Classification of chemically modified red blood cells in microflow using machine learning video analysis

We classify native and chemically modified red blood cells with an AI based video classifier. Using TensorFlow video analysis enables us to capture not only the morphology of the cell but also the trajectories of motion of individual red blood cells and their dynamics. We chemically modify cells in three different ways to model different pathological conditions and obtain classification accuracies for all three classification tasks of more than 90% between native and modified cells. Unlike standard cytometers that are based on immunophenotyping our microfluidic cytometer allows to rapidly categorize cells without any fluorescence labels simply by analysing the shape and flow of red blood cells.

Fecal microbiota composition is related to brown adipose tissue 18F-fluorodeoxyglucose uptake in young adults

OBJECTIVE

Human brown adipose tissue (BAT) has gained considerable attention as a potential therapeutic target for obesity and its related cardiometabolic diseases; however, whether the gut microbiota might be an efficient stimulus to activate BAT metabolism remains to be ascertained. We aimed to investigate the association of fecal microbiota composition with BAT volume and activity and mean radiodensity in young adults.

METHODS

82 young adults (58 women, 21.8 ± 2.2 years old) participated in this cross-sectional study. DNA was extracted from fecal samples and 16S rRNA sequencing was performed to analyse the fecal microbiota composition. BAT was determined via a static ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography-computed tomography scan (PET/CT) after a 2 h personalized cooling protocol. ¹⁸F-FDG uptake was also quantified in white adipose tissue (WAT) and skeletal muscles.

RESULTS

The relative abundance of Akkermansia, Lachnospiraceae sp. and Ruminococcus genera was negatively correlated with BAT volume, BAT SUVmean and BAT SUVpeak (all rho ≤ - 0.232, P ≤ 0.027), whereas the relative abundance of Bifidobacterium genus was positively correlated with BAT SUVmean and BAT SUVpeak (all rho ≥ 0.262, P ≤ 0.012). On the other hand, the relative abundance of Sutterellaceae and Bifidobacteriaceae families was positively correlated with ¹⁸F-FDG uptake by WAT and skeletal muscles (all rho ≥ 0.213, P ≤ 0.042). All the analyses were adjusted for the PET/CT scan date as a proxy of seasonality.

CONCLUSION

Our results suggest that fecal microbiota composition is involved in the regulation of BAT and glucose uptake by other tissues in young adults. Further studies are needed to confirm these findings.

CLINICAL TRIAL INFORMATION

ClinicalTrials.gov no. NCT02365129 (registered 18 February 2015).

Enhancements in laser-generated hot-electron production via focusing cone targets at short pulse and high contrast

We report on the increase in the accelerated electron number and energy using compound parabolic concentrator (CPC) targets from a short-pulse (∼150 fs), high-intensity (>10^{18} W/cm^{2}), and high-contrast (∼10^{8}) laser-solid interaction. We report on experimental measurements using CPC targets where the hot-electron temperature is enhanced up to ∼9 times when compared to planar targets. The temperature measured from the CPC target is 〈T_{e}〉=4.4±1.3 MeV. Using hydrodynamic and particle in cell simulations, we identify the primary source of this temperature enhancement is the intensity increase caused by the CPC geometry that focuses the laser, reducing the focal spot and therefore increasing the intensity of the laser-solid interaction, which is also consistent with analytic expectations for the geometrical focusing.

Gender and gut microbiota composition determine hepatic bile acid, metabolic and inflammatory response to a single fast-food meal in healthy adults

BACKGROUND & AIMS

Regular consumption of fast-food (FF) as a form of typical Western style diet is associated with obesity and the metabolic syndrome, including its hepatic manifestation nonalcoholic fatty liver disease. Currently, it remains unclear how intermittent excess FF consumption may influence liver metabolism. The study aimed to characterize the effects of a single FF binge on hepatic steatosis, inflammation, bile acid (BA), glucose and lipid metabolism.

METHODS

Twenty-five healthy individuals received a FF meal and were asked to continue eating either for a two-hour period or until fully saturated. Serum levels of transaminases, fasting BA, lipid profile, glucose and cytokine levels as well as transient elastography and controlled attenuation parameter (CAP; to assess hepatic steatosis) were analyzed before (day 0) and the day after FF binge (day 1). Feces was collected prior and after the FF challenge for microbiota analysis.

