European guidelines on chronic mesenteric ischaemia - joint United European Gastroenterology, European Association for Gastroenterology, Endoscopy and Nutrition, European Society of Gastrointestinal and Abdominal Radiology, Netherlands Association of Hepatogastroenterologists, Hellenic Society of Gastroenterology, Cardiovascular and Interventional Radiological Society of Europe, and Dutch Mesenteric Ischemia Study group clinical guidelines on the diagnosis and treatment of patients with chronic mesenteric ischaemia

Chronic mesenteric ischaemia is a severe and incapacitating disease, causing complaints of post-prandial pain, fear of eating and weight loss. Even though chronic mesenteric ischaemia may progress to acute mesenteric ischaemia, chronic mesenteric ischaemia remains an underappreciated and undertreated disease entity. Probable explanations are the lack of knowledge and awareness among physicians and the lack of a gold standard diagnostic test. The underappreciation of this disease results in diagnostic delays, underdiagnosis and undertreating of patients with chronic mesenteric ischaemia, potentially resulting in fatal acute mesenteric ischaemia. This guideline provides a comprehensive overview and repository of the current evidence and multidisciplinary expert agreement on pertinent issues regarding diagnosis and treatment, and provides guidance in the multidisciplinary field of chronic mesenteric ischaemia

Legume Genomics and Breeding

This chapter contains sections titled; Introduction; Constraints in Crop Production; Genomic Resources in Legumes;Trait Mapping and Marker-Assisted Selection; Summary and Prospects; Acknowledgments; Literature Cite

The role of the pYD vector in the yeast invertase screening system for isolating secreted proteins and membrane proteins

