Environment Protection by Practical Chemistry: A General Chemistry Laboratory Course with a Minimum of Chemical Waste

A first year chemistry-laboratory course for 170–210 students has been reorganized to minimize its chemical residues by input reduction and substitution, networking of material flows, separate collection, and recycling at the source. Compared to previous years, the problematic wastes were reduced by a factor of ca. 100 and total now less than 15 kg per academic year. The general types of student exercises, teaching aims, time tables, and organization were not affected, and the fraction of student time devoted to recycling is less than 10%. Permanent additional manpower and budget increases are not required. The strategies and proceedings are outlined and illustrated for selected student exercises. Implications for environment protection by practical chemistry are indicated

To whom do the results of the multicenter, randomized, controlled INSECT trial (ISRCTN 24023541) apply? - assessment of external validity

A response to Seiler et al: Interrupted or continuous slowly absorbable sutures for closure of primary elective midline abdominal incisions: a multicenter randomized trial (INSECT: ISRCTN24023541). Ann Surg 2009, 249(4):576-582

Politische Fragmentierung und kulturelle Kohärenz in der Spätantike

Der vorliegende Band bespricht mit Fallbeispielen sowohl die politisch bedingten Ausdifferenzierungen als auch die persistenten kulturellen Gemeinsamkeiten des 5. bis 6. Jhs. n. Chr. Die jahrhundertelange politische Einheit des Imperium Romanum hatte ihren Ausdruck in einer großen kultu- rellen Kohärenz gefunden, führte doch die Ausrichtung auf Rom zu Vereinheitlichungen in vielen Bereichen. Daraus resultierten allgemein gültige Normen, die sich in Gemeinsamkeiten der materiellen Kultur und der Sprache äußerten. Besonders augenfällig war die Homogenität der bildenden Kunst. Mit der Teilung des Imperiums und der Bildung germanischer Reiche auf römischem Boden zerfiel seit den Jahrzehnten um 400 n. Chr. zwar die politische Einheit, die Vorstellung eines einheitlichen Imperiums und einer gemeinsamen Kultur dauerte jedoch an

Stress Doppler echocardiography for early detection of systemic sclerosis-associated pulmonary arterial hypertension

Introduction: In patients with systemic sclerosis (SSc), associated pulmonary arterial hypertension (SSc-APAH) is the leading cause of death. The objective of this prospective screening study was to analyse sensitivity and specificity of stress Doppler echocardiography (SDE) in detecting pulmonary hypertension (PH). Methods: Pulmonary artery pressures and further parameters of PH were assessed by echocardiography and right heart catheterisation (RHC) at rest and during exercise in patients with SSc. Investigators of RHC were blinded to the results of non-invasive measurements. Results: Of 76 patients with SSc (64 were female and mean age was 58±14 years), 22 (29 %) had manifest PH confirmed by RHC: four had concomitant left heart diseases, three had lung diseases, and 15 had SSc-APAH. Echocardiography at rest missed PH diagnosis in five of 22 patients with PH when a cutoff value for systolic pulmonary arterial pressure (PASP) was more than 40 mm Hg at rest. The sensitivity of echocardiography at rest was 72.7 % (95 % confidence interval (CI) 0.52–0.88), and specificity was 88.2 % (95 % CI 0.78–0.95). When a cutoff value for PASP was more than 45 mm Hg during low-dose exercise, SDE missed PH diagnosis in one of the 22 patients with PH and improved sensitivity to 95.2 % (95 % CI 0.81–1.0) but reduced specificity to 84.9 % (95 % CI 0.74–0.93). Reduction of specificity was partly due to concomitant left heart disease. Conclusions: The results of this prospective cross-sectional study using RHC as gold standard in all patients showed that SDE markedly improved sensitivity in detecting manifest PH to 95.2 % compared with 72.7 % using echocardiography at rest only. Thus, for PH screening in patients with SSc, echocardiography should be performed at rest and during exercise. Trial registration: ClinicalTrials.gov NCT01387035 . Registered 29 June 2011

Fomitiporia mediterranea M. Fisch., the historical Esca agent: a comprehensive review on the main grapevine wood rot agent in Europe

International audienceFomitiporia mediterranea M. Fisch. (Fmed) is a basidiomycete first described in 2002, and was considered up to then as part of Fomitiporia punctata (P. Karst) Murrill. This fungus can degrade lignocellulosic biomass, causing white rot and leaving bleached fibrous host residues. In Europe Fmed is considered the main grapevine wood rot (Esca) agent within the Esca disease complex, which includes some of the most economically important Grapevine Trunk Diseases (GTDs). This review summarises and evaluates published research on Fmed, on white rot elimination by curettage or management by treatments with specific products applied to diseased grapevines, and on the relationship between wood symptoms and Grapevine Leaf Stripe Disease (GLSD) in the Esca disease complex. Information is also reviewed on the fungus biology, mechanisms of pathogenicity, and their possible relationships with external foliar symptoms of the Esca disease complex. Information on Fmed control strategies is also reviewed

Right heart size and function significantly correlate in patients with pulmonary arterial hypertension – a cross-sectional study

