Cardiac surgery in a patient with severe thrombocytopenia: How low is too low?

Platelets play a very important role in hemostasis, especially after cardiac surgery. Excessive bleeding after such surgery may lead to increased need for transfusion and its incumbent increase in post-operative morbidity and mortality. Although most cardiac surgeons will offer a surgical option to a patient with moderate thrombocytopenia (platelet count around 70 × 10 9 /L), successful cardiac surgery has not been reported in patients with significantly lower platelets counts (less than 40 × 10 9 /L). We report a case of severe thrombocytopenia (19 × 10 9 /L) where coronary artery bypass grafting was performed with minimal blood loss post-operatively, discuss the patient′s management and provide insights while dealing with such patients

Knife in the superior mediastinum: Amazing escape

This text describe through images, how a knife is retrieved from the superior mediastinum

Impact of drought, heat, and their combination on chlorophyll fluorescence and yield of wild barley (Hordeum spontaneum)

The impact of (long-term) drought acclimation and (short-term) heat stress and their combination on fast chlorophyll fluorescence induction curves (OJIP) and grain yield was tested using pot-grown plants of wild barley (Hordeum spontaneum) originating from Northern Egypt. Concerning agronomic traits, the main effect of drought was decreased biomass accumulation and grain yield, while heat specifically affected floral development. The treatments caused specific inhibitions of photosystem II (PSII) functionality. While heat stressed plants showed a reduction of maximum quantum efficiency of PSII (φP0), an indication of effects on oxygen evolving complex (OEC) functionality, and the connectivity of PSII units, these features were entirely missing in drought acclimated plants. Drought caused a reduction of the Performance Index (PIabs) and of the relative amplitude of the IP-phase of the OJIP induction curve (ΔVIP). Individuals suffering from a combination of drought and heat showed a better ability to recover photosynthetic electron transport after the relief of stress in comparison to heat stressed plants. However, this improved capacity to recover was not accompanied by an increased grain yield. Thus, we conclude that chlorophyll fluorescence measurements provide valuable physiological data; however, their use in agronomic studies for the prediction of agronomic traits should be done with some precaution

Comparative analysis of Sorghum bicolor proteome in response to drought stress and following recovery

The adaptive response of Sorghum bicolor landraces from Egypt to drought stress and following recovery was analyzed using two-dimensional difference gel electrophoresis, 2D-DIGE. Physiological measurements and proteome alterations of accession number 11434, drought tolerant, and accession number 11431, drought sensitive, were compared to their relative control values after drought stress and following recovery. Differentially expressed proteins were analysed by Matrix assisted laser desorption ionisation time-of-flight mass spectrometry, MALDI-TOF-MS. Alterations in protein contents related to the energy balance, metabolism (sensu Mewes et al. 1997), and chaperons were the most apparent features to elucidate the differences between the drought tolerant and sensitive accessions. Further alterations in the levels of proteins related to transcription and protein synthesis are discussed

Elucidating Drought Stress Tolerance in European Oaks Through Cross-Species Transcriptomics

The impact of climate change that comes with a dramatic increase of long periods of extreme summer drought associated with heat is a fundamental challenge for European forests. As a result, forests are expected to shift their distribution patterns toward north-east, which may lead to a dramatic loss in value of European forest land. Consequently, unraveling key processes that underlie drought stress tolerance is not only of great scientific but also of utmost economic importance for forests to withstand future heat and drought wave scenarios. To reveal drought stress-related molecular patterns we applied cross-species comparative transcriptomics of three major European oak species: the less tolerant deciduous pedunculate oak (Quercus robur), the deciduous but quite tolerant pubescent oak (Q. pubescens), and the very tolerant evergreen holm oak (Q. ilex). We found 415, 79, and 222 differentially expressed genes during drought stress in Q. robur, Q. pubescens, and Q. ilex, respectively, indicating species-specific response mechanisms. Further, by comparative orthologous gene family analysis, 517 orthologous genes could be characterized that may play an important role in drought stress adaptation on the genus level. New regulatory candidate pathways and genes in the context of drought stress response were identified, highlighting the importance of the antioxidant capacity, the mitochondrial respiration machinery, the lignification of the water transport system, and the suppression of drought-induced senescence – providing a valuable knowledge base that could be integrated in breeding programs in the face of climate change

Spatial and temporal regulation of the forisome gene for1 in the phloem during plant development

Forisomes are protein aggregates found uniquely in the sieve elements of Fabaceaen plants. Upon wounding they undergo a reversible, calcium-dependent conformational switch which enables them to act as cellular stopcocks. Forisomes begin to form in young sieve elements at an early stage of metaphloem differentiation. Genes encoding forisome components could therefore be useful as markers of early sieve element development. Here we present a comprehensive analysis of the developmental expression profile of for1, which encodes such a forisome component. The for1 gene is highly conserved among Fabaceaen species and appears to be unique to this phylogenetic lineage since no orthologous genes have been found in other plants, including Arabidopsis and rice. Even so, transgenic tobacco plants expressing reporter genes under the control of the for1 promoter display reporter activity exclusively in immature sieve elements. This suggests that the regulation of sieve element development is highly conserved even in plants where mature forisomes have not been detected. The promoter system could therefore provide a powerful tool for the detailed analysis of differentiation in metaphloem sieve elements in an unexpectedly broad range of plant species