Visceral leishmaniasis mimicking autoimmune hepatitis, primary biliary cirrhosis, and systemic lupus erythematosus overlap

Visceral leishmaniasis (VL) is a life-threatening infection caused by Leishmania species. In addition to typical clinical findings as fever, hepatosplenomegaly, and cachexia, VL is associated with autoimmune phenomena. To date, VL mimicking or exacerbating various autoimmune diseases have been described, including systemic lupus erythematosus (SLE), rheumatoid arthritis, and autoimmune hepatitis (AIH). Herein, we presented a patient with VL who had overlapping clinical features with SLE, AIH, as well as antimitochondrial antibody (AMA-M2) positive primary biliary cirrhosis.     

Diet and ingestion of synthetics by Cory’s Shearwater Calonectris diomedea off southern Brazil

Cory’s Shearwater, Calonectris diomedea, is a pelagic seabird that winters in the waters off the state of Rio Grande do Sul in southern Brazil. Elsewhere, its diet is comprised mostly of fish and cephalopods, but dietary details out of the breeding season are unknown. The present study analysed the diet of Cory’s Shearwater along the coast of Rio Grande do Sul based on the stomach contents of 185 birds found dead during beach surveys between July 1997 and July 1998. Food items were classified taxonomically and non-food items were categorized. The taxa identified included the cephalopods Argonauta nodosa and Histioteuthis sp. and the fish Paralonchurus brasiliensis, Porichthys porosissimus, and Prionotus punctatus. Cephalopods were present in 97% of stomachs and fish in 33% of stomachs. Synthetic materials were found in 81% of stomachs. Our data corroborate the general ideas of Procellariiform diet during migration. The high amount of synthetic materials indicates the pollution of the marine environments of southern Brazil and we call attention to this situation.     

Life cycle assessment of two baby food packaging alternatives: glass jars vs. plastic pots

Background, aim, and scope  This paper compares the life cycle assessment (LCA) of two packaging alternatives used for baby food produced by Nestlé: plastic pot and glass jar. The study considers the environmental impacts associated with packaging systems used to provide one baby food meal in France, Spain, and Germany in 2007. In addition, alternate logistical scenarios are considered which are independent of the two packaging options. The 200-g packaging size is selected as the basis for this study. Two other packaging sizes are assessed in the sensitivity analysis. Because results are intended to be disclosed to the public, this study underwent a critical review by an external panel of LCA experts. Materials and methods  The LCA is performed in accordance to the international standards ISO 14040 and ISO 14044. The packaging systems include the packaging production, the product assembly, the preservation process, the distribution, and the packaging end-of-life. The production of the content (before preservation process), as well as the use phase are not taken into account as they are considered not to change when changing packaging. The inventory is based on data obtained from the baby food producer and the suppliers, data from the scientific literature, and data from the ecoinvent database. Special care is taken to implement a system expansion approach for end-of-life open and closed loop recycling and energy production (ISO 14044). A comprehensive impact assessment is performed using two life cycle impact assessment methodologies: IMPACT 2002+ and CML 2001. An extensive uncertainty analysis using Monte Carlo as well as an extensive sensitivity study are performed on the inventory and the reference flows, respectively. Results  When looking at the impacts due to preservation process and packaging (considering identical distribution distances), we observe a small but significant environmental benefit of the plastic pot system over the glass jar system. Depending on the country, the impact is reduced by 14% to 27% for primary energy, 28% to 31% for global warming, 31% to 34% for respiratory inorganics, and 28% to 31% for terrestrial acidification/nutrification. The environmental benefit associated with the change in packaging mainly results from (a) production of plastic pot (including its end-of-life; 43% to 51% of total benefit), (b) lighter weight of packaging positively impacting transportation (20% to 35% of total benefit), and (c) new preservation process permitted by the plastic system (23% to 34% of total benefit). The jar or pot (including cap or lid, cluster, stretch film, and label) represents approximately half of the life cycle impacts, the logistics approximately one fourth, and the rest (especially on-site energy, tray, and hood) one fourth. Discussion  The sensitivity analysis shows that assumptions made in the basic scenarios are rather conservative for plastic pots and that the conclusions for the 200-g packaging size also apply to other packaging sizes. The uncertainty analysis performed on the inventory for the German market situation shows that the plastic pot system has less impact than the glass jar system while considering similar distribution distances with a confidence level above 97% for most impact categories. There is opportunity for further improvement independent of the type of packaging used, such as by reducing distribution distances while still optimizing lot size. The validity of the main conclusions presented in this study is confirmed by results of both impact assessment methodologies IMPACT 2002+ and CML 2001. Conclusions  For identical transportation distances, the plastic pot system shows a small but significant reduction in environmental burden compared to the glass jar system. Recommendations and perspectives  As food distribution plays an important role in the overall life cycle burdens and may vary between scenarios, it is important to avoid additional transportation of the packaged food in order to maintain or even improve the advantage of the plastic pot system. The present study focuses on the comparison of packaging systems and directly related consequences. It is recommended that further environmental optimization of the product also includes food manufacturing (before preservation process) and the supply chain of raw materials.     

