Red blood cell exchange in an emergency in sickle cell disease.

Red blood cell exchange (RBCEx) has become a standard therapy to remove abnormal red blood cells (RBCs) in patients with sickle cell disease (SCD). In the last few decades, numerous RBCEx procedures have been performed chronically during regular programs, while numerous procedures have also been performed in an emergency for several indications, this therapeutic option being very efficient in vital and emergency situations. In both groups of indications, large amounts of sickle RBCs have to be removed, which requires great precision and the setting of specific hematological targets. The aim of this review is to discuss the aims, clinical and biological targets, and the requirements and precautions when performing RBCEx in an emergency. Moreover, we analyze how improvement of the techniques as well as the clinical and biological targets has led to optimization of the procedures in emergency settings. We also consider the outstanding issues that require additional investigation.

Eryptosis and hemorheological responses to maximal exercise in athletes: Comparison between running and cycling.

We compared the effects of cycling and running exercise on hemorheological and hematological properties, as well as eryptosis markers. Seven endurance-trained subjects randomly performed a progressive and maximal exercise test on a cycle ergometer and a treadmill. Blood was sampled at rest and at the end of the exercise to analyze hematological and blood rheological parameters including hematocrit (Hct), red blood cell (RBC) deformability, aggregation, and blood viscosity. Hemoglobin saturation (SpO2), blood lactate, and glucose levels were also monitored. Red blood cell oxidative stress, calcium content, and phosphatidylserine exposure were determined by flow cytometry to assess eryptosis level. Cycling exercise increased blood viscosity and RBC aggregation whereas it had no significant effect on RBC deformability. In contrast, blood viscosity remained unchanged and RBC deformability increased with running. The increase in Hct, lactate, and glucose concentrations and the loss of weight at the end of exercise were not different between running and cycling. Eryptosis markers were not affected by exercise. A significant drop in SpO2 was noted during running but not during cycling. Our study showed that a progressive and maximal exercise test conducted on a cycle ergometer increased blood viscosity while the same test conducted on a treadmill did not change this parameter because of different RBC rheological behavior between the 2 tests. We also demonstrated that a short maximal exercise does not alter RBC physiology in trained athletes. We suspect that exercise-induced hypoxemia occurring during running could be at the origin of the RBC rheological behavior differences with cycling.

Laser-induced fluorescence and FT-Raman spectroscopy for characterizing patinas on stone substrates.

This article reports on a compositional investigation of stone patinas: thin colored layers applied for protective and/or aesthetic purposes on architectural or sculptural substrates of cultural heritage. The analysis and classification of patinas provide important information of historic and artistic interest, as their composition reflects local practices, the availabilities of different materials, and the development of technological knowledge during specific historical periods. Model patinas fabricated according to traditional procedures and applied onto limestone, and a historic patina sample from the main façade of the San Blas Monastery in Lerma (a village in the province of Burgos, Spain), were analyzed by laser-induced fluorescence and Fourier transform Raman spectroscopy. The results obtained demonstrate the ability of these two analytical techniques to identify the key components of each formulation and those of the reaction products which result from the chemical and mineralogical transformations that occur during aging, as well as to provide information that can aid the classification of different types of patinas.

Synthesis, Photocatalytic, and Antifungal Properties of MgO, ZnO and Zn/Mg Oxide Nanoparticles for the Protection of Calcareous Stone Heritage.

More recently, the biological colonization of stone heritage and consequently its biodeterioration has become the focus of numerous studies. Among all microorganisms, fungi are considered to be one of the most important colonizers and biodegraders on stone materials. This is why the development of new antifungal materials requires immediate action. ZnMgO nanoparticles (NPs) have several exciting applications in different areas, highlighting as an efficient antimicrobial agent for medical application. In this research, the application of Zn-doped MgO (Mg1-xZnxO, x = 0.096) NPs obtained by sol-gel method as antifungal coatings on dolomitic and calcitic stones has been explored as a means to develop effective protective coatings for stone heritage. Moreover, the photocatalytic and antifungal activity of Mg1-xZnxO NPs were comparatively studied with single ZnO and MgO NPs. Thus, compared to the MgO and ZnO nanomaterials, the Mg1-xZnxO NPs exhibited an enhanced photocatalytic activity. After UV irradiation for 60 min, 87% methylene blue was degraded over Zn-doped MgO NPs, whereas only 58% and 38% of MB was degraded over ZnO and MgO NPs, respectively. These nanoparticles also displayed a better antifungal activity than that of single pure MgO or ZnO NPs, inhibiting the growth of fungi Aspergillus niger, Penicillium oxalicum, Paraconiothyrium sp., and Pestalotiopsis maculans, which are especially active in the bioweathering of stone. The improved photocatalytic and antifungal properties detected in the Mg1-xZnxO NPs was attributed to the formation of crystal defects by the incorporation of Zn into MgO. The application of the MgO- and Zn-doped MgO NPs as protective coatings on calcareous stones showed important antifungal properties, inhibiting successfully the epilithic and endolithic colonization of A. niger and P. oxalicum in both lithotypes, and indicating a greater antifungal effectiveness on Zn-doped MgO NPs. The use of Zn-doped MgO NPs may thus represent a highly efficient antifungal protection for calcareous stone heritage.

