Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry

AIMS

The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation.

METHODS AND RESULTS

Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin.

CONCLUSION

The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.

On the mechanical properties and fracture analysis of polymer nanocomposites reinforced by functionalized silicon carbide nanotubes: A molecular dynamics investigation

The mechanical characteristics of reinforced polymer nanocomposites with Hydrogen (H)- and Fluorine (F)-functionalized silicon carbide nanotubes (H-and F-fSiCNTs) are investigated herein using molecular dynamics (MD) simulations. The effects of covalent functionalization and chirality of SiCNT, and diverse polymer materials on Young's modulus, maximum stress, and strain to the failure point, as well as strain energy are studied. The results reveal that by increasing the functionalization degree, the maximum stress, maximum strain, elastic modulus, and strain energy decrease. The tensile strength of polymer nanocomposites containing SiCNT is higher than that of pure polymer and polymers containing functionalized silicon carbide nanotubes (fSiCNTs). It is also found that the incorporation of fSiCNT into the polymer matrix (fSiCNT/polymer) gives rise to a considerable improvement in the ultimate strength of nanocomposites compared to the pure polymer. Polymer nanocomposites reinforced by armchair SiCNTs and fSiCNTs withstand higher maximum stresses and possess less longitudinal Young's modulus as compared to the same systems comprising zigzag nanotubes. In every percent of functionalization, the zigzag F-fSiCNT/polymer tends to have a higher Young's modulus as compared to the zigzag H-fSiCNT/polymer. Similarly, the armchair F-fSiCNTs incorporated into the polyethylene (PE) matrix (F-fSiCNTs/PE) are stiffer than the armchair H-fSiCNTs/PE in each weight of functionalization. Moreover, the armchair fSiCNTs/polymer nanocomposites show higher storage of strain energy in comparison with their zigzag counterparts.

Fundamental frequency analysis of endohedrally functionalized carbon nanotubes with metallic nanowires: a molecular dynamics study

The endohedral functionalization of carbon nanotubes (CNTs) with nanowires (NWs), i.e., NWs@CNTs, has been the center of attention in a lot of research due to the applications of NWs@CNTs in nanoelectronic devices, heterogeneous catalysis, and electromagnetic wave absorption. To this end, based on the classical molecular dynamics (MD) simulations, the effect of four pentagonal structures of encapsulated metallic nanowires (mNWs), namely the eclipsed pentagon (E), the deformed staggered pentagon (Ds), staggered pentagon (S), and staggered pentagonal structure without the monatomic chain passing through the centers of the parallel pentagons (R) configurations on the vibrational behavior of CNTs, is investigated. Also, the effects of geometrical parameters such as length and radius of CNTs on the natural frequencies of simulated models are explored. The results illustrate that by increasing the length, the natural frequency of pure CNTs and mNWs@CNTs decreases. In a similar length, mNWs@CNTs possess lower natural frequencies compared to the pure CNTs. According to the results, the highest and lowest natural frequencies are calculated by inserting the S structure of sodium NW and Ds structure of aluminum NW inside their proper armchair CNT, i.e., Na-S NW@ (9,9) CNT and Al-Ds NW@ (7,7) CNT, respectively.

COVID-19 re-infection or persistent infection in patient with acute myeloid leukaemia M3: a mini review

Coronavirus disease 2019 (COVID-19) pandemic has affected more than 40 million people worldwide. Some patients had episodes of symptom recurrence after the first episode of infection with variable intervals. There are multiple issues and hypotheses about re-infection or re-activation of the virus, especially in immunocompromised patients. In this paper, we present details of an individual with a recent history of COVID-19 who proceeded to acute myeloid leukaemia M3 and immunosuppression by chemotherapy, then we review some recently published articles about possible re-infection or re-activation.

Tensile characteristics of carbene-functionalized CNTs subjected to physisorption of polymer chains: a molecular dynamics study

Tensile properties such as Young's modulus and ultimate tensile force are important properties in understanding the characteristics of nanocomposites. Besides, the importance of functionalization methods in modification of the unique mechanical and elastic properties of carbon nanotubes (CNTs) is being widely recognized. In this paper, the tensile properties of CNTs functionalized with carbene under physisorption of polymer chains, i.e., aramid and polyketone chains, are investigated by using a series of molecular dynamics (MD) simulations. The results illustrated that Young's modulus of carbene-functionalized CNTs (cfCNTs) decreases by rising the weight percentage of carbene. By contrast, Young's modulus of cfCNTs under physisorption of polymer chains (cfCNTs/polymers) increases as the carbene weight rises. In a particular carbene weight, Young's modulus of cfCNTs/polymers decreases by increasing the chains of non-covalent functional groups. Moreover, it is shown that similar to Young's modulus, ultimate tensile force of cfCNTs reduces by increasing the weight percentage of carbene whereas the ultimate tensile force of cfCNTs/polymers has an increasing trend with raising the carbene weight.

