Regioselective One-pot Protection and Protection-glycosylation of Carbohydrates

Deciphering the roles and structure–activity relationships of carbohydrates in biological processes requires access to sugar molecules of confirmed structure and high purity. Chemical synthesis is one of the best ways to obtain such access. However, the synthesis of carbohydrates has long been impeded by two major challenges – the regioselective protection of the polyol moiety of each monosaccharide building block and the stereoselective glycosylation to produce oligosaccharides of desired length. Here, we review the development of the first regioselective protection-glycosylation and a revolutionary regioselective combinatorial one-pot protection of monosaccharides that can be used to differentiate the various hydroxy groups of monosaccharides with a vast array of orthogonal protective groups in one-pot procedures

Preliminary Experience With the Use of Electromagnetic Navigation for the Diagnosis of Peripheral Pulmonary Nodules and Enlarged Mediastinal Lymph Nodes

Electromagnetic navigation is a new technique that can be used with bronchoscopy to obtain samples of small peripheral nodular lesions and enlarged mediastinal lymph nodes. It is very versatile in that it enables both transbronchial biopsies and fine-needle aspiration to be performed. We describe 2 cases in which navigation with the superDimension/ Bronchus system combined with traditional diagnostic techniques facilitated a definitive diagnosis by bronchoscopy. Electromagnetic navigation can obviate the need for more invasive diagnostic procedures such as surgery, thus saving time and money and avoiding complications

Trasplante pulmonar

A lung transplant is usually the final therapeutic option for patients with respiratory insufficiency. In spite of the many advances in immunology and the management of complications, mortality and morbidity associated with this transplant are far higher than with others. Acute rejection is an almost universal problem in the first year, while obliterative bronchitis reduces long term survival. Respiratory infections also play a significant role in the complications associated with lung transplants due to the constant exposure of the graft to the outside. However, the success of this therapeutic option, which basically depends on a suitable selection of donor and recipient, are evident, above all with respect to quality of life

Temporal and spatial differences of methane flux at arctic tundra in Alaska

High latitude ecosystems were thought to enhance CH_4 emission in relation to the current arctic warming. However, we have little information about this potential feedback mechanisms on climate change, thus, model parameterization is insufficient and the observational data are required. We observed CH_4 flux at several types of tundra in Alaska over the growing seasons since 1995. From these observed data, we examined current CH_4 emission and its controlling factors on Alaskan tundra. Then we discussed about spatial and temporal differences in CH_4 flux. Daily trend of half hourly CH_4 flux had little relation with soil temperature, but the seasonal trend of daily flux changed with soil or water temperature. Cumulative CH_4 fluxes during the growing seasons were 8.1gCH_4m^(-2) on wet sedge tundra at Happy Valley in 1995, 3.3gCH_4m^(-2) on non-acidic moist tundra in 1996, and 3.58-8.24gCH_4m^(-2) on wet sedge tundra at Barrow between 1999-2003. Non-acidic tundra had low CH_4 emission with low CO_2 accumulation. There was large spatial difference in CH_4 flux caused by tundra type, and the large temporal difference at the wet sedge tundra reflected yearly weather variability

An Overview of the Body Schema and Body Image: Theoretical Models, Methodological Settings and Pitfalls for Rehabilitation of Persons with Neurological Disorders

Given the widespread debate on the definition of the terms "Body Schema" and "Body Image", this article presents a broad overview of the studies that have investigated the nature of these types of body representations, especially focusing on the innovative information about these two representations that could be useful for the rehabilitation of patients with different neurological disorders with motor deficits (especially those affecting the upper limbs). In particular, we analyzed (i) the different definitions and explicative models proposed, (ii) the empirical settings used to test them and (iii) the clinical and rehabilitative implications derived from the application of interventions on specific case reports. The growing number of neurological diseases with motor impairment in the general population has required the development of new rehabilitation techniques and a new phenomenological paradigm placing body schema as fundamental and intrinsic parts for action in space. In this narrative review, the focus was placed on evidence from the application of innovative rehabilitation techniques and case reports involving the upper limbs, as body parts particularly involved in finalistic voluntary actions in everyday life, discussing body representations and their functional role

