A recent deep earthquake doublet in light of long-term evolution of Nazca subduction.

Earthquake faulting at ~600 km depth remains puzzling. Here we present a new kinematic interpretation of two Mw7.6 earthquakes of November 24, 2015. In contrast to teleseismic analysis of this doublet, we use regional seismic data providing robust two-point source models, further validated by regional back-projection and rupture-stop analysis. The doublet represents segmented rupture of a ∼30-year gap in a narrow, deep fault zone, fully consistent with the stress field derived from neighbouring 1976-2015 earthquakes. Seismic observations are interpreted using a geodynamic model of regional subduction, incorporating realistic rheology and major phase transitions, yielding a model slab that is nearly vertical in the deep-earthquake zone but stagnant below 660 km, consistent with tomographic imaging. Geodynamically modelled stresses match the seismically inferred stress field, where the steeply down-dip orientation of compressive stress axes at ∼600 km arises from combined viscous and buoyant forces resisting slab penetration into the lower mantle and deformation associated with slab buckling and stagnation. Observed fault-rupture geometry, demonstrated likelihood of seismic triggering, and high model temperatures in young subducted lithosphere, together favour nanometric crystallisation (and associated grain-boundary sliding) attending high-pressure dehydration as a likely seismogenic mechanism, unless a segment of much older lithosphere is present at depth.

Adenovirus infection in the immunocompromised patient.

Illness associated adenovirus infection is described in 15 immunocompromised patients. Patients were immunocompromised by severe underlying disease, immunosuppressive or corticosteroid therapy or by age (prematurity). Evidence of adenovirus infection was obtained by either viral isolation or, in two cases, characteristic adenovirus inclusion bodies at postmortem study. All clinical illness was associated with high fever (temperature greater than 39 degrees C). Eighty per cent of the patients had severe systemic complaints including malaise, lethargy, fatigue and night sweats; a similar number of gastrointestinal symptoms. Pulmonary complaints were described in 11 of 15 cases and included cough (67 per cent) and tachypnea (53 per cent). Roentgenologic evidence of pneumonia was demonstrated in 12 of 15 patients (80 per cent). Elevation of serum hepatic enzyme levels (serum glutamic pyruvic transaminase (SGPT)) occurred in eight of 11 patients (73 per cent) and was moderate to severe (serum glutamic pyruvic transaminase greater than 450 IU/liter) in five of 11 (45 per cent). Nine patients died; seven after a rapid downhill course and two after a prolonged illness. Evidence of adenovirus infection microscopically by autopsy in the lung, liver or both is demonstrated in four patients with fulminant systemic illness. Adenovirus infection should be considered in the etiology of severe overwhelming illness in the immunocompromised host.

Clinical reactions and serologic responses after vaccination with whole-virus or split-virus influenza vaccines in children aged 6 to 36 months.

The reactogenicity and immunogenicity of whole-virus and split-product influenza vaccines were studied in 77 children between the ages of 6 and 36 months. Subjects initially received monovalent vaccine containing either A/USSR/77 (H1N1) antigen in 1978 or A/Brazil/78 (H1N1) antigen in 1979. One month later a trivalent preparation was given which contained the respective H1N1 antigen plus A/Texas/77 (H3N2) and B/Hong Kong/72 antigens. Temperatures of greater than or equal to 37.8 C (greater than or equal to 100 F) were observed more commonly after initial vaccination with whole-virus vaccine (35%) than after split-product vaccine (14%). No child had a temperature of greater than or equal to 39.4 C (103 F) or a febrile convulsion. The trivalent vaccines were more reactogenic than the monovalent vaccines although none of the reaction indices exceeded 0.9. The whole-virus vaccine appeared to be more immunogenic, especially in those children who were initially seronegative (preimmunization hemagglutination-inhibiting antibody titer (less than 5). Only 50% of children vaccinated with split-product vaccines with initial hemagglutination-inhibiting titers of less than 5 achieved titers of greater than or equal to 20 to the H1N1 antigen after two doses of vaccine compared with 97% in similar whole-virus vaccine recipients. The degree of antibody response to the A/Texas/77 component of the vaccines was greater than the response to the A/Brazil/78 or A/USSR/77 antigens.

Capsular polysaccharide Haemophilus influenzae type b vaccine: clinical and immunologic responses to two vaccines.

