Pathophysiology of elevated ascites fluid cholesterol in malignant ascites

The existence of marked elevations of ascitic fluid cholesterol has been observed in patients with peritoneal carcinomatosis compared to patients with cirrhosis and has been found useful in differential diagnosis. This finding could be caused by an enhanced movement of plasma lipoproteins into the peritoneal cavity. To test this hypothesis we determined the fasting concentrations of total, high density lipoprotein (HDL)- and low density lipoprotein (LDL)-cholesterol, apolipoprotein-A1 (apo-A1) and apolipoprotein-B (apo-B) in serum and ascites of 17 patients with cirrhosis and 16 patients with peritoneal carcinomatosis. The movement of proteins from plasma to ascites was calculated from the ascites/serum concentration ratios of six different sized proteins with a molecular mass ranging from 54 kDa to 971 kDa. Mean values (mg/dl) for total cholesterol (92.6 vs. 21.0), HDL-cholesterol (15.6 vs. 1.8), LDL-cholesterol (63.4 vs. 16.1), apo-A1 (50.2 vs. 13.6) and apo-B (41.2 vs. 12.9) in ascites were significantly higher in peritoneal carcinomatosis than in cirrhosis. These differences could only partially be explained by the higher serum concentrations of these parameters in peritoneal carcinomatosis, but were mainly due to a lower selectivity for the movement of plasma proteins and lipoproteins into ascites (mean ascites/serum (A/S) ratio: 0.30–0.77) in peritoneal carcinomatosis as compared to cirrhosis (mean ascites/serum ratio: 0.11–0.21). In both groups about 85% of the total cholesterol in serum and ascites consisted of HDL- and LDL-cholesterol. These findings support the hypothesis that elevations in ascitic cholesterol in peritoneal carcinomatosis compared to cirrhosis are mainly caused by the increased movement of plasma HDL and LDL into the peritoneal cavity

Landschappelijke effecten van ontwikkelingen in de landbouw

Ontwikkelingen in de land- en tuinbouw hebben gevolgen voor het Nederlandse landschap. Het Planbureau voor de Leefomgeving wil graag in beeld krijgen waar wat staat te gebeuren. Doel van dit onderzoek is om landsdekkend in kaart te brengen waar tot 2020 welke veranderingen in de landbouw zullen optreden en wat de effecten daarvan zijn op de kwaliteiten van het landschap. Voor het Nederlandse buitengebied is een onderscheid gemaakt naar in totaal 23 landschapstypen, agrarische cultuurlandschappen waarin stedelijke- en natuurgebieden buiten beschouwing zijn gelaten. De typering neemt de indeling naar fysisch geografische regio¿s als uitgangspunt. Verdere differentiatie heeft plaatsgevonden op basis van ontginningsgeschiedenis en schaalkenmerken van het landschap

Natuurgebieden in Europa: bescherming en financiering

In dit werkdocument is informatie verzameld over de bescherming van Europese natuurgebieden (Natura 2000-gebieden en overige beschermde gebieden) en over enkele Europese fondsen, die voor gebiedsbescherming worden gebruikt. Deze informatie is verzameld om inzicht te krijgen in de mate waarin de gebieden beschermd zijn tegen ongewenste veranderingen in landgebruik. Door bestaande indelingen voor gebiedsbescherming (Natura 2000 en IUCN) te combineren met de informatie over de Europese financiële middelen voor deze gebieden wordt een nieuwe indeling van beschermde gebieden gemaakt. Deze indeling zou, na nadere toetsing, gebruikt kunnen worden in modellen als EUruralis ten behoeve van scenario-ontwikkeling op Europees en NUTS 2-niveau

A carbonate-banded iron formation transition in the Early Protorezoicum of South Africa

Seven new and two resurveyed stratigraphic sections through the important carbonate-BIF transition in Griqualand West are presented and compared with six published sections. Lateral correlation within this zone is attempted but the variability was found to be too great for meaningful subdivision. Substantial lithological irregularity is the only unifying character of this zone, for which the new name Finsch Member (Formation) is proposed. Vertical and lateral lithological variations as well as chemical changes across this zone are discussed with reference to environmental aspects. Local and regional considerations lead to the conclusion that fresh water-sea water mixing occurred in a shallowing basin

Numerical Investigation of a Mesoscopic Vehicular Traffic Flow Model Based on a Stochastic Acceleration Process

In this paper a spatial homogeneous vehicular traffic flow model based on a stochastic master equation of Boltzmann type in the acceleration variable is solved numerically for a special driver interaction model. The solution is done by a modified direct simulation Monte Carlo method (DSMC) well known in non equilibrium gas kinetic. The velocity and acceleration distribution functions in stochastic equilibrium, mean velocity, traffic density, ACN, velocity scattering and correlations between some of these variables and their car density dependences are discussed.Comment: 23 pages, 10 figure

Sepsis in cirrhosis: report on the 7th meeting of the International Ascites Club.

