The impact of TEL-AML1 (ETV6-RUNX1) expression in precursor B cells and implications for leukaemia using three different genome-wide screening methods

The reciprocal translocation t(12;21)(p13;q22), the most common structural genomic alteration in B-cell precursor acute lymphoblastic leukaemia in children, results in a chimeric transcription factor TEL-AML1 (ETV6-RUNX1). We identified directly and indirectly regulated target genes utilizing an inducible TEL-AML1 system derived from the murine pro B-cell line BA/F3 and a monoclonal antibody directed against TEL-AML1. By integration of promoter binding identified with chromatin immunoprecipitation (ChIP)-on-chip, gene expression and protein output through microarray technology and stable labelling of amino acids in cell culture, we identified 217 directly and 118 indirectly regulated targets of the TEL-AML1 fusion protein. Directly, but not indirectly, regulated promoters were enriched in AML1-binding sites. The majority of promoter regions were specific for the fusion protein and not bound by native AML1 or TEL. Comparison with gene expression profiles from TEL-AML1-positive patients identified 56 concordantly misregulated genes with negative effects on proliferation and cellular transport mechanisms and positive effects on cellular migration, and stress responses including immunological responses. In summary, this work for the first time gives a comprehensive insight into how TEL-AML1 expression may directly and indirectly contribute to alter cells to become prone for leukemic transformation.

Residual stresses in glasses

The history dependence of glasses formed from flow-melted steady states by a sudden cessation of the shear rate γ[over ˙] is studied in colloidal suspensions, by molecular dynamics simulations and by mode-coupling theory. In an ideal glass, stresses relax only partially, leaving behind a finite persistent residual stress. For intermediate times, relaxation curves scale as a function of γ[over ˙]t, even though no flow is present. The macroscopic stress evolution is connected to a length scale of residual liquefaction displayed by microscopic mean-squared displacements. The theory describes this history dependence of glasses sharing the same thermodynamic state variables but differing static properties.

Acute inhibition of central c-Jun N-terminal kinase restores hypothalamic insulin signalling and alleviates glucose intolerance in diabetic mice

The hypothalamus has been identified as a main insulin target tissue for regulating normal body weight and glucose metabolism. Recent observations suggest that c-Jun-N-terminal kinase (JNK)-signalling plays a crucial role in the development of obesity and insulin resistance because neuronal JNK-1 ablation in the mouse prevented high-fat diet-induced obesity (DIO) and increased energy expenditure, as well as insulin sensitivity. In the present study, we investigated whether central JNK inhibition is associated with sensitisation of hypothalamic insulin signalling in mice fed a high-fat diet for 3 weeks and in leptin-deficient mice. We determined whether i.c.v. injection of a pharmacological JNK-inhibitor (SP600125) improved impaired glucose homeostasis. By immunohistochemistry, we first observed that JNK activity was increased in the arcuate nucleus (ARC) and the ventromedial hypothalamus (VMH) in both mouse models, relative to normoglycaemic controls. This suggests that up-regulation of JNK in these regions is associated with glucose intolerance and obesity, independent of leptin levels. Acute i.c.v. injection of SP600125 ameliorated glucose tolerance within 30 min in both leptin-deficient and DIO mice. Given the acute nature of i.c.v. injections, these effects cannot be attributed to changes in food intake or energy balance. In a hypothalamic cell line, and in the ARC and VMH of leptin-deficient mice, JNK inhibition by SP600125 consistently improved impaired insulin signalling. This was determined by a reduction of phospho-insulin receptor substrate-1 [IRS-1(Ser612)] protein in a hypothalamic cell line and a decline in the number of pIRS-1(Ser612) immunoreactive cells in the ARC and VMH. Serine 612 phosphorylation of IRS-1 is assumed to negatively regulate insulin signalling. In leptin-deficient mice, in both nuclei, central inhibition of JNK increased the number of cells immunoreactive for phospho-Akt (Ser473) and phospho-GSK-3β (Ser9), which are important markers of insulin signalling. Collectively, our data suggest that the acute inhibition of central JNK improves impaired glucose homeostasis and is associated with sensitisation of hypothalamic insulin signalling.

[Ex situ tracheobronchoplastic operations using the organ care system]

First clinical experiences with the organ care system (OCS) in lung transplantation showed that this device allows perfusion and ventilation of the lungs under practically physiological conditions. Some pulmonary pathologies necessitate ex situ operations, e.g. to avoid pneumonectomy. The objective of this work was to investigate the feasibility of ex situ pulmonary surgery within the OCS.In the first procedure a large tracheobronchial leakage was covered with a pericardial patch. The procedure was authorized by the local committee of animal welfare. In the second surgery a replacement of the distal trachea using an aortic graft was performed after removal of the heart-lung segment from a pig from the slaughterhouse. The postoperative ventilation of both lungs was free of problems. The mean pressure of the pulmonary artery remained steady during the whole experiment. The setup to prevent lung edema was basically successful.Performing thoracic surgery with the OCS is feasible; however, this approach is reserved for very special indications. Further investigations to optimize technical details of the OCS setup for this purpose are necessary.

