[Treatment of cardiogenic shock complicating acute myocardial infarction]. / Behandlung des kardiogenen Schocks im Rahmen eines akuten Myokardinfarkts.

While the mortality rate of acute myocardial infarction has decreased drastically in the last decades, the outcome of patients with cardiogenic shock complicating acute myocardial infarction is still devastating. The effectiveness of supportive medicinal therapy of cardiogenic shock is often limited by undesired side effects (e.g. arrhythmia and increased myocardial oxygen consumption) or inadequate hemodynamic support. Mechanical circulatory support in cardiogenic shock failed to show beneficial effects on short-term and long-term survival; however, there are hints for a survival benefit in therapy refractory cardiogenic shock. Therefore, future trials need to evaluate further medicinal treatment options and also the best type of mechanical support as well as the optimal time of initiation to improve the success of therapeutic management.

Identification of Arabidopsis mutants exhibiting an altered hypersensitive response in gene-for-gene disease resistance.

A mutational study was carried out to isolate Arabidopsis thaliana plants that exhibit full or partial disruption of the RPS2-mediated hypersensitive response (HR) to Pseudomonas syringae that express avrRpt2. Five classes of mutants were identified including mutations at RPS2, dnd mutations causing a "defense, no death" loss-of-HR phenotype, a lesion-mimic mutant that also exhibited an HR- phenotype, and a number of intermediate or partial-loss-of-HR mutants. Surprisingly, many of these mutants displayed elevated resistance to virulent P. syringae and, in some cases, to Peronospora parasitica. Constitutively elevated levels of pathogenesis-related (PR) gene expression and salicylic acid were also observed. In the lesion-mimic mutant, appearance of elevated resistance was temporally correlated with appearance of lesions. For one of the intermediate lines, resistance was shown to be dependent on elevated levels of salicylic acid. A new locus was identified and named IHR1, after the mutant phenotype of "intermediate HR." Genetic analysis of the intermediate-HR plant lines was difficult due to uncertainties in distinguishing the partial/intermediate mutant phenotypes from wild type. Despite this difficulty, the intermediate-HR mutants remain of interest because they reveal potential new defense-related loci and because many of these lines exhibit partially elevated disease resistance without dwarfing or other apparent growth defects.

The patient-care gap.

Although adequate attention is paid to technical principles and equipment in the radiologic technology classroom and supporting literature, little if any is devoted to the patient. The humanity of the patient and his primacy in the profession demand that in radiologic technology education and practice he be given the consideration he should and must have whenever he is in the hands of radiologic technology personnel.

The Arabidopsis dnd1 "defense, no death" gene encodes a mutated cyclic nucleotide-gated ion channel.

Gene-for-gene disease resistance typically includes a programmed cell death response known as the hypersensitive response (HR). The Arabidopsis thaliana dnd1 mutant was previously isolated as a line that failed to produce the HR in response to avirulent Pseudomonas syringae pathogens; plants homozygous for the recessive dnd1-1 mutation still carry out effective gene-for-gene resistance. The dnd1-1 mutation also causes constitutive systemic resistance and elevated levels of salicylic acid. In the present study, a positional cloning approach was used to isolate DND1. DND1 encodes the same protein as AtCNGC2, a cyclic nucleotide-gated ion channel of previously unknown organismal function that can allow passage of Ca(2+), K(+) and other cations [Leng, Q., Mercier, R. W., Yao, W. & Berkowitz, G. A. (1999) Plant Physiol. 121, 753-761]. By using a nahG transgene, we found that salicylic acid is required for the elevated resistance caused by the dnd1 mutation but that removal of salicylic acid did not completely eliminate the dwarf and loss-of-HR phenotypes of mutant dnd1 plants. A stop codon that would severely truncate the DND1 gene product was identified in the dnd1-1 allele. This demonstrates that broad-spectrum disease resistance and inhibition of the HR can be activated in plants by disruption of a cyclic nucleotide-gated ion channel.