Outpatient Management of Malignant Pleural Effusion Using a Tunneled Pleural Catheter: Preliminary Experience

Inpatient management of malignant pleural effusion includes the placement of a conventional thoracostomy tube for drainage and talc slurry pleurodesis and/or a surgical approach consisting of video-assisted thoracoscopic talc insufflation. Both techniques require prolonged hospital stays of up to 1 week. Unfortunately, life expectancy in patients with this disease does not usually exceed 6 months, and so the primary aim of any palliative intervention intended to improve quality of life should be to avoid hospital admissions and to relieve pain as far as possible. Of the few outpatient alternatives to hospital management the most frequently used is repeated thoracentesis. We describe the outpatient management of malignant pleural effusion by placement of a tunneled pleural catheter in a patient with stage IIIB lung adenocarcinoma. In our opinion, the use of this catheter offers a viable alternative to conventional therapy and is better tolerated

Hyperleptinaemia, respiratory drive and hypercapnic response in obese patients

Leptin is a powerful stimulant of ventilation in rodents. In humans, resistance to leptin has been consistently associated with obesity. Raised leptin levels have been reported in subjects with sleep apnoea or obesity-hypoventilation syndrome. The aim of the present study was to assess, by multivariate analysis, the possible association between respiratory centre impairment and levels of serum leptin. In total, 364 obese subjects (body mass index >or=30 kg.m(-2)) underwent the following tests: sleep studies, respiratory function tests, baseline and hypercapnic response (mouth occlusion pressure (P(0.1)), minute ventilation), fasting leptin levels, body composition and anthropometric measures. Subjects with airways obstruction on spirometry were excluded. Out of the 346 subjects undergoing testing, 245 were included in the current analysis. Lung volumes, age, log leptin levels, end-tidal carbon dioxide tension, percentage body fat and minimal nocturnal saturation were predictors for baseline P(0.1). The hypercapnic response test was performed by 186 subjects; log leptin levels were predictors for hypercapnic response in males, but not in females. Hyperleptinaemia is associated with a reduction in respiratory drive and hypercapnic response, irrespective of the amount of body fat. These data suggest the extension of leptin resistance to the respiratory centre

Diagnostic yield of electromagnetic navigation bronchoscopy is highly dependent on the presence of a Bronchus sign on CT imaging: results from a prospective study

Electromagnetic navigation bronchoscopy (ENB) has been developed as a novel ancillary tool for the bronchoscopic diagnosis of pulmonary nodules. Despite successful navigation in 90% of patients, ENB diagnostic yield does not generally exceed 70%. We sought to determine whether the presence of a bronchus sign on CT imaging conditions diagnostic yield of ENB and might account for the discrepancy between successful navigation and diagnostic yield. METHODS: We conducted a prospective, single-center study of ENB in 51 consecutive patients with pulmonary nodules. ENB was chosen as the least invasive diagnostic technique in patients with a high surgical risk, suspected metastatic disease, or advanced-stage disease, or in those who demanded a preoperative diagnosis prior to undergoing curative resection. We studied patient and technical variables that might condition diagnostic yield, including size, cause, location, distance to the pleural surface, and fluorodeoxyglucose uptake of a given nodule; the presence of a bronchus sign on CT imaging; registration point divergence; and the minimum distance from the tip of the locatable guide to the nodule measured during the procedure. RESULTS: The diagnostic yield of ENB was 67% (34/51). The sensitivity and specificity of ENB for malignancy in this study were 71% and 100%, respectively. ENB was diagnostic in 79% (30/38) patients with a bronchus sign on CT imaging but only in 4/13 (31%) with no discernible bronchus sign. Univariate analysis identified the bronchus sign (P = .005) and nodule size (P = .04) as statistically significant variables conditioning yield, but on multivariate analysis, only the bronchus sign remained significant (OR, 7.6; 95% CI, 1.8-31.7). No procedure-related complications were observed. CONCLUSIONS: ENB diagnostic yield is highly dependent on the presence of a bronchus sign on CT imaging

