Stable Gastric Pentadecapeptide BPC 157 Therapy for Primary Abdominal Compartment Syndrome in Rats

Recently, the stable gastric pentadecapeptide BPC 157 was shown to counteract major vessel occlusion syndromes, i.e., peripheral and/or central occlusion, while activating particular collateral pathways. We induced abdominal compartment syndrome (intra-abdominal pressure in thiopental-anesthetized rats at 25 mmHg (60 min), 30 mmHg (30 min), 40 mmHg (30 min), and 50 mmHg (15 min) and in esketamine-anesthetized rats (25 mmHg for 120 min)) as a model of multiple occlusion syndrome. By improving the function of the venous system with BPC 157, we reversed the chain of harmful events. Rats with intra-abdominal hypertension (grade III, grade IV) received BPC 157 (10 µg or 10 ng/kg sc) or saline (5 ml) after 10 min. BPC 157 administration recovered the azygos vein via the inferior–superior caval vein rescue pathway. Additionally, intracranial (superior sagittal sinus), portal, and caval hypertension and aortal hypotension were reduced, as were the grossly congested stomach and major hemorrhagic lesions, brain swelling, venous and arterial thrombosis, congested inferior caval and superior mesenteric veins, and collapsed azygos vein; thus, the failed collateral pathway was fully recovered. Severe ECG disturbances (i.e., severe bradycardia and ST-elevation until asystole) were also reversed. Microscopically, transmural hyperemia of the gastrointestinal tract, intestinal mucosa villi reduction, crypt reduction with focal denudation of superficial epithelia, and large bowel dilatation were all inhibited. In the liver, BPC 157 reduced congestion and severe sinusoid enlargement. In the lung, a normal presentation was observed, with no alveolar membrane focal thickening and no lung congestion or edema, and severe intra-alveolar hemorrhage was absent. Moreover, severe heart congestion, subendocardial infarction, renal hemorrhage, brain edema, hemorrhage, and neural damage were prevented. In conclusion, BPC 157 cured primary abdominal compartment syndrome.

A New Separation Methodology for the Maritime Sector Emissions over the Mediterranean and Black Sea Regions

The aim of this paper is to apply a new lane separation methodology for the maritime sector emissions attributed to the different vessel types and marine traffic loads in the Mediterranean and the Black Sea defined via the European Marine and Observation Data network (EMODnet), developed in 2016. This methodology is implemented for the first time on the Copernicus Atmospheric Monitoring Service Global Shipping (CAMS-GLOB-SHIP v2.1) nitrogen oxides (NOX) emissions inventory, on the Sentinel-5 Precursor Tropospheric Monitoring Instrument (TROPOMI) nitrogen dioxide (NO2) tropospheric vertical column densities, and on the LOTOS-EUROS (Long Term Ozone Simulation—European Operational Smog) CTM (chemical transport model) simulations. By applying this new EMODnet-based lane separation method to the CAMS-GLOB-SHIP v2.1 emission inventory, we find that cargo and tanker vessels account for approximately 80% of the total emissions in the Mediterranean, followed by fishing, passenger, and other vessel emissions with contributions of 8%, 7%, and 5%, respectively. Tropospheric NO2 vertical column densities sensed by TROPOMI for 2019 and simulated by the LOTOS-EUROS CTM have been successfully attributed to the major vessel activities in the Mediterranean; the mean annual NO2 load of the observations and the simulations reported for the entire maritime EMODnet-reported fleet of the Mediterranean is in satisfactory agreement, 1.26 ± 0.56 × 1015 molecules cm−2 and 0.98 ± 0.41 × 1015 molecules cm−2, respectively. The spatial correlation of the annual maritime NO2 loads of all vessel types between observation and simulation ranges between 0.93 and 0.98. On a seasonal basis, both observations and simulations show a common variability. The wintertime comparisons are in excellent agreement for the highest emitting sector, cargo vessels, with the observations reporting a mean load of 0.98 ± 0.54 and the simulations of 0.81 ± 0.45 × 1015 molecules cm−2 and correlation of 0.88. Similarly, the passenger sector reports 0.45 ± 0.49 and 0.39 ± 0.45 × 1015 molecules cm−2 respectively, with correlation of 0.95. In summertime, the simulations report a higher decrease in modelled tropospheric columns than the observations, however, still resulting in a high correlation between 0.85 and 0.94 for all sectors. These encouraging findings will permit us to proceed with creating a top-down inventory for NOx shipping emissions using S5P/TROPOMI satellite observations and a data assimilation technique based on the LOTOS-EUROS chemical transport model.

