Immunomodulation Through Beta-D-glucan in Chemically-induced Necrotizing Pancreatitis.

BACKGROUND: Although the ability of ß-D-glucan and monophosphoryl lipid A (MPLA) to modulate immune responses has been studied in human primary cells, their effect on sterile inflammation models such as necrotizing pancreatitis has never been investigated. MATERIALS AND METHODS: 85 male New Zealand rabbits were assigned into following groups: A: control, B: pretreatment with ß-D-glucan 3 d before pancreatitis, C: pretreatment with MPLA 3 d before pancreatitis, D: pretreatment with ß-D-glucan and laminarin 3 d before pancreatitis, E: treatment with ß-D-glucan 1 d after pancreatitis, and F: MPLA 1 d after pancreatitis. Pancreatitis was induced by sodium taurocholate injection into the pancreatic duct and parenchyma. Survival was recorded for 21 d. On days 1, 3, and 7, blood was collected for amylase measurement. Peripheral blood mononuclear cells were isolated and stimulated for tumor necrosis factor alpha and interleukin 10 production. Pancreatic necrosis and tissue bacterial load were assessed. RESULTS: 21-d survival was prolonged after pretreatment or treatment with ß-D-glucan; this benefit was lost with laminarin administration. At sacrifice, pancreatic inflammatory alterations were more prominent in the control group. Bacterial load was lower after pretreatment or treatment with ß-D-glucan and MPLA. Tumor necrosis factor alpha production from stimulated peripheral blood mononuclear cells was significantly decreased, whereas interleukin 10 production remained unaltered after pretreatment or treatment with ß-D- glucan. CONCLUSIONS: ß-D-glucan reduces mortality of experimental pancreatitis in vivo. This is mediated through attenuation of cytokine production and prevention of bacterial translocation.

Evaluation of the biogas potential of agricultural biomass waste for energy applications in Greece: A case study of the western Greece region.

Agricultural biomass can be best described as the organic matter residues from farming that remain within the fields after harvesting, along with tree trimmings. From the overall Greek Energy Balance, only a small fraction consists of biomass and this has been the main driving force behind this study. Due to the numerous ongoing agricultural activities, western Greece was selected as an ideal area for a case study. As a second step, the aim was to investigate the feasibility of the current anaerobic digestion plants to utilize the total biomass as feedstock. An additional scope to provide certifiable proof of the essential rural biomass assets available. Information on the potential of agricultural biomass is provided, with a focus on the performance specifications and the social advantages, but also the soil added substances and the produced biofuels. Subsequently, two options for waste management were discussed to illustrate the possibility of generating energy. The anaerobic digestion plants available in western Greece are illustrated in detail and the yearly rate of the main agrarian biomass is evaluated to be 715,080 tons. Arable crops, mechanical plants and tree trimming are recorded as the noteworthy sources. It is estimated that the proposed anaerobic digestion system will handle the entire amount of biomass and deliver max per year electricity 775 GWh and thermal energy 1.119 GWh.

A measure for cluster proximity (MCP) in child speech.

The proximity of consonant clusters in child speech is measured in the literature by the proportion of adult-like produced clusters to targeted clusters. With this measure, all clusters that are produced adult-like score 100%, while all others score 0%. Consonant clusters in child speech go through three main developmental stages: omission, reduction, two-member production (as targeted or substituted). Several authors claim that two-member clusters produced as two members should be considered acquired whether realised as targeted or not. In view of all these, a measure is needed that quantitatively differentiates all possible realisations of two-member clusters: omission, reduction, vowel epenthesis, two-member production, distinguishing substituted consonants from adult-like ones. Such a measure is proposed in the present article. To demonstrate its validity, the measure is applied to cluster productions of typically and atypically developing monolingual and bilingual children cross-linguistically. Moreover, it is applied to a bilingual Greek-English child's consonant clusters at age 2;7, when all cluster realisations are present. The aim is for the measure to be used in establishing norms for each stage in cluster development which will, in turn, guide assessment and intervention in phonologically delayed/disordered children.

A short review of primary aldosteronism in a question and answer fashion.