Interfacial properties of 3D metallic carbon nanostructures (T6 and T14)-reinforced polymer nanocomposites: A molecular dynamics study

Herein, the interfacial properties of new three-dimensional (3D) configurations of metallic carbon, namely T6 and T14, incorporated to different polymer matrices (T6 and T14@polymers) are studied using molecular dynamics (MD) simulations. The effects of two types of shape models for T6 and T14, i.e. beam- and plate-like models, various square cross-sectional areas for the reinforcements, pull-out velocity and polymer structure on the interaction energy and pull-out force of final system are investigated. The results reveal that the interfacial resistance of the system is improved by imposing a high pull-out velocity to the nanofillers. For each pull-out velocity, the effect of beam-like T6 and T14@polycarbonate (beam-like T6 and T14@PC) on increasing average pull-out force is more remarkable than that of similar models surrounded by polypropylene (PP). The beam- and plate-like structures@polymers possess the lowest and highest interfacial resistance, respectively. As the aspect ratio (length-to-width ratio) of nanofillers changes from the lowest value to the highest one, the average pull-out force decreases. The average pull-out force of plate-like T6@polymers is higher than their plate-like T14 counterparts. Besides, higher absolute values of interaction energy in plate-like T6 and T14@polymers in comparison with others imply that the load-carrying capacity from the surrounding matrix to the plate-like nanofillers is significantly increased.

[Mitochondrial DNA deletion Δ4977 in peptic ulcer disease]

Reactive oxygen species (ROS) play a critical role in peptic ulcer disease (PUD). Due to the high rate of ROS production and limited capacity for DNA repair within mitochondria, mtDNA is susceptible to oxidative damage and mutations. mtDNA deletion Δ4977 is one of the most common deletion events identified in mitochondria. We examined the association of 4977-bp mtDNA deletion with PUD. Genotypes were determined in bioptic samples of 150 PUD patients and 190 controls. The 4977-bp mtDNA deletion was found more frequently among patients with PUD (52%) than among controls (22.63%). The strong association between the mtDNA 4977-bp deletion and PUD was confirmed (OR = 3.7; 95% CI, 2.32-5.91; P = 0.0001). The 4977-bp deletion in mitochondrial DNA may be a risk factor for PUD, or may reflect an increase in oxidative stress that commonly accompanies underlying PUD disease. Larger population-based studies are needed to uncover the possible causal relationship between this deletion and peptic ulcer disease.

Multiple sclerosis immunopathic trait and HLA-DR(2)15 as independent risk factors in multiple sclerosis

We analysed HLA haplotypes in pairs of 78 sporadic multiple sclerosis (MS) patients and 78 healthy siblings. The presence of 2 oligoclonal IgG bands, detected by immunoblotting of the cerebrospinal fluid in healthy siblings, has previously been defined as MS immunopathic trait (MSIT), based on a cut-off derived from healthy unrelated volunteers. The frequency of MSIT was 17.9% (n=14/78 siblings). The HLA-DR(15)2 allelle was present in 21.4% (n=3/14) of the siblings with MSIT, in 40.6% (n =26/64) of the siblings without MSIT, and in 59% (n =46/78) of the patients with clinically-definite (CD) MS. The distribution of zero, one or two HLA-DR(2)15 alleles was significantly skewed towards a lower allelle count in the siblings with MSIT compared with the group of unrelated siblings with MS (P=0.002), and also lower than their related siblings with MS (P=0.1). These results suggest that the MS susceptibility gene, HLA-DR(2)15 type, does not induce MSIT, and conceivably these are two separate risk factors in the development of MS. The effect of HLA-DR(2)15 and MSIT in sporadic MS appears to be synergistic. Multiple Sclerosis 2007; 13: 441-445. http://msj.sagepub.com

A linkage study in two families with multiple sclerosis and healthy members with oligoclonal CSF immunopathy

We studied two extended families in which not only multiple sclerosis (MS) segregates, but also approximately 18% of the cerebrospinal fluid (CSF) investigated blood relatives have ‘MS immunopathic trait’, an oligoclonal CSF immunopathy similar to that seen in MS, but with no neurological symptoms. Both families fit a genetic model for autosomal dominant inheritance for MS immunopathic trait, although with reduced penetrance in family A. In order to identify genetic factors of importance for the development of MS immunopathic trait, we performed a genome scan using the CHLC/Weber Screening Set (ver 6A), with 285 successful markers, to test the hypothesis that a single gene is causing the MS immunopathic trait in these families. Using a parametric method, we identified regions with suggestive linkage at chromosome 6q12 with a LOD-score of 2.4, putative linkage with LOD-score 1.5 at chromosome 6p21 (HLA region), putative linkage at chromosome 12q24 with a LOD-score of 1.7 and suggestive linkage at chromosome 19q13.2 with a LOD-score of 1.8. The LOD-score at chromosome 19q13.2 increased to 2.2 when only family A was analysed. In family A, all MS patients and two of five individuals with MS immunopathic trait had HLA DRB1*(15) and in family B, all blood relatives had the rare HLA type DRB1*0103, which is associated with other autoimmune diseases. We suggest that DRB1*0103 is a necessary but not sufficient condition for the susceptibility for MS immunopathic trait in this family.

