Post-Mortem Cardiac 3T Magnetic Resonance Imaging. Visualization of Sudden Cardiac Death?

OBJECTIVES: This study aimed to investigate post-mortem magnetic resonance imaging (pmMRI) for the assessment of myocardial infarction and hypointensities on post-mortem T2-weighted images as a possible method for visualizing the myocardial origin of arrhythmic sudden cardiac death. BACKGROUND: Sudden cardiac death has challenged clinical and forensic pathologists for decades because verification on post-mortem autopsy is not possible. pmMRI as an autopsy-supporting examination technique has been shown to visualize different stages of myocardial infarction. METHODS: In 136 human forensic corpses, a post-mortem cardiac MR examination was carried out prior to forensic autopsy. Short-axis and horizontal long-axis Images were acquired in situ on a 3-T system. RESULTS: In 76 cases, myocardial findings could be documented and correlated to the autopsy findings. Within these 76 study cases, a total of 124 myocardial lesions were detected on pmMRI (chronic: 25; subacute: 16; acute: 30; and peracute: 53). Chronic, subacute, and acute infarction cases correlated excellently to the myocardial findings on autopsy. Peracute infarctions (age range: minutes to approximately 1 h) were not visible on macroscopic autopsy or histological examination. Peracute infarction areas detected on pmMRI could be verified in targeted histological investigations in 62.3% of cases and could be related to a matching coronary finding in 84.9%. A total of 15.1% of peracute lesions on pmMRI lacked a matching coronary finding but presented with severe myocardial hypertrophy or cocaine intoxication facilitating a cardiac death without verifiable coronary stenosis. CONCLUSIONS: 3-T pmMRI visualizes chronic, subacute, and acute myocardial infarction in situ. In peracute infarction as a possible cause of sudden cardiac death, it demonstrates affected myocardial areas not visible on autopsy. pmMRI should be considered as a feasible post-mortem investigation technique for the deceased patient if no consent for a clinical autopsy is obtained.

The EU’s Choice of Regulatory Venues for Trade Negotiations: A Tale of Agency Power?

This article focuses on the EU’s strategy for choosing regulatory venues to negotiate trade agreements. It analyses the existence of a clear venue hierarchy since the late 1990s and the recent change leading to a blurring of any clear preference for using bilateral, inter-regional or multilateral settings. The article challenges domestic explanations of the EU’s choice of venue, stressing the autonomy of the Commission as a major factor. Using a principal-agent framework, it shows that the Commission’s agenda-setting powers, the existence of interest divergence among principals (e.g. Member States, business groups) and the multi-level system facilitate agency.

Assessment of tumor regression of esophageal adenocarcinomas after neoadjuvant chemotherapy: comparison of 2 commonly used scoring approaches.

Histopathologic determination of tumor regression provides important prognostic information for locally advanced gastroesophageal carcinomas after neoadjuvant treatment. Regression grading systems mostly refer to the amount of therapy-induced fibrosis in relation to residual tumor or the estimated percentage of residual tumor in relation to the former tumor site. Although these methods are generally accepted, currently there is no common standard for reporting tumor regression in gastroesophageal cancers. We compared the application of these 2 major principles for assessment of tumor regression: hematoxylin and eosin-stained slides from 89 resection specimens of esophageal adenocarcinomas following neoadjuvant chemotherapy were independently reviewed by 3 pathologists from different institutions. Tumor regression was determined by the 5-tiered Mandard system (fibrosis/tumor relation) and the 4-tiered Becker system (residual tumor in %). Interobserver agreement for the Becker system showed better weighted κ values compared with the Mandard system (0.78 vs. 0.62). Evaluation of the whole embedded tumor site showed improved results (Becker: 0.83; Mandard: 0.73) as compared with only 1 representative slide (Becker: 0.68; Mandard: 0.71). Modification into simplified 3-tiered systems showed comparable interobserver agreement but better prognostic stratification for both systems (log rank Becker: P=0.015; Mandard P=0.03), with independent prognostic impact for overall survival (modified Becker: P=0.011, hazard ratio=3.07; modified Mandard: P=0.023, hazard ratio=2.72). In conclusion, both systems provide substantial to excellent interobserver agreement for estimation of tumor regression after neoadjuvant chemotherapy in esophageal adenocarcinomas. A simple 3-tiered system with the estimation of residual tumor in % (complete regression/1% to 50% residual tumor/>50% residual tumor) maintains the highest reproducibility and prognostic value.

