Evaluation of a commercially available radioimmunoassay and enzyme immunoassay for the analysis of progesterone and estradiol and the comparison of two extraction efficiency methods.

The measurement of progesterone (P4) and estradiol (E2) is essential for monitoring reproductive cycles and can aid in diagnosing the cause of poor reproductive performance in dairy cattle. Readily available, reproducible, accurate, non-radioactive assays are needed for the assessment of P4 and E2 in bovine serum. The gold standard for hormone assessment, radioimmunoassay (RIA), was compared with enzyme-linked immunoassay (EIA). Serum collected from various points in the estrous cycle was extracted with radiolabeled P4 (ie, 3H-P4; HE) and without 3H-P4 (CE) before being used in the assay. For the assessment of P4, there is a great degree of correlation between the RIA and EIA (adjusted R-square = 0.95; Pearson correlation coefficient (PCC) = 0.98, P < 0.001). A difference between the RIA and EIA methods was not detected for E2 concentrations (P = 0.16), but the correlation between techniques was poor (adjusted R-squared = 0.73; PCC = 0.87, P = 0.002). There was no difference in the serum extraction efficiency as measured with 3H-P4 as opposed to without (P = 0.94). The two methods for the measurement of serum extraction efficiency were highly correlated (adjusted R-square = 0.83; PCC = 0.92, P < 0.001). The concordance correlation coefficient (CCC) showed an excellent agreement between RIA and EIA for P4 determination (0.89) and between HE and CE methods (0.90). Although the 95% limits of agreement of the Bland-Altman plots encompassed 89% (8/9) and 92% (12/13) of the differences between methods for P4 quantification and extraction respectively, the CCC indicated an excellent agreement among them. The CCC between RIA and EIA for E2 quantification was 0.68 which corresponds with a fair agreement; however, the 95% limits of agreement of the Bland-Altman plot encompassed 100% (9/9) of differences between methods. The EIA and CE methods are comparable alternatives to the RIA and HE methods, respectively and can be used to quantify P4 and E2 for bovine serum.

Iddm1 and Iddm2 homozygous WOK.4BB rats develop lymphopenia, but no hyperglycemia like the BB/OK rats.

BB rats develop type 1 diabetes and WOKW rats facets of the metabolic syndrome. Both strains are common the RT1 (u) haplotype of major histocompatibility complex (MHC) which is essential for type 1 diabetes development in BB rats ( IDDM1). However, BB rats need an additional gene (lymphopenia, IDDM2, GIMAP5) to develop type 1 diabetes. Because WOKW lacks IDDM2 and does not develop hyperglycemia a congenic WOKW rat strain was generated recombining the region of chromosome 4 with IDDM2 onto the genetic background of WOKW rats (WOKW.4BB). These newly established rats and their parental WOKW rats were genetically and phenotypically characterized. Congenic WOKW.4BB rats showed a lymphopenic phenotype. The sequences of the highly polymorphic exon 2 of RT1-BB class II gene in WOKW, BB/OK, WOKW.4BB and LEW.1W rats were comparable and clearly showed the RT1 (u) haplotype. In addition, there were significant differences in metabolic traits between WOKW.4BB and parental WOKW. Although congenic WOKW.4BB rats were homozygous for IDDM1 and IDDM2 of the BB/OK rat none of WOKW.4BB rats developed hyperglycemia. This observation may be attributed to the idea that either WOKW.4BB rats need a third IDDM gene of BB/OK rats to develop hyperglycemia or WOKW background gene/s protect/s them for hyperglycemia.

[Comments on the 2010 guidelines on cardiopulmonary resuscitation of the European Resuscitation Council]. / Kommentar zu den Leitlinien 2010 zur kardiopulmonalen Reanimation des European Resuscitation Council.