RESULTS

The FF meal induced a modest increase in CAP, which was accompanied by a robust increase of fasting serum BA levels. Surprisingly, levels of cholesterol and bilirubin were significantly lower after the FF meal. Differentiating individuals with a relevant delta BA (>1 μmol/l) increase vs. individuals without (delta BA ≤1 μmol/l), identified several gut microbiota, as well as gender to be associated with the BA increase and the observed alterations in liver function, metabolism and inflammation.

CONCLUSION

A single binge FF meal leads to a robust increase in serum BA levels and alterations in parameters of liver injury and metabolism, indicating a novel metabolic aspect of the gut-liver axis.

Order-of-magnitude increase in laser-target coupling at near-relativistic intensities using compound parabolic concentrators

Achieving a high conversion efficiency into relativistic electrons is central to short-pulse laser application and fundamentally relies on creating interaction regions with intensities ≫10^{18}W/cm^{2}. Small focal length optics are typically employed to achieve this goal; however, this solution is impractical for large kJ-class systems that are constrained by facility geometry, debris concerns, and component costs. We fielded target-mounted compound parabolic concentrators to overcome these limitations and achieved nearly an order-of-magnitude increase to the conversion efficiency and more than tripled electron temperature compared to flat targets. Particle-in-cell simulations demonstrate that plasma confinement within the cone and formation of turbulent laser fields that develop from cone wall reflections are responsible for the improved laser-to-target coupling. These passive target components can be used to improve the coupling efficiency for all high-intensity short-pulse laser applications, particularly at large facilities with long focal length optics.

Multisystem combined uranium resistance mechanisms and bioremediation potential of Stenotrophomonas bentonitica BII-R7: Transcriptomics and microscopic study

The potential use of microorganisms in the bioremediation of U pollution has been extensively described. However, a lack of knowledge on molecular resistance mechanisms has become a challenge for the use of these technologies. We reported on the transcriptomic and microscopic response of Stenotrophomonas bentonitica BII-R7 exposed to 100 and 250 μM of U. Results showed that exposure to 100 μM displayed up-regulation of 185 and 148 genes during the lag and exponential phases, respectively, whereas 143 and 194 were down-regulated, out of 3786 genes (>1.5-fold change). Exposure to 250 μM of U showed up-regulation of 68 genes and down-regulation of 290 during the lag phase. Genes involved in cell wall and membrane protein synthesis, efflux systems and phosphatases were up-regulated under all conditions tested. Microscopic observations evidenced the formation of U-phosphate minerals at membrane and extracellular levels. Thus, a biphasic process is likely to occur: the increased cell wall would promote the biosorption of U to the cell surface and its precipitation as U-phosphate minerals enhanced by phosphatases. Transport systems would prevent U accumulation in the cytoplasm. These findings contribute to an understanding of how microbes cope with U toxicity, thus allowing for the development of efficient bioremediation strategies.

Acoustic erythrocytometer for mechanically probing cell viscoelasticity

We demonstrate an acoustic device to mechanically probe a population of red blood cells at the single cell level. The device operates by exciting a surface acoustic wave in a microfluidic channel creating a stationary acoustic wave field of nodes and antinodes. Erythrocytes are attracted to the nodes and are deformed. Using a stepwise increasing and periodically oscillating acoustic field we study the static and dynamic deformation of individual red blood cells one by one. We quantify the deformation by the Taylor deformation index D and relaxation times τ₁ and τ₂ that reveal both the viscous and elastic properties of the cells. The precision of the measurement allows us to distinguish between individual cells in the suspension and provides a quantitative viscoelastic fingerprint of the blood sample at single cell resolution. The method overcomes limitations of other techniques that provide averaged values and has the potential for high-throughput.

Production of relativistic electrons at subrelativistic laser intensities

Relativistic electron temperatures were measured from kilojoule, subrelativistic laser-plasma interactions. Experiments show an order of magnitude higher temperatures than expected from a ponderomotive scaling, where temperatures of up to 2.2 MeV were generated using an intensity of 1×10^{18}W/cm^{2}. Two-dimensional particle-in-cell simulations suggest that electrons gain superponderomotive energies by stochastic acceleration as they sample a large area of rapidly changing laser phase. We demonstrate that such high temperatures are possible from subrelativistic intensities by using lasers with long pulse durations and large spatial scales.

