Adsorption of the disinfectant benzalkonium chloride on montmorillonite. Synergistic effect in mixture of molecules with different chain lengths.

The biocide benzalkonium chloride (BAC) is a mix of cationic alkylbenzyldimethylammonium surfactants having different alkyl chain lengths. A comparative study of adsorption on the phyllosilicate clay montmorillonite of two of these surfactants, with alkyl chains having respectively 12 C atoms (BAC-12) and 14 C atoms (BAC-14), and a mixture of both surfactants is presented in this work. Adsorption isotherms were performed for individual surfactants and for a 1:1 mixture BAC-12+BAC-14. The adsorption was investigated in an ample concentration range that covers almost seven orders of magnitude in concentrations (from 1 nM to 10 mM), range that includes environmentally relevant concentrations. Quantification of BAC was performed by HPLC-UV and LC-MS and the results were completed with powder X-Ray diffraction. The adsorption of both surfactants leads to adsorption isotherms with two well differentiated steps. The first step corresponds almost exclusively to a cation exchange process, and the binding constant is very similar for both surfactants. The second step of the isotherms is observed at higher concentrations and adsorption is mainly driven by lateral interactions between surfactant molecules. The binding constant of this step is larger for BAC-14 than for BAC-12. Adsorption from a BAC-12+BAC-14 mixture shows a synergistic behaviour, possibly due to a better packing arrangement in the interlayer. Calculations show that in natural systems silicate clays are major sorbents of BAC at low concentrations whereas binding to humic acid is predominant at high concentrations.

[Irreversible loss of brain function : Requirements and Clinical diagnosis]. / Irreversibler Hirnfunktionsausfall : Voraussetzungen und Klinische Diagnostik.

Brain death (irreversible loss of brain function), according to German regulations, is investigated exclusively by qualified specialists in a strictly hierarchical three-step pattern and a four-eyes principle. In step 1 all necessary prerequisites are to be checked and the pathophysiology of brain damage has to be classified. Step 2 comprises the clinical investigation of reactivity to external stimuli and the upper, middle and lower brain stem reflexes including apnea testing. Step 3 exclusively checks for irreversibility of this condition. The latter is achieved by appropriate technical investigations or by repeated clinical examinations within context-specified intervals (range 12-72 h). However, exclusion of contributing primarily infratentorial pathologies is necessary to avoid limitations of the clinical findings. In this paper, both the initiation of brain death diagnostics and the approved clinical tests regarding to their execution, their alternatives and limits are presented and special situations like conditions with extracorporeal membrane oxygenation (ECMO) are also examined.

A novel model concept for modelling the leaching of natural toxins: results for the case of ptaquiloside.

Phytotoxins are a large class of highly diverse emerging environmental contaminants that have been detected at high concentrations in plants, water and soils. This study presents a novel modelling approach for assessing the fate of plant toxins in the soil-plant-atmosphere continuum, developed for the specific case of ptaquiloside (PTA), a carcinogenic phytotoxin produced by Pteridium aquilinum. The mechanistic model DAISY has been adapted for reproducing phytotoxin dynamics in plants, covering processes such as toxin generation in the canopy, wash off by precipitation and toxin recovery in the canopy after depletion events. Transport of the toxin in the soil was simulated by the advection-dispersion equation assuming weak sorption and degradation for two Danish soils. The model simulates realistic toxin contents in the plant during the growing season, where the actual PTA content is dynamic and a function of the biomass. An average of 48% of the PTA produced in the canopy is washed off by precipitation, with loads in the soil often in the order of mg m-2 and up to a maximum of 13 mg m-2 in a single rain event. Degradation in the soil removes 99.9% of the total PTA input to the soil, while only 0.1% leaches into the soil. The median annual flux-averaged predicted environmental concentrations during single events are often in the order of µg L-1, reaching up to 60 µg L-1 for the worst-case scenario. The simulated results for both degradation and wash off are of the same order of magnitude as the published data. Based on the results, we conclude that DAISY, with the newly implemented processes, is a useful tool for understanding, describing and predicting the fate of PTA in the soil. Further work comparing the model results with real data is needed for the calibration and validation of the model.

Dissipation and leaching of acephate, chlorpyrifos, and their main metabolites in field soils of Malaysia.