Gas phase hydrogen deuterium exchange reactions of a model peptide: FT-ICR and computational analyses of metal induced conformational mutations.

We utilized gas phase hydrogen/deuterium (H/D) exchange reactions and ab initio calculations to investigate the complexation between a model peptide (Arg-Gly-Asp[triple bond]RGD) with various alkali metal ions. The peptide conformation is drastically altered upon alkali metal ion complexation. The associated conformational changes depend on both the number and type of complexing alkali metal ions. Sodium has a smaller ionic diameter and prefers a multidentate interaction that involves all three amino acids of the peptide. Conversely, potassium and cesium form different types of complexes with the RGD. The [RGD + 2Cs - H]+ species exhibit the slowest H/D exchange reactivity (reaction rate constant of approximately 6 x 10(-13) cm3molecule(-1)s(-1) for the fastest exchanging labile hydrogen with ND3). The reaction rate constant of the protonated RGD is two orders of magnitude faster than that of the [RGD + 2Cs - H]+. Addition of the first cesium to the RGD reduces the H/D exchange reaction rate constant (i.e., D0) by a factor of seven whereas sodium reduces this value by a factor of thirty. Conversely, addition of the second alkali metal ions has the opposite effect; the rate of D0 disappearance for all [RGD + 2Met - H]+ species (Met[triple bond]Na, K, and Cs) decreases with the alkali metal ion size.

Two treatments of eye bank donor corneas.

The many published studies on sterile procedures used by eye banks have included none until now on ways to optimize sterile handling of corneas procured in the morgues of forensic pathologists. The present study sought to discover if fewer positive cultures would be reported at the time of surgery from corneas which had been treated with an entire bottle of antibiotic (10 ml), as opposed to the more usual method of instilling 10 to 12 drops of antibiotic prior to the corneal excision. The result showed a marginal improvement of 3.1% fewer positive cultures when the entire bottle of antibiotic was used. The findings bolstered the theory that thorough and vigorous washing of the conjunctival sac prior to corneal removal is important and that positive cultures are no more likely when the cornea is shipped away from the eye bank than when used locally.

Morphologic changes of K-Sol preserved human corneas.

Supplementation of tissue culture medium with chondroitin sulfate has been shown to enhance donor corneal preservation. We assessed the efficacy of one of these chondroitin-supplemented media (K-Sol) in comparison with McCarey-Kaufman (MK) medium in maintaining corneal cellular morphology. Thirty-six human corneas, obtained within 8.6 h after death, were placed into K-Sol medium for up to 20 days preservation, and five paired control corneas were placed into MK medium for up to 6 days preservation. Specular photomicrographs were obtained every second to third day for a predetermined storage interval, then studied morphologically in a masked protocol by light microscopy, transmission electron microscopy, and scanning electron microscopy. Endothelial cell loss by specular microscopy averaged 5.8% after 1 week (6 to 8 days) and 7.4% after 13 days in K-Sol medium. Epithelial changes were erratic throughout the 20 day K-Sol preservation period. However, substantial keratocyte changes occurred after 10 days, and endothelial morphology uniformly deteriorated after 17 days. The morphologic data suggest that human corneas may be able to be preserved in K-Sol medium at 4 degrees C for up to 10 days but should be cautiously used thereafter.

Methane oxidation and formation of EPS in compost: effect of oxygen concentration.