Thermal conductivity measurements of proton-heated warm dense aluminum

Thermal conductivity is one of the most crucial physical properties of matter when it comes to understanding heat transport, hydrodynamic evolution, and energy balance in systems ranging from astrophysical objects to fusion plasmas. In the warm dense matter regime, experimental data are very scarce so that many theoretical models remain untested. Here we present the first thermal conductivity measurements of aluminum at 0.5–2.7 g/cc and 2–10 eV, using a recently developed platform of differential heating. A temperature gradient is induced in a Au/Al dual-layer target by proton heating, and subsequent heat flow from the hotter Au to the Al rear surface is detected by two simultaneous time-resolved diagnostics. A systematic data set allows for constraining both thermal conductivity and equation-of-state models. Simulations using Purgatorio model or Sesame S27314 for Al thermal conductivity and LEOS for Au/Al release equation-of-state show good agreement with data after 15 ps. Discrepancy still exists at early time 0–15 ps, likely due to non-equilibrium conditions.

Synthesis, chemical behavior, structure elucidation and iNOS inhibitory activity of 1-substituted 3-methylsulfanyl-5,6,7,8-tetrahydro-1H-[1,2,4]triazolo[1,2-a]pyridazines. Pharmazie 2017;72:371-382. [PMID: 29441933 DOI: 10.1691/ph.2017.6902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Novel slim and shapely sp3-rich nitrogen containing heterocyclic ring systems are sought-after platforms for the expansion of molecular diversity in lead discovery. The present work describes the synthesis and characterization of a series of derivatives of hitherto unknown 3-methylsulfanyl-5,6,7,8-tetrahydro-1H-[1,2,4]triazolo[1,2-a]pyridazines 2. This approach was guided by a computational study, aiming at an optimization of previously reported [1,2,4]triazolo[1,2-a]pyridazine-1-thiones 1 known to inhibit the inducible nitric oxide synthase (iNOS). The title compounds are accessible by methylation of compounds 1 under mild conditions. The products were biologically evaluated by the same cell-based assay as applied for previous products of type 1 using RINm5F cells, which were stimulated to produce NO on the influence of proinflammatory cytokines IL-1β and IFN-γ. Compounds 2 did not display the anticipated improved iNOS inhibitory activity in the selected assay but contribute to SAR in the field. In addition, an unprecedented formation of side-products 3 via oxidation has been investigated. The novel scaffolds represent attractive starting points for the construction of diverse molecules which differ considerably from known compounds based on flat and lipophilic aromatic scaffolds.

Transition from Collisional to Collisionless Regimes in Interpenetrating Plasma Flows on the National Ignition Facility

A study of the transition from collisional to collisionless plasma flows has been carried out at the National Ignition Facility using high Mach number (M>4) counterstreaming plasmas. In these experiments, CD-CD and CD-CH planar foils separated by 6-10 mm are irradiated with laser energies of 250 kJ per foil, generating ∼1000  km/s plasma flows. Varying the foil separation distance scales the ion density and average bulk velocity and, therefore, the ion-ion Coulomb mean free path, at the interaction region at the midplane. The characteristics of the flow interaction have been inferred from the neutrons and protons generated by deuteron-deuteron interactions and by x-ray emission from the hot, interpenetrating, and interacting plasmas. A localized burst of neutrons and bright x-ray emission near the midpoint of the counterstreaming flows was observed, suggesting strong heating and the initial stages of shock formation. As the separation of the CD-CH foils increases we observe enhanced neutron production compared to particle-in-cell simulations that include Coulomb collisions, but do not include collective collisionless plasma instabilities. The observed plasma heating and enhanced neutron production is consistent with the initial stages of collisionless shock formation, mediated by the Weibel filamentation instability.

Helicobacter pylori infection is associated with a reduced risk of developing eosinophilic oesophagitis

BACKGROUND

Eosinophilic oesophagitis (EoE) represents a chronic immune-antigen-mediated allergic disease of the oesophagus of still unknown aetiology. Environmental exposure has been postulated to play a pathogenetic role. Helicobacter pylori (H. pylori) infection has been inversely associated with allergic diseases including atopic dermatitis, asthma and allergic rhinitis and H. pylori may play a protective role in these conditions. Little is known about the relationship between EoE and H. pylori.

AIM

To investigate in a case-control study whether H. pylori infection is associated with a reduced risk of developing EoE.

