How do certain atmospheric aerosols affect Cu-binding organic ligands in the oligotrophic coastal sea surface microlayer?

It is still unclear how the chemical speciation of Cu in surface seawater is impacted by aerosols from various sources deposited on the sea surface, which is surprising, considering the environmental importance of Cu. Therefore, we used voltammetry to investigate Cu complexing capacity (CuCC) in the sea surface microlayer (SML) and in the underlying water (ULW) of the oligotrophic middle Adriatic Sea during February-July 2019. The focus was on the impacts of specific atmospheric processes such as open-fire biomass burning (BB), pollination season and Saharan dust intrusion. The presence of ligand class L2 (19.9-392.0, average 63.8, median 43.1) nM; log K2 (8.3-10.2, average 9.6, median 9.6) was observed in all samples, while ligand class L1 (40.5-76.1, average 53.6, median 48.9) nM; log K1 (10.3-11.1, average 10.6, median 10.5) was found in only 25% of SML samples. Throughout the period, the SML was enriched with organic ligands by a factor of up to 9.1 compared to the ULW, mainly due to the high sensitivity of the SML to specific atmospheric depositions. In addition, measurements with corresponding specific model aerosols were conducted to analyse their impacts on CuCC. Pollen directly affected CuCC in the SML by increasing the concentration of allochthonous ligands such as proteins. The deposition of BB aerosols rich in nutrients and trace metals stimulated the biological production of organic ligands, showing an indirect effect on CuCC delayed by up to two weeks. Finally, Saharan dust had a negligible impact on CuCC. This study illustrates the susceptibility of oligotrophic coastal area to the effects of pollen and open-fire BB aerosols in altering the Cu-binding organic ligands in the SML.

Superior load-to-failure in an all-suture anchor system for all-inside meniscal repair compared to a PEEK-cage anchor system in an experimental cadaveric test setting.

Purpose: The purpose of this study was to compare the biomechanical properties of a latest generation all-suture anchor repair device (ASARD) for meniscal repair with that of a latest generation PEEK-cage anchor repair device (PCARD) in an experimental setting using cadaveric menisci. Methods: Twenty-six menisci were obtained from the knees of fresh body donors. Artificially created meniscal lesions were treated randomly, using a single stitch with either an ASARD or a PCARD. Cyclic biomechanical testing, utilising a universal material testing machine and following an established protocol, was carried out and load-to-failure (LTF), displacement, stiffness, and mode-of-failure (MOF) reported. Results: Mean LTF was found to be 61% higher in the ASARD group at 107.10 N (standard deviation [SD], 42.34), compared to 65.86 N (SD, 27.42) in the PCARD group with statistical significance (p = 0.022). The ASARD exhibited a trend towards higher stiffness (10.35 N; SD, 3.92 versus 7.78 N; SD; 3.59) and higher displacement at cycles one, 100, and 499 (1.64, 3.27, and 4.17 mm versus 0.93, 2.19, and 2.83 mm) compared to the PCARD. Cheese wiring was the most common mode-of-failure in both groups (76.9%). Conclusions: This study demonstrates that an ASARD shows a higher mean LTF than a PCARD when compared in an experimental biomechanical setting. Level of evidence: Level III.

Analysis of the unresolved organic fraction in atmospheric aerosols with ultrahigh-resolution mass spectrometry and nuclear magnetic resonance spectroscopy: organosulfates as photochemical smog constituents.

