Heart-type fatty acid-binding protein for risk assessment of chronic thromboembolic pulmonary hypertension

Heart-type fatty acid-binding protein (H-FABP) is a reliable marker of myocardial injury and was recently identified as a predictor of outcome in acute pulmonary embolism. The aim of the present study was to investigate the prognostic value of H-FABP in chronic thromboembolic pulmonary hypertension (CTEPH). In total, 93 consecutive patients with CTEPH were studied. During long-term follow-up (median duration 1,260 days, interquartile range (IQR) 708-2,460 days), 46 (49%) patients had an adverse outcome, defined as CTEPH-related death, lung transplantation or persistent pulmonary hypertension after pulmonary endarterectomy (PEA). Baseline H-FABP levels in plasma ranged from 0.69-24.3 ng x mL(-1) (median (IQR) 3.41 (2.28-4.86) ng x mL(-1)). Cox regression analysis revealed a hazard ratio of 1.10 (95% confidence interval 1.04-1.18) for each increase of H-FABP by 1 ng x mL(-1), and continuous elevations of H-FABP emerged as an independent predictor of adverse outcome by multivariable analysis. PEA was performed in 52 patients and favourably affected the long-term outcome. Kaplan-Meier analysis revealed that patients with baseline H-FABP concentrations >2.7 ng x mL(-1), the median value of the biomarker in the surgically treated population, had a lower probability of event-free survival after PEA. Heart-type fatty acid-binding protein is a promising novel biomarker for risk stratification of patients with chronic thromboembolic pulmonary hypertension.

Aerosol optical depth, aerosol composition and air pollution during summer and winter conditions in Budapest

The dependence of aerosol optical depth (AOD) on air particulate concentrations in the mixing layer height (MLH) was studied in Budapest in July 2003 and January 2004. During the campaigns gaseous (CO, SO(2), NO(x), O(3)), solid components (PM(2.5), PM(10)), as well as ionic species (ammonium, sulfate and nitrate) were measured at several urban and suburban sites. Additional data were collected from the Budapest air quality monitoring network. AOD was measured by a ground-based sun photometer. The mixing layer height and other common meteorological parameters were recorded. A linear relationship was found between the AOD and the columnar aerosol burden; the best linear fit (R(2)=0.96) was obtained for the secondary sulfate aerosol due to its mostly homogeneous spatial distribution and its optically active size range. The linear relationship is less pronounced for the PM(2.5) and PM(10) fractions since local emissions are very heterogeneous in time and space. The results indicate the importance of the mixing layer height in determining pollutant concentrations. During the winter campaign, when the boundary layer decreases to levels in between the altitudes of the sampling stations, measured concentrations showed significant differences due to different local sources and long-range transport. In the MLH time series unexpected nocturnal peaks were observed. The nocturnal increase of the MLH coincided with decreasing concentrations of all pollutants except for ozone; the ozone concentration increase indicates nocturnal vertical mixing between different air layers.

Thrombotic phenotype of mice with a combined deficiency in plasminogen activator inhibitor 1 and vitronectin

OBJECTIVE

The role of vitronectin (VN) in thrombosis is not fully understood, primarily because this adhesive glycoprotein not only stabilizes plasminogen activator inhibitor 1 (PAI-1) and thus protects fibrin from premature lysis, but also because it binds to platelet integrins and may influence platelet aggregation. The absence of quantitative approaches to characterize the thrombi formed in animal models under different conditions further complicates this analysis.

METHODS

In this report, we describe a more comprehensive approach to assess the stability of thrombi formed in mice deficient in PAI-1 (PAI-1(-/-)), VN (VN(-/-)) or both (PAI-1(-/-)/VN(-/-)).

RESULTS

We observed that all deficient mice developed unstable thrombi compared with wild type (WT) mice. Thus, only 31% of the thrombi formed in WT mice were unstable compared with 74% of PAI-1(-/-), 80% of VN(-/-), and 87% of PAI-1(-/-)/VN(-/-) mice. In this regard, the average number of emboli per WT mouse was significantly lower (0.55) compared with VN(-/-) (2.66), PAI-1(-/-) (2.1), and VN(-/-)/PAI-1(-/-) (2.35) mice. Finally, the total duration of complete vascular occlusion was higher and the rate of vascular patency was lower in the WT mice compared with the deficient mice.