GesamtdissertationEinleitung: Ziel dieser Arbeit ist die Rolle des pYD-Vektors bei der Entwicklung eines Selektionssystems zum Screening von cDNA Bibliotheken auf sezernierte Proteine und Membranproteine darzustellen. Die Überprüfung der Sensitivität und Spezifität des Systems sollte mit einer humanen Endothelzellbibliothek durchgeführt werden. Gleichzeitig sollten neue Moleküle, die Kontrollfunktion in der Angiogenese ausüben, identifiziert und charakterisiert werden. Der Sekretionsweg durch die Zellmembran wird für die meisten bekannten Proteine über eine aminoterminale Sequenz, bekannt als Signalpeptid, vermittelt. Methode: Hierzu wurde der Selektionsplasmid pYD entwickelt. Als Ausgangspunkt für die Vektorkonstruktion wurde der E.coli/-Hefe Shuttlevektor pYEUra3 benutzt. In diesem Plasmid wurde das Hefegen suc2 (Invertase-Gen) kloniert. Im Invertase-Gen wurden zuvor Startcodon und Signalpeptid deletiert und eine neue, einmalige Restriktionsstelle NotI an Stelle des Startcodons geschaffen. Um die Funktionsfähigkeit des Plasmids nachzuweisen, wurde eine cDNA-Bibliothek aus Endothelzellen in die NotI Schnittstelle des pYD Plasmids kloniert und mittels in vivo Exzision des Bakteriophagen eine Plasmidbibliothek hergestellt. Nach der Hefetransformation und Isolierung des Plasmids aus den gewachsenen Klonen, wurde das inserierte cDNA Fragment isoliert und sequenziert. Ergebnisse: Dabei wurden bekannte und unbekannte Klone identifiziert. Mit diesem Verfahren wurden jeweils drei Mäuse Embryonen Bibliotheken konstruiert, analysiert und mit der hmEC Bibliothek verglichen. Das Hefe-Selektionsverfahren hat sich grundsätzlich als effizient erwiesen, systematisch nach sezernierten Proteinen zu suchen, die eine Signalpeptidsequenz aufweisen können. Der Vorteil dieses Selektionsverfahrens liegt in der Handhabung und in der einfachen, effektiven Selektion ohne Anwendung hochkomplizierter, zeitintensiver Anwendung von immunologischen Verfahren. Diskussion: In vitro kultivierte humane Endothelzellen spiegeln jedoch nicht die Komplexität der Expression wieder, die man für diesen Screen erwarten würde. Im Vergleich zu den etablierten Methoden bietet das Hefe Invertase System keine überragenden Vorteile. Es wurden keine Moleküle entdeckt, die eine Rolle in der Angiogenese spielen könnten. Daher muss eine Schlussfolgerung gezogen werden, dass dieser Screen ungeeignet ist, um nach neuen angiogenetischen Molekülen zu suchen.Introduction: The purpose of this work is to be represented the role of the pYD vector in the yeast invertase screening system for isolating secreted proteins and membrane proteins. The examination of the sensitivity and specificity of the system should be accomplished with a human microvascular endothelial cell library. At the same time new molecules, which play a function in the angiogenesis, should be found. Receptors, membrane proteins, and secreted proteins, are of considerable interest for understanding cell signalling. A system identification of genes encoding these proteins has not been possible. Signal peptides are a unique feature of secreted proteins and membrane proteins. Methods: Secreted invertase, coded for by the suc gene, is essential for wild type yeast to metabolize sucrose. A yeast/E.coli phagemid vector(pYD) containing a secretion deficient suc gene was constructed. Suc(-)yeast strains will not grow on sucrose agar. Invertase is inactive without signal peptide. Mammalian signal peptides are functional in yeast. Thus, a cDNA coding for a signal peptide, intoduced 5´ of the suc gene can complement for invertase activity. Random primed cDNA libraries are directionally ligated into restriction sites located 5´ of the suc gene. The library is then introduced into an invertase deficient yeast strain and plated on dissacharide agar. Results: Mouese embyonic and human microvascular endothelial cells (hmEC) were used to generate cDNA library. Selective growth occurs for clones containing functional signal peptides, expressed as invertase fusion proteins. False positives are evoked by rRNA and antisense clones.Changes in transcriptional activity of genes, as observed under culture conditions, lead to misrepresentation. Sequence information obtained allows for classification. New genes or est homologues with an interesting expression pattern will be selected for further analysis, including full length cloning and targeted mutation in mice. Discussion: The advantage of this selection system is in the handling and effective selection without application of high- complicated, time-intensive use of immunological procedures.The yeast invertase screening system is en efficient and powerful system to isolate genes for proteins containing signal sequencees from mammalian cDNA libraries. Anaylysis of hmEC has not yieled an endothelial cell specific gene yet. In vitro cultured hmEC did not expose complexity of expression which is desirable for screening. Therefore a conclusion must be drawn that this screen is unsuitable, in order to look for new angiogenic molecules

The importance of emergency open surgery for ruptured abdominal aortic aneurysms in a single center retrospective study

Background: A ruptured abdominal aortic aneurysm (rAAA) is life-threatening. The mortality is high and emergency surgery is vital. Endovascular (ER) and open surgical repair (OR) are alternative approaches. Although ER is considered as first-line treatment, there are scenarios which still require OR. We report a single-centre experience for rAAA treated by OR. Methods: Medical records from patients with rAAA from 1 January 2005 through 31 December 2016 were screened. We defined rAAA as retro- or intraperitoneal haemorrhage originating from the infra- or juxtarenal aorta. We analysed the surgical approaches and report patient short-term and follow-up outcomes. Statistical differences were examined by log rank and chi-square test. Results: Thirty-five patients at the mean age of 73 ± 10 years (47–91) were included. Aneurysm location was infrarenal (n = 20), juxtarenal (n = 8), and involved the iliac arteries (n = 7). OR was performed by tube (n = 26) or bifurcation graft (n = 9) implantation. Additional vascular reconstructions were performed in 14 patients. We observed one intra-operative oesophageal leakage. Post-operative complications included haemodialysis (n = 17), tracheotomy (n = 15), multiple organ failure (n = 11), cardiopulmonary resuscitation (n = 5), intestinal ischaemia (n = 5), sepsis (n = 5), stroke (n = 3) and coronary stenting (n = 2). Nine patients required early revision surgery. There were twelve patients available for the follow-up. Thirty-day mortality was 37%, and overall mortality was 40% after 118 months. Mortality was associated with the direction of rupture, the shock index (SI) and the need for early revision surgery (p = <0.05). Conclusion: OR for rAAA remains valuable. In cases for which OR is warranted, the direction of rupture, SI and need for early revision surgery were predictors for mortality

