Integrating marine oil snow and MOSSFA into oil spill response and damage assessment

Marine snow formation and vertical transport are naturally occurring processes that carry organic matter from the surface to deeper waters, providing food and sequestering carbon. During the Deepwater Horizon well blowout, oil was incorporated with marine snow aggregates, triggering a Marine Oil Snow (MOS) Sedimentation and Flocculent Accumulation (MOSSFA) event, that transferred a significant percentage of the total released oil to the seafloor. An improved understanding of processes controlling MOS formation and MOSSFA events is necessary for evaluating their impacts on the fate of spilled oil. Numerical models and predictive tools capable of providing scientific support for oil spill planning, response, and Natural Resource Damage Assessment are being developed to provide information for weighing the ecological trade-offs of response options. Here we offer considerations for oil spill response and recovery when assessing the potential for a MOSSFA event and provide tools to enhance decision-making.

Mapping spatial and temporal variation of seafloor organic matter Δ14C and δ13C in the Northern Gulf of Mexico following the Deepwater Horizon Oil Spill

Following the Deepwater Horizon oil spill of 2010, large amounts of biodegraded oil (petrocarbon) sank to the seafloor. Our objectives were to 1) determine post-spill isotopic values as the sediments approached a new baseline and 2) track the recovery of affected sediments. Sediment organic carbon δ¹³C and Δ¹⁴C reached a post-spill baseline averaging -21.2 ± 0.9‰ (n = 129) and -220 ± 66‰ (n = 95). Spatial variations in seafloor organic carbon baseline isotopic values, ¹³C and ¹⁴C, were influenced by river discharge and hydrocarbon seepage, respectively. Inverse Distance Weighting of surface sediment Δ¹⁴C values away from seep sites showed a 50% decrease in the total mass of petrocarbon, from 2010 to 2014. We estimated a rate of loss of -2 × 10⁹ g of petrocarbon-C/year, 2-11% of the degradation rates in surface slicks. Despite the observed recovery in sediments, lingering residual material in the surface sediments was evident seven years following the blowout.

Mercury in sediment cores from the southern Gulf of Mexico: Preindustrial levels and temporal enrichment trends

Spatial and temporal variability of mercury concentrations in sediments was evaluated in ²¹⁰Pb-dated sediment cores from offshore and intertidal areas in the southern Gulf of Mexico. In offshore cores, mercury concentrations were comparable (11.2-69.2 ng g^-1), and intermediate between concentrations in intertidal cores from the eastern (6.0-34.4 ng g^-1) and the western (34.9-137.7 ng g^-1) inlets of Términos Lagoon. The enrichment factor (EF) indicated minimal contamination (EF < 2) in most offshore cores, whereas in some intertidal cores steadily increasing mercury enrichment and fluxes were observed along the past century. No evidence of oil industry related mercury contamination was found, as the minor but increasing enrichment in intertidal cores is most likely related to land-derived sources such as catchment eroded soils and waste water runoff. Results highlight the importance to control catchment erosion and untreated sewage releases to reduce mercury loadings to the coastal zone.

Dispersant Enhances Hydrocarbon Degradation and Alters the Structure of Metabolically Active Microbial Communities in Shallow Seawater From the Northeastern Gulf of Mexico

Dispersant application is a primary emergency oil spill response strategy and yet the efficacy and unintended consequences of this approach in marine ecosystems remain controversial. To address these uncertainties, ex situ incubations were conducted to quantify the impact of dispersant on petroleum hydrocarbon (PHC) biodegradation rates and microbial community structure at as close as realistically possible to approximated in situ conditions [2 ppm v/v oil with or without dispersant, at a dispersant to oil ratio (DOR) of 1:15] in surface seawater. Biodegradation rates were not substantially affected by dispersant application at low mixing conditions, while under completely dispersed conditions, biodegradation was substantially enhanced, decreasing the overall half-life of total PHC compounds from 15.4 to 8.8 days. While microbial respiration and growth were not substantially altered by dispersant treatment, RNA analysis revealed that dispersant application resulted in pronounced changes to the composition of metabolically active microbial communities, and the abundance of nitrogen-fixing prokaryotes, as determined by qPCR of nitrogenase (nifH) genes, showed a large increase. While the Gammaproteobacteria were enriched in all treatments, the Betaproteobacteria and different families of Alphaproteobacteria predominated in the oil and dispersant treatment, respectively. Results show that mixing conditions regulate the efficacy of dispersant application in an oil slick, and the quantitative increase in the nitrogen-fixing microbial community indicates a selection pressure for nitrogen fixation in response to a readily biodegradable, nitrogen-poor substrate.

