The role of cardiovascular magnetic resonance imaging in cardiac resynchronisation therapy

Cardiac electromechanical resynchronisation therapy (CRT) is an effective non-pharmacological treatment of patients suffering from drug refractory heart failure. However, approximately 20–30% of patients are non-responder. Cardiac magnetic resonance imaging (CMR) may play significant role in clarifying many questions in this patient population. Forty-five patients, suffering from severe drug refractory heart failure, underwent CMR before applying CRT. Left ventricular end-diastolic, end-systolic volumes, ejection fraction, myocardial mass, wall motion disturbances, localisation of non-viable myocardium were determined. Left ventricular dyssynchrony was determined by illustrating wall-time thickening in short-axis slices of left ventricle from basis to apex. CMR-proved underlying heart disease were postinfarction heart failure, dilated cardiomyopathy and non-compaction cardiomyopathy in 62, 27 and in 11%, respectively. Mean left ventricular ejection fraction was 24.5±10%, intraventricular dyssynchrony was 200±78 ms. In four patients, requiring surgical revascularisation after unsuccessful coronary sinus electrode implantation, optimal position for epicardial screw-in electrode was selected. According to the results of CMR, biventricular device was not implanted in 7 patients. During the follow-up of the 38 patients, 5 patients (13.16%) were non-responders, despite the approximately 22% non-responder ratio in our whole patient population treated by CRT but without performing previous CMR examination. In this patient population CMR may have a significant role in the selection of responder patient population.

PAC1 receptor localization in a model nervous system: light and electron microscopic immunocytochemistry on the earthworm ventral nerve cord ganglia

The presence and pattern of pituitary adenylate cyclase activating polypeptide (PACAP) type I (PAC1) receptors were identified by means of pre- and post-embedding immunocytochemical methods in the ventral nerve cord ganglia (VNC) of the earthworm Eisenia fetida. Light and electron microscopic observations revealed the exact anatomical positions of labeled structures suggesting that PACAP mediates the activity of some interneurons, a few small motoneurons and certain sensory fibers that are located in ventrolateral, ventromedial and intermediomedial sensory longitudinal axon bundles of the VNC ganglia. No labeling was located on large interneuronal systems such as dorsal medial and lateral giant axon systems and ventral giant axons. At the ultrastructural level labeling was mainly restricted to endo- and plasma membranes showing characteristic unequal distribution in various neuron parts. An increasing abundance of PAC1 receptors located on both rough endoplasmic reticulum and plasma membranes was seen from perikarya to neural processes, indicating that intracellular membrane traffic might play a crucial role in the transportation of PAC1 receptors. High number of PAC1 receptors was found in both pre- and postsynaptic membranes in addition to extrasynaptic sites suggesting that PACAP acts as neurotransmitter and neuromodulator in the earthworm nervous system.

Co-transport of sex hormone-binding globulin/SHBG with oxytocin in transport vesicles of the hypothalamo-hypophyseal system

The intrinsic expression of sex hormone binding globulin (SHBG) in magnocellular hypothalamic neurons, in part co-localized with either vasopressin or oxytocin, was recently described. This study is focused on the ultrastructural localization of SHBG in the hypothalamo-neurohypophyseal pathway in rats. Immunostaining for SHBG in the hypothalamic perikarya was increased by colchicine treatment, indicating that the steroid-binding globulin is subject to rapid axoplasmic transport along with the classical posterior lobe peptides. With immunoelectron-microscopic double labeling, we found co-localization of oxytocin and sex hormone binding globulin in a portion of the large dense-core vesicles in paraventricular and supraoptic perikarya and in axonal varicosities in the median eminence and in the posterior lobe. Our observations show that SHBG is processed, transported and stored along with oxytocin suggesting that SHBG is released from nerve terminals in the posterior lobe, the median eminence and possibly the brain similarly to and in conjunction with oxytocin.

Earthworm leukocyte populations specifically harbor lysosomal enzymes that may respond to bacterial challenge

Earthworm leukocytes (coelomocytes) are responsible for innate cellular immune functions such as phagocytosis and encapsulation against parasites and pathogens. Microbial killing results from the combined action of the phagocytic process with humoral immune factors such as agglutinins (e.g., lectins), lysosomal enzymes (e.g., acid phosphatase, lysozyme), and various cytotoxic and antimicrobial molecules. There is also evidence of weak adaptive immune responses against foreign transplants. This study focused on aspects of the innate immune response. First, anti-human acid phosphatase (anti-AcP) polyclonal antibody characterized different acid hydrolase patterns in coelomocytes. Second, flow cytometry identified a strongly immunoreactive coelomocyte population. Third, ultrastructural and cytochemical analyses revealed acid phosphatase in discrete granules (lysosomes) of effector hyaline and granular coelomocytes but not in mature chloragocytes. Coelomocytes were exposed to bacteria to assess how phagocytosis influences: (a) the production of acid phosphatase using Western blot, and (b) release of acid phosphatase using ELISA from cell-free coelomic fluid. Fourth, after phagocytosis, acid phosphatase levels differed between controls and experimentals. Fifth, we found a 39-kDa molecule that reacted intensely with anti-AcP. Our results suggest that effector earthworm coelomocytes may not eliminate pathogens only by phagocytosis but also by extracellular lysis.

