A roadmap for breeding orphan leafy vegetable species: a case study of Gynandropsis gynandra (Cleomaceae)

Despite an increasing awareness of the potential of "orphan" or unimproved crops to contribute to food security and enhanced livelihoods for farmers, coordinated research agendas to facilitate production and use of orphan crops by local communities are generally lacking. We provide an overview of the current knowledge on leafy vegetables with a focus on Gynandropsis gynandra, a highly nutritious species used in Africa and Asia, and highlight general and species-specific guidelines for participatory, genomics-assisted breeding of orphan crops. Key steps in genome-enabled orphan leafy vegetables improvement are identified and discussed in the context of Gynandropsis gynandra breeding, including: (1) germplasm collection and management; (2) product target definition and refinement; (3) characterization of the genetic control of key traits; (4) design of the 'process' for cultivar development; (5) integration of genomic data to optimize that 'process'; (6) multi-environmental participatory testing and end-user evaluation; and (7) crop value chain development. The review discusses each step in detail, with emphasis on improving leaf yield, phytonutrient content, organoleptic quality, resistance to biotic and abiotic stresses and post-harvest management.

Growth rates of pulmonary metastases after liver transplantation for unresectable colorectal liver metastases

Background

The previously reported SECA study demonstrated a dramatic 5-year survival improvement in patients with unresectable colorectal liver metastases (CLM) treated with liver transplantation (LT) compared with chemotherapy. The objective of this study was to assess whether immunosuppressive therapy accelerates the growth of pulmonary metastases in patients transplanted for unresectable CLM.

Methods

Chest CT scans from 11 patients in the SECA study resected for 18 pulmonary metastases were reviewed retrospectively. Tumour diameter, volume and CT characteristics were registered and tumour volume doubling time was calculated. Findings in the SECA group were compared with those of a control group consisting of 12 patients with non-transplanted rectal cancer resected for 26 pulmonary metastases. Disease-free survival (DFS) and overall survival (OS) after first pulmonary resection were determined.

Results

Median doubling time based on tumour diameter and volume in the SECA and control groups were 125 and 130 days (P = 0·658) and 110 and 129 days (P = 0·632) respectively. The metastases in both groups were distributed to all lung lobes and were mostly peripheral. Median DFS after LT in the SECA group and after primary pelvic surgery in the control group was 17 (range 6–42) and 18 (2–57) months respectively (P = 0·532). In the SECA group, estimated 5-year DFS and OS rates after first pulmonary resection were 39 and 51 per cent respectively.

Conclusion

Patients treated by LT for unresectable CLM have a good prognosis following resection of pulmonary metastases. Doubling time did not appear to be worse with the immunosuppression used after LT.

Mapping and estimating the total living biomass and carbon in low-biomass woodlands using Landsat 8 CDR data

BACKGROUND

A functional forest carbon measuring, reporting and verification (MRV) system to support climate change mitigation policies, such as REDD+, requires estimates of forest biomass carbon, as an input to estimate emissions. A combination of field inventory and remote sensing is expected to provide those data. By linking Landsat 8 and forest inventory data, we (1) developed linear mixed effects models for total living biomass (TLB) estimation as a function of spectral variables, (2) developed a 30 m resolution map of the total living carbon (TLC), and (3) estimated the total TLB stock of the study area. Inventory data consisted of tree measurements from 500 plots in 63 clusters in a 15,700 km² study area, in miombo woodlands of Tanzania. The Landsat 8 data comprised two climate data record images covering the inventory area.

RESULTS

We found a linear relationship between TLB and Landsat 8 derived spectral variables, and there was no clear evidence of spectral data saturation at higher biomass values. The root-mean-square error of the values predicted by the linear model linking the TLB and the normalized difference vegetation index (NDVI) is equal to 44 t/ha (49 % of the mean value). The estimated TLB for the study area was 140 Mt, with a mean TLB density of 81 t/ha, and a 95 % confidence interval of 74-88 t/ha. We mapped the distribution of TLC of the study area using the TLB model, where TLC was estimated at 47 % of TLB.

CONCLUSION

The low biomass in the miombo woodlands, and the absence of a spectral data saturation problem suggested that Landsat 8 derived NDVI is suitable auxiliary information for carbon monitoring in the context of REDD+, for low-biomass, open-canopy woodlands.