OBJECTIVES: The aim of this study was to present up to date information concerning the diagnosis and treatment of primary aldosteronism (PA). PA is the most common cause of endocrine hypertension. It has been reported up to 24% of selective referred hypertensive patients. METHODS: We did a search in Pub-Med and Google Scholar using the terms: PA, hyperaldosteronism, idiopathic adrenal hyperplasia, diagnosis of PA, mineralocorticoid receptor antagonists, adrenalectomy, and surgery. We also did cross-referencing search with the above terms. We had divided our study into five sections: Introduction, Diagnosis, Genetics, Treatment, and Conclusions. We present our results in a question and answer fashion in order to make reading more interesting. RESULTS: PA should be searched in all high-risk populations. The gold standard for diagnosis PA is the plasma aldosterone/plasma renin ratio (ARR). If this test is positive, then we proceed with one of the four confirmatory tests. If positive, then we proceed with a localizing technique like adrenal vein sampling (AVS) and CT scan. If the lesion is unilateral, after proper preoperative preparation, we proceed, in adrenalectomy. If the lesion is bilateral or the patient refuses or is not fit for surgery, we treat them with mineralocorticoid receptor antagonists, usually spironolactone. CONCLUSIONS: Primary aldosteronism is the most common and a treatable case of secondary hypertension. Only patients with unilateral adrenal diseases are eligible for surgery, while patients with bilateral and non-surgically correctable PA are usually treated by mineralocorticoid receptor antagonist (MRA). Thus, the distinction between unilateral and bilateral aldosterone hypersecretion is crucial.

A step by step approach in differential diagnosing of adrenal incidentaloma (epinephroma), (with comments on the new Clinical Practice Guidelines of the European Society of Endocrinology).

OBJECTIVES: To present a step by step approach for the diagnosis of adrenal incidentaloma (AI). METHOD: An extensive review of the literature was conducted, searching the Pub-Med and Google Scholar using the Mesh terms; Adrenal; Incidentaloma; Adrenal tumours; Radiology; Diagnosis. We also did a cross-referencing search of the literature. Comments on the new European guidelines are presented. RESULTS: The majority of the tumours are non-functioning benign adenomas. The most important radiological characteristic of an adrenal incidentaloma is the radiation attenuation coefficient. Wash out percentage and the imaging characteristics of the tumour may help in diagnosis. CONCLUSION: Density less than 10 HU is in most cases characteristic of a lipid rich benign adenoma. More than 10 HU or/and history of malignancy raise the possibility for cancer. 1 mg dexamethasone test and plasma metanephrines should be done in all patients. If there is history of hypokalemia and/or resistant hypertension we test the plasma aldosterone to plasma renin ratio (ARR). Newer studies have shown that tumours even nonfunctioning and less than 4 cm may increase the metabolic risks so we may consider surgery at an earlier stage.

Current concepts in the management of necrotizing fasciitis.

Necrotizing fasciitis (NF) is a severe, rare, potentially lethal soft tissue infection that develops in the scrotum and perineum, the abdominal wall, or the extremities. The infection progresses rapidly, and septic shock may ensue; hence, the mortality rate is high (median mortality 32.2%). Prognosis becomes poorer in the presence of co-morbidities, such as diabetes mellitus, immunosuppression, chronic alcohol disease, chronic renal failure, and liver cirrhosis. NF is classified into four types, depending on microbiological findings. Most cases are polymicrobial, classed as type I. The clinical status of the patient varies from erythema, swelling, and tenderness in the early stage to skin ischemia with blisters and bullae in the advanced stage of infection. In its fulminant form, the patient is critically ill with signs and symptoms of severe septic shock and multiple organ dysfunction. The clinical condition is the most important clue for diagnosis. However, in equivocal cases, the diagnosis and severity of the infection can be secured with laboratory-based scoring systems, such as the laboratory risk indicator for necrotizing fasciitis score or Fournier's gangrene severity index score, especially in regard to Fournier's gangrene. Computed tomography or ultrasonography can be helpful, but definitive diagnosis is attained by exploratory surgery at the infected sites. Management of the infection begins with broad-spectrum antibiotics, but early and aggressive drainage and meticulous debridement constitute the mainstay of treatment. Postoperative management of the surgical wound is also important for the patient's survival, along with proper nutrition. The vacuum-assisted closure system has proved to be helpful in wound management, with its combined benefits of continuous cleansing of the wound and the formation of granulation tissue.

Impact of free calcium oxide content of fly ash on dust and sulfur dioxide emissions in a lignite-fired power plant.

Emitted pollutants from the Agios Dimitrios lignite-fired power plant in northern Greece show a very strong linear correlation with the free calcium oxide content of the lignite ash. Dust (fly ash) emissions are positively correlated to free calcium oxide content, whereas sulfur dioxide (SO2) emissions are negatively correlated. As a result, at present, the Agios Dimitrios Power Plant operates very strictly within the legislative limits on atmospheric particulate emission. In the present study, the factors to be considered in assessing the impact of lignite combustion on the environment are presented and evaluated statistically. The ash appears to have a remarkable SO2 natural dry scrubbing capability when the free calcium oxide content ranges between 4 and 7%. Precipitator operating problems attributable to high ash resistivity can be overcome by injecting sulfur trioxide to reduce the ash resistivity, with, of course, a probable increase in operating costs.