Philip Morris In A Dying Industry - The Creative Destruction Of The Cigarette

This report represents an equity valuation of Philip Morris International Inc., one of the leading tobacco firms worldwide. For this, an intrinsic valuation in form of a DCF model and a relative valuation based on multiples and transactions was conducted. A target share price of $108.16 was derived which depicts a Buy recommendation and a total upside potential including a dividend of 10.79%. The firm was valued especially in light of its shifting business model and a clear focus towards Risk-Reduced Products going forward. Additionally, scenario and sensitivity analyses were performed

Vitrifikation von Hornhautlamellen

0\. Titelblatt 1\. Grundlagen und Problemstellung 7 1.1 Anatomie und Physiologie der Hornhaut 7 1.2 Hornhauttransplantation 12 1.3 Hornhautbanken 15 1.4 Routineververfahren der Hornhautkonservierung 16 1.5 Die Gefrierkonservierung der Hornhaut 19 1.6 Ziele dieser Arbeit 35 2\. Material und Methoden 38 2.1 Das Hornhautgewebe 38 2.2 Präparation der Hornhautlamellen 38 2.3 Das Berlin-Mikrokeratom 40 2.4 Vitrifikationsmedium 42 2.5 Einschleusung des Vitrifikationsmediums 43 2.6 Der Gefriergutbehälter 45 2.7 Das Vitrifikationsverfahren 47 2.8 Das Auftauverfahren 49 2.9 Ausschleusung des Vitrifikationsmediums 49 2.10 Die Organkultur 50 2.11 Die Vitalfärbung 51 2.12 Fotodokumentation und Endothelzellanalyse 53 2.13 Übersicht über den gesamten Verfahrensablauf 54 3\. Ergebnisse 56 3.1 Endothelzellanalyse unbehandelter Hornhautlamellen 56 3.2 Verträglichkeit der Oberfläche des Gefriergutbehälters mit dem Hornhautendothel 58 3.3 Vitrifikation von Hornhautlamellen bei -140°C 59 3.4 Fotografische Dokumentation der Devitrifikation bei Raumtemperatur 66 3.5 Endothelzellanalyse nach erfolgter Vitrifikation bei -196°C und Erwärmung im Wasserbad 67 3.6 Toleranz des Hornhautendothels gegenüber dem verwendeten Organkulturmedium 69 3.7 Toleranz des Hornhautendothels gegenüber der verwendeten Vitrifikationslösung 71 4\. Diskussion 76 4.1 Erzielte Fortschritte 76 4.2 Vorteile und Perspektiven der Vitrifikation 79 4.3 Toxizität der Kryoprotektoren 80 4.4 Devitrifikation 82 4.5 Berücksichtigung der post-mortem-Zeit 84 4.6 Aussagekraft der Endothelzellanalyse 84 4.7 Vorschläge für Untersuchungen zur weiteren Verbesserung des Vitrifikationsverfahrens 85 5\. Zusammenfassung 88 6\. Literaturverzeichnis 90In the work presented here it has been possible for the first time to carry out the vitrification of corneal lamellae without there being any ice formation or cracking of the frozen product. The basis for this success were three modifications of the vitrification procedure: (1) Instead of using corneoscleral discs which were previously used for freezing experiments, posterior corneal lamellae were used in this investigation. The resulting simultaneous volume reduction led to a more rapid and controllable heat exchange between the corneal tissue and the coolant. (2) By using frozen product packaging which was very thin-walled, transparent and Teflon-coated (Kapton / Teflon peel pouch) it was possible to achieve direct contact between the cornea and the frozen product packaging without endothelial cell damage, whereby the heat exchange was likewise optimized. (3) The flash freezing to -140°C which promotes vitrification was achieved by means of a newly developed freezing device using methylcyclopentane and propane as coolants. Since, despite the successful vitrification, only a maximum of 10% of the endothelial cells were vital after heating, the toxicity of the cryoprotectors which was determined to be the cause, and the devitrification which occurred during the heating process, should be further examined.In der hier vorgestellten Arbeit ist es erstmals gelungen, Hornhautlamellen zu vitrifizieren, ohne daß es dabei zu einer Eis- oder Rißbildung im Gefriergut gekommen ist. Grundlage für diesen Erfolg waren drei Modifikationen des Vitrifikationsverfahrens. (1) Statt der bislang für Gefrierversuche verwendeten Korneoskleralscheiben wurden in dieser Untersuchung hintere Hornhautlamellen verwendet. Die damit einhergehende Volumenreduktion bedingte einen schnelleren und besser zu kontrollierenden Wärmeaustausch zwischen Hornhautgewebe und Kühlmedium. (2) Durch Verwendung eines sehr dünnwandigen, transparenten und teflonbeschichteten Gefriergutträgers (Kapton/Teflon Peel Pouch) konnte ein direkter Kontakt von Hornhaut und Gefriergutträger ohne Endothelzellschädigung erreicht werden, wodurch ebenfalls der Wärmeaustausch optimiert wurde. (3) Die für die Vitrifikation förderliche schockartige Abkühlung bis -140° C wurde mit einer neu entwickelten Einfriervorrichtung unter Verwendung von Methylcyclopentan und Propan als Kühlmittel erreicht. Da trotz erfolgreicher Vitrifikation nur maximal 10% der Endothelzellen nach dem Erwärmen vital waren, sollte die dafür als ursächlich ermittelte Toxizität der Kryoprotektoren und die während des Aufwärmvorganges auftretende Devitrifikation weiter untersucht werden

First experience with the wearable cardioverter defibrillator in the Netherlands

The implantable cardioverter defibrillator (ICD) has significantly improved survival in patients with an increased risk of sudden cardiac death (SCD). The wearable cardioverter defibrillator (WCD) is an alternative to the ICD in patients with a transient ICD indication or those in whom an ICD temporarily cannot be implanted. We describe here the technical details of the WCD and report three patients who were treated with a WCD in an outpatient setting. The WCD allowed the cardiac condition of two patients to improve to such an extent that permanent ICD implantation was deemed unnecessary. This new form of therapy may result in significant cost reduction, avoidance of unnecessary ICD implantation, and increased patient satisfaction

In vivo confocal microscopy and histopathology of the conjunctiva in trachomatous scarring and normal tissue: a systematic comparison.

AIM: To compare in vivo confocal microscopy (IVCM) with the histopathological examination of tissue and cellular changes in normal and diseased conjunctiva. METHODS: Participants underwent clinical examination and IVCM of the tarsal conjunctiva. A biopsy of the upper tarsal conjunctiva was collected and stained with tinctorial stains and by immunohistochemical staining for CD45 and CD83. Connective tissue scarring, inflammatory cell density and the presence of dendritiform cells were quantitatively assessed in a masked manner by both IVCM and histological assessments for comparative analysis. RESULTS: Thirty-four participants with severe trachomatous conjunctival scarring and 33 participants with healthy conjunctiva were recruited. The IVCM connective tissue scarring score was strongly associated with the histological grading of scarring (p<0.001). There was limited evidence of an association between the IVCM inflammatory cell infiltrate and the histological inflammatory cell grade (p=0.05). We did not find any evidence to support the hypothesis that dendritiform cells seen with IVCM are mature, conventional dendritic cells. CONCLUSIONS: The results show that IVCM can be used to robustly quantitate connective tissue scarring and also has a role in measuring the inflammatory cell infiltrate. The discordance between IVCM dendritiform cells and immunohistochemical dendritic cells may be a result of study limitations or may be because these dendritiform structures represent another cell type, such as fibroblasts, rather than dendritic cells