Análisis multiescala de las comunidades de coral hermatípico del Pacífico Central Mexicano

The Mexican Central Pacific is located in a zone of oceanographic transition between two biogeographic provinces with particular conditions that affect the associated fauna. The objective of this study was to evaluate the variation of hermatypic coral assemblages in this region and to determine their relationship with the heterogeneity of the benthonic habitat and spatial variables. A total of 156 transects were carried out at 41 sites in the years 2010 and 2011. The sampling effort returned 96.7% of the coral richness expected for the area, with a total of 15 species recorded. The results showed that richness, diversity and cover of corals varied only at the site and state scales. However, the composition and coverage of all coral species, as well as the benthonic habitat structure, differed significantly across the study scales (i.e. sites, zones and states). Canonical redundancy analysis showed that variation in the richness, diversity and assemblages of corals was explained by the cover of live corals, articulated calcareous algae, sandy substrate, sponges and fleshy macroalgae. This study suggests that local scale (i.e. site) variation in the coral assemblages of the Mexican Central Pacific is the result of the heterogeneity of the benthonic habitat, while geomorphological and oceanographic characteristics play a greater role at regional scale.El Pacífico Central Mexicano se localiza en una zona de transición oceanográfica entre dos provincias biogeográficas con condiciones ambientales particulares que afectan la fauna asociada. El objetivo del estudio fue evaluar la variación de las comunidades de coral hermatípico de esta región y determinar su relación con la heterogeneidad del hábitat bentónico y variables espaciales. Se realizaron 156 transectos en 41 sitios en los años 2010 y 2011. El esfuerzo de muestreo representó el 96.7% de la riqueza de coral esperada para el área, con un total de 15 especies registradas. Los resultados mostraron que la riqueza, diversidad y cobertura de corales variaron sólo en las escalas de sitio y de estado. En cambio, la composición y cobertura de todas las especies de coral, así como la estructura del hábitat bentónico, fueron significativamente diferentes en todas las escalas estudiadas (i.e. sitio, zona y estado). Los análisis de redundancia canónica mostraron que la variación de la riqueza, diversidad y de las comunidades de corales eran explicadas por la cobertura de coral vivo, algas calcáreas articuladas, sustrato arenoso, esponjas y macroalgas carnosas. Este trabajo sugiere que la variación de las comunidades de coral en el Pacífico Central Mexicano a escala local (i.e. sitio) se debe a la heterogeneidad del hábitat bentónico, mientras que a escala regional, las características geomorfológicas y oceanográficas desempeñan un papel más importante

Emphysema presence, severity, and distribution has little impact on the clinical presentation of a cohort of patients with mild to moderate COPD

Phenotypic characterization of patients with COPD may have potential prognostic and therapeutic implications. Available information on the relationship between emphysema and the clinical presentation in patients with COPD is limited to advanced stages of the disease. The objective of this study was to describe emphysema presence, severity, and distribution and its impact on clinical presentation of patients with mild to moderate COPD. METHODS: One hundred fifteen patients with COPD underwent clinical and chest CT scan evaluation for the presence, severity, and distribution of emphysema. Patients with and without emphysema and with different forms of emphysema distribution (upper/lower/core/peel) were compared. The impact of emphysema severity and distribution on clinical presentation was determined. RESULTS: Fifty percent of the patients had mild homogeneously distributed emphysema (1.84; 0.76%-4.77%). Upper and core zones had the more severe degree of emphysema. Patients with emphysema were older, more frequently men, and had lower FEV(1)%, higher total lung capacity percentage, and lower diffusing capacity of the lung for carbon monoxide. No differences were found between the clinical or physiologic parameters of the different emphysema distributions. CONCLUSIONS: In patients with mild to moderate COPD, although the presence of emphysema has an impact on physiologic presentation, its severity and distribution seem to have little impact on clinical presentation