ADULTS: Administer chest compressions (minimum 100/min, minimum 5 cm depth) at a ratio of 30:2 with ventilation (tidal volume 500-600 ml, inspiration time 1 s, F(I)O2 if possible 1.0). Avoid any interruptions in chest compressions. After every single defibrillation attempt (initially biphasic 120-200 J, monophasic 360 J, subsequently with the respective highest energy), chest compressions are initiated again immediately for 2 min independent of the ECG rhythm. Tracheal intubation is the optimal method for securing the airway during resuscitation but should be performed only by experienced airway management providers. Laryngoscopy is performed during ongoing chest compressions; interruption of chest compressions for a maximum of 10 s to pass the tube through the vocal cords. Supraglottic airway devices are alternatives to tracheal intubation. Drug administration routes for adults and children: first choice i.v., second choice intraosseous (i.o.). Vasopressors: 1 mg epinephrine every 3-5 min i.v. After the third unsuccessful defibrillation amiodarone (300 mg i.v.), repetition (150 mg) possible. Sodium bicarbonate (50 ml 8.4%) only for excessive hyperkaliemia, metabolic acidosis, or intoxication with tricyclic antidepressants. Consider aminophylline (5 mg/kgBW). Thrombolysis during spontaneous circulation only for myocardial infarction or massive pulmonary embolism; during on-going cardiopulmonary resuscitation (CPR) only when indications of massive pulmonary embolism. Active compression-decompression (ACD-CPR) and inspiratory threshold valve (ITV-CPR) are not superior to good standard CPR. CHILDREN: Most effective improvement of outcome by prevention of full cardiorespiratory arrest. Basic life support: initially five rescue breaths, followed by chest compressions (100-120/min depth about one third of chest diameter), compression-ventilation ratio 15:2. Foreign body airway obstruction with insufficient cough: alternate back blows and chest compressions (infants), or abdominal compressions (children >1 year). Treatment of potentially reversible causes: ("4 Hs and 4 Ts") hypoxia and hypovolaemia, hypokalaemia and hyperkalaemia, hypothermia, and tension pneumothorax, tamponade, toxic/therapeutic disturbances, thrombosis (coronary/pulmonary). Advanced life support: adrenaline (epinephrine) 10 µg/kgBW i.v. or i.o. every 3-5 min. Defibrillation (4 J/kgBW; monophasic or biphasic) followed by 2 min CPR, then ECG and pulse check. NEWBORNS: Initially inflate the lungs with bag-valve mask ventilation (p(AW) 20-40 cmH2O). If heart rate remains <60/min, start chest compressions (120 chest compressions/min) and ventilation with a ratio 3:1. Maintain normothermia in preterm babies by covering them with foodgrade plastic wrap or similar. POSTRESUSCITATION PHASE: Early protocol-based intensive care stabilization; initiate mild hypothermia early regardless of initial cardiac rhythm [32-34°C for 12-24 h (adults) or 24 h (children); slow rewarming (<0.5°C/h)]. Consider percutaneous coronary intervention (PCI) in patients with presumed cardiac ischemia. Prediction of CPR outcome is not possible at the scene, determine neurological outcome <72 h after cardiac arrest with somatosensory evoked potentials, biochemical tests and neurological examination. ACUTE CORONARY SYNDROME: Even if only a weak suspicion of an acute coronary syndrome is present, record a prehospital 12-lead ECG. In parallel to pain therapy, administer aspirin (160-325 mg p.o. or i.v.) and clopidogrel (75-600 mg depending on strategy); in ST-elevation myocardial infarction (STEMI) and planned PCI also prasugrel (60 mg p.o.). Antithrombins, such as heparin (60 IU/kgBW, max. 4000 IU), enoxaparin, bivalirudin or fondaparinux depending on the diagnosis (STEMI or non-STEMI-ACS) and the planned therapeutic strategy. In STEMI define reperfusion strategy depending on duration of symptoms until PCI, age and location of infarction. TRAUMA: In severe hemorrhagic shock, definitive control of bleeding is the most important goal. For successful CPR of trauma patients a minimal intravascular volume status and management of hypoxia are essential. Aggressive fluid resuscitation, hyperventilation and excessive ventilation pressure may impair outcome in patients with severe hemorrhagic shock. TRAINING: Any CPR training is better than nothing; simplification of contents and processes is the main aim.

Influence of airway management strategy on "no-flow-time" in a standardized single rescuer manikin scenario (a comparison between LTS-D and I-gel).

BACKGROUND: In 2005 the European Resuscitation Council (ERC) published a revised version of the guidelines for Advanced Life Support (ALS). One of the aims was to reduce the time without chest compression in the first period of cardiac arrest (no-flow-time; NFT). We evaluated in a manikin study the influence on NFT using the single use laryngeal tube with suction option (LTS-D) compared to single use I-gel for emergency airway management. METHODS: A randomised prospective study with 200 paramedics who performed standardised simulated cardiac arrest management in a manikin. RESULTS: The use of the LTS-D did not significantly reduce NFT compared with the I-gel (104.7s vs. 105.1s; p>0.05). The LTS-D was inserted as fast as the I-gel (10.4s vs. 9.3s; p>0.05). The LTS-D was correctly positioned by 98% of the participants on the first attempt compared to 96% with the I-gel. During the cardiac arrest simulation, establishing and performing first ventilation took an average of 40.5s with the LTS-D compared to 40.9s with the I-gel. CONCLUSION: In our manikin study, NFT was comparable using the LTS-D and the I-gel. Therefore, for personnel not experienced in tracheal intubation, the LTS-D and the I-gel seem to be equal alternatives in establishing the airway during cardiac arrest. However, relevant clinical studies are appropriate because any change in guidelines in this area must be based on clinical evidence.

