If the stenosis affects subclavian artery, changed hemodynamic sp

If the stenosis affects subclavian artery, changed hemodynamic spectra suggesting subclavian steal syndrome are recorded (Fig. S1 supplementary file). When occlusion of the subclavian artery sets in, in ipsilateral vertebral artery hemodynamic spectra are completely inverse (Fig. S2 supplementary file), and in the contralateral one it is accelerated. Transcranial Doppler of the Willis circle and vertebrobasilar system shows redistribution of the hemodynamics. GCA, is also known as temporal arteritis or cranial arteritis, is the most Selleck ABT199 common form of vasculitis that occurs in adults [8]. Almost all patients who develop GCA are over

the age of 50. It is a granulomas arteritis affecting large or medium-sized artery, usually CP-868596 cost temporal or ophthalmic artery. It has an acute or subacute start. Symptoms are headache, jaw pain, blurred or double vision. If the disease is undiagnosed complications like blindness and, less often, stroke may occur. Standard test for diagnosing GCA is biopsy of the temporal artery. More samples are needed because the inflammation may not occur in all parts of the artery. Prompt treatment with corticosteroids relieves symptoms and prevents loss of vision. Ultrasound finding will show swelling of the arterial wall presenting as a hypoechoic dark halo around the color coded flow in the temporal, ophthalmic artery or external carotid artery [7] and [9]. The disease is segmental, therefore, its

visualization is suitable for new localization of the biopsy. Due to noninvasiveness it is suitable

for monitoring the disease. During healing regression of the dark halo will be visible parallel with the restitution of the color coded flow. Fibromuscular dysplasia (FMD) is a fibrous thickening of the arterial wall, causing segmental narrowing of arteries in the kidneys (in 75% of patients), carotid or vertebral arteries and the arteries of the abdomen [10]. It is an autosomal dominant disorder, affecting up to 5% of the population, in 2/3 the internal carotid artery (ICA), usually the C2 segment. It is usually asymptomatic, but if dissection occurs, it causes aneurysm and occlusion and becomes symptomatic. There are three types of fibromuscular dysplasia: intimal, medial, and subadventitial (perimedial) of the arterial wall. These three types of FMD are not easily differentiated by findings on angiography. The medial type of FMD is by far the most common (about 80–85%) and it is classically diagnosed on the basis of a “string of beads” appearance on angiography. This appearance is explained by the presence of luminal stenosis alternating with aneurysmal dilatation. Classically, the intimal form of FMD is associated with smooth focal stenoses on angiography. Type 1 is the most common form. In 6–12% of patients with arterial fibroplasia, a long tubular stenosis may be seen. This form is most commonly seen with the intimal form.

Van Buren and Fedio (1976) applied DES in 60 Hz pulses with a tot

Van Buren and Fedio (1976) applied DES in 60 Hz pulses with a total duration of 2.5 msec, with a current of 1 mA. Lüders et al. (1987) applied pulses of .3 msec duration in 50 Hz trains of 5–10 sec. For each electrode, the applied current was increased in .5 or 1 mA steps. Stimulation was stopped when i) a response was obtained, ii) after discharges were observed or iii) the arbitrary limit of 15 mA was reached. Most subsequent studies used Dabrafenib datasheet similar stimulation parameters, with

the exceptions of Fried et al. (1991), who applied .1 msec pulses; and Chauvel et al. (1996), who applied pulses of 1 msec duration. The final stimulation current is rarely reported. NMAs will only be found if the electrode of interest