Impacts of the Deepwater Horizon oil spill evaluated using an end-to-end ecosystem model

We use a spatially explicit biogeochemical end-to-end ecosystem model, Atlantis, to simulate impacts from the Deepwater Horizon oil spill and subsequent recovery of fish guilds. Dose-response relationships with expected oil concentrations were utilized to estimate the impact on fish growth and mortality rates. We also examine the effects of fisheries closures and impacts on recruitment. We validate predictions of the model by comparing population trends and age structure before and after the oil spill with fisheries independent data. The model suggests that recruitment effects and fishery closures had little influence on biomass dynamics. However, at the assumed level of oil concentrations and toxicity, impacts on fish mortality and growth rates were large and commensurate with observations. Sensitivity analysis suggests the biomass of large reef fish decreased by 25% to 50% in areas most affected by the spill, and biomass of large demersal fish decreased even more, by 40% to 70%. Impacts on reef and demersal forage caused starvation mortality in predators and increased reliance on pelagic forage. Impacts on the food web translated effects of the spill far away from the oiled area. Effects on age structure suggest possible delayed impacts on fishery yields. Recovery of high-turnover populations generally is predicted to occur within 10 years, but some slower-growing populations may take 30+ years to fully recover.

‘Sorry, no beds’: a problem for acute psychiatric admissions

Perceived difficulty in obtaining hospital admission for acute psychiatric patients was investigated in one health region using a self-reporting method. Over 17 months both inner city and rural districts reported a total of 327 episodes of difficulty in finding a bed. One hundred and six (32%) of reported cases could not be admitted, the remainder being admitted to a ‘leave’ bed, a bed booked for another patient, or elsewhere, solutions likely to compromise care. Attempts to locate a vacant bed required numerous telephone calls and led to considerable delays. Thirty-nine (12%) of the patients were described as particularly ill, but five of them absconded during the prolonged search for a bed, and a further 17 had to remain in the community, pending a vacant bed, including two aggressive and eight suicidal patients. Considerable under-reporting was confirmed. Possible consequences of the situation are discussed.

Sedimentation Pulse in the NE Gulf of Mexico following the 2010 DWH Blowout

The objective of this study was to investigate the impacts of the Deepwater Horizon (DWH) oil discharge at the seafloor as recorded in bottom sediments of the DeSoto Canyon region in the northeastern Gulf of Mexico. Through a close coupling of sedimentological, geochemical, and biological approaches, multiple independent lines of evidence from 11 sites sampled in November/December 2010 revealed that the upper ~1 cm depth interval is distinct from underlying sediments and results indicate that particles originated at the sea surface. Consistent dissimilarities in grain size over the surficial ~1 cm of sediments correspond to excess ²³⁴Th depths, which indicates a lack of vertical mixing (bioturbation), suggesting the entire layer was deposited within a 4–5 month period. Further, a time series from four deep-sea sites sampled up to three additional times over the following two years revealed that excess ²³⁴Th depths, accumulation rates, and ²³⁴Th inventories decreased rapidly, within a few to several months after initial coring. The interpretation of a rapid sedimentation pulse is corroborated by stratification in solid phase Mn, which is linked to diagenesis and redox change, and the dramatic decrease in benthic formanifera density that was recorded in surficial sediments. Results are consistent with a brief depositional pulse that was also reported in previous studies of sediments, and marine snow formation in surface waters closer to the wellhead during the summer and fall of 2010. Although sediment input from the Mississippi River and advective transport may influence sedimentation on the seafloor in the DeSoto Canyon region, we conclude based on multidisciplinary evidence that the sedimentation pulse in late 2010 is the product of marine snow formation and is likely linked to the DWH discharge.

δ(13)C and δ(15)N in deep-living fishes and shrimps after the Deepwater Horizon oil spill, Gulf of Mexico

The blowout of the Deepwater Horizon (DWH) drill-rig produced a surface oil layer, dispersed micro-droplets throughout the water column, and sub-surface plumes. We measured stable carbon and nitrogen isotopes in mesopelagic fishes and shrimps in the vicinity of DWH collected prior to, six weeks after, and one year after the oil spill (2007, 2010 and 2011). In 2010, the year of the oil spill, a small but significant depletion of δ(13)C was found in two mesopelagic fishes (Gonostoma elongatum and Chauliodus sloani) and one shrimp (Systellaspis debilis); a significant δ(15)N enrichment was identified in the same shrimp and in three fish species (G. elongatum, Ceratoscopelus warmingii, and Lepidophanes guentheri). The δ(15)N change did not suggest a change of trophic level, but did indicate a change in diet. The data suggest that carbon from the Deepwater Horizon oil spill was incorporated into the mesopelagic food web of the Gulf of Mexico.

