Potentiation of GM-CSF or GCSF Induced Mobilization of Circulating Progenitor Cells by Pretreatment with IL-3 and Harvest by Apheresis

Recombinant human colony-stimulating factors (CSFs) are increasingly used for mobilizing progenitor cells in the peripheral blood (PB). 7 patients were treated with GM-CSF or GCSF at a dose of 5μg/kg/d for 5 days and after a treatment free interval received another cycle of the same cytokine after pretreatment with IL-3. Pretreatment with 5μg/kg/d of IL-3 for 7 days did not mobilize by itself but significantly potentiated GM-CSF or GCSF induced mobilization of PB progenitor cells in all 5 patients tested. As compared to the mobilization capacity of GM-CSF or GCSF alone, 7 day IL-3 pretreatment potentiated maximum values of CFU-GM by 3.7-6.3 fold in patients receiving GM-CSF (n=2) and by 1.8-3.3 fold in patients receiving GCSF leading to a 10-23 fold increase in numbers of circulating CFU-GM by the combination IL-3/GM-CSF, and a 26-101 fold increase by IL-3/GCSF, respectively. Stem cell apheresis in patients treated with IL-3 + GCSF or GM-CSF yielded enough PB-stem cells to ensure complete engraftment after ablative chemotherapy.

Strong Neutron Pairing in core+4n Nuclei

The emission of neutron pairs from the neutron-rich N=12 isotones ^{18}C and ^{20}O has been studied by high-energy nucleon knockout from ^{19}N and ^{21}O secondary beams, populating unbound states of the two isotones up to 15 MeV above their two-neutron emission thresholds. The analysis of triple fragment-n-n correlations shows that the decay ^{19}N(-1p)^{18}C^{*}→^{16}C+n+n is clearly dominated by direct pair emission. The two-neutron correlation strength, the largest ever observed, suggests the predominance of a ^{14}C core surrounded by four valence neutrons arranged in strongly correlated pairs. On the other hand, a significant competition of a sequential branch is found in the decay ^{21}O(-1n)^{20}O^{*}→^{18}O+n+n, attributed to its formation through the knockout of a deeply bound neutron that breaks the ^{16}O core and reduces the number of pairs.

How Can Acute Mountain Sickness be Quantified at Moderate Altitude?

Reports of acute mountain sickness (AMS) at moderate altitude show a wide variability, possibly because of different investigation methods. The aim of our study was to investigate the impact of investigation methods on AMS incidence. Hackett's established AMS score (a structured interview and physical examination), the new Lake Louise AMS score (a self-reported questionnaire) and oxygen saturation were determined in 99 alpinists after ascent to 2.94 km altitude. AMS incidence was 8% in Hackett's AMS score and 25% in the Lake Louise AMS score. Oxygen saturation correlated inversely with Hackett's AMS score with no significant correlation with the Lake Louise AMS score. At moderate altitude, the new Lake Louise AMS score overestimates AMS incidence considerably. Hackett's AMS score remains the gold standard for evaluating AMS incidence.

Striatale Aufnahme von 1-123-ß-CIT und I-123-IBZM bei Patienten mit extrapyramidaler Symptomatik

