Tangled: A Pictorial Review of Ultrasound and Angiography of Postpartum Hemorrhage due to Uterine Arteriovenous Malformations and Sub-Involution of the Placental Bed

Background: PPH can occur in up to 6% of deliveries and is a major cause of maternal mortality. UAE is preferred for PPH after failure of conservative treatment, as UAE can be performed in an emergent manner and can be repeated if necessary. UAE is effective for multiple types of PPH, and 24 hours after delivery, AVMs are the most common type to require UAE. Sub-involution of the placenta bed (SIPB) as an etiology for PPH is a relatively underrecognized etiology in both diagnostic and interventional radiology. SIPB describes a persistence of large placental vessels within the myometrium greater than 24 hours after delivery. We present a pictorial review of ultrasound and angiographic cases to illustrate the differences between uterine AVM and SIP. Clinical Findings/Procedure Details: The appearance of uterine AVM and SIPB in the setting of PPH can be nearly identical on ultrasound with both showing enlarged myometrial vessels with low-resistance on Doppler. However, uterine vessel angiography can clearly diagnose a uterine AVM with tortuous and hypertrophied uterine vessels and an early draining vein. We present several cases of PPH with uterine AVM diagnosed on ultrasound that were confirmed with angiography and embolized successfully. We contrast those cases to patients with PPH and features that were consistent with AVM on ultrasound, whom had no evidence of AVM on angiography, thus suggestive of SIPB. Despite the lack of AVM found on angiography, these cases were embolized via gelatin foam with successful hemostasis of the PPH. Conclusion/Teaching Points: PPH is a significant factor of maternal mortality and can be successfully treated with UAE. Uterine AVM and SIPB can have nearly identical features on ultrasound but can be distinguished during angiography, however, the lack of an AVM on angiography should not preclude embolization.https://scholarlycommons.henryford.com/merf2019clinres/1001/thumbnail.jp

Enhanced catalysis of the electrochemical hydrogen evolution reaction using composites of molybdenum-based compounds, gold nanoparticles and carbon

Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG geförderten) Allianz- bzw. Nationallizenz frei zugänglich.This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.Molybdenum nitride has been recently reported to interact synergistically with gold to show an enhanced activity for the electrochemical hydrogen evolution reaction (2H(+) + 2e(-) -> H-2, HER). In this work, we elucidated the roles of nitrogen, carbon, molybdenum and gold on this observed phenomenon. Composites of Mo-based compounds, carbon black (black pearl 2000) and/or Au nanoparticles (Au-NP) were prepared, and their activities for the HER in a 0.5 M H2SO4 electrolyte were measured using linear sweep voltammetry. We show and discuss here for the first time that, while the presence of carbon is necessary for the synergy phenomenon, the nitrogen atoms present in the compounds play no apparent role in this synergy. In fact, all the compounds containing Mo, namely Mo2N, MoB and metallic Mo-0, exhibited extensive synergy with Au for the HER. A hypothesis for the enhanced catalysis of H-2 evolution by the mixed metal composites is proposed and discussed

Platelet-derived extracellular vesicles express NADPH oxidase-1 (Nox-1), generate superoxide and modulate platelet function

Background: Platelets release platelet-derived extracellular vesicles (PDEVs) upon activation – in a process that is regulated by generation of reactive oxygen species (ROS). Platelet NADPH oxidase-1 (Nox-1) contributes to ROS generation and thrombus formation downstream of the collagen receptor GPVI. Objectives: We aimed to investigate whether PDEVs contain Nox-1 and whether this is relevant for PDEV-induced platelet activation. Methods: PDEVs were isolated through serial centrifugation after platelet activation with thrombin receptor agonist TRAP-6 (activated PDEVs) or in the absence of agonist (resting PDEVs). The physical properties of PDEVs were analysed through nanoparticle tracking analysis. Nox-1 levels, fibrinogen binding and P-selectin exposure were measured using flow cytometry, and protein levels quantified by immunoblot analysis. ROS were quantified using DCF fluorescence and electron paramagnetic resonance. Results: Nox-1 was found to be increased on the platelet outer membrane upon activation and was found to be present in PDEVs. PDEVs induced platelet activation, while co-addition of GPVI agonist collagen-related peptide (CRP) did not potentiate this response. PDEVs were shown to be able to generate superoxide in a process at least partially mediated by Nox- 1, while Nox-1 inhibition with ML171 (also known as 2-APT) did not influence PDEV production. Finally, inhibition of Nox-1 abrogated PDEV-mediated platelet activation. Conclusions: PDEVs are able to generate superoxide, bind to and activate platelets in a process mediated by Nox-1. These data provide novel mechanisms by which Nox-1 potentiates platelet responses, thus proposing Nox-1 inhibition as a feasible strategy to treat and prevent thrombotic diseases

