Rapid pre-concentration of mercury in solids and water for isotopic analysis.

The precise quantification of mercury (Hg) stable isotope compositions in low concentration or dilute samples poses analytical challenges due to Hg mass limitations. Common Hg pre-concentration procedures require extended processing times, making rapid Hg stable isotope measurements challenging. Here we present a modified pre-concentration method that combines commonly used Hg reduction and gold trap amalgamation followed by semi-rapid thermal desorption (less than 1 h) and chemical trapping. This custom designed system was demonstrated to perform adequately on multiple trapping matrices including a new bromine monochloride (BrCl) wet oxidant trap (40% 3HNO3:BrCl), capable of trapping consistently in 2 mL volume over a wide range of Hg masses (5-200 ng). The procedure was also shown to work effectively on natural matrices, waters and sediments, producing comparable isotope results to the direct digestion analyses. Here, we present a method that can effectively triple sample throughput in comparison to traditional procedures, and also access lower concentration matrices without compromising the accuracy or precision of Hg isotope measurements.

Understanding STAT3 signaling in cardiac ischemia.

Cardiovascular disease is the leading cause of death worldwide. It remains one of the greatest challenges to global health and will continue to dominate mortality trends in the future. Acute myocardial infarction results in 7.4 million deaths globally per annum. Current management strategies are centered on restoration of coronary blood flow via percutaneous coronary intervention, coronary artery bypass grafting and administration of anti-platelet agents. Such myocardial reperfusion accounts for 40-50 % of the final infarct size in most cases. Signaling transducer and activator of transcription 3 (STAT3) has been shown to have cardioprotective effects via canonical and non-canonical activation and modulation of mitochondrial and transcriptional responses. A significant body of in vitro and in vivo evidence suggests that activation of the STAT3 signal transduction pathway results in a cardio protective response to ischemia and attempts have been made to modulate this with therapeutic effect. Not only is STAT3 important for cardiomyocyte function, but it also modulates the cardiac microenvironment and communicates with cardiac fibroblasts. To this end, we here review the current evidence supporting the manipulation of STAT3 for therapeutic benefit in cardiac ischemia and identify areas for future research.

Understanding Complete Pathologic Response in Oesophageal Cancer: Implications for Management and Survival.

Despite significant improvement over recent decades, oesophageal cancer survival rates remain poor. Neoadjuvant chemoradiotherapy followed by oesophageal resection is mainstay of therapy for resectable oesophageal tumours. Operative morbidity and mortality associated with oesophagectomy remain high and complications arise in up to 60% of patients. Management strategies have moved towards definitive chemoradiotherapy for a number of tumour sites (head and neck, cervical, and rectal) particularly for squamous pathology. We undertook to perform a review of the current status of morbidity and mortality associated with oesophagectomy, grading systems determining pathologic response, and data from clinical trials managing patients with definitive chemoradiotherapy to inform a discussion on the topic.

The 100 most cited publications in cardiac surgery: a bibliometric analysis.

INTRODUCTION: This study is a citation analysis of the top 100 most cited papers in adult cardiac surgery. Bibliometric analyses are viewed as a proxy marker of a paper's influence and, therefore, an analysis of the most influential papers published in recent decades. METHODS: Impact factor ranking as of 2012 was used to decide which journals to include in our searches. The Thompson Reuters Web of Knowledge was used to search for citations of all papers relevant to cardiac surgery within selected journals. Journals in the areas of surgery, cardiothoracic surgery, general medicine, anaesthesia, perfusion and pathology were included. RESULTS: The most frequently cited paper was found to be that of Nashef et al. (Eur J Cardiothorac Surg 16(1):9-13, 1999) introducing the EuroSCORE operative risk evaluation system. A number of authors including Alderman, Carpentier and Cox had more than one paper in the top 100. CONCLUSION: Despite the potential flaws with bibliometric analysis, and its application to cardiac surgery, there is inherent merit in an analysis of this type.