Ziel: In der vorliegenden Pilotstudie wurde untersucht, ob charakteristische Veränderungen der Dopamintransportfunktion und der D2-Bin-dungskapazität bei Patienten mit der klinischen Diagnose eines idiopathischen Parkinson-Syndroms (IPS) mit der SPET nachgewiesen werden können und ob sich diese Veränderungen von jenen unterscheiden, die mit sekundärem Parkinson-Syndrom (SPS) einhergehen. Methode: Bei 16 Patienten wurden SPET-Studien (Doppelkopfkamera) sowohl mit I-123-ß-CIT als auch mit I-123-IBZM 20-24 h p.i. bzw. 2 h p.i. durchgeführt (darunter 6 Pt. mit IPS, 6 Pt. mit SPS außer M. Wilson und 4 Pt. mit M. Wilson). Die Auswertung der ß-CIT-Studien erfolgte auf der Grundlage der Aktivitätsrelationen zwischen Basalganglien (BG) und Cerebellum (CER), die der IBZM-Studien unter Verwendung von BG und medialem frontalen Kortex (MFC). Ergebnisse: Die Relation BG/CER für 1-123-ß-CIT betrug 3,04 ± 0,83 bei IPS und 7,73 ± 3,28 bei SPS ohne Morbus Wilson (p< 0,05). Die Relation BG/MFC für I-123-IBZM war bei IPS jeweils kontralateral zur Symptomatik erhöht (MW = 1,75 ± 0,12 gegenüber 1,61 ± 0,16). Die entsprechenden Werte bei SPS waren gegenüber denen bei IPS nur mäßig, aber signifikant vermindert (1,58 ± 0,24 vs. 1,68 ± 0,16). Bei den Patienten mit M. Wilson war die Relation BG/MFC für IBZM zum Teil erheblich vermindert (bis 1,29), während die I-123-ß-CIT-Aufnahme mit BG/CER-Relationen von 8,00 ± 2,90 gegenüber der von Patienten mit SPS (p < 0,01) nur gering reduziert war. Schlußfolgerung: Es wird gefolgert, daß die beiden verwendeten Radiopharmaka zwar tendenziell die bei den untersuchten Krankheitsbildern erwarteten neurochemischen Veränderungen darzustellen in der Lage sind, daß aber eine Differenzierung zwischen IPS und SPS eher mit I-123-ß-CIT gelingt als mit I-123-IBZM.

Quasifree (p, 2p) Reactions on Oxygen Isotopes: Observation of Isospin Independence of the Reduced Single-Particle Strength

Quasifree one-proton knockout reactions have been employed in inverse kinematics for a systematic study of the structure of stable and exotic oxygen isotopes at the R^{3}B/LAND setup with incident beam energies in the range of 300-450  MeV/u. The oxygen isotopic chain offers a large variation of separation energies that allows for a quantitative understanding of single-particle strength with changing isospin asymmetry. Quasifree knockout reactions provide a complementary approach to intermediate-energy one-nucleon removal reactions. Inclusive cross sections for quasifree knockout reactions of the type ^{A}O(p,2p)^{A-1}N have been determined and compared to calculations based on the eikonal reaction theory. The reduction factors for the single-particle strength with respect to the independent-particle model were obtained and compared to state-of-the-art ab initio predictions. The results do not show any significant dependence on proton-neutron asymmetry.

Polydiacetylenic nanofibers as new siRNA vehicles for in vitro and in vivo delivery

Polydiacetylenic nanofibers (PDA-Nfs) obtained by photopolymerization of surfactant 1 were optimized for intracellular delivery of small interfering RNAs (siRNAs). PDA-Nfs/siRNA complexes efficiently silenced the oncogene Lim-1 in the renal cancer cells 786-O in vitro. Intraperitoneal injection of PDA-Nfs/siLim1 downregulated Lim-1 in subcutaneous tumor xenografts obtained with 786-O cells in nude mice. Thus, PDA-Nfs represent an innovative system for in vivo delivery of siRNAs.

Calcaneal Displacement Osteotomies - Less Soft Tissue Irritation in Lateral Compression Plate than Screws

PURPOSE OF THE STUDY With the concept of the lateral compression plate (LLCP) a technique has been available designed to combine the advantages of a fixed-angle fixation with a complete sinking of the implant into the proximal bone. The objective of the present study was to investigate the results of the LLCP compared with classical screw osteosynthesis (SO). MATERIAL AND METHODS 31 patients with pes planovalgus who received calcaneal displacement osteotomy and osteosyntheses with screws (n = 17) or LLCP (n = 14) between 2010 and 2015 were investigated retrospectively.The ankle-hindfoot scale, Kaikkonen score, VAS, and the SF-36 were determined preoperatively as well as at the last clinical follow-up. In addition, a radiological control of osseous integration was performed in all patients 12 weeks after surgery. RESULTS With regard to clinical scores both methods depicted significant improvement. In the overall cohort there were no pseudarthroses. In the SO group 5 cases (29%) showed hardware irritation, in the LLCP group there were none. Results in the LLCP group were significantly superior in the area of the physical section of the SF 36. CONCLUSIONS Based on the results of our study, surgical treatment of stage II pes planovalgus by means of calcaneal displacement osteotomy using the LLCP is equivalent to SO with a lower incidence of hardware irritation. Key words:pes planovalgus, lateral compression plate, osteosynthesis, screw, hardware irritation.