Preventive treatment with insecticides at high dosing rates before planting of a new crop- soil drenching- is a common practice in some tropical intensive cropping systems, which may increase the risk of leaching, soil functioning, and pesticide uptake in the next crop. The degradation rates and migration of acephate and chlorpyrifos and their primary metabolites, methamidophos and 3,5,6-trichloropyridinol (TCP), have been studied in clayey red yellow podzolic (Typic Paleudults), alluvial (Typic Udorthents), and red yellow podzolic soils (Typic Kandiudults) of Malaysia under field conditions. The initial concentrations of acephate and chlorpyrifos in topsoils were found to strongly depend on solar radiation. Both pesticides and their metabolites were detected in subsoils at the deepest sampling depth monitored (50 cm) and with maximum concentrations up to 2.3 mg kg(-1) at soil depths of 10 to 20 cm. Extraordinary high dissipation rates for weakly sorbed acephate was in part attributed to preferential flow which was activated due to the high moisture content of the soils, high precipitation and the presence of conducting macropores running from below the A horizons to at least 1 m, as seen from a dye tracer experiment. Transport of chlorpyrifos and TCP which both sorb strongly to soil organic matter was attributed to macropore transport with soil particles. The half-lives for acephate in topsoils were 0.4 to 2.6 d while substantially longer half-lives of between 12.6 and 19.8 d were observed for chlorpyrifos. The transport through preferential flow of strongly sorbed pesticides is of concern in the tropics.

[New guidelines for the diagnosis of irreversible loss of brain function : Concept and limitations, organizational demands, and implementation]. / Neue Richtlinien zur Diagnostik des irreversiblen Hirnfunktionsausfalls : Konzept und Limitationen, organisatorische Vorgaben und Ausführung.

In 2015, the German Medical Association (Bundesärztekammer) issued new guidelines on the diagnosis of the "irreversible loss of brain function" (ILBF). ILBF replaced the colloquial term "brain death" in order to leave the notion that concepts of death might vary such as "cardiac death" or "apparent death" and stress the objective medical-scientific matter. The German Transplantation Law describes ILBF as "the final, irreversible loss of all function of the cerebrum, cerebellum, and brainstem." The new guidelines are to be followed closely. They demand higher qualifications of physicians involved in the diagnosis of ILBF and emphasize at the same time the interdisciplinary approach and the mandatory involvement of at least one specialist in the neurological field. Several technical methods were added as additional tools to support the ILBF diagnosis such as CT-angiography and duplex ultrasound of brain and neck vessels. The new guidelines thereby raise the impact of demonstrating complete cerebral circulatory arrest but leave other options to prove irreversibility. Many procedures, such as the apnea test, were specified in more detail. This article summarizes the new features of the new guideline with a practical overview on who must be involved in the diagnosis of ILBF, how often, how the diagnosis is achieved stepwise from stage I to III and how it is secured as well as what technical methods may be involved at what stage of the procedure.

Migraine and delayed ischaemic neurological deficit after subarachnoid haemorrhage in women: a case-control study.

The aim of the present case-control study was to investigate the role of migraine as a potential risk factor for a delayed ischaemic neurological deficit (DIND) after subarachnoid haemorrhage (SAH). A telephone interview was performed in patients or their relatives to determine the prevalence of migraine. Thirty-six women aged <60 years had SAH with Hunt & Hess grade I-III and DIND (group A). This group was compared with an age-matched group of 36 female SAH patients, Hunt & Hess grade I-III without DIND (group B). The two populations were also characterized regarding hypertension, smoking, diabetes mellitus and alcohol use. A significant difference was only found for the prevalence of migraine with 47% in group A and 25% in group B (P < 0.05; odds ratio: 2.68, confidence interval: 0.99-7.29). Migraineurs revealed similar prevalences of risk factors independently of the presence of DINDs. This retrospective study suggests that women with migraine have a higher risk to develop a DIND than women without migraine.

Sorption and fractionation of dissolved organic matter and associated phosphorus in agricultural soil.

