Successful hemostatic radiotherapy for massive airway bleeding from infectious pulmonary cavity: a case report.

We present a patient with life-threatening airway bleeding from an infectious pulmonary cavity with limited treatment options. Bronchial artery embolization was unsuccessful. Surgery was not feasible due to compromised lung function. Lung transplant was considered but not endorsed. Palliative hemostatic radiotherapy with 20 Gy in 5 fractions was delivered to the site of bleeding as a last resort. Hemoptysis gradually disappeared within a month and did not recur during the 4­month follow-up. There were no side effects. We highlight the potential of radiotherapy for massive hemoptysis of infectious etiology, especially in cases with exhausted standard treatment options.

PGE2 EP1 receptor inhibits vasopressin-dependent water reabsorption and sodium transport in mouse collecting duct.

PGE2 regulates glomerular hemodynamics, renin secretion, and tubular transport. This study examined the contribution of PGE2 EP1 receptors to sodium and water homeostasis. Male EP1-/- mice were bred with hypertensive TTRhRen mice (Htn) to evaluate blood pressure and kidney function at 8 weeks of age in four groups: wildtype (WT), EP1-/-, Htn, HtnEP1-/-. Blood pressure and water balance were unaffected by EP1 deletion. COX1 and mPGE2 synthase were increased and COX2 was decreased in mice lacking EP1, with increases in EP3 and reductions in EP2 and EP4 mRNA throughout the nephron. Microdissected proximal tubule sglt1, NHE3, and AQP1 were increased in HtnEP1-/-, but sglt2 was increased in EP1-/- mice. Thick ascending limb NKCC2 was reduced in the cortex but increased in the medulla. Inner medullary collecting duct (IMCD) AQP1 and ENaC were increased, but AVP V2 receptors and urea transporter-1 were reduced in all mice compared to WT. In WT and Htn mice, PGE2 inhibited AVP-water transport and increased calcium in the IMCD, and inhibited sodium transport in cortical collecting ducts, but not in EP1-/- or HtnEP1-/- mice. Amiloride (ENaC) and hydrochlorothiazide (pendrin inhibitor) equally attenuated the effect of PGE2 on sodium transport. Taken together, the data suggest that EP1 regulates renal aquaporins and sodium transporters, attenuates AVP-water transport and inhibits sodium transport in the mouse collecting duct, which is mediated by both ENaC and pendrin-dependent pathways.

PGE2 receptor EP3 inhibits water reabsorption and contributes to polyuria and kidney injury in a streptozotocin-induced mouse model of diabetes.

AIMS/HYPOTHESIS: The first clinical manifestation of diabetes is polyuria. The prostaglandin E2 (PGE2) receptor EP3 antagonises arginine vasopressin (AVP)-mediated water reabsorption and its expression is increased in the diabetic kidney. The purpose of this work was to study the contribution of EP3 to diabetic polyuria and renal injury. METHODS: Male Ep 3 (-/-) (also known as Ptger3 (-/-)) mice were treated with streptozotocin (STZ) to generate a mouse model of diabetes and renal function was evaluated after 12 weeks. Isolated collecting ducts (CDs) were microperfused to study the contribution of EP3 to AVP-mediated fluid reabsorption. RESULTS: Ep 3 (-/-)-STZ mice exhibited attenuated polyuria and increased urine osmolality compared with wild-type STZ (WT-STZ) mice, suggesting enhanced water reabsorption. Compared with WT-STZ mice, Ep 3 (-/-)-STZ mice also had increased protein expression of aquaporin-1, aquaporin-2, and urea transporter A1, and reduced urinary AVP excretion, but increased medullary V2 receptors. In vitro microperfusion studies indicated that Ep 3 (-/-) and WT-STZ CDs responded to AVP stimulation similarly to those of wild-type mice, with a 60% increase in fluid reabsorption. In WT non-injected and WT-STZ mice, EP3 activation with sulprostone (PGE2 analogue) abrogated AVP-mediated water reabsorption; this effect was absent in mice lacking EP3. A major finding of this work is that Ep 3 (-/-)-STZ mice showed blunted renal cyclooxygenase-2 protein expression, reduced renal hypertrophy, reduced hyperfiltration and reduced albuminuria, as well as diminished tubular dilation and nuclear cysts. CONCLUSIONS/INTERPRETATION: Taken together, the data suggest that EP3 contributes to diabetic polyuria by inhibiting expression of aquaporins and that it promotes renal injury during diabetes. EP3 may prove to be a promising target for more selective management of diabetic kidney disease.

Distinct interacting cortical networks for stimulus-response and repetition-suppression.