Sealed operation of a rf driven ion source for a compact neutron generator to be used for associated particle imaging.

We present the recent development of a prototype compact neutron generator to be used in conjunction with the method of associated particle imaging for the purpose of active neutron interrogation. In this paper, the performance and device specifications of these compact generators that employ rf driven ion sources will be discussed. Initial measurements of the generator performance include a beam spot size of 1 mm in diameter and a neutron yield of 2x10(5) n/s with air cooling.

Influence of natural dissolved organic carbon on the bioavailability of mercury to a freshwater alga.

Bioavailability of mercury (Hg) to Selenastrum capricornutum was assessed in bioassays containing field-collected freshwater of varying dissolved organic carbon (DOC) concentrations. Bioconcentration factor (BCF) was measured using stable isotopes of methylmercury (MeHg) and inorganic Hg(II). BCFs for MeHg in low-DOC lake water were significantly larger than those in mixtures of lake water and high-DOC river water. The BCF for MeHg in rainwater (lowest DOC) was the largest of any treatment. Rainwater and lake water also had larger BCFs for Hg(II) than river water. Moreover, in freshwater collected from several US and Canadian field sites, BCFs for Hg(II) and MeHg were low when DOC concentrations were >5mg L(-1). These results suggest high concentrations of DOC inhibit bioavailability, while low concentrations may provide optimal conditions for algal uptake of Hg. However, variability of BCFs at low DOC indicates that DOC composition or other ligands may determine site-specific bioavailability of Hg.

"SMART" drug delivery systems: double-targeted pH-responsive pharmaceutical nanocarriers.

To develop targeted pharmaceutical carriers additionally capable of responding to certain local stimuli, such as decreased pH values in tumors or infarcts, targeted long-circulating PEGylated liposomes and PEG-phosphatidylethanolamine (PEG-PE)-based micelles have been prepared with several functions. First, they are capable of targeting a specific cell or organ by attaching the monoclonal antimyosin antibody 2G4 to their surface via pNP-PEG-PE moieties. Second, these liposomes and micelles were additionally modified with biotin or TAT peptide (TATp) moieties attached to the surface of the nanocarrier by using biotin-PE or TATp-PE or TATp-short PEG-PE derivatives. PEG-PE used for liposome surface modification or for micelle preparation was made degradable by inserting the pH-sensitive hydrazone bond between PEG and PE (PEG-Hz-PE). Under normal pH values, biotin and TATp functions on the surface of nanocarriers were "shielded" by long protecting PEG chains (pH-degradable PEG(2000)-PE or PEG(5000)-PE) or by even longer pNP-PEG-PE moieties used to attach antibodies to the nanocarrier (non-pH-degradable PEG(3400)-PE or PEG(5000)-PE). At pH 7.4-8.0, both liposomes and micelles demonstrated high specific binding with 2G4 antibody substrate, myosin, but very limited binding on an avidin column (biotin-containing nanocarriers) or internalization by NIH/3T3 or U-87 cells (TATp-containing nanocarriers). However, upon brief incubation (15-30 min) at lower pH values (pH 5.0-6.0), nanocarriers lost their protective PEG shell because of acidic hydrolysis of PEG-Hz-PE and acquired the ability to become strongly retained on an avidin column (biotin-containing nanocarriers) or effectively internalized by cells via TATp moieties (TATp-containing nanocarriers). We consider this result as the first step in the development of multifunctional stimuli-sensitive pharmaceutical nanocarriers.

Distribution and fluxes of total and methylmercury in Lake Superior.

