Pre-conditioning with synthetic CpG-oligonucleotides attenuates myocardial ischemia/reperfusion injury via IL-10 up-regulation

The aim of the study was to investigate whether pre-conditioning with CpG-oligodeoxynucleotides (CpG-ODN) may change cardiac ischemia/reperfusion (I/R)-dependent inflammation and modulates infarct size and cardiac performance. WT and TLR9-deficient mice were pre-treated with 1668-, 1612- and H154-thioate or D-Gal as control. Priming with 1668-thioate significantly induced inflammatory mediators in the serum and a concomitant increase of immune cells in the blood and spleen of WT mice. Furthermore, it induced myocardial pattern recognition receptors and pro-inflammatory cytokines peaking 2 h after priming and a continuous increase of IL-10. 16 h after pre-conditioning, myocardial ischemia was induced for 1 h. Infarct size determined after 24 h of I/R was reduced by 75 % due to pre-conditioning with 1668-thioate but not in the other groups. During reperfusion, cytokine expression in 1668-thioate primed mice increased further with IL-10 exceeding the other mediators by far. These changes were observed neither in animals pre-treated with 1612- or H154-thioate nor in TLR9-deficient mice. The 1668-thioate-dependent increase of IL-10 was further supported by results of a micro-array analysis 3 h after begin of reperfusion. Block of IL-10 signaling increased I/R size and prevented influence of priming. In the group pre-treated with 1668-thioate, cardiac function was preserved 24 h, 14 days and 28 days after I/R, whereas animals without pre-conditioning exhibited impaired heart function 24 h and 14 days after I/R. The excessive 1668-thioate-dependent IL-10 up-regulation during pre-conditioning and after I/R seems to be the key factor for reducing infarct size and improving cardiac function. This is in agreement with the finding that IL-10 block prevents cardioprotection by pre-conditioning.

Congenital rubella with agenesis of the inferior cerebellar vermis and total anomalous pulmonary venous drainage

Congenital rubella infection has been associated with a number of abnormalities including cardiac, central nervous system and placental complications. We present a case with multiple fetal abnormalities detected on prenatal ultrasound, and confirmed postnatally, that included a single umbilical artery, severe tricuspid regurgitation, micrognathia and agenesis of the inferior cerebellar vermis. Postnatal echocardiography additionally revealed unobstructed total anomalous pulmonary venous drainage (TAPVD) into the coronary sinus. Placental examination showed signs of placentitis, and polymerase chain reaction on neonatal serum was positive for rubella. Following a multidisciplinary team review, it was decided to provide only supportive care, and the infant died at 6 months of age owing to a respiratory tract infection. To our knowledge, TAPVD and agenesis of the inferior cerebellar vermis have not been reported previously in association with congenital rubella infection. This case illustrates how congenital infection may present in atypical ways and stresses the importance of considering congenital infection in the differential diagnosis of fetal anomalies when multiple features are present.

A Biomedical Informatics Perspective on Human Factors:

to select and summarize excellent research published during 2011 in the study of human factors in bio-medical informatics.

we attempt to derive a synthetic overview of the activity and new trends in this field, from a wide selection of worldwide research papers published during 2011.

We selected four papers. The first one presents an international effort aiming to design a guideline for good evaluation practice in health informatics (GEP-HI) [2]. The second reviews medical errors taxonomies from a human factor perspective [3]. The third one advocates the need to systematically perform a deep evaluation process after all healthcare information technologies project deployment [4]. The fourth one explores exit strategies performed by clinician using health record system and how/why we need to anticipate them [5].

This papers selection will provide our readers with valuable evidences on past and existing research in the specific field of human factors in healthcare informatics. It can also act as a foundation for stakeholders in the healthcare industry that emphasize the significance of human factors and ergonomics in designing healthcare information systems of the future.