Mobility of dissolved organic matter (DOM) strongly affects the export of nitrogen (N) and phosphorus (P) from soils to surface waters. To study the sorption and mobility of dissolved organic C and P (DOC, DOP) in soil, the pH-dependent sorption of DOM to samples from Ap, EB, and Bt horizons from a Danish agricultural Humic Hapludult was investigated and a kinetic model applicable in field-scale models tested. Sorption experiments of 1 to 72 h duration were conducted at two pH levels (pH 5.0 and 7.0) and six initial DOC concentrations (0-4.7 mmol L(-1)). Most sorption/desorption occurred during the first few hours. Dissolved organic carbon and DOP sorption decreased strongly with increased pH and desorption dominated at pH 7, especially for DOC. Due to fractionation during DOM sorption/desorption at DOC concentrations up to 2 mmol L(-1), the solution fraction of DOM was enriched in P indicating preferred leaching of DOP. The kinetics of sorption was expressed as a function of how far the solution DOC or DOP concentrations deviate from "equilibrium." The model was able to simulate the kinetics of DOC and DOP sorption/desorption at all concentrations investigated and at both pH levels making it useful for incorporation in field-scale models for quantifying DOC and DOP dynamics.

Thrombectomy vs. Systemic Thrombolysis in Acute Embolic Stroke with High Clot Burden: A Retrospective Analysis.

PURPOSE: The efficacy of i. v. thrombolysis in acute stroke with high clot burden is limited. Successful recanalization is very unlikely if the thrombus length exceeds 7 mm. Thus this retrospective controlled study evaluated the efficacy and safety of neurothrombectomy in the treatment of acute embolic stroke in patients selected by a thrombus length of ≥ 8 mm using the stent retriever Trevo(®) device. MATERIALS AND METHODS: 40 patients with acute occlusion of the anterior intracranial arteries with a thrombus length of ≥ 8 mm were treated with neurothrombectomy. We compared the outcome with a historical cohort of 42 patients with a thrombus length of ≥ 8 mm that received i. v. thrombolysis only. Clinical outcome was assessed by modified Rankin scale in both groups at discharge and on day 90. RESULTS: Patients did not differ in age, mRS on admission, thrombus length or time from symptom onset to i. v. thrombolysis, but the thrombectomy group had higher NIHSS on admission. Successful recanalization was achieved in 33/40 patients (83 %) with neurothrombectomy. 15 patients received i. v. thrombolysis prior to neurothrombectomy. Median mRS at discharge was 3.5 (1.25 - 5) vs. 5 (4 - 6; p < 0.01) and on day 90 3 (1 - 4) vs. 5 (4 - 6; p < 0.01). Symptomatic hemorrhage occurred in 3 vs. 7 patients. 3 vs. 17 patients died within 90 days (thrombectomy vs. control each). There were only a few intervention-related complications. CONCLUSION: Thrombectomy in acute stroke with high clot burden using the Trevo(®) device has a low risk and improved clinical outcome compared to i. v. thrombolysis alone. Treatment selection by a clot length of ≥ 8 mm might be a powerful approach to improve the outcome of mechanical thrombectomy. KEY POINTS: • Clot length of ≥ 8 mm might be a valuable criterion for indicating neurothrombectomy. • Thrombolysis only in high clot burden is associated with poor clinical outcome. • Thrombectomy using the Trevo(®) stent retriever is safe and effective.

Reversible dementia in idiopathic hypoparathyroidism associated with normocalcemia.

Dementia in idiopathic hypoparathyroidism is generally ascribed to hypocalcemia and improves following normalization of the serum calcium level. We report a 51-year-old man with severe dementia and hypoparathyroidism, but without serum hypocalcemia and without clinical signs of hypocalcemia. There was rapid and sustained improvement and normalization of symptoms after therapy with 1,25-dihydroxy-cholecalciferol. We conclude that hypocalcemia is not the sole cause of dementia in idiopathic hypoparathyroidism.

Detection and monitoring of intracranial pressure dysregulation in liver failure by ultrasound.