Oxygen concentration plays an important role in the regulation of methane oxidation and the microbial ecology of methanotrophs. However, this effect is still poorly quantified in soil and compost ecosystems. The effect of oxygen on the formation of exopolymeric substances (EPS) is as yet unknown. We studied the effect of oxygen on the evolution of methanotrophic activity. At both high and low oxygen concentrations, peak activity was observed twice within a period of 6 months. Phospholipid fatty acid analysis showed that there was a shift from type I to type II methanotrophs during this period. At high oxygen concentration, EPS production was about 250% of the amount at low oxygen concentration. It is hypothesized that EPS serves as a carbon cycling mechanism for type I methanotrophs when inorganic nitrogen is limiting. Simultaneously, EPS stimulates nitrogenase activity in type II methanotrophs by creating oxygen-depleted zones. The kinetic results were incorporated in a simulation model for gas transport and methane oxidation in a passively aerated biofilter. Comparison between the model and experimental data showed that, besides acting as a micro-scale diffusion barrier, EPS can act as a barrier to macro-scale diffusion, reducing the performance of such biofilters.

[Anterograde insertion of ureteral catheter]. / Inserción anterógrada de catéter ureteral.

We report twenty-four patients with urinary obstruction, in which twenty-seven antegrade ureteral stent (double J) insertions were attempted (in six patients the obstruction was bilateral and in three other patients we failed). In all of them access to the urinary tract was through a nephrostomy catheter, in seventeen cases we proceeded to insert the antegrade catheter immediately after percutaneous nephrostomy and in ten remaining cases we achieved in a second try after carrying nephrostomy and failing a conventional retrograde approach to ureteral stent insertion. We got a 90-per cent success rate. A case of perirrenal hematoma occurred after applying a nephrostomy. It was the only relevant complication. In conclusion we consider that the antegrade ureteral stent insertion is a good alternative when, under several circumstances, the conventional retrograde insertion fails.

[Retroperitoneal germ cell tumor]. / Tumor de células germinales retroperitoneal.

We report a case of retroperitoneal extragonadal germ-cell tumor in an 17 years old patient who presented with aedema and pain in left inferior extremity asociated with hemopthysis caused by pulmonar metastasis, who was treated with chemotherapy and resection of residual mass and pulmonary nodes. Dyagnosis was stableshed by fine neadle aspiration biopsy of the wass. We comment on the difficult of stableshing differential dyagnosis between retroperitoneal extragonadal germ-cell tumor and metastasis of a testicular tumor. Dyagnosis is stableshed by the finding of a histologically malignant germ-cell tumor with normal testis. We considered physical examination and ecographyc exploration enough for a correct dyagnosis.

[Value of prostate-specific antigen density and transitional-zone prostate-specific antigen density in the diagnosis of prostate cancer]. / Valor de la densidad del antígeno prostático específico y de la densidad del antígeno prostático específico de la zona transicional en el diagnóstico del cáncer de próstata.

INTRODUCTION: With serum prostate specific antigen (PSA) levels of 4.1 to 10 ng/ml a significant number of patients are unnecessary subjected to biopsy. We try to determine if the calculation of prostate specific antigen density (PSAD) and prostate specific antigen density of the transition zone (PSADTZ) improve the capacity to discriminate between non-malignant disease and prostate cancer. METHODS: A prospective study including 314 males with PSA levels between 4.1 and 10 ng/ml is reported. Transrectal ultrasonography and prostatic biopsy were performed in all of them and total prostate and transition-zone volumes were calculated. PSA density and PSA density of the transition zone were calculated for each patient. Receiver operating characteristics (ROC) curves for PSA, PSAD and PSADTZ were constructed for all the patients and for those patients with digital rectal examination unsuspicous of malignancy, determining the sensitivity and specificity for several cutoff values. RESULTS: The area under the curve for both, PSAD and PSADTZ, were greater than for PSA (p < 0.05), without any significant differences between PSADTZ and PSAD. The cutoff value of greatest diagnostic efficiency for PSAD was 0.17 ng/ml/cc (71.4% sensitivity and 55.7% specificity), while it was 0.41 ng/ml/cc for DPSATZ (70% sensitivity and 61.5% specificity). For those cases of normal digital rectal examination, no differences were observed between PSA and PSAD but they were between PSA and PSADTZ. In any event, the area under ROC curves was always less than 0.7, and, in order to avoid a large number of biopsies (high specificity), a large number of cancers are left without diagnosis (low sensitivity). CONCLUSIONS: We conclude that PSAD and PSADTZ are not excessively useful for adequately discriminating between patients with prostate cancer and those with non-malignant disease, particularly when digital rectal examination is normal.