Effects on the ATP Content of Cultured Cells after Radiographic Contrast Media Exposure

The ATP content of cultured cells after exposure to meglumine-calcium metrizoate, sodium metrizoate, iohexol, iopamidol and saline was studied. Initially, the ATP content diminished rapidly for a short period and thereafter slowly during the incubation. After incubation with contrast media or saline, the ATP content slowly increased to normal when the cells were reincubated with fresh nutrient medium. Different contrast media and saline with the same final osmolality produced a similar effect on the ATP content of the cultured cells. Cellular association of meglumine-sodium diatrizoate, sodium metrizoate, sodium-iothalamate, iohexol and iopamidol was also examined. The established cell line NHIK 3025 as well as primary cultures of human umbilical endothelium were found to accumulate contrast media in a time-and concentration-dependent manner. When the incubation was carried out at 4°C, the cellular accumulation of contrast medium was less than 35 per cent of that seen at 37°C. It therefore seems that energy-dependent processes are involved to some degree.

Novel Hydraulic Vulnerability Proxies for a Boreal Conifer Species Reveal That Opportunists May Have Lower Survival Prospects under Extreme Climatic Events

Top dieback in 40-60 years old forest stands of Norway spruce [Picea abies (L.) Karst.] in southern Norway is supposed to be associated with climatic extremes. Our intention was to learn more about the processes related to top dieback and in particular about the plasticity of possible predisposing factors. We aimed at (i) developing proxies for P 50 based on anatomical data assessed by SilviScan technology and (ii) testing these proxies for their plasticity regarding climate, in order to (iii) analyze annual variations of hydraulic proxies of healthy looking trees and trees with top dieback upon their impact on tree survival. At two sites we selected 10 tree pairs, i.e., one healthy looking tree and one tree with visual signs of dieback such as dry tops, needle shortening and needle yellowing (n = 40 trees). Vulnerability to cavitation (P 50) of the main trunk was assessed in a selected sample set (n = 19) and we thereafter applied SilviScan technology to measure cell dimensions (lumen (b) and cell wall thickness (t)) in these specimen and in all 40 trees in tree rings formed between 1990 and 2010. In a first analysis step, we searched for anatomical proxies for P 50. The set of potential proxies included hydraulic lumen diameters and wall reinforcement parameters based on mean, radial, and tangential tracheid diameters. The conduit wall reinforcement based on tangential hydraulic lumen diameters ((t/b ht)(2)) was the best estimate for P 50. It was thus possible to relate climatic extremes to the potential vulnerability of single annual rings. Trees with top dieback had significantly lower (t/b ht)(2) and wider tangential (hydraulic) lumen diameters some years before a period of water deficit (2005-2006). Radial (hydraulic) lumen diameters showed however no significant differences between both tree groups. (t/b ht)(2) was influenced by annual climate variability; strongest correlations were found with precipitation in September of the previous growing season: high precipitation in previous September resulted in more vulnerable annual rings in the next season. The results are discussed with respect to an "opportunistic behavior" and genetic predisposition to drought sensitivity.

Monitoring forest carbon in a Tanzanian woodland using interferometric SAR: a novel methodology for REDD

BACKGROUND

REDD+ implementation requires establishment of a system for measuring, reporting and verification (MRV) of forest carbon changes. A challenge for MRV is the lack of satellite based methods that can track not only deforestation, but also degradation and forest growth, as well as a lack of historical data that can serve as a basis for a reference emission level. Working in a miombo woodland in Tanzania, we here aim at demonstrating a novel 3D satellite approach based on interferometric processing of radar imagery (InSAR).

RESULTS

Forest carbon changes are derived from changes in the forest canopy height obtained from InSAR, i.e. decreases represent carbon loss from logging and increases represent carbon sequestration through forest growth. We fitted a model of above-ground biomass (AGB) against InSAR height, and used this to convert height changes to biomass and carbon changes. The relationship between AGB and InSAR height was weak, as the individual plots were widely scattered around the model fit. However, we consider the approach to be unique and feasible for large-scale MRV efforts in REDD+ because the low accuracy was attributable partly to small plots and other limitations in the data set, and partly to a random pixel-to-pixel variation in trunk forms. Further processing of the InSAR data provides data on the categories of forest change. The combination of InSAR data from the Shuttle RADAR Topography Mission (SRTM) and the TanDEM-X satellite mission provided both historic baseline of change for the period 2000-2011, as well as annual change 2011-2012.

CONCLUSIONS

A 3D data set from InSAR is a promising tool for MRV in REDD+. The temporal changes seen by InSAR data corresponded well with, but largely supplemented, the changes derived from Landsat data.