METHODS

H. pylori infection was evaluated by serology in 58 [11(19%) female, 47 (81%) male, median age: 36.5 years, range 20-72 years] patients with a clinical and histologically proven diagnosis of EoE and 116 age and sex-matched controls (1 case: 2 controls). Antibodies against H. pylori were identified by enzyme-linked immunosorbent assay. Patients with H. pylori-specific IgG ≥ 30 enzyme immunounits were classified as H. pylori-positive.

RESULTS

3/58 (5.2%) patients with EoE had serological evidence of H. pylori infection (EoE - H. pylori current infection) and 5/58 (8.6%) reported prior eradication therapy for H. pylori infection (EoE - H. pylori former infection). The control group demonstrated significantly higher seroprevalence of H. pylori (37.9%, P < 0.0001) when compared to patients with EoE. EoE was inversely associated with H. pylori infection [odds ratio (OR) 0.24, 95% confidence interval (CI) 0.11-0.50].

CONCLUSION

Helicobacter pylori infection is inversely associated with EoE. Our results may contribute to further understanding the pathogenesis and evolving aetiology of EoE.

High-contrast laser acceleration of relativistic electrons in solid cone-wire targets

The consequences of small scale-length precursor plasmas on high-intensity laser-driven relativistic electrons are studied via experiments and simulations. Longer scale-length plasmas are shown to dramatically increase the efficiency of electron acceleration, yet, if too long, they reduce the coupling of these electrons into the solid target. Evidence for the existence of an optimal plasma scale-length is presented and estimated to be from 1 to 5μm. Experiments on the Trident laser (I=5×10(19)W/cm(2)) diagnosed via Kα emission from Cu wires attached to Au cones are quantitively reproduced using 2D particle-in-cell simulations that capture the full temporal and spatial scale of the nonlinear laser interaction and electron transport. The simulations indicate that 32%±8%(6.5%±2%) of the laser energy is coupled into electrons of all energies (1-3 MeV) reaching the inner cone tip and that, with an optimized scale-length, this could increase to 35% (9%).

Commissioning of a frequency-resolved optical gating system at the OMEGA EP laser facility: SpecFROG

We present the design and commissioning of a new single-shot, frequency-resolved optical gating system on the OMEGA EP laser facility - dubbed "SpecFROG" - for characterizing the instantaneous intensity and phase of ∼10 ps pulses used to study ultra-intense laser-plasma interactions. A polarization-gating geometry is employed to ensure tha the diagnostic is broadband and has unambiguous time directionality. SpecFROG is capable of characterizing ∼10 s of mJ pulses with durations between 0.5-25 ps with ≲285 fs geometrical temporal blurring and ∼0.1% spectral shift resolutions over an adjustable total spectral shifting window of ∼15% of the carrier wavelength λo; configurations currently exist for both the fundamental (1ω, λo = 1.054 μm) and second harmonic (2ω, λo = 0.527 μm) of the EP pulse. Initial specular reflectivity measurements of the ∼1 kJ, ∼10 ps OMEGA EP laser off solid density aluminum targets suggest drastically different scalings for specular pulse properties compared to picosecond-scale pulses of comparable intensities.

Scaling the yield of laser-driven electron-positron jets to laboratory astrophysical applications

We report new experimental results obtained on three different laser facilities that show directed laser-driven relativistic electron-positron jets with up to 30 times larger yields than previously obtained and a quadratic (∼E_{L}^{2}) dependence of the positron yield on the laser energy. This favorable scaling stems from a combination of higher energy electrons due to increased laser intensity and the recirculation of MeV electrons in the mm-thick target. Based on this scaling, first principles simulations predict the possibility of using such electron-positron jets, produced at upcoming high-energy laser facilities, to probe the physics of relativistic collisionless shocks in the laboratory.

Enhanced relativistic-electron-beam energy loss in warm dense aluminum

Energy loss in the transport of a beam of relativistic electrons in warm dense aluminum is measured in the regime of ultrahigh electron beam current density over 2×10^{11}  A/cm^{2} (time averaged). The samples are heated by shock compression. Comparing to undriven cold solid targets, the roles of the different initial resistivity and of the transient resistivity (upon target heating during electron transport) are directly observable in the experimental data, and are reproduced by a comprehensive set of simulations describing the hydrodynamics of the shock compression and electron beam generation and transport. We measured a 19% increase in electron resistive energy loss in warm dense compared to cold solid samples of identical areal mass.

