Athanasios I. Papadopoulos

Increased values of mean platelet volume and platelet size deviation width may provide a safe positive diagnosis of idiopathic thrombocytopenic purpura.

Introduction: It has been shown recently that platelet indices like mean platelet volume (MPV), platelet size deviation width (PDW) and platelet-to-large-cell ratio (P-LCR) are helpful in the discrimination between hyperdestructive thrombocytopenia like idiopathic thrombocytopenic purpura (ITP) and hypoproductive thrombocytopenia (HT). The aim of the study is to assess the reliability of these indices in the differentiation of ITP from other thrombocytopenias. Methods: We recruited 134 thrombocytopenic patients (69 men, 65 women) who were divided into two groups according to the underlying disease: group I (n = 63) included ITP patients, whereas group II (n = 71) included patients with HT due to myelosuppression secondary to chemotherapy for hematological malignancies. Platelet indices were derived from a Sysmex automated cell counter. Sensitivity, specificity, positive prognostic value, negative prognostic value, efficiency and Youden index were calculated. Results: Concerning MPV and PDW indices, sensitivity, specificity, positive prognostic value, negative prognostic value, efficiency and Youden index were 100% for the diagnosis of ITP. On the contrary, the values for P-LCR were significantly lower. Conclusions: MPV and PDW can be safely relied on for a positive diagnosis of ITP. MPV and PDW were superior to P-LCR.

Alterations of some glutathione S-transferase characteristics during the development of Tenebrio molitor (Insecta: Coleoptera)

Abstract Cytosolic glutathione S-transferase activity was studied in the three developmental stages of Tenebrio molitor . The highest activity towards both CDNB and DCNB was observed in the newly emerged pupae, while towards ethacrynic acid was in the young larvae. The pH optimum of GST activity towards CDNB was 8.5 in larvae and pupae and 8.25 in adults. GSTs operate at a high rate even at pH values 1 or 2 units from their pH optimum. A second lower pH optimum apparently existed in pupae (pH 8). The kinetic parameters (K m and V max ) for both GSH and CDNB were determined in the three developmental stages and showed the total amount of GSTs to be elevated in pupae. Three fractions ( not bound, low affinity and high affinity ) were obtained after GSH-Epoxy activated Sepharose 6B affinity chromatography of larval homogenate. Chromatofocusing of the fractions, in the pH range 7-4, revealed the presence of four isoenzymes. Changes in kinetic properties and substrate specificities of GSTs during development suggest a differential isoenzymic expression between larval and pupal stages, or alternatively, expression of the same isoenzymes at a different percentage. They also indicate a potentially lower importance of GST detoxification system in the adult stage.

Efficient Screening and Selection of Post-combustion CO2 Capture Solvents

We develop an approach for the screening and selection of post combustion CO2 capture solvents using as the performance criteria the molecular and mixture properties associated with thermodynamics, reactivity and sustainability. The proposed approach involves a fast screening stage in which numerous solvents are evaluated based on the simultaneous consideration of pure component properties. Several properties are specifically selected to represent the effects of molecular chemistry on the capture process. A few high-performing solvents are further evaluated using predictive models accounting for the very nonideal mixture behaviour. The prediction of pure component properties is supported by standard group contribution models. The solvent-water-CO2 interactions are represented within the SAFT-VR and SAFT-γ equations of state to predict accurately the mixture vapour-liquid equilibrium behaviour. The proposed developments are tested successfully on a dataset consisting of 126 potential solvent candidates.Alzheimer’s disease (AD) is a progressive neurodegenerative disorder, characterized by irreversible decline of mental faculties, emotional and behavioral changes, loss of motor skills, and dysfunction of autonomic nervous system and disruption of circadian rhythms (CRs). We attempted to describe the morphological findings of the hypothalamus in early cases of AD, focusing our study mostly on the suprachiasmatic nucleus (SCN), the supraoptic nucleus (SON), and the paraventricular nucleus (PVN). Samples were processed for electron microscopy and silver impregnation techniques. The hypothalamic nuclei demonstrated a substantial decrease in the neuronal population, which was particularly prominent in the SCN. Marked abbreviation of dendritic arborization, in association with spinal pathology, was also seen. The SON and PVN demonstrated a substantial number of dystrophic axons and abnormal spines. Alzheimer’s pathology, such as deposits of amyloid-β peptide and neurofibrillary degeneration, was minimal. Electron microscopy revealed mitochondrial alterations in the cell body and the dendritic branches. The morphological alterations of the hypothalamic nuclei in early cases of AD may be related to the gradual alteration of CRs and the instability of autonomic regulation.