is stimulated during an ongoing action of the appropriate musculature. Moreover, NMAs were not the main interest of many of these studies. In some cases, they are reported anecdotally, as incidental findings. Accordingly, the probability of finding an NMA depends on how many alternative movements GSK2126458 cost the experimenter tries to arrest. Since many of the reported NMAs involve inhibition of a single type of motor response, it seems likely that many possible NMAs may be missed, due to sparse sampling (see Effector specificity, below). Nevertheless, NMAs are surprisingly common, and 3% (Chassagnon et al., 2008) to 35% (Nii et al., 1996) of stimulation sites have been classified as NMAs. A typical procedure involves asking the patient to read a text out loud and then serially stimulating all electrodes (Lüders et al., 1988, Lüders et al., 1992 and Penfield and Jasper, 1954). If and only if speech arrest effects are found, inhibition of other motor actions from the same site is then evaluated. Unsurprisingly therefore, speech arrest is the most frequently reported negative

motor response, while NMAs for non-speech movement are relatively rare. This may represent an artefact of the sampling procedure, ADAMTS5 rather than a fundamental feature of neural organisation of action inhibition. The screening protocol based on reading aloud also overemphasises the overlap between speech and non-speech NMAs, and thus underestimates any actual effector specificity of NMAs. Stimulation at a given cortical site generally produces negative motor responses in a restricted set of muscles only, without affecting the ability to make other voluntary movements (Chassagnon et al., 2008 and Hanakawa et al., 2001; Ikeda et al., 1999, Lim et al., 1994, Mikuni et al., 2006 and Penfield and Rasmussen, 1950). That is, NMAs can sometimes be effector-specific. Negative motor effects are predominantly contralateral. Further, negative motor responses were in some cases stronger and more frequent for distal muscles than for proximal ones, and for fingers as opposed to toes (Lüders et al., 1992). This suggests an effector-specific organisation of motor inhibition.

Sham treatment or ABT-888 was administered 30 minutes prior to ir

Sham treatment or ABT-888 was administered 30 minutes prior to irradiation. Anesthetized mice were imaged with BLI and subsequently transported to the small animal radiation research platform (SARRP). Using the guidance software utility of the SARRP, bioluminescent images were co-registered by manual fusion with CBCT images and the isocenter of the tumor was identified and Epacadostat aligned with the central axis of the beam, as previously described 20. Mice were irradiated with the SARRP using 225 kVp x-ray beams at a dose rate of 2.5 Gy/minute using varying collimator widths adapted to the optical image of the tumor (gross tumor volume) plus a 5 mm radial

margin for set up error (planning target volume). Mice underwent BLI twice per week until day 9 and weekly thereafter to assess tumor response and were humanely euthanized when moribund, if they experienced weight gain or loss in excess of 20% of pre-treatment weight, or if tumor burden increased

more than 10-fold as determined by BLI. Two-tailed Student’s t test was utilized to assess statistically significant differences between groups (P < .05). Kaplan-Meier curve was constructed for survival analysis with log-rank test. The effects of increasing doses of radiation and ABT-888, individually and concurrently, on cell viability were assessed to determine levels of radiation dose-enhancement (Figure 1). Significant reductions in cell viability were seen with single-fraction learn more radiation doses exceeding 2 Gy at 2, 4, 6 and 8 days post-treatment. The IC10, IC20 and IC50 of radiation were calculated

to be 0.5 Gy, 2 Gy and 5 Gy, respectively (Figure 1A, 6 days post-treatment). Increasing doses of ABT-888 had little effect on cell viability until doses exceeding 5 μmol/l were used. The IC10 for treatment with ABT-888 alone was calculated to be 10 μmol/l and this dose was utilized for subsequent in vitro studies ( Figure 1B). Significant radiosensitization was noted when ABT-888 was added to cells irradiated with vehicle alone. Co-treatment with 1 μmol/l, 10 μmol/l and 100 μmol/l of ABT-888 led to radiation dose enhancement factors of 1.29, 1.41 and 2.36 (P < .05), MYO10 respectively ( Figure 1C). Minimal intrinsic cytotoxicity was noted when cells were treated with ABT-888 alone at these same doses. Radiation-induced DNA damage results in relatively immediate activation of PARP and accumulation of ribosylated protein products, such as PAR, primarily through single-strand breaks and BER. Therefore, PARP and PAR protein levels were measured as a function of time to assess the impact of treatment with radiation. An immediate and significant increase was noted in PAR levels following treatment with 10 Gy consistent with single-strand DNA damage, which persisted through the 30 minute time point before returning to control levels (Figure 2A).

