Allogeneic hematopoietic SCT as treatment option for patients with mitochondrial neurogastrointestinal encephalomyopathy (MNGIE): a consensus conference proposal for a standardized approach

Allogeneic hematopoietic SCT (HSCT) has been proposed as a treatment for patients with mitochondrial neurogastrointestinal encephalomyopathy (MNGIE). HSCT has been performed in nine patients using different protocols with varying success. Based on this preliminary experience, participants of the first consensus conference propose a common approach to allogeneic HSCT in MNGIE. Standardization of the transplant protocol and the clinical and biochemical assessments will allow evaluation of the safety and efficacy of HSCT as well as optimization of therapy for patients with MNGIE.Bone Marrow Transplantation advance online publication, 3 May 2010; doi:10.1038/bmt.2010.100.

Dégradation des forêts et stock de carbone dans la biomasse épigée de la forêt dense humide de Manompana - Nord Est de Madagascar

L’estimation du stock de carbone contenu dans les forêts peut être effectuée de plusieurs manières. Les méthodes les plus connues sont destructives et nécessitent l’abattage d’un grand nombre représentatif d’arbres. Cette représentativité est difficilement atteinte dans les forêts tropicales, présentant une diversité d’espèces exceptionnelles, comme à Madagascar. Afin d’évaluer le niveau de dégradation des forêts, une étude d'images par télédétection est effectuée au moyen de l’analyse du signal radiométrique, combinée à un inventaire non destructif de biomasse. L’étude de la dynamique du paysage proposé est alors basée sur une correction atmosphérique d’une image SPOT 5, de l’année 2009, et sur une classification semi supervisée de l’occupation des sols, combinant une classification préliminaire non supervisée, un échantillonnage aléatoire des classes et une classification supervisée avec un maximum de vraisemblance. La validation est effectuée à l’aide de points indépendants relevés lors des inventaires de biomasse avec des valeurs du stock de carbone bien précises. La classification non supervisée a permis de ressortir deux classes de forêt dénommées « peu dégradée » et « dégradée ». La première désigne l’état climax (le stock de carbone a atteint une valeur qui varie peu) alors que la seconde est caractérisée par un taux de carbone plus faible que le niveau climax, mais qui peut être atteint sans perturbation. Cette première classification permet alors de répartir les placettes d’inventaire dans chaque classe. La méthode d’inventaire recueille à la fois des données dendrométriques classiques (espèce, densité, hauteur totale, hauteur fût, diamètre) et des échantillons représentatifs de branches et de feuilles sur un arbre. Ces différents paramètres avec la densité de bois permettent d’établir une équation allométrique de laquelle est estimée la biomasse totale d’un arbre et conséquemment de la formation forestière. Par la suite, la classification supervisée a été effectuée à partir d’échantillons aléatoires donnant la valeur de séparabilité des classes, de la classification finale. De plus, les valeurs de stocks de carbone à l’hectare, estimées de chaque placette, ont permis de valider cette classification et d’avoir une évaluation de la précision. La connaissance de ce niveau de dégradation issue de données satellitaires à haute résolution spatiale, combinées à des données d’inventaire, ouvre le champ du suivi interannuel du stock de carbone et subséquemment de la modélisation de la situation future du stock de carbone dans différents types de forêts.

Structural modification of DNA--a therapeutic option in SLE?

Systemic lupus erythematosus (SLE) is an autoimmune disease that affects multiple organs, with glomerulonephritis representing a frequent and serious manifestation. SLE is characterized by the presence of various autoantibodies, including anti-DNA antibodies that occur in approximately 70% of patients with SLE and which contribute to disease pathogenesis. Consequently, immunosuppressive therapies are applied in the treatment of SLE to reduce autoantibody levels. However, increasing evidence suggests that DNA--especially double--stranded DNA-constitutes an important pathogenic factor that is able to activate inflammatory responses by itself in autoimmune diseases. Therefore, modifying the structure of DNA to reduce its pathogenicity might be a more targeted approach for the treatment of SLE than immunosuppression. This article presents information in support of this strategy, and discusses the potential methods of DNA structure manipulation--in light of data obtained from mouse models of SLE--including topoisomerase I inhibition, administration of DNase I, or modification of histones using heparin or histone deacetylase inhibitors.