Sepsis is a systemic inflammatory response to the presence of infection, mediated via the production of many cytokines, including tumour necrosis factor ¿ (TNF-¿), interleukin (IL)-6, and IL-1, which cause changes in the circulation and in the coagulation cascade. There is stagnation of blood flow and poor oxygenation, subclinical coagulopathy with elevated D-dimers, and increased production of superoxide from nitric oxide synthase. All of these changes favour endothelial apoptosis and necrosis as well as increased oxidant stress. Reduced levels of activated protein C, which is normally anti-inflammatory and antiapoptotic, can lead to further tissue injury. Cirrhotic patients are particularly susceptible to bacterial infections because of increased bacterial translocation, possibly related to liver dysfunction and reduced reticuloendothelial function. Sepsis ensues when there is overactivation of pathways involved in the development of the sepsis syndrome, associated with complications such as renal failure, encephalopathy, gastrointestinal bleed, and shock with decreased survival. Thus the treating physician needs to be vigilant in diagnosing and treating bacterial infections in cirrhosis early, in order to prevent the development and downward spiral of the sepsis syndrome. Recent advances in management strategies of infections in cirrhosis have helped to improve the prognosis of these patients. These include the use of prophylactic antibiotics in patients with gastrointestinal bleed to prevent infection and the use of albumin in patients with spontaneous bacterial peritonitis to reduce the incidence of renal impairment. The use of antibiotics has to be judicious, as their indiscriminate use can lead to antibiotic resistance with potentially disastrous consequences

A Vehicular Traffic Flow Model Based on a Stochastic Acceleration Process

A new vehicular traffic flow model based on a stochastic jump process in vehicle acceleration and braking is introduced. It is based on a master equation for the single car probability density in space, velocity and acceleration with an additional vehicular chaos assumption and is derived via a Markovian ansatz for car pairs. This equation is analyzed using simple driver interaction models in the spatial homogeneous case. Velocity distributions in stochastic equilibrium, together with the car density dependence of their moments, i.e. mean velocity and scattering and the fundamental diagram are presented.Comment: 27 pages, 6 figure

Andalusi Muslims: A Bourdieuian Analysis of Ethnic Group Identity, (881-1110 C.E.)

This work examines ethnic group identities among the Muslim population in the Iberian Peninsula, or al-Andalus, between 881 and 1110 C.E. It specifically addresses three moments in Andalusi history in which ethnic conflict erupted into the political sphere: 1) The revolt of Ibn Hafsun in the late Ninth/early Tenth Century C.E. 2) The collapse of the Umayyad Caliphate in the late Tenth/early Eleventh Century C.E. 3) The arrival of the North African Almoravid dynasty in the late Eleventh/early Twelfth Century C.E. Through an investigation of each period it argues that ethnic categorization in al-Andalus has been under-theorized. The work addresses the complications of religious conversion and the resultant ramifications on religious identity, which, over time, significantly influenced deployable ethnic identities among the Muslim population. It utilizes the theoretical tools of the French social theorist Pierre Bourdieu in order to re-conceptualize the understanding of Andalusi Muslim ethnic group identities. It considers how the role of women and systems of clientage have been underappreciated in the understanding of these identities and through attention to these dynamics argues that Andalusi Muslims created an Andalusi Arab Muslim identity that increasingly unified and strengthened this social group as the political structure around it disintegrated.Religio

Health-Related Quality Of Life And Physical Activity In University Employees

Background: Health-related quality of life (HRQL) reflects an individual’s subjective perception. The relationship between health-related quality of life and physical activity has been investigated in various populations, but is not well-documented in University employees. Additionally, variables such as an individual’s beliefs about physical activity and their satisfaction with functioning at work have yet to be investigated in this population. Little is known about the relationship between HRQL and these variables. Purpose: Evaluate the relationships among multiple measures of HRQL and physical activity in University employees and provide a descriptive picture of the University population. Methods: Participants (N = 324, M age = 41.07 years, sex = 70.6% female) completed an online questionnaire which included the SF-36v2 to measure HRQL. Results: The University employees were primarily sedentary and more physically active in their leisure time compared to time spent at work. HRQL scores were comparable to general population norms, with the Mental Component Score (MCS) being slightly diminished in the employees. A stepwise linear regression analysis indicated that satisfaction with functioning at work was the best predictor for MCS. The best predictor for Physical Component Score (PCS) was beliefs about physical activity. Self-reported physical activity or sedentary activity were not significant predictors for HRQL. Conclusions: The findings support that University employees show differences in MCS and physical activity when compared to the general population, and that beliefs about physical activity and satisfaction with functioning at work are significant variables for predicting HRQL