The use of the laryngeal tube disposable (LT-D) by paramedics during out-of-hospital resuscitation-an observational study concerning ERC guidelines 2005.

UNLABELLED: In the current guidelines of the European Resuscitation Council (ERC), tracheal intubation, as an instrument for securing the airway during resuscitation, has become less important for persons not trained in this method. For those persons, different supraglottic airway devices are recommended by the ERC. The present investigation deals with the application of the laryngeal tube disposable (LT-D) during pre-hospital resuscitation by paramedics. METHODS: During a period of 2 years (2006-2008), we registered all cardiac arrest situations in which the LT-D had been applied according to the ERC guidelines 2005. Therefore, we investigated one emergency medical system in Germany. RESULTS: During the defined period, 92 resuscitation attempts, recorded on standardised data sheets, were included. The LT-D was used in 46% of all cardiac arrest situations. Overall, the LT-D was successfully inserted in more than 90% of all cases on first attempt. In 95% of all cases, no problems concerning ventilation of the patient were described. CONCLUSION: As an alternative airway device recommended by the ERC in 2005, the LT-D may enable airway control rapidly and effectively. Additionally, by using the LT-D, a reduced "no-flow-time" and a better outcome may be possible.

["Laryngeal Tube-D" (LT-D) and "Laryngeal Mask" (LMA)]. / Larynxtubus-D (LT-D) und Larynxmaske (LMA).

BACKGROUND AND OBJECTIVES: In 2005 the European Resuscitation Council (ERC) published a revised version of the guidelines for Advanced Life Support (ALS). One of the aims was to reduce the time without chest compression in the first period of cardiac arrest. We evaluated in a manikin study whether using the single use laryngeal tube (LT-D) instead of single use laryngeal mask (LMA) for emergency airway management could reduce the "No Flow Time" (NFT). The NFT is defined as the time during which no chest compressions take place. METHODS: Randomised prospective study with 200 volunteers who performed a standardised simulated cardiac arrest management in a manikin following one-day cardiac arrest training (simulation scenario 430 s). Two supraglottic airway devices were compared (LT-D and LMA). Endpoints were the total "no flow time" during the scenario, and the successful airway management with the used airway device. RESULTS: In the present manikin study the use of the LT-D significantly reduced NFT compared with the LMA (104.2 s vs. 124.0 s; p < 0.01). The LT-D was correctly positioned by 98 % of the participants on the first attempt compared to 74 % with the LMA. The LT-D was inserted significantly faster than the LMA (12.4 s vs. 29.1 s, p < 0.01). During the cardiac arrest simulation establishing and performing first ventilation took an average of 40.5 s with the LT-D compared to 47.9 s with LMA. CONCLUSIONS: In this manikin study data showed that the LT-D may be a good alternative airway device compared to LMA for providing and maintaining a patent airway during resuscitation.

[Chest compression without ventilation during basic life support? Confirmation of the validity of the European Resuscitation Council (ERC) guidelines 2005]. / Thoraxkompression ohne Beatmung bei der Laienreanimation? Bestätigung der Gültigkeit der "European Resuscitation Council (ERC) Guidelines 2005".

Basic life support (BLS) refers to maintaining airway patency and supporting breathing and the circulation, without the use of equipment other than infection protection measures. The scientific advisory committee of the American Heart Association (AHA) published recommendations (online-first) on March 31 2008, which promote a call to action for bystanders who are not or not sufficiently trained in cardiopulmonary resuscitation (CPR) and witness an adult out-of-hospital sudden collapse probably of cardiac origin. These bystanders should provide chest compression without ventilation (so-called compression-only CPR). If bystanders were previously trained and thus confident with CPR, they should decide between conventional CPR (chest compression plus ventilation at a ratio of 30:2) and chest compression alone. However, considering current evidence-based medicine and latest scientific data both the European Resuscitation Council (ERC) and the German Resuscitation Council (GRC) do not at present intend to change or supplement the current resuscitation guidelines "Basic life support for adults". Both organisations do not see any need for change or amendments in central European practice and continue to recommend that only those lay rescuers that are not willing or unable to give mouth-to-mouth ventilation should provide CPR solely by uninterrupted chest compressions until professional help arrives. It is also stressed that the training of young people especially teenagers as lay rescuers should be promoted and the establishment of training programs through emergency medical organizations and in schools should be encouraged.