Strategies for clinical implementation of TNM-Immunoscore in resected nonsmall-cell lung cancer

Immunoscore is a prognostic tool defined to quantify in situ immune cell infiltrates and appears highly promising as a supplement to the tumor-node-metastasis (TNM) classification of various tumors. In colorectal cancer, an international task force has initiated prospective multicenter studies aiming to implement TNM-Immunoscore (TNM-I) in a routine clinical setting. In breast cancer, recommendations for the evaluation of tumor-infiltrating lymphocytes (TILs) have been proposed by an international working group. Regardless of promising results, there are potential obstacles related to implementing TNM-I into the clinic. Diverse methods may be needed for different malignancies and even within each cancer entity. Nevertheless, a uniform approach across malignancies would be advantageous. In nonsmall-cell lung cancer (NSCLC), there are several previous reports indicating an apparent prognostic importance of TILs, but studies on TILs in a TNM-I setting are sparse and no general recommendations are made. However, recently published data is promising, evoking a realistic hope of a clinical useful NSCLC TNM-I. This review will focus on the TNM-I potential in NSCLC and propose strategies for clinical implementation of a TNM-I in resected NSCLC.

Modelling atmospheric oxidation of 2-aminoethanol (MEA) emitted from post-combustion capture using WRF-Chem

Carbon capture and storage (CCS) is a technological solution that can reduce the amount of carbon dioxide (CO2) emissions from the use of fossil fuel in power plants and other industries. A leading method today is amine based post-combustion capture, in which 2-aminoethanol (MEA) is one of the most studied absorption solvents. In this process, amines are released to the atmosphere through evaporation and entrainment from the CO2 absorber column. Modelling is a key instrument for simulating the atmospheric dispersion and chemical transformation of MEA, and for projections of ground-level air concentrations and deposition rates. In this study, the Weather Research and Forecasting model inline coupled with chemistry, WRF-Chem, was applied to quantify the impact of using a comprehensive MEA photo-oxidation sequence compared to using a simplified MEA scheme. Main discrepancies were found for iminoethanol (roughly doubled in the detailed scheme) and 2-nitro aminoethanol, short MEA-nitramine (reduced by factor of two in the detailed scheme). The study indicates that MEA emissions from a full-scale capture plant can modify regional background levels of isocyanic acid. Predicted atmospheric concentrations of isocyanic acid were however below the limit value of 1 ppbv for ambient exposure. The dependence of the formation of hazardous compounds in the OH-initiated oxidation of MEA on ambient level of nitrogen oxides (NOx) was studied in a scenario without NOx emissions from a refinery area in the vicinity of the capture plant. Hourly MEA-nitramine peak concentrations higher than 40 pg m(-3) did only occur when NOx mixing ratios were above 2 ppbv. Therefore, the spatial variability and temporal variability of levels of OH and NOx need to be taken into account in the health risk assessment. The health risk due to direct emissions of nitrosamines and nitramines from full-scale CO2 capture should be investigated in future studies.

Forest biomass change estimated from height change in interferometric SAR height models

BACKGROUND

There is a need for new satellite remote sensing methods for monitoring tropical forest carbon stocks. Advanced RADAR instruments on board satellites can contribute with novel methods. RADARs can see through clouds, and furthermore, by applying stereo RADAR imaging we can measure forest height and its changes. Such height changes are related to carbon stock changes in the biomass. We here apply data from the current Tandem-X satellite mission, where two RADAR equipped satellites go in close formation providing stereo imaging. We combine that with similar data acquired with one of the space shuttles in the year 2000, i.e. the so-called SRTM mission. We derive height information from a RADAR image pair using a method called interferometry.

RESULTS

We demonstrate an approach for REDD based on interferometry data from a boreal forest in Norway. We fitted a model to the data where above-ground biomass in the forest increases with 15 t/ha for every m increase of the height of the RADAR echo. When the RADAR echo is at the ground the estimated biomass is zero, and when it is 20 m above the ground the estimated above-ground biomass is 300 t/ha. Using this model we obtained fairly accurate estimates of biomass changes from 2000 to 2011. For 200 m² plots we obtained an accuracy of 65 t/ha, which corresponds to 50% of the mean above-ground biomass value. We also demonstrate that this method can be applied without having accurate terrain heights and without having former in-situ biomass data, both of which are generally lacking in tropical countries. The gain in accuracy was marginal when we included such data in the estimation. Finally, we demonstrate that logging and other biomass changes can be accurately mapped. A biomass change map based on interferometry corresponded well to a very accurate map derived from repeated scanning with airborne laser.

CONCLUSIONS

Satellite based, stereo imaging with advanced RADAR instruments appears to be a promising method for REDD. Interferometric processing of the RADAR data provides maps of forest height changes from which we can estimate temporal changes in biomass and carbon.

Ecologically implausible carbon response?