Using natural abundance radiocarbon to trace the flux of petrocarbon to the seafloor following the Deepwater Horizon oil spill

In 2010, the Deepwater Horizon accident released 4.6–6.0 × 10(11) grams or 4.1 to 4.6 million barrels of fossil petroleum derived carbon (petrocarbon) as oil into the Gulf of Mexico. Natural abundance radiocarbon measurements on surface sediment organic matter in a 2.4 × 10(10) m(2) deep-water region surrounding the spill site indicate the deposition of a fossil-carbon containing layer that included 1.6 to 2.6 × 10(10) grams of oil-derived carbon. This quantity represents between 0.5 to 9.1% of the released petrocarbon, with a best estimate of 3.0–4.9%. These values may be lower limit estimates of the fraction of the oil that was deposited on the seafloor because they focus on a limited mostly deep-water area of the Gulf, include a conservative estimate of thickness of the depositional layer, and use an average background or prespill radiocarbon value for sedimentary organic carbon that produces a conservative value. A similar approach using hopane tracer estimated that 4–31% of 2 million barrels of oil that stayed in the deep sea settled on the bottom. Converting that to a percentage of the total oil that entered into the environment (to which we normalized our estimate) converts this range to 1.8 to 14.4%. Although extrapolated over a larger area, our independent estimate produced similar values.

Toxicity and mutagenicity of Gulf of Mexico waters during and after the deepwater horizon oil spill

The Deepwater Horizon oil spill is unparalleled among environmental hydrocarbon releases, because of the tremendous volume of oil, the additional contamination by dispersant, and the oceanic depth at which this release occurred. Here, we present data on general toxicity and mutagenicity of upper water column waters and, to a lesser degree, sediment porewater of the Northeastern Gulf of Mexico (NEGOM) and west Florida shelf (WFS) at the time of the Deepwater Horizon oil spill in 2010 and thereafter. During a research cruise in August 2010, analysis of water collected in the NEGOM indicated that samples of 3 of 14 (21%) stations were toxic to bacteria based on the Microtox assay, 4 of 13 (34%) were toxic to phytoplankton via the QwikLite assay, and 6 of 14 (43%) showed DNA damaging activity using the λ-Microscreen Prophage induction assay. The Microtox and Microscreen assays indicated that the degree of toxicity was correlated to total petroleum hydrocarbon concentration. Long-term monitoring of stations on the NEGOM and the WFS was undertaken by 8 and 6 cruises to these areas, respectively. Microtox toxicity was nearly totally absent by December 2010 in the Northeastern Gulf of Mexico (3 of 8 cruises with one positive station). In contrast, QwikLite toxicity assay yielded positives at each cruise, often at multiple stations or depths, indicating the greater sensitivity of the QwikLite assay to environmental factors. The Microscreen mutagenicity assays indicated that certain water column samples overlying the WFS were mutagenic at least 1.5 years after capping the Macondo well. Similarly, sediment porewater samples taken from 1000, 1200, and 1400 m from the slope off the WFS in June 2011 were also highly genotoxic. Our observations are consistent with a portion of the dispersed oil from the Macondo well area advecting to the southeast and upwelling onto the WFS, although other explanations exist. Organisms in contact with these waters might experience DNA damage that could lead to mutation and heritable alterations to the community pangenome. Such mutagenic interactions might not become apparent in higher organisms for years.

