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To report the clinical efficiency and complications in patients treated with retrograde transvenous ethanol embolization of high-flow peripheral arteriovenous malformations (AVMs). Retrograde transvenous ethanol embolization of high-flow AVMs is a technique that can be used to treat AVMs with a dominant outflow vein whenever conventional interventional procedures have proved insufficient.This is a retrospective study of the clinical effectiveness and complications of retrograde embolization in five patients who had previously undergone multiple arterial embolization procedures without clinical success.Clinical outcomes were good in all patients but were achieved at the cost of serious, although transient, complications in three patients.Retrograde transvenous ethanol embolization is a highly effective therapy for high-flow AVMs. However, because of the high complication rate, it should be reserved as a last resort, to be used after conventional treatment options have failed.

AbstractAutotrophs play an essential role in the cycling of carbon and nutrients, yet disease‐ecosystem relationships are often overlooked in these dynamics. Importantly, the availability of elemental nutrients like nitrogen and phosphorus impacts infectious disease in autotrophs, and disease can induce reciprocal effects on ecosystem nutrient dynamics. Relationships linking infectious disease with ecosystem nutrient dynamics are bidirectional, though the interdependence of these processes has received little attention. We introduce disease‐mediated nutrient dynamics (DND) as a framework to describe the multiple, concurrent pathways linking elemental cycles with infectious disease. We illustrate the impact of disease–ecosystem feedback loops on both disease and ecosystem nutrient dynamics using a simple mathematical model, combining approaches from classical ecological (logistic and Droop growth) and epidemiological (susceptible and infected compartments) theory. Our model incorporates the effects of nutrient availability on the growth rates of susceptible and infected autotroph hosts and tracks the return of nutrients to the environment following host death. While focused on autotroph hosts here, the DND framework is generalizable to higher trophic levels. Our results illustrate the surprisingly complex dynamics of host populations, infection patterns, and ecosystem nutrient cycling that can arise from even a relatively simple feedback between disease and nutrients. Feedback loops in disease‐mediated nutrient dynamics arise via effects of infection and nutrient supply on host stoichiometry and population size. Our model illustrates how host growth rate, defense, and tissue chemistry can impact the dynamics of disease–ecosystem relationships. We use the model to motivate a review of empirical examples from autotroph–pathogen systems in aquatic and terrestrial environments, demonstrating the key role of nutrient–disease and disease–nutrient relationships in real systems. By assessing existing evidence and uncovering data gaps and apparent mismatches between model predictions and the dynamics of empirical systems, we highlight priorities for future research intended to narrow the persistent disciplinary gap between disease and ecosystem ecology. Future empirical and theoretical work explicitly examining the dynamic linkages between disease and ecosystem ecology will inform fundamental understanding for each discipline and will better position the field of ecology to predict the dynamics of disease and elemental cycles in the context of global change.

A common treatment of low-grade cartilaginous lesions of bone is intralesional curettage with local adjuvant therapy. Because of the wide variety of different diagnoses and treatments, there is still a lack of knowledge about the effectiveness of the use of phenol as local adjuvant therapy in patients with grade-I central chondrosarcoma of a long bone.A retrospective study was done to assess the clinical and oncological outcomes after intralesional curettage, application of phenol and ethanol, and bone-grafting in eighty-five patients treated between 1994 and 2005. Inclusion criteria were histologically proven grade-I central chondrosarcoma and location of the lesion in a long bone. The average age at surgery was 47.5 years (range, 15.6 to 72.3 years). The average duration of follow-up was 6.8 years (range, 0.2 to 14.1 years). Patients were evaluated periodically with conventional radiographs and gadolinium-enhanced magnetic resonance imaging (Gd-MRI) scans. When a lesion was suspected on the basis of the MRI, the patient underwent repeat intervention. Depending on the size of the recurrent lesion, biopsy followed by radiofrequency ablation (for lesions of <10 mm) or repeat curettage (for those of ≥10 mm) was performed.Of the eighty-five patients, eleven underwent repeat surgery because a lesion was suspected on the basis of the Gd-MRI studies during follow-up. Of these eleven, five had a histologically proven local recurrence (a recurrence rate of 5.9% [95% confidence interval, 0.9% to 10.9%]), and all were grade-I chondrosarcomas. General complications consisted of one superficial infection, and two femoral fractures within six weeks after surgery.This retrospective case series without controls has limitations, but the use of phenol as an adjuvant after intralesional curettage of low-grade chondrosarcoma of a long bone was safe and effective, with a recurrence rate of <6% at a mean of 6.8 years after treatment.

Abstract The paper reviews large scale experiments with various fuels in air where successful deflagration to detonation transition (DDT) took place. This includes a recent experiment disclosed in the Buncefield R&D program, where DDT developed in the propane/air mixture. The DDT occurred in branches of deciduous trees in a premixed stagnant mixture. An internal R&D investigation programme was initiated to better understand the phenomena. A large scale experiment in an open space with ethane air mixture is presented in the paper. The premixed mixture was ignited at the edge of the congested three-dimensional rigs which consisted of vertical and horizontal pipes. After ignition, the flame accelerated in the congestion and transitioned to detonation at the end of congestion. Stable detonation propagated through the remaining open and uncongested space. The flame acceleration process leading to DDT is scale dependent. It also depends on many parameters leading to a large investigation array and, significant cost. However, such R&D efforts aimed toward a safer plant design, i.e. the prevention of occurrence of a major accident, are a small fraction of a real accident cost.

