Eponymous instruments in plastic surgery

Surgeons use eponymous instruments daily, yet the stories behind these instruments are often lost in history. The authors have selected eponymous instruments commonly used in plastic surgery and provide a brief biography of the surgeons who invented them. This list represents more than two centuries of surgical history, and the physicians come from a number of disciplines, including general surgery, plastic surgery, ophthalmic surgery, and rural medicine. Remembering the life stories of surgeon inventors enriches our understanding of the history of our profession and allows us to appreciate our instruments instead of taking them for granted.     

Pseudomonas aeruginosa toxin ExoU induces a PAF-dependent impairment of alveolar fibrin turnover secondary to enhanced activation of coagulation and increased expression of plasminogen activator inhibitor-1 in the course of mice pneumosepsis

Background

ExoU, a Pseudomonas aeruginosa cytotoxin with phospholipase A₂ activity, was shown to induce vascular hyperpermeability and thrombus formation in a murine model of pneumosepsis. In this study, we investigated the toxin ability to induce alterations in pulmonary fibrinolysis and the contribution of the platelet activating factor (PAF) in the ExoU-induced overexpression of plasminogen activator inhibitor-1 (PAI-1).

Methods

Mice were intratracheally instilled with the ExoU producing PA103 P. aeruginosa or its mutant with deletion of the exoU gene. After 24 h, animal bronchoalveolar lavage fluids (BALF) were analyzed and lung sections were submitted to fibrin and PAI-1 immunohistochemical localization. Supernatants from A549 airway epithelial cells and THP-1 macrophage cultures infected with both bacterial strains were also analyzed at 24 h post-infection.

Results

In PA103-infected mice, but not in control animals or in mice infected with the bacterial mutant, extensive fibrin deposition was detected in lung parenchyma and microvasculature whereas mice BALF exhibited elevated tissue factor-dependent procoagulant activity and PAI-1 concentration. ExoU-triggered PAI-1 overexpression was confirmed by immunohistochemistry. In in vitro assays, PA103-infected A549 cells exhibited overexpression of PAI-1 mRNA. Increased concentration of PAI-1 protein was detected in both A549 and THP-1 culture supernatants. Mice treatment with a PAF antagonist prior to PA103 infection reduced significantly PAI-1 concentrations in mice BALF. Similarly, A549 cell treatment with an antibody against PAF receptor significantly reduced PAI-1 mRNA expression and PAI-1 concentrations in cell supernatants, respectively.

Conclusion

ExoU was shown to induce disturbed fibrin turnover, secondary to enhanced procoagulant and antifibrinolytic activity during P. aeruginosa pneumosepsis, by a PAF-dependent mechanism. Besides its possible pathophysiological relevance, in vitro detection of exoU gene in bacterial clinical isolates warrants investigation as a predictor of outcome of patients with P. aeruginosa pneumonia/sepsis and as a marker to guide treatment strategies.     

Tillage and Nitrogen Application Effects on Nitrous and Nitric Oxide Emissions from Irrigated Corn Fields

A 2-year study was conducted to investigate the potential of no-till cropping systems to reduce N₂O and NO emissions under different N application rates in an irrigated corn field in northeastern Colorado. Flux measurements were begun in the spring of 2003, using vented (N₂O) and dynamic (NO) chambers, one to three times per week, year round, within plots that were cropped continuously to corn (Zea mays L.) under conventional-till (CT) and no-till (NT). Plots were fertilized at planting in late April with rates of 0, 134 and 224 kg N ha⁻¹ and corn was harvested in late October or early November each year. N₂O and NO fluxes increased linearly with N application rate in both years. Compared with CT, NT did not significantly affect the emission of N₂O but resulted in much lower emission of NO. In 2003 and 2004 corn growing seasons, the increase in N₂O-N emitted per kg ha⁻¹ of fertilizer N added was 14.5 and 4.1 g ha⁻¹ for CT, and 11.2 and 5.5 g ha⁻¹ for NT, respectively. However, the increase in NO-N emitted per kg ha⁻¹ of fertilizer N added was only 3.6 and 7.4 g ha⁻¹ for CT and 1.6 and 2.0 g ha⁻¹ for NT in 2003 and 2004, respectively. In the fallow season (November 2003 to April 2004), much greater N₂O (2.0–3.1 times) and NO (13.1–16.8 times) were emitted from CT than from NT although previous N application did not show obvious carry-over effect on both gas emissions. Results from this study reveal that NT has potential to reduce NO emission without an obvious change in N₂O emission under continuous irrigated corn cropping compared to CT.     

Quantitative characterization of the thrombin-heparin interaction. Discrimination between specific and nonspecific binding models

Equilibrium binding of human alpha-thrombin to heparin was investigated at pH 7.4 as a function of thrombin and heparin concentrations, NaCl concentration, temperature, and heparin chain length with the extrinsic fluorescence probe, p-aminobenzamidine, or by quantitative affinity chromatography, in order to distinguish between sequence-specific and nonspecific electrostatic modes of binding. Analysis of binding data by a nonspecific binding model developed for protein-nucleic acid interactions, or by the discrete binding site model previously used to analyze the thrombin-heparin interaction, indicated that both models described the binding interaction equally well over the range of thrombin binding densities accessible to measurement. However, the strong dependence of the thrombin-heparin binding interaction on NaCl concentration, its minimal dependence on temperature, and the increase in apparent binding affinity with increasing heparin oligosaccharide chain length were best accounted for by a nonspecific electrostatic association of thrombin with 5 to 6 anionic residues contained in a 3-disaccharide binding site of heparin. This interaction was characterized by an intrinsic dissociation constant (KD,obs) of 6-10 microM at physiological ionic strength. Although the nonspecific binding model satisfactorily described the binding of thrombin to heparin chains ranging in size from 3 to approximately 13 disaccharides in terms of a single intrinsic KD,obs, deviations from this model were apparent with longer heparin chains (approximately 22 to approximately 35 disaccharides) from a progressive decrease in the intrinsic KD,obs of up to 4-fold. Sedimentation equilibrium analyses of thrombin-heparin complexes suggested a second weaker binding site on thrombin for heparin, which accounted for these deviations as well as the observed insolubility of thrombin-heparin complexes at high thrombin binding densities.