Spatially resolved genomic, stable isotopic, and lipid analyses of a modern freshwater microbialite from Cuatro Ciénegas, Mexico

Microbialites are biologically mediated carbonate deposits found in diverse environments worldwide. To explore the organisms and processes involved in microbialite formation, this study integrated genomic, lipid, and both organic and inorganic stable isotopic analyses to examine five discrete depth horizons spanning the surface 25 mm of a modern freshwater microbialite from Cuatro Ciénegas, Mexico. Distinct bacterial communities and geochemical signatures were observed in each microbialite layer. Photoautotrophic organisms accounted for approximately 65% of the sequences in the surface community and produced biomass with distinctive lipid biomarker and isotopic (δ(13)C) signatures. This photoautotrophic biomass was efficiently degraded in the deeper layers by heterotrophic organisms, primarily sulfate-reducing proteobacteria. Two spatially distinct zones of carbonate precipitation were observed within the microbialite, with the first zone corresponding to the phototroph-dominated portion of the microbialite and the second zone associated with the presence of sulfate-reducing heterotrophs. The coupling of photoautotrophic production, heterotrophic decomposition, and remineralization of organic matter led to the incorporation of a characteristic biogenic signature into the inorganic CaCO(3) matrix. Overall, spatially resolved multidisciplinary analyses of the microbialite enabled correlations to be made between the distribution of specific organisms, precipitation of carbonate, and preservation of unique lipid and isotopic geochemical signatures. These findings are critical for understanding the formation of modern microbialites and have implications for the interpretation of ancient microbialite records.

Comment on "A persistent oxygen anomaly reveals the fate of spilled methane in the deep Gulf of Mexico"

Kessler et al. (Reports, 21 January 2011, p. 312) reported that methane released from the 2010 Deepwater Horizon blowout, approximately 40% of the total hydrocarbon discharge, was consumed quantitatively by methanotrophic bacteria in Gulf of Mexico deep waters over a 4-month period. We find the evidence explicitly linking observed oxygen anomalies to methane consumption ambiguous and extension of these observations to hydrate-derived methane climate forcing premature.

Metagenomic and stable isotopic analyses of modern freshwater microbialites in Cuatro Ciénegas, Mexico

Ancient biologically mediated sedimentary carbonate deposits, including stromatolites and other microbialites, provide insight into environmental conditions on early Earth. The primary limitation to interpreting these records is our lack of understanding regarding microbial processes and the preservation of geochemical signatures in contemporary microbialite systems. Using a combination of metagenomic sequencing and isotopic analyses, this study describes the identity, metabolic potential and chemical processes of microbial communities from living microbialites from Cuatro Ciénegas, Mexico. Metagenomic sequencing revealed a diverse, redox-dependent microbial community associated with the microbialites. The microbialite community is distinct from other marine and freshwater microbial communities, and demonstrates extensive environmental adaptation. The microbialite metagenomes contain a large number of genes involved in the production of exopolymeric substances and the formation of biofilms, creating a complex, spatially structured environment. In addition to the spatial complexity of the biofilm, microbial activity is tightly controlled by sensory and regulatory systems, which allow for coordination of autotrophic and heterotrophic processes. Isotopic measurements of the intracrystalline organic matter demonstrate the importance of heterotrophic respiration of photoautotrophic biomass in the precipitation of calcium carbonate. The genomic and stable isotopic data presented here significantly enhance our evolving knowledge of contemporary biomineralization processes, and are directly applicable to studies of ancient microbialites.

Comparison of prostaglandin and cimetidine in protection of isolated gastric glands against indomethacin injury

Prostaglandins can protect the in vivo gastric mucosa against necrosis produced by a variety noxious agents. Cimetidine has also been shown to have protective properties in humans and in some models of experimental injury. Whether prostaglandins or cimetidine may protect gastric mucosal cells directly in the absence of systemic factors remains controversial. In the present study, the potential protective actions of prostaglandin and cimetidine against indomethacin injury were assessed in isolated rat gastric glands. Gastric glands were pre-incubated in oxygenated medium with either placebo, 16,16 dimethyl prostaglandin E(2) (dm PGE(2)) or cimetidine and incubated at 37 degrees C in medium containing 0.5 mg/ml of indomethacin for 2, 4 and 6 hrs. Cell injury and protection was assessed by the Fast Green exclusion test (viability test), leakage of lactate dehydrogenase (LDH) into the medium, and by scanning and transmission electron microscopy. In addition, the generation of PGE(2) by the gland cells was determined using RIA assay. Indomethacin by itself significantly reduced the viability of gastric glands, increased LDH release into the medium and produced prominent ultrastructural damage. In contrast to cimetidine, co-incubation of gastric glands with dm PGE(2) added to indomethacin, significantly reduced indomethacin-induced injury, increased the number of viable cells, reduced LDH leakage and diminished the extent of ultrastructural damage. The dose of indomethacin (5 microg/ml) which significantly inhibited the generation of PGE(2) (up to 90% inhibition) had no effect on cell viability nor LDH release. We conclude that 1) exogenous PGE2 exerts a potent protective activity in vitro which is independent on neural, vascular and hormonal factors; 2) inhibition of endogenous PGs may not the primary mechanism in the deleterious action of indomethacin against damage to gastric glandular cells and 3) indomethacin can exert a direct cytotoxic effect on the mucosal cells in gastric glands.