Magnani et al. present a very strong correlation between mean lifetime net ecosystem production (NEP, defined as the net rate of carbon (C) accumulation in ecosystems) and wet nitrogen (N) deposition. For their data in the range 4.9-9.8 kg N ha(-1) yr(-1), on which the correlation largely depends, the response is approximately 725 kg C per kg N in wet deposition. According to the authors, the maximum N wet deposition level of 9.8 kg N ha(-1) yr(-1) is equivalent to a total deposition of 15 kg N ha(-1 )yr(-1), implying a net sequestration near 470 kg C per kg N of total deposition. We question the ecological plausibility of the relationship and show, from a multi-factor analysis of European forest measurements, how interactions with site productivity and environment imply a much smaller NEP response to N deposition.

Aluminum dynamics in forest soil waters in Norway

We report on weekly aluminum (Al) concentration measurements in soil water from forested catchments monitored throughout Norway since 1986. Originating in acidification research, and thus accompanied by many other chemical variables, they constitute a comprehensive data set suited for analysis of short- as well as long-term variations in a geographic perspective. The Al time series at 21 sites are characterized by high temporal variability, seasonal behavior, and episodic events with peak values in the range 200-800 micromol/l, mostly caused by sea salts blown inland in storms, with a subsequent release of Al after cation exchange. Despite a clear south-north gradient in possible acidification over Norway, we found no indication of such south-north trends in Al chemistry, neither in mean values, maximum values, nor time trends. We identified two main drivers for variation in Al concentrations. The first one was sea salts, where Al was released to the soil solution after cation exchange. The second driver was high production of DOC, where Al was driven into the soil solution by complexation with DOC. There appears to be little risk for aluminum toxicity to trees in Norwegian forests. Except during occasional episodes, aluminum concentrations generally lay far below the supposed threshold values for toxic effects on Norway spruce, Scots pine and birch. Much dissolved aluminum was non-labile, and thus relatively non-toxic. Although the Ca2+/labile Al ratio was often below 1.0, considerable doubt exists as to the applicability of this variable in the field.

Increased Growth Rate of Abdominal Aortic Aneurysms in Women. The Tromsø Study

OBJECTIVES

The present study was undertaken in order to assess the effect of gender on the growth rate of abdominal aortic aneurysms (AAAs).

METHODS

One hundred and eighty-five men and 49 women with AAAs were studied, mean follow-up 62 months, giving 14,544 patient-months of follow-up. A mean of 16 ultrasound examinations was performed on each patient.

RESULTS

The mean growth rate was 1.82; 1.65 and 2.43 mm per year in men and women, respectively. In a weighted linear regression analysis, high initial diameter and female gender were independent and significant (p < 0.001 and p = 0.003, respectively) predictors for increased growth rate of AAAs. None of the other considered risk factors predicted the growth rate.

CONCLUSIONS

This is the first study to report a significantly different growth rate of AAAs in females compared to males. It, thus, adds evidence to the view that AAA is a more malignant condition in females than in males and could have implications for the frequency of follow-up in women.

The difference between ultrasound and computed tomography (CT) measurements of aortic diameter increases with aortic diameter: analysis of axial images of abdominal aortic and common iliac artery diameter in normal and aneurysmal aortas. The Tromsø Study, 1994-1995

OBJECTIVE

To assess agreement between ultrasound and computed tomography (CT) measurements from axial images of normal and aneurysmatic aortic and common iliac artery diameter.

DESIGN

Part of a population health screening for abdominal aortic aneurysm conducted in 1994-1995.

MATERIALS AND METHODS

Three hundred and thirty-four subjects with and 221 subjects without ultrasound-detected aneurysm were scanned with CT. Three technicians and one radiologist measured ultrasonographic diameters and five radiologists measured CT diameters. The paired ultrasound-CT measurement differences were analyzed to assess agreement.

RESULTS

Compared to CT measurements, ultrasound slightly underestimated the diameter in normal aortas and tended to overestimate the diameter in aneurysmal aortas. In 555 ultrasound-CT pairs of measurements, the absolute differences for measurements of maximal aortic diameter were 2 mm or less in 62, 60 and 77% in anterior-posterior, transverse and maximum diameter in any plane, respectively. The corresponding figures for an absolute difference of 5 mm or more were 14, 18 and 8%, respectively. Variability increased with increasing diameter.

CONCLUSIONS

Both ultrasound and CT measurements of abdominal aortic diameter are liable to variability and neither of these methods can be considered to be 'gold standard'. Both methods can be used, while taking variability into consideration when making clinical decisions.

Intra- and interobserver variability in the measurements of abdominal aortic and common iliac artery diameter with computed tomography. The Tromsø study

OBJECTIVES

to assess intra- and interobserver variability in the measurement of aortic and common iliac artery diameter by means of computed tomography (CT).

DESIGN

reproducibility study.