CONCLUSIONS

Taken together, these observations indicate that the thrombotic phenotype of mice with a combined deficiency in PAI-1 and VN does not differ significantly from the phenotype of mice with deficiencies in only PAI-1 or VN. This observation suggests that PAI-1 and VN may influence thrombus stability by regulating a common pathway.

[Ultrasonic Quantification of spinal configuration and postural capacity for evaluation of different muscle strengthening programs in the therapy of back pain]

AIM

The aim of this study was the evaluation of the effectiveness of different muscle strengthening programs in the therapy of back pain.

METHODS

102 male longshoremen aged from 29 to 63 years with chronic back pain since > two years, matched by pain intensity and functional limitations, were randomized to three test groups (TG) and one control group (CG). The test persons carried out a program for intensified muscle strengthening over a period of six months one to two times weekly in a therapeutic practice (TG1), in a health club (TG2) and in a gymnastic group (TG3). The CG did not complete any intervention. Ultrasound topometry for recording spinal configuration and postural capacity as well as the determination of pain intensity and functional limitations were used as instruments of assessment.

RESULTS

The data obtained for the CG remained virtually unchanged over the period of investigation. In contrast a decrease of pain intensity and functional limitations could be proved for all TG. Furthermore, the training programs induced both an improved postural capacity while performing the arm-raising test and an increasingly erect sagittal spinal profile. The power of effectiveness was on a homogeneous level for the medical training therapy (0.41), the fitness training (0.4) and the spinal gymnastics (0.41).

CONCLUSION

The three muscle strengthening programs investigated have equally favorable effects on the parameters evaluated and are qualified as effective strategies in the therapy for chronic spinal discomforts.

Numerical description of selected endo- and ectocranial dimensions in Homo sapiens and the three Homo heidelbergensis: Kabwe, Atapuerca and Petralona

Investigation of hominid cranial morphology is of particular importance for those dealing with questions concerning both ontogenetic and phylogenetic aspects in the genus Homo. The present study provides a numerical description of several regions of extant human crania and, in addition, mid-Pleistocene crania, given in distances and angles. This study is seen as a basic preparatory work that is most useful for further investigation on cranial development in hominids. The sample used consisted of 60 recent adult human crania as well as stereolithographic models of three H. heidelbergensis crania: Kabwe, Atapuerca and Petralona. 12 ecto- and 20 endocranial landmarks were selected and 3D-coordinates taken on each cranium using a 3D Polhemus 3Space FASTRAK tracking system. From the resulting data set, 21 ectocranial and 17 endocranial distances were calculated, in addition to 41 angles of the ectocranium and 21 angles of the endocranium; the measurements are presented in tables, serving as a reference database.

Leptin-dependent platelet aggregation and arterial thrombosis suggests a mechanism for atherothrombotic disease in obesity

Obesity is associated with increased cardiovascular morbidity and mortality and with elevated circulating levels of the satiety factor leptin. This study provides evidence for a direct link between leptin and the risk for thrombotic complications in obese individuals. For example, although arterial injury provokes thrombosis in both lean and obese (ob/ob) mice, the time to complete thrombotic occlusion is significantly delayed in the ob/ob mice, and the thrombi formed are unstable and frequently embolize. The ob/ob mice lack leptin, and intraperitoneal administration of leptin to these mice before injury restores the phenotype of lean mice by shortening the time to occlusion, stabilizing the thrombi, and decreasing the patency rate. The thrombi that form when leptin receptor-deficient obese (db/db) mice are injured also are unstable. However, in this instance, leptin has no effect. Platelets express the leptin receptor, and leptin potentiates the aggregation of platelets from ob/ob but not db/db mice in response to known agonists. These results reveal a novel receptor-dependent effect of leptin on platelet function and hemostasis and provide new insights into the molecular basis of cardiovascular complications in obese individuals. The results suggest that these prothrombotic properties should be considered when developing therapeutic strategies based on leptin.