HPTLC-Densitometric Determination of Cetirizine and Montelukast Analysis in Combined Tablet Dosage Forms

A simple, accurate and rapid high performance thin layer chromatography (HPTLC)- densitometric method was developed for separation and determination of cetirizine (CET) as a long acting antihistamine and montelukast (MON) as an antileukotriene in pharmaceutical dosage forms. The compounds were separated on silica gel 60 F254 HPTLC plates using a mixture of ethyl acetate : methanol : ammonia solution (25%) (14 : 3 : 2 v/v/v) as mobile phase. The plates were developed vertically up to a distance of 80 mm. Compact spots of both cetirizine (Rf = 0.30 ± 0.01) and montelukast (Rf = 0.52 ± 0.02) were obtained. UV detection was performed at 230 nm. Quantitative analysis was performed by absorbance densitometry using peak area. The method was validated in terms of linearity, precision, accuracy, limit of detection (LOD), and limit of quantification (LOQ). The calibration curves were linear in the range of 40-2000 ng spot(-1) for cetirizine and 120-1000 ng spot(-1) for montelukast. For MON, recovery varied in range of 99.20-100.88% with RSD ranging from 1.02 to 1.90% and for CET, recovery varied in range of 98.13-100.05% with RSD ranging from 1.57 to 1.85%. The LODs were found to be 3.94 and 2.08 ng spot(-1) for CET and MON, respectively. It was observed that the proposed HPTLC method could be used for efficient analysis and monitoring of the CET and MON in combined tablet dosage forms, more convenient with better precision and accuracy than HPLC method.

Voluntary exercise does not ameliorate spatial learning and memory deficits induced by chronic administration of nandrolone decanoate in rats

Chronic exposure to the anabolic androgenic steroids (AAS) nandrolone decanoate (ND) in supra-physiological doses is associated with learning and memory impairments. Given the well-known beneficial effects of voluntary exercise on cognitive functions, we examined whether voluntary exercise would improve the cognitive deficits induced by chronic administration of ND. We also investigated the effects of ND and voluntary exercise on hippocampal BDNF levels. The rats were randomly distributed into 4 experimental groups: the vehicle-sedentary group, the ND-sedentary group, the vehicle-exercise group, and the ND-exercise group. The vehicle-exercise and the ND-exercise groups were allowed to freely exercise in a running wheel for 15 days. The vehicle-sedentary and the ND-sedentary groups were kept sedentary for the same period. Vehicle or ND injections were started 14 days prior to the voluntary exercise and continued throughout the 15 days of voluntary exercise. After the 15-day period, the rats were trained and tested on a water maze spatial task using four trials per day for 5 consecutive days followed by a probe trial two days later. Exercise significantly improved performance during both the training and retention of the water maze task, and enhanced hippocampal BDNF. ND impaired spatial learning and memory, and this effect was not rescued by exercise. ND also potentiated the exercise-induced increase in hippocampal BDNF levels. These results seem to indicate that voluntary exercise is unable to improve the disruption of cognitive functions by chronic ND. Moreover, increased levels of BDNF may play a role in ND-induced impairments in learning and memory. The harmful effects of ND and other AAS on learning and memory should be taken into account when athletes decide to use AAS for performance or body image improvement.

Myelin glycosphingolipid immunoreactivity and CSF levels in multiple sclerosis

OBJECTIVES

Patients with multiple sclerosis were reported to harbour antibodies not only against proteins and glycoproteins but also against glycolipids, including sulfatide and galactosylceramide (GalCer), the two major glycosphingolipids of myelin. However, previous results were inconsistent concerning glycosphingolipid levels, antibody type, dominance of serum or Cerebrospinal fluid compartments and relationship to the multiple sclerosis (MS) course.

RESULTS

We hereby report that the cerebrospinal fluid levels of sulfatide were increased in patients with MS (n = 46) compared with controls (n = 50, P < 0.001). In addition, patients had higher serum IgM anti-glycosphingolipid titres than controls (P = 0.03 for sulfatide, <0.001 for GalCer), while the anti-glycosphingolipid IgM antibodies in the cerebrospinal fluid were essentially normal. However, in seven of 46 patients cerebrospinal fluid IgG antibodies against GalCer (P = 0.004) could be detected, which was not found in any of the control individuals, and this finding might mirror the occurrence of more specific B-cell clones behind the blood-brain barrier.

CONCLUSIONS

The IgM immunoreactivity in serum did not show any relationship to the type of course or severity of MS, arguing against a phenomenon secondary to myelin damage. Thus, the IgM antibody findings are compatible with an early antigen challenge or autoimmunity associated with natural antibodies.