In den USA lieferte der Third

In den USA lieferte der Third selleck screening library National Health and Nutrition Examination Survey (NHANES-III) Daten zur Zinkaufnahme (angegeben als Median) bei weißen, dunkelhäutigen und hispanischen US-Amerikanern verschiedenen Alters und Geschlechts ( Tabelle 1) [20]. Ältere Menschen (> 69 Jahre) haben offenbar ein erhöhtes Risiko für Zinkmangel. Dem US Department of Agriculture 1994–1996 Continuing Survey of Food Intakes by Individuals zufolge betrug die mittlere tägliche Zinkaufnahme

bei Männern und Frauen im Alter von > 20 Jahren 13,5 bzw. 9,0 mg [21], bei Männern und Frauen im Alter von ≥ 60 Jahren 12,0 bzw. 8,9 mg [22] und bei Kindern im Alter von < 1 Jahr, 1 – 3 Jahren und 4 – 5 Jahren 6,6, 7,6 bzw. 9,1 mg [23]. Im Rahmen des 2000–2001 United Kingdom National Diet and Nutrition Survey wurden bei Erwachsenen im Alter von 19 – 64 Jahren für die Zinkaufnahme Werte von 10,7 ± 5,7 mg (Männer) und 7,9 ± 3,5 mg (Frauen) ermittelt [24]. Bei britischen Kindern im Alter von 15 – 18 Jahren wurden ähnliche Werte wie bei den Erwachsenen

festgestellt [25], bei Kindern im Alter von 11 – 14 Jahren betrugen sie 7,7 mg (Jungen) bzw. 6,7 mg (Mädchen). Die Einnahme von Nahrungsergänzungsmitteln kann die Zinkaufnahme deutlich erhöhen. In den I-BET-762 clinical trial USA ist die Einnahme von Nährstoffsupplementen weit verbreitet. Der Third National Health and Nutrition Examination Survey zeigt, dass etwa 40% der Bevölkerung Nahrungsergänzungsmittel konsumieren. Bei den Erwachsenen im Alter von ≥60 Jahren nahmen 35 – 41% der Männer und 36 – 45% der Frauen nach aktuellen Standards zu wenig Zink mit

der Nahrung auf, wobei Supplemente die Zufuhr verbesserten [26]. Fast 32% der Kinder im Alter von 24 Monaten erhielten in den USA Supplemente, wobei die Mehrzahl jedoch über die Ernährung GBA3 ausreichend mit den meisten Vitaminen und Mineralstoffen, einschließlich Zink, versorgt war [27]. Dagegen nahmen in Deutschland nur 6% der Kinder zwischen 2 und 18 Jahren ergänzend Mineralstoffe ein [28]. Die Auswirkungen einer Zinksupplementierung bei adäquater Zinkaufnahme mit der Nahrung sind noch nicht ausreichend verstanden und werden weiter unten diskutiert. In vielen Ländern ist die durchschnittliche Zinkaufnahme zwar ausreichend, dennoch gibt es in allen Bevölkerungen Untergruppen mit einem Risiko für Zinkmangel. Einige der Faktoren, die dazu beitragen, sind Armut, eingeschränkte Versorgung mit Nahrungsmitteln und Ernährungsgewohnheiten. Verbreiteter Zinkmangel hat ernste Auswirkungen auf Gesundheit und Leistungsfähigkeit. Daher ist die Verhütung des Zinkmangels eine bedeutende Herausforderung. Die Zinkversorgung ist abhängig von der Menge und der Bioverfügbarkeit des Zinks in der Nahrung. Der Zinkgehalt einiger in den USA gängiger Lebensmittel variiert um wenigstens eine Größenordnung [28]. Weltweit sind für die meisten Menschen Hülsenfrüchte und Getreide die wichtigsten Zinkquellen [30].

