Analysis of pulmonary embolus size at the time of recurrence compared with presentation: a single-centre retrospective study.

Essentials Size of pulmonary embolus (PE) at the time of recurrence compared with first event is unstudied. In a retrospective cohort of patients we compared PE size at recurrence versus the initial PE. Rates of massive PE at recurrence were low whether the first PE was massive or unmassive. Studies to determine PE size and severity at recurrence when anticoagulation is stopped are needed. SUMMARY: Background The size of recurrent pulmonary embolus (PE) in relation to a prior event could be a factor in deciding whether to continue anticoagulation. There are no published data on this subject to help with counselling patients. Objectives To determine whether size of a first PE predicts the size at recurrence. Patients and methods This was a retrospective cohort study of consecutive patients with recurrent PE over 25 months at a single tertiary center. In confirmed cases the sizes of first and recurrent PEs were grouped into radiologically non-massive PE (RNMPE) or radiologically massive PE (RMPE) if there was bilateral main pulmonary artery thrombus, saddle PE or right ventricular strain on the computerized tomography pulmonary angiogram. Results Sixty-three patients were included in the study (37 exclusions). Thirty-seven patients were men and 26 women, with a median age of 72 years; 33.3% of PEs were unprovoked. Patients whose first PE was an RNMPE (46/63 or 73% of patients) had a 15.2% (95% confidence interval [CI], 7.6-28.2%) chance of RMPE at recurrence and a 32.6% (95% CI 20.9-47.0%) chance of having a larger PE at recurrence, whereas those who presented first with an RMPE (17/63 or 27% or patients) had a 17.6% (95% CI, 6.2-41.0%) chance of RMPE at recurrence (odds ratio, 1.19; CI, 0.27-5.27). Conclusions Risk of a massive PE at recurrence is low (and similar) irrespective of the size of the first PE in this single study. Further studies are warranted as this could help in decisions on long-term anticoagulation.

Aquaculture: a rapidly growing and significant source of sustainable food? Status, transitions and potential.

The status and potential of aquaculture is considered as part of a broader food landscape of wild aquatic and terrestrial food sources. The rationale and resource base required for the development of aquaculture are considered in the context of broader societal development, cultural preferences and human needs. Attention is drawn to the uneven development and current importance of aquaculture globally as well as its considerable heterogeneity of form and function compared with established terrestrial livestock production. The recent drivers of growth in demand and production are examined and the persistent linkages between exploitation of wild stocks, full life cycle culture and the various intermediate forms explored. An emergent trend for sourcing aquaculture feeds from alternatives to marine ingredients is described and the implications for the sector with rapidly growing feed needs discussed. The rise of non-conventional and innovative feed ingredients, often shared with terrestrial livestock, are considered, including aquaculture itself becoming a major source of marine ingredients. The implications for the continued expected growth of aquaculture are set in the context of sustainable intensification, with the challenges that conventional intensification and emergent integration within, and between, value chains explored. The review concludes with a consideration of the implications for dependent livelihoods and projections for various futures based on limited resources but growing demand.

Meeting the food and nutrition needs of the poor: the role of fish and the opportunities and challenges emerging from the rise of aquaculture.

People who are food and nutrition insecure largely reside in Asia and Sub-Saharan Africa and for many, fish represents a rich source of protein, micronutrients and essential fatty acids. The contribution of fish to household food and nutrition security depends upon availability, access and cultural and personal preferences. Access is largely determined by location, seasonality and price but at the individual level it also depends upon a person's physiological and health status and how fish is prepared, cooked and shared among household members. The sustained and rapid expansion of aquaculture over the past 30 years has resulted in >40% of all fish now consumed being derived from farming. While aquaculture produce increasingly features in the diets of many Asians, it is much less apparent among those living in Sub-Saharan Africa. Here, per capita fish consumption has grown little and despite the apparently strong markets and adequate biophysical conditions, aquaculture has yet to develop. The contribution of aquaculture to food and nutrition security is not only just an issue of where aquaculture occurs but also of what is being produced and how and whether the produce is as accessible as that from capture fisheries. The range of fish species produced by an increasingly globalized aquaculture industry differs from that derived from capture fisheries. Farmed fishes are also different in terms of their nutrient content, a result of the species being grown and of rearing methods. Farmed fish price affects access by poor consumers while the size at which fish is harvested influences both access and use. This paper explores these issues with particular reference to Asia and Africa and the technical and policy innovations needed to ensure that fish farming is able to fulfil its potential to meet the global population's food and nutrition needs.

