Critical leg ischaemia with tissue loss : a challenge for the vascular surgeon

There is a widespread reporting habit of combining the outcomes for patients with rest pain (Fontaine III) and tissue loss (Fontaine IV) under the single category of critical leg ischaemia (CLI). This study focused on patients with ischaemic tissue loss treated with infrainguinal bypass surgery (IBS). All patients included in the study were treated at Helsinki University Central Hospital in 2000-2007. First, ulcer healing time after IBS and factors influencing healing time were prospectively assessed in 2 studies including 148 and 110 patients, respectively. Second,the results of redo IBS were retrospectively evaluated in 593 patients undergoing primary IBS for CLI with tissue loss . Third,long-term outcome were retrospectively analysed in 636 patients who underwent IBS for CLI with tissue loss . Fourth, the outcome of IBS was retrospectively compared with endovascular treatment (PTA) of the infrapopliteal arteries in 1023 CLI patients. Fifth, the influence multidrug resistant Pseudomans aeruginosa (MDR Pa) bacteria contamination in CLI patients treated with IBS was retropectively assessed. Sixty-four patients with positive MDR Pa -culture were matched with 64 MDR Pa - negative controls. Complete ulcer healing rate, including the ischemic ulcers and incisional wounds, was 40% at 6 months after IBS and 75% at one year. Diabetes was a risk factor for prolonged complete ulcer healing time. Ischaemic tissue lesions located in mid-and hindfoot healed poorly. At one year after IBS 50% of the patients were alive with salvaged leg and completely healed ulcers. The absence of gap between tertiary graft patency and leg salvage rates indicates the importance of a patent infrainguinal graft to save a leg with ischaemic tissue loss. Long-term survival for patients with ischaemic tissue loss was poor, 38% at 5 years. Only 30% of the patients were alive without amputation at 5 years. Several of the patient comorbidities increased independently the mortality risk; coronary artery disease, renal insufficiency, chronic obstructive lung disease and high age. When both PTA and bypass is feasible, infrapopliteal PTA as a first-line strategy is expected to achieve similar long-term results to bypass surgery in CLI when redo surgery is actively utilized. MDR Pa in a patient with CLI should be considered as a serious event with increased risk of early major amputation or death. Conclusion: Despite a successful infrainguinal bypass healing of the ischaemic ulcers and incisional wounds ulcer healing is a slow process especially in diabetics. Bypass surgery and PTA improve the outcome of the ischaemic leg but the mortality rate of the patients is high due to their severe comorbidities.

Photosynthesis of ground vegetation in boreal Scots pine forests

Research on carbon uptake in boreal forests has mainly focused on mature trees, even though ground vegetation species are effective assimilators and can substantially contribute to the CO2 uptake of forests. Here, I examine the photosynthesis of the most common species of ground vegetation in a series of differently aged Scots pine stands, and at two clear-cut sites with substantial differences in fertility. In general, the biomass of evergreen species was highest at poor sites and below canopies, whereas grasses and herbs predominated at fertile sites and open areas. Unlike mosses, the measured vascular species showed clear annual cycles in their photosynthetic activity, which increased earlier and decreased later in evergreen vascular species than in deciduous species. However, intraspecific variation and self-shading create differences in the overall level of photosynthesis. Light, temperature history, soil moisture and recent possible frosts could explain the changes in photosynthesis of low shrubs and partially also some changes in deciduous species. Light and the occurrence of rain events explained most of the variation in the photosynthesis of mosses. The photosynthetic production of ground vegetation was first upscaled, using species-specific and mass-based photosynthetic activities and average biomass of the site, and then integrated over the growing season, using changes in environmental factors. Leaf mass-based photosynthesis was highest in deciduous species, resulting in notably higher photosynthetic production at fertile sites than at poor clear-cut sites. The photosynthetic production decreased with stand age, because flora changed towards evergreen species, and light levels diminished below the canopy. In addition, the leaf mass-based photosynthetic activity of some low shrubs declined with the age of the surrounding trees. Different measuring methods led to different momentary rate of photosynthesis. Therefore, the choice of measuring method needs special attention.

New combinations of the fern genus Tectaria (Tectariaceae) for the Flora of China.

For studies on the fern family Tectariaceae for the Flora of China, four species previously treated as Ctenitopsis need new combinations in Tectaria. The new combinations are proposed here and information on their types is provided.