Restrictive use of immunosuppressive treatment in patients with idiopathic membranous nephropathy: high renal survival in a large patient cohort

BACKGROUND

Immunosuppressive treatment initiated at an early stage in patients with idiopathic membranous nephropathy (iMN) improves renal survival. Treatment should ideally be restricted to high-risk patients.

AIM

To evaluate the efficacy of a restrictive immunosuppressive treatment strategy for patients with iMN.

DESIGN

Prospective cohort study evaluating a predefined treatment protocol.

METHODS

From 1988, we adopted a restrictive treatment strategy: immunosuppressive treatment, mainly consisting of cyclophosphamide and steroids, was advised only in patients with renal insufficiency or severe intolerable nephrotic syndrome. We evaluated this strategy in a large patient cohort. To exclude any bias, we included all adult patients with iMN biopsied in the study period with a serum creatinine (Scr) < 135 micromol/l, a proteinuria > or = 3.0 g/day and/or a serum albumin (Salb) < or = 30 g/l at the time of biopsy. Analysis was according to the intention-to-treat principle.

RESULTS

We studied 69 patients. At the time of biopsy, mean age was 51 years, Scr 90 micromol/l, Salb 23 g/l and proteinuria 6.7 g/day. Average follow-up was 5.5 years. Thus far 33 (48%) patients have received immunosuppressive therapy, mainly because of renal insufficiency (n = 24). Status at the end of follow-up was: complete remission n = 22 (32%), partial remission n = 24 (35%), nephrotic syndrome n = 15 (22%), persistent proteinuria n = 1 (1.4%), ESRD n = 6 (8.7%), death n = 1 (1.4%; due to bladder carcinoma after cyclophosphamide therapy). Patient survival was 100% at 5 and 7 years. Renal survival was 94% at 5 years and 88% at 7 years.

DISCUSSION

In patients with iMN, a restrictive treatment policy assures a favourable prognosis, while preventing exposure to immunosuppressive therapy in >50% of the patients.

Inflammatory bowel diseases and brain-gut axis

The influence of stress on inflammation in inflammatory bowel disease (IBD) is reviewed. In experimental forms of colitis in rats, stress reactivated the disease. A study of stable IBD patients who were followed for over five years explored the influence of stress on exacerbating the disease. Those patients with high prolonged stressful life events were found to have a 90% recurrence rate of their colitis as compared to only 40% recurrence in low stress patients. Some of the mediators of stress include VIP, TNFalpha, heat shock proteins, glucocorticoid and catecholamines. Stress was shown to increase intestinal permeability to markers such as Cr-EDTA, HRP and dextran 10,000 in rats. In addition, stress increases the permeability of intestinal M-cells. Finally, stress increased the permeability of Paneth cells to HRP. Since Paneth cells synthesize NOD2 mRNA and protein, stress may play a role in the genesis or reactivation of Crohn's disease involving the terminal ileum. Brain-gut interactions via neural, hormonal and cytokine signals can diminish the mucosal protective factors and increase the permeability of luminal antigens into the intestinal epithelial and immune cells. Stress appears to play a key role in exacerbating and accentuating the intestinal inflammation in IBD through brain-gut interactions.

[Management of soft tissue injury in III B open tibial fractures: are local muscle flaps still up-to-date?]

Local muscle flaps for covering pretibial defects have been widely replaced due to the establishment of microsurgical procedures. The intention of the following study is to examine the results of soft tissue covering using local muscle flaps and to find out if its application is still indicated. At our level 1 trauma center 21 patients with III B open tibial fractures were treated with a local muscle flap to repair the soft tissue injury in the proximal and medial part of the lower leg. At the late follow-up after the average of 29 months all soft tissue defects and fractures were healed. Except of slight swelling under full weight stress no obstruction of blood circulation could be verified. 14 patients rated their functional outcome as good to excellent. In view of our results we consider local muscle flaps a suitable alternative to the free myoplasty for situations in which a more elaborate surgery is not feasible in due time, e. g. patients with acute brain edema, organ failure or lack of compliance.