[Reduction in no flow time using a laryngeal tube: comparison to bag-mask ventilation]. / "No-flow-time"-Reduzierung durch Einsatz des Larynxtubus: Vergleich zur Beutel-Masken-Beatmung.

OBJECTIVE: In 2005 the European Resuscitation Council (ERC) published the new guidelines for Advanced Life Support (ALS). One of the aims was to reduce the no flow time (NFT), without chest compression in the first period of cardiac arrest. Furthermore the guidelines recommend that endotracheal intubation should only be carried out by personnel experienced in this procedure. METHODS: An attempt was made to evaluate whether the use of the laryngeal tube suction (LTS-D) for emergency airway management could contribute to reduce NFT compared to bag-mask ventilation (BMV). In a randomised prospective study 50 participants were asked to perform standardised simulated cardiac arrest management on a full-scale simulator following a one-day cardiac arrest training. Each participant was randomised into the LTS-D and the BMV group for airway management. At the end of each scenario an evaluation of the use of each ventilation procedure by the participants was made by means of a questionnaire. RESULTS: During the manikin scenario (430 s for LTS-D and 420 s for BMV) there was a significant difference in the overall NFT comparing the use of the LTS-D vs. BMV (105.8 s, range 94-124 s vs. 150.7 s, range 124-179 s; p<0.01). This corresponded during the whole scenario to a proportion of 24.6% (LTS-D) or 35.9% (BMV). Using the LTS-D all participants were able to ventilate the manikin successfully (tidal volume 500-600 ml). In a subjective evaluation of the different airway management procedures by the participants more than 90% expressed a positive opinion about the LTS-D with respect to ease of insertion and safety of ventilation. CONCLUSION: The use of the LTS-D on a manikin by emergency physicians after standardised cardiac arrest training significantly reduces the NFT in comparison to BMV. Therefore the LTS-D seems to be a good alternative to BMV during a simulated cardiac arrest scenario.

Vaccination against the avian infectious bronchitis virus affects sperm concentration, sperm quality and blood testosterone concentrations in cockerels.

1. It was previously found that cockerels vaccinated with live attenuated avian infectious bronchitis virus (AIBV) have decreased serum testosterone concentrations, epididymal stones and reduced fertility. The objectives of this study were twofold: to determine if reduced fertility following vaccination with live attenuated virus was the result of reduced sperm concentration or reduced sperm quality and to determine if vaccination with a killed strain of virus caused a similar reduction in sperm function in vivo. 2. Specific-pathogen-free Single Comb White Leghorn cockerels were divided into three treatment groups: no vaccination (NONVAC), vaccination with killed AIBV virus (KVAC) or vaccination with live attenuated AIBV virus (LVAC). Semen was collected daily from 17 to 27 weeks of age, and semen quality was assessed frequently by analysing sperm concentration, viability, motility, and ability to reach and interact with the ovum in vivo. Blood plasma was assayed for testosterone concentration. 3. Differences in sperm analysis among treatment groups were limited. Sperm viability was increased in NONVAC during week 20 which then decreased in week 22 when compared to vaccinated cockerels. Acrosome damage was increased in vaccinated cockerels in week 22, and decreased in weeks 25 and 27 when compared to controls, which correlate to the period of epididymal stone development. Plasma testosterone concentrations and sperm concentrations among treatment groups were different only at 16 and 19 weeks of age, respectively. There were no differences across treatment groups in sperm mobility through Accudenz or in numbers of sperm holes in perivitelline membranes of eggs following insemination with semen from 27-week-old cockerels. No differences were observed in viability or acrosome integrity between cockerels with and without epididymal stones within treatment groups. 4. In conclusion, pre-pubertal vaccination against AIBV and subsequent epididymal stone formation had a limited effect on sperm concentration, sperm quality and plasma testosterone concentrations. Vaccination with killed AIBV vaccine did not diminish effects on sperm function in vivo.

Inhibition of BCL11B expression leads to apoptosis of malignant but not normal mature T cells.

The B-cell chronic lymphocytic leukemia (CLL)/lymphoma 11B gene (BCL11B) encodes a Krüppel-like zinc-finger protein, which plays a crucial role in thymopoiesis and has been associated with hematopoietic malignancies. It was hypothesized that BCL11B may act as a tumor-suppressor gene, but its precise function has not yet been elucidated. Here, we demonstrate that the survival of human T-cell leukemia and lymphoma cell lines is critically dependent on Bcl11b. Suppression of Bcl11b by RNA interference selectively induced apoptosis in transformed T cells whereas normal mature T cells remained unaffected. The apoptosis was effected by simultaneous activation of death receptor-mediated and intrinsic apoptotic pathways, most likely as a result of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) upregulation and suppression of the Bcl-xL antiapoptotic protein. Our data indicate an antiapoptotic function of Bcl11b. The resistance of normal mature T lymphocytes to Bcl11b suppression-induced apoptosis and restricted expression pattern make it an attractive therapeutic target in T-cell malignancies.