七鳃鳗胆道闭锁过程中胆汁酸耐受机制研究进展

胆道闭锁(biliary atresia,BA)是一种罕见的婴幼儿肝胆疾病,其特征是纤维硬化性胆管病变,导致肝外胆管和肝内胆管阻塞或闭塞,胆汁不能向肠道排泄,胆汁酸对肝实质细胞造成严重损伤,最后导致肝硬化和肝衰竭危及生命.目前,胆道闭锁的发病机理尚不明确,临床上普遍采用"先葛西"、"后移植"的序贯性治疗方式.葛西手术(...     

急性胆源性胰腺炎行腹腔镜胆囊切除的体会

目的:探讨应用腹腔镜技术治疗急性胆源性胰腺炎的可行性、有效性和手术方法。方法:回顾分析我院腹腔镜胆囊切除术在急性胆源性胰腺炎治疗中的病人资料,将其按发病后的手术时间分为三组,统计各组病人的手术耗时、术后住院天数、住院花费以及并发症的有无。结果:经过随访有34位患者术后恢复良好,有1位复发,三组之间的手术耗时、术后住院天数、住院花费以及并发症无统计学差异(P>0.05)。结论:急性胆源性胰腺炎患者采用腹腔镜手术治疗效果明显、安全,手术时机的选择无严格的限定。     

胆道手术患者胆汁的菌群分析

本文对59例胆道手术患者的胆汁标本进行了菌群分析。共检出各类细菌156株,其中厌氧菌70株,以类杆菌最为常见(44株);兼性需氧菌86株,以大肠杆菌最为常见(37株)。胆汁细菌培养阳性率为86.4％(51/59);64.4％(38/59)的标本为厌氧菌与兼性厌氧菌混合污染。22.0％(13/59)的标本中仅分离到兼性需氧菌。提示,胆汁中污染的类杆菌及大肠杆菌是胆道手术后感染的主要原因菌。     

Antimitochondrial antibodies (AMA) in primary biliary cirrhosis. I. Separation of the PBC antigen activity from mitochondrial ATPase activity

Antimitochondrial antibodies are found in a variety of autoimmune liver diseases, particularly primary biliary cirrhosis. The antigen against which these antibodies are directed is localized on the inner mitochondrial membrane. Earlier work suggested that this antigen was associated with the mitochondrial ATPase. However, we have succeeded in separating the enzyme activity from the antigenic activity using gel filtration and ion-exchange chromatography. Furthermore, the antigenic activity is not affected by modulators of ATPase enzymatic activity like aurovertin or oligomycin. The antigenic activity is, however, very susceptible to reagents which block thiol groups. The mitochondrial antigen, in contrast to the ATPase enzyme, is found in high amounts in brown fat mitochondria. Identification of this antigen may help to explain why specific antimitochondrial antibodies arise in the sera of patients with primary biliary cirrhosis.Abbreviations ATPase adenosine triphosphatase - PBC primary biliary cirrhosis - AMA antimitochondrial antibodies - SMPs submitochondrial particles - CFT complement fixation test - SDS sodium dodecyl sulfate - BSA bovine serum albumin - BAT brown adipose tissue     