Background: The objective of this study was to assess, whether right atrial (RA) and ventricular (RV) size is related to RV pump function at rest and during exercise in patients with pulmonary arterial hypertension (PAH). Methods: We included 54 patients with invasively diagnosed PAH that had been stable on targeted medication. All patients underwent clinical assessments including right heart catheterization and echocardiography at rest and during exercise. RV output reserve was defined as increase of cardiac index (CI) from rest to peak exercise (∆CIexercise). Patients were classified according to the median of RA and RV-area. RV pump function and further clinical parameters were compared between groups by student’s t-test. Uni- and multivariate Pearson correlation analyses were performed. Results: Patients with larger RA and/or RV-areas (above a median of 16 and 20cm2, respectively) showed significantly lower ∆CIexercise, higher mean pulmonary arterial pressure, pulmonary vascular resistance at rest and NT-proBNP levels. Furthermore, patients with higher RV-areas presented with a significantly lower RV stroke volume and pulmonary arterial compliance at peak exercise than patients with smaller RV-size. RV area was identified as the only independent predictor of RV output reserve. Conclusion: RV and RA areas represent valuable and easily accessible indicators of RV pump function at rest and during exercise. Cardiac output reserve should be considered as an important clinical parameter. Prospective studies are needed for further evaluation

Clinical and morphological phenotype of the filamin myopathy: a study of 31 German patients

Mutations in the filamin C gene (FLNC) cause a myofibrillar myopathy (MFM), morphologically characterized by focal myofibrillar destruction and abnormal accumulation of several proteins within skeletal muscle fibres. We studied 31 patients from four German families to evaluate the phenotype of filaminopathy. All patients harboured the same p.W2710X mutation in FLNC. Haplotype analysis suggested a founder mutation in these German filaminopathy families. The mean age at onset of clinical symptoms was 44 +/− 6 years (range, 24-57 years). Slowly progressive muscle weakness was mostly pronounced proximally, initially affecting the lower extremities and involving the upper extremities in the course of disease progression, similar to the distribution of weakness seen in limb-girdle muscular dystrophies (LGMD). Patients frequently developed respiratory muscle weakness. About one-third of the patients showed cardiac abnormalities comprising conduction blocks, tachycardia, diastolic dysfunction and left ventricular hypertrophy indicating a cardiac involvement in filaminopathy. Serum creatine kinase levels varied from normal up to 10-fold of the upper limit. Magnetic resonance imaging studies showed a rather homogenous pattern of muscle involvement in the lower extremities differing from that in other types of MFM. Myopathological features included perturbation of myofibrillar alignment, accumulation of granulofilamentous material similar to that seen in primary desminopathies and abnormal intracellular protein deposits typical of MFM. Decreased activities of oxidative enzymes and fibre hypertrophy seem to be early features, whereas dystrophic changes were present in advanced stages of filaminopathy. Rimmed vacuoles were detected in only a few cases. The intracellular aggregates were composed of a variety of proteins including filamin C, desmin, myotilin, Xin, dystrophin and sarcoglycans. Therapy is so far limited to symptomatic treatment. The German filaminopathy cohort, the largest group of patients studied so far, shares phenotypic features with LGMD and presents with characteristic histopathological findings of MF

Case report: a unique pediatric case of a primary CD8 expressing ALK-1 positive anaplastic large cell lymphoma of skeletal muscle

Primary involvement of skeletal muscle is a very rare event in ALK-1 positive anaplastic large cell lymphoma (ALCL). We describe a case of a 10-year old boy presenting with a three week history of pain and a palpable firm swelling at the dorsal aspect of the left thigh. Histological examination of the lesion revealed a tumoral and diffuse polymorphic infiltration of the muscle by large lymphoid cells. Tumor cells displayed eccentric, lobulated "horse shoe" or "kidney-shape" nuclei. The cells showed immunohistochemical positivity for CD30, ALK-1, CD2, CD3, CD7, CD8, and Perforin. Fluorescence in situ hybridization analysis revealed a characteristic rearrangement of the ALK-1 gene in 2p23 leading to the diagnosis of ALK-1 positive ALCL. Chemotherapy according to the ALCL-99-NHL-BFM protocol was initiated and resulted in a complete remission after two cycles. This case illustrates the unusual presentation of a pediatric ALCL in soft tissue with a good response to chemotherapy

Connectivity and Synchronisation of Lake Ecosystems in Space and Time - CONNECT

Within the project CONNECT we are establishing a collaborative network between experts in remote sensing (RS) and freshwater ecology to study connectivity and coherence of lake ecosystems in a regional context at unprecedented temporal and spatial resolution. The overall aim is to understand the yet unexplained variation in phytoplankton dynamics among river-connected German lowland lakes, many of which are presently classified as in poor to bad ecological status. These lakes often face a high risk of eutrophication, mass development of harmful algal blooms, and high production of greenhouse gases. We suggest if measured on adequate temporal and spatial scales much of the among-lake variation in phytoplankton dynamics to be explained by the strength of hydrological lake-to-lake and lake-to-catchment connectivity as modulated by lake depth and mixing regime. This may have profound implications for the maximum intensity, spatial range and regional-scale magnitude of eutrophication impacts. We will use (i) a large-scale experimental manipulation of lake connectivity, and (ii) an observational field campaign contrasting deep and shallow river-connected lakes, to challenge this research frontier by an innovative combination of automatic high- frequency in situ measurements with state of the art near-to-far RS technology. Climate change is expected to alter the hydrology, and thus the connectivity of lake-river systems. However, it is also predicted to increase extreme weather events leading to an increased input of nutrients as well as colored dissolved organic matter (cDOM). By providing data of high spatio-temporal coverage, CONNECT will provide basic high quality data to better understand mechanisms of eutrophication at the local and regional scale. Our data, thus, provide a valuable basis to improve current management of such river-connected lake ecosystems under future climate scenarios. To reach this ambitious goal, the project will (i) build a cross- disciplinary collaborative network of excellence, (ii) develop a mechanistic understanding of lake ecosystem functioning at local and regional scale, (iii) improve future environmental monitoring and interpretation of available data from inland waters, and (iv) support more effective integrated management of river-connected lakes to mitigate eutrophication impacts