Reactions of some cucurbitaceous species Tozucchini yellow mosaic virus (ZYMV)

Zucchini yellow mosaic virus (ZYMV) is a widespread serious pathogen of cucurbitaceous plants. ZYMV was first detected in Hungary in 1995. Since then it has become one of the most dangerous viruses of the Cucurbitaceae family causing serious epidemics. The virus has many hosts, which - particularly perennial ones - may play important role as virus reservoirs and infection sources in virus epidemiology. On the other hand wild weed species maybe sources of resistance to viruses. Our research was carried out on a total of 15 wild species from 8 genera (Cucumis, Cucurbita, Cyclanthera, Ecballium Momordica, Lagenaria, Zehneria, Bryonia). Test plants were mechanically inoculated with ZYMV. Local and systemic symptoms were determined and 5 weeks after inoculation DAS-ELISA tests were also carried out. Symptomless plants were reinoculated to Cucumis sativus cv. Accordia test plants. On the basis of the results we determined the percentages of infections and so we classified the test-plants into sensitive and resistance categories. On the basis of the results new host plants of ZYMV are the followings: Bryonia dioica, Cyclanthera pedata, Ecballium elaterium, Momordica balsamina, Momordica rostrata, and Zehneria scabra. Among them Momordica balsamina and Ecballium elaterium showed latent to ZYMV. Bryonia alba and Zehneria indica are especially remarkable, because they proved resistant to ZYMV on the basis of symptomatology and serology. Our results might have significant role in the field of research of host range, virus resistance and virus differentiation.

High-throughput prediction of blood-brain partitioning: a thermodynamic approach

A high-throughput in silico screening tool for potentially CNS active compounds was developed on the basis of the correlation of solvation free energies and blood-brain partitioning (log(cbrain/cblood) = log BB) data available from experimental sources. Utilizing a thermodynamic approach, solvation free energies were calculated by the fast and efficient generalized Born/surface area continuum solvation model, which enabled us to evaluate more than 10 compounds/min. Our training set involved a structurally diverse set of 55 compounds and yielded a function of log BB = 0.035Gsolv + 0.2592 (r = 0.85, standard error 0.37). Calculation of solvation free energies for 8700 CNS active compounds (CIPSLINE database) revealed that Gsolv is higher than -50 kJ/mol for the 96% of these compounds which can be used as suitable criteria for the identification of compounds preferable for CNS penetration.

A neural network based virtual high throughput screening test for the prediction of CNS activity

A virtual high throughput screening test to identify potentially CNS-active drugs has been developed. Discrimination was based on the knowledge available in databases containing CNS-active (Cipsline from Prous Science) and inactive compounds (Chemical Directory from Sigma-Aldrich). Molecular structures were represented using 2D Unit y fingerprints and a feedforward neural network was trained to classify molecules regarding their CNS activity. The parameterized network was validated by reclassification of the training set elements, by the classification of a test set preselected from the Prous database, and also by the prediction of activity for known CNS drugs not used in the training set but available in the Medchem database (Daylight). These tests revealed that our neural net recognized at least 89% of CNS-active compounds and would be suitable for use in our virtual screening protocol.

[Treatment of chronic myeloid leukemia with interferon-alpha]

The authors have treated 38 patients with chronic phase chronic myeloid leukemia in their single center in the last five years. Conventional chemotherapy provided about 40-50% hematological response, interferon-alpha seems to be more effective, complete hematological remission occurred in 65%. Interphase cytogenetics and fluorescein in situ hybridisation technique was used to measure the cytogenetic response. They observed complete cytogenetic remission in two cases (8%), major response in 11 (39%), minor response in 4 (15%) and minimal response in 4 cases (15%). Interferon-alpha is an effective, well-tolerated medicine in the treatment of chronic myeloid leukemia.

[The role of TNF-alpha in myelodysplastic syndrome: immunoserologic and immunohistochemical studies]

TNF alpha is a highly active cytokine which plays an important role in the regulation of apoptotic cell death, a mechanism involved in the pathophysiology of myelodysplastic syndrome (MDS). In this study we investigated the expression of TNF alpha on the bone marrow trephine biopsies by immunohistochemical method and the TNF alpha production of peripheral blood mononuclear cells by ELISA method in 15 patients affected by MDS. Five of seven patients without excess of blasts showed high or intermediate TNF alpha expression in the bone marrow biopsies, whereas two patients with excess of blasts were negative and one had low expression. The five CMML patients revealed low or intermediate expression. The production of TNF alpha by the PBMC was analysed in 10 patients, four patients with RA and two with CMML produced higher level of TNF alpha which increased after stimulation with phorbol myristic acetate, but none of the RAEB patients revealed increase in TNF alpha production. In conclusion we suppose that increased TNF alpha expression and production by PBMC may be a further indirect evidence of the role of increased apoptosis in low risk MDS patients, in the course of progression the cytokine expression and production decreases.