Fishers average weekly takings after fuel costs, ranged from $US

Fishers average weekly takings after fuel costs, ranged from $US 450 to 3150 for fish ($US 1671±730) and from $US 210 to 1753 for lobster ($US 836±458), highlighting the profitability of fishing in Anguilla. The most recent hurricanes

that severely impacted Anguilla are hurricanes Luis in 1995 and Lenny in 1999. Hurricane Lenny caused significant flooding and damage to land-based infrastructure, but less impact at sea or on the fishing community. Consequently, when recounting impacts suffered from hurricanes, respondents CDK activation predominantly focused their responses to the effects of hurricane Luis (Table 1). The accuracy of these recollections may be enhanced by both the age of these fishers and that many were fishing during hurricane Luis, in addition to the general significance of hurricane Luis for the whole island. The majority of respondents (75%) lost gear (fish and/or lobster traps) as a consequence of hurricane Luis, with losses per fisher ranging from 13 to 250 (mean±SD, 86±67) traps. The combination of lost gear and the impact of the hurricane on hotels meant that fishers were unable to fish for at least two months (Table 1),

although one fisher stated he did not return to fishing for approximately three years. Respondents stated that the Anguilla government provided some financial assistance to the fishing community by giving each

fisher three traps to re-start fishing, and offering subsidies on wire mesh and buoys to help fishers rebuild traps. In addition to the substantial financial MK-2206 in vivo impacts accrued, six respondents stated that the fishing grounds had been altered by the hurricane. Another six respondents mentioned that the fishing grounds had been completely destroyed. All respondents continued to fish after the devastation of this hurricane, even though some took several years to return to fishing. It would appear that, despite the destruction of the Lepirudin hurricane, fishing remained a viable occupation, and the profitability of fishing in Anguilla will likely have influenced the decision of these fishers to continue fishing. The personal and cultural ties that fishers have with their occupation, their ‘fisher ethic’, may provide an additional explanation for why fishers continued to fish after hurricane Luis. When asked why they fished, 63% (n=15/24) of respondents stated their motive was because of an ingrained cultural or personal desire to fish. By comparison, fewer respondents (33%, n=8/24) mentioned the financial motivation. Examples of respondent response categories and selected quotes illustrating ‘fisher ethic’ are shown in Table 2. The impact of hurricane Luis was manifest in seasonal changes in the fishing practices on Anguilla.

° mês pós-operatório, identificou metastização pulmonar bilateral

° mês pós-operatório, identificou metastização pulmonar bilateral. Realizou protocolo de quimioterapia (5-fluorouracil) durante 6 meses, encontrando-se, neste momento, assintomático. A prevalência dos tumores do intestino delgado é significativamente Copanlisib inferior comparativamente à dos tumores do cólon. No entanto, e apesar de ainda não ser completamente conhecida, a carcinogénese do adenocarcinoma primário do intestino delgado segue

os princípios fundamentais da sequência adenoma-carcinoma inicialmente descrita para os tumores do cólon7. Esta sequência é caracterizada por múltiplas etapas em que ocorrem alterações genéticas e epigenéticas envolvendo a ativação de oncogenes e inativação de antioncogenes. No doente apresentado, a peça cirúrgica confirmou a presença de uma neoplasia com 6,5 cm de maior eixo, composta por adenocarcinoma invasor de baixo grau e adenoma tubuloviloso com displasia de alto grau, em provável relação com a evolução previamente mencionada. A sintomatologia associada a este tipo de patologia é bastante inespecífica, podendo o doente permanecer assintomático até o tumor atingir

