Membranöse Glomerulonephritis: Ätiopathogenese, Diagnostik und moderne Therapie

Zusammenfassung: Die membranöse Glomerulonephritis (MGN) ist die häufigste Ursache eines nephrotischen Syndroms bei Erwachsenen. Meist liegt eine idiopathische Form vor, doch sollen alle potenziellen Ursachen (in erster Linie Tumoren, Medikamente oder Infekte) aktiv gesucht bzw. ausgeschlossen werden. Die Behandlung der primären MGN bleibt kontrovers. Bei 30% der Patienten tritt eine spontane Remission auf, bei 30% kommt es zur dialysepflichtigen Niereninsuffizienz. Risikofaktoren für einen ungünstigen Verlauf sind: höheres Lebensalter, männliches Geschlecht, arterielle Hypertonie, schwere Proteinurie, eingeschränkte Nierenfunktion and tubulointerstitielle Fibrose. Auf jeden Fall sollte ein ACE-Hemmer und/oder Angiotensin-II-Antagonist und ein Statin eingesetzt werden. Bei Zunahme der Proteinurie oder Verschlechterung der Nierenfunktion nach 6 Monaten besteht die Indikation zur Immunsuppression mit Steroiden in Kombination mit Cyclophosphamid oder Cyclosporin

ANALYZE THE TREATMENT REGIMENS AND THROMBOSIS PROPHYLAXIS USED IN CORONARY ARTERY INTERVENTION AT INTERVENTIONAL CARDIOLOGY UNIT IN CAN THO CENTRAL GENERAL HOSPITAL

Objective: The study was conducted to analyze the rationality of treatment regimens and thrombosis prophylaxis used in coronary artery intervention to compare to guidelines for treatment according to VNHA and recommendation of ACC/AHA at Interventional cardiology in Can Tho Central General Hospital. Methods: The cross-sectional study was based on the data collected from entire medical records of patients at Interventional cardiology in Can Tho Central General Hospital from August 2017 to February 2018. The rationality of the antithrombotic regimen used at the Hospital is assessed through criteria such as medical combination, dosage, time to take medicine, clinical trials during the treatment. Results: The study found that 95.6% and 90.7% were suitable for medical combination before and after PCI; 100% fit for the use of medicine; and 100% was suitable for antithrombotic agents and clinical trials during treatment time; in terms of dosage, the result showed that entrance and maintenance were 84.9% and 100% for aspirin respectively; 71.7% and 100% for clopidogrel; 100% and 94.7% for ticagrelor; 90.2-92.8% and 98.1% for enoxaparin; especially, heparin-100% anticoagulant was appropriate to recommend. Conclusion: The study showed that treatment regimens and thrombosis prophylaxis in percutaneous coronary intervention at Interventional cardiology in Can Tho Central General Hospital were quite suitable compared to the recommendations of the Heart Association. The results from the study are a scientific basis for the Hospital to maintain or consider adjustments to improve the quality of treatment, ensure the effectiveness and safety of patients

Quantum coherence engineering in the integer quantum Hall regime

We present an experiment where the quantum coherence in the edge states of the integer quantum Hall regime is tuned with a decoupling gate. The coherence length is determined by measuring the visibility of quantum interferences in a Mach-Zehnder interferometer as a function of temperature, in the quantum Hall regime at filling factor two. The temperature dependence of the coherence length can be varied by a factor of two. The strengthening of the phase coherence at finite temperature is shown to arise from a reduction of the coupling between co-propagating edge states. This opens the way for a strong improvement of the phase coherence of Quantum Hall systems. The decoupling gate also allows us to investigate how inter-edge state coupling influence the quantum interferences' dependence on the injection bias. We find that the finite bias visibility can be decomposed into two contributions: a Gaussian envelop which is surprisingly insensitive to the coupling, and a beating component which, on the contrary, is strongly affected by the coupling.Comment: 4 pages, 5 figure

The Infrared Properties of Submillimeter Galaxies: Clues From Ultra-Deep 70 Micron Imaging

We present 70 micron properties of submillimeter galaxies (SMGs) in the Great Observatories Origins Deep Survey (GOODS) North field. Out of thirty submillimeter galaxies (S_850 > 2 mJy) in the central GOODS-N region, we find two with secure 70 micron detections. These are the first 70 micron detections of SMGs. One of the matched SMGs is at z ~ 0.5 and has S_70/S_850 and S_70/S_24 ratios consistent with a cool galaxy. The second SMG (z = 1.2) has infrared-submm colors which indicate it is more actively forming stars. We examine the average 70 micron properties of the SMGs by performing a stacking analysis, which also allows us to estimate that S_850 > 2 mJy SMGs contribute 9 +- 3% of the 70 micron background light. The S_850/S_70 colors of the SMG population as a whole is best fit by cool galaxies, and because of the redshifting effects these constraints are mainly on the lower z sub-sample. We fit Spectral Energy Distributions (SEDs) to the far-infrared data points of the two detected SMGs and the average low redshift SMG (z_{median}= 1.4). We find that the average low-z SMG has a cooler dust temperature than local ultraluminous infrared galaxies (ULIRGs) of similar luminosity and an SED which is best fit by scaled up versions of normal spiral galaxies. The average low-z SMG is found to have a typical dust temperature T = 21 -- 33 K and infrared luminosity L_{8-1000 micron} = 8.0 \times 10^11 L_sun. We estimate the AGN contribution to the total infrared luminosity of low-z SMGs is less than 23%.Comment: Accepted by ApJ. 14 pages, 6 figures. Minor revisions 20th Dec 200