LEVEL OF EVIDENCE

Level IV, retrospective case serie.

Long-wavelength macromolecular crystallography - First successful native SAD experiment close to the sulfur edge

Phasing of novel macromolecular crystal structures has been challenging since the start of structural biology. Making use of anomalous diffraction of natively present elements, such as sulfur and phosphorus, for phasing has been possible for some systems, but hindered by the necessity to access longer X-ray wavelengths in order to make most use of the anomalous scattering contributions of these elements. Presented here are the results from a first successful experimental phasing study of a macromolecular crystal structure at a wavelength close to the sulfur K edge. This has been made possible by the in-vacuum setup and the long-wavelength optimised experimental setup at the I23 beamline at Diamond Light Source. In these early commissioning experiments only standard data collection and processing procedures have been applied, in particular no dedicated absorption correction has been used. Nevertheless the success of the experiment demonstrates that the capability to extract phase information can be even further improved once data collection protocols and data processing have been optimised.

Deciphering Tacrolimus-Induced Toxicity in Pancreatic β Cells

β Cell transcription factors such as forkhead box protein O1 (FoxO1), v-maf musculoaponeurotic fibrosarcoma oncogene homolog A (MafA), pancreatic and duodenal homeobox 1, and neuronal differentiation 1, are dysfunctional in type 2 diabetes mellitus (T2DM). Posttransplant diabetes mellitus resembles T2DM and reflects interaction between pretransplant insulin resistance and immunosuppressants, mainly calcineurin inhibitors (CNIs). We evaluated the effect of tacrolimus (TAC), cyclosporine A (CsA), and metabolic stressors (glucose plus palmitate) on insulinoma β cells in vitro and in pancreata of obese and lean Zucker rats. Cells were cultured for 5 days with 100 μM palmitate and 22 mM glucose; CsA (250 ng/mL) or TAC (15 ng/mL) were added in the last 48 h. Glucose plus palmitate increased nuclear FoxO1 and decreased nuclear MafA. TAC in addition to glucose plus palmitate magnified these changes in nuclear factors, whereas CsA did not. In addition to glucose plus palmitate, both drugs reduced insulin content, and TAC also affected insulin secretion. TAC withdrawal or conversion to CsA restored these changes. Similar results were observed in pancreata of obese animals on CNIs. TAC and CsA, in addition to glucose plus palmitate, induced comparable inhibition of calcineurin and nuclear factor of activated T cells (NFAT); therefore, TAC potentiates glucolipotoxicity in β cells, possibly by sharing common pathways of β cell dysfunction. TAC-induced β cell dysfunction is potentially reversible. Inhibition of the calcineurin-NFAT pathway may contribute to the diabetogenic effect of CNIs but does not explain the stronger effect of TAC compared with CsA.