Outcome of cardiopulmonary resuscitation in intensive care units in a university hospital.

UNLABELLED: The purpose of this study is to evaluate the demographic characteristics of patients who suffered cardiac arrest in our intensive care units (ICUs) as well as to identify those factors influencing outcome after resuscitation following cardiac arrest. METHODS: We reviewed the records of all patients who underwent cardiopulmonary resuscitation (CPR) in our ICUs at the Georg-August University Hospital, Goettingen, Germany, from January 1, 1999 to December 31, 2003. RESULTS: One hundred and sixty-nine patients underwent CPR. Severity of illness assessed by SAPS II score on admission was 51.8+/-18.5 (predicted mortality 46.6%). The initially monitored rhythm at the time of arrest was asystole in 51 (30.2%) patients. Ventricular tachycardia/fibrillation (VT/VF) was recorded in 65 (38.5%) and pulseless electrical activity in 49 (29.0%) patients. Twenty (23.8%), 28 (33.3%) and 33 (39.3%) patients with initially recorded asystole, VT/VF and pulseless electrical activity (PEA) rhythms, respectively, survived to ICU discharge. Eighty of the 169 patients survived to hospital discharge giving a survival rate of 47.3%. The highest ICU mortality was seen in patients admitted for neurosurgery (80%) followed by major vascular surgery (77.8%), non-surgical patients (67.4%) and patients with severe sepsis (66.7%). The occurrence of cardiac arrest within the first 24h was associated with a significantly lower ICU mortality compared to a later incident. At hospital discharge 66 patients (82.5% of the survivors) achieved good cerebral recovery, 12 patients (15.0%) were severely disabled (CPC 3) while 2 (2.5%) remained unconscious. CONCLUSION: Several factors affect the outcome from CPR. However, quicker triage to ICU, closer monitoring along with prompt intervention might minimise the consequences of cardiac arrest and its complications.

Outcome of cardiopulmonary resuscitation in the intensive care units of a university hospital.

The purpose of this study is to evaluate the demographic characteristics of patients who suffered cardiac arrest in our ICUs and to identify those factors influencing outcome after resuscitation following cardiac arrest. We reviewed the records of all patients who underwent CPR in the two ICUs at the Georg-August University Hospital Goettingen, Germany from 1 January, 1999 to 31 December, 2003. During the study period 169 patients underwent CPR and 80 of the 169 patients survived to hospital discharge, giving a survival to hospital discharge rate of 47.3%. The initial monitored rhythm recorded at the time of arrest was asystole in 99 (58.6%) patients, ventricular tachycardia/fibrillation in 59 (34.9%) and pulseless electrical activity in 7 (4.1%) patients. The respective survival rates were 46 (54.8%), 31 (36.9%) and 5 (6.0%) to hospital discharge. Of the 80 patients that survived to hospital discharge 75 (93.8%) achieved good cerebral recovery (CPC 1 or 2) and were alert and fully oriented on discharge; 4 patients (5.0%) were severely disabled (CPC 3), while 1 (1.2%) remained unconscious and was reported dead five days after discharged to another local hospital. Illness severity as assessed by SAPS II score on admission was 38.8 +/- 16.0. None of our patients with > 40 SAPS II score 24 hours after CPR survived to be discharged from the ICU. Our study showed that nearly half the patients that had cardiac arrest in our hospital ICUs had a favourable outcome despite initial rhythms that are traditionally associated with a poor outcome. This confirms that good results are achievable in these groups of patients.

[The new 2005 resuscitation guidelines of the European Resuscitation Council: comments and supplements]. / Die neuen Reanimationsleitlinien 2005 des European Resuscitation Council: Kommentar und Ergänzungen.