Systemic and intrahippocampal administrations of the glucocorticoid receptor antagonist RU38486 impairs fear memory reconsolidation in rats

Reconsolidation is the process by which previously consolidated memories are stabilized after retrieval. Several lines of evidence indicate that glucocorticoids modulate distinct phases of learning and memory. These effects are considered to be mediated by mineralocorticoid receptors and glucocorticoid receptors (GRs), which display a high concentration and distinct distribution in the hippocampus. The role of glucocorticoid system in fear memory reconsolidation is the subject of some controversy. Moreover, we found no studies that assessed the role of hippocampal GRs in fear memory reconsolidation. Here, we investigated the effect of GR blockade on fear memory reconsolidation in rats. Rats were trained and tested in an inhibitory avoidance task. Intrahippocampal or systemic administration of the GR antagonist RU38486 immediately following memory reactivation produced a deficit in post-retrieval long-term memory that persisted over test sessions, and memory did not re-emerge following a footshock reminder. These results indicate that hippocampal GRs are required for reconsolidation of fear-based memory.

Photocatalytic Mechanism of Action of Apatite-Coated Ag/Agbr/Tio2 on Phenol and Escherichia Coli and Bacillus Subtilis Bacteria Under Various Conditions

Multi-component photocatalysts based on apatite-coated Ag/AgBr/TiO2 were prepared by the deposition method. The effects of various kinds of apatites, with hydroxyl and fluoro substituents, on photocatalytic activity were investigated. The antibacterial processes in the dark, and under visible light, on two types of bacteria indicate that the multi-composites can inhibit the growth of bacteria by two different mechanisms. TEM images and optical microscopic data demonstrate that by attaching the nanosize catalyst to the outer membrane of the cell, the bacteria could not derive nourishment from surrounding media, i.e. this component acts as bacteria-stal ic. The median ism for deactivation of bacteria in the dark can be related to the linkage between the phosphate group of the composite and the outer membrane of the cell. The photocatalytic destruction of bacteria under visible I ight indicates that attachment of the catalysts to the outer wall of the cell causes them to destroy effectively the cell wall and inner membrane by various reactive species such as OH, O2 - and 1O2. Thus this effect increases the photoactivity more than two-fold. Oxidation of phenol was also achieved under visible light- and UVA- irradiation using apatite-coated Ag/AgBr/TiO2 powders. Under UVA illumination, the ‘OH produced from the hole of the TiO2 valence band is responsible for the photodegradation of phenol, while under visible light, AgBr acts as the photoactive component of the catalyst, that can not produce’ OH and oxidize the phenol.

Elevated cerebrospinal fluid levels of prostaglandin E2 and 15-(S)-hydroxyeicosatetraenoic acid in multiple sclerosis

OBJECTIVE

To test the hypothesis that the arachodinic acid metabolites prostaglandin E2 (PGE2) and 15-(S)-hydroxyeicosatetraenoic acid (15(S)-HETE) in cerebrospinal fluid (CSF) are elevated and reflect neuroinflammation and degenerative changes in multiple sclerosis (MS).

PATIENTS AND METHODS

We measured PGE2 and 15(S)-HETE concentrations, as well as markers of axonal and astroglial injury in CSF from 46 MS patients, 46 healthy siblings and 50 controls.

RESULTS

We found elevated levels of both PGE2 and 15(S)-HETE in MS compared with the control and sibling groups. Siblings had lower PGE2 levels and higher 15(S)-HETE levels than controls. There were no correlations between either PGE2 or 15(S)-HETE and clinical scores of MS severity or biochemical markers of axonal or astroglial injury.

CONCLUSION

These data suggest no direct involvement of PGE2 and 15(S)-HETE in the MS disease process. Rather, the elevated levels reflect a general up-regulation of arachidonic acid metabolism and neuroinflammation.

Reduced cerebrospinal fluid BACE1 activity in multiple sclerosis

Background

Cell and animal experiments have shown that β-site APP-cleaving enzyme 1 (BACE1) may be involved in myelination.

Objective

Here, we assess the association of cerebrospinal fluid (CSF) BACE1 activity with multiple sclerosis (MS).

Methods

BACE1 activity and levels of secreted amyloid precursor protein (APP) and amyloid-β (Aβ) isoforms were analyzed in CSF from 100 patients with MS and 114 neurologically healthy controls. Patients with systemic lupus erythematosus (SLE), 26 with and 41 without cerebral engagement, were also included to enable comparisons with regards to another autoimmune disease. A subset of patients with MS and controls underwent a second lumbar puncture after 10 years.

Results

MS patients had lower CSF BACE1 activity than controls ( P = 0.03) and patients with cerebral SLE ( P < 0.001). Patients with cerebral SLE had higher BACE1 activity than any other group ( P < 0.05 for all comparisons). BACE1 activity correlated with the different amyloid markers in all study groups. BACE1 activity decreased over 10 years in the MS group ( P = 0.039) and correlated weakly with clinical disease severity scores in an inverse manner.