Female crickets assess relatedness during mate guarding and bias storage of sperm towards unrelated males.

Recent evidence shows that females exert a post-copulatory fertilization bias in favour of unrelated males to avoid the genetic incompatibilities derived from inbreeding. One of the mechanisms suggested for fertilization biases in insects is female control over transport of sperm to the sperm-storage organs. We investigated post-copulatory inbreeding-avoidance mechanisms in females of the cricket Teleogryllus oceanicus. We assessed the relative contribution of related and unrelated males to the sperm stores of double-mated females. To demonstrate unequivocally that biased sperm storage results from female control rather than cryptic male choice, we manipulated the relatedness of mated males and of males performing post-copulatory mate guarding. Our results show that when guarded by a related male, females store less sperm from their actual mate, irrespective of the relatedness of the mating male. Our data support the notion that inhibition of sperm storage by female crickets can act as a form of cryptic female choice to avoid the severe negative effects of inbreeding.

Island hopping introduces Polynesian field crickets to novel environments, genetic bottlenecks and rapid evolution.

Teleogryllus oceanicus, a cricket native to Australia, was introduced to Hawaii where it encounters a novel natural enemy responsible for their recent rapid evolutionary loss of singing ability. To explore how genetic diversity varies across their broad range, their mode of introduction to Hawaii and nonadaptive influences on the sexual signalling system, we assessed variation at seven microsatellite loci in 19 Australian and island populations. Genetic variability was highest in Australia, intermediate in Oceania and lowest in Hawaii, and differentiation among local populations was a clear function of geographical distance. Hawaiian populations are most closely related to those from the Society Islands and Cook Islands, and a neighbour-joining tree based on D(A) is consistent with movement by Polynesian settlers. We found evidence of bottlenecks in six island populations (including three Hawaiian populations), supporting previous findings in which bottlenecks were implicated in the crickets' loss of singing ability.

Vascular endothelial growth factors C and D represent novel prognostic markers in colorectal carcinoma using quantitative image analysis.

BACKGROUND/AIMS: Vascular endothelial growth factor C (VEGF-C) and vascular endothelial growth factor D (VEGF-D) are potent lymphangiogenic and angiogenetic mediators in many kinds of tumors. However, the exact impacts of VEGF-C and VEGF-D on the prognosis of colorectal cancer (CRC) remain elusive. The aims of this study were to demonstrate the expression of VEGF-C and VEGF-D and to correlate their expression levels with clinicopathological factors and long-term survival in patients with CRC. PATIENTS AND METHODS: Between January 1996 and January 1998, 69 patients with pathologically confirmed CRC who received routine follow-up at the Ruijin Hospital were included in this study. VEGF-C and VEGF-D protein expression and microvessel density of 69 surgical specimens were assessed by immunohistochemistry, with 20 samples of normal colorectal tissues as controls. All patients were followed up for 108 months or until death. The Immunohistochemical stains were quantified and analyzed by means of a Zeiss Axioplan 2 imaging analysis system. RESULTS: The protein expression of VEGF-C and VEGF-D in tumor tissues was much higher than that in normal colorectal tissues (p < 0.01). The VEGF-C expression significantly correlated with lymph node metastasis (p = 0.011) and clinical stages of CRC (p < 0.01). The VEGF-D expression correlated with patient ages (p = 0.013), depth of tumor invasion (p = 0.013), and lymph node metastasis (p = 0.028). The expression of VEGF-C and VEGF-D was significantly correlated with the microvessel density. Both overall survival and disease-free survival at 108 months were significantly lower in the CRC patients with a high VEGF-C and/or a high VEGF-D expression, and the patients with a high expression of both VEGF-C and VEGF-D had the shortest overall survival and disease-free survival when compared with other patients. CONCLUSION: The VEGF-C or VEGF-D expression was significantly correlated with lymph node metastasis and long-term prognosis and could be applied as prognostic markers in CRC.

SNAT expression in rat placenta.