The new CPR guidelines are based on a scientific consensus which was reached by 281 international experts. Chest compressions (100/min, 4-5 cm deep) should be performed in a ratio of 30:2 with ventilation (tidal volume 500 ml, Ti 1 s, FIO2 if possible 1.0). After a single defibrillation attempt (initially biphasic 150-200 J, monophasic 360 J, subsequently with the respective highest energy), chest compressions are initiated again immediately for 2 min. Endotracheal intubation is the gold standard; other airway devices may be employed as well depending on individual skills. Drug administration routes for adults and children: first choice IV, second choice intraosseous, third choice endobronchial [epinephrine dose 2-3x (adults) or 10x (pediatric patients) higher than IV]. Vasopressors: 1 mg epinephrine every 3-5 min IV. After the third unsuccessful defibrillation attempt amiodarone IV (300 mg); repetition (150 mg) possible. Sodium bicarbonate (1 ml/kg 8.4%) only in excessive hyperkalemia, metabolic acidosis, or intoxication with tricyclic antidepressants. Consider atropine (3 mg) and aminophylline (5 mg/kg). Thrombolysis during spontaneous circulation only in myocardial infarction or massive pulmonary embolism; during CPR only during massive pulmonary embolism. Cardiopulmonary bypass only after cardiac surgery, hypothermia or intoxication. Pediatrics: best improvement in outcome by preventing cardiocirculatory collapse. Alternate chest thumps and chest compression (infants), or abdominal compressions (>1-year-old) in foreign body airway obstruction. Initially five breaths, followed by chest compressions (100/min; approximately 1/3 of chest diameter): ventilation ratio 15:2. Treatment of potentially reversible causes (4 "Hs", "HITS": hypoxia, hypovolemia, hypo- and hyperkaliemia, hypothermia, cardiac tamponade, intoxication, thrombo-embolism, tension pneumothorax). Epinephrine 10 microg/kg IV or intraosseously, or 100 microg (endobronchially) every 3-5 min. Defibrillation (4 J/kg; monophasic oder biphasic) followed by 2 min CPR, then ECG and pulse check. Newborns: inflate the lungs with bag-valve mask ventilation. If heart rate<60/min chest compressions:ventilation ratio 3:1 (120 chest compressions/min). Postresuscitation phase: initiate mild hypothermia [32-34 degrees C for 12-24 h; slow rewarming (<0.5 degrees C/h)]. Prediction of CPR outcome is not possible at the scene; determining neurological outcome within 72 h after cardiac arrest with evoked potentials, biochemical tests and physical examination. Even during low suspicion for an acute coronary syndrome, record a prehospital 12-lead ECG. In parallel to pain therapy, aspirin (160-325 mg PO or IV) and in addition clopidogrel (300 mg PO). As antithrombin, heparin (60 IU/kg, max. 4000 IU) or enoxaparine. In ST-segment elevation myocardial infarction, define reperfusion strategy depending on duration of symptoms until PCI (prevent delay>90 min until PCI). Stroke is an emergency and needs to be treated in a stroke unit. A CT scan is the most important evaluation, MRT may replace a CT scan. After hemorrhage exclusion, thrombolysis within 3 h of symptom onset (0.9 mg/kg rt-PA IV; max 90 mg within 60 min, 10% of the entire dosage as initial bolus, no aspirin, no heparin within the first 24 h). In severe hemorrhagic shock, definite control of bleeding is the most important goal. For successful CPR of trauma patients, a minimal intravascular volume status and management of hypoxia are essential. Aggressive fluid resuscitation, hyperventilation, and excessive ventilation pressure may impair outcome in severe hemorrhagic shock. Despite bad prognosis, CPR in trauma patients may be successful in select cases. Any CPR training is better than nothing; simplification of contents and processes remains important.

Ion transporters for fluid reabsorption in the rooster (Gallus domesticus) epididymal region.

Testicular fluid is highly condensed during its passage through the epididymal region in the avian species. In the present study, major ion transporters that are responsible for condensation mainly by water resorption in the reproductive tract as identified in the mammalian epididymis were localized within the rooster (Gallus domesticus) epididymis by immunohistochemistry. The results show that the efferent ductule epithelium expressed sodium-potassium ATPase (Na(+),K(+)-ATPase), carbonic anhydrase II (CAII) and sodium hydrogen exchanger isoform 3 (NHE3) and that the connecting ductule and epididymal duct epithelia expressed Na(+),K(+)-ATPase and CAII. These data suggest that a model proposed for reabsorption in mammalian efferent ductules can be applied to avian efferent ductules.

Thermal mismatch strains in sidewall functionalized carbon nanotube/polystyrene nanocomposites.

We present an unusual temperature dependence of thermal strains in 4-(10-hydroxy)decyl benzoate (HDB) modified SWNTPS (SWNT-single wall carbon nanotube, PS-polystyrene) nanocomposites. The strain transfer from the matrix to nanotubes in these nanocomposites, inferred from the frequency change of the Raman active tangential modes of the nanotubes, is enhanced strongly below 300 K, whereas it is vanishingly small at higher temperatures. The increased strain transfer is suggestive of reinforcement of the HDB-SWNTPS nanocomposites at low temperatures. On the other hand, the pristine SWNTs couple weakly to the PS matrix over the entire temperature range of 4.5-410 K. We argue that the strain transfer in HDB-SWNTPS is determined by the thermomechanical properties of the interface region composed of polystyrene plasticized by the tethered alkanelike modifier.