Immunomodulation by intrathymic injection of donor leukocytes in rhesus monkeys

BACKGROUND

Several studies have demonstrated that intrathymic injection of donor cells into adult rodents can result in long-term allograft survival. The rationale for using the intrathymic route of donor cell administration is that in the thymic environment immature T cells are educated to discriminate between self and non-self antigens. The validity of this approach was tested in non-human primates.

METHODS

The effect of the intrathymic injection of allogeneic donor cells was investigated in rhesus monkeys and compared with IV and intracutaneous administration of donor cells. Intrathymic injections were carried out without and with antithymocyte globulin. All animals received subsequently an allogeneic skin graft of the same donor and no immunosuppression post transplantation.

RESULTS

Skin graft survival was slightly shorter in animals treated with IC donor cell injections (mean survival time [MST]=8.9+/-0.52) than untreated control animals (MST=10.0+/-0.44), indicating that this route caused sensitisation. Intravenous donor cell injection showed prolongation of graft survival times (MST=11.6+/-1.69). Intrathymic donor cell injection resulted in a graft survival of 9.2+/-1.44 days although addition of antithymocyte globulin slightly prolonged graft survival to 10.3+/-2.84 (not significant). Whereas the cellular responses after intrathymic and intravenous donor cell injections increased, antithymocyte globulin treated animals did not show an increased cellular response. Recipients of intrathymic donor cells showed a significantly decreased humoral anti-donor response as compared to other groups.

CONCLUSIONS

Donor cell pretreatment alters the subsequent response to an allogeneic skin graft in monkeys and is dependent on the route of donor cell administration. This is also reflected in the alloantibody response and the in vitro cellular reactivity. Intrathymic administration of donor cells does not lead to prolonged skin graft acceptance.

Influence of laparoscopy and laparotomy on systemic and peritoneal T lymphocytes in a rat model

Little is known about the local influence of pneumoperitoneum on components of the peritoneal immune defense mechanisms. We investigated CD25, CD4, CD8 expression and CD4/CD8 ratio of systemic and peritoneal T lymphocytes in a rat model. Fifty male Sprague Dawley rats underwent laparotomy, CO2 pneumoperitoneum, helium pneumoperitoneum, gasless laparoscopy, or anesthesia only. After 24 h venous blood was drawn, and peritoneal lavage was performed to harvest CD25+, CD4+, and CD8+ cells. CD4+, CD8+, and CD25+ T lymphocytes were determined. A significantly lower peritoneal CD4/CD8 ratio was found after CO2 and helium laparoscopy than in controls (P<0.05). However, no significant differences in systemic CD4/CD8 ratio or peritoneal or systemic CD25 expression were found between the different operative groups. Pneumoperitomeum independently of the insufflation gas (CO2 or helium) leads to comparable postoperative immunmodulations of peritoneal CD4+ and CD8+ T-lymphocytes. The mechanical pressure of the pneumoperitoneum seems to aggravate peritoneal T lymphocytes.

CO2 environment influences the growth of cultured human cancer cells dependent on insufflation pressure

BACKGROUND

Experimental and clinical studies, have suggested that the CO2 pneumoperitoneum influences the development of intraabdominal tumor dissemination and port site metastases. Previous experiments performed both in vitro and in vivo have proved that CO2 insufflation stimulates malignant cell growth. Therefore, we designed a study to investigate the influence of CO2 insufflation administered at different pressures on the growth of cultured human tumor cells.

METHODS

Two human tumor cell lines (CX-2 colon adenocarcinoma, DAN-G pancreas adenocarcinoma) were exposed to a CO2 environment maintained at different pressures (0 mmHg, 6 mmHg, 12 mmHg). Tumor growth was determined at different times after exposure to CO2 using fluorescence photometry. Cytotoxity of the CO2 environment different pressures was investigated using flow cytometry.

RESULTS

At 1-4 days after exposure to CO2 insufflation, CX-2 and DAN-G tumor cell growth was decreased significantly (p < 0.01). Proliferation of pancreatic adenocarcinoma DAN-G increased significantly from day 5 to day 15 independent of the insufflation pressure (p < 0.01). Proliferation of colon adenocarcinoma CX-2 increased significantly from day 5 to day 15 but was found to be dependent on the insufflation pressure. CX-2 growth increased significantly with higher pressures (p < 0.05).

CONCLUSION

CO2 insufflation influences the growth of cultured human tumor cells. After a short period of suppression, the CO2 environment stimulates malignant cell growth. The insufflation pressure may also have additional effects in promoting tumor growth.