[Acute and chronic heart failure in light of the new ESC guidelines]

In June 2012, the New Guidelines for the Treatment of Acute and Chronic Heart Failure of the European Society of Cardiology were published. According to the EMPHASIS-HF trial, mineralocorticoid receptor antagonists are indicated in all stages of symptomatic chronic heart failure under treatment with β-blockers and ACE inhibitors. Based on the SHIFT trial, patients with class NYHA II-IV heart failure, an ejection fraction <35%, and sinus rhythm with a heart rate of >70/min despite pharmacological treatment including β-blockers at the maximum tolerated dose should be treated with ivabradin. The RAFT trial justified the extended indication for CRT systems. In acute heart failure, the RELAX-AHF trial showed promising results with serelaxin. This manuscript summarizes the innovations of the new guidelines and the underlying clinical trials.

Comparisons of dense-plasma-focus kinetic simulations with experimental measurements

Dense-plasma-focus (DPF) Z-pinch devices are sources of copious high-energy electrons and ions, x rays, and neutrons. The mechanisms through which these physically simple devices generate such high-energy beams in a relatively short distance are not fully understood and past optimization efforts of these devices have been largely empirical. Previously we reported on fully kinetic simulations of a DPF and compared them with hybrid and fluid simulations of the same device. Here we present detailed comparisons between fully kinetic simulations and experimental data on a 1.2 kJ DPF with two electrode geometries, including neutron yield and ion beam energy distributions. A more intensive third calculation is presented which examines the effects of a fully detailed pulsed power driver model. We also compare simulated electromagnetic fluctuations with direct measurement of radiofrequency electromagnetic fluctuations in a DPF plasma. These comparisons indicate that the fully kinetic model captures the essential physics of these plasmas with high fidelity, and provide further evidence that anomalous resistivity in the plasma arises due to a kinetic instability near the lower hybrid frequency.

Pharmacological treatment of acute heart failure: current treatment and new targets

Acute heart failure (AHF) is defined as the rapid onset of, or changes in, the symptoms and signs of heart failure (HF). It is a life-threatening situation in which diagnosis and initiation of therapy are crucial. The treatment aims are to stabilize the patient, improve clinical symptoms, and increase long-term survival rates. Few treatments have been investigated in clinical trials. This review summarizes the principles of pharmacologic treatment, the underlying clinical trials, and new pharmacologic targets.

Emission of energetic protons from relativistic intensity laser interaction with a cone-wire target

Emission of energetic protons (maximum energy ∼18 MeV) from the interaction of relativistic intensity laser with a cone-wire target is experimentally measured and numerically simulated with hybrid particle-in-cell code, lsp [D. R. Welch et al., Phys. Plasmas 13, 063105 (2006)]. The protons originate from the wire attached to the cone after the OMEGA EP laser (670 J, 10 ps, 5 × 10^{18} W/cm^{2}) deposits its energy inside the cone. These protons are accelerated from the contaminant layer on the wire surface, and are measured in the radial direction, i.e., in a direction transverse to the wire length. Simulations show that the radial electric field, responsible for the proton acceleration, is excited by three factors, viz., (i) transverse momentum of the relativistic fast electrons beam entering into the wire, (ii) scattering of electrons inside the wire, and (iii) refluxing of escaped electrons by "fountain effect" at the end of the wire. The underlying physics of radial electric field and acceleration of protons is discussed.

Dynamics of relativistic laser-plasma interaction on solid targets

A novel time-resolved diagnostic is used to record the critical surface motion during picosecond-scale relativistic laser interaction with a solid target. Single-shot measurements of the specular light show a redshift decreasing with time during the interaction, corresponding to a slowing-down of the hole boring process into overdense plasma. On-shot full characterization of the laser pulse enables simulations of the experiment without any free parameters. Two-dimensional particle-in-cell simulations yield redshifts that agree with the data, and support a simple explanation of the slowing-down of the critical surface based on momentum conservation between ions and reflected laser light.

Feasibility and efficacy of transcranial motor-evoked potential monitoring in neuroendovascular surgery

BACKGROUND AND PURPOSE

Neurophysiological monitoring for neuroendovascular procedures typically involves EEG and SSEP monitoring via cutaneous electrodes. MEP monitoring has been used less frequently because, traditionally, this has required subdural electrode placement. With the advent of transcutaneous techniques, MEP monitoring use has increased. However, little has been published regarding the use of this technique in therapeutic neuroendovascular procedures. The purpose of this study was therefore to determine whether TcMEP monitoring is feasible and efficacious in therapeutic neuroendovascular procedures.

