Imaging low-mass planets within the habitable zone of α Centauri.

Giant exoplanets on wide orbits have been directly imaged around young stars. If the thermal background in the mid-infrared can be mitigated, then exoplanets with lower masses can also be imaged. Here we present a ground-based mid-infrared observing approach that enables imaging low-mass temperate exoplanets around nearby stars, and in particular within the closest stellar system, α Centauri. Based on 75-80% of the best quality images from 100 h of cumulative observations, we demonstrate sensitivity to warm sub-Neptune-sized planets throughout much of the habitable zone of α Centauri A. This is an order of magnitude more sensitive than state-of-the-art exoplanet imaging mass detection limits. We also discuss a possible exoplanet or exozodiacal disk detection around α Centauri A. However, an instrumental artifact of unknown origin cannot be ruled out. These results demonstrate the feasibility of imaging rocky habitable-zone exoplanets with current and upcoming telescopes.

Kinetic interactions between azlocillin, cefotaxime, and cefotaxime metabolites in normal and impaired renal function.

Cefotaxime (CTX) kinetics, alone and in combination with azlocillin (AZ), were determined in 18 subjects with either normal or impaired renal function. After the single dose and with increasing renal insufficiency, total CTX clearance fell from 266 to 71 ml/min/1.73 m2. At the same time the terminal t1/2 rose from 1.1 to 2.8 hr. Regardless of the degree of renal function, CTX clearance in combination with AZ in all patients was only 50% to 60% of that with CTX alone. This reduction in total body clearance was due to a parallel decrease in renal and nonrenal clearance. In advanced renal failure, particularly after AZ, the terminal t1/2 of the CTX metabolites increased up to 1000% to 1500% of normal. On the basis of these findings, CTX dosage adjustment is recommended only in patients with a glomerular filtration rate (GFR) below 20 ml/min. After AZ, however, dosage reduction of CTX seems to be advisable at an earlier stage of renal impairment (GFR 40 ml/min).

Efficacy of an unselected protein diet (25 g) with minor oral supply of essential amino acids and keto analogues compared with a selective protein diet (40 g) in chronic renal failure.

The efficacy of a mixed protein-poor diet (25 g) with an intake of only 12 tablets of essential amino acids or keto analogues (= 0.9 Rose units) was compared with that of a selective protein diet (40 g). Twenty-eight patients with chronic renal insufficiency (creatinine clearance 13.2 +/- 5.6 ml/min per 1.73 m2) were included in the prospective study with four periods of 3 months each. Each patient served as his own control. The mixed protein-poor diet showed a better patient compliance irrespective of the type of supplement. In addition, the essential amino acid supplementations showed no advantages over the standard diet. In patients with a creatinine clearance less than 10 ml/min, the keto analogue supplementation led to an improvement of the uremic intoxication and the nutritional state. An increase in renal function was not observed. The phosphate decrease occurred even when there were signs of portein malnutrition.

Four patients with AL amyloidosis treated with high-dose chemotherapy and autologous stem cell transplantation.

Four patients with AL amyloidosis underwent high-dose chemotherapy and autologous stem cell transplantation at our institutions. Here, we report the clinical courses and outcomes in these patients. Two patients with multi-organ amyloid deposits including cardiac involvement died within 12 days after high-dose chemotherapy. However, in the other two patients, one of whom was suffering from amyloid-related cardiac failure, a significant improvement of organ function was achieved.

Severe panarteritis associated with drug abuse.

A case of panarteritis with purpura fulminans, mononeuritis multiplex, gastrointestinal manifestation and presumably cardiac involvement in a previously healthy 22-year-old man with a history of drug abuse including cocaine, cannabinoids and methamphetamines is described. Histopathological examination of the gut led to the diagnosis of panarteritis without immune deposits. Antineutrophil antibodies were negative. Besides the drugs, no other possible cause of vasculitis was found. The patient recovered completely after 1 year. Drug abuse is a thus possible cause of severe extracerebral disabling vasculitis.

HLA-antigens in systemic lupus erythematosus (SLE).

Histocompatibility antigens were determined in 27 patients with SLE and 283 normal blood donors. HLA-B8 was significantly increased in patients with SLE (59.3%) as compared to the controls (20.5%, Pc less than 0.005). The relative risk for HLA-B8 was 5.64. No correlation could be demonstrated to specific organ involvement, immunopathological data, age of onset or prognosis.