Colorectal cancer risk variants at 8q23.3 and 11q23.1 are associated with disease phenotype in APC mutation carriers

Familial adenomatous polyposis (FAP) is a dominantly inherited syndrome caused by germline mutations in the APC gene and characterized by the development of multiple colorectal adenomas and a high risk of developing colorectal cancer (CRC). The severity of polyposis is correlated with the site of the APC mutation. However, there is also phenotypic variability within families with the same underlying APC mutation, suggesting that additional factors influence the severity of polyposis. Genome-wide association studies identified several single nucleotide polymorphisms (SNPs) that are associated with CRC. We assessed whether these SNPs are associated with polyp multiplicity in proven APC mutation carriers. Sixteen CRC-associated SNPs were analysed in a cohort of 419 APC germline mutation carriers from 182 families. Clinical data were retrieved from the Dutch Polyposis Registry. Allele frequencies of the SNPs were compared for patients with <100 colorectal adenomas versus patients with ≥100 adenomas, using generalized estimating equations with the APC genotype as a covariate. We found a trend of association of two of the tested SNPs with the ≥100 adenoma phenotype: the C alleles of rs16892766 at 8q23.3 (OR 1.71, 95 % CI 1.05-2.76, p = 0.03, dominant model) and rs3802842 at 11q23.1 (OR 1.51, 95 % CI 1.03-2.22, p = 0.04, dominant model). We identified two risk variants that are associated with a more severe phenotype in APC mutation carriers. These risk variants may partly explain the phenotypic variability in families with the same APC gene defect. Further studies with a larger sample size are recommended to evaluate and confirm the phenotypic effect of these SNPs in FAP.

Evaluating the performance of thermal sensation prediction with a biophysical model

Neutral thermal sensation is expected for a human body in heat balance in near-steady-state thermal environments. The physiological thermoneutral zone (TNZ) is defined as the range of operative temperatures where the body can maintain such heat balance by actively adjusting body tissue insulation, but without regulatory increases in metabolic rate or sweating. These basic principles led to the hypothesis that thermal sensation relates to the operative temperature distance from the thermoneutral centroid (dTNZ_op ). This hypothesis was confirmed by data from respiratory climate chamber experiments. This paper explores the potential of such biophysical model for the prediction of thermal sensation under increased contextual variance. Data (798 votes, 47 participants) from a controlled office environment were used to analyze the predictive performance of the dTNZ_op model. The results showed a similar relationship between dTNZ_op and thermal sensation between the dataset used here and the previously used dataset. The predictive performance had the same magnitude as that of the PMV model; however, potential benefits of using a biophysical model are discussed. In conclusion, these findings confirm the potential of the biophysical model with regard to the understanding and prediction of human thermal sensation. Further work remains to make benefit of its full potential.

The role of recombination in evolutionary adaptation of Escherichia coli to a novel nutrient

The benefits and detriments of recombination for adaptive evolution have been studied both theoretically and experimentally, with conflicting predictions and observations. Most pertinent experiments examine recombination's effects in an unchanging environment and do not study its genomewide effects. Here, we evolved six replicate populations of either highly recombining R⁺ or lowly recombining R^- E. coli strains in a changing environment, by introducing the novel nutrients L-arabinose or indole into the environment. The experiment's ancestral strains are not viable on these nutrients, but 130 generations of adaptive evolution were sufficient to render them viable. Recombination conferred a more pronounced advantage to populations adapting to indole. To study the genomic changes associated with this advantage, we sequenced the genomes of 384 clones isolated from selected replicates at the end of the experiment. These genomes harbour complex changes that range from point mutations to large-scale DNA amplifications. Among several candidate adaptive mutations, those in the tryptophanase regulator tnaC stand out, because the tna operon in which it resides has a known role in indole metabolism. One of the highly recombining populations also shows a significant excess of large-scale segmental DNA amplifications that include the tna operon. This lineage also shows a unique and potentially adaptive combination of point mutations and DNA amplifications that may have originated independently from one another, to be joined later by recombination. Our data illustrate that the advantages of recombination for adaptive evolution strongly depend on the environment and that they can be associated with complex genomic changes.

Use of an in-house Monte Carlo platform to assess the clinical impact of algorithm-related dose differences on DVH constraints

PURPOSE

The aim of the present work is to evaluate a semi-automatic prescription and validation system of treatment plans for complex delivery techniques, integrated in a Monte Carlo platform, and to investigate the clinical impact of dose differences due to the calculation algorithms, by assessing the changes in DVH constraints.