Multiple Acetabular Revisions in THA - Poor Outcome Despite Maximum Effort

A consecutive series of 52 acetabular revisions was evaluated retrospectively. Inclusion criteria for all patients were at least one former exchange of the acetabular component. Reconstruction was performed with reliable techniques and implants other than extensively porous coated device (e.g. tantalum). The mean follow up was 5.63 (0.01-14.05) years. Cumulative survival at 14.05 years with removal of the acetabular component due to aseptic loosening or the worst case criterion (removal of the acetabular component for any cause and/or lost to follow-up) as the end point was 66.38 (95 % C.-I.: 47.80-84.96) % and 58.42 (95 % C.-I.: 41.01-75.83) %, respectively. The cumulative survival rate with mechanical failure of the acetabular reconstruction as the endpoint was significantly lower in patients with two or more previous revisions in comparison to those with only one former procedure (log rank test: p=0,0112 respectively). The mean Merle d'Aubignée-score improved from 7.3 (0-14) preoperatively to 10.6 (0-17) points at latest follow up examination.Survival of acetabular reconstructions with common techniques and implants is decreasing with the number of previous revisions. This may cause major concerns with regard to the rising number of patients needing repeated revisions. Maximizing durability of primary THA, precise preoperative planning as well as improved techniques and implants for revision may decrease this problem in the long term.

[On general practitioners' care of patients with asthma]

This review offers readers new aspects for the guideline-compliant care of asthma patients. Here, attention is focused on illustrating the bottlenecks in the administration of good and practicable therapeutic care and listing these as "major challenges for GPs". The interdisciplinary team of authors - consisting of three hospital-based pulmonologists, one pulmonologist in private practice, one internist in general practice, one pharmacist and one health economist discussed aspects of asthma therapy relevant in clinical practice.

RESULTS AND CONCLUSIONS

Practicable results for the reader included an asthma pentagram, a graphic depicting the links and interactions between diagnosis, symptom management, communication, application and costs. From this emerged a consensus on four recommendations that can help GPs improve their care of their patients: (1) Whenever possible, have a specialist verifythe diagnosis. (2) Practice inhalation techniques with the patient and check up on their technique at regular intervals. (3) Monitor and fine-tune the therapeutic goals set down together with the patient. (4) Clearly define the (patient's) responsibilities and who is organizing care (communication between GP-specialist-patient-pharmacist-family members).

Tagged-particle motion in glassy systems under shear: Comparison of mode coupling theory and Brownian dynamics simulations

We study the dynamics of a tagged particle in a glassy system under shear. The recently developed integration through transients approach, based on mode coupling theory, is continued to arrive at the equations for the tagged-particle correlators and the mean squared displacements. The equations are solved numerically for a two-dimensional system, including a nonlinear stability analysis of the glass solution, the so called β-analysis. We perform Brownian Dynamics simulations in 2D and compare with theory. After switch on, transient glassy correlation functions show strong fingerprints of the stress overshoot scenario, including, additionally to previously studied superexponential decay, a shoulder-like slowing down after the overshoot. We also find a new type of Taylor dispersion in glassy states which has intriguing similarity to the known low-density case. The theory qualitatively captures most features of the simulations with quantitative deviations concerning the shear-induced time scales. We attribute these deviations to an underestimation of the overshoot scenario in the theory.

Simultaneous cardiac and lung surgery for incidental solitary pulmonary nodule: learning from the past

BACKGROUND

Incidental solitary pulmonary nodules (ISPN) detected prior to scheduled cardiac surgery are rare but challenging. We evaluated the long-term outcome of patients with ISPN undergoing simultaneous cardiac and lung surgery.

METHODS

The clinical records of 33 consecutive patients with ISPN undergoing cardiac and lung surgery, either simultaneously (n = 30) or sequentially (n = 3), were retrospectively evaluated and completed by detailed follow-up.

RESULTS

On histological examination, 14 cases (42.4%) of primary NSCLC were identified. Benign findings consisted mostly of hamartoma and inflammation. Malignant ISPN were larger in size (22.5 ± 12.4 vs. 13.6 ± 8.6 mm) and ISPN with a diameter >10 mm had a higher incidence of malignancy compared to those ≤10 mm (56.0% vs. 0%). Patients undergoing concomittant heart and lung surgery received either a wedge resection (n = 26) or a lobectomy (n = 4). The 5-year survival of patients with malignant ISPN was lower than that of patients with benign ISPN (43.6% vs. 85.6%).

CONCLUSIONS

Our results corroborate a high incidence of malignancy in ISPN detected prior to scheduled cardiac surgery. Simultaneous cardiac and lung surgery for NSCLC appears to be associated with a poor long-term outcome.

