A rare case of an acute type B aortic dissection contained infrarenal rupture of the false lumen after prior endovascular abdominal aneurysm repair

New-onset acute type B aortic dissection (ATBD) after prior endovascular aneurysm repair (EVAR) is extremely rare. The extension of aortic dissection can cause destabilization of the previously implanted stent graft, thrombosis of the stent graft, and the rupture of the aneurysmal sac with high mortality rate without therapy. This report describes the case of a 66-year-old patient complaining of sudden abdominal pain radiating to both flanks. A computed tomography angiography (CTA) of the aorta revealed ATBD with infrarenal rupture of the false lumen after endovascular abdominal aneurysm repair five years prior. The patient underwent infrarenal open surgical conversion with suprarenal aortic clamping and implantation of a bifurcated dacron graft. Postoperatively no serious complications occurred of the treatment, except a fascial dehiscence. In these cases, the patients can be treated in an emergency situation with open repair in spite of the high risk for complications and mortality

Complex c-di-GMP Signaling Networks Mediate Transition between Virulence Properties and Biofilm Formation in Salmonella enterica Serovar Typhimurium

Upon Salmonella enterica serovar Typhimurium infection of the gut, an early line of defense is the gastrointestinal epithelium which senses the pathogen and intrusion along the epithelial barrier is one of the first events towards disease. Recently, we showed that high intracellular amounts of the secondary messenger c-di-GMP in S. typhimurium inhibited invasion and abolished induction of a pro-inflammatory immune response in the colonic epithelial cell line HT-29 suggesting regulation of transition between biofilm formation and virulence by c-di-GMP in the intestine. Here we show that highly complex c-di-GMP signaling networks consisting of distinct groups of c-di-GMP synthesizing and degrading proteins modulate the virulence phenotypes invasion, IL-8 production and in vivo colonization in the streptomycin-treated mouse model implying a spatial and timely modulation of virulence properties in S. typhimurium by c-di-GMP signaling. Inhibition of the invasion and IL-8 induction phenotype by c-di-GMP (partially) requires the major biofilm activator CsgD and/or BcsA, the synthase for the extracellular matrix component cellulose. Inhibition of the invasion phenotype is associated with inhibition of secretion of the type three secretion system effector protein SipA, which requires c-di-GMP metabolizing proteins, but not their catalytic activity. Our findings show that c-di-GMP signaling is at least equally important in the regulation of Salmonella-host interaction as in the regulation of biofilm formation at ambient temperature

Charakterisierung und in vitro Zytotoxizität humaner allogener CD3+CD4-CD8-T Zellen gegen akute myeloische Leukämie

1.1 Background and aims Acute myeloid leukemia (AML) is the most common form of adult acute leukemia withvery poor survival due to high relapse rates after chemotherapy. The significant challengein AML treatment is disease heterogeneity stemming from variability in maturationstate of leukemic cells of origin, genetic aberrations among patients and existenceof multiple disease clones within a single patient. Current treatments for acute myelogenousleukemia have not changed for several decades and have not resulted in satisfactory outcomes. In 2011, Dr. Li Zhang´s group developed a protocol enabling ex vivo expansion of DNTs from AML patients and showed that human autologous CD3+ CD4C-D8- T cells (DNTs) have potent anti-leukemia activity in vitro (Merims et al., 2011).DNTs are a small subset of peripheral T cells that do not kill normal PBMC in vitro or in vivo and thereby not cause graft-versus-host disease. Hopefully, the new therapeuticapproach using DNT cells is effective way to prevent relapse (Zhang et al., 2013). 1.2 Methods DNT cells were enriched by depleting CD4 and CD8 T cells from human PBMCs of nine healthy donors from different age and gender, and ex vivo expanded in two weeks.The phenotype check of cell culture was examined on day 0, 7, 10, 12 and 14 by flowcytometry. Upon contamination of cell culture with CD4 and CD8 T cells, DNTs werepurified by using magnetic cell sorting (MACS). The cytotoxic activity of ex vivo expanded DNTs against leukemic cell line OCI/AML3,autologous and allogeneic PBMCs, and 27 primary AML patient blasts was measuredby a 2h or 4h flow-based in vitro killing assay. The level of IFN-γ from collected supernatant of two hour in vitro killing assay was determined using ELISA. 1.3 Results and observations The thesis data demonstrated that expansion of allogeneic DNTs from nine healthy donors of different ages in two weeks with high purity and an average of 106.04}59.88- expansion fold is possible. Likewise, DNTs can be expanded from cryopreserved samples without significant changing of phenotype. The regulation of CD27 expression playsome role in expansion of the cell culture. The results from killing assay show that 15 out of 27 AML blasts were killed and 55%of chemotherapy-resistant patients were recognized and targeted by DNTs. Futhermore,a dose-dependent killing of primary AML blasts from different DNT donors was consistentlyobserved. The patient samples with secondary AML to prior myelodysplasticsyndrome (MDS) showed very low cytolysis under 10%. The experimental resultsindicate that allogeneic DNTs are cytotoxic to AML blasts, but do not kill in vitro normal autologous or allogeneic PBMCs. DNTs don´t cause GvHD. Statistically, no correlation was observed between the susceptibility to DNTs and the patient’s age at diagnosis, gender, WBC count, %AML blasts in bone marrow or MRC cytogenetic risk groups. After two hours co-culture with primary AML samples, the ex vivo expanded DNT cells expressed IFN-γ as a one of proinflammatory cytokine that can contribute to tumor immunity. 1.4 Conclusions Taken together, this study suggests that allogeneic DNTs may be used as a novelimmunotherapy to reduce AML burden by targeting primary leukemic blasts including chemotherapy-resistant AML