MATERIALS AND METHODS

We retrospectively reviewed our data base of therapeutic neuroendovascular procedures performed with the use of TcMEP monitoring. We specifically determined the incidence of TcMEP changes compared with changes in either SSEP or EEG. We then correlated these changes to actual adverse neurologic events.

RESULTS

Although TcMEP monitoring was technically successful in all of the 140 patients in which it was attempted, we observed significant changes in TcMEP signals in only 1 patient. This patient experienced changes involving all 3 monitoring modalities after intraprocedural aneurysm rupture. In contrast, changes in SSEP tracings alone were found in 9 patients. Of these, 2 patients were known to be moribund before their procedures and neither recovered. Among the remaining 7 patients, temporary SSEP changes tended to correlate with temporary neurologic deficits, while permanent changes were associated with permanent or long-lasting deficits.

CONCLUSIONS

These results suggest that TcMEP monitoring is feasible in therapeutic neuroendovascular procedures. However, it appears that the addition of TcMEP monitoring provides no added benefit to SSEP and EEG monitoring alone.

[21-year-old woman with Reye's syndrome after influenza]

HISTORY AND ADMISSION FINDINGS

A 21-year old woman was referred to the hospital because of progressively deteriorating consciousness. Initially agitation and irritability, later confusion and delirium predominated. Previously influenza with high temperature, headache and vomiting had occurred and been treated with acetylsalicylic acid for some days. Non preliminary diseases were reported. CLINICAL INVESTIGATION: Besides of the deterioration in consciousness no clinical or neurological abnormalities were found. Electroencephalography demonstrated general abnormalities of medium range. Cranial magnetic resonance imaging and liquor investigations showed no pathological findings. In laboratory tests a marked increase of transaminases and ammonia were found. The toxicological screening was normal.

TREATMENT AND COURSE

A hepatic encephalopathy due to acute hepatic failure was diagnosed and a detoxication of ammonemia with lactulose was started immediately. Transjugular liver biopsy showed a marked fattening of liver tissue without serological or histological findings for a reason. Because of progressive deterioration in consciousness mechanical ventilation became necessary. Despite of a rapid decline of ammonium serum levels further neurological deterioration occurred. Cranial computed tomography showed oedema of the cerebrum with beginning cerebral occlusion. Despite immediate therapy of cerebral oedema the patient died because of secondary cerebral oedema in hepatic encephalopathy.

CONCLUSION

Reye's syndrome is an acute illness characterized by hepatic encephalopathy and fatty degeneration of the liver. It often occurs after viral infections. After a viral infection that was eventually treated with acetylsalicylic acid Reye's syndrome has to be discussed after exclusion of common causes of hepatic failure.

Hot electron temperature and coupling efficiency scaling with prepulse for cone-guided fast ignition

The effect of increasing prepulse energy levels on the energy spectrum and coupling into forward-going electrons is evaluated in a cone-guided fast-ignition relevant geometry using cone-wire targets irradiated with a high intensity (10(20) W/cm(2)) laser pulse. Hot electron temperature and flux are inferred from Kα images and yields using hybrid particle-in-cell simulations. A two-temperature distribution of hot electrons was required to fit the full profile, with the ratio of energy in a higher energy (MeV) component increasing with a larger prepulse. As prepulse energies were increased from 8 mJ to 1 J, overall coupling from laser to all hot electrons entering the wire was found to fall from 8.4% to 2.5% while coupling into only the 1-3 MeV electrons dropped from 0.57% to 0.03%.

[32-year-old patient with acute myocardial infarction possibly induced by the appetite suppressant sibutramine]

HISTORY

A 32-year-old, very slightly overweight woman (body mass index of 25) without any cardiovascular risk factors presented with acute chest pain. She reported taking the appetite suppressant sibutramine daily for three months. She was not pregnant and did not remember episodes of serious mental stress or infection during the last few weeks. Physical examination was unsuspicious.

INVESTIGATION

Laboratory results revealed an elevation of serum markers of myocardial ischemia. The electrocardiogram showed ST segment depressions and T wave inversions in leads II, III and aVF, indicating a nontransmural inferior myocardial infarction.