Unary Pushdown Automata and Straight-Line Programs

We consider decision problems for deterministic pushdown automata over a unary alphabet (udpda, for short). Udpda are a simple computation model that accept exactly the unary regular languages, but can be exponentially more succinct than finite-state automata. We complete the complexity landscape for udpda by showing that emptiness (and thus universality) is P-hard, equivalence and compressed membership problems are P-complete, and inclusion is coNP-complete. Our upper bounds are based on a translation theorem between udpda and straight-line programs over the binary alphabet (SLPs). We show that the characteristic sequence of any udpda can be represented as a pair of SLPs---one for the prefix, one for the lasso---that have size linear in the size of the udpda and can be computed in polynomial time. Hence, decision problems on udpda are reduced to decision problems on SLPs. Conversely, any SLP can be converted in logarithmic space into a udpda, and this forms the basis for our lower bound proofs. We show coNP-hardness of the ordered matching problem for SLPs, from which we derive coNP-hardness for inclusion. In addition, we complete the complexity landscape for unary nondeterministic pushdown automata by showing that the universality problem is $\Pi_2 \mathrm P$-hard, using a new class of integer expressions. Our techniques have applications beyond udpda. We show that our results imply $\Pi_2 \mathrm P$-completeness for a natural fragment of Presburger arithmetic and coNP lower bounds for compressed matching problems with one-character wildcards

Understanding functional group and assembly dynamics in temperature responsive systems leads to design principles for enzyme responsive assemblies

Understanding the molecular rules behind the dynamics of supramolecular assemblies is fundamentally important for the rational design of responsive assemblies with tunable properties. Herein, we report that the dynamics of temperature-sensitive supramolecular assemblies is not only affected by the dehydration of oligoethylene glycol (OEG) motifs, but also by the thermally-promoted molecular motions. These counteracting features set up a dynamics transition point (DTP) that can be modulated with subtle variations in a small hydrophobic patch on the hydrophilic face of the amphiphilic assembly. Understanding the structural factors that control the dynamics of the assemblies leads to rational design of enzyme-responsive assemblies with tunable temperature responsive profiles

Acute life-threatening extrinsic allergic alveolitis in a paint controller

Background Occupational diisocyanate-induced extrinsic allergic alveolitis (EAA) is a rare and probably underestimated diagnosis. Two acute occupational EAA cases have been described in this context, but neither of them concerned hexamethylene diisocyanate (HDI) exposure. Aims To investigate the cause of a life-threatening EAA arising at work in a healthy 30-year-old female paint quality controller. Methods Occupational medical assessment, workplace evaluation, airborne and biological monitoring and immunodermatological tests. Results Diagnosis of EAA relied on congruent clinical and radiological information, confirmed occupational HDI exposure and positive IgG antibodies and patch tests. The patient worked in a small laboratory for 7 years, only occasionally using HDI-containing hardeners. While working with HDI for 6 h, she developed breathlessness, rapidly progressing to severe respiratory failure. Workplace HDI airborne exposure values ranged from undetectable levels to 4.25 p.p.b. Biological monitoring of urinary hexamethylene diamine in co-workers ranged from <1.0 to 15.4 μg/g creatinine. Patch tests 8 months later showed delayed skin reaction to HDI at 48 h. Subsequent skin biopsy showed spongiotic dermatitis with infiltration of CD4+ and CD8+ T cells. Conclusions We believe this is the first reported case of acute life-threatening EAA following exposure to HDI. Low concentrations of airborne HDI and relatively high urinary hexamethylene diamine suggest significant skin absorption of HDI could have significantly contributed to the development of this acute occupational EA

Size dependent tunneling and optical spectroscopy of CdSe quantum rods

Photoluminescence excitation spectroscopy and scanning tunneling spectroscopy are used to study the electronic states in CdSe quantum rods that manifest a transition from a zero dimensional to a one dimensional quantum confined structure. Both optical and tunneling spectra show that the level structure depends primarily on the rod diameter and not on length. With increasing diameter, the band-gap and the excited state level spacings shift to the red. The level structure was assigned using a multi-band effective-mass model, showing a similar dependence on rod dimensions.Comment: Accepted to PRL (nearly final version). 4 pages in revtex, 4 figure

Early complications after living donor nephrectomy: analysis of the Swiss Organ Living Donor Health Registry.

We evaluated the prospectively collected data about the incidence of early peri- and postoperative complications, and potential risk factors for adverse outcomes after living kidney donation in Switzerland. Peri- and postoperative events were prospectively recorded on a questionnaire by the local transplant teams of all Swiss transplant centres and evaluated by the Swiss Organ Living Donor Health Registry. Complications were classified according to the Clavien grading system. A total of 1649 consecutive donors between 1998 and 2015 were included in the analysis. There was no perioperative mortality observed. The overall complication rate was 13.5%. Major complications defined as Clavien ≥3 occurred in 2.1% of donors. Obesity was not associated with any complications. Donor age &gt;70years was associated with major complications (odds ratio [OR] 3.99) and genitourinary complications (urinary tract infection OR 5.85; urinary retention OR 6.61). There were more major complications observed in donors with laparoscopic surgery versus open surgery (p = 0.048), but an equal overall complication rate (p = 0.094). We found a low rate of major and minor complications, independent of surgical technique, after living donor nephrectomy. There was no elevated complication rate in obese donors. In contrast, elderly donors &gt;70 years had an elevated risk for perioperative complications