Venous thromboembolism in children with cancer – a population-based cohort study

Introduction: Cancer is a known risk factor for venous thromboembolism (VTE) in adults, but population-based data in children are scarce. Materials and methods: We conducted a cohort study utilising linkage of the Clinical Practice Research Database (primary care), Hospital Episodes Statistics (secondary care), UK Cancer Registry data and Office for National Statistics cause of death data. From these databases, we selected 498 children with cancer diagnosed between 1997 and 2006 and 20,810 controls without cancer. We calculated VTE incidence rates in children with cancer vs. controls, and hazard ratios (HRs) using Cox regression. Results: We identified four VTE events in children with cancer compared with four events in the larger control population corresponding to absolute risks of 1.52 and 0.06 per 1000 person-years respectively. The four children with VTE and cancer were diagnosed with hematological, bone or non-specified cancer. Childhood cancer was hence associated with a highly increased risk of VTE (HR adjusted for age and sex: 28.3; 95%CI = 7.0-114.5). Conclusions: Children with cancer are at increased relative risk of VTE compared to those without cancer. Physicians could consider thromboprophylaxis in children with cancer to reduce their excess risk of VTE however the absolute risk is extremely small and the benefit gained therefore would need to be balanced against the risk invoked of implementing such a strategy. Novelty & Impact Statements: While there is a reasonable level of knowledge about the risk of VTE in adult populations, it is not well known whether this risk is reflected in paediatric patients. We found a substantial increase in risk of VTE in children with cancer compared to a child population without cancer. While this finding is important, the absolute risk of VTE is still low and must be balanced with the risks of anticoagulation

Pyrenoid loss impairs carbon-concentrating mechanism induction and alters primary metabolism in Chlamydomonas reinhardtii

Carbon-concentrating mechanisms (CCMs) enable efficient photosynthesis and growth in CO2-limiting environments, and in eukaryotic microalgae localisation of Rubisco to a microcompartment called the pyrenoid is key. In the model green alga Chlamydomonas reinhardtii, Rubisco preferentially relocalises to the pyrenoid during CCM induction and pyrenoid-less mutants lack a functioning CCM and grow very poorly at low CO2. The aim of this study was to investigate the CO2 response of pyrenoid-positive (pyr+) and pyrenoid-negative (pyr–) mutant strains to determine the effect of pyrenoid absence on CCM induction and gene expression. Shotgun proteomic analysis of low-CO2-adapted strains showed reduced accumulation of some CCM-related proteins, suggesting that pyr– has limited capacity to respond to low-CO2 conditions. Comparisons between gene transcription and protein expression revealed potential regulatory interactions, since Rubisco protein linker (EPYC1) protein did not accumulate in pyr– despite increased transcription, while elements of the LCIB/LCIC complex were also differentially expressed. Furthermore, pyr− showed altered abundance of a number of proteins involved in primary metabolism, perhaps due to the failure to adapt to low CO2. This work highlights two-way regulation between CCM induction and pyrenoid formation, and provides novel candidates for future studies of pyrenoid assembly and CCM function

Advanced Fluorescence Microscopy Techniques-FRAP, FLIP, FLAP, FRET and FLIM

Fluorescence microscopy provides an efficient and unique approach to study fixed and living cells because of its versatility, specificity, and high sensitivity. Fluorescence microscopes can both detect the fluorescence emitted from labeled molecules in biological samples as images or photometric data from which intensities and emission spectra can be deduced. By exploiting the characteristics of fluorescence, various techniques have been developed that enable the visualization and analysis of complex dynamic events in cells, organelles, and sub-organelle components within the biological specimen. The techniques described here are fluorescence recovery after photobleaching (FRAP), the related fluorescence loss in photobleaching (FLIP), fluorescence localization after photobleaching (FLAP), Forster or fluorescence resonance energy transfer (FRET) and the different ways how to measure FRET, such as acceptor bleaching, sensitized emission, polarization anisotropy, and fluorescence lifetime imaging microscopy (FLIM). First, a brief introduction into the mechanisms underlying fluorescence as a physical phenomenon and fluorescence, confocal, and multiphoton microscopy is given. Subsequently, these advanced microscopy techniques are introduced in more detail, with a description of how these techniques are performed, what needs to be considered, and what practical advantages they can bring to cell biological research