TREATMENT AND COURSE

Coronary angiography showed patent coronary arteries with inferior wall hypokinesia. There were no signs of a coronary dissection. Assuming that the acute coronary syndrome had been induced by coronary spasms, the patient was treated with amlodipine and ramipril.

CONCLUSION

It seemed reasonable to suspect that the intake of sibutramine had induced coronary spasms. However, this is a diagnosis of exclusion. Three case reports have previously been published about acute myocardial infarctions, possibly related to sibutramin intake, in young patients with a negligible cardiovascular risk profile. The European Medicines Agency has questioned the marketing authorisations for sibutramine (January 2010). In patients presenting with acute coronary syndromes which can not be clearly related to cardiovascular risk factors, it is crucial to obtain a complete drug history. Some patients might continue to take sibutramine.

Limitation on prepulse level for cone-guided fast-ignition inertial confinement fusion

The viability of fast-ignition (FI) inertial confinement fusion hinges on the efficient transfer of laser energy to the compressed fuel via multi-MeV electrons. Preformed plasma due to the laser prepulse strongly influences ultraintense laser plasma interactions and hot electron generation in the hollow cone of an FI target. We induced a prepulse and consequent preplasma in copper cone targets and measured the energy deposition zone of the main pulse by imaging the emitted K_{alpha} radiation. Simulation of the radiation hydrodynamics of the preplasma and particle in cell modeling of the main pulse interaction agree well with the measured deposition zones and provide an insight into the energy deposition mechanism and electron distribution. It was demonstrated that a under these conditions a 100 mJ prepulse eliminates the forward going component of approximately 2-4 MeV electrons.

Electron heated target temperature measurements in petawatt laser experiments based on extreme ultraviolet imaging and spectroscopy

Three independent methods (extreme ultraviolet spectroscopy, imaging at 68 and 256 eV) have been used to measure planar target rear surface plasma temperature due to heating by hot electrons. The hot electrons are produced by ultraintense laser-plasma interactions using the 150 J, 0.5 ps Titan laser. Soft x-ray spectroscopy in the 50-400 eV region and imaging at the 68 and 256 eV photon energies give a planar deuterated carbon target rear surface pre-expansion temperature in the 125-150 eV range, with the rear plasma plume averaging a temperature approximately 74 eV.

Diagnostics for fast ignition science (invited)

The ignition concept for electron fast ignition inertial confinement fusion requires sufficient energy be transferred from an approximately 20 ps laser pulse to the compressed fuel via approximately MeV electrons. We have assembled a suite of diagnostics to characterize such transfer, simultaneously fielding absolutely calibrated extreme ultraviolet multilayer imagers at 68 and 256 eV; spherically bent crystal imagers at 4.5 and 8 keV; multi-keV crystal spectrometers; MeV x-ray bremmstrahlung, electron and proton spectrometers (along the same line of sight), and a picosecond optical probe interferometer. These diagnostics allow careful measurement of energy transport and deposition during and following the laser-plasma interactions at extremely high intensities in both planar and conical targets. Together with accurate on-shot laser focal spot and prepulse characterization, these measurements are yielding new insights into energy coupling and are providing critical data for validating numerical particle-in-cell (PIC) and hybrid PIC simulation codes in an area crucial for fast ignition and other applications. Novel aspects of these diagnostics and how they are combined to extract quantitative data on ultrahigh intensity laser-plasma interactions are discussed.

A Bremsstrahlung spectrometer using k-edge and differential filters with image plate dosimeters

A Bremsstrahlung spectrometer using k-edge and differential filtering has been used with image plate dosimeters to measure the x-ray fluence from short-pulse laser/target interactions. An electron spectrometer in front of the Bremsstrahlung spectrometer deflects electrons from the x-ray line of sight and simultaneously measures the electron spectrum. The response functions were modeled with the Monte Carlo code INTEGRATED TIGER SERIES 3.0 and the dosimeters calibrated with radioactive sources. An electron distribution with a slope temperature of 1.3 MeV is inferred from the Bremsstrahlung spectra.

