Risk of donor-site lymphatic vessel dysfunction after microvascular lymph node transfer

BACKGROUND: Microvascular lymph node transfer has been used to improve lymphatic function in patients with lymphoedema. We previously reported changes in the lymphatic function of the donor limb after lymph node transfer. For this reason, we modified our surgical method to be more conservative. SUBJECTS AND METHODS: Microvascular lymph node transfer was performed in 13 patients using the previously reported original method. Sixteen patients were operated upon using the more conservative modified method. Lymphatic function in the donor limb was evaluated using volumetry, lymphoscintigraphy and tissue water percentage. RESULTS: In the original method group, the donor-limb volume was on average greater (199 ± 540 ml) than in the non-operated control limb. The volume difference between the limbs was smaller (151 ± 463 ml) in the modified method group. Two patients in the original method group had abnormal transport index (Ti) values in lymphoscintigraphy indicating decreased lymphatic function of the donor limb. In the modified method group, the Ti-values remained normal. The tissue water percentage of the donor limb was on average 40% ± 4% in the original method group and 40% ± 3% in the modified method group. Importantly, none of the patients in either group developed clinical lymphoedema in the donor limb during the 11-84-month follow-up. CONCLUSIONS: Even with the more conservative lymph node transfer method, we can observe slight, subclinical signs of lymphatic dysfunction in the donor limb. These results highlight the importance of minimizing the surgical exploration in the inguinal area and avoiding damage to the lymphatic vessels or sentinel nodes draining the lower limb.</p

Finland’s forests 2018

Luken kirjat, raportit, oppaat ja esitteet201

Effects of Pollen Allergy on Pulmonary Function Tests

Background: To investigate the effect of high air-borne pollen count on respiratory system.Methods: This cross sectional (descriptive) study included sixty known asthmatics, of either sex and of all ages. Pollen count as per cubic meter was recorded daily during February to May as reported by meteorological department. History, clinical examination and lung function tests were recorded in each case. The Pulmonary Function Test (PFT) with pollen count of asthmatic patients was correlated.Results: The PFT of asthmatic patients were adversely affected significantly during pollen season. There was negative correlation of moderate strength with FEV1 in asthmatic patients with high air borne pollen count during the pollen season.Conclusion: Spirometry was shown to be an effective technique to study the pollen allergy problem in already asthmatic patient

Collective plasmonic modes of metal nano-particles in two-dimensional periodic regular arrays

We investigate the collective plasmonic modes of metal nano-particles in periodic two-dimensional (2D) arrays within a point-dipole description. As an open system, the full-dynamic dispersion relations of the 2D arrays are obtained through an efficient method which gives an effective polarizability describing the collective response of a system. Both the dispersion relations and mode qualities are simultaneously related to the imaginary part of the effective polarizability, which has contributions from the single-particle response as well as the inter-particle coupling. The transversal long-range dipolar interaction is dominated by a wave term together with a purely geometrical constant representing the static geometrical contribution to resonant frequencies. As concrete examples, we considered small Ag spheres arranged in a square lattice. We find that inside the light-cone, the transverse quasi-mode has a reasonably high mode quality while the two in-plane modes show significant radiation damping. Near the light-line, we observe strong coupling with free photons for the bands of the transverse mode and the transversal in-plane mode, and the longitudinal in-plane mode exhibits a negative group-velocity inside the light-cone. Vanishing group velocities in the light-cone for all the quasi-modes are found to be intrinsic properties of the 2D metal nano-sphere dense arrays.Comment: 26 pages, 8 figure

An integrated hardware/software design methodology for signal processing systems

This paper presents a new methodology for design and implementation of signal processing systems on system-on-chip (SoC) platforms. The methodology is centered on the use of lightweight application programming interfaces for applying principles of dataflow design at different layers of abstraction. The development processes integrated in our approach are software implementation, hardware implementation, hardware-software co-design, and optimized application mapping. The proposed methodology facilitates development and integration of signal processing hardware and software modules that involve heterogeneous programming languages and platforms. As a demonstration of the proposed design framework, we present a dataflow-based deep neural network (DNN) implementation for vehicle classification that is streamlined for real-time operation on embedded SoC devices. Using the proposed methodology, we apply and integrate a variety of dataflow graph optimizations that are important for efficient mapping of the DNN system into a resource constrained implementation that involves cooperating multicore CPUs and field-programmable gate array subsystems. Through experiments, we demonstrate the flexibility and effectiveness with which different design transformations can be applied and integrated across multiple scales of the targeted computing system