Stages and duration of spermatogenesis in the domestic ferret (Mustela putorius furo).

Classification of seminiferous tubules is the basis for understanding normal and abnormal spermatogenesis. The aim of the present study was to determine spermatogenic stages and the duration of the cycle in the domestic ferret using bromodeoxyuridine (BrdU) as a tracer. Eleven adult male ferrets that were maintained in a breeding condition were used. Testicular sections were stained with the periodic acid-Schiff reaction for light microscopy. To determine the cycle duration, six ferrets were injected intraperitoneally with BrdU, and testes were collected 3h later and 10 days and 3h later. BrdU was detected by immunohistochemistry. Seminiferous tubules were classified into eight stages, and frequencies of stages I-VIII were 10.6, 2.2, 7.9, 13.1, 22.3, 21.9, 14.0 and 8.0%, respectively. The most advanced BrdU-labeled cells at 3h post-injection were leptotene spermatocytes in stage VI and those at 10 days and 3h were pachytene spermatocytes in stage V. From differences in stage frequency and BrdU staining frequency between two time points, the duration of one cycle was estimated to be 13.0 days. The present observations indicate that stages and the cycle duration of the ferret spermatogenesis are similar to those reported in other carnivores.

Mechanisms of electron acceptor utilization: implications for simulating anaerobic biodegradation.

Simulation of biodegradation reactions within a reactive transport framework requires information on mechanisms of terminal electron acceptor processes (TEAPs). In initial modeling efforts, TEAPs were approximated as occurring sequentially, with the highest energy-yielding electron acceptors (e.g. oxygen) consumed before those that yield less energy (e.g., sulfate). Within this framework in a steady state plume, sequential electron acceptor utilization would theoretically produce methane at an organic-rich source and Fe(II) further downgradient, resulting in a limited zone of Fe(II) and methane overlap. However, contaminant plumes often display much more extensive zones of overlapping Fe(II) and methane. The extensive overlap could be caused by several abiotic and biotic processes including vertical mixing of byproducts in long-screened monitoring wells, adsorption of Fe(II) onto aquifer solids, or microscale heterogeneity in Fe(III) concentrations. Alternatively, the overlap could be due to simultaneous utilization of terminal electron acceptors. Because biodegradation rates are controlled by TEAPs, evaluating the mechanisms of electron acceptor utilization is critical for improving prediction of contaminant mass losses due to biodegradation. Using BioRedox-MT3DMS, a three-dimensional, multi-species reactive transport code, we simulated the current configurations of a BTEX plume and TEAP zones at a petroleum-contaminated field site in Wisconsin. Simulation results suggest that BTEX mass loss due to biodegradation is greatest under oxygen-reducing conditions, with smaller but similar contributions to mass loss from biodegradation under Fe(III)-reducing, sulfate-reducing, and methanogenic conditions. Results of sensitivity calculations document that BTEX losses due to biodegradation are most sensitive to the age of the plume, while the shape of the BTEX plume is most sensitive to effective porosity and rate constants for biodegradation under Fe(III)-reducing and methanogenic conditions. Using this transport model, we had limited success in simulating overlap of redox products using reasonable ranges of parameters within a strictly sequential electron acceptor utilization framework. Simulation results indicate that overlap of redox products cannot be accurately simulated using the constructed model, suggesting either that Fe(III) reduction and methanogenesis are occurring simultaneously in the source area, or that heterogeneities in Fe(III) concentration and/or mineral type cause the observed overlap. Additional field, experimental, and modeling studies will be needed to address these questions.

Surface and intracellular Fas expression associated with cytokine-induced apoptosis in rodent islet and insulinoma cells.