An overview of chalcophile element contents of pyrrhotite, pentlandite, chalcopyrite, and pyrite from magmatic Ni-Cu-PGE sulfide deposits

We have compiled the trace element concentrations in pyrrhotite, pentlandite, chalcopyrite, and pyrite from magmatic Ni-Cu-PGE ore deposits with the aim of understanding their petrogenesis and whether these minerals can be used as indicator minerals. Among the samples, there are some of the most studied world-class Ni-Cu- (Aguablanca, Duluth, Jinchuan, Noril’sk-Talnakh-Kharaelakh, Sudbury, Voisey’s Bay, and others) and PGE-dominated (Bushveld, Lac des Iles, Stillwater, Great Dyke, and Penikat) deposits. Crustal assimilation may be constrained using As/Se and Sb/Se ratios in pentlandite. The degree of interaction between the silicate and sulfide liquids (R-factor) can be estimated by the content of highly chalcophile elements (Dsulf liq/sil liq above 1000) in sulfide minerals. The fractional crystallization of the sulfide liquid can be traced using Se/Te ratios of pentlandite. Pyrite formed by exsolution from MSS has higher Rh, Ru, Ir, and Os than co-existing pyrrhotite, whereas pyrite formed by hydrothermal alteration of pyrrhotite inherits the Rh, Ru, Ir, and Os contents of the pyrrhotite it replaced. Sulfide minerals are preserved in transported glacial cover and their trace element chemistry can be used to discriminate their source. Pentlandite from Ni-Cu deposits has much lower Rh and Pd concentrations than those from PGE-dominated deposits, pyrite from magmatic deposits has higher Co/Sb and Se/As ratios relative to pyrite from hydrothermal deposits, and chalcopyrite from magmatic deposits has much higher Ni and lower Cd concentrations than those from hydrothermal deposits

Textural and compositional evidence for the formation of pentlandite via peritectic reaction: Implications for the distribution of highly siderophile elements

The distribution of highly siderophile elements is used in the study of a wide variety of geological topics, from planet formation and evolution to the formation of ore deposits. Under mantle and crustal conditions, these elements behave as highly chalcophile elements, and pentlandite (Pn) is an important host for most of these elements. Therefore, understanding how Pn forms is important to understanding the processes that control these elements. The classic model for the formation of Pn is that below 650 °C, the high-temperature sulfides—monosulfide solid solution (MSS) and intermediate solid solution (ISS)—are no longer stable and exsolve into pyrrhotite (Po), Pn, and chalcopyrite (Ccp). However, Pn has been shown to be the main host of Pd in many ore deposits, and given that Pd is incompatible with both MSS and ISS, this observation is inconsistent with the exsolution model. Furthermore, experimental work has shown that Pn can form by peritectic reaction between MSS and fractionated sulfide liquid. To date, this type of Pn has not been reported in natural samples. In our study of chalcophile-element concentrations in Pn from iconic magmatic Ni–Cu–platinum-group element deposits, we observed three textures of Pn: contact Pn in between Po and Ccp, granular Pn included within Ccp or Po, and flame Pn included within Po. The contact Pn shows zonation in Mo, Rh, Ru, Re, Os, and Ir, with these elements being enriched toward the Po contact and depleted toward the Ccp contact. In some cases, Pd displays a zonation antithetical to that of these elements. In this contribution, we propose that the contact Pn formed via the peritectic reaction described above, and inherited Mo, Ru, Rh, Re, Os, and Ir from the MSS, whereas Pd was contributed from the fractionated sulfide liquid. We expect that this type of Pn should be present wherever MSS and fractionated sulfide liquid remained in contact

