The detection of extragalactic 15^{15}N: Consequences for nitrogen nucleosynthesis and chemical evolution

Detections of extragalactic $^{15}$N are reported from observations of the rare hydrogen cyanide isotope HC$^{15}$N toward the Large Magellanic Cloud (LMC) and the core of the (post-) starburst galaxy NGC 4945. Accounting for optical depth effects, the LMC data from the massive star-forming region N113 infer a $^{14}N/^{15}$N ratio of 111 $\pm$ 17, about twice the $^{12}C/^{13}$C value. For the LMC star-forming region N159HW and for the central region of NGC 4945, $^{14}N/^{15}$N ratios are also $\approx$ 100. The $^{14}N/^{15}$N ratios are smaller than all interstellar nitrogen isotope ratios measured in the disk and center of the Milky Way, strongly supporting the idea that $^{15}$N is predominantly of `primary' nature, with massive stars being its dominant source. Although this appears to be in contradiction with standard stellar evolution and nucleosynthesis calculations, it supports recent findings of abundant $^{15}$N production due to rotationally induced mixing of protons into the helium-burning shells of massive stars.Comment: 15 pages including one postscript figure, accepted for publication by ApJ Letter, further comments: please contact Yi-nan Chi

Goitre and Iodine Deficiency in Europe

The prevalence of endemic iodine-deficiency goitre in Europe has been reduced in many areas by the introduction of iodination programmes. Recent reports, however, show that goitre remains a significant problem and that its prevalence has not decreased in a number of European countries. Hetzel1 has pointed out that the high global prevalence of iodine-deficiency disorders could be eradicated within 5-10 years by introduction of an iodised salt programme. The current World Health Organisation recommendations for iodine intake are between 150 and 300 μg/da

Scattering theory for Klein-Gordon equations with non-positive energy

We study the scattering theory for charged Klein-Gordon equations: \{{array}{l} (\p_{t}- \i v(x))^{2}\phi(t,x) \epsilon^{2}(x, D_{x})\phi(t,x)=0,[2mm] \phi(0, x)= f_{0}, [2mm] \i^{-1} \p_{t}\phi(0, x)= f_{1}, {array}. where: \epsilon^{2}(x, D_{x})= \sum_{1\leq j, k\leq n}(\p_{x_{j}} \i b_{j}(x))A^{jk}(x)(\p_{x_{k}} \i b_{k}(x))+ m^{2}(x), describing a Klein-Gordon field minimally coupled to an external electromagnetic field described by the electric potential $v(x)$ and magnetic potential $\vec{b}(x)$. The flow of the Klein-Gordon equation preserves the energy: h[f, f]:= \int_{\rr^{n}}\bar{f}_{1}(x) f_{1}(x)+ \bar{f}_{0}(x)\epsilon^{2}(x, D_{x})f_{0}(x) - \bar{f}_{0}(x) v^{2}(x) f_{0}(x) \d x. We consider the situation when the energy is not positive. In this case the flow cannot be written as a unitary group on a Hilbert space, and the Klein-Gordon equation may have complex eigenfrequencies. Using the theory of definitizable operators on Krein spaces and time-dependent methods, we prove the existence and completeness of wave operators, both in the short- and long-range cases. The range of the wave operators are characterized in terms of the spectral theory of the generator, as in the usual Hilbert space case

Extracorporeal membrane oxygenation (ECMO) as salvage treatment for pulmonary Echinococcus granulosus infection with acute cyst rupture

Extracorporeal membrane oxygenation (ECMO) has been used successfully for the treatment of patients with respiratory failure due to severe infections. Although rare, parasites can also cause severe pulmonary disease. Tapeworms of the genus Echinococcus give rise to the development of cystic structures in the liver, lungs, and other organs. Acute cyst rupture leads to potentially life-threatening infection, and affected patients may deteriorate rapidly. The case of a young woman from Bulgaria who was admitted to hospital with severe dyspnoea, progressive chest pain, and haemoptysis is described. Computed tomography of the chest was pathognomonic for cystic echinococcosis with acute cyst rupture. Following deterioration on mechanical ventilation, she was cannulated for veno-venous ECMO. The patient's condition improved considerably, and she was weaned successfully from ECMO and mechanical ventilation. Following lobectomy of the affected left lower lobe, the patient was discharged home in good condition. This appears to be the first report of the successful use of ECMO as salvage treatment for a severe manifestation of a helminthic disease. Due to recent migration to Western Europe, the number of patients presenting with respiratory failure due to pulmonary echinococcosis with cyst rupture is likely to increase