MATERIAL AND METHODS

three radiologists performed measurements of aortic diameter at five different levels and of both common iliac arteries with CT. Fifty-nine subjects were examined, 29 with and 30 without abdominal aortic aneurysms (AAA) as assessed by ultrasound.

RESULTS

intraobserver variability varied between radiologists, measurement plane (anterior-posterior vs transverse) and measurement level. The interobserver variability was markedly higher at the bifurcation than at the suprarenal level and higher than intraobserver variability for measurements at all levels. Both intraobserver and interobserver variability increased with increasing vessel diameter and were largest in patients with AAA. The absolute intraobserver difference of the maximal infrarenal aortic diameter was 2mm or less in 94% of intraobserver pairs. The corresponding interobserver difference was 82%.

CONCLUSIONS

interobserver variability of CT measurements of aortic and common iliac artery diameter is not negligible and should be taken into account when making clinical decisions. When assessing change in aortic diameter, previous CT-scans should be reviewed simultaneously as a routine to exclude interobserver variability.

Time series study of concentrations of SO4(2-) and H+ in precipitation and soil waters in Norway

Along with a steady reduction of acid inputs during 14 years of intensive forest monitoring in Norway, the influence of acid deposition upon soil water acidity is gradually reduced in favour of other and internal sources of H+ and sulphate, in particular from processes in the upper soil layer. We used statistical analyses in two steps for precipitation, throughfall and soil water at 5, 15 and 40 cm depths. Firstly, we employed time series analyses to model the temporal variation as a long-term linear trend and a monthly variation, and by this filtered out residual, weekly variation. Secondly, we used the parameter estimates and the residuals from this to show that the long term, the monthly and the weekly variation in one layer were correlated to similar temporal variation in the above, adjacent layer. This was strongly evident for throughfall correlated to precipitation, but much weaker for soil water. Continued acidification in soil water on many plots suggests that the combined effects of anthropogenic and natural acid inputs exceed in places the buffering capacity of the soil.

Prevalence of and risk factors for abdominal aortic aneurysms in a population-based study : The Tromsø Study

In a population-based study of 6,386 men and women aged 25--84 years in Tromsø, Norway, in 1994--1995, the authors assessed the age- and sex-specific distribution of the abdominal aortic diameter and the prevalence of and risk factors for abdominal aortic aneurysm. Renal and infrarenal aortic diameters were measured with ultrasound. The mean infrarenal aortic diameter increased with age. The increase was more pronounced in men than in women. The age-related increase in the median diameter was less than that in the mean diameter. An aneurysm was present in 263 (8.9%) men and 74 (2.2%) women (p < 0.001). The prevalence of abdominal aortic aneurysm increased with age. No person aged less than 48 years was found with an abdominal aortic aneurysm. Persons who had smoked for more than 40 years had an odds ratio of 8.0 for abdominal aortic aneurysm (95% confidence interval: 5.0, 12.6) compared with never smokers. Low serum high density lipoprotein cholesterol was associated with an increased risk for abdominal aortic aneurysm. Other factors associated with abdominal aortic aneurysm were a high level of plasma fibrinogen and a low blood platelet count. Antihypertensive medication (ever use) was significantly associated with abdominal aortic aneurysm, but high systolic blood pressure was a risk factor in women only. This study indicates that risk factors for atherosclerosis are also associated with increased risk for abdominal aortic aneurysm.

[Curriculum vitae aortae]

The Greek word aorta means lifter. The vessel was so termed because Aristotle, who first described it, assumed that the heart was lifted by/hanging in aorta. Leonardo da Vinci described the detailed anatomy of aorta. During the 17th century our present understanding of the aorta and the circulation of blood took form due to the descriptions given by William Harvey. The first known operation for abdominal aortic aneurysm was performed in London in 1817 by Sir Astley Cooper who ligated the infrarenal aorta above the aneurysm. Puncture with needles and application of electricity were later tried in order to induce thromboses in the aneurysm. In 1948 Albert Einstein was operated with wrapping of his abdominal aneurysm with cellophane. In 1955 he suffered rupture and died after having refused operation. In 1951 the first successful operation for abdominal aortic aneurysm was performed in Paris by Charles Dubost. With slight modifications, the same operative technique is used today.

Intra- and interobserver variability in ultrasound measurements of abdominal aortic diameter. The Tromsø Study

OBJECTIVES

To assess the variability of ultrasonographic measurements at different levels of the abdominal aorta.

DESIGN

Reproducibility study as part of a population health screening for abdominal aortic aneurysm.