Amino acid transport System A (SysA) activity is present within the rodent and human placentas. Inhibition of this transport system is associated with fetal growth retardation. Several cDNAs encoding SysA transport proteins have been discovered, and their presence documented within the human placenta. We have demonstrated the presence of mRNA encoding three of these transporters, SNAT1, 2, and 4 within the rat placenta over the final third of gestation. Abundance of these mRNA species increases from day 14 to day 20 of gestation. Immunohistochemistry demonstrates the presence of SNAT1 and 2 within the placental labyrinth at both days 14 and 20. Transport proteins are also present within marginal giant cells and, for SNAT1, within fetal endothelium. In conclusion, several proteins capable of SysA transport activity are present within the rodent placenta. mRNA expression increases over the final third of gestation, coincident with the period of greatest need for fetal amino acid delivery.

Acid burns from personal assault in Uganda.

Acid burns from assault represent a substantial and neglected proportion of burn injuries in the developing world. A retrospective chart review was conducted to assess the frequency of acid burns in relation to total burns requiring admission in Kampala, Uganda. Seventeen percent of the adult burns admitted at New Mulago hospital over an 18-month period resulted from acid assault. Patients had a mean age of 33.1 years, with a male to female ratio of 1.1:1. The average extent of injury was 14.1% total body surface area (TBSA), commonly involving the face (86.7%), head and neck (66.7%), upper limbs (60.0%) and chest (53.3%). Thirty-three percent of patients suffered partial or complete blindness. Mean length of stay in hospital was 49.5 days and all patients survived. Patterns of assault followed two common trends: attacks during robberies (46.7%), and attacks associated with domestic disputes (33.3%). The Ugandan pattern is contrasted with patterns reported from Bangladesh, Cambodia and Jamaica with a view to understanding the social context underlying such assaults. Prevention of these hideous injuries will require further understanding of their underlying social and cultural determinants. Serious questions remain whether public education programs will reduce the incidence of acid assault or increase it by giving potential assailants an idea they did not have before.

Reproductive ecology of a neotropical cichlid fish, Cichla monoculus (Osteichthyes: Cichlidae).

The reproductive ecology of the freshwater fish Cichla monoculus Spix, 1831 (Osteichthyes: Cichlidae) was investigated in the Campo Grande Reservoir, Northeast Brazil. Rainfall, temperature, pH, dissolved oxygen and electrical conductivity of the water were recorded monthly. Fish collected on a monthly basis were measured, weighted, dissected, sexed and the stage of maturation of the gonads were assessed by macro and microscopic means. The semi-arid study region has short spells of rain of 2-3 months duration interspersed with dry seasons. A positive correlation was observed between rainfall and air and water temperatures and conductivity of the water. The study population had an extended spawning season, with peak reproductive activity coinciding with low water temperatures. Males were longer and heavier than females on average and were larger at onset of sexual maturity. The size frequency distributions of the oocytes indicate that C. monoculus is a multiple spawner with an estimated batch fecundity of 3100. Condition factor showed an inverse relationship in relation to gonad size during maturation in both sexes and spent fish were in poor condition. In mature males, lipid stores in the post-occipital cephalic protuberance, a secondary sexual characteristic developed during the reproductive phase, which depleted in spent individuals. The success of this fish is attributed to its reproductive capacity and to the phenotypic plasticity that allows it to adapt to the harsh ecological conditions that prevail in the semi-arid region of Northeast Brazil.

Reproductive ecology of a neotropical cichlid fish, Cichla monoculus (Osteichthyes: Cichlidae)

The reproductive ecology of the freshwater fish Cichla monoculus Spix, 1831 (Osteichthyes: Cichlidae) was investigated in the Campo Grande Reservoir, Northeast Brazil. Rainfall, temperature, pH, dissolved oxygen and electrical conductivity of the water were recorded monthly. Fish collected on a monthly basis were measured, weighed, dissected, sexed and the stage of maturation of the gonads were assessed by macro and microscopic means. The semi-arid study region has short spells of rain of 2-3 months duration interspersed with dry seasons. A positive correlation was observed between rainfall and air and water temperatures and conductivity of the water. The study population had an extended spawning season, with peak reproductive activity coinciding with low water temperatures. Males were longer and heavier than females on average and were larger at onset of sexual maturity. The size frequency distributions of the oocytes indicate that C. monoculus is a multiple spawner with an estimated batch fecundity of 3100. Condition factor showed an inverse relationship in relation to gonad size during maturation in both sexes and spent fish were in poor condition. In mature males, lipid stores in the post-occipital cephalic protuberance, a secondary sexual characteristic developed during the reproductive phase, which depleted in spent individuals. The success of this fish is attributed to its reproductive capacity and to the phenotypic plasticity that allows it to adapt to the harsh ecological conditions that prevail in the semi-arid region of Northeast Brazil

Regulation of glutamate transport and transport proteins in a placental cell line.