BACKGROUND: Development of elevated intracranial pressure (ICP) in hepatic failure indicates poor prognosis. Its detection by invasive methods poses methodological problems. We applied ultrasound studies of the optic nerves to noninvasively estimated ICP status. METHODS: A total of 22 pediatric patients with hepatic failure were examined by serial B scan ultrasound and followed up clinically. Outcome was scored as survival or death due to multiorgan failure (MOF) or raised ICP. In 18 patients, transplantations were performed. RESULTS: Four patients died before transplantation was possible (raised ICP: n=3, MOF: n=1). After OLT there were 10 survivors and 8 patients died (MOF: n=3, raised ICP: n=5). In 10 patients we found optic nerve sheath diameter (ONSD) above normal limits. Eight patients died, mostly because of raised ICP (n=7). Only 2 of the 10 survivors experienced a transient ONSD increase, steadily normalized after transplantation. Preoperatively, normal ONSD was detected in four of seven patients. The outcome of these four cases was clearly superior (three survivors and one MOF) compared with abnormal pre-OLT ultrasound findings (raised ICP: n=3). CONCLUSION: Patients with poor prognosis related to raised ICP in pediatric liver failure can be identified by ultrasound measurement of ONSD without the disadvantages of invasive procedures. Although the exact intracranial pressure level cannot be deduced from single examinations, ONSD trends can reflect the evolution of ICP in hepatic encephalopathy.

Differential potentiation of GABAA receptor function by two stereoisomers of diimidazoquinazoline analogues.

1. U-84935, diimidazo[1,5-a;1',2'-C]quinazoline,5-(5-cyclopropyl-1,2,4-oxid iazol-3yl)- 2,3-dihydro, is a ligand of high affinity for the benzodiazepine site of the GABAA receptor composed of alpha 1 beta 2 gamma 2 subunits. 2. The efficacy of its analogues was measured with their ability to potentiate GABA-mediated Cl- currents in the whole cell configuration of the patch clamp techniques in human kidney cells (A293 cells) expressing the subtype of the GABAA receptor. 3. The analogues displayed various levels of efficacy including agonists, partial agonists and antagonists without marked changes in their affinity for the receptors. 4. The major determinant of their efficacy was the spacial configuration of a methyl substituent of the C2 atom of the rigid and planar diimidazoquinazoline ring: U-90167, containing the methyl substituent projected below the plane of the ring, markedly enhanced the GABA current with a maximal potentiation of 220 +/- 25%, while its stereoisomer, U-90168, marginally increased the GABA response with a maximal potentiation of 45 +/- 10%, to which its methyl group appeared to contribute very little. 5. U-90167 potentiated the GABA response with an EC50 of 8.1 nM and a Hill coefficient of 1.1 and did not alter the reversal potential for the Cl- current. 6. From computational modelling, the sensitive methyl group of U-90167 could be assigned to the general region for the 5-phenyl group of diazepam. The diimidazoquinazoline, because of its rigid and plantar ring structure, may be useful to define further the out-of-plane region responsible for agonistic activity and to pinpoint other areas pivotal to the functionality of benzodiazepine ligands.

Plasmid profiles of Salmonella enterica serovar berta isolated from broilers in Denmark.

Salmonella enterica serovar berta was isolated for the first time in Denmark in October 1984. This serovar has subsequently become endemic in the broiler industry. Plasmid profile analysis of 610 strains of S. berta isolated from broilers and broiler parent stock in the period October 1984 to July 1989 showed that plasmids were present in 85.7% of strains investigated, with a mean of 1.8 plasmids per strain. A significant increase in the mean number of plasmids per strain was seen during the observation period. Seventeen different plasmid sizes and 90 different plasmid profiles were identified. Plasmid profiling of S. berta appears to represent a promising tool for analysing the epidemiology of S. berta infections in broilers.

The characterization of Danish isolates of Salmonella enterica serovar Enteritidis by phage typing and plasmid profiling: 1980-1990.

Plasmid profiling, phage typing and antimicrobial resistance typing have been carried out on 736 isolates of Salmonella enterica serovar Enteritidis collected in Denmark during the period 1980 to 1990. Strains originated from cases of human salmonellosis, broiler poultry flocks, layer poultry flocks, quarantined imported poultry, environmental samples from hatchery units, and from bovines. Phage type (PT) 1 was found to be the most common type among isolates of poultry origin (57.6%) followed by PT4 (28.8%). Isolates belonging to PT8 were found exclusively in imported birds. Phage typing of a representative sample of human isolates revealed the predominance, as in most other Western European countries, of PT4 (61.8%). PT1, however, was found in 17.0% of human strains, a much higher incidence than expected. Antibiotic resistance was observed in 4 out of 107 human isolates (3.7%) and 2 out of 205 non-human isolates (1%) tested.