grandes dimensões. Náuseas, vómitos, dor abdominal, emagrecimento e sinais e sintomas compatíveis com hemorragia digestiva (melenas, anemia por deficiência de ferro)8, podem constituir o quadro de apresentação dos tumores do duodeno. A icterícia pode ser o principal sintoma quando o tumor se localiza numa região periampular, obstruindo a via biliar distal. A duração média dos sintomas antes do diagnóstico é de 10 meses9. A investigação diagnóstica deste tipo de neoplasias deverá ser individualizada, não existindo recomendações de learn more consenso relativamente à sequência de exames a realizar perante a suspeita clínica de um tumor do intestino delgado. A avaliação endoscópica através de esofagogastroduodenoscopia (sensibilidade de 88%), com Farnesyltransferase realização de biopsias para confirmação histológica caso seja identificada uma lesão, é um dos procedimentos de eleição na maior parte dos casos. Assim, e como habitualmente o limiar de inserção máxima na EDA é a segunda porção duodenal, deverá ser tentada uma inserção mais profunda, procurando

alcançar o ângulo de Treitz ou mesmo o jejuno proximal, sempre que o doente apresente sintomatologia sugestiva, nomeadamente enfartamento pós-prandial, vómitos e emagrecimento significativo. Esta manobra, nem sempre exequível, torna-se ainda mais premente quando há evidência endoscópica de estase gástrica. Na última década foram introduzidas novas modalidades endoscópicas que permitem uma melhor avaliação do intestino delgado, como a videocápsula e a enteroscopia de duplo balão. Os estudos imagiológicos, nomeadamente a enteroclise/enterografia por TC ou ressonância magnética também desempenham um papel importante na avaliação dos doentes com suspeita de lesões do intestino delgado. No caso concreto da TC, a mesma será sempre necessária para o estadiamento e planeamento terapêutico.

In the

coastal zone, tourism, road transportation and rec

In the

coastal zone, tourism, road transportation and recreation are major uses. According to IPCC (2007) and Lionello et al. (2010), the study area is a climate change hotspot, especially vulnerable to the increased sea surface temperature (SST) caused by greenhouse gas emissions. Parada & Canton (1998) found that 1993 satellite thermal this website images of the Alboran Sea indicated that the western Alboran anticyclonic gyre was an important feature; they also found seasonal SST variation over the Alboran Sea. Marullo et al. (1999) stated that the eastern Mediterranean SST is defined by two extreme distribution patterns, i.e. winter (zonal) and summer (meridional) patterns, with a transition period between them. They also identified permanent SST features in the eastern Mediterranean Sea (e.g. the Cretan Cyclone and Pelops Anticyclone). Their analysis was based on advanced very-high-resolution radiometer (AVHRR) weekly data with a spatial resolution of 18 km. Leitz (1999) demonstrated that the Ionian Sea is characterised by strong seasonal variability with a mesoscale structure. Skliris et al. (2011) stated that the Aegean SST clearly increased southwards, partly check details due to exchange with cold Black Sea water

through the Dardanelles Strait and with warm Levantine water through the Cretan Arc Straits. D’Ortenzio et al. (2000) analysed AVHRR SST data from 1985 to 1996 and found no significant trend in the Mediterranean SST. Based on in situ observations, Lelieveld et al. (2002) claimed that the Mediterranean SST had cooled significantly from 1970 to 1980 and then warmed significantly (i.e. 0.03°C yr− 1) up to 2000. On the basis of satellite observations from 1985 to 2006, Nykjaer (2009) claimed that the Mediterranean SST had warmed by a significant 0.03 and 0.05 °C yr− 1 in the western and eastern Mediterranean sub-basins, respectively, most markedly in June and in the Tyrrhenian sub-basin. Skliris et

al. (2011) demonstrated during that the Aegean SST displayed a general annual warming trend of 0.045 °C yr− 1 over the 1985-2008 period, especially in summer (0.045 °C yr− 1). Skliris et al. (2012) stated that the whole Mediterranean Sea displayed a significant warming trend of 0.037°C yr− 1 from 1985 to 2008, especially in the eastern Mediterranean Sea. However, the warming trend in the Black Sea was much more marked: Ginzburg et al. (2004) noted significant SST warming (i.e. 0.09 °C yr− 1) there from 1980 to 2000, as indicated by night-time satellite observations, while satellite SST data indicated significant warming (0.06 °C yr− 1) from 1982 to 2002 (Belkin 2009). Tsimplis & Rixen (2002), Luterbacher et al. (2004) and Skliris et al. (2011) demonstrated that the eastern Mediterranean SST is negatively correlated with the North Atlantic Oscillation Index (NAOI), which potentially affects water transport over the western Mediterranean Sea (Rixen et al. 2005). In addition, Skliris et al.