We utilized HRP.1 cells derived from midgestation rat placental labyrinth to determine that the primary pathway for glutamate uptake is via system X, a Na(+)-dependent transport system. Kinetic parameters of system X activity were similar to those previously determined in rat and human placental membrane vesicle preparations. Amino acid depletion caused a significant upregulation of system X activity at 6, 24, and 48 h. This increase was reversed by the addition of glutamate and aspartate but not by the addition of alpha-(methylamino)isobutyric acid. Immunoblot analysis of the three transport proteins previously associated with system X activity indicated a trend toward an increase in GLT1, EAAC1, and GLAST1 immunoreactive protein contents by 48 h; cell surface expression of the same was enhanced by 24 h. Inhibition analysis suggested key roles for EAAC1 and GLAST1 in basal anionic amino acid transfer, with an enhanced role for GLT1 under conditions of amino acid depletion. In summary, amino acid availability as well as intracellular metabolism regulate anionic amino acid uptake into this placental cell line.

Minimizing blood loss in burn surgery.

BACKGROUND: Significant blood loss continues to plague early tangential excision of the burn wound. Although various techniques to reduce intraoperative blood loss have been described, there is an absence of uniformity and consistency in their application. Furthermore, it is unclear whether these techniques compromise intraoperative tissue assessment and wound outcome. The purpose of this study was to evaluate the effects of a comprehensive intraoperative blood conservation strategy on blood loss, transfusion requirements, and wound outcome in burn surgery. METHODS: An intraoperative blood conservation strategy (CONSV) that included donor site and burn wound adrenaline tumescence, donor site and excised wound topical adrenaline, and limb tourniquets was prospectively evaluated and compared with a historical control group (HIST) where only topical adrenaline and thrombin were applied to donor sites and excised wounds. RESULTS: Estimated blood loss was reduced from 211 +/- 166 mL per percentage body surface area excised and grafted in the HIST group to 123 +/- 106 mL in the CONSV group (p = 0.02). Similarly, the intraoperative transfusion requirement in the HIST group was reduced from 3.3 +/- 3.1 units per case to 0.1 +/- 0.3 units per case in the CONSV group (p < 0.001). There was no compromise in wound outcome in the CONSV group, which had a mean skin graft take rate of 96 +/- 4.2%. CONCLUSION: The application of a strict and comprehensive intraoperative blood conservation strategy during burn excision and grafting resulted in a profound reduction in blood loss and transfusion requirements, without compromising wound outcome.

Anionic amino acid transporter expression in late gestation rodent yolk sac.

The yolk sac plays an important role in fetal nutrition. Transport of amino acids by the rodent visceral yolk sac has been shown previously. We have demonstrated the presence of several amino acid transport proteins capable of the Na(+)-dependent transport of anionic amino acids within late gestation mouse visceral yolk sac and uterine epithelium. We speculate that these proteins may be involved in the efflux of glutamate from the fetal to the maternal circulations.

Detection of p56(lck) kinase activity using scintillation proximity assay in 384-well format and imaging proximity assay in 384- and 1536-well format.

p56(lck) is a lymphocyte-specific tyrosine kinase that plays an important role in both T-cell maturation and activation. We have developed a homogeneous assay in which p56(lck) catalyzes the transfer of the gamma-phosphate group from [gamma-(33)P]ATP to a biotinylated peptide substrate. The labeled peptide is then captured on a streptavidin-coated scintillation proximity assay (SPA) bead or imaging proximity bead. The SPA is counted in a microplate scintillation counter and the imaging proximity assay is counted in a charge-coupled device-based imaging system called LEADseekertrade mark, recently launched as a homogeneous imaging system by Amersham Pharmacia Biotech. We show, via time-dependence assays and inhibitor studies, that this assay can be performed in 1536-well microplate format using imaging proximity as the method of detection. The results compare favorably with the same assay performed in 384-well microplate format using both SPA and imaging proximity as the detection methods. From this study, we conclude that a kinase assay can be performed in 384- and 1536-well format using imaging as the detection method, with significant time savings over standard scintillation counting. In addition, we show cost saving advantages of 1536- over 384-well format in terms of reagent usage, higher throughput, and waste disposal.