On the synthesis and optimization of liquid-liquid extraction processes using stochastic search methods

Abstract This paper addresses the synthesis and optimal design of liquid–liquid extraction processes using stochastic optimization algorithms. The main objective is to comparatively study stochastic optimization algorithms in view of speed and robustness when searching conventional as well as complex process representations for optimal solutions. The work employs a generic representation framework that accounts for simple as well as complex extraction process arrangements. The resulting superstructure formulations encompass all the potential configurations and interconnections that may exist for liquid–liquid extraction systems. The task of optimizing the superstructure is assigned to stochastic optimization algorithms in the form of simulated annealing (SA), genetic algorithms (GA) and ant colony optimization (ACO). The proposed model is applied to different separation problems involving quaternary mixtures. The liquid phase non-idealities are modeled both by highly non-linear correlations and standard thermodynamic methods. All three algorithms have been found to address the problem with success in terms of the quality of the solution found.

A new approach on bullous pemphigoid therapy

Bullous pemphigoid (BP) is the most common subepidermal autoimmune blistering skin disease seen in the elderly. The prognosis of BP is poor, since the 1-year mortality rate has been reported to range from 25% to 40% in recent studies [1]. Corticosteroids have been so far the mainstay of therapy [2]. Antibiotics and immunosuppressants, such as cyclophosphamide and azathioprine, have also been used in order to manage the disease. Prolonged administration of such agents, however, leads to serious adverse effects, resulting in the limitation of available treatment options. Mortality associated with BP is mostly attributed to the effects of the medications [3]. Rituximab is a chimeric murine/human monoclonal antibody against human CD20, an antigen present in normal and malignant B-lymphocytes. This biological agent activates complement-dependent cytotoxicity and binds to human Fc receptors, mediating cell death through antibodydependent cellular toxicity [4]. We report here two cases of BP in patients with chronic lymphocytic leukemia under complete remission, presenting excellent outcome after being treated with rituximab. Patients were female, 58 and 78 years old, respectively. They both appeared with vesiculobullous lesions ranging from 0.5 to 5 cm in diameter. They were distributed in all extremities as well as in the trunk, along with severe pruritus. Skin biopsy demonstrated prominent eoshinophil infiltration at the skin basement membrane area. Direct immunofluorescence (DIF) of perilesional skin was positive, revealing deposition of complement (C3) and immunoglobulins (IgG) in a linear band at the dermal–epidermal junction. Diagnosis was achieved by incubating the patients’ biopsy sample in 1 mol/l salt and repetition of DIF on salt-split skin. Thus, IgG deposits observed on the blister roof. After an initial but ineffective regimen using oral and local H1-antihistamines added to methylprednisolone, rituximab was administrated i.v. at a dosage of 375 mg/m once weekly for 4 weeks. When infusion was completed, no blisters were observed on patients’ skin, the latter being totally free of bullae (Figure 1). Subsequent treatment included one dose of rituximab every 2 months resulting in neither bullae nor serious toxic effects for a follow-up period of 3 years. To our knowledge, rituximab has so far been used only once for the treatment of BP. In this report, rituximab infused in combination with anti-CD25 antibody. The two cases that we present are the first in which rituximab was successfully used as monotherapy in BP. Rituximab seems to be a safe, effective and long-lasting therapy permitting reconsideration of therapeutic strategies for such a potentially fatal disease.

