Mechanical extraction of chronic venous thrombus using a novel device: a report of two cases.

In deep vein thrombosis (DVT), the structure and composition of the venous thrombus can change rapidly over time. Studies have shown mixed results with anticoagulant and thrombolytic therapies, and the issue will be exacerbated in the case of chronic DVT (defined as thrombus still present after ≥4 weeks of failed treatment after a DVT diagnosis), with no well-accepted interventions. In the present report, we have described two patients in whom mechanical thrombectomy with a novel device was used to remove extensive, chronic thrombus. At follow-up, both patients showed improved blood flow and patency with resolution of their edema and pain. Because thrombus can often be more chronic than expected from a patient's medical history alone, mechanical intervention as the first approach might be warranted.

Venous Intervention Improves Patient Outcomes.

INTRODUCTION: The healing of venous ulcers is difficult, and several sources indicate a multidisciplinary plan of care as the best approach to the healing of these wounds. MATERIALS AND METHODS: Seventy-five patients with suspected venous disease being treated at Northern New Jersey Medical Center were assessed by dedicated interventional radiology physicians as part of Wound Center protocol. Of those patients, 27 required diagnostic testing, such as CT venogram or venography. Of these patients, 11 were determined to be appropriate candidates and underwent surgical intervention, such as venous ablation or vein stenting. RESULTS: Results support continued referral for venous interventions. Of the 75 patients referred for assessment, 27 required diagnostic testing, and 11 of those patients met criteria for intervention and treatment. Of the 11 patients who underwent surgical intervention, 100% experienced success in reduction of one or more cardinal signs of inflammation, and all patients with open wounds experienced either reduction in wound size and, more commonly, complete wound closure. CONCLUSION: Adding venous evaluation referral to wound center protocol in patients with suspected venous disease improved healing outcomes, thus improving quality of life.

Rhs proteins from diverse bacteria mediate intercellular competition.

Rearrangement hotspot (Rhs) and related YD-peptide repeat proteins are widely distributed in bacteria and eukaryotes, but their functions are poorly understood. Here, we show that Gram-negative Rhs proteins and the distantly related wall-associated protein A (WapA) from Gram-positive bacteria mediate intercellular competition. Rhs and WapA carry polymorphic C-terminal toxin domains (Rhs-CT/WapA-CT), which are deployed to inhibit the growth of neighboring cells. These systems also encode sequence-diverse immunity proteins (RhsI/WapI) that specifically neutralize cognate toxins to protect rhs(+)/wapA(+) cells from autoinhibition. RhsA and RhsB from Dickeya dadantii 3937 carry nuclease domains that degrade target cell DNA. D. dadantii 3937 rhs genes do not encode secretion signal sequences but are linked to hemolysin-coregulated protein and valine-glycine repeat protein G genes from type VI secretion systems. Valine-glycine repeat protein G is required for inhibitor cell function, suggesting that Rhs may be exported from D. dadantii 3937 through a type VI secretion mechanism. In contrast, WapA proteins from Bacillus subtilis strains appear to be exported through the general secretory pathway and deliver a variety of tRNase toxins into neighboring target cells. These findings demonstrate that YD-repeat proteins from phylogenetically diverse bacteria share a common function in contact-dependent growth inhibition.

Identification of a quenching species in ruthenium tris-bipyridine electroluminescent devices.

We have used matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry and micro-Raman spectroscopy to identify a quenching species that is formed during operation of [Ru(bpy)3]2+ electroluminescent devices. We identify this performance-degrading product to be the oxo-bridged dimer [(bpy)2(H2O)RuORu(OH2)(bpy)2]4+ and show this dimer to be an effective quencher of device luminescence. This work is the first to detect a specific chemical degradation product formed during iTMC OLED operation.