Microbe sampling by mucosal dendritic cells is a discrete, MyD88-independent step in DeltainvG S. Typhimurium colitis.

Intestinal dendritic cells (DCs) are believed to sample and present commensal bacteria to the gut-associated immune system to maintain immune homeostasis. How antigen sampling pathways handle intestinal pathogens remains elusive. We present a murine colitogenic Salmonella infection model that is highly dependent on DCs. Conditional DC depletion experiments revealed that intestinal virulence of S. Typhimurium SL1344 DeltainvG mutant lacking a functional type 3 secretion system-1 (DeltainvG)critically required DCs for invasion across the epithelium. The DC-dependency was limited to the early phase of infection when bacteria colocalized with CD11c(+)CX3CR1(+) mucosal DCs. At later stages, the bacteria became associated with other (CD11c(-)CX3CR1(-)) lamina propria cells, DC depletion no longer attenuated the pathology, and a MyD88-dependent mucosal inflammation was initiated. Using bone marrow chimeric mice, we showed that the MyD88 signaling within hematopoietic cells, which are distinct from DCs, was required and sufficient for induction of the colitis. Moreover, MyD88-deficient DCs supported transepithelial uptake of the bacteria and the induction of MyD88-dependent colitis. These results establish that pathogen sampling by DCs is a discrete, and MyD88-independent, step during the initiation of a mucosal innate immune response to bacterial infection in vivo.

Ueber die Ernährung der Kinder

von Heinrich Nestle

Christlicher Trauwungs-Sermon : sampt der Hochzeit-Predigt, ... Bey der Ehren-Frewden-Trawungs- vnnd Hochzeits-Solennität Deß WolEdlen, Gestrengen vnd Vesten, Herrn Dominici Porß, Fürstl. Hessischen wol-vornehmen Raths ... Vnd der WolEdlen, VielEhrn- vnd Tugendreichen Jungfrawen, Annen-Elisabethen, gebohrnen von Moltzan, vff Grubenhagen, etc. ...

Gehalten von M. Martino Erythropilo, Fürstlichem Hessischem Hoffpredigern daselbsten ...

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 157 - Bestätigung der im Testament verfügten Unterstützung des Berliner Invalidenhauses

u.a.: Eisenbahnfahrt; 1848er Revolution in Frankfurt am Main; Mobilmachung der preussischen Armee; Chemiestudium und Promotion des Sohnes von Carl John; Landwirtschaftliche Akademie in Proskau/Oberschlesien; Kenntnisnahme des preußischen Königs von Schopenhauers Unterstützung; Geheimer Kriegsrat Stricker; Geheimer Hofrat Carl John;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 440 - Eigenhändige Abschrift aus Giordano Bruno

abgedruckt in: Schopenhauer-Jahrbuch 38 (1967), S 170-175

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 534 - Konzeptschrift eines Gutachtens zum geplanten Goethe-Denkmal in Frankfurt am Main

veröffentlicht in: Schopenhauer, Arthur : Arthur Schopenhauers sämtliche Werke - München : Piper - Bd. 16 : Der Briefwechsel Arthur Schopenhauers ; 3, S 268;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 558 - Antwortschreiben von Abraham Ludwig Muhl auf die Zurückweisung des vorgeschlagenen Vergleichs

u.a.: Appell für die Annahme des Vergleichs; Friedrich Soermans;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 559 - Entgegnung von Abraham Ludwig Muhl auf das abgelehnte Vergleichsangebot

u.a.: Friedrich Soermans;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 516 - Antwortschreiben auf die Appellation in der Sache Marquet

u.a.: Caroline Marquet; Carolin Médon;

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 389 - Zwei Bescheide des Königlichen Polizeipräsidiums an Arthur Schopenhauer

3 Seiten

Na 50 Nachlass Arthur Schopenhauer - 'Schopenhauer-Archiv', 867 - Glückwünsche zum Geburtstag

abgedruckt in: Schopenhauer-Jahrbuch 30 (1943), S. 212-213