During the process of insulitis in the pathogenesis of type I (insulin-dependent) diabetes mellitus, proinflammatory cytokines induce expression of the death receptor Fas on the surface of pancreatic beta-cells and thereby contribute to the enhanced susceptibility of beta-cells for apoptosis. The aim of this study was to compare cell-surface and intracellular Fas expression associated with cytokine-induced apoptosis in commonly used beta-cell models such as isolated islets and insulinoma lines derived from mouse and rat. The cell line NIT-1 responded to the interleukin (IL)-1beta+interferon (IFN)-gamma stimulus with translocation of Fas to the cell surface. Likewise, islet cells from non-obese diabetic (NOD) mice and BB/OK rats expressed increasing amounts of the Fas receptor on their surfaces after exposure to IL-1beta in combination with IFN-gamma and tumour necrosis factor-alpha. Moreover, islets obtained from BB/OK rats at an age near the onset of diabetes had an increased surface expression of Fas compared with young rats. In contrast, western blot analysis of cell lysates from cytokine-exposed islets and insulinoma cells revealed total Fas expression levels comparable to those of untreated controls. In conclusion, islets from BB/OK rats and NOD mice, in addition to NIT-1 insulinoma cells, responded to cytokine exposure with surface expression of the Fas receptor, whereas in cell lysates the levels of expression of Fas were found to be independent of cytokine exposure. Taken together, the findings indicate that cytokine-treated beta-cells might possess two pools of Fas protein, one of which is inducible by cytokines and accounts for surface Fas expression, whereas the other is constitutively expressed in cytoplasmic compartments. The underlying mechanisms, including possible interactions between these two sources of cellular Fas expression, need to be investigated in future studies.

[To resuscitate or not? The emergency physician's decision in the prehospital setting]. / Reanimieren oder nicht? Die notärztliche Entscheidung im Rettungsdienst.

OBJECTIVE: To identify factors affecting the decision to withhold resuscitative attempts or to terminate cardiopulmonary resuscitation (CPR) in the prehospital setting. METHODS: In a physician-based emergency medical system (EMS) standardised interviews with the emergency physicians were performed within 24 hours after unsuccessful or withheld CPR-efforts. RESULTS: Over a period of one year 170 prehospital cardiac arrests were evaluated. 47 patients (28 %) were declared dead on arrival by the emergency physician. The decision to withhold CPR was based on obvious clinical signs of death (32 patients) or the diagnosis of cardiac arrest due to severe trauma (8 patients). In 4 cases the terminal state of a fatal illness was the emergency physician's criterion not to initiate resuscitative efforts. In 3 patients an extended response time (more than 10 minutes) was mentioned, in combination with a primary rhythm of either asystole or electromechanical dissociation and additional information given by the family doctor. In 123 patients CPR was attempted. In 72 cases (59 %) resuscitative efforts were terminated as no return and stabilisation of spontaneous circulation was achieved. In 58 patients the decision to stop CPR was based on the evidence of cardiac death. Additional criteria for the termination of the resuscitation attempt were the duration of CPR, an extended response time, pre-existing diseases, age, pupillary status, missing brain stem reflexes, the reason of cardiac arrest, information given by the family or the family doctor and secondarily evolving signs of death. In 14 patients the emergency physicians reported that their decision to terminate CPR was primarily based on these co-factors, the evidence of cardiac death was not explicitly mentioned in these cases. CONCLUSION: In the pre-hospital setting the decision to withhold or to withdraw CPR is mostly based on reliable criteria such as obvious clinical signs of death, fatal trauma or evidence of cardiac death. Nevertheless, in a small but considerable number of cases exceptions to this rule are made by emergency physicians.

Role of FSH and epidermal growth factor (EGF) in the initiation of steroidogenesis in granulosa cells associated with follicular selection in chicken ovaries.

In chicken ovaries, one small yellow follicle (SYF) is selected daily from a pool of follicles of similar size and becomes a preovulatory follicle. FSH induces follicular growth and steroidogenesis. Epidermal growth factor (EGF), an intraovarian hormone, suppresses granulosa cell differentiation. This study demonstrates that recruitment of SYFs into the hierarchy of preovulatory follicles is associated with a change in steroidogenic activity in granulosa cells regulated, at least in part, by FSH and EGF. Abundance of P450 side-chain cleavage (P450scc) mRNA was higher in the smallest preovulatory follicle (F6) compared with SYF, whereas FSH and EGF receptor (FSHr and EGFr, respectively) mRNA abundance was similar. FSH increased P450scc mRNA abundance and progesterone secretion and decreased FSHr mRNA in cultured granulosa cells, whereas EGF attenuated or suppressed P450scc mRNA and decreased FSHr mRNA abundance. None of the hormones influenced EGFr mRNA abundance. When used in combination, EGF attenuated or suppressed the stimulatory effect of FSH on the expression of P450scc mRNA and production of progesterone in a dose-dependent manner. The results indicate that (1) selection is associated with an increase in P450scc mRNA; (2) FSH stimulates expression of P450scc mRNA and progesterone secretion in granulosa cells of SYF; and (3) induction of P450scc mRNA and progesterone secretion by FSH is attenuated or blocked by EGF.