Extracorporeal membrane oxygenation (ECMO) as salvage treatment for pulmonary Echinococcus granulosus infection with acute cyst rupture

Extracorporeal membrane oxygenation (ECMO) has been used successfully for the treatment of patients with respiratory failure due to severe infections. Although rare, parasites can also cause severe pulmonary disease. Tapeworms of the genus Echinococcus give rise to the development of cystic structures in the liver, lungs, and other organs. Acute cyst rupture leads to potentially life-threatening infection, and affected patients may deteriorate rapidly. The case of a young woman from Bulgaria who was admitted to hospital with severe dyspnoea, progressive chest pain, and haemoptysis is described. Computed tomography of the chest was pathognomonic for cystic echinococcosis with acute cyst rupture. Following deterioration on mechanical ventilation, she was cannulated for veno-venous ECMO. The patient’s condition improved considerably, and she was weaned successfully from ECMO and mechanical ventilation. Following lobectomy of the affected left lower lobe, the patient was discharged home in good condition. This appears to be the first report of the successful use of ECMO as salvage treatment for a severe manifestation of a helminthic disease. Due to recent migration to Western Europe, the number of patients presenting with respiratory failure due to pulmonary echinococcosis with cyst rupture is likely to increase

Evolution of non-thyroidal illness syndrome in acute decompensation of liver cirrhosis and acute-on-chronic liver failure

Background and aimsNon-thyroidal illness syndrome (NTIS) is frequent in critically ill patients and associated with adverse outcomes. We aimed to characterize the evolution of NTIS in patients with acute decompensation (AD) of cirrhosis and acute-on-chronic liver failure (ACLF), since NTIS is not well described in these newly defined syndromes.MethodsThyroid hormones (TH) were quantified at baseline in consecutive patients with cirrhosis. In addition, 76 inflammatory mediators were quantified by proximity extension analysis assay in a subgroup of patients. Associations between TH, cirrhosis stage, mortality and inflammation were assessed.ResultsOverall, 437 patients were included, of whom 165 (37.8%), 211 (48.3%), and 61 (14%) had compensated cirrhosis (CC), AD, and ACLF. FT3 concentrations were lower in AD versus CC, and further decreased in ACLF. Importantly, NTIS was present in 83 (39.3%) patients with AD and in 44 (72.1%) patients with ACLF (P<0.001). Yet, TSH and TSH-based indexes (TSH/FT3-ratio, thyroid index) showed an U-shaped evolution during progression of cirrhosis, suggesting a partially preserved responsiveness of the hypothalamus and pituitary in AD. Infections were associated with lower FT3 concentrations in AD, but not in ACLF. Low FT3 concentrations correlated significantly with 90-day mortality. Both, AD/ACLF and NTIS, were associated with signatures of inflammatory mediators, which were partially non-overlapping.ConclusionNTIS is frequent already in AD and therefore precedes critically illness in a subgroup of patients with decompensated cirrhosis. This might constitute a new paradigm of TH signaling in cirrhosis, offering opportunities to explore preventive effects of TH in AD

Exact results for nucleation-and-growth in one dimension

We study statistical properties of the Kolmogorov-Avrami-Johnson-Mehl nucleation-and-growth model in one dimension. We obtain exact results for the gap density as well as the island distribution. When all nucleation events occur simultaneously, the island distribution has discontinuous derivatives on the rays x_n(t)=nt, n=1,2,3... We introduce an accelerated growth mechanism where the velocity increases linearly with the island size. We solve for the inter-island gap density and show that the system reaches complete coverage in a finite time and that the near-critical behavior of the system is robust, i.e., it is insensitive to details such as the nucleation mechanism.Comment: 9 pages, revtex, also available from http://arnold.uchicago.edu/~ebn