[Percentage of tumor in prostatic biopsy cylinders as prognosis factor of organ-limited disease in candidates for radical prostatectomy]. / El porcentaje de tumor en cilindros de biopsia prostática como factor pronóstico de enfermedad órganoconfinada en pacientes candidatos a prostatectomía radical.

UNLABELLED: The present study analyzes the prognostic influence of tumor percentage in cylinders of prostatic biopsy in this patient group. MATERIAL AND METHODS: Retrospective study of 68 patients with a diagnosis of adenocarcinoma, clinical stage T1-T2 who had undergone a radical prostatectomy from May 1997 to october 2000. Following preoperative parameters were analyzed: age, PSA, clinical staging, Gleason and six cylinders of ultrasonography-leaded transrectal prostatic biopsy, studying the amount of positive biopsies, the tumor percentage of the total amount of biopsies and the maximum percentage of tumor in one cylinder. Univariate (square-Chi, Student t) and multivariate (multiple logistic regression) analysis are performed in order to study the relationship of these parameters with the presence or not of an organ-located disease. RESULTS: An organ-located disease was shown at 44 patients through the piece of radical prostatectomy. The univariate analysis gave all studied parameters, except age, a prognostic value of the existence or not of an organ-located disease. In the multivariate analysis only the total percentage of biopsy tumors (p = 0.0002) and PSA (p = 0.005) behaved as independent prognostic factors. CONCLUSION: Tumor percentage in prostatic biopsy seems to be a factor with a high predictive value of an organ-located disease, possibly because it is an index of tumoral volume.

Sulfolane attenuation by surface and subsurface soil matrices.

This study was undertaken to evaluate sulfolane (tetrahydrothiophene-1, 1-dioxide) attenuation by soil and subsurface materials collected from a sour gas plant site using batch equilibration systems. The analyzed sample materials used in this study showed a wide range in terms of their selected physical and chemical properties. The reaction of sulfolane with the sample materials was fast initially and followed by slower rates at longer times. There was not much increase in the amount of sulfolane sorbed after about 5 hours of equilibration time irrespective of the temperature of the system. The rate of sorption of sulfolane followed a first-order reaction at both 25 and 8 degrees C temperature conditions and not affected by the temperatures range considered in this study. It appears that the sorption data of sulfolane on the various sorbents could be best described mathematically by the Freundlich equation. Kd values derived at 25 degrees C ranged from 0.05 to 0.88 L/kg and from 0.30 to 1.23 L/kg at 8 degrees C. Furthermore, increasing the ionic strength of the solution didn't affect sulfolane sorption by the various sorbents, which indicates that sulfolane sorption is not consistent with an ion-exchange mechanism but rather occurs through dipole-dipole interactions. Desorption of sulfolane was relative high in all systems. Multiple regression analysis shows a high level of correlation between Kd and several soil parameters. No sulfolane biodegradation was detected under anerobic conditions in any of the microcosms systems after 45 days of incubation at 25 and 8 degrees C, respectively. Sulfolane biodegradation data could be all fitted to zero-order kinetics. Biodegradation rates of sulfolane in the microcosms was the highest in sample depth 0-0.20 m, decreased with sample depth but significantly increased with the addition of nitrogen, and markedly decreased with temperature. At 25 degrees C and no supplement of N, biodegradation rate ranged from 4.26 to 12.70 mg/kg/day but with addition of N, the range was from 9.41 to 16.50 mg/kg/day.

Assessing sanitary landfill stabilization using winter and summer waste streams in simulated landfill cells.

This study was undertaken to provide a better understanding and to further define the stabilization processes involved in a typical municipal landfill representative of the city of Calgary, Canada, area. The objectives of this study were: (1) to characterize the composition of the solid waste constituents entering the landfill site, (2) to assess the relative decomposition of various waste components in the simulated test cells, (3) to parametize selected chemical and physical changes occurring during the stabilization process and (4) to determine water absorptive capacity of the different waste constituents. The results of the long term landfill stabilization using simulated landfill cell systems filled with winter and summer waste streams, respectively, have illustrated the potential changes that may occur with time with such systems. Based on the results, it can be inferred that the seasonal variation in waste composition deposited in a landfill will likely effect the rate of decomposition and settlement, chemical and physical characteristics of the leachate, moisture sorbing capacity of the site as well as variation in seasonal contaminants. Assuming that the results from the simulated landfills used during this study can be extrapolated to larger-scale landfill operations, it seems that summer waste streams pose a higher pollution threat to the environment than winter waste streams. The several trends observed in this study and the conclusions reported herein would have wide applications in landfill management.

