Postischemia myocardial injury in coronary artery bypass patients (PP6)

PURPOSE

To investigate the reperfusion injury of the myocardium in patients undergoing elective coronary artery bypass surgery (CABG) with cardiopulmonary bypass (CPB), we monitored the blood levels of troponin I (TNI), white blood cells, oxygen radicals, malondialdehyde, and myeloperoxidase seeking to define the relationship between the CABG-induced systemic inflammation and myocardial injury.

MATERIALS AND METHODS

We selected 10 patients undergoing primary CABG with CPB at moderate hypothermia and cardioplegic arrest concomitant with intermittent warm blood cardioplegia. We compared all data with their own baseline values to study the reperfusion injury. After release of the aortic clamp, blood was drawn from the coronary sinus, via a catheter placed through the right atrium. We measured plasma levels of inflammatory mediators, such as malondialdehyde, myeloperoxidase, oxygen radicals, and the myocardium injury parameter of TNI.

RESULTS

Patients showed no difference concerning aortic clamp time. TNI increased significantly at 1, 15, and 30 minutes after the onset of reperfusion. Blood levels of white blood cells, oxygen radicals, malondialdehyde, and myeloperoxidase also increased significantly with reperfusion time.

CONCLUSIONS

Reperfusion of ischemic myocardium induced increased TNI, which may be related to the systemic inflammatory responses induced by ischemia and reperfusion of the myocardium among patients undergoing elective coronary bypass surgery.

Differential profiles of gene expression in grouper Epinephelus coioides, infected with Singapore grouper iridovirus, revealed by suppression subtractive hybridization and DNA microarray

Suppression subtractive hybridization (SSH) was used to generate a subtracted cDNA library enriched with gene transcripts differentially expressed in the spleen of orange-spotted grouper Epinephelus coioides after 5 days of infection with Singapore grouper iridovirus (SGIV). In the forward and reverse-subtracted libraries, 260 and 153 non-redundant expressed sequence tags (EST), respectively, were identified. These annotated genes responding to SGIV infection were grouped into eight gene categories related to immunity, cell structure, transcription-translation, cell signalling, metabolism, mitochondrial proteins, ribosomal proteins and unknown or hypothetical proteins. A DNA microarray containing all the differentially expressed genes was constructed, and the gene expression patterns in different tissues were investigated in virus-infected E. coioides. Of these genes, four associated with the infection processes were identified and further investigated by quantitative real-time PCR. These results provide new insights into the molecular basis of host-pathogen interactions in E. coioides, and will help the development of control strategies against SGIV infection.

A survey of the anti-apoptotic Bcl-2 subfamily expression in cancer types provides a platform to predict the efficacy of Bcl-2 antagonists in cancer therapy

We investigated the mRNA expression levels of all six antiapoptotic Bcl-2 subfamily members in 68 human cancer cell lines using qPCR techniques and measured the ability of known Bcl-2 inhibitors to induce cell death in 36 of the studied tumor cell lines. Our study reveals that Mcl-1 represents the anti-apoptotic Bcl-2 subfamily member with the highest mRNA levels in the lung, prostate, breast, ovarian, renal, and glioma cancer cell lines. In leukemia/lymphoma and melanoma cancer cell lines, Bcl-2 and Bfl-1 had the highest levels of mRNA, respectively. The observed correlation between the cell killing properties of known Bcl-2 inhibitors and the relative mRNA expression levels of anti-apoptotic Bcl-2 proteins provide critical insights into apoptosis-based anticancer strategies that target Bcl-2 proteins. Our data may explain current challenges of selective Bcl-2 inhibitors in the clinic, given that severe expression of Bcl-2 seems to be limited to leukemia cell lines. Furthermore, our data suggest that in most cancer types a strategy targeted to Mcl-1 inhibition, or combination of Bfl-1 and Mcl-1 inhibition for melanoma, may prove to be more successful than therapies targeting only Bcl-2.

Pharmacokinetics of methotrexate in solid tumors

The transport of methotrexate (MTX) into Walker 256 carcinoma (W256) and hepatoma 5123 (H5123) transplanted in rats was investigated after a pulse injection and continuous infusion of the drug. A mathematical model was developed which adequately described the distribution and transport of MTX in both solid tumors. In H5123 the uptake was limited by the amount of drug carried by plasma (flow-limited transport), but in W256 MTX uptake was limited by the rate at which the drug crossed the tissue barriers (tissue-limited transport). Relative uptake by the solid tumors was almost eightfold more efficient with low than with high doses. MTX concentration in tumor interstitial fluid equilibrated with that of plasma in about 50 hr using a micropore chamber with a diffusion coefficient of 0.5 microm/min as sampling device. MTX concentration was higher in resistant than in responsive tumors.