Transformation kinetics of alloys under non-isothermal conditions

The overall solid-to-solid phase transformation kinetics under non-isothermal conditions has been modeled by means of a differential equation method. The method requires provisions for expressions of the fraction of the transformed phase in equilibrium condition and the relaxation time for transition as functions of temperature. The thermal history is an input to the model. We have used the method to calculate the time/temperature variation of the volume fraction of the favored phase in the alpha-to-beta transition in a zirconium alloy under heating and cooling, in agreement with experimental results. We also present a formulation that accounts for both additive and non-additive phase transformation processes. Moreover, a method based on the concept of path integral, which considers all the possible paths in thermal histories to reach the final state, is suggested.Comment: 16 pages, 7 figures. To appear in Modelling Simul. Mater. Sci. En

Traditional and Nontraditional Cardiovascular Risk Factors and Estimated Risk for Coronary Artery Disease in Renal Transplant Recipients: A Single-Center Experience

Background/Aims: The prevalence of cardiovascular disease in renal transplant recipients is markedly higher than in the general population due to the high prevalence of traditional cardiovascular risk factors, renal transplant function impairment and treatment with immunosuppressive drugs that affect blood pressure, cholesterol and blood glucose levels. Methods: Cross-sectional analysis using our renal transplant clinic cohort investigating (1) the cardiovascular risk factors present in this cohort, and (2) estimating their impact on the risk of coronary artery disease (CAD) by using the Framingham algorithm. Results: Control of modifiable cardiovascular risk factors in 231 renal transplant recipients is suboptimal, i.e. 47.2% of patients are hypertensive, 10.3% actively smoke, 39.4% have serum cholesterol concentrations >200 mg/dl, and 19.7% have diabetes mellitus. Blood pressure, age, hyperlipidemia, smoking and diabetes modulate the estimated CAD risk in males and females. Furthermore, a short time period (less than 1 year) since transplantation and increased serum creatinine levels negatively influenced the CAD risk in this patient population. Conclusion: According to current guidelines, the control of modifiable cardiovascular risk factors in renal transplant recipients is suboptimal. The decreasing CAD risk over time after transplantation may be due to the reduction of immunosuppressive drugs with time and survival bias

Histological assessment of paxgene tissue fixation and stabilization reagents

Within SPIDIA, an EC FP7 project aimed to improve pre analytic procedures, the PAXgene Tissue System (PAXgene), was designed to improve tissue quality for parallel molecular and morphological analysis. Within the SPIDIA project promising results were found in both genomic and proteomic experiments with PAXgene-fixed and paraffin embedded tissue derived biomolecules. But, for this technology to be accepted for use in both clinical and basic research, it is essential that its adequacy for preserving morphology and antigenicity is validated relative to formalin fixation. It is our aim to assess the suitability of PAXgene tissue fixation for (immuno)histological methods. Normal human tissue specimens (n = 70) were collected and divided into equal parts for fixation either with formalin or PAXgene. Sections of the obtained paraffin-embedded tissue were cut and stained. Morphological aspects of PAXgene-fixed tissue were described and also scored relative to formalin-fixed tissue. Performance of PAXgene-fixed tissue in immunohistochemical and in situ hybridization assays was also assessed relative to the corresponding formalin-fixed tissues. Morphology of PAXgene-fixed paraffin embedded tissue was well preserved and deemed adequate for diagnostics in most cases. Some antigens in PAXgene-fixed and paraffin embedded sections were detectable without the need for antigen retrieval, while others were detected using standard, formalin fixation based, immunohistochemistry protocols. Comparable results were obtained with in situ hybridization and histochemical stains. Basically all assessed histological techniques were found to be applicable to PAXgene-fixed and paraffin embedded tissue. In general results obtained with PAXgene-fixed tissue are comparable to those of formalin-fixed tissue. Compromises made in morphology can be called minor compared to the advantages in the molecular pathology possibilities