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Dementia with Lewy bodies (DLB) is the second most common form of dementia and is assumed to be often under- or misdiagnosed, especially in early stages. Here we present a complex case of probable DLB with major depression and alcohol and benzodiazepine dependence in which DLB was ruled out initially. This case highlights the challenging diagnostic workup of DLB patients. Core clinical features can be missing and indicative biomarkers can be negative, especially in early stages of the disease. Initially, Fluorodeoxyglucose positron emission tomography as well as neuropsychological assessment were suspicious for a possible DLB diagnosis in our patient while core clinical criteria were missing and the indicative biomarker 123I-FP-CIT SPECT was negative. Follow up was performed two years later and the patients showed several core and supportive clinical features of DLB and 123I-FP-CIT SPECT showed a pathological pattern. Extensive neuropsychological assessment in combination with PET imaging might provide crucial evidence for DLB even in early stages. If neuropsychology and PET imaging point to an early DLB diagnosis careful follow-up should be performed as core symptoms and indicative biomarkers might appear in later stages of the disease. Open-Access-Publikationsfonds 2020 peerReviewed

Mortality of patients with end-stage renal disease tremendously exceeds that of the general population due to excess cardiovascular morbidity. Large middle-sized molecules (LMM) including pro-inflammatory cytokines are major drivers of uremic cardiovascular toxicity and cannot be removed sufficiently by conventional high-flux (HFL) hemodialysis. We tested the ability of plasma from 19 hemodialysis patients participating in a trial comparing HFL with high cut-off (HCO) membranes facilitating removal of LMM to induce calcification in mesenchymal stromal cells (MSC) functioning as vascular progenitors. HCO dialysis favorably changed plasma composition resulting in reduced pro-calcific activity. LMM were removed more effectively by HCO dialysis including FGF23, a typical LMM we found to promote osteoblastic differentiation of MSC. Protein-bound uremic retention solutes with known cardiovascular toxicity but not LMM inhibited proliferation of MSC without direct toxicity in screening experiments. We could not attribute the effect of HCO dialysis on MSC calcification to distinct mediators. However, we found evidence of sustained reduced inflammation that might parallel other anti-calcifying mechanisms such as altered generation of extracellular vesicles. Our findings imply protection of MSC from dysfunctional differentiation by novel dialysis techniques targeted at removal of LMM. HCO dialysis might preserve their physiologic role in vascular regeneration and improve outcomes in dialysis patients.

This work investigates the influence of ammonium ions and the organic load (chemical oxygen demand (COD)) on the UV/chlorine AOP regarding the maintenance of free available chlorine (FAC) and elimination of 16 emerging contaminants (ECs) from wastewater treatment plant effluent (WWTE) at pilot scale (UV chamber at 0.4 kW). COD inhibited the FAC maintenance in the UV chamber influent at a ratio of 0.16 mg FAC per mg COD (kHOCl&ndash, COD = 182 M&minus, 1s&minus, 1). An increase in ammonium ion concentration led to a stoichiometric decrease of the FAC concentration in the UV chamber influent. Especially in cold seasons due to insufficient nitrification, the ammonium ion concentration in WWTE can become so high that it becomes impossible to achieve sufficiently high FAC concentrations in the UV chamber influent. For all ECs, the elimination effect by the UV/combined Cl2 AOP (UV/CC) was not significantly higher than that by sole UV treatment. Accordingly, the UV/chlorine AOP is very sensitive and loses its effectiveness drastically as soon as there is no FAC but only CC in the UV chamber influent. Therefore, within the electrical energy consumption range tested (0.13&ndash, 1 kWh/m3), a stable EC elimination performance of the UV/chlorine AOP cannot be maintained throughout the year.

Netosis in an adult control. In vitro imaging of NETs forming neutrophils with representative images for one control subject. A brightfield image allowed quantification of total cells, SYTOX® Green allowed quantification of NETosis based on size of events and comparison of different stimuli. One representative example of the unstimulated and one PMA stimulated sample is shown. Fiji Software was used to measure NET area. Images of SYTOX® Green stained cells were taken with a Leica DMI 4000 B microscope; exposure time = 170 ms. (PDF 2057 kb)

Monocytic intracellular expression (MFI) of NE and MPO per cell in stroke patients versus controls. Stroke patients were analysed and compared to healthy controls. MPO (A) and NE (B) were measured intracellularly in monocytes using flow cytometry and are expressed in MFI. MPO was measured on the day of stroke admission (d0) and on days 1, 3 and 5 after stroke (d1, d3, d5) (A; ncrtl = 14, nd0 = 14, nd1 = 18, nd3 = 14, nd5 = 16). NE was measured on day 1 (d1) after stroke onset, day 3 (d3) and day 5 (d5) by flow cytometry (B, ncrtl = 10, nd1 = 10, nd3 = 10, nd5 = 10), and the mean and SD ranges are given. ANOVA was used for the data in A and B. (PDF 2057 kb)