Improved Interference Filter Structures Made of Porous Silicon

Recently passive optical devices like filter structures or waveguides based on porous silicon have attracted high interest due to their easy and cheap fabrication. We have formed interference filters using porous silicon by changing the current density during formation. For the specific design of these filter structures a calibration of the etch rate and the refractive indices is required. Therefore we have determined the effective dielectric function for different substrate doping levels and anodization current densities by fitting reflectance spectra. Based on these results different kinds of reflectance filters consisting of discrete layers (Bragg reflectors, Fabry-Perot filters) as well as filters with a continuous change of the refractive indices with depth (rugate-filters) can be realised. Furthermore we present applications of these filter structures such as anti-reflectance coatings and high quality mirrors.

Optical Interference Filters Made of Porous Silicon

Porous silicon (PS) layers can easily be formed by an electrochemical etch process using a mixture of hydrofluoric acid (HF) and ethanol. The microstructure and porosity of the layers depend on the HF concentration, the doping level of the substrate and the current density applied during the etch process. Changing the current density during the etch process will result in a well defined layer structure consisting of layers with different porosities. Each single layer can be treated as an effective medium exhibiting a refractive index depending mainly on the porosity of the layer. Using reflectance measurements we have investigated the dependence of the refractive index of PS layers on the formation current density for different substrates. In addition the etch rate was determined by thickness measurements with an electron microscope. Based on these results various kinds of optical interference filters were studied. We have formed samples consisting of discrete single layers with different porosities (e.g. Bragg reflectors) as well as samples with continuous variation of the refractive index (rugate filters). Combining these PS filters with standard photolithography steps, microoptical devices such as spectral sensitive photodiodes can be realized.

Cardio-respiratory and metabolic responses to different levels of compression during submaximal exercise

OBJECTIVE

The effects of knee-high socks that applied different levels of compression (0, 10, 20, 30 and 40 mmHg) on various cardio-respiratory and metabolic parameters during submaximal running were analysed.

METHODS

Fifteen well-trained, male endurance athletes (age: 22.2 ± 1.3 years; peak oxygen uptake: 57.2 ± 4.0 mL/minute/kg) performed a ramp test to determine peak oxygen uptake. Thereafter, all athletes carried out five periods of submaximal running (at approximately 70% of peak oxygen uptake) with and without compression socks that applied the different levels of pressure. Cardiac output and index, stroke volume, arterio-venous difference in oxygen saturation, oxygen uptake, arterial oxygen saturation, heart rate and blood lactate were monitored before and during all of these tests.

RESULTS

Cardiac output (P = 0.29) and index (P = 0.27), stroke volume (P = 0.50), arterio-venous difference in oxygen saturation (P = 0.11), oxygen uptake (P = 1.00), arterial oxygen saturation (P = 1.00), heart rate (P = 1.00) and arterial lactate concentration (P = 1.00) were unaffected by compression (effect sizes = 0.00-0.65).

CONCLUSION

This first evaluation of the potential effects of increasing levels of compression on cardio-respiratory and metabolic parameters during submaximal exercise revealed no effects whatsoever.

Modification of Mo-Si alloy microstructure by small additions of Zr

Molybdenum and its alloys are potential materials for high-temperature applications. However, molybdenum is susceptible to embrittlement because of oxygen segregation at the grain boundaries. In order to alleviate the embrittlement small amounts of zirconium were alloyed to a solid solution of Mo-1.5Si alloy. Two Mo-based alloys, namely Mo-1.5Si and Mo-1.5Si-1Zr, were investigated by the complementary high-resolution methods transmission electron microscopy and atom probe tomography. The Mo-1.5Si alloy shows a polycrystalline structure with two silicon-rich intermetallic phases Mo(5)Si(3) and Mo(3)Si located at the grain boundaries and within the grains. In addition, small clusters with up to 10 at% Si were found within the molybdenum solid solution. Addition of a small amount of zirconium to Mo-1.5Si leads to the formation of two intermetallic phases Mo(2)Zr and MoZr(2), which are located at the grain boundaries as well as within the interior of the grain. Transmission electron microscopy shows that small spherical Mo-Zr-rich precipitates (<10nm) decorate the grain boundaries. The stoichiometry of the small precipitates was identified as Mo(2)Zr by atom probe tomography. No Si-enriched small precipitates were detected in the Mo-1.5Si-1Zr alloy. It is concluded that the presence of zirconium hinders their formation.

[Assessment of fitness for police custody: the physicians' responsibility and legal liability]

In contrast to several other European countries, German law provides only insufficient regulations on who is responsible for the medical assessment of persons in police custody. The police frequently report that doctors refuse to assess fitness for custody. Under consideration of the current legal background, we will discuss whether and, if so, which physicians can be obligated to carry out these assessments. We also examine a physician's possible exposure to criminal and civil liability if he or she refuses to assess fitness for custody or fails to render a correct assessment.