Conclusions

These results suggest an involvement of BACE1 in the MS disease process.

Thyroid autoantibodies in women with and without thyroid disorders in an iodine-replete area

To compare the prevalence of positive autoantibodies in patients with thyroid disorders and healthy subjects in an iodine-replete area of the Islamic Republic of Iran, we studied 930 women in a clinic-based study: 698 patients (286 hypothyroid, 140 hyperthyroid, 272 with simple goitre) and 232 healthy women. Serum thyroxine (T4), triiodothyronine (T3), thyroid stimulating hormone, and anti-thyroid antibodies were measured. Positive autoantibodies were detected in 75.5% of patients with hypothyroidism, 73.6% of those with hyperthyroidism, 48.9% of those with simple goitre and 35.8% of the control group (P < 0.001). Autoimmunity may have a role in the genesis of common thyroid disorders.

Comparing invasive and non-invasive of isolated Shigella flexneri by electron microscopy of cell culture, SDS-PAGE and Congo red method

BACKGROUND

The aim of this study was to compare invasive and non-invasive strains of Shigella flexneri isolated from Tehran by a 120 kDa protein band by SDS-PAGE, electron microscopy of cell culture and Congo red dye methods.

METHODS

S. flexneri strains were isolated by standard bacterial methods from fecal specimens of children attending to the 3 children's hospitals. Phenotype analysis for screening virulent of strains of S. flexneri was done on a plate of tryptic soy agar contained 0.003% Congo red dye. Whole membrane protein preparations were used to examine the protein profiles of the inner and outer membrane of these Gram-negative bacteria. The protein mixture was electrophoresed through a polyacrylamide gel. The gel was stained with Coomassie brilliant blue R250 and destained with ethanol and acetic acid. HeLa cell culture was done by two-step preparations: one for light microscopy and the other for electron microscopy.

RESULTS

Some of S. flexneri (46%) were Congo red positive colonies. S. flexneri with negative Congo red phenotype could not enter the HeLa cell culture. A 120 kDa protein band was found in 46% of these bacteria which could enter into HeLa cell culture. Pseudopod structures which facilitate bacterial cell-to-cell spread were readily identified by electron microscopy.

DISCUSSION

Since the existence of 120-kDa protein band was corresponded to enter of S. flexneri into the HeLa cell culture and correlated with Congo red dye positive, for identification of invasive and non-invasive S. flexneri strains, the use of a 120-kDa protein band by SDS-PAGE or a simple, rapid and very cheap Congo red dye method is recommended. Because, there are some deaths due to Shigella sp. in our country, notification on the isolation of these bacteria in both children hospitals laboratories and private clinical laboratories is important.

[Tc]-99m thyroid scintigraphy in congenital hypothyroidism screening program

The aetiology of congenital hypothyroidism (CH) may be important in determining disease severity, outcome and treatment schedules because athyroid patients need higher treatment doses and close monitoring particularly early in life. The aim of this study was to evaluate thyroid scintigraphy (TS) findings in infants with CH and to determine the relationship of serum TSH and T4 values with thyroid agenesia, in an attempt to identify factors that may detect thyroid agenesia before treatment. Since August 2002 to April 2005, screening program for CH was carried out in the Isfahan University of Medical Sciences and Health Services, Isfahan, Iran. Screening was performed by measuring both the serums T4 and TSH concentration at day 3-7 of birth. Full-term newborns were recalled based on a serum TSH >20 mIU/l or serum T4 < 6.5 microg/dl and premature newborns based on T4 level by weight and TSH level by age. After repeating the laboratory test and clinical evaluation, Tc-99m TS was recommended for all infants with suspected CH before thyroxin replacement therapy. On the basis of Tc-99m TS, the thyroid gland was classified as normal scan, ectopic, goiter and athyrosis. TS results were compared with serum T4 and TSH levels. Of 93 381 newborns screened over a period of nearly 3 years, 262 neonates were found to have CH. The overall incidence of CH was 1 : 357 live births with a female/male ratio (F/M) of 1.4/1. Thyroid scan was performed on 116 (54%) of the infants with CH; of them, 33 cases (28.4%) were athyrotic (F/M = 0.8/1) while seven infants (6%) had ectopic thyroid (F/M = 1.3/1) and 76 cases (65.6%) had a normal thyroid scan (F/M = 1.5/1). Infants with the absence of thyroid in TS had significantly higher TSH value in comparison with those with ectopic or normal TS (116.3 +/- 109.64 vs. 108.10 +/- 62.92 or 55.35 +/- 48.26 mIU/l, respectively, P < 0.0001). Although not statistically different, the mean T4 level was higher in normal TS group than in ectopic and athyrotic groups (8.03 +/- 3.48 vs. 6.36 +/- 5.57 or 5.04 +/- 3 microg/dl, respectively, P = 0.09). We conclude that Tc-99m TS is a useful diagnostic tool for the initial investigation of suspected CH and considering the correlation of TS results with blood TSH levels, proper management and close monitoring of hypothyroid infants with severe hormonal alterations is necessary for the detection of thyroid agenesia.

