Ethanol Causes Protein Precipitation—New Safety Issues for Catheter Locking Techniques

Objective

The ethanol lock technique has shown great potential to eradicate organisms in biofilms and to treat or prevent central venous catheter related infections. Following instillation of ethanol lock solution, however, the inherent density gradient between blood and ethanol causes gravity induced seepage of ethanol out of the catheter and blood influx into the catheter. Plasma proteins so are exposed to highly concentrated ethanol, which is a classic agent for protein precipitation. We aimed to investigate the precipitating effect of ethanol locks on plasma proteins as a possible cause for reported catheter occlusions.

Methods

Plasma samples were exposed in-vitro to ethanol (concentrations ranging from 7 to 70 v/v%) and heparin lock solutions. In catheter studies designed to mimic different in-vivo situations, the catheter tip was placed in a plasma reservoir and the material contained within the catheter was analyzed after ethanol lock instillation. The samples underwent standardized investigation for protein precipitation.

Results

Protein precipitation was observed in plasma samples containing ethanol solutions above a concentration of 28%, as well as in material retrieved from vertically positioned femoral catheters and jugular (subclavian) catheters simulating recumbent or head down tilt body positions. Precipitates could not be re-dissolved by dilution with plasma, urokinase or alteplase. Plasma samples containing heparin lock solutions showed no signs of precipitation.

Conclusions

Our in-vitro results demonstrate that ethanol locks may be associated with plasma protein precipitation in central venous catheters. This phenomenon could be related to occlusion of vascular access devices locked with ethanol, as has been reported. Concerns should be raised regarding possible complications upon injection or spontaneous gravity induced leakage of such irreversibly precipitated protein particles into the systemic circulation. We suggest limiting the maximum advisable concentration of ethanol to 28 v/v% in catheter lock solutions.     

Die Esche (Fraxinus excelsior) auf den Bergen des Wienerwaldes

Ohne Zusammenfassung     

Varroa-tolerant Italian honey bees introduced from Brazil were not more efficient in defending themselves against the mite Varroa destructor than Carniolan bees in Germany

In Europe and North America honey bees cannot be kept without chemical treatments against Varroa destructor. Nevertheless, in Brazil an isolated population of Italian honey bees has been kept on an island since 1984 without treatment against this mite. The infestation rates in these colonies have decreased over the years. We looked for possible varroa-tolerance factors in six Italian honey bee colonies prepared with queens from this Brazilian island population, compared to six Carniolan colonies, both tested at the same site in Germany. One such factor was the percentage of damaged mites in the colony debris, which has been reported as an indicator of colony tolerance to varroa. A mean of 35.8% of the varroa mites collected from the bottoms of the Italian bee colonies were found damaged, among which 19.1% were still alive. A significantly greater proportion of damaged mites were found in the Carniolan bees (42.3%) and 22.5% were collected alive. The most frequent kind of damage found was damaged legs alone, affecting 47.4% of the mites collected from debris in Italian bees, which was similar to the amount found in Carniolan colonies (46%). The mean infestation rate by the varroa mite in the worker brood cells in the Italian bee colonies was 3.9% in June and 3.5% in July, and in drone brood cells it was 19.3% in June. In the Carniolan honey bee colonies the mean infestation rates in worker brood cells were 3.0 and 6.7%, respectively in the months of June and July and 19.7% in drone brood cells in June. In conclusion, the 'Varroa-tolerant' Italian honey bees introduced from Brazil produced lower percentages of damaged mites (Varroa destructor) in hive debris and had similar brood infestation rates when compared to 'susceptible' Carniolan bees in Germany. In spite of the apparent adaptation of this population of Italian bees in Brazil, we found no indication of superiority of these bees when we examined the proportions of damaged mites and the varroa-infestation rates, compared to Carniloan bees kept in the same apiary in Germany.     

Clinical impact of atrial fibrillation in patients with pulmonary hypertension

Background

Pulmonary hypertension (PH) is associated with progressive impairment of right ventricular function, reduced exercise capacity and a poor prognosis. Little is known about the prevalence, clinical manifestation and impact of atrial fibrillation (AF) on cardiac function in PH.

Methods

In a four year single-centre retrospective analysis 225 patients with confirmed PH of various origins were enrolled to investigate the prevalence of AF, and to assess the clinical manifestation, 6-minute walk distance, NT-proBNP levels, echocardiographic parameters and hemodynamics obtained by right heart catheterization in PH with AF.