Open vascular treatment of median arcuate ligament syndrome

Abstract Background Median arcuate ligament syndrome is a rare condition with abdominal symptoms. Accepted treatment options are open release of median arcuate ligament, laparoscopic release of edian arcuate ligament, robot-assisted release of median arcuate ligament and open vascular treatment. Here we aimed to evaluate the central priority of open vascular therapy in the treatment of median arcuate ligament syndrome. Methods We conducted a monocentric retrospective study between January 1996 and June 2016. Thirty-one patients with median arcuate ligament syndrome underwent open vascular surgery, including division of median arcuate ligament in 17 cases, and vascular reconstruction of the celiac artery in 14 cases. Results In a 20-year period, 31 patients (n = 26 women, n = 5 men) were treated with division of median arcuate ligament (n = 17) or vascular reconstruction in combination with division of median arcuate ligament (n = 14). The mean age of patients was 44.8 ± 15.13 years. The complication rate was 16.1% (n = 5). Revisions were performed in 4 cases. The 30-day mortality rate was 0%. The mean in-hospital stay was 10.7 days. Follow-up data were obtained for 30 patients. The mean follow-up period was 52.2 months (range 2–149 months). Patients were grouped into a decompression group (n = 17) and revascularisation group (n = 13). The estimated Freedom From Symptoms rates were 93.3, 77.8, and 69.1% for the decompression group and 100, 83.3, and 83.3% for the revascularisation group after 12, 24 and 60 months respectively. We found no significant difference in the Freedom From Re-Intervention CA rates of the decompression (100% at 12, 24 and 60 months post-surgery) and revascularisation (100% at 12 months, and 91.7% at 24 and 60 months post-surgery) groups during follow-up (p = 0.26). Conclusions Open vascular treatment of median arcuate ligament syndrome is a safe, low mortality-risk procedure, with low morbidity rate. Treatment choice depends on the clinical and morphological situation of each patient

Contemporary Surgical Management of Aberrant Right Subclavian Arteries (Arteria Lusoria)

Background: An aberrant right subclavian artery (ARSA) is in most cases an asymptomatic aortic arch anomaly. However, dysphagia, aneurysm formation (ARSAA), associated Kommerell diverticulum, or cerebellar/arm malperfusion may require invasive therapy. Large-scale clinical trials do not exist in current literature. We report our patient's outcome of a single-center experience and delineate indications for treatment and surgical techniques. Methods: A single-center retrospective study was conducted between January 1, 2012 through March 1, 2018. Symptomatic or asymptomatic patients with ARSAA who received invasive treatment at the Department for Vascular and Endovascular Surgery, University Hospital Dusseldorf, Germany were included. Results Eight patients (4 men, 63 ± 14 (39–78) years) were treated with single-stage (n = 4) or multistage (n = 4) procedures. Treatment for ARSAA (n = 4) included ARSA revascularization (subclavian-carotid transposition (SCT) = 3; carotid-subclavian bypass (CSB) = 1), aortic arch debranching (left SCT = 2, bilateral aorto-carotid bypass + left CSB = 1, right-to-left CSB + left-carotid-to-bypass transposition = 1), and thoracic endovascular aortic repair (TEVAR; n = 4). Other strategies included SCT for dysphagia (n = 2) or subclavian steal syndrome (n = 1) and balloon angioplasty for arm claudication (n = 1). Complications involved vascular access (n = 2) and each one partial common carotid artery overstenting without stroke during TEVAR and Horner syndrome after SCT. Mean follow-up was 23 ± 26 (9–67) months. After 7 months, 1 patient required vertebral artery coiling due to type II endoleak with ARSAA progression. Overall mortality was 0%. Technical and clinical success rates were 100%. Conclusions: Surgical concepts for ARSA aim on preventing aneurysm rupture and alleviate dysphagia or ischemic symptoms. To generate satisfying patient outcomes, individualized therapy planning in specialized centers is vital