Early Onset of Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) after Allogeneic Haematopoietic Stem Cell Transplantation: Case Report and Review of the Literature

Severe hyponatraemia and syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a rare but fatal complication following stem cell transplantation (SCT). This case report details a patient with early-onset SIADH after allogeneic haematopoietic SCT (allo-HSCT) and reviews the literature on risk factors for the development of this condition. The patient, who had chronic myelogenous leukaemia, developed acute graft-versus-host disease (GVHD) on day 5 after allo-HSCT, which was relieved promptly by steroids. On day 18, he presented with hyponatraemia, which was refractory. Despite intensive restriction of fluid and administration of hypertonic saline, his condition worsened and he died of multiple systemic organ dysfunction. A review of the literature reveals that early-onset SIADH following SCT is insidious, but progresses rapidly. The severity of the disorder is underestimated because of the non-specific clinical features and the lack of effective treatment. Myeloablative conditioning and acute GVHD are two major important predisposing factors in SIADH.

The detecting and clinical value of anti-cyclic citrullinated peptide antibodies in patients with systemic lupus erythematosus

The aim of this article is to compare the prevalence of anti-cyclic citrullinated peptide (anti-CCP) antibodies in systemic lupus erythematosus (SLE) patients with and without arthritis and in patients with rheumatoid arthritis (RA). Anti-CCP antibodies were measured using ELISA in 159 SLE patients with arthritis (12 patients with erosive arthritis), 108 SLE patients without arthritis, 76 RA patients, and 87 healthy subjects (controls). The following had anti-CCP antibodies above the cut-off level (5 U/ml): 27.3% of SLE patients, 42.1% SLE patients with arthritis, 5.6% SLE patients without arthritis, 85.5% RA patients and 1.1% controls. The mean titre of anti-CCP antibodies in the SLE group was much lower than that in the RA group (33 +/- 72 vs. 160 +/- 125 U/ml), but higher in SLE patients with erosive arthritis than those with non-erosive arthritis (221 +/- 88 vs. 32 +/- 42 U/ml). Hand poly-arthritis occurred more frequently in anti-CCP-positive SLE patients with erosive arthritis than those with non-erosive arthritis. Anti-CCP antibodies were prevalent in some SLE patients, more prevalent in SLE patients with arthritis than those without arthritis. Anti-CCP-positive SLE patients were more likely associated with hand poly-arthritis, and high titre of anti-CCP antibodies might be used as a predictor for the complication of erosive arthritis.

Effects of moderately high pressure plus heat on the germination and inactivation of Bacillus cereus spores lacking proteins involved in germination

AIMS

To determine the germination and inactivation of Bacillus cereus spores lacking various germination proteins using moderately high pressure (MHP) and heat.

METHODS

The inactivation and germination of wild-type B. cereus spores in buffer by MHP (150 MPa) at various temperatures, as well as the MHP inactivation and germination of B. cereus spores lacking individual germinant receptors and monovalent cation antiporters, was determined.

RESULTS

Loss of individual germinant receptors had no large effects on spore inactivation or germination, although germination of receptor-deficient spores was generally slightly decreased. Loss of the GerN in particular the GerN and GerT antiporters also decreased spore germination by MHP, especially at 40 and 50 degrees C.

CONCLUSIONS

Both inactivation and germination of B. cereus spores by MHP increased with rise of temperature; however, mutant strains lacking individual germinant receptor had similar levels of germination as compared to wild-type spores. To evaluate the role of germinant receptors in MHP, a strain lacking a large number of germinant receptors is needed.

SIGNIFICANCE AND IMPACT OF THE STUDY

The results of this work may lead to a better understanding of how MHP causes germination of spores of B. cereus.

EPR Study of Mouse Tissues in Search for Adaptive Responses to Low Level Whole-body X-irradiation