Over-Dose Lithium Toxicity as an Occlusive-like Syndrome in Rats and Gastric Pentadecapeptide BPC 157

Due to endothelial impairment, high-dose lithium may produce an occlusive-like syndrome, comparable to permanent occlusion of major vessel-induced syndromes in rats; intracranial, portal, and caval hypertension, and aortal hypotension; multi-organ dysfunction syndrome; brain, heart, lung, liver, kidney, and gastrointestinal lesions; arterial and venous thrombosis; and tissue oxidative stress. Stable gastric pentadecapeptide BPC 157 may be a means of therapy via activating loops (bypassing vessel occlusion) and counteracting major occlusion syndromes. Recently, BPC 157 counteracted the lithium sulfate regimen in rats (500 mg/kg/day, ip, for 3 days, with assessment at 210 min after each administration of lithium) and its severe syndrome (muscular weakness and prostration, reduced muscle fibers, myocardial infarction, and edema of various brain areas). Subsequently, BPC 157 also counteracted the lithium-induced occlusive-like syndrome; rapidly counteracted brain swelling and intracranial (superior sagittal sinus) hypertension, portal hypertension, and aortal hypotension, which otherwise would persist; counteracted vessel failure; abrogated congestion of the inferior caval and superior mesenteric veins; reversed azygos vein failure; and mitigated thrombosis (superior mesenteric vein and artery), congestion of the stomach, and major hemorrhagic lesions. Both regimens of BPC 157 administration also counteracted the previously described muscular weakness and prostration (as shown in microscopic and ECG recordings), myocardial congestion and infarction, in addition to edema and lesions in various brain areas; marked dilatation and central venous congestion in the liver; large areas of congestion and hemorrhage in the lung; and degeneration of proximal and distal tubules with cytoplasmic vacuolization in the kidney, attenuating oxidative stress. Thus, BPC 157 therapy overwhelmed high-dose lithium intoxication in rats.

A New Separation Methodology for the Maritime Sector Emissions Over the Mediterranean and Black Sea Regions

The aim of this paper is to apply a new lane separation methodology for the maritime sector emissions attributed to the different vessel types and marine traffic loads in the Mediterranean and the Black Sea defined via the European Marine and Observation Data network (EMODnet), developed in 2016. This methodology is implemented for the first time on the Copernicus Atmospheric Monitoring Service Global Shipping (CAMS-GLOB-SHIP v2.1) nitrogen dioxide (NOX) emissions inventory, on the Sentinel-5 Precursor TROPOspheric Monitoring Instrument (TROPOMI) nitrogen dioxide (NO2) tropospheric vertical column densities and on the LOTOS-EUROS (LOng Term Ozone Simulation – EURopean Operational Smog) chemical transport model simulations. By applying this new, EMODnet-based lane separation method to the CAMS-GLOB-SHIP v2.1 emission inventory, we find that cargo and tanker vessels account for approximately 80% of the total emissions in the Mediterranean, followed by fishing, passenger, and other vessel emissions with contributions of 8%, 7% and 5%, respectively. Tropospheric NO2 vertical column densities sensed by TROPOMI for 2019 and simulated by the LOTOS-EUROS CTM have been successfully attributed to the major vessel activities in the Mediterranean; the mean annual NO2 load of the observations and the simulations reported for the entire maritime EMODnet-reported fleet of the Mediterranean is in satisfactory agreement, 1.26 ± 0.56x1015 molecules cm-2 and 0.98 ± 0.41x1015 molecules cm-2, respectively. The spatial correlation of the annual maritime NO2 loads of all vessel types between observation and simulation ranges between 0.93 and 0.98. On seasonal basis, both observations and simulations show a common variability. The winter-time comparisons are in excellent agreement for the highest emitting sector, cargo vessels, with the observations reporting a mean load of 0.98 ± 0.54 and the simulations of 0.81 ± 0.45x1015 molecules cm-2 and correlation of 0.88. Similarly, the passenger sector reports 0.45 ± 0.49 and 0.39 ± 0.45x1015 molecules cm-2 respectively, with correlation of 0.95. In summertime, the simulations report a higher decrease in modelled tropospheric columns than the observations, however still resulting in a high correlation between 0.85 and 0.94 for all sectors. These encouraging findings will permit us to proceed with creating a top-down inventory for NOx shipping emissions using S5P/TROPOMI satellite observations and a data assimilation technique based on the LOTOS-EUROS chemical transport model.