Defective Platelet Aggregation in Myelodysplastic Syndromes

Introduction: Hemorrhagic tendency in patients with myelodysplastic syndrome (MDS) is mainly attributed to thrombocytopenia. However, platelet function in these patients has not been thoroughly investigated. Aim: The aim of our study is to evaluate platelet function in patients with primary MDS. Methods: Platelet function was studied with aggregometry in response to ristocetin, collagen, ADP and adrenaline in 26 MDS patients and 15 healthy individuals. Results: Aggregation was defective in 21 patients (80.7%). Adrenaline was the agonist with the most profound defect (45.9%), followed by ADP (58.7%), whereas aggregation with ristocetin and collagen was at the borderline. Abnormal aggregation to all four agonists was detected in 6 patients (23%). On the contrary, aggregation results were normal in only 5 patients (19.2%). RAEB-t (refractory anemia with excess blasts in transformation) patients were most seriously affected. Conclusions: MDS patients have impaired platelet aggregation in response to one or more stimulants. Platelet aggregation was not statistically different between MDS patients at early stages of the disease (<12 months) and those at later stages (>12 months). Defective platelet aggregation is strongly related to MDS of worse prognosis. None of our patients was detected to have hyperfunctional platelets, defined as platelets aggregating spontaneously. Functional defects in MDS do not elicit hemorrhagic tendency.

Multi-level Design and Selection of Optimum Working Fluids and ORC Systems for Power and Heat Cogeneration from Low Enthalpy Renewable Sources

This work presents a multi-level method for the design and selection of heat exchange working fluids tailored for Organic Rankine Cycle (ORC) systems used in power and/or heat cogeneration from renewable, low enthalpy sources. A systematic methodology is employed supporting the design of optimum working fluid candidates using Computer Aided Molecular Design (CAMD). The performance of the designed fluids is evaluated using ORC models that enable simulation and economic design optimization. In addition to chemical/physical properties the performed evaluation considers working fluid characteristics such as safety (toxicity and flammability) and environmental properties (ozone depletion potential and global warming potential) that are equally important to economic efficiency. The proposed approach is illustrated through a case study involving varying geothermal field conditions employed as energy sources for greenhouse power and heat co-generation.

The Robo-AO software: fully autonomous operation of a laser guide star adaptive optics and science system

Robo-AO is the first astronomical laser guide star adaptive optics (AO) system designed to operate completely independent of human supervision. A single computer commands the AO system, the laser guide star, visible and near-infrared science cameras (which double as tip-tip sensors), the telescope, and other instrument functions. Autonomous startup and shutdown sequences as well as concatenated visible observations were demonstrated in late 2011. The fully robotic software is currently operating during a month long demonstration of Robo- AO at the Palomar Observatory 60-inch telescope.

Computer-aided molecular design and selection of CO2 capture solvents based on thermodynamics, reactivity and sustainability

The identification of improved carbon dioxide (CO2) capture solvents remains a challenge due to the vast number of potentially-suitable molecules. We propose an optimization-based computer-aided molecular design (CAMD) method to identify and select, from hundreds of thousands of possibilities, a few solvents of optimum performance for CO2 chemisorption processes, as measured by a comprehensive set of criteria. The first stage of the approach involves a fast screening stage where solvent structures are evaluated based on the simultaneous consideration of important pure component properties reflecting thermodynamic, kinetic, and sustainability behaviour. The impact of model uncertainty is considered through a systematic method that employs multiple models for the prediction of performance indices. In the second stage, high-performance solvents are further selected and evaluated using a more detailed thermodynamic model, i.e. the group-contribution statistical associating fluid theory for square well potentials (SAFT-γ SW), to predict accurately the highly non-ideal chemical and phase equilibrium of the solvent–water–CO2 mixtures. The proposed CAMD method is applied to the design of novel molecular structures and to the screening of a data set of commercially available amines. New molecular structures and commercially-available compounds that have received little attention as CO2 capture solvents are successfully identified and assessed using the proposed approach. We recommend that these solvents should be given priority in experimental studies to identify new compounds.

Differential diagnosis and treatment of primary, cutaneous, anaplastic large cell lymphoma : not always an easy task

Primary cutaneous anaplastic large cell lymphoma (PC-ALCL) is a rare and distinct neoplasm appearing de novo on the skin. We present a case of a 75-year-old man diagnosed with PC-ALCL in his left femoral region. We describe the morphology of lesions along with the differential diagnosis, treatment, clinical course and prognosis. We further discuss parameters concerning treatment that should be considered when a PC-ALCL is diagnosed. Our case report demonstrates the complexity in classification, staging, differential diagnosis and therapy selection of PC-ALCLs. It is crucial to emphasize the importance of clinical criteria in diagnosing a PC-ALCL in combination with immunohistochemistry.