Silent Philadelphia chromosome: a distinct developmental stage in a philadelphia chromosome-positive chronic myeloproliferation?

In this paper, a patient is described who presented with peripheral blood and bone marrow features uncharacteristic of chronic granulocytic leukemia, which proved to be Philadelphia (Ph) chromosome-positive by metaphase and interphase cytogenetic analyses but lacked the p210 type of BCR/ABL fusion gene mRNA product by two different sensitive RT-PCR assays. In the course of the 32-month follow-up with a termination into a myeloblastic crisis, molecular investigations were performed four times. They indicated a constantly high rate of Ph positive cells and lack of BCR/ABL mRNA expression, except in the second investigation, when the patient showed reverse transcription polymerase chain reaction positivity with b3/a2 type of chimera, fusion gene mRNA expression, and a striking change in the bone marrow histology. Our findings might indicate that the dormant Ph chromosome state may exist not only at the primitive progenitor, but also at the entire peripheral blood cell compartment level.

Detection of TNFalpha expression in the bone marrow and determination of TNFalpha production of peripheral blood mononuclear cells in myelodysplastic syndrome

TNFalpha is a highly active cytokine which plays an important role in the regulation of apoptotic cell death, a mechanism involved in the pathophysiology of myelodysplastic syndrome (MDS). In this study we investigated the expression of TNFalpha of the bone marrow trephine biopsies by immunohistochemical method and the TNFalpha production of peripheral blood mononuclear cells by ELISA method in 15 patients affected by MDS. Five of seven patients without excess of blasts showed high or intermediate TNFalpha expression in the bone marrow biopsies, whereas two patients with excess of blasts were negative and one had low expression. The five CMML patients revealed low or intermediate expression. The production of TNFalpha by the PBMC was analysed in 10 patients, four patients with RA and two with CMML produced higher level of TNFalpha which increased after stimulation with phorbol myristic acetate, but none of the RAEB patients revealed increase in TNFalpha production. In conclusion we suppose that increased TNFalpha expression and production by PBMC may be an indirect evidence of the role of increased apoptosis in low risk MDS patients.

Neurotoxicity of paraquat and triphenyltin in the earthworm, Eisenia fetida Sav. A histo- and cytopathological study

Neuropathological effects of the pesticides paraquat (PQ, a herbicide) and triphenyltin (TPT, a fungicide) were studied on the postclitellar segmental ganglia of juvenile E. fetida specimens using light and electron microscopic methods. Growth retardation of the worms in standard culture medium was used as quantitative marker of sublethal effect. There is a distinct neuron group in the segmental ganglia characterised by high sensitivity against PQ- and another one against TPT-toxication. However the marked histo- and neurocytopathological alterations were similar in PQ and TPT treated worms. Both chromatolysis and vacuolation of perikarya were revealed in sensitive neurons. Damaged cells were swollen and possessed degenerated rough endoplasmic reticulum cisternae. They were also characterised by swollen mitochondria, with electronlucent matrix and damaged inner membranes, and vesicular structures of various diameters as well as numerous lysosomes. Necrotic neurons with pyknotic nuclei and highly eosinophilic cytoplasm were also found in affected ganglia. Several dividing neurons were found in PQ-toxicated worms while no cell division occurred either in control or TPT-toxicated animals. The exact neurochemical and functional identification of PQ- and TPT-sensitive neurons needs further investigations.

[Microsurgical reconstruction of facial defects using a forearm flap]

The perforating facial defects are often results of the removal of malignant tumours and less commonly are caused by accidents and shotgun injuries. The advent of musculocutan flaps and the microvascular tissue transplantation has made essential changes in the treatment of full thickness cheek defects during the last decade. The authors describe three cases, where the reconstruction has been made with free radial forearm flaps.

Value of different serological tests in the diagnosis of bovine brucellosis in the Amazonian region

The high prevalence of brucellosis is one of the most serious animal health problems affecting cattle and buffalo herds of the Amazonian region. Modern diagnostic methods are not used or not even known, and thus test results are not available in that region. Therefore, in this study a total of 878 selected sera were subjected to comparative examination by five different serological tests (buffered plate agglutination test, tube agglutination test, complement fixation test, indirect ELISA, competitive ELISA). Indirect ELISA gave the highest number of positive results, except in samples derived from the Marajó island, for which the competitive ELISA proved to be the most sensitive. The sensitivity of the classical tests (agglutination, complement fixation) was markedly lower than that of the two ELISAs. After vaccination of 2-month-old heifer calves with the B19 vaccine, all tests showed a 50-60% seropositivity, which disappeared within four months.