Urinary clusterin and cystatin B as biomarkers of tubular injury in dogs following envenomation by the European adder

Diagnosing acute kidney injury remains a challenge since the established renal biomarkers, serum creatinine (sCr) and symmetric dimethylarginine (SDMA) reflect glomerular function and not tubular injury. Sensitive tubular markers such as urinary clusterin (uClust) and cystatin B (uCysB) have been proposed to detect AKI at an earlier stage. Since envenomation by the European adder (Vipera berus berus) could serve as a spontaneous disease model of AKI we investigated these new biomarkers in affected dogs. Concentrations of uClust and uCysB as well as sCr and SDMA were analyzed retrospectively in stored samples from 26 dogs with snake envenomation and 13 healthy controls. Higher concentrations of uClust (P <0.012) and uCysB (P <0.001) were observed in the snake-envenomed group. Normalization of uClust and uCysB to urinary creatinine did not alter the results. No differences were observed in sCr and SDMA between the snake-envenomed group and the healthy control group. Spearman rank correlation analysis revealed a strong association of uClust with uCysB in the snake-envenomed dogs (r = 0.75 P <0.001) but not in the healthy controls. The high percentage of snake-envenomed dogs with increased uClust and uCysB concentrations in the absence of increased sCr and SDMA suggests renal tubular injury in the affected dogs. Larger prospective case-controlled studies are warranted to evaluate the clinical utility and prognostic value of these biomarkers.Peer reviewe

Self-rated health and objective health status as predictors of all-cause mortality among older people: a prospective study with a 5-, 10-, and 27-year follow-up

BackgroundDespite a non-specific nature of self-rated health (SRH), it seems to be a strong predictor of mortality. The aim of this study is to assess the association of SRH and objective health status (OH) with all-cause mortality in 70-year-old community-dwelling older people in Finland.MethodsA prospective study with 5-, 10- and 27-year follow-ups. SRH (n=1008) was assessed with a single question and OH (n=962) by the Rockwood's Frailty Index (FI). To assess the association of SRH and OH with mortality, Cox regression model was used.ResultsOf the 1008 participants, 138 (13.7%), 319 (31.6%), and 932 deceased (86.3%) during the 5-, 10- and 27-year follow-ups, respectively. In unadjusted models, subjects with poor SRH had almost eightfold risk for mortality compared to those with good SRH during the 5-year follow-up; among those with poor OH, the risk was fourfold compared to those with good OH. In the 10-year-follow up, both poor SRH and poor OH predicted about fourfold risk for mortality compared to those with good health. During the 27-year follow-up, OH was a stronger predictor of mortality than SRH. Poor SRH, compared to good SRH, showed 95% sensitivity and 34% specificity for 5-year mortality; corresponding figures for OH were 54 and 80%, respectively.ConclusionsSingle-item SRH seems to be able to capture almost the same as OH in predicting a short-term (less than 10years) mortality risk among older adults in clinical settings. The use of SHR may also enhance the focus on patient-centered care

Chandra COSMOS Legacy Survey : Clustering dependence of Type 2 active galactic nuclei on host galaxy properties

Aims. We perform clustering measurements of 800 X-ray selected Chandra COSMOS Legacy (CCL) Type 2 active galactic nuclei (AGN) with known spectroscopic redshift to probe the halo mass dependence on AGN host galaxy properties, such as galaxy stellar mass M-star, star formation rate (SFR), and specific black hole accretion rate (BHAR; lambda(BHAR)) in the redshift range z;=;[0-3]. Methods. We split the sample of AGN with known spectroscopic redshits according to M-star, SFR and lambda(BHAR), while matching the distributions in terms of the other parameters, including redshift. We measured the projected two-point correlation function w(p)(r(p)) and modeled the clustering signal, for the different subsamples, with the two-halo term to derive the large-scale bias b and corresponding typical mass of the hosting halo. Results. We find no significant dependence of the large-scale bias and typical halo mass on galaxy stellar mass and specific BHAR for CCL Type 2 AGN at mean z;similar to;1, while a negative dependence on SFR is observed, i.e. lower SFR AGN reside in richer environment. Mock catalogs of AGN, matched to have the same X-ray luminosity, stellar mass, lambda(BHAR), and SFR of CCL Type 2 AGN, almost reproduce the observed M-star - M-h, lambda(BHAR) - M-h and SFR-M-h relations, when assuming a fraction of satellite AGN f(AGN)(sat) similar to 0.15fAGNsat similar to 0.15$f_{\mathrm{AGN}}{\mathrm{sat}} \sim 0.15$. This corresponds to a ratio of the probabilities of satellite to central AGN of being active Q;similar to;2. Mock matched normal galaxies follow a slightly steeper M-star - M-h relation, in which low mass mock galaxies reside in less massive halos than mock AGN of similar mass. Moreover, matched mock normal galaxies are less biased than mock AGN with similar specific BHAR and SFR, at least for Q > 1.Peer reviewe