MATERIALS AND METHODS

In 1994/1995 a total of 6892 subjects underwent ultrasound examination of the abdominal aorta. Variability of measurements was assessed in the beginning and end of the survey period by inviting 112 randomly selected participants to a second ultrasound scan within 3 weeks of the first scan. The subjects were examined by an experienced radiologist and three sonographers who had been given a short course in ultrasonography. All examiners were blinded to each other's results.

RESULTS

Variability was similar in the beginning and end of the survey period. Both the intra- and interobserver variability were less than 4 mm for all sonographers in measurements of maximal infrarenal aortic diameter, and variability was similar for measurements in the anterior-posterior and transverse plane. Variability was greater for measurements at the renal level than aortic bifurcation level. The radiologist had lower variability than the other sonographers.

CONCLUSION

Ultrasound measurements of the maximal diameter can be obtained with a high degree of accuracy. Inexperienced sonographers may achieve acceptable performance given appropriate training and surveillance.

Crown condition of Norway spruce in relation to sulphur and nitrogen deposition and soil properties in southeast Norway

Atmospheric deposition of sulphur and nitrogen compounds may lead to enhanced leaching of base cations, accumulation of nitrogen in organic matter, lowered pH and increased concentration of toxic aluminium in soil, which in turn may affect the vitality of forest trees. A general monitoring of forest condition has been initiated in many European countries, partly in order to reveal stresses caused by acidification. However, forest condition is also affected by many other factors. This paper examines a seven-year series of crown-condition data from Local County Monitoring Plots in Norway spruce stands in Norway. Average, time trend and lability variables were calculated for crown density and crown colour for each plot. Wet deposition of sulphate, ammonium and nitrate for each plot were estimated using data from the national air and precipitation monitoring programmes. Soil data are based on soil sampling within the plots. The analysis gave no evident support for the hypothesized negative effect on crown condition from sulphur and nitrogen deposition and related alterations in soil.

Beyond empathy: expanding expressions of caring

In this paper, a model describing nurses' responses to patients who are suffering is presented. The nurse's level of engagement with the patient is affected by whether the caregiver is focused on him-/herself or on the sufferer (i.e. embodied with the patient) and whether the caregiver is responding reflexively or with a learned response. Four types of communication patterns are identified: engaged responses (first-level) are used in a connected relationship; when the nurse responses reflexively and is focused on him-/herself, the response is reflected; when the caregiver is patient-focused, a learned response is labelled a professional response; and a self-focused, learned response is labelled detached. Examples of each type of response are provided.

A new protective solution for hypothermic storage of free vein grafts in cardiovascular surgery

In order to reduce the operative injury of the endothelium in free reversed vein grafts, cultured human endothelial cells were used to test the optimal concentration of the constituents of a flushing solution for improved protection of the endothelium. The following solution proved to be the most suitable when tested at 20 degrees C; mannitol 160 mmol l-1, glucose 15 mmol l-1, NaCl 30 mmol l-1, KHCO3 5 mmol l-1, K2SO4 10 mmol l-1, KH2PO4 4 mmol l-1, MgSO4 20 mmol l-1, CaCl2 1.5 mmol l-1, potassium citrate 1.0 mmol l-1, Pluronic F-68 20 mg l-1, HEPES 4 mmol l-1, HEPES-Na 6 mmol l-1, pH 7.25, osmolality 325 mosmol kg-1 H2O. When endothelial cell injury was measured by a 51Cr-release assay, the new solution protected human endothelial cells in culture during hypothermic incubation better than isotonic NaCl, St Thomas' cardioplegic solution or Krebs-Henseleit's buffer. Transmission and scanning electron microscopy showed that the endothelium of human saphenous vein grafts was well preserved following 6 h of incubation at 20 degrees C with the new solution. As determined by morphometry using scanning electron microscopy, the endothelium of free porcine vein grafts was better preserved after incubation for 2 h at 20 degrees C with the new solution than with either isotonic NaCl (p = 0.02) or diluted, heparinized blood (p = 0.02) as the incubation medium, all cases observed following 2 h of subsequent arterial flow. The present study indicates that the endothelium of free vein grafts can be well protected against hypothermia when the flushing and irrigation fluid has a composition favouring endothelial protection. It appears likely that such treatment of vein grafts will reduce the frequency of vein graft narrowing and occlusion, post-operatively.

Comparative analysis of conceptualizations and theories of caring

We delineated and compared various definitions of caring according to the five major conceptualizations of caring: caring as a human trait; caring as a moral imperative; caring as an affect; caring as an interpersonal interaction; and caring as an intervention. The implications of these diverse conceptualizations of caring for nursing practice are identified, and the commonalities, strengths and weaknesses discussed. It is concluded that caring is relatively undeveloped as a concept, has not been clearly explicated and often lacks relevance for nursing practice.