The effects of ethanol-feeding to rats, over a 6-week period, on the activation of genotoxic compounds of different chemical classes, requiring metabolic conversion to exert their mutagenic activity, were studied in isolated rat hepatocytes. The influence of such treatment on cytochrome P-450 content and N-acetylation in isolated hepatocytes was also investigated. Benzidine (BZ), dimethylnitrosamine (DMN), diethylnitrosamine (DEN), isoniazid (INH) and cyclophosphamide (CP) were more effectively activated to products mutagenic towards Salmonella typhimurium by hepatocytes from ethanol-pretreated rats than by hepatocytes from controls. The mutagenic potency of 2-aminofluorene (2-AF) and 2-acetylaminofluorene (2-AAF) was not influenced by ethanol pretreatment. Ethanol consumption was found to be associated with increased cytochrome P-450 content and enhanced N-acetylation in the isolated hepatocytes. Our results support the hypothesis that an alteration of the hepatic drug-metabolizing system may be responsible for the ethanol-induced increase in susceptibility to certain genotoxic compounds.

An impaired vascular response is implicated in the pathogenesis of dialysis-induced hypotension, which is at least partly related to changes in extracorporeal blood temperature (Temp). However, little is known about changes in core Temp and differences in energy balance between standard and cool dialysis. In this study, core Temp and energy transfer between extracorporeal circuit and patient, as well as the blood pressure response, were assessed during dialysis with standard (37.5 degrees C) and cool (35.5 degrees C) Temp of the dialysate. Nine patients (4 men, 5 women; mean age, 69 +/-10 [SD] years) were studied during low- and standard-Temp dialysis, each serving as his or her own control. Bicarbonate dialysis and hemophane membranes were used. Energy transfer was assessed by continuous measurement of Temp in the arterial (Tart) and venous side (Tven) of the extracorporeal system according to the formula: c. rho.Qb*(Tven - Tart)*t, where c = specific thermal capacity (3.64 kJ/kg* degrees C), Qb = extracorporeal blood flow, rho = density of blood (1,052 kg/m3), and t = dialysis time (hours). Core Temp was also measured by Blood Temperature Monitoring (BTM; Fresenius, Bad Homburg, Germany). Core Temp increased during standard-Temp dialysis (36.7 degrees C +/- 0.3 degrees C to 37.2 degrees C +/- 0.2 degrees C; P < 0.05) despite a small negative energy balance (-85 +/- 43 kJ) from the patient to the extracorporeal circuit. During cool dialysis, energy loss was much more pronounced (-286 +/- 73 kJ; P < 0.05). However, mean core Temp remained stable (36.4 degrees C +/- 0.6 degrees C to 36.4 degrees C +/- 0.3 degrees C; P = not significant), and even increased in some patients with a low predialytic core Temp. Both during standard and cool dialysis, the increase in core Temp during dialysis was significantly related to predialytic core Temp (r = 0.88 and r = 0.77; P < 0.05). Systolic blood pressure (RR) decreased to a greater degree during standard-Temp dialysis compared with cool dialysis (43 +/- 21 v 22 +/- 26 mm Hg; P < 0.05), whereas diastolic RR tended to decrease more (15 +/- 10 v 0 +/- 19 mm Hg; P = 0.07). Core Temp increased in all patients during standard-Temp dialysis despite a small net energy transfer from the patient to the extracorporeal system. Concluding, Core Temp remained generally stable during cool dialysis despite significant energy loss from the patient to the extracorporeal circuit, and even increased in some patients with a low predialytic core Temp. The change in core Temp during standard and cool dialysis was significantly related to the predialytic blood Temp of the patient, both during cool- and standard-Temp dialysis. The results suggest that the hemodialysis procedure itself affects core Temp regulation, which may have important consequences for the vascular response during hypovolemia. The removal of heat by the extracorporeal circuit and/or the activation of autoregulatory mechanisms attempting to preserve core Temp might be responsible for the beneficial hemodynamic effects of cool dialysis.

Transformed root cultures of Artemisia annua grown in autoclaved medium show large variations in biomass and artemisinin production regardless of the culture conditions or clonal type. However, using filter-sterilized sugars singly or in combination while holding the carbon level in the medium constant resulted in an unexpected variability in biomass production and artemisinin yield. Autoclaving results in variable hydrolysis of sucrose in the culture medium. Subsequent experiments using combinations of filter-sterilized sugars at a constant total carbon level in the medium showed a stimulation of artemisinin production by glucose. Growth in sucrose was equivalent to growth in fructose and significantly better than in glucose. These results suggest that sugars may be affecting terpenoid metabolism not only as carbon sources, but also as signal molecules.

Coal fly ashes (CFA) are complex particles of a variable composition, which is mainly dependent on the combustion process, the source of coal and the precipitation technique. Toxic constituents in these particles are considered to be metals, polycyclic aromatic hydrocarbons and silica. The purpose of this review was to study the in vitro and in vivo data on coal fly ash and relate the studied endpoints to the role of (crystalline) silica, considering its recent classification as a human carcinogen. For most of the effects coal mine dust was chosen as a reference, since it contains up to 10% of crystalline silica (alpha-quartz) and is well studied both in vivo and in vitro. Most studies on fly ash toxicity were not designed to elucidate the effect of its silica-content nor did they include coal mine dust as a reference. Taking this into account, both in vitro and in vivo experimental studies show lower toxicity, inflammatory potential and fibrogenicity of CFA compared to silica and coal mine dust. Although in vitro and in vivo studies suggest genotoxic effects of fly ash, the data are limited and do not clarify the role of silica. Epidemiological studies in fly ash exposed working populations have found no evidence for effects commonly seen in coal workers (pneumoconiosis, emphysema) with the exception of airway obstruction at high exposure. In conclusion, the available data suggest that the hazard of coal fly ash is not to be assessed by merely adding the hazards of individual components. A closer investigation of 'matrix' effects on silica's toxicity in general seems an obligatory step in future risk assessment on fly ashes and other particles that incorporate silica as a component.