Effect of a low dose of whole-body X-irradiation (D1 = 0.075 Gy) of mice on some biochemical changes induced in the spleen and thymus by a subsequent challenge dose (D2 = 1.5 Gy) was studied by electron paramagnetic resonance (EPR). Kunming and SHK mice were used. Concentration of ribonucleotide reductase (RR) in the spleen and thymus of unirradiated Kunming mice was 0.70 and 0.46 microM respectively, and of unirradiated SKH mice--0.37 and 0.21 microM respectively (systematic error 45%). For mice exposed only to the low dose (D1 group), a stimulating effect on RR activity in spleen and thymus was found, while in mice subjected only to the D2 dose (D2 group) activity of the enzyme in the organs decreased considerably 18 h after irradiation. The group of mice irradiated with D1 and D2 doses, given at a 6-h interval (D1 plus D2 group), showed a RR activity in the organs lower than D1 and higher than D2 groups. This finding indicates that there exists an adaptation-like response to a low-dose whole-body irradiation in murine spleen and thymus. This low 'inductive' dose makes the organs' RR less susceptible to inhibition induced by a subsequent challenge dose. Preliminary results showed that the same kind of response is probably a characteristic of the RR content of splenocytes as well as of the rate of thymidine incorporation into splenocytes. 5-Thyml radicals of DNA (TH radicals) induced in whole tissues by gamma-irradiation in vitro at 77 K were also studied. Radiochemical yield of these radicals (4.0 and 5.3 nmol j-1), for spleen and thymus respectively of unirradiated Kunming mice, and 2.3 and 2.6 nmol J-1, for spleen and thymus respectively of unirradiated SHK mice (systematic error 30%), decreased significantly in both organs upon D2 irradiation. This decrease, however, was the consequence of DNA content diminishing upon D2 irradiation rather than change of DNA radiosensitivity: the beta value of TH radicals, i.e. yield of radicals per unit mass of DNA in each organ was equal for the mice from all D1, D1 plus D2, D2 and control groups. The beta values of TH radicals in mouse spleen and thymus were of the same order of magnitude compared with the yield of the single-strand breaks of DNA measured previously in rat organs just after whole-body irradiation, i.e. about 1 x 10(2) (Gy x 10(12) Da)-1.

Cell-free miR-10b and miR-21 as diagnostic biomarkers for malignant effusions

11035

Background: Numerous studies have proved the roles of tissue microRNAs (miRNAs) as biomarkers in cancer diagnosis. Cell-free miRNAs from plasma or serum have been shown to be good biomarkers in the diagnosis of cancers. Here we tried to explore the potential application of cell-free miRNAs as diagnostic biomarkers to discriminate malignant effusions from benign. Methods: To obtain a molecular signature for malignant effusions, a stem-loop real-time PCR was adopted to measure the expression of 23 tumor-related miRNAs. After a pre-screening for discarding low amount miRNAs in 10 samples (5 benign/5 malignant) and a proper internal control was identified, the expression levels of 7 miRNAs were further compared among 74 malignant effusion samples (35 gastric cancer-related ascites and 39 lung cancer-related plural effusions) and 30 benign effusions. miRNAs specifically associated with malignant effusions were derived from a training group (20 malignant/10 benign) and tested in a validation group (54 malignant/20 benign). All samples were confirmed by both pathological and clinical diagnosis. Results: miR-215 was employed as the reference RNA for its abundance and consistence. The expression of miR-10b was significantly different between benign and malignant effusions (P< 0.001). Furthermore, it was showed that miR-10b can distinguish malignant plural effusions with high accuracy (areas under the curve (AUC) of receiver operating characteristic (ROC) curve 0.98, 95% CI, 0.90 to 1.0, P< 0.001), and miR-21 can be used to discriminate malignant ascites (AUC of ROC curve 0.71, 95% CI, 0.56 to 0.83, P= 0.018). Conclusions: In the present study, we demonstrated that cell-free miRNA can serve as a novel diagnostic biomarker in distinguishing malignant from benign effusions.

No significant financial relationships to disclose.

A novel model including CXCR4 and CDK6 as potential predictive marker for docetaxel (doc) sensitivity in gastric cancer (GC)

e15548

Background: A growing body of evidence has shed light on biomarkers for chemotherapeutic agent sensitivity in gastric cancer (GC) treatment. It has been demonstrated β-tubulin Ш (TUBB3) and microtubule associated protein tau (MAPT) might be considered as potential markers for taxanes treatment. However, an integrated predictive model for docetaxel (doc) sensitivity is still needed to customized chemotherapy in gastric cancer. Methods: Doc resistant gastric cancer cell line was established by exposure to gradually increasing doc concentration on an intermittent dosage schedule. Microarray was performed to explore different gene expression levels between parental cells and resistant cells. 11 gastrointestinal cancer cell lines were used to validate gene levels by real-time quantitative PCR as well as doc cytotoxicity. Histoculture drug response assay (HDRA) was adopted to examine doc sensitivity in 25 surgically dissected GC specimens. Discrimination analyses were used to determine which linear combinations of these genes best distinguished responder patients from nonresponder patients by adding one more genes each time. Results: After functional analysis of microarray, a panel of 11 genes were further validated, which resulting 4 genes, CXCR4 (P=0.047), CDK6 (P=0.014), USP15 (P<0.001) and CDH1 (P=0.001) that correlated to the doc sensitivity. The mRNA levels of CXCR4 and CDK6 were significantly higher in resistant GC specimens (P=0.0298, 0.022 respectively). A final response index including 5 genes (CXCR4, CDK6, USP15, TUBB3 and MAPT) showed potential predictive value for doc associated chemotherapy with an accuracy of 84% (P=0.001). Conclusions: A predictive model with five genes for doc therapy was generated and showed novel predictive role in doc sensitivity in GC.