Incorporation of dietary linoleic and conjugated linoleic acids and related effects on eggs of laying hens

In the present study, laying hens received 29 g per kg diet of a preparation containing either 70% linoleic acid (LA) or approximately the same amount of conjugated linoleic acid (CLA) in the control and experimental treatments, respectively. The CLA preparation consisted predominantly of cis-9,trans-11 and trans-10,cis-12 fatty acid isomers as free fatty acids in a ratio of 1:1. The diets were fed for 8 wk to determine the effect of dietary CLA on quality characteristics of eggs. In addition, the fatty acid composition of liver and heart was analyzed. Performance parameters (egg weight, feed efficiency) were not significantly affected by feeding the diets supplemented with CLA. The overall amount of CLA that was incorporated into yolk was 7.95 g CLA/100 g total fatty acids, or approximately 400 mg CLA/egg. The transfer efficiency of the cis-9,trans-11 isomer was higher than that of the trans-10,cis-12 isomer; however, the transfer rate of CLA isomers into yolk and tissues was significantly lower than that of linoleic acid. Dietary CLA increased the concentration of saturated fatty acids in yolk and tissues at the expense of monounsaturated fatty acids. The proportions of myristic, palmitic, and stearic acids in yolk lipids were also changed by dietary CLA. Additionally, long-chain polyunsaturated fatty acids (arachidonic acid and docosahexaenoic acid) were decreased without changing the balance of the n-6/n-3 ratio in egg yolk. The inclusion of CLA in layer diets altered the shape of the yolk and various egg parameters (albumen height, foam index, and yolk index). The results of this study indicate that CLA induces various changes in lipid and fatty acid metabolism of laying hens and affects quality characteristics of eggs.

Virtual anthropology: the digital evolution in anthropological sciences

The discovery and explanation of differences among organisms is a major concern for evolutionary and systematic biologists. In physical anthropology, the discrimination of taxa and the qualitative and quantitative description of ontogenetic or evolutionary change require, of course, the analysis of morphological features. Since the 1960s, a remarkable amount of fossil material was excavated, some of it still awaiting a detailed first analysis, some of it requiring re-examination by more developed methods. While the fossil record grew continuously, a revolution in anthropological research took place with advances in computer technology in the 1980s: a handful of innovative researchers working in specialized anthropology laboratories or medical departments developed the methodological inventory needed to extract critical information from subjects in vivo and from fossilized remains. A considerable part of this information is preserved in the physically heretofore inaccessible interior of anatomical structures. Virtual Anthropology (VA) is a means of making them visible and measurable. Thus, VA also allows access to 'hidden' landmarks; in addition, the large number of semilandmarks accessible on the form enhances the power of Geometric Morphometrics analysis. Furthermore, the density information in volume data allows manipulations such as segmentation, impossible with the real, physical object. Moreover, metric body measurements generally, and cranial measurements specifically, are also an important source of information for the analysis of the ontogenetic development of the skeletal system, and--last but not least--for clinical use (e.g., operation planning, operation simulation, prosthetics). Thus, there developed a fruitful interdisciplinary cooperation between statistics, medicine, and physical anthropology.

Plasminogen activator inhibitor-1 and its cofactor vitronectin stabilize arterial thrombi after vascular injury in mice

BACKGROUND

The origin and contribution of plasminogen activator inhibitor-1 (PAI-1) and its cofactor vitronectin (VN) to arterial thrombosis/thrombolysis in vivo is controversial.

METHODS AND RESULTS

Ferric chloride was used to induce carotid artery injury in 97 wild-type (WT), 84 PAI-1-/-, and 84 VN-/- mice. Complete thrombotic occlusion was observed in 70% of PAI-1-/- mice versus 92% of WT (P:<0.001) and 87% of VN-/- (P:=0.015) mice. In vessels that occluded, mean times to occlusion were significantly longer in PAI-1-/- than in WT or VN-/- mice. The initial thrombotic response of VN-/- mice was similar to that of WT mice, but their thrombi were unstable and frequently embolized. As a result, the patency rate of carotid vessels 30 minutes after injury was as high in VN-/- mice (36%) as in PAI-1-/- mice (which demonstrate progressive thrombolysis) and significantly higher than that of WT mice (12%; P:=0.013). Histochemical and reverse transcription-polymerase chain reaction studies revealed an early upregulation of PAI-1 mRNA and protein expression in the thrombus and the vessel wall, which persisted for >/=1 week. VN protein also accumulated after injury, but VN mRNA levels remained low at all times.