IL-6 and CCL2 levels in CSF are associated with the clinical course of MS: implications for their possible immunopathogenic roles

Biological markers would provide valuable tools for tracking disease activity, immunopathological processes or therapeutic efficacy in MS. In this study we analysed a panel of Th(1)/Th(2) cytokines and the chemokine CCL2 in serum and CSF from MS patients and healthy controls. Increased levels of IL-6 (p<0.05) and decreased levels of CCL2 (p<0.001), with the lowest levels during acute relapses, was found in CSF from patients with relapsing-remitting MS. CSF levels of CCL2 correlated with indices for intrathecal IgG production and the CSF level of the neurofilament light protein, a marker for axonal damage, indicating a immunopathogenic role for CCL2.

Fluorometric variable-temperature kinetics investigations of the transesterification reaction of procaine with aliphatic alcohols

PURPOSE

Variable-Temperature Kinetics has been used to obtain the rate constants of the reaction at various temperatures during one kinetic run.

METHODS

Pseudo-first-order rate constants for the transesterification of procaine with aliphatic alcohols ethanol, n-propanol and tert-butanol were obtained by the fluorescence spectroscopy using the variable-temperature kinetics (VTK) method.

RESULTS

The activation parameters of the reactions were calculated (24-28 kcal x mol(-1)). The half-life of the procaine decreases in the ethanol solution compared with the other alcoholic solutions in the presence of sodium ethoxide.

CONCLUSIONS

The investigation time of the reactions is reduced to one-tenth of the one used for usual kinetic methods.

Neurofilament light protein and glial fibrillary acidic protein as biological markers in MS

OBJECTIVE

To determine if CNS-derived proteins present in the CSF of multiple sclerosis (MS) patients reflect different pathologic processes of MS and if these proteins could be useful as biologic markers of disease activity.

METHODS

Concentrations of the neurofilament light protein (NFL), glial fibrillary acidic protein (GFAP), S100B, and the neuron-specific enolase protein (NSE) were determined in the CSF of 66 MS patients and 50 healthy control subjects with immunoassays.

RESULTS

The mean levels of the NFL were increased during all stages of MS compared with controls (p < 0.001), peaking almost 10 times higher during acute relapses. The highest levels of GFAP were found during the secondary progressive course (p < 0.001) with a strong correlation with neurologic deficits (Expanded Disability Status Scale score, r = 0.73, p < 0.001). No increase of S100B or NSE protein was found in the CSF of MS patients compared with control subjects.

CONCLUSIONS

Increased level of NFL is a general feature of MS, indicating continuous axonal damage during the entire course of the disease with the most profound damage during acute relapses. GFAP may serve as a biomarker for disease progression, probably reflecting the increasing rate of astrogliosis.

Cerebrospinal fluid markers in MS patients and their healthy siblings

In a previous study we found that nine of 47 siblings to multiple sclerosis (MS) patients with a normal neurological examination carry an intrathecal oligoclonal immunopathy with limited specificity, a condition we termed MS immunopathic trait. The purpose of this study is to further characterize the MS immunopathic trait phenotype. We found that the neurofilament light protein (NFL) and glial fibrillary acidic protein (GFAp) concentrations were increased in the group of patients with clinically definite MS (n = 47) in latent or slowly progressive phases. There was no increase in GFAp and NFL in cerebrospinal fluid in the healthy siblings of MS patients (n = 47), nor in the subgroup of these siblings with MS immunopathic trait (n = 9) compared with a group of healthy control subjects (n = 50). Thus, there was no indication of presymptomatic CNS parenchymal involvement in MS immunopathic trait.

Multiple sclerosis siblings with cerebrospinal fluid immunopathy but without any indication of neuronal damage

OBJECTIVE

In a previous study, we found that nine of the 47 siblings to multiple sclerosis (MS) patients with a normal neurologic examination carry an intrathecal oligoclonal immunopathy with limited specificity, a condition we termed MS immunopathic trait. Here we searched for neurological dysfunction with increased sensitivity.

METHOD

We used high-pass resolution perimetry, which reveals visual pathway lesions by their impaired neural effective capacity (EC) in early MS cases even without optic neuritis.

RESULTS

These nine individuals with MS immunopathic trait did not differ from nine healthy controls with normal cerebrospinal fluid regarding their EC.

CONCLUSION

This is further evidence that a group of MS immunopathic trait individuals, siblings to MS patients, are essentially free from the central nervous system functional loss typically found in MS.