Despite the importance and size of Lake Superior, little is known regarding the biogeochemical cycling or distribution of mercury within its waters. We present the results from two research cruises on total Hg (HgT) and methylmercury (MeHg) distributions in aqueous and particulate phases, and in offshore sediments. Open waters of Lake Superior are similar in HgT content to Lakes Michigan and Ontario (sub-ng L(-1)), whereas MeHg was only 1% of HgT. Seasonality in aqueous HgT distribution was observed, most likely from tributary inputs during Spring snowmelt. Suspended particles were enriched in MeHg relative to water and surficial sediments, suggesting enhanced particle partitioning followed by demethylation in the water column and in surface sediments. Distribution coefficients for mercury in surficial sediments were lower than those in suspended material, likely due to remineralization. Preliminary estimates of mass balance indicate that air-water exchange processes such as evasion and wet deposition dominate the HgT budget, due to the basin's relatively small watershed area relative to lake area. In contrast, methylmercury cycling within Lake Superior is influenced more strongly by watershed sources, as well as by sedimentary sources and photodemethylation. The Hg cycle in Lake Superior is unique in that it is more similar in many aspects to that in marine systems than in small lakes, where management data for freshwaters typically originates.

Partitioning of total mercury and methylmercury to the colloidal phase in freshwaters.

Using tangential flow ultrafiltration, total mercury (HgT) and methylmercury (MeHg) concentrations in the colloidal phase (0.4 microm-10 kDa) were determined for 15 freshwaters located in the upper Midwest (Minnesota, Michigan, and Wisconsin) and the Southern United States (Georgia and Florida). Unfiltered concentrations were typical of those reported for freshwater and ranged from 0.9 to 27.1 ng L(-1) HgT and from 0.08 to 0.86 ng L(-1) MeHg. For some rivers, HgT and MeHg in the colloidal phase comprised up to 72% of the respective unfiltered concentration. On average, however, HgT and MeHg concentrations were evenly distributed between the particulate (>0.4 microm), colloidal, and dissolved (<10 kDa) phases. The pool of Hg in the colloidal phase decreased with increasing specific conductance. Results from experiments on freshwaters with artificially elevated specific conductance suggest that HgT and MeHg may partition to different subfractions of colloidal material. The colloidal-phase HgT correlation with filtered organic carbon (OC(F)) was generally poor (r2 < 0.14; p > 0.07), but the regression of MeHg with OC(F) was strong, especially in the upper Midwest (r2 = 0.78; p < 0.01). On a mass basis, colloidal-phase Hg concentrations were similar to those of unimpacted sediments in the Midwest. Mercury to carbon ratios averaged 352 pg of HgT/mg of C and 25 pg of MeHg/mg of C and were not correlated to ionic strength. The log of the partition coefficient (log K(D)) for HgT and MeHg ranged from 3.7 to 6.4 and was typical of freshwater values determined using a 0.4 microm cutoff between the particulate phase and the dissolved phase. Log K(D) calculated using the <10 kDa fraction as "dissolved" ranged from 4.3 to 6.6 and had a smaller standard deviation about the mean. In addition, our data support the "particle concentration effect" (PCE) hypothesis that the association of Hg with colloids in the filter-passing fraction can lower the observed log K(D). The similarity between colloidal and particulate-phase partition coefficients suggests that colloidal mass and not preferential colloidal partitioning drives the PCE.

Effects of gilvin on the composition and dynamics of metalimnetic communities of phototrophic bacteria in freshwater North-American lakes.