The comforting behaviors of caregivers toward distressed postoperative neonates

The comforting behaviors of nurses caring for four postoperative neonates were examined by analyzing 40 hours of videotaped caregiving. Using the techniques of qualitative ethology, 30 periods of distress were identified. During these periods, 98 episodes of direct tactile and verbal comforting occurred. The types and patterns of comforting touch are delineated. Observations revealed that comforting occurs in response to infant cues, comfort touch had limited effect in settling the infants, infants were often distressed for long periods without being comforted, and the infants were handled as normal infants without regard for their incisions. Suggestions for further research are presented.

Lack of ability to synthesize tissue factor by endothelial cells in intact human saphenous veins

It is well established that cultured endothelial cells are induced to generate tissue factor activity when incubated with either endotoxin or thrombin. In this study a perfusion system was used on 3-4 cm long human saphenous veins. The veins were perfused with thrombin (2.5 U/ml), endotoxin (30 ng/ml) or just medium for 3 h at 37 degrees C. After the perfusion, the veins were treated with collagenase, and EC were collected and subjected to tissue factor activity measurements. Some perfused veins were examined for tissue factor activity on the vessel wall by allowing factor VII and factor X to interact with the lumen of the intact vessels, followed by quantitation of generated factor Xa in a chromogenic assay. No formation of tissue factor activity could be found after perfusion in either collagenase-dissolved endothelial cells or in the coupled chromogenic assay for tissue factor activity performed in the lumen of the vessel. Our data strongly suggest that endothelial cells in intact endothelium may behave quite differently from isolated endothelial cells stimulated in cell cultures.

Effects on the ATP content of cultured cells after radiographic contrast media exposure. Evidence for accumulation of contrast media in cultured cells

The ATP content of cultured cells after exposure to meglumine-calcium metrizoate, sodium metrizoate, iohexol, iopamidol and saline was studied. Initially, the ATP content diminished rapidly for a short period and thereafter slowly during the incubation. After incubation with contrast media or saline, the ATP content slowly increased to normal when the cells were reincubated with fresh nutrient medium. Different contrast media and saline with the same final osmolality produced a similar effect on the ATP content of the cultured cells. Cellular association of meglumine-sodium diatrizoate, sodium metrizoate, sodium-iothalamate, iohexol and iopamidol was also examined. The established cell line NHIK 3025 as well as primary cultures of human umbilical endothelium were found to accumulate contrast media in a time- and concentration-dependent manner. When the incubation was carried out at 4 degrees C, the cellular accumulation of contrast medium was less than 35 per cent of that seen at 37 degrees C. It therefore seems that energy-dependent processes are involved to some degree.

The effects of two different crystalloid cardioplegic solutions on cultured human endothelial cells

The effects on cultured human endothelial cells of incubation with two standard crystalloid cardioplegic solutions (St. Thomas' and Bretschneider's) for one or five hours at 10 degrees C or 20 degrees C were studied. The cells were prelabelled with 51Cr and cell injury was measured by release of 51Cr, cell detachment, and by electron microscopy. The injury was also studied after a rewarming period of 35 minutes in cell culture medium at 37 degrees C. Endothelial cells incubated with cell culture medium, but otherwise treated in a similar way, served as controls. Both cardioplegic solutions caused significantly greater release of 51Cr than cell culture medium when incubated at 10 degrees C or 20 degrees C. The Bretschneider's solution induced slightly more release of 51Cr than did the St. Thomas' solution. The cells did not become detached during incubation. Electron microscopy of the cells after 5 hours with the cardioplegic solutions at 10 degrees C revealed contraction of the cells, mild intracellular oedema, swelling of mitochondria, and blebs or craters on the luminal surface of the cells. After rewarming in culture medium for 35 min the cells were not contracted and showed only minimal signs of injury, indicating a rapid and nearly complete reversibility of the changes. The present observations indicate that cultured endothelial cells get some protection, albeit not optimal, from the two crystalloid cardioplegic solutions tested. The presence of procaine-CL increased the injurious effect of the solutions.

Effect of cooling on the intracellular concentrations of Na+, K+ and Cl- in cultured human endothelial cells

Cooling is accepted as a practical way of lowering cell metabolism in vein grafts during coronary by-pass surgery. We have previously shown that low temperature causes endothelial cells to become detached, both in in vitro and in vein graft. In this study we have looked at the effect of cold on the concentrations of intra- and extracellular electrolytes. Human endothelial cells were grown on titanium grids for electron microscopy. The cells were incubated for 30 min at 37 degrees, 20 degrees, and 4 degrees C with cell culture medium containing human serum, and at 20 degrees and 4 degrees C with heparinized sodium acetate solution with serum, frequently used for flushing and distending vein grafts. Freeze-dried cells were then subjected to elemental X-ray microanalysis. The ambient fluid was analysed by flame photometry. At 20 degrees and 4 degrees C, intracellular concentration of sodium increased, and potassium decreased, compared with controls (37 degrees C). The changes in sodium concentrations were aggravated when cell culture medium was replaced by heparinized sodium acetate. The intracellular chloride concentration did not change when cells were stored in cold cell culture medium. The extracellular concentration of potassium increased with increasing incubation time at 4 degrees C. The connection between these findings and cell detachment is discussed.