Abeta-fiber mediated activation of cingulate cortex as correlate of central post-stroke pain.

A patient is presented who suffered a lateral brainstem infarction which selectively abolished pain and temperature sensitivity in the lower right limb. One year later central post-stroke pain had developed in the affected limb with touch and cold allodynia. P40m dipoles calculated from magnetoencephalographic fields after electrical stimulation of both tibial nerves were localized in SI as is seen in normal subjects. However, stimulation of the affected side caused deep pain sensations and elicited a large N80m component, best explained by an additionally active dipole in cingulate cortex. This early co-activation in a limbic structure suggests peripheral Abeta-fiber mediation and lemniscal projection. Abnormal link to the pain system may be due to sensitization and reorganization above the level of nociceptive deafferentation.

Characterization of novel ligands for wild-type and natural mutant diazepam-insensitive benzodiazepine receptors.

A series of benzodiazepine receptor ligands with different chemical structures were evaluated for their affinities at diazepam-sensitive and diazepam-insensitive binding sites for [3H]Ro 15-4513 (ethyl-8-azido-5,6-dihydro-5-methyl-6-oxo-4H-imidazo-[1,5a][1,4] benzodiazepine-3-carboxylate) in cerebellar GABAA receptors. Rats of Wistar strain and of alcohol-sensitive (ANT) and alcohol-insensitive (AT) lines were used. The ANT rats possess a single point mutation in their GABAA receptor alpha 6 subunit, which makes their diazepam-insensitive sites sensitive to benzodiazepine agonists, unlike those of AT and Wistar rats. All compounds evaluated displayed high-affinity binding to diazepam-sensitive sites (Ki < 50 nM). In contrast, a wider range of affinities were observed at diazepam-insensitive sites which depended upon the basic structure and substitutions. The 7- and 8-halogen substituted imidazobenzodiazepines and 12-halogen substituted diimidazoquinazolines displayed the highest affinities (Ki < 15 nM), while intermediate to low affinities (100 < Ki < 4000 nM) were displayed by imidazoquinazolines, thienopyrimidines, one oxoimidazoquinoxaline, and some cyclopyrrolones. The imidazoquinoxalines evaluated displayed the lowest affinity (Ki > 10000 nM). The oxoimidazoquinoxaline, 6-chloro-3-(5-cyclopropyl-1,2,4-oxadiazol-3-yl)-4,5-dihydro-5-isop ropyl-4-oxo-imidazo[1,5-a]quinoxaline (NNC 14-0578) and suriclone represent the first benzodiazepine receptor full agonists to bind with relatively high affinity (Ki approximately 100 nM) to diazepam-insensitive sites. The 5 position substituted methoxybenzyl, dimethylallyl, and 4-fluorobenzyl oxoimidazoquinoxaline analogs demonstrated a 58-336-fold higher affinity for ANT than AT diazepam-insensitive sites.(ABSTRACT TRUNCATED AT 250 WORDS)

Anticonvulsant profile of the imidazoquinazolines NNC 14-0185 and NNC 14-0189 in rats and mice.