The spectral distribution of light reaching the populations of phototrophic bacteria in the metalimnion of stratified lakes is a selective factor determining the community composition. At deep metalimnia, light spectra are enriched in photons of the central part of the spectrum (500-600 nm) and benefit Chromatiaceae, brown-coloured Chlorobiaceae and phyco-erythrine-containing cyanobacteria. Their carotenoids (okenone, spiriloxanthine, isorenieratene) and phycoerythrines allow these phototrophic bacteria to use light from the narrow central spectral wavebands. Otherwise, shallow metalimnetic communities receive light from a wide range (400-800 nm) and their composition is more diverse and usually enriched in green-coloured Chlorobiaceae, which are unable to take advantage of the central part of the spectrum. Gilvin compounds (humic substances dissolved in water), have strong effects on light absorption, especially at shorter wavelengths. Therefore, light spectra in lakes with high gilvin contents are enriched in photons of long wavelengths (> 600 nm). Several Wisconsin lakes with different gilvin contents were studied during the period of summer stratification in 1994. Spectral distribution of light reaching their metalimnia changed with increasing gilvin contents (measured as g(440) ). In the latter, phototrophic metalimnetic bacterial communities were absolutely dominated by green-coloured Chlorobiaceae. Intermediate lakes could experiment changes on their community composition depending on variations in gilvin content, as happened in Little Long lake. The dynamics of this lake was studied during summer 1995. The ratio of green-coloured species in respect to brown-coloured species increased after a sudden increase of gilvin due to strong rainfall. These results agree with the photosynthetic advantage of green-coloured Chlorobiaceae under red-light illumination, inferred from laboratory experiments, and suggest a bacteriochlorophyll-dependent, light-harvesting strategy of these phototrophic sulphur bacteria.

Surgical relief of tracheobronchial obstruction in infants and children.

OBJECTIVE: Congenital tracheobronchial obstruction (TBO) presents a complex problem both in terms of diverse aetiology, presence of associated anomalies and the operative strategy to be adopted. We report a single centre experience in managing this difficult problem. METHODS: Twenty-four infants and children with TBO referred to our unit over a 12-year period are reviewed. Aetiology of TBO included vascular rings (n = 9), anomalous innominate artery (n = 6), congenital tracheal stenosis (n = 5), segmental bronchial stenosis (n = 2) and pulmonary artery compression of the main bronchi (n = 2). Seven patients had concurrent cardiac anomalies. Stridor was the commonest presenting symptom (67%). Mean delay from onset of symptoms to referral was 19 months. One patient died preoperatively due to acute airway obstruction. Mean age at operation was 33.1 +/- 42 months (range 4 days-156 months) and 11 children were under 1 year at the time of surgery. In cases of TBO secondary to vascular rings, division of the ring resulted in relief of symptoms in seven cases, with two requiring further surgery for resultant tracheomalacia. Four of the five patients having tracheal resection were operated on with the use of cardiopulmonary bypass; three of these patients had concurrent correction of cardiac lesions, with two survivors. Tracheobronchial anastomoses were carried out using continuous polydioxanone (PDS). Patients with anomalous innominate arteries required aortopexy in five and innominate artery suspension in one, while those with pulmonary artery compression of the main bronchi had correction of their intracardiac defects (n = 2). RESULTS: Hospital mortality was 8.7% and there has been one late death due to Eisenmenger syndrome secondary to pulmonary regurgitation, atrial septal defect (ASD) and patent ductus arteriosus (PDA). On follow-up (mean 40 +/- 31 months), 19 patients are alive and symptom free. There have been no anastomotic strictures following tracheobronchial resection. The single most important predictor of mortality was the presence of associated cardiac anomalies. CONCLUSIONS: TBO can be managed effectively by a single operation in both infants and children without a detrimental effect on tracheal growth. We advocate consideration of concurrent repair of the tracheal and cardiac lesions. Cardiopulmonary bypass (CPB) allows this concurrent correction of cardiac lesions and also facilitates tracheal resection.

A malignant astrocytoma containing simian virus 40 DNA in a macaque infected with simian immunodeficiency virus.

Polyomaviruses have proven oncogenicity in nonhost experimental animals; however, studies concerning the association between human brain tumors and simian and human polyomaviruses have yielded inconclusive results. We examined the relationship of SV40 to a malignant astrocytoma found in the right frontal lobe of a pigtail macaque (Macaca nemestrina) infected with simian immunodeficiency virus (SIV). Consistent with the histologic diagnosis, the tumor was immunoreactive with antibodies to S-100 protein, vimentin, and glial fibrillary acidic protein, but negative for neurofilament protein, synaptophysin, neuron-specific enolase, and chromogranin A. At the time of SIV inoculation, the animal was seropositive for SV40. Polymerase chain reaction assay of tumor DNA, but not normal brain DNA, yielded a 300 base-pair fragment corresponding to the carboxy-terminal coding region (C-terminus) of the large T antigen gene of SV40, suggesting an association with the tumor.