CONCLUSIONS

PAI-1 and VN participate in the thrombotic response to arterial injury by preventing premature thrombus dissolution and embolization. The accumulation of PAI-1 in the thrombus/vessel wall after injury may result, at least in part, from local synthesis, whereas the VN protein appears to be derived from plasma.

Methicillin-resistant Staphylococcus aureus in a teaching hospital: investigation of nosocomial transmission using a matched case-control study

In early 1996 a hospital-wide methicillin-resistant Staphylococcus aureus (MRSA) epidemic was recognized in a 900-bed university hospital. In order to investigate hospital-specific transmission routes, a case-control study was carried out. Cases and controls were matched for age (+/- 10 years), sex, admission date (+/- 10 days) and clinical department on admission. Data on potential risk factors, were retrieved by chart review. Between June 1996 and February 1997, 67 patients with hospital-acquired MRSA were identified. Molecular typing showed that 85% of the cases carried an indistinguishable strain. The average time at risk for cases and controls was 17.3 and 23.7 days, respectively (P= 0.01). Seventeen patients (25.4%) developed infection. Conditional multivariate regression analysis showed that intensity of care (P= 0.002), number of transfers (P= 0.019), and fluoroquinolone therapy (P= 0.025) were independently associated with acquisition of MRSA. Intensity of care can be considered as a surrogate marker for a number of manipulations which represent the main risk factors for MRSA transmission. Frequent transfers within the hospital hinder, not only the epidemiological analyses, but also efforts to bring an outbreak under control. Our findings give epidemiological support to recent molecular studies which suggest that fluoroquinolone use may increase the transmissibility of MRSA in hospitals.

Construction and characterization of a gridded cattle BAC library

A bovine genomic large-insert bacterial artificial chromosome (BAC) library has been constructed from leukocytes of a Holstein-Friesian male. Size fractionated DpnII-digested genomic DNA was ligated to the dephosphorylated BamH1 ends of a pBACe3.6 vector. Approximately 8.3 x 10(4) individual BAC clones were picked into 384-well plates. Two-hundred and sixty-seven randomly chosen clones were characterized by pulsed-field gel electrophoresis (PFGE). The average insert size was 104 kb with a frequency of clones without inserts of 5.5%. Thirty-four BAC clones were mapped by fluorescence in situ hybridization (FISH) to cattle chromosomes. Three showed signals at more than one location, one of them on the centromeric regions of all autosomes, indicating that the clone contains centromeric repeats. A subset of these BAC clones was used for the development of sequence tagged sites. Both subcloning and direct sequencing of the BACs were used for generating sequence tagged site information. The clones from the library were gridded onto high-density membranes, and PCR superpools were produced from the same set of clones. Membranes and superpools are available through the Resource Centre of the German Human Genome Project in Berlin (http:// www.rzpd.de).

Decrease of cholestasis under "continuous extracorporeal stool transport (CEST)" in prematures and neonates with stomas

According to recent studies, the percentage of neonates suffering a combination of very low birth weight (VLBW) and intestinal malformation or diseases that require surgery has increased. As opposed to mature newborn, split stoma is the therapy of choice in VLBW infants. These neonates and patients with other causes for a congenital or acquired short-bowel syndrome usually require parenteral nutrition and have a high risk of a cholestasis. Until 1993, stoma patients were treated with a special diet in our department, but depending of the stoma site often required parenteral nutrition, while the non-used distal bowel was irrigated with an isotonic electrolyte solution. With this regime, up to 38.5% of the treated patients (10126) were found to have a hyperbilirubinemia (> 3 mg/dl) after the 21st day of life. 1994, we started to use a device that continuously transfers the intestinal chylus from the proximal into the aboral bowel via a pump like a continuous extracorporeal stool transport (CEST). In this study, we evaluated the risk of cholestasis by comparison of the prospectively investigated group (CEST-group 1994-1998) of 33 infants with the results of the retrospectively studied group of 26 patients operated on between 1987 and 1993. We found a significantly lower risk of cholestasis in the CEST-Group (12.9% versus 38.5%; p<0.04). Only 3% of our patients with CEST (one patient) required permanent parenteral nutrition, compared to 50% of the conventionally treated patients.