The anticonvulsant effects of NNC 14-0185 (3-(3-cyclopropyl-5-isoxazolyl)-6-fluoro-5-morpholino-imidazo[1,5- a] quinazoline) and NNC 14-0189 (3-(5-cyclopropyl-1,2, 4-oxadiazol-3-yl)-7-fluoro-5-(4-methyl-1-piperazinyl)-imidazo[1,5- a] quinazoline) in mice and rats were evaluated and compared with those of diazepam, clonazepam and the novel beta-carboline, abecarnil. Following i.p. administration, NNC 14-0185 and NNC 14-0189 prevented audiogenic seizures in DBA/2 mice and the clonic convulsions induced in mice by pentylenetetrazole, DMCM (methyl 6, 7-dimethoxy-4-ethyl-beta-carboline-3-carboxylate), 3-mercaptopropionic acid and a low dose of bicuculline. NNC 14-0185 and NNC 14-0189 prevented seizures induced by pentylenetetrazole in rats and were also effective anticonvulsants in amygdala-kindled rats. In general, the anticonvulsant potencies of NNC 14-0185 and NNC 14-0189 were comparable to those of the reference benzodiazepines. However, like abecarnil, they were not effective against the seizures induced in mice by maximal electroshock and a high dose of bicuculline. The anticonvulsant effects of NNC 14-0185 and NNC 14-0189 against pentylenetetrazole-induced seizures were apparent within 5 min of i.p. injection and persisted for at least 2 h. These effects appeared to be mediated by benzodiazepine receptors since they were inhibited by concurrent administration of flumazenil. Both NNC 14-0185 and NNC 14-0189 showed greater separation between their anticonvulsant and muscle relaxant effects (measured as impaired rotarod performance) than did diazepam. In this respect, their therapeutic windows were similar (NNC 14-0185) to or better (NNC 14-0189) than that of abecarnil. Tolerance did not develop to the anticonvulsant effects of NNC 14-0185 and NNC 14-0189 over a 4-day test. In comparison, the anticonvulsant effects of diazepam and abecarnil were attenuated by repeated drug administration. Thus, NNC 14-0185 and NNC 14-0189 have a promising anticonvulsant and side-effect profile in comparison with diazepam, clonazepam and abecarnil. The potential use of these compounds in the treatment of epilepsy should be explored further.

Development of 123I-labelled NNC 13-8241 as a radioligand for SPECT visualization of benzodiazepine receptor binding.

[125I]- and [123I]NNC 13-8241 were prepared from the trimethyltin precursor and radioactive iodide using the chloramine-T method. The total radiochemical yields of [125I]- and [123I]NNC 13-8241 were 60-70% and 40-50% respectively, with radiochemical purity higher than 98%. In binding studies with [125I]NNC 13-8241 in rats in vitro and in vivo a high uptake of radioactivity was demonstrated in brain regions known to have a high density of benzodiazepine (BZ) receptors such as the occipital and frontal cortex. SPECT examination with [123I]NNC 13-8241 in a Cynomolgus monkey demonstrated a high uptake of radioactivity in the occipital and frontal cortex. After displacement with flumazenil radioactivity in these brain regions was reduced to the level of a central region including the pons. Four hours after injection about 80% of the radioactivity in monkey plasma represented unchanged radioligand. This low degree of metabolism indicates that NNC 13-8241 is metabolically more stable than the radioligands hitherto developed for imaging of BZ-receptors in the primate brain.

Recovery from brain-stem lesions involving the nociceptive pathways: comparison of clinical findings with laser-evoked potentials.

Dissociated sensory impairment in brain-stem disorders suggests a lateral lesion involving the spinothalamic tract. Evoked potential studies of the somatosensory system with standard electrical stimulation (SEP) generally fail to establish objective correlates of such sensory deficits, because electrical stimuli predominantly activate large myelinated fibers that project into the medial lemniscal system. In contrast, laser-evoked potentials (LEPs), in response to brief radiant heat pulses, stimulate nociceptive afferents of the superficial skin and allow evaluation of thin fiber and spinothalamic tract function. We describe the recovery of deficits in pain sensitivity in five patients with isolated lateral brain-stem lesions that could be successfully monitored by LEP recordings in the acute stage and after intervals ranging from 7 months to 4 years. Upon first examination, LEPs were abnormal on the affected body side in all five cases of lateral medullary syndrome, irrespective of whether the etiology was vascular or inflammatory. The degree of recovery of pain sensitivity upon reexamination was reflected by the extent of normalization of the LEP. A control patient with vascular pontine lacunar stroke had normal LEPs on both sides, suggesting preserved spinothalamic conduction. The peak-to-peak amplitude of the main LEP component (N250-P400) correlated significantly with clinical pain sensitivity scored by standardized sensory testing (r = 0.76, p < 0.01). In contrast, early and late SEPs, after standard electrical median or tibial nerve stimulation, were normal in all patients, consistent with their intact mechanosensitivity. In conclusion, LEP studies allow the status of nociceptive function to be objectively and reliably documented on repeated examinations and therefore provide a useful supplement to multimodal sensory assessment in brain-stem disorders.