Density measurement of shock compressed foam using two-dimensional x-ray radiography

We have used spherically bent quartz crystal to image a laser-generated shock in a foam medium. The foam targets had a density of 0.16 g/cm(3) and thickness of 150 microm, an aluminum/copper pusher drove the shock. The experiment was performed at the Titan facility at Lawrence Livermore National Laboratory using a 2 ns, 250 J laser pulse to compress the foam target, and a short pulse (10 ps, 350 J) to generate a bright Ti K alpha x-ray source at 4.5 keV to radiograph the shocked target. The crystal used gives a high resolution (approximately 20 microm) monochromatic image of the shock compressed foam.

Determination of electron-heated temperatures of petawatt laser-irradiated foil targets with 256 and 68 eV extreme ultraviolet imaging

Measurements of plasma temperature at the rear surface of foil targets due to heating by hot electrons, which were produced in short pulse high intensity laser matter interactions using the 150 J, 0.5 ps Titan laser, are reported. Extreme ultraviolet (XUV) imaging at 256 and 68 eV energies is used to determine spatially resolved target rear surface temperature patterns by comparing absolute intensities to radiation hydrodynamic modeling. XUV mirrors at these two energies were absolutely calibrated at the Advanced Light Source at the Lawrence Berkeley Laboratory. Temperatures deduced from both imagers are validated against each other within the range of 75-225 eV.

Latency analysis of single auditory evoked M100 responses by spatio-temporal filtering

Appropriate spatial filtering followed by temporal filtering is well suited for the single-trial analysis of multi-channel magnetoencephalogram or electroencephalogram recordings. This is demonstrated by the results of a single-trial latency analysis obtained for auditory evoked M100 responses from nine subjects using two different stimulation frequencies. Spatial filters were derived automatically from the data via noise-adjusted principle component analysis, and single-trial latencies were estimated from the signal phase after complex bandpass filtering. For each of the two stimulation frequencies, estimated single-trial latencies were consistent with results obtained from a standard approach using averaged evoked responses. The quality of the estimated single-trial latencies was additionally assessed by their ability to separate between the two different stimulation frequencies. As a result, more than 80% of the single trials can be classified correctly by their estimated latencies.

Operative Versorgung einer pertrochantären Femurfraktur unmittelbar nach Stent-PTCA eines akuten Myokardinfarkts

Due to the high risk of perioperative adverse events, elective surgery should be suspended for at least 4 weeks after myocardial infarction and coronary stent revascularization, as current guidelines suggest. This report describes the successful management of a patient who underwent urgent surgery for a displaced hip fracture immediately after stent revascularization of an acute myocardial infarction. No new perioperative ischemia was detected. The therapeutic options and the timing of surgical procedures after stent revascularization are discussed.

[Detection of phenol by means of 4-aminophenazone according to Emerson]

In the literature it is reported that 4-(N,N-dimethylamino) phenazone, like 4-amino phenazone, gives a positive Emerson reaction. This, however, is not true and seems to be a misinterpretation due to very similar common names of the substances.

The effect of single-dose naproxen on eicosanoid formation in human gastroduodenal mucosa

BACKGROUND

In animal studies, aspirin and non-aspirin non-steroidal anti-inflammatory drugs contribute to gastroduodenal damage via cyclo-oxygenase inhibition and consecutive leucotriene formation (COX-LOX eicosanoid shunt).

AIM AND METHODS

Ten Helicobacter pylori-negative healthy volunteers received a single dose of 500 mg naproxen to address two questions: (i) is there a crosstalk between eicosanoids before medication in the human gastroduodenal mucosa and (ii) can we demonstrate a COX-LOX shunt following single-dose naproxen?

RESULTS

Significant correlations in the stomach mucosa before medication were obtained between leucotriene B4 (LTB4) and thromboxane B(2) (TxB(2); r = -0.38, P = 0.05), as well as LTB4 and prostaglandin E(2) (PGE(2); r = 0.71, P < 0.0001). In serum, a >90% inhibition of TxB(2) and PGE(2) occurred within 30 min of naproxen administration. In gastric mucosa, a significant decrease of TxB(2) occurred already at 15 min and preferably in the antrum. For LTB4 there was a non-significant trend towards a transient increase. Mucosal PGE(2) was unchanged in all regions; transcript levels of both cyclo-oxygenases/5-lipoxygenase were unaffected (except for a trend of increasing cyclo-oxygenase-2 in the corpus).

CONCLUSIONS

Baseline correlations between LTB4-TxB(2) and LTB4-PGE(2) reflect a crosstalk between these eicosanoids. A COX-LOX shunt; however, cannot be demonstrated following single-dose naproxen in a low-risk population.