Complementary molecular and atomic signatures obtained from Fourier transform ion cyclotron resonance (FTICR) mass spectra and NMR spectra provided unequivocal attribution of CHO, CHNO, CHOS, and CHNOS molecular series in secondary organic aerosols (SOA) and high-resolution definition of carbon chemical environments. Sulfate esters were confirmed as major players in SOA formation and as major constituents of its water-soluble fraction (WSOC). Elevated concentrations of SO(2), sulfate, and photochemical activity were shown to increase the proportion of SOA sulfur-containing compounds. Sulfonation of CHO precursors by means of heterogeneous reactions between carbonyl derivatives and sulfuric acid in gas-phase photoreactions was proposed as a likely formation mechanism of CHOS molecules. In addition, photochemistry induced oligomerization processes of CHOS molecules. Methylesters found in methanolic extracts of a SOA subjected to strong photochemical exposure were considered secondary products derived from sulfate esters by methanolysis. The relative abundance of nitrogen-containing compounds (CHNO and CHNOS series) appeared rather dependent on local effects such as biomass burning. Extensive aliphatic branching and disruption of extended NMR spin-systems by carbonyl derivatives and other heteroatoms were the most significant structural motifs in SOA. The presence of heteroatoms in elevated oxidation states suggests a clearly different SOA formation trajectory in comparison with established terrestrial and aqueous natural organic matter.

Palliative treatment of esophageal carcinoma with self-expanding plastic stents: a report on 69 cases.

OBJECTIVES: The use of self-expandable plastic stents has offered a reasonable alternative of self-expandable metal stents in palliative treatment of esophageal malignancies, in the recent years. Studies and clinical data on the use of self-expandable plastic stents in esophageal cancer are, however, available in a very limited number. Here, we present the results of our 3-year study designed to evaluate the efficacy of self-expandable plastic stents in palliation of advanced esophageal carcinoma. PATIENTS AND METHODS: Between January 2001 and February 2004, 69 patients with advanced nonoperable esophageal cancer were enrolled in the study and followed up until their death, after insertion of Polyflex self-expandable plastic stents. Dysphagia scores, Karnofsky indices and body weights were determined and compared in order to evaluate the effect of the stent insertion on general status and well-being of the patients. RESULTS: Insertion of Polyflex self-expandable plastic stents and covered self-expandable metal stents was performed in 66 cases and in eight cases, respectively; in certain patients, owing to complications, more than one stent had to be inserted. In all cases, the insertion of stents has been performed without major complication and it has led to an instant improvement in swallowing and dysphagia scores. The rates of tumoral overgrowth and of stent migration were low. The mean follow-up time of our patients was 129 days (10-312 days). CONCLUSION: In concordance with previous studies, according to our results, the use of self-expandable plastic stents in palliation of esophageal cancer seems to be safe and effective in improving the quality of life of these patients.

[Balloon dilatation of cervical anastomosis stricture after subtotal resection of the esophagus]. / Szubtotális nyelócsó-resectio után kialakult nyaki anastomosisszukület endoszkópos tágítása és annak eredményei.

AIMS: The stricture of the anastomosis is one of the most common complications of the subtotal esophageal resections. The authors present indications, technics and results of the endoscopic dilatation. PATIENTS AND METHODS: In a 10 year period 26 patients (22 male, 4 female, mean age of 53.7 years) with stricture of anastomosis between the esophagus and the neo-esophagus after subtotal esophageal resection were dilated endoscopically 82 times. The indication of the resection was tumour in 23 (88.5%) cases, congenital atresia in 2 (7.7%) cases and corrosive disease in one (3.8%) case. In 7 (31.8%) cases the stricture developed after anastomosis leakage. The mean time between the operation and the dilatation was 7.8 months. The cause of the stricture was cancer recurrency in 4 (15.4%) cases. RESULTS: There were no complications related to the dilatation. The mean number of the dilatation was 3.2 (1-9). There was no significant difference between the number of dilatation in patients with or without previously anastomotic leakage. The success rate of the dilatation for benign strictures was 95.5%. In only one patient (4.5%) was needed operative intervention. In the 4 patients with tumour recurrency a stent was also implanted in the stenosis. CONCLUSIONS: The endoscopic dilatation for the treatment of the cervical anastomosis stricture after subtotal esophageal resection is a successful method with a low rate of complications. In cases of tumour recurrency a stent implantation is suggested.

[Stromal tumor of the stomach causing life-threatening arterial bleeding]. / A gyomor életveszélyes arteriás vérzést okozó stromalis tumora.