Dysplasia in colorectal adenomas related to the presence of O-acylated sialic mucin and to morphometric measurements

In a study of 41 surgically removed colorectal adenomas of unselected size, the dysplasia was graded as mild in 9, as moderate in 22, and severe in 10 cases. Twenty-four of the lesions were classified as tubular adenomas and 17 as tubulo-villous. The presence of O-acylated sialic mucin was for each of the adenomas assessed as normal (19 cases), intermediate (13 cases) or absent (9 cases). The absence of O-acylated mucin was in the present study found to be highly predictive for severe dysplasia (89%). The morphometric measurements of epithelial structures showed that nuclear shape factor and nuclear stratification index were most significantly related to the grades of dysplasia. In a multivariate analysis, the grading of O-cylated sialic mucin most significantly contributed to the grade of dysplasia, and to a lesser degree, nuclear shape factor and nuclear stratification index. The presence of villous elements and the size of the adenomas had no independent influence on the grade of dysplasia in this statistical analysis.

Cold induced endothelial cell detachment in human saphenous vein grafts

The effect of profound (4 degrees C) and moderate cooling (20 degrees C) on the endothelium of human saphenous vein grafts for aortocoronary bypass was studied. When harvesting the vein, a piece (5-6 cm) was taken for the study and divided in two equal parts. The segments were incubated in cell culture medium for 45 minutes at 4 degrees C and 20 degrees C respectively. They were then perfused with cell culture medium at a flow rate of 100 ml/min, with a pressure of 85 mmHg and a temperature of 20 degrees C. After termination of perfusion the percentage of luminal surface without endothelial cells was determined by morphometry with scanning electron microscopy. The veins that were exposed to 4 degrees C had a significantly higher degree of endothelial cell detachment than those exposed to 20 degrees C (p less than 0.003). This study indicates that cooling to 4 degrees C may be harmful to the endothelial lining of veins which are prepared for grafting into the arterial system. Such cooling should therefore probably be avoided.

Dose-response relationships for traffic noise and annoyance

The annoyance due to road traffic noise was studied in 18 areas in five countries. A total of 1379 interviews was performed and noise measurements were made in each area. The relation between Leq and the extent of the population expressing that they were "very annoyed" was poor (rxy = 0.03). An augmentation of the number of heavy vehicles from 1000/24 hr up to greater than 3000/24 hr did not increase the extent of annoyance. The highest correlation was obtained for the maximum noise level. The dose-response relationship implies that the number of events above a certain limit will not increase the extent of annoyance: it is determined by the highest noise level from single vehicles. It is suggested that this model for the human reaction to environmental noise, which has now been demonstrated for aircraft, train, and traffic noise, should be considered for the establishment of standards.

Differences in reactivity of confluent and nonconfluent cultures of human endothelial cells toward thrombin-stimulated platelets or heparinized salt solution

This study examined whether nonconfluent endothelial cell cultures reacted differently than confluent ones toward thrombin-stimulated platelets or a heparinized salt solution. The adherence to the endothelial cell cultures of 51Cr-labeled human platelets stimulated at different thrombin concentrations was studied. There was significantly higher adherence of stimulated platelets to nonconfluent cultures compared with confluent ones. This was confirmed by scanning electron microscopy, which also revealed a tendency for the platelets to adhere at the cell periphery. Electron microscopy also showed that thrombin-stimulated platelets induced endothelial cell contraction. Part of the peripheral endothelial cell surface toward the bottom of the culture dish was inverted, facing the lumen of the dish. This phenomenon was particularly seen in nonconfluent cultures. When 51Cr-labeled endothelial cultures were incubated with a mildly injurious fluid as heparinized sodium acetate and 20% serum, at 20 degrees C for 30 min, the nonconfluent cultures showed significantly more cell detachment and release of 51Cr than the confluent ones. We conclude that under the conditions of the present experiments there are differences in the reactivity of confluent and nonconfluent endothelial cell cultures. These differences probably reflect biological dissimilarities. In experiments where properties of cultured endothelium are studied, care should be taken that the degree of confluency is standardized.