Inhibitory effects of wood extracts on the spoilage flora of marinated poultry meat

Polyphenolic compounds occurring naturally in knotwood of plants are known to have antimicrobial effects. The knots (i.e. the branch bases inside tree stems) and outer branches in pine trees contain a remarkably high concentration of phenolic stilbenes, while lignans are the major phenolic constituents of spruce knots. Large amount of these phenolic compounds can be extracted from wood knots at pulp and paper mills where their presence is undesirable. In Finland, marinating of broiler meat is done not only to increase or add value to the meat, but also to enhance the safety and shelf-life. These products are usually packed under a modified atmosphere for further protection against spoilage microorganisms. However, studies have revealed that addition of marinades to poultry products do not have an inhibitory effect on either some psychrotrophic anaerobic bacteria, such as Brochothrix thermosphacta or lactic acid bacteria associated with spoilage. Also, the activity of pathogenic Campylobacter jejuni is not affected by marinating. The objective of this study was to investigate the inhibitory and lethal activities of extracts from spruce (Picea spp.) and pine (Pinus spp.) knotwood and outer branches that are dissolved in ethanol against the spoilage microorganisms in modified atmosphere packaged marinated broiler products. Modified atmosphere packaged broiler products were separately inoculated with ‘normal’ marinades, marinades with 70% ethanol, marinades with a mixture of spruce and pine extracts dissolved in 70% ethanol or mixture of spruce and pine extracts in powder form. The bacterial colony forming units per gram obtained from each of the samples were analysed on de Man Rogosa and Sharpe agar at days 1, 6, 12 and 15. The results showed that there were significant differences in bacterial colony forming units per gram (P <0.05) between packages with ‘normal’ marinades and packages with extracts added to their marinades on the 12th and 15th day. It can be concluded that the addition of extracts from spruce and pine knotwood to marinades significantly retarded growth of spoilage microorganisms during the 15 day test period. However further research is warranted to characterise and establish the safety and suitability of the compound(s) in spruce and pine knotwood extracts that are responsible for inhibitory or lethal activity against the microbes that may be present in marinated poultry meat.

Wetland flora of Uttara Kannada

Uttara Kannada with its luxuriant tropical climate coupled with heavy rainfall harbours a large number of seasonal wetlands, which are inhabited by diverse wetland plants. These wetland plants are of diverse habitats as they may be aquatic, semiaquatic or of moist soils. Different localities were selected throughout the district and studied for their species composition, diversity, richness across different habitats, families, etc. Many wetland plants were found to be endemic and endangered having many economical uses due to their medicinal properties, edibility, etc.

Sharavathi River Basin Flora Information System(SRFIS)

The INFORMATION SYSTEM with user friendly GUI’s (Graphical user Interface) is developed to maintain the flora data and generate reports for Sharavathi River Basin. The database consists of the information related to trees, herbs, shrubs and climbers. The data is based on the primary field survey and the information available in flora of Shimoga, Karnataka and Hassan flora. User friendly query options based on dichotomous keys are provided to help user to retrieve the data while data entry options aid in updating and editing the database at family, genus and species levels.

A digital herbarium for the flora of Karnataka

A herbarium-based database (virtual herbarium) is a referral system for plants that maximizes the usefulness of the collections. The information content of such a database is essentially built on the voucher specimens that the herbarium has in its care. The present article reports on the construction of a `virtual herbarium' for the state-wide collection of flowering plants in the Herbarium JCB housed at the Centre for Ecological Sciences, Indian Institute of Science, Bangalore, that is expected to be launched soon. The taxonomic data on each species include all information presented on the herbarium specimen label, namely species name, author citation, sub-species if any, variety if any, family, subfamily, collection number, locations, date of collection, habitat and the collector's name. The data further comprise `flora' in which the species are described. Additional information includes the nomenclature update according to `The Plant List', a detailed description, phenology, species distribution, threat status and comments on any special features of the taxon. The live images of the species provided in the database form an information synergy on the species. This initiative is the first of its kind for herbaria in peninsular India.

Análisis de la contribución de los sistemas silvopastoriles a la conservación de la flora y fauna en tres comunidades de la reserva de biósfera Bosawás

El estudio se realizó en tres comunidades del Territorio Miskitu Indian Tasbaika Kum, Reserva de Biósfera BOSAWAS (Shiminka, Boca de Plis y Esperanza), para describir la interacción entre especies de flora y avifauna y su influencia en la conservación de estas especies en las áreas de pastoreo, a partir de tres criterios: 1) cuantificar flora y avifauna, 2) prácticas de manejo tradicional, 3) estimar beneficios económico generado por sistemas de pastoreo. Se establecieron tres puntos de conteo dentro de transeptos para avifauna, se estableció parcelas para muestreo de la vegetación en cada comunidad, se seleccionó una comunidad beneficiada por subproyectos del Proyecto Corazón (MARENA) y dos áreas clasificadas como bosque secundario. Para evaluar el beneficio económi co se aplicó entrevistas abiertas y estructuradas dirigida a propietarios de ganado, para documentar los principales beneficios tangibles e intangibles que la población obtiene de estos agrosistemas. El análisis de resultados se determinó en base a índices de diversidad, dominancia, equidad y similitud; tomando en cuenta la riqueza, abundancia y densidad de especies. Se encontró que para flora Shiminka obtuvo los mayores valores de dominancia lo que indica que se encuentran especies de mayor importancia, Esperanza tiene mayor equidad y diversidad, en Shiminka y Esperanza se necesitan mayores estudios, el análisis de Clúster arrojó que aunque existe alguna concordancia entre Boca de Plis y Shiminka, las tres difieren entre sí y el mismo resultado se encontró para la avifauna; y para fauna mayor equidad en Shiminka y Esperanza, mientras la más diversa resultó Esperanza. La similitud establece que Boca de Plis y Esperanza necesitan mayor intensidad de muestreo.