Deforestation and forest degradation monitoring and assessment of biomass and carbon stock of lowland rainforest in the Analanjirofo region, Madagascar

Madagascar is currently developing a policy and strategies to enhance the sustainable management of its natural resources, encouraged by United Nations Framework Convention on Climate Change (UNFCCC) and REDD. To set up a sustainable financing scheme methodologies have to be provided that estimate, prevent and mitigate leakage, develop national and regional baselines, and estimate carbon benefits. With this research study this challenge was tried to be addressed by analysing a lowland rainforest in the Analanjirofo region in the district of Soanierana Ivongo, North East of Madagascar. For two distinguished forest degradation stages: “low degraded forest” and “degraded forest” aboveground biomass and carbon stock was assessed. The corresponding rates of carbon within those two classes were calculated and linked to a multi-temporal set of SPOT satellite data acquired in 1991, 2004 and 2009. Deforestation and particularly degradation and the related carbon stock developments were analysed. With the assessed data for the 3 years 1991, 2004 and 2009 it was possible to model a baseline and to develop a forest prediction for 2020 for Analanjirofo region in the district of Soanierana Ivongo. These results, developed applying robust methods, may provide important spatial information regarding the priorities in planning and implementation of future REDD+ activities in the area.

Spatial assessment of carbon stocks of living vegetation at the national level in Lao PDR

The international mechanism for Reducing Greenhouse Gas Emissions from Deforestation and Forest Degradation (REDD) supposedly offers new opportunities for combining climate mitigation, conservation of the environment, and socio-economic development for development countries. In Laos REDD is abundantly promoted by the government and development agencies as a potential option for rural development. Yet, basic information for carbon management is missing: to date no knowledge is available at the national level on the quantities of carbon stored in the Lao landscapes. In this study we present an approach for spatial assessment of vegetation-based carbon stocks. We used Google Earth, Landsat and MODIS satellite imagery and refined the official national land cover data to assess carbon stocks. Our study showed that more than half (52%) of carbon stock of Laos is stored in natural forests, but that 70% of this stock is located outside of national protected areas. On the basis of two carbon-centered land use scenarios we calculated that between 30 and 40 million tons of carbon could be accumulated in shifting cultivation areas; this is less than 3% of the existing total stock. Our study suggests that the main focus of REDD in Laos should be on the conservation of existing carbon stocks, giving highest priority to the prevention of deforestation outside of national protected areas.

Continuous flow left ventricular assist devices: a valid option for heart failure patients

Recent outstanding clinical advances with new mechanical circulatory systems (MCS) have led to additional strategies in the treatment of end stage heart failure (HF). Heart transplantation (HTx) can be postponed and for certain patients even replaced by smaller implantable left ventricular assist devices (LVAD). Mechanical support of the failing left ventricle enables appropriate hemodynamic stabilisation and recovery of secondary organ failure, often seen in these severely ill patients. These new devices may be of great help to bridge patients until a suitable cardiac allograft is available but are also discussed as definitive treatment for patients who do not qualify for transplantation. Main indications for LVAD implantation are bridge to recovery, bridge to transplantation or destination therapy. LVAD may be an important tool for patients with an expected prolonged period on the waiting list, for instance those with blood group 0 or B, with a body weight over 90 kg and those with potentially reversible secondary organ failure and pulmonary artery hypertension. However, LVAD implantation means an additional heart operation with inherent peri-operative risks and complications during the waiting period. Finally, cardiac transplantation in patients with prior implantation of a LVAD represents a surgical challenge. This review summarises the current knowledge about LVAD and continuous flow devices especially since the latter have been increasingly used worldwide in the most recent years. The review is also based on the institutional experience at Berne University Hospital between 2000 and 2012. Apart from short-term devices (Impella, Cardiac Assist, Deltastream and ECMO) which were used in approximately 150 cases, 85 pulsatile long-term LVAD, RVAD or bi-VAD and 44 non-pulsatile LVAD (mainly HeartMateII and HeartWare) were implanted. After an initial learning curve, one-year mortality dropped to 10.4% in the last 58 patients.

Bryophyllum pinnatum inhibits detrusor contractility in porcine bladder strips--a pharmacological study towards a new treatment option of overactive bladder

A broad spectrum of synthetic agents is available for the treatment of overactive bladder. Anti-cholinergic drugs show a poor compliance due to side effects. There is an increasing use of plant extracts in medicine. We have therefore investigated the inhibitory effects of leaf press juice from Bryophyllum pinnatum (Lam.) Oken (Kalanchoe pinnata L.) on bladder strips and compared the effects to that of oxybutynin.