Stromal tumors of the gastrointestinal tract are rare mesenchymal neoplasms. The majority of them are appearing in the stomach: their quite common first manifestation is bleeding. The authors report a case of polypoid gastric GIST causing severe bleeding which needed urgent surgical intervention and partial resection of the stomach. Although histological analysis of the tumor revealed low proliferation rate, the urgent operation did not result in a complete eradication of the neoplasm, thereby our patient needs further follow-up and treatment.

[Wireless capsule endoscopy and its role in gastroenterology: our results and a review of the literature]. / Kapszulás endoszkópia helye a gasztroenterológiai diagnosztikában: irodalmi attekintés saját eredményeink tükrében.

INTRODUCTION: Since its recent introduction, capsule endoscopy has revolutionized the diagnostics of diseases of the small bowel. The number of studies on the use of this method is constantly increasing. Along with this, our knowledge about the usability and diagnostic power of capsule endoscopy is growing and the indications for this technique are getting progressively more accurate. AIMS: To study the usability of capsule endoscopy in suspected Crohn's disease, in gastrointestinal bleeding of small bowel origin, and in undetermined abdominal complains. METHOD: Capsule endoscopy was performed in 20, previously examined, carefully selected patients. RESULTS: Positive findings were recorded in all patients with gastrointestinal bleeding and in 3/4 of patients with suspected Crohn's disease. However, in patients with indeterminate abdominal complains, the capsule endoscopy proved to be inefficient. CONCLUSION: In the study below, based on their own experience, the authors try to provide an overall picture of capsule endoscopy by reviewing contemporary medical literature. The usability of the capsule endoscopy in suspected Crohn's disease and gastrointestinal bleeding of small bowel origin is suggested by the results of the study.

[Use of self-expanding stents in benign and malignant esophageal disease]. / Ontáguló stentek alkalmazása benignus es malignus nyelocsobetegségekben.

Of patients with malignant esophageal tumors, more than the half has incurable disease at the time of diagnosis. In such cases, quality of life and ability to swallow should be improved or restored by palliating the process e.g. by inserting esophageal stents. In the recent years, use of covered self-expandable metal stents (SEMS) has led to an increased success rate in the palliative treatment of--mainly malignant--strictures of the esophagus. High occurrence of complications (perforation, bleeding) associated with the use of rigid plastic esophageal stents necessitated the development of flexible stents. First generation self-expandable stents were made of special metal alloys, such as nickel-titanium. In the recent years, self-expandable plastic stents are available, too, offering new alternatives in the palliative treatment of esophageal diseases. In our present review article, we discuss the most important aspects about the use of self-expanding esophageal stents, based on recent clinical observations and data.

[Comparison of the effectiveness and tolerability of the saccharosum-sennosid-B solution and sodium-picosulfate in preparation for colonoscopy. Prospective, multicenter, randomized study]. / A saccharosum + sennosid-B oldat és a Na-pikoszulfát effektivitásának és tolerálhatóságának összehasonlítása kolonoszkópos elókészítés során. Multicentrikus, prospektív, randomizált vizsgálat.

INTRODUCTION: The effectivity, evaluability of the colonoscopic procedure depends greatly on the preparation and the cleanliness of the colon. A large scale of laxatives used for colon preparation are also available in our country (phenolphtalein, Karlsbad-salt, saccharosum + sennosid-B solution, bisacodyl, powder mixtures). AIMS: The authors examined in 5 gastroenterology centres the tolerability and effectivity of two frequently used laxatives--saccharosum + sennosid-B solution and Na-picosulphate--during colonoscopic preparation in 157 patients. METHODS: Exclusion criteria were: severe anemia, renal insufficiency, cardiac failure, active ulcerative colitis and Crohn's disease, possible stenotising colonic process and hypersensibility to one of the compounds. The patients were randomised prospectively. In the case of the saccharosum + sennosid-B solution the colon preparation was performed according to the manufacturers prescriptions, in the case of the Na-pikosulfate the investigator's own procedure was used based on literature data. The tolerability of the preparation was assessed using a questionnaire. The investigators made their statements concerning the cleanliness of the different colon sections based on uniform criteria. RESULTS: Both methods showed good efficacy concerning the cleanliness of the colon. The patients considered the Na-picosulphate better tolerable--based on the questionnaire data. The authors consider the analysis of further laxatives to help improve the work of their fellow endoscopists.