Effect of aquaculture on world fish supplies.

Global production of farmed fish and shellfish has more than doubled in the past 15 years. Many people believe that such growth relieves pressure on ocean fisheries, but the opposite is true for some types of aquaculture. Farming carnivorous species requires large inputs of wild fish for feed. Some aquaculture systems also reduce wild fish supplies through habitat modification, wild seedstock collection and other ecological impacts. On balance, global aquaculture production still adds to world fish supplies; however, if the growing aquaculture industry is to sustain its contribution to world fish supplies, it must reduce wild fish inputs in feed and adopt more ecologically sound management practices.

Placental anionic and cationic amino acid transporter expression in growth hormone overexpressing and null IGF-II or null IGF-I receptor mice.

The role of growth hormone (GH), insulin-like growth factor (IGF)-II and the IGF-I receptor (IGF-Ir) in the regulation of the in vivo expression of Na(+)-coupled anionic [System X-AG; GLAST1 (EAAT1), GLT1 (EAAT2), EAAC1 (EAAT3), EAAT4; where the human homologues of amino acid transport proteins first cloned in the rat are given in parentheses] and Na(+)-independent cationic (System y(+);CAT1) amino acid transport proteins was evaluated by comparing transporter expression in day 17 placentae of mice that overexpressed bovine GH (GH+) or that carried null gene mutations for IGF-II or IGF-Ir. Northern analysis revealed no apparent difference in the mRNA content of GLAST1 (EAAT1), EAAC1 (EAAT3), or EAAT4, in homogenates of GH+ placentae, but levels of GLT1 (EAAT2) and CAT1 mRNA were increased. Immunoblot analysis revealed that whole-placental steady-state GLAST1 (EAAT1), EAAC1 (EAAT3), and EAAT4 protein levels were not affected by GH+, whereas GLT1 (EAAT2) levels were increased. Immunohistochemical analysis showed that the cell-specific expression of the anionic and CAT1 transporters was not affected by overexpression of GH. Similar analyses of null IGF-II placentae demonstrated increases in GLAST1 (EAAT1), EAAT4 and CAT1 mRNAs. Parallel immunoblot analysis demonstrated decreased expression of GLT1 (EAAT2), GLAST1 (EAAT1) and EAAC1 (EAAT3) protein, but an increased expression of EAAT4. In null IGF-II and IGF-Ir placentae, however, GLT1 (EAAT2) and EAAC1 (EAAT3) protein content was decreased in junctional zone cells, whereas CAT1 content was increased in junctional and labyrinth zone cells. These data indicate that an excess level of GH stimulates GLT1 (EAAT2) expression and that a normal level of IGF-II is required for typical expression of GLT1 (EAAT2), GLAST1 (EAAT1) and EAAC1 (EAAT3), but that IGF-II downregulates the expression of EAAT4 and CAT1.

Activity and protein localization of multiple glutamate transporters in gestation day 14 vs. day 20 rat placenta.

Concentrative absorption of glutamate by the developing placenta is critical for proper fetal development. The expression of GLAST1, GLT1, EAAC1, and EAAT4, known to be capable of D-aspartate-inhibitable and Na(+)-coupled glutamate transport (system X-AG), was evaluated in day 14 vs. day 20 rat chorioallantoic placenta. Steady-state mRNA levels were greater at day 20 for all transporters. Immunohistochemistry determined that the expression of GLAST1, GLT1, and EAAC1 was greater throughout the day 20 placenta and was asymmetric with respect to cellular localization. EAAT4 protein was not detected. System X-AG activity was responsible for most of the Na(+)-dependent glutamate uptake and was greater in day 20 than in day 14 apical and basal membrane subdomains of the labyrinth syncytiotrophoblast. Greater quantities of EAAC1 and GLAST1 protein were identified on day 20, and quantities were greater in basal than in apical membranes. GLT1 expression, unchanged in apical membranes, was decreased in basal membranes. These data correlate transporter mRNA and protein content with transport activity and demonstrate an increasing capacity for glutamate absorption by the developing placenta.