Prevalência de anticorpos contra a linfadenite caseosa em criações comerciais de ovinos no Distrito Federal, Brasil

O objetivo deste trabalho foi determinar a prevalência de anticorpos contra linfadenite caseosa (LC) em rebanhos ovinos comerciais do Distrito Federal (DF). Foram coletadas 1.028 amostras de soro entre março e junho de 2004, de todas as propriedades (32) do Distrito Federal com pelo menos 20 fêmeas adultas no rebanho. A soroprevalência da linfadenite caseosa foi determinada por ELISA com proteínas secretadas de Corynebacterium pseudotuberculosis. Cinquenta por cento das 32 propriedades apresentaram pelo menos um animal soropositivo para o LC e a prevalência real para animais foi de 44,0% (IC 95: 41,0; 47,0), portanto, esses dados sugerem que a LC está presente em rebanhos ovinos comerciais no Distrito Federal.

Durch die Augen von Laplace: Die Rolle der Wandspannung bei Varikosis

Einleitung: Trotz ihrer Bedeutung für beinahe ein Drittel der erwachsenen Bevölkerung in den Industrienationen ist nur wenig über die Mechanismen, die eine gesunde Vene in eine Varize transformieren, bekannt. Epidemiologisch und ätiologisch ist nachgewiesen, dass viele Risikofaktoren, welche die Spannung der Venenwand vergrößern – wie stehendes Arbeiten oder eine Adipositas-bedingte Erhö-hung des Venendrucks – auch die Wahrscheinlichkeit für eine Varikosis bzw. chronische venöse Insuffizienz (CVI) erhöhen.

Methodik und Ergebnisse: Vor diesem Hinter-grund wurde mit Hilfe der Ligation einer Ohrmuschelvene der Maus der Venendruck lokal erhöht und venöse Remodellierungsprozesse induziert. Auf Basis dieses neuartigen Mausmodells konnten wir kürzlich zeigen, dass die Steigerung der Wandspannung venöse Endothel- und glatte Muskelzellen aktiviert, und konsekutiv den varikösen Umbau der Venen-wand initiiert.

Schlussfolgerung: Unsere Ergebnisse deuten darauf hin, dass eine erhöhte venöse Wand-spannung ausreichend ist, um Varikosis zu initiieren und zu fördern. In diesem Artikel versuchen wir diese durch die Laplace-Beziehung beschriebene biomechanische Kraft etwas nä-her zu beleuchten, und erläutern wie die Wandspannung die verschiedenen Varikosisassoziierten Wandumbauprozesse und deren Behandlungsstrategien beeinflussen kann.

Cardiac effects of osteostatin in mice

Mouse parathyroid hormone-related peptide (PTHrP) is a peptide hormone consisting of 139 amino acids. It is target of proteolysis resulting in circulation of N- and C-terminal peptides. C-terminal PTHrP peptides act in a PTH/PTHrP receptor-independent way with a minimal peptide sequence required to exert these effects covering amino acids 107-111 also known as osteostatin. Although effects of osteostatin on cardiac hypertrophy have been described in vitro, the in vivo relevance of these findings remained to be defined. The study was performed in two experimental series. In the first series, mice were randomly distributed into placebo or treatment group (each n=7) and osteostatin was administered via osmotic minipumps. In the second series, mice underwent a banding of the thoracic aorta to induce pressure overload and were again randomly distributed into placebo or treatment group (n=9 each). After 14 days, mice were anaesthetized and cardiac function, ECG, and cardiac hypertrophy were determined. Osteostatin increased the expression of ANF and reduced P-wave duration with little effects on cardiac performance in mice without pressure overload. In TAC banded mice, however, osteostatin significantly reduced TAC-induced loss of body weight, induced right ventricular hypertrophy, and reduced P-wave duration again. In osteostatin treated mice with pressure overload, the protein kinase C-dependent phosphorylation of connexin 43 was preserved. In summary, osteostatin attenuated pressure-overload-dependent loss of body weight without affecting left ventricular hypertrophy or left ventricular function but preserved atrial conduction. Osteostatin exerts moderate cardioprotective effects in mice under hemodynamic stress.

