[Vena cava cement embolism after percutaneous kyphoplasty. Interventional radiological recovery in metastasized urothelial cancer]

For patients suffering from vertebral metastases vertebroplasty and kyphoplasty offer two relatively new treatment options for the stabilization of vertebral compression fractures. This can help to reduce the fracture-associated symptoms and can improve the quality of life. Cement extravasation is a specific complication of this therapy. This article reports a case of multiple cement paravasations in the paravertebral veins, the vena cava inferior and peripheral segmental and subsegmental pumonary arteries after kyphoplasty of an extensive pathological vertebral body fracture in a 64-year-old man suffering from metastatic urothelial cancer.

VCSEL-based, high-speed, in situ TDLAS for in-cylinder water vapor measurements in IC engines

We report the first application of a vertical-cavity surfaceemitting laser (VCSEL) for calibration- and sampling-free, high-speed, in situ H2O concentration measurements in IC engines using direct TDLAS (tunable diode laser absorption spectroscopy). Measurements were performed in a single-cylinder research engine operated under motored conditions with a time resolution down to 100 μs (i.e., 1.2 crank angle degrees at 2000 rpm). Signal-to-noise ratios (1σ) up to 29 were achieved, corresponding to a H2O precision of 0.046 vol.% H2O or 39 ppm · m. The modulation frequency dependence of the performance was investigated at different engine operating points in order to quantify the advantages of VCSEL against DFB lasers.

Evaluation of prognostic factors in liver-limited metastatic colorectal cancer: a preplanned analysis of the FIRE-1 trial

Background:

Liver-limited disease (LLD) denotes a specific subgroup of metastatic colorectal cancer (mCRC) patients.

Patients and Methods:

A total of 479 patients with unresectable mCRC from an irinotecan-based randomised phase III trial were evaluated. Patients with LLD and non-LLD and hepatic resection were differentiated. Based on baseline patient characteristic, prognostic factors for hepatic resection were evaluated. Furthermore, prognostic factors for median overall survival (OS) were estimated via Cox regression in LLD patients.

Results:

Secondary liver resection was performed in 38 out of 479 patients (resection rate: 7.9%). Prognostic factors for hepatic resection were LLD, lactate dehydrogenase (LDH), node-negative primary, alkaline phosphatase (AP) and Karnofsky performance status (PS). Median OS was significantly increased after hepatic resection (48 months), whereas OS in LLD (17 months) and non-LLD (19 months) was comparable in non-resected patients. With the inapplicability of Koehne's risk classification in LLD patients, a new score based on only the independent prognostic factors LDH and white blood cell (WBC) provided markedly improved information on the outcome.

Conclusion:

Patients undergoing hepatic resection showed favourable long-term survival, whereas non-resected LLD patients and non-LLD patients did not differ with regard to progression-free survival and OS. The LDH levels and WBC count were confirmed as prognostic factors and provide a useful and simple score for OS-related risk stratification also in LLD.

Viability and function of primary human endothelial cells on smooth poly(ether imide) films

Poly(ether imide) (PEI) is being explored as potential biomaterial for cardiovascular applications. Different studies showed that human umbilical venous endothelial cells (HUVEC) are able to adhere and proliferate on PEI membranes (R(q) = 13.20 ± 1.58 nm). A recently published study revealed evidence for much lower platelet adhesion on very smooth PEI-films (R(q) = 2.37 ± 1.40 nm). Therefore, we explored whether primary human venous endothelial cells (HUVEC) are able to adhere and proliferate on such very smooth PEI-films compared to tissue-cultured polystyrene (TCP) as reference material. Cytotoxicity testing revealed that PEI had a slight cytotoxic effect on HUVEC accompanied by a marginal reduced integrity of the plasma membrane and a significant lower mitochondrial activity. However long-term seeding experiments up to eleven days exhibited that HUVEC were able to proliferate on the PEI-films till confluence (TCP 96,190 ± 18,289 cells/cm(2); PEI 91,590 ± 19,583 cells/cm(2)). Further studies are planned to monitor the influence of shear force on the endothelial cell monolayer in a dynamic test system to determine its stability in view of shear resistant endothelialization of PEI for cardiovascular devices.

Effect of cytochrome P450-dependent epoxyeicosanoids on Ristocetin-induced thrombocyte aggregation

Epoxyeicosatrienoic acids (EETs) produced by cytochrome P450 (CYP)-dependent epoxidation of arachidonic acid (AA) inhibit thrombocyte adhesion to the vascular wall. Upon dietary omega-3 fatty acid supplementation, EETs are partially replaced by eicosapentaenoic acid (EPA)-derived epoxyeicosatetraenoic acids (EEQs) and docosahexaenoic acid (DHA)-derived epoxydocosapentaenoic acids (EDPs). We hypothesized that the omega-3 epoxy-metabolites may exhibit superior anti-thrombogenic properties compared to their AA-derived counterparts. To test this hypothesis, we analyzed the effects of 11,12-EET, 17,18-EEQ and 19,20-EDP on Ristocetin-induced thrombocyte aggregation (RITA), a process that mimics thrombocyte adhesion to the vascular wall. The eicosanoids were added for 5, 30, or 60 minutes to thrombocyte-rich plasma freshly prepared immediately after blood collection from stringently selected apparently healthy subjects. Thrombocyte aggregation was then induced by Ristocetin (0.75 mg/mL) and assessed by turbidimetric measurements. After 60 minutes of preincubation, all three epoxy-metabolites significantly decreased the rate of RITA. 17,18-EEQ and 19,20-EDP were effective already at 1 μM, whereas 5-fold higher concentrations were required with 11,12-EET. Addition of AUDA, an inhibitor of the soluble epoxide hydrolase, potentiated the effect of 17,18-EEQ resulting in a significant further decrease of the velocity as well as amplitude of the aggregation process. In contrast to their profound effects on RITA, none of the epoxy-metabolites was effective in reducing collagen- or ADP-induced thrombocyte aggregation. These results indicate a highly specific role of CYP-eicosanoids in preventing thromboembolic events and suggest that the formation of 17,18-EEQ and 19,20-EDP may contribute to the anti-thrombotic effects of omega-3 fatty acids.

