[Perioperative anticoagulant and antiplatelet treatment in general thoracic surgery]. / Perioperativer Umgang mit Antikoagulanzien und Thrombozytenaggregationshemmern in der Thoraxchirurgie.

The perioperative use of anticoagulants in general thoracic surgery can be considered to be a "two-edged sword": the goal to minimise the risk of a thromboembolic episode is contrary to the ongoing effort of the surgeon to minimise the risk of intra- and postoperative blood loss. Dispositional factors such as excessive tobacco use are common for thoracic surgery patients and often lead to cardiovascular comorbidity which necessitates the use of anticoagulants or antiplatelet drugs. For deep venous thrombosis prophylaxis and for the indication and use of vitamin K antagonists or antiplatelet drugs it is proven in the literature that the risk profile of the patient and his/her classification in the appropriate risk group are of major importance. Through the individual risk profile of the patient it is possible to plan the appropriate perioperative anticoagulant therapy which will safely assist the surgeon and his/her patient during the peri- and postoperative phase on the knife-edge between blood loss and eminent thromboembolism. Unfortunately there are not enough existing data and published literature for evidence-based guidelines referring to the correct perioperative management for the new oral anticoagulants. Management algorithms are being recommended according to the multiple aspects of anticoagulant-treatment.

Expression of polyhydroxybutyric acid as a model for metabolic engineering of soybean seed coats.

The feasibility of genetically engineering soybean seed coats to divert metabolism towards the production of novel biochemicals was tested. The genes phbA, phbB, phbC from Ralstonia eutropha each under the control of the seed coat peroxidase promoter were introduced into soybean and the production of polyhydroxybutyrate (PHB) was assayed. The analysis of seed coats arising from 4 independent transformation events demonstrated that PHB was produced at a mean of 0.12% seed coat dried weight with individual values up to 0.36%. These values demonstrate that it is possible to metabolically engineer soybean seed coats.

Hepatocellular carcinoma in HIV positive patients.

Highly active antiretroviral therapy (HAART) has dramatically changed the natural history of HIV-1-infected patients leading to increased survival and a better quality of life. Hepatitis C virus (HCV) and hepatitis B virus (HBV) infections are common among HIV-1-infected subjects and represent the most important risk factors for hepatocellular carcinoma (HCC). Whether HIV plays a direct role in hepatocellular carcinoma (HCC) pathogenesis remains to be established.HCC clinical course depends on stage of cancer disease, performance status and comorbidities. Therapeutic options include liver transplantation, local antiblastic chemotherapy and biological drugs. In the HIV setting few data are available about treatment options. The increased longevity of patients with HIV imposes new strategies for prevention and therapeutic management of patients. The aim of this article is to provide an up-to-date review of HIV-related HCC in the HAART era.

Potential for Electric Vehicle Adoption to Mitigate Extreme Air Quality Events in China.

Electric vehicle (EV) adoption promises potential air pollutant and greenhouse gas (GHG) reduction co-benefits. As such, China has aggressively incentivized EV adoption, however much remains unknown with regard to EVs' mitigation potential, including optimal vehicle type prioritization, power generation contingencies, effects of Clean Air regulations, and the ability of EVs to reduce acute impacts of extreme air quality events. Here, we present a suite of scenarios with a chemistry transport model that assess the potential co-benefits of EVs during an extreme winter air quality event. We find that regardless of power generation source, heavy-duty vehicle (HDV) electrification consistently improves air quality in terms of NO2 and fine particulate matter (PM2.5), potentially avoiding 562 deaths due to acute pollutant exposure during the infamous January 2013 pollution episode (~1% of total premature mortality). However, HDV electrification does not reduce GHG emissions without enhanced emission-free electricity generation. In contrast, due to differing emission profiles, light-duty vehicle (LDV) electrification in China consistently reduces GHG emissions (~2 Mt CO2), but results in fewer air quality and human health improvements (145 avoided deaths). The calculated economic impacts for human health endpoints and CO2 reductions for LDV electrification are nearly double those of HDV electrification in present-day (155M vs. 87M US$), but are within ~25% when enhanced emission-free generation is used to power them. Overall, we find only a modest benefit for EVs to ameliorate severe wintertime pollution events, and that continued emission reductions in the power generation sector will have the greatest human health and economic benefits.

Two-dimensional crystallization conditions of human leukotriene C4 synthase requiring adjustment of a particularly large combination of specific parameters.