Flora arvense y ruderal del pacífico y centro de Nicaragua

El texto “Flora Arvense y Ruderal del Pacífico y Centro de Nicaragua” intenta reivindicar éstas especies de plantas. En el pasado, estas especies han sido vilipendiadas al considerárseles perjudiciales en los ecosistemas agrícolas y en áreas aledañas a los mismos. El nombre que se ha usado en el pasado para estas plantas “Malezas” y/o “Malas hierbas”, considera el aspecto nocivo que algunas de estas especies tienen sobre los cultivos, sin considerar, que como componentes propios del ecosistema, se constituyen en elementos importantes que ayudan a la regulación y balance del mismo. El termino arvenses deriva del latín arvensis , que significa campo en el sentido agrícola. Por tanto, las plantas silvestres que crecen en los campos agrícolas se les conoce como plantas arvenses. El estudio de estas plantas ha estado orientado únicamente a evaluar el aspecto nocivo que algunas de éstas tienen sobre los cultivos. En consecuencia, los costos que implica la presencia de algunas han favorecido que el término “maleza” se aplique indiscriminadamente a la vegetación arvense o a todas las especies silvestres que crecen entre los cultivos, independientemente de lo nocivas que éstas sean. Por otra parte, al referirnos a estas plantas como arvenses, significa que la planta crece en forma silvestre en terrenos cultivados sin ninguna connotación respecto a nocividad o bondad de éstas para los agricultores.

Crimes contra a flora : análise sucinta

Consultora Legislativa - Área XI - Meio Ambiente e Direito Ambiental, Organização Territorial, Desenvolvimento Urbano e Regional. Apresenta Quadro comparativo entre os dispositivos do Decreto 6.514/2008 e da Lei de Crimes Ambientais (LCA) que têm a flora como bem tutelado.

Isolation of mineralizing Nestin+ Nkx6.1+ vascular muscular cells from the adult human spinal cord

Background: The adult central nervous system (CNS) contains different populations of immature cells that could possibly be used to repair brain and spinal cord lesions. The diversity and the properties of these cells in the human adult CNS remain to be fully explored. We previously isolated Nestin(+) Sox2(+) neural multipotential cells from the adult human spinal cord using the neurosphere method (i.e. non adherent conditions and defined medium). -- Results: Here we report the isolation and long term propagation of another population of Nestin(+) cells from this tissue using adherent culture conditions and serum. QPCR and immunofluorescence indicated that these cells had mesenchymal features as evidenced by the expression of Snai2 and Twist1 and lack of expression of neural markers such as Sox2, Olig2 or GFAP. Indeed, these cells expressed markers typical of smooth muscle vascular cells such as Calponin, Caldesmone and Acta2 (Smooth muscle actin). These cells could not differentiate into chondrocytes, adipocytes, neuronal and glial cells, however they readily mineralized when placed in osteogenic conditions. Further characterization allowed us to identify the Nkx6.1 transcription factor as a marker for these cells. Nkx6.1 was expressed in vivo by CNS vascular muscular cells located in the parenchyma and the meninges. -- Conclusion: Smooth muscle cells expressing Nestin and Nkx6.1 is the main cell population derived from culturing human spinal cord cells in adherent conditions with serum. Mineralization of these cells in vitro could represent a valuable model for studying calcifications of CNS vessels which are observed in pathological situations or as part of the normal aging. In addition, long term propagation of these cells will allow the study of their interaction with other CNS cells and their implication in scar formation during spinal cord injury.

Úlceras en Extremidades Inferiores de Etiología Vascular y Pie Diabético

En el siguiente trabajo se proporcionará una clasificación detallada de las úlceras vasculares y pie diabético, así como de su fisiopatología y epidemiología, posibles complicaciones, métodos diagnósticos, pautas de prevención y tratamiento, y por último, se añade un apartado, con la finalidad de conseguir la comprensión por parte del lector de la repercusión de las úlceras en la calidad de vida del paciente.