[Laparoscopic cardiomyotomy in the treatment of achalasia]. / Laparoszkópos cardiomyotomia az achalasia kezelésében.

The laparoscopic cardiomyotomy (Heller) with Dor type anterior fundoplication is accepted for treatment of esophageal achalasia. Between December 1994 and December 1998, 21 patients with esophageal achalasia underwent laparoscopic Heller's operation with Dor's antireflux procedures after preoperative assessment which involved radiological, endoscopic and manometric investigations. Results were evaluated on the basis of our experiences and postoperative investigations. There were no intraoperative complications. Operating time was 40-90' (mean 65'). Conversion to laparotomy was not required. One patient had postoperative stenosis, and another had esophageal perforation which was treated. Postoperative manometry in all patients showed a decreased lower esophageal sphincter pressure. Based on the obtained results it could be concluded that cardiomyotomy with Dor fundoplication through a laparoscopic approach leeds to good functional results and seems effective and safe procedure in the treatment of esophageal achalasia.

The ecotoxicological evaluation of Cylindrospermopsis raciborskii from Lake Balaton (Hungary) employing a battery of bioassays and chemical screening.

Ecotoxicity of four Cylindrospermopsis raciborskii strains (ACT 9502, ACT 9503, ACT 9504, ACT 9505) isolated from Lake Balaton (Hungary) was evaluated in four aquatic bioassays including the Thamnocephalus platyurus acute lethality test; Daphnia magna acute immobilization assay; D. magna feeding inhibition assay and Danio rerio embryo developmental toxicity assay, assisted by chemical screening for known toxins by HPLC-MS. For reference, we analyzed in parallel the toxin content and toxic effects of two previously characterized toxin-producing strains: the Australian cylindrospermopsin producer AQS C. raciborskii and the anatoxins producer Oscillatoria sp. PCC 6506. Bioassays were used to evaluate the overall toxicity of the hydrophilic bioactive metabolites pool synthesized by the selected cyanobacteria. Chemical screening has proven that the ACT C. raciborskii extracts investigated did not contained cylindrospermopsins and anatoxins. The relative toxicity of the ACT C. raciborskii aqueous extracts observed in each bioassay was comparable to the effects recorded for the anatoxins producer PCC 6506 strain while toxicity values (EC50/LC50) calculated for the AQS extract were in general one order of magnitude lower. Concerning sublethal effects of ACT C. raciborskii extracts to the D. rerio embryogenesis, the general morphological abnormality observed was a significant retardation of development. Overall, our results suggest that C. raciborskii populating Lake Balaton produce metabolites with significant bioactive potencies. Therefore, continued investigation of these unknown compounds is required.

Photocatalytic degradation of benzenesulfonate on colloidal titanium dioxide.

Titanium dioxide-mediated photocatalyzed degradation of benzenesulfonate (BS) was investigated by monitoring chemical oxygen demand (COD), total organic carbon (TOC) content, sulfate concentration, pH as well as the absorption and emission spectral changes in both argon-saturated and aerated systems. Liquid chromatography-mass spectrometry analysis was utilized for the detection of intermediates formed during the irradiation in the UVA range (λ(max) = 350 nm). The results obtained by these analytical techniques indicate that the initial step of degradation is hydroxylation of the starting surfactant, resulting in the production of hydroxy- and dihydroxybenzenesulfonates. These reactions were accompanied by desulfonation, which increases [H(+)] in both argon-saturated and aerated systems. In accordance with our previous theoretical calculations, the formation of ortho- and meta-hydroxylated derivatives is favored in the first step. The main product of the further oxygenation of these derivatives was 2,5-dihydroxy-benzesulfonate. No decay of the hydroxy species occurred during the 8-h irradiation in the absence of dissolved oxygen. In the aerated system much more efficient desulfonation and hydroxylation, moreover, a significant decrease of TOC took place at the initial stage. Further hydroxylation led to cleavage of the aromatic system, due to the formation of polyhydroxy derivatives, followed by ring fission, resulting in the production of aldehydes and carboxylic acids. Total mineralization was achieved by the end of the 8-h photocatalysis. It has been proved that in this photocatalytic procedure the presence of dissolved oxygen is necessary for the cleavage of the aromatic ring because hydroxyl radicals photochemically formed in the deaerated system too alone are not able to break the C-C bonds.