Our anchors were stories rather than lectures and were designed t

Our anchors were stories rather than lectures and were designed to be explored by students and teachers”. The anchor characteristics emphasized here and focused on in the present contribution are “active construction”, authenticity

(“realistic contexts”) and a narrative, motivating embedding (“story character”). A particular strength of Anchored Instruction and its BIBF 1120 supplier characteristics is the fact that its idea of situatedness combines fostering of both cognition and motivation: appropriate anchor problems can create meaningful contexts, where motivational and cognitive activation should go hand in hand. 2 Indeed, the benefits of AI were shown in more than a dozen of studies, well summarized in the meta-analysis of Blumschein (2003). A weighted average of explained variance 〈r2〉≈0.14 was found 3 (corresponding to an effect size on the boundary from medium to large, see Cohen, 1988), with values up to r2=0.66 ( Bottge et al., 2002) for solving contextualized problems (a main purpose

AI was invented for). Note, that AI thus offers considerable support for the theoretical expectation (explained in the preceding subsection on “Cognition and Learning”), that story contexts can foster meaningful learning. Moreover, it does so by using the “embedding” form of story contexts (mentioned above), where students are supposed to work and learn with various problems related to the embedded Selleck Forskolin science content. AI has thus both sound theoretical and empirical support, and the NSP approach was strongly inspired by it. Concerning however a broader implementation of its idea, and their further development in classroom practice, there are

some difficulties put forward in particular by both educational researchers and teachers interested in classroom innovation. A first Amylase difficulty with multimedia anchors is the considerable amount of time (and money) necessary for their development, usually far beyond the budgets available in schools. 4 Moreover, in most cases the necessary technological know-how cannot be assumed to be already present, which for broad classroom implementation requires even more unrealistic expenses for training. Two more difficulties teachers are particularly worried about, is the small flexibility of multimedia anchors with respect to curricular and instructional features, and the large extent to which a change of the teaching script is required by AI. A given classroom situation is defined by topics to be covered, length, complexity (and other features) appropriate for the particular class being taught and the like, all of which cannot be easily changed or adapted in videodiscs or other multimedia software (or only at the expense of the large investment of resources as already mentioned). Moreover, the very far-reaching change of the teaching script required by AI is very often not feasible (or desirable) for a given teacher in a given teaching situation.

Another point to be taken into account for the management of the

Another point to be taken into account for the management of the patient is the comprehension of the local bifurcation disease causing the pseudo-occlusion: atherosclerotic processes usually involve longer tracts of the artery, limiting the possibilities

of surgery when the stenosis extends too distally, while a migrating thrombus is usually of smaller size and induces damage of the vessel wall only at the site of adhesion. We have already described the advantages of US in respect to CT and MR to identify carotid occlusions due to cardiac embolism [7] and, in these new cases, US could easily identify uncommon carotid “saddle” thrombi attached to the vessel wall and leaving the distal tract of the vessel

open and without wall disease. Alpelisib concentration Even without strictly click here following stroke guidelines, surgery was performed successfully in one case. The identification with high-resolution US of the embolic source on the plaque surface in case 3 indicated that surgery had to be performed as soon as possible, and not on elective bases. This small case series underline that high-resolution US, even with contrast agents, is a feasible and reliable technique, nowadays commonly diffused in clinical practice, with more and more detailed imaging quality. These better resolution pictures can be of help in reducing operator’s dependency, usually claimed as a major limit of Ribonucleotide reductase US investigations. The detection of dynamic, real-time, aspects “in motion” is a strong potentiality of this technique, to better understand vascular pathophysiology. Moreover, ultrasound can easily differentiated cardiac clots from local thrombosis on a complicated atherosclerotic plaque, with the related clinical implications. All these findings underline the role