The clinical reactions and immunologic responses to two Haemophilus influenzae type b capsular polysaccharide vaccines were studied in 24- to 36-month-old children. A candidate vaccine (Connaught) induced greater than or equal to 1.0 microgram/ml of antipolysaccharide antibody in 37 (61.7%) of 60 infants 24 to 26 months of age; this compared with 8 (38.1%) of 21 infants 24 to 36 months of age given a licensed vaccine (Praxis). Reactions to both vaccines within 24 hours of administration were minimal; a smaller percentage of recipients of the candidate vaccine were asymptomatic (P less than 0.05). The lower levels of antibody production than previously reported may necessitate a reevaluation of current recommendations.

Adenovirus hepatitis in an immunosuppressed adult patient.

The role of adenovirus as an etiologic agent of hepatic damage has been controversial. A fatal case of adenovirus infection with fulminant hepatitis in a young immunosuppressed adult patient is presented. Intranuclear inclusions were confined to the liver. Electron microscopy revealed crystalline arrays of virions within hepatocytes. This is apparently the first reported case of adenovirus hepatitis occurring in an adult. Adenovirus hepatitis represents another hazard for the immunosuppressed patient.

Hydrocarbons in green and blue-green algae.

Liquid column chromatography and thin-layer chromatography were used to determine the total content of hydrocarbons and gas chromatography was used to evaluate composition of hydrocarbons in green algae (Chlorella kessleri, C. vulgaris, Chlorella sp., Scenedesmus acutus, S. acuminatus, S. obliquus) and the blue-green alga (Spirulina platensis) cultivated under autotrophic or heterotrophic conditions. In C. kessleri cultivated under heterotrophic conditions the content of hydrocarbons was found to be about 10(-2)% (per dry mass), whereas under autotrophic conditions it was about 10(-3)% (per dry mass). The highest content of hydrocarbons was detected in species of the genus Scenedesmus cultivated autotrophically (10(-1)%). Heptadecane and hexacosane were found as major alkanes, 1-heptadecene was detected among alkenes.

Serum and ultradiafiltrate middle molecules in hemodialysed patients.

The gel filtration technique was used for the fractionation of middle molecular substances (MMS) in plasma from conservatively treated patients, from dialysed patients with renal failure and in the ultradiafiltrate from dialysed ones. The following observations were made: 1. MMS accumulate in the plasma of conservatively treated patients in chronic renal failure. 2. The accumulation of MMS in dialysed patients is even higher. 3. The elimination of the most important MMS in the ultradiafiltrate is excellent. 4. It is concluded that hemofiltration and ultradiafiltration are indicated also for the removal of MMS, namely in the case of clinical complications which cause a further accumulation of MMS.

[Changes in amino acids in a regular dialysis program]. / Aktuální zmeny aminokyselin v pravidelném dialyzacním programu.

BACKGROUND: Dialyzed patients are chronically in a state of negative nitrogen balance, and amino acids, their building stones, are also significantly affected by dialysis. The purpose of the present investigation was to assess whether they should be supplied, how frequently and for how long and how they are influenced by the usual diet of patients. METHODS AND RESULTS: The examination was made in a group of 13 patients included in a regular haemodialysis programme. Their mean age was 53.2 +/- 12.4 years, they were dialyzed for an average period of 55 months, maximum 163 months. The patients were dialyzed three times per week for four hours, bicarbonate dialysate was used. The patients' diet was not modified in any way. A total of 52 haemodialysis were examined: losses of alpha-amino nitrogen were monitored as well as changes of serum concentrations of different amino acids. Their mean losses were 119 +/- 54.69 mmol/4 h: this corresponds to 10.5 +/- 4.8 mg amino acids. The dialysis clearance was on average 122.7 +/- 63.2 ml/min. This value did not differ significantly from the dialysis clearance of urea, but it was significantly higher than creatinine clearance (p < 0.05). During dialysis a significant drop (p < 0.001) of the plasma concentration of amino nitrogen occurred, however, the changes of serum concentrations of amino acids differed. A significant drop was recorded in serum concentrations of histamine, lysine, cysteine, methionine, tyrosine, glycine, asparagine, citrullin, glutamine, taurine. Before the beginning of dialysis the values of valine, lysine, threonine, serine, alanine and asparagine were lower than corresponds to the reference interval in healthy subjects. CONCLUSIONS: Changes of serum concentrations of individual amino acids are significantly influenced not only by their losses into the dialysate but also by their shift from cells into the extracellular fluid and by resorption from the digestive tract during protein intake in the course of dialysis. An adequate supply of high quality protein can compensate for these losses. Investigation of serum concentration of individual amino acids does not record their kinetic changes but can give an idea on the effectiveness of the dietary regime.

[Complications of subclavian and femoral cannulas]. / Komplikace podklíckových a femorálních kanyl.