Human leukotriene C(4) synthase (LTC(4)S) forms highly ordered two-dimensional (2D) crystals under specific reconstitution conditions. It was found that control of a larger number of parameters than is usually observed for 2D crystallization of membrane proteins was necessary to induce crystal formation of LTC(4)S. Here, we describe the parameters that were optimized to yield large and well-ordered 2D crystals of LTC(4)S. Careful fractioning of eluates during the protein purification was essential for obtaining crystals. While the lipid-to-protein ratio was critical in obtaining order, four parameters were decisive in inducing growth of crystals that were up to several microns in size. To obtain a favorable diameter, salt, temperature, glycerol, and initial detergent concentration had to be controlled with great care. Interestingly, several crystal forms could be grown, namely the plane group symmetries of p2, p3, p312, and two different unit cell sizes of plane group symmetry p321.

Hourglass cell development in the soybean seed coat.

BACKGROUND AND AIMS: Hourglass cells (HGCs) are prominent cells in the soybean seed coat, and have potential use as 'phytofactories' to produce specific proteins of interest. Previous studies have shown that HGCs initiate differentiation at about 9 d post-anthesis (dpa), assuming their characteristic morphology by 18 dpa. This study aims to document the structural changes in HGCs during this critical period, and to relate these changes to the concurrent development of a specific soybean peroxidase (SBP) encoded by the Ep gene. METHODS: Pods were collected from plants at specific growth stages. Fresh material was processed for analysis of Ep peroxidase activity. Tissues were processed for scanning and transmission electron microscopy, as well as extracted for western blotting. A null variety lacking expression of Ep peroxidase was grown as a control. KEY RESULTS AND CONCLUSIONS: At 9 dpa, HGCs are typical undifferentiated plant cells, but from 12-18 dpa they undergo rapid changes in their internal and external structure. By 18 dpa, they have assumed the characteristic hourglass shape with thick cell walls, intercellular air spaces and large central vacuoles. By 45 dpa, all organelles in HGCs have been degraded. Additional observations indicate that plasmodesmata connect all cell types. SBP activity and SBP protein are detectable in the HGC before they are fully differentiated (approx. 18 dpa). In very early stages, SBP activity appears localized in a vacuole as previously predicted. These results increase our understanding of the structure and development of the HGC and will be valuable for future studies aimed at protein targeting to components of the HGC endomembrane systems.

Public Health and Climate Benefits and Trade-Offs of U.S. Vehicle Electrification.

Vehicle electrification is a common climate change mitigation strategy, with policymakers invoking co-beneficial reductions in carbon dioxide (CO2) and air pollutant emissions. However, while previous studies of U.S. electric vehicle (EV) adoption consistently predict CO2 mitigation benefits, air quality outcomes are equivocal and depend on policies assessed and experimental parameters. We analyze climate and health co-benefits and trade-offs of six U.S. EV adoption scenarios: 25% or 75% replacement of conventional internal combustion engine vehicles, each under three different EV-charging energy generation scenarios. We transfer emissions from tailpipe to power generation plant, simulate interactions of atmospheric chemistry and meteorology using the GFDL-AM4 chemistry climate model, and assess health consequences and uncertainties using the U.S. Environmental Protection Agency Benefits Mapping Analysis Program Community Edition (BenMAP-CE). We find that 25% U.S. EV adoption, with added energy demand sourced from the present-day electric grid, annually results in a ~242 M ton reduction in CO2 emissions, 437 deaths avoided due to PM2.5 reductions (95% CI: 295, 578), and 98 deaths avoided due to lesser ozone formation (95% CI: 33, 162). Despite some regions experiencing adverse health outcomes, ~$16.8B in damages avoided are predicted. Peak CO2 reductions and health benefits occur with 75% EV adoption and increased emission-free energy sources (~$70B in damages avoided). When charging-electricity from aggressive EV adoption is combustion-only, adverse health outcomes increase substantially, highlighting the importance of low-to-zero emission power generation for greater realization of health co-benefits. Our results provide a more nuanced understanding of the transportation sector's climate change mitigation-health impact relationship.

Stearic acid as plasma replacement for intracellular in vitro culture of Plasmodium knowlesi.

A chloroform extract of Cohn's fraction IV-4 of human plasma successfully replaced whole fraction IV-4 for the intracellular in vitro culture of Plasmodium knowlesi. We are now able to report the successful replacement of monkey plasma by stearic acid.

Plasma replacement for in vitro culture of Plasmodium knowlesi.

Of six fractions of human plasma tested, only Cohn's fraction IV-4 was effective for the replacement of whole plasma from monkey (Macaca mulatta) for the in vitro culture of Plasmodium knowlesi. The effects observed on multiplication and morphology of parasites suggest a specific role of some substance or substances in fraction IV-4.

The 'egg sandwich': a method for linking spatially resolved salmonid hatching rates with habitat variables in stream ecosystems.