Electronic and steric effects in gold(i) phosphine thiolate complexes.

The unusual yellow color of Au(2)(dppm)(SR)(2) (R = 4-tolyl; dppm = diphenylphosphinomethane) is attributed to a red-shift in the S-->Au charge transfer caused by destabilization of the sulfur highest occupied molecular orbital (HOMO). Variable temperature experiments show two broad bands at -80 degrees C in the (31)P{(1)H} NMR spectrum of Au(2)(dppm)(SR)(2) and the activation energy for interconversion is 10 kcal/mol. Only one sharp band is observed down to -80 degrees C in the spectrum of the white complex, Au(2)(dppe)(SR)(2) (dppe = diphenylphosphinoethane). Molecular mechanics calculations on Au(2)(dppm)(SR)(2) and Au(2)(dppe)(SR)(2) reveal that, for Au(2)(dppe)(SR)(2), a series of maxima and minima, separated by 2.5 kcal/mol, occur every 120 degrees which is consistent with rotation around an unhindered carbon-phosphorus single bond. The Au atoms are not within bonding distance in any conformation. Computational results for Au(2)(dppm)(SR)(2) indicate one minimum energy structure in which the Au-P bonds are anti. There is a high energy conformation (9 kcal/mol above the global minimum) where overlap between golds is maximized. The implications of gold-gold bonding in this complex are discussed. The steric influence of the thiolate ligand has been examined by synthesizing a series of dinuclear gold(I) complexes in which the steric properties of the thiolate are varied: Au(2)(dppm)(SR)(2) (R = 2,6-dichlorophenyl; 2,6-dimethylphenyl; 3,5-dimethylphenyl). The 2,6-disubstituted complexes are white, while the 3,5-dimethyl complex is yellow. These results, along with VT-NMR experiments, are consistent with the conclusion that the more sterically-bulky thiolates hinder the close approach of the golds in the dinuclear complexes.

Tromantadine: inhibitor of early and late events in herpes simplex virus replication.

Unlike amantadine (1-adamantanamine), tromantadine (N-1-adamantyl-N-[2-(dimethyl amino)ethoxy]acetamide hydrochloride) inhibits herpes simplex virus type 1 (KOS strain)-induced cytopathic effect and virus replication with limited toxicity to the cells. Vero and HEp-2 cells tolerated up to 2 mg of tromantadine per 2 X 10(6) cells for 24-, 48-, or 96-h incubation periods with little change in cell morphology. Treatment of the cells with 10 to 50 micrograms of tromantadine reduced herpes simplex virus-induced cytopathic effect. Treatment with 100 to 500 micrograms of tromantadine inhibited herpes simplex virus-induced cytopathic effect and reduced virus production. Complete inhibition of virus production was observed with treatments of 500 micrograms to 1 mg. The antiherpetic activity of tromantadine was dependent upon the viral inoculum size and the time of addition of the compound with respect to infection. Virion synthesis and viral polypeptide synthesis were inhibited by addition of tromantadine at the time of infection or 4 h postinfection. The results are consistent with tromantadine inhibition of an early event in herpes simplex virus infection, before macromolecular synthesis, and a late event, such as assembly or release of virus.

Prognostic factors for response to sildenafil in patients with erectile dysfunction.

OBJECTIVE: To assess the clinical efficacy of sildenafil as treatment for erectile dysfunction (ED) the factors associated with treatment failure were investigated. METHODS: Open, prospective study including 244 patients suffering from ED who were evaluated by anamnesis, physical exploration, blood test, dynamic penile color duplex ultrasonography and Sexual Health Inventory for Male (SHIM). The efficacy of sildenafil was assessed by repeating the SHIM 2 months after therapy, independent of the final dose used. Side effects were also recorded. Factors influencing treatment outcome were evaluated by univariate and multivariate statistical analysis. RESULTS: Overall, sildenafil was effective in 56.8% of 213 eligible patients. When the etiologic diagnosis was not included in the multivariate analysis, antecedents of diabetes mellitus, non-nerve-sparing radical prostatectomy and SHIM basal score were selected as predictors of a poor response. In a second analysis including etiologic diagnosis, only SHIM basal score and etiological diagnosis proved to be of prognostic value. Side effects were noticed by 24.4% of patients, none of them being severe. CONCLUSIONS: Sildenafil is a rather effective and well-tolerated treatment for ED. The basal severity of ED and etiological diagnosis are the prognostic factors most significantly associated with treatment outcome.