Interactions between mezlocillin and sisomicin in vitro and in patients with normal and various degrees of impaired renal function.

During in vitro experiments using pooled human plasma at 37 degrees C, sisomicin alone showed only a small loss of activity of 12% in 24 hr. Incubation with 80 micrograms/ml mezlocillin did not alter the rate of inactivation. But, after the addition of 300 micrograms/ml mezlocillin to either 5.0 or 2.5 micrograms/ml sisomicin, the sisomicin half-life was reduced by 50% and 100% respectively. When the mean drug concentration ratios are compared, inactivation of sisomicin by mezlocillin was significantly less than that reported for carbenicillin or ticarcillin. Sisomicin pharmacokinetics were studied in 27 patients with normal and various degrees of impaired renal function (Part A) and were not changed by the simultaneous administration of mezlocillin 60 mg/kg (Part B). Furthermore, even in far advanced renal insufficiency, sisomicin inactivation by mezlocillin could not be demonstrated. The differing results obtained with mezlocillin compared to carbenicillin or ticarcillin might be explained by differences in the physico-chemical properties of the drugs in addition to the different kinetic behavior of mezlocillin in patients with impaired renal function.

[Estimation of 131I-Iodohippurate-clearance by a simplified method using a single plasma sample (author's transl)]. / Die Bestimmung der 131J-Hippuranclearance nach einer vereinfachten Methode mit nur einer Blutentnahme.

Theoretical volumes calculated from the reciprocal of the plasma concentration after intravenous injection of 131I-Iodohippurate were compared in 95 patients with clearance values calculated by the 2-compartment-method and in 18 patients with conventional PAH-clearance. For estimating Hippurate-clearance from a single blood sampling the most favorable time is 45 min. after injection (r = 0.96; clearance < 400/ml/min.: r = 0.98). Clearance values may be derived from the formula: C = 0.4 + 7.26 V - 0.021 . V2 (V = injected activity/activity per l plasma taken 45 min. after injection). The simplicity, precision and reproducibility of the above mentioned clearance-method is emphazised.

[Ultrasound in diffuse renal parenchymal disease (author's transl)]. / Die Sonographie bei diffusen beiderseitigen Nierenparenchymerkrankungen.

Ultrasound examinations were compared with histopathological findings in 22 patients with diffuse renal parenchymal disease (glomerulonephritis, interstitial nephritis, glomerulosclerosis). The echogenicity of the renal parenchyma was graded by comparing it with the echogenicity of the liver, the spleen and the renal sinus and correlated with glomerular and interstitial findings. There was a direct correlation between echo intensity of the renal parenchyma and severity of renal parenchyma and severity of renal interstitial disease. Glomerular changes intensified the echogenicity of the parenchyma, but grading was not possible. Ultrasound is capable of documenting the course of disease and recognizing complications.

Multiple-dose-kinetics of ofloxacin after intraperitoneal application in CAPD patients.

Pharmacokinetics of ofloxacin in plasma and peritoneal fluid were studied in 11 patients on continuous ambulatory peritoneal dialysis (CAPD). Seven patients without peritonitis received 20 mg ofloxacin added to 2L dialysate i.p. every 6 h for one day only, while 4 patients with acute peritonitis were treated with this same dosage every 4 h for 3 days, then every 6 h for the next 7 days. Ofloxacin concentrations in plasma and dialysate were determined by HPLC. After i.p. drug application there was a rapid elimination of ofloxacin from dialysate, this being significantly faster in patients with peritonitis as compared to those without. Likewise, the total amount lost from the first bag after a 3 h dwell was higher in the peritonitis group (84.7 +/- 1.5%; mean +/- SEM) than in the non-peritonitis group (75.6 +/- 2.1%). Twenty-four h after start of ofloxacin treatment, the mean peritoneal fluid concentrations at the end of each exchange studied were all above 3 mg/L. In patients with peritonitis, plasma concentrations of ofloxacin rose to 0.94 +/- 0.05 mg/L after 24 h reaching a Cmax of 1.8 +/- 0.2 mg/L after a tmax of 84 +/- 23 h. Intraperitoneal administration of ofloxacin was well tolerated, and no local or systemic adverse events were observed. Peritonitis episodes that were caused by Staphylococcus epidermidis (3) and by E. coli (1) were cured in all patients.