This paper describes the development of the 'egg sandwich', a system for assessing stream substratum quality by linking measurements of depth-specific salmonid egg hatching success and physico-chemical water variables from the same sites within the interstitial zone.

Effects of a high polyunsaturated fat diet and vitamin E supplementation on high-density lipoprotein oxidation in humans.

Oxidative modification of high-density lipoproteins (HDL) impairs several biologic functions critical to its role in reverse cholesterol transport. We therefore investigated the effect of dietary polyunsaturated fat and vitamin E on the kinetics of HDL oxidation. Ten subjects were fed sequentially: a baseline diet in which the major fat source was olive oil; a high polyunsaturated fat diet in which the major fat source was safflower oil; and the safflower oil diet plus 800 I.U. vitamin E per day. Plasma lipoprotein levels, vitamin E content, fatty acid composition, and oxidation lag time and rate were determined after 3 weeks on each diet. The polyunsaturated fat diet increased the mean HDL(2) lag time from 45.8+/-12.5 to 83.3+/-11.6 min with no change in oxidation rate. Addition of vitamin E further increased the HDL(2) lag time to 115.6+/-4.4 min and decreased the HDL(2) oxidation rate 10-fold. Neither the polyunsaturated diet alone nor the diet with vitamin E supplementation had any effect on HDL(3) oxidation. We conclude that under conditions of controlled dietary fat intake, a high polyunsaturated fat intake does not increase the oxidation susceptibility of HDL subfractions, and that in this setting, vitamin E supplementation reduces the oxidation susceptibility of HDL(2). These data suggest that antioxidants could influence HDL function in vivo.

Antimicrobial action of compound 48/80 against protozoa, bacteria, and fungi.

Compound 48/80 inhibited the growth of protozoa, bacteria, and fungi but had no effect on the multiplication of viruses. All susceptible organisms were inhibited by 10 microgram/ml of crude compound 48/80, and some were inhibited by as little as 0.1 microgram/ml. Against Tetrahymena pyriformis, this drug was seven times more potent than quinine. Separation of compound 48/80 into different fractions indicated that some antimicrobial activity could be separated from the histamine-liberating activity. It was found that compound 48/80 is not surface active at 500 microgram/ml.

Effects of red cell extract on in vitro growth and multiplication of malarial parasites.

An extract of red blood cells was prepared from monkey blood. Red cell extract (RCE) of Aotus monkeys was beneficial for the in-vitro cultivation of 2 strains of P. falciparum. The active material(s) in Aotus RCE was not sedimented by centrifugation at 34,800 g for 1 hr. Rhesus monkey RCE improved the growth of P. knowlesi for in-vitro cultivation through 4 schizogonous cycles (88 hr).

Persisting effect of Ca(2+)-channel blockers on left ventricular function in hypertrophic cardiomyopathy after 14 years' treatment.

Ca(2+)-channel blockers of the verapamil type have been reported to exert a beneficial effect on clinical symptoms and survival rates in hypertrophic cardiomyopathy. The effects of verapamil have been attributed predominantly to an improved diastolic filling. It is unknown whether an effect on diastolic filling persists in these patients after long-term treatment. Fourteen patients (12 men, 2 women, median age fifty-one [thirty-two to fifty-five] years) with hypertrophic cardiomyopathy were included in the study. Patients had been treated with verapamil 240-480 mg/d or gallopamil 150-200 mg/d for fourteen (seven to seventeen) years. The effect of a withdrawal of Ca(2+)-channel blockers on parameters of left ventricular diastolic function was evaluated at rest and during exercise in patients with hypertrophic cardiomyopathy after long-term therapy. Investigations were performed at rest and during supine ergometric exercise during ongoing Ca(2+)-channel blocking therapy and after five (four to nine) days' withdrawal (control). Pulsed Doppler echocardiography was used to record diastolic mitral flow profiles from an apical four-chamber view. Withdrawal of Ca(2+)-channel blockers of the phenylalkylamine type after long-term treatment of hypertrophic cardiomyopathy resulted in a significant reduction of early diastolic inflow velocity at rest and during exercise. In conclusion, these results indicate a persistent improvement of early diastolic filling by Ca(2+)-channel blockers even after long-term treatment.

Are yeasts in vaginal smears intracellular or extracellular?

Using light microscopic cytodiagnosis the only thing that can be said about the position of the yeast cells in relation to the epithelial cells is that the epithelial cells and the parasite are very close to one another. It is not possible to say whether both elements are only temporarily projected above one another or in direct contact. This question can only be answered unequivocally with the aid of the electron microscope. It is possible to verify that the yeast cells, despite their size, are able to invade intact epithelial cells and are capable of reproduction within these same cells.