during a ramp program or a constant workload test. In this paper, also the CPX parameters of the ramp program, the constant workload test and the CO2-rebreathing method are defined and explained. The normal values of CPX are dependent of age, sex, body weight and exercise program. This should be kept in mind in interpreting the measured CPX data. Additionally, the performance of a routine CPX will be reported. Furthermore, the accuracy of the CPX parameters and the potential influences on the data will be discussed. Finally, problems during measurements and their analysis will be clarified.

[Cardiopulmonary exercise capacity in VVI stimulation in patients with high grade AV block]. / Kardiopulmonale Belastbarkeit unter VVI-Stimulation bei Patienten mit höhergradigen AV-Blockierungen.

VVI-pacemaker patients with high-grade atrioventricular block were subjected to cardiopulmonary exercise testing. An interindividual comparison was made between patients with intermittent intrinsic rhythm (n = 9) and patients with permanent VVI-stimulation (n = 15). Patients with intermittent sinus rhythm on exercise had no significant increase in exercise capacity as quantified by the O2-uptake at the anaerobic threshold. An intermittent sinus rhythm is of no relevance to therapeutic decisions, such as choosing the appropriate pacing mode. Exercise capacity is determined by multiple, partly peripheral factors.

[Methodologic and clinical comparison of four different ergospirometry systems]. / Methodischer und klinischer Vergleich von vier verschiedenen Ergospirometriesystemen.

The clinician who uses cardio-pulmonary exercise testing (CPX) systems relies on the technical informations from the device producers. In this paper, the practicability, the accuracy and the safety of four different, available CPX systems are compared in the clinical area, using clinically orientated criteria. The exercise tests were performed in healthy subjects, in patients with cardiac and/or pulmonary disease as well as in young or old people. The comparison study showed, that there were partially large differences in device design and measurement accuracy. Furthermore, our investigation demonstrated that beneath repetitive calibrations of the CPX systems a frequent validation of the devices by means of a metabolic simulator is necessary. Problems in calibration can be caused by an inadequate performance or by unclean calibration gases. Problems in validation can be due to incompatibility of the CPX device and the validator. The comparison study of the four different systems showed that in the future standards for CPX testing should be defined.

[Cardiopulmonary capacity in patients with coronary heart disease]. / Kardiopulmonale Leistungsfähigkeit bei Patienten mit koronarer Herzkrankheit.

Cardiopulmonary exercise testing (CPX) allows a non-invasive control of the cardiopulmonary exercise capacity. In this study, we wanted to investigate if the CPX can be securely, practicably, and accurately performed in patients with invasively documented coronary heart disease (CHD). Furthermore, we wanted to find out the clinical value of CPX in CHD diagnosis. The CPX measurements (symptom-limited; ramp program with 20 Watts increase/min; semi-supine position; continuous registration of the cardio-circulatory parameters (HR, RR, ECG), of the gas exchange parameters (O2, CO2) and of the ventilation) in 101 patients have shown that CPX is secure, accurate, and practicable. The day-to-day reproducibility is high (r > 0.8). The respiratory anaerobic threshold can be manually evaluated by means of the PET O2 criterion in 95% of the cases. The CCS-classification of angina pectoris could not accurately describe the cardiopulmonary exercise capacity as compared to the Weber-classification. The disadvantage of the Weber-classification is that it does not respect the age-, sex- and weight-dependent differences of the normal values. Our own data and results from the literature demonstrate that the anaerobic threshold, the maximum VO2 and the maximum O2-pulse are the more reduced the more coronary arteries are involved, the more reduced the left ventricular function is. But, nevertheless, the range of values shows large overlaps so that an exact differentiation, based upon these parameters, is not possible. Patients with similar functional results or degree of reduced exercise capacity have different morphological alterations. Most patients demonstrated typical ischemic cascade with anaerobic threshold, ST-segment alterations, angina pectoris and, finally, reduced max. VO2. In conclusion, CPX does not replace the traditional methods of non-invasive and invasive ischemia detection, but enables secure, practicable, and accurate measurements of the individual cardiopulmonary exercise capacity and the interaction between muscles, heart, circulation, and lungs. Possibly, CPX can be used in the near future for identifying CHD patients with low, medium or high risk.

Integrin expression in uveal melanoma differs from cutaneous melanoma.