Temperature and water content effects on the viscoelastic behavior of<Emphasis Type="Italic"> Tilia americana</Emphasis> (Tiliaceae) sapwood

The effects of temperature and water content on the viscoelasticity of living and dehydrated Tilia americana sapwood were examined using transient creep (time- and load-dependent deformation) tests under sustained bending loads. Creep tests were performed at 21.1°C and –20.5°C to determine the magnitudes and types of strains in living and dehydrated samples. Temperature had no effect on the creep rate of living sapwood. However, the creep rate of dehydrated samples at –20.5°C was significantly faster than that at 21.1°C. Regardless of temperature, sapwood had a faster creep rate than dehydrated samples. With small bending loads, the residual strains in sapwood were larger at 21.1°C compared to –20.5°C. Temperature did not significantly affect the residual strains in dehydrated samples. For small bending loads, frozen sapwood recovered all residual creep strains when thawed. With larger loads, residual and plastic (permanent) strains increased. We speculate that ice formation in cell lumens partially dehydrates (and thus stiffens and strengthens) cell wall materials and prevents cell wall buckling and elastic restoration after unloading. However, when thawed, sapwood can elastically restore its original configuration, provided it is not excessively bent (by ice or snow accumulations) when frozen.     

Site conditions exert more control than genetic differentiation on modulation of secondary growth and climate sensitivity of Pinus pinaster

The adaptive potential and genetic background of tree species will determine their performance and vitality under changing climate conditions. How environment and genotype influence secondary growth and their climate sensitivity in boreal and temperate conifers has been fairly studied. Provenance studies assessing the genetic variation in plasticity of radial growth, however, are scarce in Mediterranean tree species. We explored the impact of climate on tree-ring growth in Pinus pinaster based on plantation sites and genetic background. We assessed the climate sensitivity, plastic response of growth, and intraspecific genetic differentiation of pines from 10 provenances planted in two trials in south-central Spain. Trees from areas with a climate similar to that of the planting sites showed greater growth rates. Higher within-site than among-site similitude in inter-annual growth variation was evidenced by similar growth patterns in each trial test, irrespective of seed provenance. We found positive growth responses to mild conditions in late winter, and to wet and cloudy conditions in spring and early summer. Greater site-dependent than genetically-driven control was observed on growth sensitivity to climate. Central Spanish seed sources were better able to withstand the combination of stressful environmental conditions in the test sites. Inter-site environmental variation was the factor that explained a higher number of growth responses to climate variation. The significant “genetic × environment” interaction on radial growth suggested that genotypic determinants were strongly modulated by plastic adaptations due to local conditions. The site-dependent relationships of provenance climate responses with the conditions at origin also reflected the prevailing local adaptation to site constraints. Since plastic response of P. pinaster trees to local environment has more influence than its genetic predisposition, assessing the spatio-temporal variation of growth sensitivity to climate becomes increasingly important.     

Modeling of stents exhibiting negative Poisson's ratio effect

Intravascular stents are metallic scaffolding structures deployed in the stenotic arteries to restore the lumen for the blood flow to the down stream tissues. Most stents are balloon expandable and are deployed from its crimped state through a balloon catheter. The efficacy of the stenting procedure mainly depends on the way the stent is deployed. Both numerical and experimental evaluations show that almost all the present day stents undergo the most undesirable effects namely: (i) longitudinal foreshortening: the axial contraction in the length, and (ii) dogboning: flaring of the distal edges, during the radial expansion of the stents. Due to the foreshortening effect, clinicians are forced to select stents longer than the plaque. Still, the final length of the stent depends on the amount of radial expansion, which is subjective during the procedure. This paper introduces a new stent model called “Murugan”, which exhibits negative Poisson's ratio effect. That is, the stent may have zero axial contraction or can have extension when under radial expansion. The presence of hyperelastic balloon and the stent–balloon friction is also considered to study their effects in mechanical properties of the stents under consideration. Free expansion analysis is done using finite element method (FEM) to compare the new stent model with the present day stent geometries.