Anti-inflammatory effects of flap and lymph node transfer

Background: Transfer of healthy tissue is commonly used in the treatment of complicated wounds and in reconstruction of tissue defects. Recently, microvascular lymph node transfer (LN) has been used to improve the lymphatic function in lymphedema patients. To elucidate the biological effects of flap transfer (with and without lymph nodes), we have studied the postoperative production of proinflammatory, anti-inflammatory, prolymphangiogenic and antilymphangiogenic cytokines, and growth factors (interleukin 1 alpha [IL-1 alpha], IL-1 beta, tumor necrosis factor alpha [TNF-alpha], IL-10, transforming growth factor beta 1 [TGF-beta 1], IL-4 and IL-13, and vascular endothelial growth factor C [VEGF-C] and VEGF-D) in postoperative wound exudate samples. Methods: Axillary wound exudate samples were analyzed from four patient groups: axillary lymph node dissection (ALND), microvascular breast reconstruction (BR), LN, and combined LN and BR (LN-BR). Results: The concentration of proinflammatory cytokines was low in all the flap transfer groups as opposed to the ALND group, which showed an extensive proinflammatory response. The level of anti-inflammatory and antifibrotic cytokine IL-10 was increased in the LN-BR group samples compared with the ALND and BR groups. In the LN and LN-BR groups, the cytokine profile showed an anti-inflammatory response. Conclusions: Transfer of healthy tissue hinders the proinflammatory response after surgery, which may explain the beneficial effects of flap transfer in various patient groups. In addition, flap transfer with lymph nodes seems to also promote an antifibrotic effect. The clinical effects of LN in lymphedema patients may be mediated by the increased production of prolymphangiogenic growth factor (VEGF-C) and antifibrotic cytokine (IL-10). (C) 2015 Elsevier Inc. All rights reserved.Peer reviewe

Proton Motive Force-Dependent Hoechst 33342 Transport by the ABC Transporter LmrA of Lactococcus lactis

The fluorescent compound Hoechst 33342 is a substrate for many multidrug resistance (MDR) transporters and is widely used to characterize their transport activity. We have constructed mutants of the adenosine triphosphate (ATP) binding cassette (ABC)-type MDR transporter LmrA of Lactococcus lactis that are defective in ATP hydrolysis. These mutants and wild-type LmrA exhibited an atypical behavior in the Hoechst 33342 transport assay. In membrane vesicles, Hoechst 33342 transport was shown to be independent of the ATPase activity of LmrA, and it was not inhibited by orthovanadate but sensitive to uncouplers that collapse the proton gradient and to N,N'-dicyclohexylcarbodiimide, an inhibitor of the F0F1-ATPase. In contrast, transport of Hoechst 33342 by the homologous, heterodimeric MDR transporter LmrCD showed a normal ATP dependence and was insensitive to uncouplers of the proton gradient. With intact cells, expression of LmrA resulted in an increased rate of Hoechst 33342 influx while LmrCD caused a decrease in the rate of Hoechst 33342 influx. Cellular toxicity assays using a triple knockout strain, i.e., L. lactis ΔlmrA ΔlmrCD, demonstrate that expression of LmrCD protects cells against the growth inhibitory effects of Hoechst 33342, while in the presence of LmrA, cells are more susceptible to Hoechst 33342. Our data demonstrate that the LmrA-mediated Hoechst 33342 transport in membrane vesicles is influenced by the transmembrane pH gradient due to a pH-dependent partitioning of Hoechst 33342 into the membrane.