of early ultrasound in the management of acute stroke patients. In conclusion, the achievement of his “kingdom” for the patient is linked to the availability of an expert joker, able to obtain the best results from his horse, besides … “saddle problems”. “
“Intravascular papillary endothelial hyperplasia (IPEH) is a relatively uncommon benign and non-neoplastic vascular lesion [1], [2], [3] and [4]. Firstly described by Masson in 1923, as an endothelial proliferation associated with thrombosis and fibrin deposition, leading to obliteration of the vascular lumen [1], [2], [3] and [4]. Histologically it is characterized by the presence of endothelium-lined papillary structures composed by a single layer of plump cells around a fibrin core that sometimes forms irregular anatomizing clefts, simulating an angiosarcoma [5], [6], [7] and [8]. However, the absence of cellular polymorphism, mitotic activity and necrosis represent a differential feature of IPEH [5]. The prognosis of this lesion is excellent, and recurrence is an unusual finding.

Major beaches in the Polish part of the lagoon are Stepnica, Trze

Major beaches in the Polish part of the lagoon are Stepnica, Trzebież, Czarnocin, Lake Nowowarpieńskie and Wolin. The municipalities differ considerably in terms of population and income. The municipalities with the highest income are the tourism resorts located on the Baltic Sea coast. Municipalities around the lagoon have an income below the national average mainly from farming, light industry and commerce. However, tourism is still growing and of increasing importance. Especially the fast development of marinas in the lagoon with about 2 400 mooring spaces is one indicator (10 marinas on the Polish side

with altogether about 600 mooring spaces as well as 14 marinas in the German part of the lagoon) (Steingrube et al., 2004). The regional plan by the Marshal of Zachodniopomorskie Voivodship click here suggests the creation of a West Pomeranian Sailing Route covering Lumacaftor mouse the lagoon and the Baltic. It includes new sport boat harbours and the modernization of existing ones. For a further development of tourism around the lagoon a good water quality is imperative. During recent years, the Oder/Odra estuary faced many problems with microorganisms. A Salmonella pollution event in the sea-side resort Miedzyzdroje caused a beach closing for more than 4 weeks during high-season in August 2008. High concentrations of V. vulnificus were frequently found in Karlshagen, Island of Usedom

and in Lubmin, Greifswald Bodden. In 2009, the maximum was above 1 million germs per litre in Lubmin. In 2003, PD184352 (CI-1040) 2010 bathers died after a vibrion infection and in 2006, three people fell ill but and were saved only by fast application of antibiotics (LAGUS pers. com). However, most common are problems due to high concentrations of coliform, E. coli and Enterococci bacteria. In the past, coliform bacteria often caused a closing of beaches according to EU Bathing Water Quality Directive (76/160/EEC), e.g. in Stepnica (from 08.08.2006 for 25 days; from 19.07.2006 for 15 days), in Trzebież (from 01.08.2006 for 42 days; from 20.07.2007 for 42 days; from 24.07.2008

for an unknown period) and in Czarnocin (from 27.07.2006 for 50 days; from 10.07.2007 for 35 days and from 01.08. 2008 for an unknown number of days). Data on bathing water quality in Poland are publicly provided by the Chief Sanitary Inspectorate. Data on local bathing water quality are also available on the websites of public health services. Insufficiently treated sewage water is the most important reason for microbial problems and caused serious water quality problems in the lagoon during the last decades. Today the situation is improving because 288 million Euros have recently been invested in sewage treatment plants around the city of Szczecin, which is the major centre and located at the Odra river, north of the lagoon.