A Biomedical Informatics Perspective on Human Factors: The Necessity of Consistent Evaluation Procedures to Design the Future and not Impair the Present

OBJECTIVES

to select and summarize excellent research published during 2011 in the study of human factors in bio-medical informatics.

METHODS

we attempt to derive a synthetic overview of the activity and new trends in this field, from a wide selection of worldwide research papers published during 2011.

RESULTS

We selected four papers. The first one presents an international effort aiming to design a guideline for good evaluation practice in health informatics (GEP-HI) [2]. The second reviews medical errors taxonomies from a human factor perspective [3]. The third one advocates the need to systematically perform a deep evaluation process after all healthcare information technologies project deployment [4]. The fourth one explores exit strategies performed by clinician using health record system and how/why we need to anticipate them [5].

CONCLUSIONS

This papers selection will provide our readers with valuable evidences on past and existing research in the specific field of human factors in healthcare informatics. It can also act as a foundation for stakeholders in the healthcare industry that emphasize the significance of human factors and ergonomics in designing healthcare information systems of the future.

Reversal of UVA skin photosensitivity and DNA damage in kidney transplant recipients by replacing azathioprine

Azathioprine is associated with enhanced skin photosensitivity to ultraviolet A (UVA) and leads to incorporation of 6-thioguanine (6-TG) into DNA of dividing cells. Unlike canonical DNA, 6-TG DNA is damaged by UVA, which comprises more than 90% of the ultraviolet reaching earth. Skin photosensitivity to UVA and UVB was measured in 48 kidney transplant patients immunosuppressed either by azathioprine (n = 32) or mycophenolate (n = 16). In 23 patients, azathioprine was subsequently replaced by mycophenolate and skin photosensitivity, DNA 6-TG content in peripheral blood mononuclear cells, and susceptibility to UVA-induced DNA damage were monitored for up to 2 years. The mean minimal erythema dose to UVA on azathioprine was twofold lower than on mycophenolate. Three months after replacing azathioprine by mycophenolate mofetil, the minimal erythema dose to UVA had increased from 15 to 25 J/cm(2) (p < 0.001) accompanied by reduced DNA 6-TG content. P53 protein expression in irradiated skin indicated reduced susceptibility to UVA-induced DNA damage. 6-TG DNA in peripheral blood mononuclear cells remained measurable for over 2 years. Replacing azathioprine selectively reduced the skin photosensitivity to UVA, attenuated UVA-induced skin DNA damage, and is likely based on incorporated 6-TG in DNA.

The future of heart valve banking and of homografts: perspective from the Deutsches Herzzentrum Berlin

Ever since the early days of homograft implantation in 1956, and the introduction into clinical practice by Ross and Barrat Boyes, homograft heart valves have proven to have many advantages. Its disadvantages became evident during long-term follow up. Factors, such as donor and recipient morbidity, tissue banking techniques, and the often complex surgical technique required to implant, are of great influence on the long term results. Because of European Directives, legally binding quality assurance regulations have been introduced in homograft banks. However, still not all processing methods have been scientifically sub-structured on their effects on the final product and its durability. The donor shortage has stimulated researchers and industries to develop and improve mechanical and biological valve substitutes such as the stentless bioprostheses. In general, candidates for homograft valve implantation include patients with: endocarditis, congenital defects and women who wish to become pregnant. For each category of patients different implantation techniques are required. The results of homograft banking and homograft transplantation in the German Heart Institute Berlin are satisfactory. Freedom of re-infection rate after homograft implantation is 91.9% +/- 3.6% after 15 years. Current developments show an increased interest in tissue engineered as well as in de- and re-cellularization of heart valve homografts. The advantages and disadvantages of the several processing techniques have not yet been proven in long term clinical results. For homograft bankers these developments pose as a challenge to join forces and to initiate cooperate projects aimed at scientific and organizational development.