In the course of 15 years in the author's department some 15,000 cannulas were inserted into the subclavian or femoral vein. This number included cca 2300 cannulas inserted to dialyzed patients. 213 patients (inl. 28 dialyzed) died with the inserted cannula. In these patients the incidence of complications was evaluated. A parietal thrombosis was the most frequent complication and was recorded in 119 cases, i.e. in 56% (in non-dialyzed in 57% and in dialyzed in 50%). In two non-dialyzed patients it was the cause of embolization into the lungs. In the incidence of complications there is no significant difference in dialyzed and non-dialyzed patients. For completeness the authors present a preliminary calculation per approximate number of inserted cannulas during this period. From the total number of 15,000 inserted cannulas fatal complications occurred in 0.06% (in dialyzed in 0.13% and non-dialyzed in 0.047%).

[Determination of lactoferrin in the diagnosis of pancreatopathy in patients with chronic kidney failure]. / Stanovení laktoferinu v diagnostice pankreatopatií u nemocných s chronickým selháním ledvin.

The authors investigated in patients with renal disease the lactoferrin content in duodenal aspirate. The aspirate was obtained after previous stimulation of the pancreas with pancreozymin. Lactoferrin estimation is described in the literature as a sensitive examination of changes of exocrine pancreatic secretion. The authors provided evidence that by assessing lactoferrin it is possible to detect initial changes of reduced exocrine pancreatic capacity already in subjects who are on the waiting list of chronic intermittent haemodialyzation programmes (CHIDP); maximum increase of the lactoferrin content in the duodenal aspirate corresponds with the severity of chronic renal failure. Transplantation of the kidneys leads to normalization of the amount of lactoferrin secreted by the pancreas which is evidence of normalization of pancreatic secretion. In patients with chronic renal failure lactoferrin is a sensitive marker of developing uraemic pancreatopathy.

[Early acute tubulointerstitial nephropathy in transplanted kidneys]. / Casná akutní tubulointersticiální nefropatie transplantované ledviny.

The authors investigated in a group of 124 patients the effect of acute tubular nephropathy and rejection on the period of functional persistence of transplanted kidneys. Transplants which developed tubulointerstitial nephropathy during the first two weeks after transplantation of the kidney had significantly lower cumulative indexes of survival for as long as the second year after transplantation. Grafts which were rejected during the first two weeks after transplantation had a significantly lower cumulative survival index only during the first and second year. The statistical significance was always tested in comparison with grafts where the postoperative course was uneventful. It is better to evaluate the functional prognosis of transplanted kidneys from the maximal achieved glomerular filtration after a load; it did not matter whether tubulointerstitial nephropathy or rejection was involved.

[Hemorrhage into the digestive tract as a cause of death in patients after kidney transplantation]. / Krvácení do zazívacího traktu jako prícina úmrtí u nemocných po transplantaci ledvin.

The authors investigated the prevalence, cause and possible prevention of haemorrhage into the gastrointestinal tract in 218 patients after transplantation of the kidney (TK). 1. Haemorrhage into the gastrointestinal tract after TK occurred in 32 patients incl. 53.1% who died. In the total mortality after TK haemorrhage into the gastrointestinal tract account for 15.7%. 2. The danger of haemorrhage into the gastrointestinal tract is increased in particular: in the early postoperative period (within one month after transplantation of the kidney), during acute rejection with declining function of the graft, in infectious complications, after graftectomy, in preexisting peptic ulcers. 3. The most frequent cause of haemorrhage were duodenal ulcers. The authors elaborated a system of preventive provisions which involve: a) medicamentous prophylaxis by administration of H2 blockers and antacids not only at the time of transplantation of the kidney and during the early postoperative period but also when there is an increased risk, b) detailed gastroenterological examination before transplantation of the kidney, c) in case of relapsing peptic ulceration in the case-history or haemorrhage into the gastrointestinal tract, subject patients on the waiting list for transplantation of the kidneys during the dialyzation period to proximal gastric vagotomy, or so-called highly selective vagotomy.

[Determination of urea distribution space on the basis of hemodialysis quantification]. / Stanovení distribucního prostoru mocoviny na podklade kvantifikace hemodialýzy.

By using direct dialysis quantification--DDQ--in 124 haemodialyses made in 14 patients the authors assessed the urea output in mmol in the dialyzation fluid collected after every dialysis. The evaluation of total body fluids, which accounts roughly for 60% of the total body weight, was replaced by a calculated distribution space of urea (Vu) according to the Du/Ppre--Ppost formula. This equation was modified with regard to the degree of ultrafiltration and urea formation. The authors found a 5% difference between the values of the modified Vu equation and total body fluids corresponding to 60% of the body weight.