Incidence of CSF abnormalities in siblings of multiple sclerosis patients and unrelated controls

We found that 19% (9/47) of healthy siblings of patients with clinically definite multiple sclerosis had an intrathecal immunological reaction with two or more 2 CSF-enriched oligoclonal bands (OCBs), in contrast to (4%) (2/50) unrelated healthy controls. Furthermore, in this group of nine healthy sibs the measles CSF IgG antibody titers were higher than that of the other sibs and that of controls. There were also differences in the serum titers for measles IgG antibody, which were higher in the group of all healthy sibs than in healthy volunteers, and (as with CSF titers) higher in the subgroup of healthy sibs with two or more 2 CSF-enriched OCBs than the other sibs. Thus a significant proportion of healthy siblings to MS patients have a partially hyperimmune condition similar to that occurring in MS, which in 19% manifested itself as an OCB reaction, in 9% as increased CSF measles IgG antibody titers, and in 21% as increased serum measles IgG antibody titers, these phenomena tending to occur in the same individuals. This condition is characterized by CSF-enriched OCBs with undefined specificity, although some increased antiviral reactivity is found both in the serum and CSF. While it needs further characterization, a genetic trait interacting with common infections is suggested. The recurrence risk of this condition is approximately five times higher than the 3-4% recurrence risk for manifest MS reported for sibs.

Changes in gene expression in response to polyamine depletion indicates selective stabilization of mRNAs

We used differential display analysis to identify mRNAs responsive to changes in polyamine synthesis. As an overproducing model we used the kidneys of transgenic hybrid mice overexpressing ornithine decarboxylase and S-adenosylmethionine decarboxylase, two key enzymes in polyamine biosynthesis. To identify mRNAs that respond to polyamine starvation, we treated Rat-2 cells with alpha-difluoromethylornithine, a specific inhibitor of polyamine biosynthesis. We isolated 41 partial cDNA clones, representing 37 differentially expressed mRNAs. Of these, 15 have similarity with known genes, five appear to be similar to reported expressed sequence tags and seventeen clones were novel sequences. Of the 35 mRNAs expressed differentially after alpha-difluoromethylornithine treatment, 26 were up-regulated. The expression of only three mRNAs was altered in the transgenic animals and all three were down-regulated. Determination of mRNA half-life of three of the mRNAs up-regulated in response to polyamine depletion revealed that the accumulation results from stabilization of the messages. Because most of the transcripts identified from Rat-2 cells suffering polyamine starvation were accumulated, we conclude that polyamine depletion, while blocking cell growth, is stabilizing mRNAs. This may be due to the lack of spermidine for post-translational modification of the eukaryotic initiation factor 5A, which plays a major role in mRNA turnover. The coupling of mRNA stabilization with cell-growth arrest in response to polyamine starvation provides cells with an economical way to resume growth after recovery from polyamine deficiency.

Physiological analysis of motor reorganization following lower limb amputation

It is now known that amputation results in reorganization of central motor pathways, but the mechanism for the changes is unclear. One possibility is alteration of the excitability of the alpha motoneurons. We studied motor reorganization and excitability of alpha motoneurons to Ia input in 6 subjects with unilateral lower limb amputation. A Cadwell MES-10 stimulator was used to deliver transcranial magnetic stimuli through a circular coil centered on the sagittal axis 4 cm anterior to Cz and through an 8-shaped coil positioned over scalp locations 1 cm apart along the coronal axis. Surface EMG was recorded bilaterally from quadriceps femoris, the first muscle immediately proximal to the site of amputation. Excitability of the spinal alpha motoneuron pool to Ia afferents was assessed by determining the ratio of the maximal H reflex to the maximal M response (H/M ratio) elicited in the quadriceps femoris. Stimuli of equal intensity delivered to optimal scalp positions recruited a larger percentage of the alpha motoneuron pool in muscles ipsilateral to the stump than in those contralateral to the stump (P less than 0.01). Mean onset latencies of motor evoked potentials were shorter in ipsilateral muscles than in contralateral muscles (P less than 0.01). Muscles ipsilateral to the stump showed a trend toward activation from a larger number of scalp positions than those contralateral to the stump (P = 0.06). There was no difference in the quadriceps H/M ratios (7.2% ipsilateral vs. 10.9% contralateral). The absence of changes in the excitability of the alpha motoneuron pool in the presence of motor reorganization targeting muscles proximal to the stump suggests that reorganization occurs proximal to the alpha motoneuron level.

Magnetic transcranial and electric direct stimulation of the facial motor cortex in dogs

Magnetic stimulation may allow noninvasive study of the entire course of the facial nerve. Our goal was to determine if evoked muscle action potentials can be obtained in facial musculature using electric direct cortical and noninvasive transcranial magnetic stimulation of the canine motor cortex. Thirty-four dogs were studied with electric direct cortical stimulation through a craniotomy and magnetic transcranial stimulation of the facial motor cortex. Facial nerve stimulation in the cerebellopontine angle allowed comparison to cortical responses. Latencies of 6.08 and 9.52 msec for orbicularis oculi and levator nasolabialis, respectively, were determined with magnetic transcranial stimulation, compared with 4.22 and 5.78 msec with electric direct cortical stimulation. In conclusion, magnetic stimulation of the facial motor cortex is possible in dogs, with longer central conduction times than with electric direct stimulation.