PURPOSE: During the process of metastasis, changes in cell-cell and cell-matrix contacts occur; therefore, expression of integrins, a superfamily of adhesion molecules, may be important. Expression of integrins has been studied extensively in cutaneous melanoma. Because it is known that uveal melanoma has a metastatic behavior different from cutaneous melanoma, the authors investigated integrin expression in uveal melanoma. METHODS: The authors used monoclonal antibodies recognizing integrin subunits alpha 1-6, alpha v, beta 1, and beta 4 and integrins alpha v beta 3 and alpha v beta 5 on frozen sections of 32 human primary uveal melanomas and 4 metastases, followed by an avidin-biotin-peroxidase complex-immunoperoxidase technique. RESULTS: As in cutaneous melanoma, alpha 4 expression was rare, but most lesions expressed alpha 3 and alpha 6. In contrast to cutaneous melanoma, in which alpha 2 is well expressed in most lesions and alpha 5 is expressed only in a small percentage of lesions, alpha 2 expression was rare in uveal melanoma and alpha 5 expression was found in all lesions. A major difference was observed with regard to the alpha v beta 3 vitronectin receptor. In contrast to cutaneous melanoma, in which alpha v beta 3 is expressed in advanced primary melanomas and metastases, alpha v beta 3 was not detected in any of the primary uveal melanomas, but all lesions strongly expressed alpha v beta 5. CONCLUSIONS: Integrin expression in uveal melanoma cannot be correlated with cell type or invasiveness. In contrast to cutaneous melanoma, it seems that determination of the integrin expression profile is not suitable for categorizing uveal melanomas as less malignant and highly malignant lesions.

[Effect of a single blood donation on ergo-spirometrically determined cardiopulmonary performance capacity of young healthy probands]. / Einfluss einer einmaligen Blutspende auf die ergospirometrisch bestimmte kardiopulmonale Leistungsfähigkeit bei jungen gesunden Probanden.

Autologous blood donation is an established method for an effective reduction of the blood-transfusion-associated infectious diseases (hepatitis, HIV infections, etc.) in elective surgical procedures. The aim of the study was to investigate the effects of a blood donation of 450 ml on the cardiopulmonary exercise capacity in 16 apparently healthy young subjects. The 24 cardiopulmonary exercise tests were performed on a bicycle ergometer (Ergoline 900) in a semisupine position, using a ramp program (+20 watt/min) 1-7 days before and 2 days after blood donation. By means of continuous breath-by-breath measurements of the gas exchange (VO2, VCO2) and ventilation parameters (minute ventilation VE), as well as of the routine parameters (heart rate, blood pressure, work rate) during incremental exercise the respiratory anaerobic threshold VO2AT, the maximum VO2 (VO2max and the maximal working capacity (max. WR) were determined. Serum hemoglobin concentration was significantly (p < 0.0005) reduced from 14.5 +/- 1.0 to 13.0 +/- 1.4 g/dl after blood donation. The ventilatory anaerobic threshold (before: 68.5 +/- 17.0; after: 52.0 +/- 20.3% pred. max. VO2), the max. VO2 (before: 124.2 +/- 21.3; after: 110.2 +/- 23.2% pred. max. VO2) and max. WR (before: 287.1 +/- 75.6; after 265.5 +/- 76.2 watt) fell significantly (VO2AT: p < 0.0005; max. VO2: p < 0.0005; max. WR: p < 0.025). Heart rate and minute ventilation showed a steeper increase (dHR/dWR: before: 0.31 +/- 0.06; after: 0.34 +/- 0.05 beats/min/watt; dVE/dWR: before: 0.29 +/- 0.05; after: 0.31 +/- 0.05 l/watt) in relation to the increase in WR after blood donation as compared to the test before.(ABSTRACT TRUNCATED AT 250 WORDS)

[Local vascular complications in heart catheter studies]. / Lokale Gefässkomplikationen bei Herzkatheteruntersuchungen.

Over a period of 30 months (1. 1. 89-30. 6. 91) 3516 patients who had either a diagnostic (2718) or therapeutic (798) heart catheterization were followed for local vascular complications. 774 patients were investigated prospectively. The following complications were observed in declining frequency: 1. relevant haematoma, 2. pseudoaneurysm, 3. arteriovenous fistula, 4. arterial thrombosis/dissection, 5. venous thrombosis, 6. rupture of the vessel, 7. local infection. The total complication rate was 2.22%. With prospective investigation it was significantly higher (3.23%) than with retrospective investigation (1.93%). The complication rate was also significantly higher in therapeutical procedures (3.76%) than in diagnostic catheterizations (1.76%). Factors associated with a significantly higher incidence of local vascular complications were age (p < 0.01), female gender (p < 0.025), manifest arterial hypertension (p < 0.005), aortic regurgitation (p < 0.1), peri-interventional medication with acetylsalicylic acid and full dose heparin (p < 0.001), full dose heparin alone (p < 0.001) or fibrinolysis-therapy (p < 0.025). Relevant technical factors were: duration of the procedure, duration of the placement of the catheter-sheath, French size of the catheter, left femoral access, arterial and venous access at one extremity. In about half of the cases the treatment of the complications was conservative, in the other half it was surgical (51%). In relation to all surgically treated patients the percentage of emergency operations was 25%, the percentage of reoperations was 15%.