Crossroads of coagulation and innate immunity: the case of deep vein thrombosis

Deep vein thrombosis (DVT) is a common condition characterized by the formation of an occlusive blood clot in the venous vascular system, potentially complicated by detachment and embolization of thrombi into the lung. Recent evidence from mouse models has shed light on the sequence of events and on the cellular (innate immune cells, platelets) and molecular (hematopoietic tissue factor, nucleic acids) components involved. In response to decreased blood flow, circulating neutrophils and monocytes adhere to the activated endothelium within hours. They initiate and propagate DVT by interacting with platelets and by the exposure and activation of circulating tissue factor and FXII. Intravascular blood coagulation is also induced by extracellular nucleosomes released mainly from activated neutrophils. Interestingly, these mechanisms are closely linked to an evolutionary conserved immune defense mechanism activated in response to infections. In this review, we will give an overview of DVT and the role of innate immune pathways supporting this process. While the latter are aimed at preserving tissue integrity and function, uncontrolled blood coagulation and activation of immune cells may result in pathological thrombus formation and vascular occlusion. Understanding the molecular and cellular players triggering occlusion of large veins, and their distinction from physiological hemostasis, is important for the development of strategies to prevent and treat DVT.

Acute and chronic nitrite toxicity in juvenile pike-perch (Sander lucioperca) and its compensation by chloride

Pike-perch Sander lucioperca is currently considered as one of the most promising candidates for production in freshwater recirculation aquaculture systems (RAS). Here, due to the lack of studies on nitrite (NO(2)(-)) toxicity in pike-perch, a flow-through exposure at 0, 0.44, 0.88, 1.75, 3.5, 7, 14 and 28 mg/L NO(2)(-)-N was carried out to determine the acute and chronic toxicity over a period of 32 days. In juvenile pike-perch, 120 h LC(50) was 6.1mg/L NO(2)(-)-N and at ≥14 mg/L NO(2)(-)-N all fish had died within 24 h. Chronic exposure revealed a significant build up of NO(2)(-) in the plasma as well as in the muscles at ≥0.44 mg/L NO(2)(-)-N peaking in fish exposed to the highest concentration of 3.5 mg/L NO(2)(-)-N after 32 days. Still, due to high individual variation methemoglobin (MetHb) was only significantly increased (p<0.01) at 3.5 mg/L NO(2)(-)-N. No adverse effects on red blood cells (RBC) and hematocrit were observed in any of the treatments. In a second experiment, compensation of NO(2)(-) toxicity at increasing chloride concentrations (40 (freshwater), 65, 90, 140, 240, 440 mg/L Cl(-)) was observed at a constant exposure of 10 mg/L NO(2)(-)-N for 42 days. At ≥240 mg/L Cl(-), NO(2)(-) build-up in blood plasma and muscle was completely inhibited. At lower Cl(-) concentrations (≤140 mg/L), NO(2)(-) was significantly increased in plasma, but only insignificantly elevated in muscle due to high individual variation. MetHb was increased significantly difference only at 40 mg/L Cl(-) (freshwater control) compared to the control. Again, high individual variations were observed. As a conclusion, S. lucioperca is moderately sensitive towards NO(2)(-) and acceptable levels in RAS should hence not exceed 1.75 mg/L NO(2)(-)-N to avoid MetHb formation. However, based on the 120 h LC(50) and a factor of 0.01 according to Sprague (1971), a NO(2)(-) concentration of ≤0.061 mg/L NO(2)(-)-N is considered as "safe." Thereby, no NO(2)(-) should accumulate in the plasma or muscle tissue during chronic exposure. For 10 mg/L NO(2)(-)-N, ≥240 mg/L chloride compensates for NO(2)(-) uptake in plasma and muscle.

Experimental investigation and modeling of the kinetics of CCl4 pyrolysis behind reflected shock waves using high-repetition-rate time-of-flight mass spectrometry

The pyrolysis kinetics of CCl(4) behind reflected shock waves was studied with high-repetition-rate time-of-flight mass spectrometry. For modeling, quantum mechanical calculations were performed to evaluate the dissociation energies of CCl bonds for the different CCl(x) (x = 1 to 4) radicals. Good agreement with the JANAF thermochemical table was found. With the reaction mechanism developed for CCl(4) decomposition satisfactory agreement with experimental results was obtained. The investigations show the importance of C(2)Cl(2) formation for understanding the processes of carbon cluster growth leading to carbonaceous particle formation.