Motor-evoked potentials of facial musculature in dogs

Motor responses of limb musculature have been elicited by transcranial brain stimulation using electrical and magnetic stimulation. Recording from muscles innervated by cranial nerves has not previously been reported. A unilateral hemispheric craniotomy was performed in 24 dogs. An electric stimulus was delivered directly to the exposed motor cortex via surface electrodes. Evoked electromyographic responses to motor cortex stimulation were recorded from the contralateral orbicularis oculi and orbicularis oris muscles. Preliminary investigation into the use of magnetic stimulation of the motor cortex is compared to direct electrical cortical stimulation. This study demonstrates the potential for magnetic stimulation in the intraoperative and outpatient clinical evaluation of facial nerve disorders. It appears possible, for the first time using magnetic stimulation, to noninvasively stimulate these nerves proximal to the point of injury and to evaluate more central conduction pathways.

Motor-evoked potentials of tongue musculature in dogs

Transcranial brain stimulation by either electrical or noninvasive magnetic stimulation has produced motor responses of limb musculature. However, recordings from muscles innervated by cranial nerves have not previously been reported. A right-sided craniotomy was performed in 18 dogs. An electric stimulus was delivered to the motor cortex via surface electrodes and evoked EMG responses were recorded from the tongue musculature to determine conduction time. Magnetic stimulation of the motor cortex yielded EMG latencies similar to those obtained by electrical direct cortical stimulation, thus demonstrating the potential of magnetic stimulation in intraoperative and outpatient clinical evaluation of hypoglossal nerve disorders. For the first time, it appears possible to noninvasively stimulate the cranial nerves proximal to the point of injury and to evaluate more central conduction pathways.

Environmental exposure to Coxiella burnetii: a sero-epidemiologic survey among domestic animals

The prevalence of agglutinating serum antibodies against Coxiella burnetii, the cause of Q fever in humans, was tested in a hospital population of companion animals and livestock in California during 1973--1975. A sample of stray dogs was also tested. Among the hospitalized animals 346 (48%) of 724 dogs, 7 (9%) of 80 cats, 9 (32%) of 28 cattle and 31 (26%) of 121 horses had antibodies against C. burnetii. Of 316 stray dogs 208 (66%) were seropositive. The overall prevalence of 53% among 1040 dogs tested was comparable to the 63% antibody prevalence found in an earlier survey among coyotes and foxes in wildlife areas of California. When the dog was considered as a sentinel animal for the presence of C. burnetii surrounding household environments, it was hypothesized that the common, low level exposures in the community are similar to those found in more remote wildlife areas.

Inhibitory studies of DNA, RNA and protein synthesis in Escherichia coli by platinum containing complexes

Previous studies have shown various platinum containing compounds to be effective anti-tumor agents in man and animals. Many of these compounds have also been shown to be effective inhibitors of bacterial DNA, RNA and protein synthesis. Data is presented here which compares the inhibitory effectiveness of a number of recently synthesized platinum compounds toward the inhibition of the synthesis of DNA, RNA and protein in Escherichia coli. We also compared the effectiveness of these compounds toward the inhibition of bacterial growth. Some of these new derivatives appear to be nearly 3-fold more potent than the more thoroughly studied cis-diamminedichloroplatinum(II) (cis-PDD) and trans-diamminedichloroplatinum(II) (trans-PDD).

The prevalence of antibodies against Toxoplasma gondii among hospitalized animals and stray dogs

Hospitalized animals and stray dogs were serologically tested for antibodies against Toxoplasma gondii. In addition, the data were examined for the possibility of toxoplasmosis infection being associated with the clinical diagnosis and with the discharge status (alive vs. dead). Among 1056 hospitalized animals, 17 (20%) of 86 cats, 112 (14%) of 804 dogs, 34 (26%) of 133 horses and 6 (18%) of 33 cattle had serological evidence of infection with T. gondii. Only 22 (6%) of 342 young (median age = one year) stray dogs were seropositive. The difference in antibody prevalence between hospitalized and stray dogs was thought to be due to age and dietary factors. Of 249 dogs grouped by clinical diagnosis, there was significantly (p less than 0.01) higher prevalence of seropositives among dogs with diseases of the kidney or with adrenocortical hyperfunction than among dogs hospitalized for other diseases. Of 19 dogs with diseases of the kidney and 12 with adrenocortical hyperfunction 37% and 42%, respectively, were seropositive.. There was higher risk of being discharged from the hospital dead among seropositive dogs, cattle and horses than among seronegative animals of the same species. The exception was cats, where of 69 seronegative cats 29% were dead at discharge and where of 17 seropositive cats 18% were dead at discharge. The possible effects of stress due to hospitalization need further research.