Microbiological, molecular biological and stable isotopic evidence for nitrogen fixation in the open waters of Lake Michigan

We have used a combination of microbiological, molecular biological and stable isotope methods to relate specific microbial populations to elemental cycling at an offshore site in Lake Michigan. Several lines of evidence suggest that atmospheric N2 may be a significant source of nitrogen to the lake. Particulate organic nitrogen (PON) at approximately equals 10-15m depth in July and October had a delta15N of 0.5-1.5%o. These values closely reflect the 15N composition of atmospheric N2, suggesting biological nitrogen fixation. Historical data show a developing late-summer N:P minimum at approximately equals 15 m; low abundance of inorganic nitrogen relative to phosphorus favours species able to acquire atmospheric nitrogen. Microscopic examination of October water samples revealed abundant heterocystous cyanobacteria, including Nodularia sp. Potentially nitrogen-fixing Anabaena spp. have been found in Lake Michigan before but, to our knowledge, this is the first report of Nodularia. Finally, we have amplified both cyanobacterial and non-cyanobacterial nifH sequences (encoding the nitrogenase iron protein) from lakewater samples, evidence for the presence of bacteria capable of nitrogen fixation. The surface waters of Lake Michigan are considered to be phosphate limited in the stratified season and, under these conditions, energetically expensive nitrogen fixation is expected to be uncompetitive with assimilation of combined nitrogen. Our results suggest that, from both microbiological and biogeochemical perspectives, this may be an oversimplification.

Serum insulin-like growth factor-I (IGF-I) does not correlate positively with isometric strength, fatigue, and quality of life in post-polio syndrome

OBJECTIVES AND BACKGROUND

To determine if serum insulin-like growth factor-I (IGF-I) levels are associated with strength, body mass index (BMI), fatigue, or quality of life in post-poliomyelitis syndrome (PPS). PPS is likely due to a distal disintegration of enlarged post-polio motor units as a result of terminal axonal sprouting. Age-related decline in growth hormone and IGF-I (which support terminal axonal sprouts) is proposed as a contributing factor.

METHODS

As part of the North American Post-Poliomyelitis Pyridostigmine Study (NAPPS), baseline data on maximum voluntary isometric contraction (MVIC), BMI, subjective fatigue (fatigue severity scale, Hare fatigue symptom scale), health-related quality of life (short form health survey-36; SF-36), and serum IGF-I levels were gathered on 112 PPS patients. Pearson correlation coefficients were calculated to evaluate the association between serum IGF-I and MVIC in 12 muscles, BMI, two fatigue scales, and SF-36 scale scores.

RESULTS

There is a significant inverse correlation of IGF-I levels with MVIC in left ankle dorsiflexors (r=-0.30, P<0.01), and left and right knee extensors (r=-0.22, -0.25, P=<0.01, 0.01), but no significant correlations in other muscles. When men and women were evaluated separately, inverse correlations of IGF-I levels with MVIC were found only in men. IGF-I correlated inversely with BMI (r=-0.32, P=0006) and age (r=-0.32, P=0.0005). IGF-I did not correlate with the fatigue or SF-36 scales.

CONCLUSIONS

In this exploratory study, we found that contrary to our expectations, IGF-I did not correlate positively with strength. IGF-I correlated negatively with strength in several lower extremity muscles, BMI, and age. IGF-I is likely not an important factor in the pathogenesis of fatigue and in determining quality of life in PPS, but its role on strength should be studied further.

Using an esterified hyaluronan fleece to promote healing in difficult-to-treat wounds

Hyaluronic acid enhances angiogenesis and promotes re-epithelialisation and scar formation. Two case studies illustrate how a dressing that creates a hyaluronan-rich environment at the wound surface achieved full healing in two patients with underlying physiological problems.

A multicenter, randomized, double-blinded trial of pyridostigmine in postpolio syndrome

BACKGROUND

Postpoliomyelitis syndrome (PPS) is likely due to degeneration and dysfunction of terminal axons of enlarged postpolio motor units. Age-related decline in growth hormone and insulin-like growth factor (IGF-I) may be a contributing factor. Neuromuscular junction abnormalities and decreased IGF-I levels may respond to the anticholinesterase pyridostigmine, with consequent improvement in strength, fatigue, and quality of life.