A rare case of an acute type B aortic dissection contained infrarenal rupture of the false lumen after prior endovascular abdominal aneurysm repair

New-onset acute type B aortic dissection after prior endovascular aneurysm repair is extremely rare. Extension of an aortic dissection can cause destabilization of the previously implanted stent graft, thrombosis of the stent graft, and rupture of the aneurysmal sac, with high mortality without therapy. This report describes the case of a 66-year-old patient complaining of sudden abdominal pain radiating to both flanks. Computed tomography angiography of the aorta revealed acute type B aortic dissection with infrarenal rupture of the false lumen after endovascular abdominal aneurysm repair 5 years prior. The patient underwent infrarenal open surgical conversion with suprarenal aortic clamping and implantation of a bifurcated Dacron graft. Postoperatively, no serious complications resulted from the treatment, except for fascial dehiscence. In such cases, the patients can be treated in an emergency situation with open repair, despite the high risk of complications and mortality

Dienstleistungsnomadismus am Schwarzen Meer : Zigeunergruppen zwischen Symbiose und Dissidenz

E. Marushiakova, Udo Mischek, Vesselin Popov, Bernhard Strec

Soil solarization and sustainable agriculture

Pesticide treatments provide an effective control of soilborne pests in vegetable and fruit crops, but their toxicity to animals and people and residual toxicity in plants and soil, and high cost make their use hazardous and economically expensive. Moreover, actual environmental legislation is imposing severe restrictions on the use or the total withdrawal of most soil-applied pesticides. Therefore, an increasing emphasis has been placed on the use of nonchemical or pesticide-reduced control methods. Soil solarization is a nonpesticidal technique which kills a wide range of soil pathogens, nematodes, and weed seeds and seedlings through the high soil temperatures raised by placing plastic sheets on moist soil during periods of high ambient temperature. Direct thermal inactivation of target organisms was found to be the most important mechanism of solarization biocidal effect, contributed also by a heat-induced release of toxic volatile compounds and a shift of soil microflora to microorganisms antagonist of plant pathogens. Soil temperature and moisture are critical variables in solarization thermal effect, though the role of plastic film is also fundamental for the solarizing process, as it should increase soil temperature by allowing the passage of solar radiation while reducing energetic radiative and convective losses. Best solarizing properties were shown by low-density or vynilacetate- coextruded polyethylene formulations, but a wide range of plastic materials were documented as also suitable to soil solarization. Solar heating was normally reported to improve soil structure and increase soil content of soluble nutrients, particularly dissolved organic matter, inorganic nitrogen forms, and available cations, and shift composition and richness of soil microbial communities, with a marked increase of plant growth beneficial, plant pathogen antagonistic or root quick recolonizer microorganisms. As a consequence of these effects, soil solarization was largely documented to increase plant growth and crop yield and quality along more than two crop cycles. Most important fungal plant pathogenic species were found strongly suppressed by the solarizing treatment, as several studies documented an almost complete eradication of economically relevant pathogens, such as Fusarium spp., Phytophthora spp., Pythium spp., Sclerotium spp., Verticillium spp., and their related diseases in many vegetable and fruit crops and in different experimental conditions. Beneficial effects on fungal pathogens were stated to commonly last for about two growing seasons and also longer. Soil solarization demonstrated to be effective for the control of bacterial diseases caused by Agrobacterium spp., Clavibacter michiganensis and Erwinia amylovora, but failed to reduce incidence of tomato diseases caused by Pseudomonas solanacearum. Solarization was generally found less effective on phytoparasitic nematodes than on other organisms, due to their quicker soil recolonization compared to fungal pathogens and weeds, but field and greenhouse studies documented consistant reductions of root-knot severity and population densities of root-knot nematodes, Meloidogyne spp., as well as a satisfactory control of cyst-nematode species, such as Globodera rostochiensis and Heterodera carotae, and bulb nematode Ditylenchus dipsaci. Weeds were variously affected by solar heating, as annual species were generally found almost completely suppressed and perennial species more difficult to control, due to the occurrence deep propagules not exposed to lethal temperature. Residual effect of solarization on weeds was found much more pronounced than on nematodes and most fungal pathogens. Soil solarization may be perfect fit for all situations in which use of pesticides is restricted or completely banned, such as in organic production, or in farms located next to urban areas, or specialty crops with few labeled pesticides. Advantages of solarization also include economic convenience, as demonstrated by many comparative benefit/cost analyses, ease of use by growers, adaptability to many cropping systems, and a full integration with other control tools, which makes this technique perfectly compatible with principles of integrated pest management required by sustainable agriculture