Non-invasive studies consider the initial neural stimulus response (SR) and repetition suppression (RS) - the decreased response to repeated sensory stimuli - as engaging the same neurons. That is, RS is a suppression of the SR. We challenge this conjecture using electrocorticographic (ECoG) recordings with high spatial resolution in ten patients listening to task-irrelevant trains of auditory stimuli. SR and RS were indexed by high-frequency activity (HFA) across temporal, parietal, and frontal cortices. HFASR and HFARS were temporally and spatially distinct, with HFARS emerging later than HFASR and showing only a limited spatial intersection with HFASR: most HFASR sites did not demonstrate HFARS, and HFARS was found where no HFASR could be recorded. ß activity was enhanced in HFARS compared to HFASR cortical sites. θ activity was enhanced in HFASR compared to HFARS sites. Furthermore, HFASR sites propagated information to HFARS sites via transient θ:ß phase-phase coupling. In contrast to predictive coding (PC) accounts our results indicate that HFASR and HFARS are functionally linked but have minimal spatial overlap. HFASR might enable stable and rapid perception of environmental stimuli across extended temporal intervals. In contrast HFARS might support efficient generation of an internal model based on stimulus history.

Time-Multiplexed Illumination for simultaneous Structural and Functional Voltage Sensitive Dye Recordings with a single Photo Sensor.

The in-vivo optical imaging of the cortical surface provides the ability to record different types of biophysiological signals, e.g., structural information, intrinsic signals, like blood oxygenation coupled reflection changes as well as extrinsic properties of voltage sensitive probes, like fluorescent voltage-sensitive dyes. The recorded data sets have very high temporal and spatial resolutions on a meso- to macroscopic scale, which surpass conventional multi-electrode recordings. Both, intrinsic and functional data sets, each provide unique information about temporal and spatial dynamics of cortical functioning, yet have individual drawbacks. To optimize the informational value it would thus be opportune to combine different types of optical imaging in a near simultaneous recording.Due to the low signal-to-noise ratio of voltage-sensitive dyes it is necessary to reduce stray light pollution below the level of the camera's dark noise. It is thus impossible to record full-spectrum optical data sets. We address this problem by a time-multiplexed illumination, bespoke to the utilized voltage sensitive dye, to record an alternating series of intrinsic and extrinsic frames by a high-frequency CMOS sensor. These near simultaneous data series can be used to compare the mutual influence of intrinsic and extrinsic dynamics (with regards to extracorporeal functional imaging) as well as for motion compensation and thus for minimizing frame averaging, which in turn results in increased spatial precision of functional data and in a reduction of necessary experimental data sets (3R principle).

Detailed molecular analysis of the induction of the L-PK gene by glucose.

Glucose has powerful effects on gene expression and participates in the fasted-to-fed transition of the liver. However, the molecular mechanism of glucose-regulated gene expression has not been completely described. In the present study, we performed a detailed analysis of the molecular events of the insulin-independent glucose response of the liver-type pyruvate kinase (L-PK) gene. L-PK mRNA was increased by glucose at the transcriptional level as determined by real-time RT-PCR, mRNA stability measurements, and nuclear run-on assays. LY294002 and LY303511 inhibited the glucose response of the L-PK gene at the transcriptional level. Histones H3 and H4 associated with the L-PK gene promoter were hyperacetylated and HNF4alpha was constitutively bound in low and high glucose. Treatment with 20mM glucose increased recruitment of ChREBP, additional HNF4alpha, and RNA polymerase II. Glucose-stimulated the phosphorylation of the C-terminal domain of RNA polymerase II, with increased Ser5 phosphorylation near the transcription start site and increased Ser2 phosphorylation near the termination signal. LY294002 and LY303511 blocked the recruitment of RNA polymerase II to the L-PK gene, reducing the rate of transcription. The results of these studies demonstrate fundamental details of the molecular mechanism of glucose activated gene expression.

Response Priming with More or Less Biological Movements as Primes.

Response priming in general is a suitable tool in cognitive psychology to investigate motor preactivations. Typically, compatibility effects reflect faster reactions in cases in which prime and target suggest the same response (i.e., compatible trials) compared with cases in which prime and target suggest opposite responses (i.e., incompatible trials). With moving dots that were horizontally aligned, Bermeitinger (2013) found a stable pattern of results: with short SOAs, faster responses in compatible trials were found; with longer SOAs up to 250 ms, faster responses in incompatible trials were found. It is unclear whether these results are specific to the special motion used therein or whether it generalizes to other motions. We therefore used other motions realized by arrangements of dots. In four experiments, we tested point-light displays (biological coherent walkers vs. less biological scrambled/split displays) as primes. In two experiments, eye gaze motions realized by moving dots representing irises and pupils (i.e., biological) versus the same motion either without surrounding face information or integrated in an abstract line drawing (i.e., less biological) were used. We found overall large positive compatibility effects with biological motion primes and also positive-but smaller-compatibility effects with less biological motion primes. Most important, also with very long SOAs (up to 1320 ms), we did not find evidence for negative compatibility effects. Thus, the pattern of positive-followed-by-negative-compatibility effects found in Bermeitinger (2013) seems to be specific to the materials used therein, whereas response priming in general seems an applicable tool to study motion perception.