OBJECTIVES

To determine the effect of pyridostigmine in PPS on health-related quality of life, isometric muscle strength, fatigue, and serum IGF-I levels; and to assess the safety of pyridostigmine in PPS.

METHODS

The study was a multicenter, randomized, double-blinded, placebo-controlled trial of a 6-month course of pyridostigmine 60 mg three times per day in 126 PPS patients. The primary data analysis compared mean changes of outcomes between treatment and control groups at 6 months using an intention to treat approach. Secondary analyses included a comparison of outcomes at 6 and 10 weeks, and in compliant patients.

RESULTS

The study showed no significant differences in pyridostigmine and placebo-treated patients with regard to changes in quality of life, isometric strength, fatigue, and IGF-I serum levels at 6 months in the primary analysis and in compliant patients. There were no differences in outcomes at 6 and 10 weeks between groups. However, very weak muscles (1 to 25% predicted normal at baseline) were somewhat stronger (p = 0.10, 95% CI of difference -9.5 to 73.3%), and in compliant patients IGF-I was somewhat increased (p = 0.15, 95% CI of difference -6.4 to 44.8 ng/mL) at 6 months with the medication. Pyridostigmine was generally well tolerated.

CONCLUSIONS

This study showed no significant differences between pyridostigmine and placebo-treated PPS patients on measures of quality of life, isometric strength, fatigue, and serum IGF-I.

Intestinal permeability, leaky gut, and intestinal disorders

A major task of the intestine is to form a defensive barrier to prevent absorption of damaging substances from the external environment. This protective function of the intestinal mucosa is called permeability. Clinicians can use inert, nonmetabolized sugars such as mannitol, rhamnose, or lactulose to measure the permeability barrier or the degree of leakiness of the intestinal mucosa. Ample evidence indicates that permeability is increased in most patients with Crohn's disease and in 10% to 20% of their clinically healthy relatives. The abnormal leakiness of the mucosa in Crohn's patients and their relatives can be greatly amplified by aspirin preadministration. Permeability measurements in Crohn's patients reflect the activity, extent, and distribution of the disease and may allow us to predict the likelihood of recurrence after surgery or medically induced remission. Permeability is also increased in celiac disease and by trauma, burns, and nonsteroidal anti-inflammatory drugs. The major determinant of the rate of intestinal permeability is the opening or closure of the tight junctions between enterocytes in the paracellular space. As we broaden our understanding of the mechanisms and agents that control the degree of leakiness of the tight junctions, we will be increasingly able to use permeability measurements to study the etiology and pathogenesis of various disorders and to design or monitor therapies for their management.

Autologous keratinocytes cultured on benzylester hyaluronic acid membranes in the treatment of chronic full-thickness ulcers

Keratinocytes were obtained from three patients with chronic full-thickness ulcers of different aetiologies. The cells were isolated, cultured and then seeded on to a membrane composed of benzylester hyaluronic acid. Once the keratinocytes had become subconfluent, the keratinocyte-containing matrix sheets were then applied as autologous grafts to the patients' ulcers. Results indicate that autologous grafting of keratinocytes cultured on benzylester hyaluronic acid membranes provides improved graft handling, reduces total time required for tissue cultivation and enhances cellular vitality because of the possibility of grafting at a subconfluent non-differentiated stage.

Ischemic preconditioning as an adjunct to crystalloid or blood cardioplegia for myocardial protection in routine coronary surgery

Experimental preconditioning is commonly regarded as a powerful protective phenomenon in case of subsequent ischemia. However, little is known about the applicability of preconditioning as an adjunct to cardioplegic myocardial protection in routine coronary surgery. For this reason, a prospective clinical study (611995 to 4/1996) was initiated to evaluate normothermic ischemic preconditioning prior to crystalloid or cold blood cardioplegic arrest. Preconditioning was performed in two cycles of 5 min ischemia and 10 min reperfusion. Four groups of 7 patients each were compared regarding release of troponin T, creatine kinase-myocardial isoform (CK-MB), lactate, and total CK in coronary sinus effluents over a 12-hour period. In the absence of perioperative myocardial infarction, there were no significant differences in these ischemic and metabolic parameters. Unexpectedly, the heed of postoperative pharmacological inotropic support was greater after preconditioning. These results may indicate that ischemic preconditioning as an adjunct to cardioplegic arrest may be associated with impairment of left-ventricular contractility, thus even exerting potentially detrimental functional effects. Overall, the proven beneficial effects of experimental preconditioning seem not to be directly transferable into the clinical settings.