Etiological aspects of double monsters.

Four cases of double monsters are reported, including a rare case of craniofacial duplication (diprosopus). Based on the findings observed, etiological factors of these malformations are discussed. We suggest that exogenous (environmental) factors such as habits, way of life or religious practices of certain populations can influence the development of double monsters.

The flight experiment ANITA--a high performance air analyser for manned space cabins.

Analysing Interferometer for Ambient Air (ANITA) is a flight experiment as precursor for a permanent continuous trace gas monitoring system on the International Space Station (ISS). For over 10 years, under various ESA contracts the flight experiment was defined, designed, breadboarded and set up. For the safety of the crew, ANITA can detect and quantify quasi on-line and simultaneously 32 trace gases with ppm or sub-ppm detection limits. The self-standing measurement system is based on Fourier Transform Infrared Spectrometer (FTIR) technology. The system represents a versatile air monitor allowing for the first time the detection and monitoring of trace gas dynamics of a spacecraft atmosphere. It is envisaged to accommodate ANITA in a Destiny (US LAB) Express Rack on the ISS. The transportation to the ISS is planned with the first ATV 'Jules Verne'. The options are either the Space Shuttle or the Automated Transfer Vehicle.

Does captopril reduce renal function in renovascular disease by postglomerular vasodilatation?

In hypertensive patients with bilateral renal artery stenosis (RAS) or RAS of a solitary kidney, reversible decrease of glomerular filtration rate (GFR) or acute renal failure has been observed following captopril administration. Decrease of GFR has been ascribed to preferential efferent vasodilatation. To test this hypothesis, acute changes of mean arterial pressure (MAP), renal plasma flow (RPF), GFR, plasma renin activity (PRA) and PGE2-excretion after 50 mg captopril orally were measured in post-transplant hypertensives with and without transplant renal artery stenosis (TRAS) during treatment with diuretics. The fall in MAP was similar in both groups; RPF did not change significantly; GFR decreased from 58 +/- 14 (s.d.) to 49 +/- 14 ml/min (TRAS, n = 8) and from 60 +/- 15 to 50 +/- 16 ml/min (without TRAS, n = 8). There was no evidence of postglomerular dilatation in patients with TRAS, and filtration fraction decreased only in patients without TRAS. Increase of PRA after captopril was not significantly different between the two groups. PGE2-excretion did not change significantly. In one patient with severe TRAS, long term angiotensin converting enzyme (ACE) inhibition and acute normalization of MAP with sodium nitroprusside both induced a comparable decrease of GFR. The results demonstrate that acute postglomerular vasodilatation does not necessarily occur after ACE inhibition in patients with TRAS and a high-renin state.

Development of a mirror-based endoscope for divertor spectroscopy on JET with the new ITER-like wall (invited).

A new endoscope with optimised divertor view has been developed in order to survey and monitor the emission of specific impurities such as tungsten and the remaining carbon as well as beryllium in the tungsten divertor of JET after the implementation of the ITER-like wall in 2011. The endoscope is a prototype for testing an ITER relevant design concept based on reflective optics only. It may be subject to high neutron fluxes as expected in ITER. The operating wavelength range, from 390 nm to 2500 nm, allows the measurements of the emission of all expected impurities (W I, Be II, C I, C II, C III) with high optical transmittance (≥ 30% in the designed wavelength range) as well as high spatial resolution that is ≤ 2 mm at the object plane and ≤ 3 mm for the full depth of field (± 0.7 m). The new optical design includes options for in situ calibration of the endoscope transmittance during the experimental campaign, which allows the continuous tracing of possible transmittance degradation with time due to impurity deposition and erosion by fast neutral particles. In parallel to the new optical design, a new type of possibly ITER relevant shutter system based on pneumatic techniques has been developed and integrated into the endoscope head. The endoscope is equipped with four digital CCD cameras, each combined with two filter wheels for narrow band interference and neutral density filters. Additionally, two protection cameras in the λ > 0.95 µm range have been integrated in the optical design for the real time wall protection during the plasma operation of JET.