Selective ensemble methods for deep learning segmentation of major vessels in invasive coronary angiography

Invasive coronary angiography is a primary imaging modality that visualizes the lumen area of coronary arteries for the diagnosis of coronary artery diseases and guidance for interventional devices. In the current practice of quantitative coronary analysis (QCA), semi-automatic segmentation tools require labor-intensive and time-consuming manual correction; this limits their application in the catheterization room. For a more automated QCA, it is necessary to minimize operator intervention through robust segmentation methods with improved predictability. In this study, we introduced two selective ensemble methods that integrated the weighted ensemble approach with per-image quality estimation. In our selective ensemble methods, the segmentation outcomes from five base models with different loss functions were ranked by mask morphology or estimated dice similarity coefficient (DSC). The final output was determined by imposing different weights according to the ranking. The ranking criteria based on mask morphology were determined empirically to avoid frequent types of segmentation errors, whereas the estimation of DSCs was performed by comparing the pseudo-ground truth generated from a meta-learner. In the assessment with 7,426 frames from 2,924 patients, the selective ensemble methods improved segmentation performance with DSCs of up to 93.11\% and provided a better delineation of lumen boundaries near the coronary lesion with local DSCs of up to 94.04\%, outperforming all individual models and hard voting ensembles. The probability of mask disconnection at the most narrowed region could be minimized to <1\%. The robustness of the proposed methods was evident in the external validation. Inference time for major vessel segmentation was approximately one-third, indicating that our selective ensemble methods may allow the real-time application of QCA-based diagnostic methods in routine clinical settings.

Hydatid disease with pseudo-aneurysm formation of the descending thoracic aorta: a case report

Cystic echinococcosis, also known as hydatid disease, rarely occurs in aorta. In this article, we report a rare case of pseudo-aneurysm of the lower descending thoracic aorta communicating with the hydatid cyst; surgical excision was performed with primary repair of aorta. This report emphasizes the need for early diagnosis of hydatid cyst with high index of suspicion in endemic areas, particularly if in the vicinity of a major vessel and aggressive investigations followed by subsequent early treatment before disabling and life-threatening complications occur.

Complete Response in Metastatic Hepatocellular Carcinoma with Cardiac and Lung Involvement via Multimodality Treatment

Background: Until recently, advanced HCC patients with major vessel and cardiac involvement have had an extremely poor prognosis without satisfactory treatment. Case presentation: A 63-year-old Taiwanese male presented with metastatic HCC with RA and IVC thrombi, as well as pulmonary metastases that were successfully treated by multimodal management, encompassed by surgical thrombectomy, concurrent systemic sorafenib and locoregional therapies, and immunotherapy. The patient has achieved a complete response over the past 33 months. Conclusion: Through this case report, which shows a successful outcome via multimodal management, a more aggressive approach should be considered when a patient is expected to tolerate the risks and side effects of various treatments.