Screening the toxic potential of Cylindrospermopsis raciborskii strains isolated from Lake Balaton, Hungary.

Cylindrospermopsis raciborskii is becoming a major concern among cyanobacteria, due to its potential ability to produce toxic metabolites. We assessed the cytotoxic potential of four C. raciborskii strains (ACT 9502, ACT 9503, ACT 9504 and ACT 9505) isolated from Lake Balaton (Hungary), by lactate dehydrogenase (LDH) leakage measurements and by detecting morphological alterations in CHO-K1 (Chinese Hamster Ovary) cells. The Australian AQS (cylindrospermopsin producer) strain of C. raciborskii and purified cylindrospermopsin (CYN) were used as positive references in both the biochemical and morphological studies. Chemical analysis for known cyanotoxins was performed on aqueous extracts of ACT and AQS strains by the HPLC-MS technique. Comparing threshold values of LDH leakage data, different toxic potentials of cyanobacterial extracts are suggested in short term (3 h) and long (24 h) exposure regimes. In the acute (3 h) experiments the aqueous extract of the ACT 9505 strain proved to be most toxic (EC(50) = 7.4 mg mL(-1)), while after 24 h the ACT 9504 extract was the most effective (EC(50) = 0.65 mg mL(-1)). The extract of the AQS strain and the purified CYN exerted most of their toxic effects after 3 h exposure (EC(50) = 0.74 mg mL(-1), and 0.9 µg mL(-1) respectively). The morphological changes of CHO-K1 cells induced by the crude extracts of the ACT strains included fragmentation of the actin filaments then relocation of the depolymerized actin to the perinuclear region, resulting cell rounding and loss of adhesion. Exposure of CHO-K1 cells to the crude extract of the AQS strain, moreover, resulted cell shrinking and formation of filopodia, i.e. distinctly different cytological alterations from that induced by the ACT extracts and the purified CYN. Chemical analysis of the cyanobacterial crude extracts confirmed the presence of cylindrospermopsin in the extract of the AQS strain (8.5 mg CYN g(-1) dry weight), and none of the presently known cyanotoxins have been analytically confirmed in the extracts of the ACT strains isolated from the Lake Balaton. Although a significant toxicity of all four ACT C. raciborskii strains is confirmed by both biochemical and morphological studies, our results also pointed out the necessity of further studies to identify the toxic, but still unknown metabolic components produced by these cyanobacterial members of the phytoplankton communities.

Gastric bleeding in a patient with rheumatoid arthritis complicated by immune thrombocytopenic purpura.

Rheumatoid arthritis, in common with other systemic autoimmune diseases, can involve several other organs presenting with complex immunological manifestations. Immune thrombocytopenic purpura caused by an autoimmune reaction against platelets is an infrequent haematological complications. A female patient with rheumatoid arthritis rapidly developed extremely severe immune thrombocytopenic purpura upon suspending oral corticosteroid therapy. Besides the involvement of the mucosa of the coecum, ascending colon and the gastric antrum, the situation was further complicated by bleeding of a gastric polyp, at the nadir of the thrombocytopenic crisis. The bleeding was managed by endoscopic intervention and platelet count recovered upon high dose corticosteroid treatment within a couple of days.