Results

AF was prevalent in 31.1%. In patients with PH and AF, parameters of clinical deterioration (NYHA/WHO functional class, 6-minute walk distance, NT-proBNP levels) and renal function were significantly compromised compared to patients with PH and sinus rhythm (SR). In the total PH cohort and in PH not related to left heart disease occurrence of AF was associated with an increase of right atrial pressure (RAP) and right atrial dilatation. While no direct association was found between pulmonary artery pressure (PAP) and AF in these patients, right ventricular function was reduced in AF, indicating more advanced disease. In PH due to left heart failure the prevalence of AF was particularly high (57.7% vs. 23.1% in other forms of PH). In this subgroup, left atrial dilatation, increase of pulmonary capillary wedge pressure, PAP and RAP were more pronounced in AF than in SR, suggesting that more marked backward failure led to AF in this setting.

Conclusion

PH is associated with increased prevalence of AF. Occurrence of AF in PH indicates clinical deterioration and more advanced disease.     

The UL7 gene of pseudorabies virus encodes a nonessential structural protein which is involved in virion formation and egress

Homologues of the UL7 gene of herpes simplex virus type 1 are conserved in alpha-, beta-, and gammaherpesviruses. However, little is known about their functions. Using a monospecific rabbit antiserum raised against a bacterial fusion protein, we identified the UL7 gene product of the neurotropic alphaherpesvirus pseudorabies virus (PrV). In Western blot analyses of infected cells and purified PrV particles the serum specifically detected a 29-kDa protein, which matches the calculated mass of the 266-amino-acid translation product of PrV UL7. For functional analysis, UL7 was deleted by mutagenesis of an infectious full-length clone of the PrV genome in Escherichia coli. The obtained recombinant PrV-DeltaUL7F was replication competent in rabbit kidney cells, but maximum virus titers were decreased nearly 10-fold and plaque diameters were reduced by ca. 60% compared to wild-type PrV. Electron microscopy of infected cells revealed that in the absence of UL7, formation and nuclear egress of nucleocapsids were not affected, whereas secondary envelopment of cytoplasmic nucleocapsids appeared to be delayed and release of mature virions was less efficient. The observed replication defects were corrected by repair of the viral UL7 gene or by propagation of PrV-DeltaUL7F in UL7-expressing cells. PrV-DeltaUL7F was moderately attenuated in mice. Compared to wild-type virus, mean survival times were prolonged from 2 to 3 days after intranasal infection. However, neuroinvasion and transneuronal spread of PrV were not abolished in the absence of UL7. Thus, UL7 encodes a virion protein of PrV, which plays a role during virion maturation and egress both in vitro and in vivo.     

Filamentous Proteins from Plant Sieve Tubes

PROTEIN filaments are characteristic structural components of the assimilatory conducting elements of angiosperm plants (“P protein” of Cronshaw and Esau¹). We have isolated filamentous structures from the phloem exudate of cut cucurbit stems². The presence of the filaments could be clearly demonstrated after negative staining with the electron microscope.     

In wounded sugar beet (Beta vulgaris L.) tap-root, hexose accumulation correlates with the induction of a vacuolar invertase isoform.

Wounding of sugar beet tap-root causes an induction of invertase activity, which contributes to post-harvest sucrose losses. In this first comprehensive monitoring of wound-induced invertase mRNAs, proteins, enzyme activities, and tissue hexose concentrations, the VI isoform responsible for wound-induced hexose accumulation in mature tap-root could be identified.     

Prevalence of mutagens in the environment: experimental data versus simulations

The recent availability of experimental data on the mutagenicity in Salmonella of a subset of high production volume chemicals allowed a comparison with the estimate derived from computer-based simulations. The prevalence of mutagens in the subsets was not significantly different: 20% versus 19.5% based upon experimental and simulation data, respectively. This provides support for the use of the rapid and low-cost simulation approach.     

Novel structural concepts in elucidating the potential genotoxicity and carcinogenicity of tetrandrine, a traditional herbal drug

Tetrandrine, a widely used remedy, is predicted to be a 'genotoxic' carcinogen. This finding suggests that the usage of this substance in non-life-threatening situations should be evaluated.