METHODS

A new prescription module was implemented into the Moderato system, an in-house Monte Carlo platform, with corresponding dose constraints generated depending on the anatomical region and fractionation scheme considered. The platform was tested on 83 cases treated with Cyberknife and Tomotherapy machines, to assess whether dose variations between the re-calculated dose and the Treatment Planning System might impact the dose constraints on the sensitive structures.

RESULTS

Dose differences were small (within 3%) between calculation algorithms in most of the thoracic, pelvic and abdominal cases, both for the Cyberknife and Tomotherapy machines. On the other hand, spinal and head and neck treatments presented a few significant dose deviations for constraints on small volumes, such as the optic pathways and the spinal cord. These differences range from -11% to +6%, inducing constraint violations of up to 8% over the dose limit.

CONCLUSIONS

The Moderato platform offers an interesting tool for plan quality validation, with a prescription module highlighting crucial features in the structures list, and a Monte Carlo dose re-calculation for complex modern techniques. Due to the high number of warnings appearing in some situations, display optimization is required in practice.

Mechanical Thrombectomy with the Embolus Retriever with Interlinked Cages in Acute Ischemic Stroke: ERIC, the New Boy in the Class

BACKGROUND AND PURPOSE

The Embolus Retriever with Interlinked Cages (ERIC) device is a novel stent retriever for mechanical thrombectomy. It consists of interlinked cages and could improve procedural benchmarks and clinical outcome compared with classic stent retrievers. This study compares the rates of recanalization, favorable clinical outcome, procedural adverse events, and benchmarks between the ERIC device and classic stent retrievers.

MATERIALS AND METHODS

From 545 patients treated with thrombectomy between 2012 and 2015, 316 patients were included. The mean age was 69 ±13 years, the mean baseline NIHSS score was 17 ± 5, and 174 (55%) were men. The ERIC was used as the primary thrombectomy device in 59 (19%) patients. In a propensity score matched analysis including the NIHSS score, clot location, delay to groin puncture, neurointerventionalist, and anesthetic management, 57 matched pairs were identified.

RESULTS

Patients treated with the ERIC device compared with classic stent retrievers showed equal rates of recanalization (86% versus 81%, P = .61), equal favorable 3-month clinical outcome (mRS 0-2: 46% versus 40%, P = .71), and procedural adverse events (28% versus 30%, P = 1.00). However, in patients treated with the ERIC device, thrombectomy procedures were less time-consuming (67 versus 98 minutes, P = .009) and a rescue device was needed less often (18% versus 39%, P = .02) compared with classic stent retrievers.

CONCLUSIONS

Mechanical thrombectomy with the ERIC device is effective and safe. Rates of favorable procedural and clinical outcomes are at least as good as those with classic stent retrievers. Of note, the ERIC device might be time-saving and decrease the need for rescue devices. These promising results call for replication in larger prospective clinical trials.

Application of ideal pressure distribution in development process of automobile seats

BACKGROUND

In designing a car seat the ideal pressure distribution is important as it is the largest contact surface between the human and the car. Because of obstacles hindering a more general application of the ideal pressure distribution in seating design, multidimensional measuring techniques are necessary with extensive user tests.

OBJECTIVE

The objective of this study is to apply and integrate the knowledge about the ideal pressure distribution in the seat design process for a car manufacturer in an efficient way.

METHODS

Ideal pressure distribution was combined with pressure measurement, in this case pressure mats. In order to integrate this theoretical knowledge of seating comfort in the seat development process for a car manufacturer a special user interface was defined and developed.

RESULTS

The mapping of the measured pressure distribution in real-time and accurately scaled to actual seats during test setups directly lead to design implications for seat design even during the test situation. Detailed analysis of the subject's feedback was correlated with objective measurements of the subject's pressure distribution in real time. Therefore existing seating characteristics were taken into account as well.

CONCLUSIONS

A user interface can incorporate theoretical and validated 'state of the art' models of comfort. Consequently, this information can reduce extensive testing and lead to more detailed results in a shorter time period.