No significant financial relationships to disclose.

Unusual doping dependence of the electronic structure and coexistence of spin-density-wave and superconductor phases in single crystalline Sr1-xKxFe2As2

The nature of the spin-density wave (SDW) and its relation with superconductivity are crucial issues in the newly discovered iron-pnictide superconductors. Particularly, it is unclear whether the superconducting phase and SDW are truly exclusive from each other. We here report splittings of the band structures in Sr1-xKxFe2As2 (x=0, 0.1, 0.18), and their unusual doping dependence. Our data on single crystalline samples prove that the SDW and superconductivity could coexist in iron pnictides.

The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection

OBJECTIVE

To validate and refine two sets of candidate criteria for the classification/diagnosis of axial spondyloarthritis (SpA).

METHODS

All Assessment of SpondyloArthritis international Society (ASAS) members were invited to include consecutively new patients with chronic (> or =3 months) back pain of unknown origin that began before 45 years of age. The candidate criteria were first tested in the entire cohort of 649 patients from 25 centres, and then refined in a random selection of 40% of cases and thereafter validated in the remaining 60%.

RESULTS

Upon diagnostic work-up, axial SpA was diagnosed in 60.2% of the cohort. Of these, 70% did not fulfil modified New York criteria and, therefore, were classified as having "non-radiographic" axial SpA. Refinement of the candidate criteria resulted in new ASAS classification criteria that are defined as: the presence of sacroiliitis by radiography or by magnetic resonance imaging (MRI) plus at least one SpA feature ("imaging arm") or the presence of HLA-B27 plus at least two SpA features ("clinical arm"). The sensitivity and specificity of the entire set of the new criteria were 82.9% and 84.4%, and for the imaging arm alone 66.2% and 97.3%, respectively. The specificity of the new criteria was much better than that of the European Spondylarthropathy Study Group criteria modified for MRI (sensitivity 85.1%, specificity 65.1%) and slightly better than that of the modified Amor criteria (sensitivity 82.9, specificity 77.5%).

CONCLUSION

The new ASAS classification criteria for axial SpA can reliably classify patients for clinical studies and may help rheumatologists in clinical practice in diagnosing axial SpA in those with chronic back pain.

TRIAL REGISTRATION NUMBER

NCT00328068.

Electronic structure and unusual exchange splitting in the spin-density-wave state of the BaFe2As2 parent compound of iron-based superconductors

The magnetic properties in the parent compounds are often intimately related to the microscopic mechanism of superconductivity. Here we report the first direct measurements on the electronic structure of a parent compound of the newly discovered iron-based superconductor, BaFe2As2, which provides a foundation for further studies. We show that the energy of the spin density wave in BaFe2As2 is mainly lowered through exotic exchange splitting of the band structure.

Cardiac transplantation in situs inversus: two cases reports

The challenge of heart transplantation in patients with situs inversus is reconstruction of the systemic venous return. Herein we have presented 2 cases of complex congenital heart disease with atriovisceral situs inversus. Both of the patients shared many common cardiac anomalies, such as a single ventricle, a single AV valve with severe regurgitation, and severe pulmonary stenosis. We completed the venous connection in 2 different ways. In the first case, the donor inferior vena cava (IVC) was anastomosed to the recipient left-sided IVC directly, making the heart slightly counterclockwise rotated. In the second case, the IVC venous reconnection was accomplished by a composite conduit made of recipient right atrium.

Primary role of the barely occupied states in the charge density wave formation of NbSe2

NbSe2 is a prototypical charge-density-wave (CDW) material, whose mechanism remains mysterious so far. With angle resolved photoemission spectroscopy, we recovered the long-lost nesting condition over a large broken-honeycomb region in the Brillouin zone, which consists of six saddle band point regions with high density of states (DOS), and large regions away from Fermi surfaces with negligible DOS at the Fermi energy. We show that the major contributions to the CDW formation come from these barely occupied states rather than the saddle band points. Our findings not only resolve a long-standing puzzle, but also overthrow the conventional wisdom that CDW is dominated by regions with high DOS.

Extending donor source with bench coronary angiography: a case report

This report proposes a safer, economical method to examine the marginal donor heart for a better chance of use, which also delivers comparable image quality of catheterization (CathLab) without creating potential damage to the kidney. Currently the examination of the coronary system mainly relies on the CathLab, which is not commonly accessible, and also results in nephrotoxic effects. Therefore, bench coronary angiography is hereby proposed because it is commonly available and economical as well as able to indicate coronary lesions for surgeons as well as the CathLab study. These benefits altogether provide a better chance to select usable hearts from older donors to help relieve the organ shortage.