The diverse potential of thoracoscopic assisted surgery.

Thoracoscopy has been a part of thoracic surgical practice for many years. The introduction of the camera chip and newer instrumentation has awakened a new interest in this technique and led to the development of video-assisted thoracic surgery (VATS). One hundred and seventy consecutive procedures performed on 158 patients are reviewed. Video-assisted techniques have proven useful in a broad spectrum of thoracic surgical procedures both diagnostic (n = 90) and therapeutic (n = 80). Hospital mortality was 1.3%. Conversion to formal thoracotomy was required in 2.5%, and re-exploration for bleeding in 0.6%. The technique was safe and the incidence of complications acceptable. VATS was particularly helpful in diagnosing "indeterminate" pulmonary nodules (sensitivity of 95%), interstitial lung disease (histological diagnosis in all), anterior mediastinal masses and post transplant pneumonitis. VATS may now be the surgical treatment of choice in those with spontaneous pneumothorax, and it also proved useful in a variety of benign disorders. Its role in the management of empyaema is limited with a 57% conversion rate. While pulmonary resections are feasible, its role in the therapeutic management of malignancy is questioned. Further studies are required to define the precise role of VATS in thoracic surgery.

Video-assisted thoracic surgery for delayed pericardial effusion post-CABG.

Delayed-onset pericardial effusion following coronary artery bypass grafts can give rise to significant morbidity in its presentation and in its management by traditional surgical techniques. A video-assisted thoracoscopic technique to create a pericardial window, with the advantage of a minimally invasive approach combined with excellent visualization in such a patient is described.

Thoracoscopic assisted paraoesophageal hernia repair.

A video assisted thoracic surgical repair of a paraoesophageal hernia is described. The advantage of the procedure was the combination of the diagnostic and therapeutic facility characteristic of a transthoracic approach without exposing the patient to the morbidity of formal thoracotomy.

Retrospective analysis of the utility of video-assisted thoracic surgery in 100 consecutive procedures.

One hundred consecutive video-assisted thoracic surgery (VATS) procedures, diagnostic (n = 54) and therapeutic (n = 46), in 90 patients over a 2-year period are reviewed. Hospital mortality was 2%. Conversion to formal thoracotomy was required in 3%, and re-exploration for bleeding in 1%. Seven patients required intensive care unit facilities postoperatively. The technique described was safe and there was minimal postoperative morbidity. Diagnostic VATS was of particular use in cases of indeterminate pulmonary masses (Sensitivity of 96%), anterior mediastinal masses and in immunocompromised patients. Video-assisted thoracic surgery may now be the treatment of choice for recurrent pneumothoraces and it demonstrated potential for development in a variety of other benign thoracic disorders. This method had a limited role in the management of empyaema with a 60% conversion rate to formal thoracotomy. Pulmonary resections were feasible but its role in the treatment of malignancy is questioned.

Imaged thoracoscopic surgery--patent ductus arteriosus ligation.

Video-assisted thoracic surgery (VATS) combines excellent visualization of the intrathoracic structures with a minimally invasive technique. A patient is presented who underwent successful ligation of a patent ductus arteriosus with a video-assisted thoracoscopic technique.

Video assisted thoracic surgery.

Using video thoracoscopic techniques in 30 patients over a twelve month period we have been able to perform 33 procedures that would have been previously performed by thoracotomy, with its associated morbidity. We have found the applications of this procedure to be diverse, being both diagnostic (n = 16) and therapeutic (n = 17). The diagnostic procedures were associated with a high diagnostic yield and allowed accurate staging. The therapeutic procedures were associated with minimal morbidity and short hospital stay. Our experience indicates an established and expanding role for Video Assisted Thoracic Surgery.