Tracking the Connection between Disorder and Energy Landscape in Glasses Using Geologically Hyperaged Amber

Fossil amber offers the unique opportunity to investigate an amorphous material that has been exploring its energy landscape for more than 110 million years of natural aging. By applying different X-ray scattering methods to amber before and after annealing the sample to erase its thermal history, we identify a link between the potential energy landscape and the structural and vibrational properties of glasses. We find that hyperaging induces a depletion of the vibrational density of states in the terahertz region, also ruling the sound dispersion and attenuation properties of the corresponding acoustic waves. Critically, this is accompanied by a densification with structural implications different in nature from that caused by hydrostatic compression. Our results, rationalized within the framework of fluctuating elasticity theory, reveal how upon approaching the bottom of the potential energy landscape (9% decrease in the fictive temperature) the elastic matrix becomes increasingly less disordered (6%) and longer-range correlated (22%).

Glassy Anomalies in the Low-Temperature Thermal Properties of a Minimally Disordered Crystalline Solid

The low-temperature thermal and transport properties of an unusual kind of crystal exhibiting minimal molecular positional and tilting disorder have been measured. The material, namely, low-dimensional, highly anisotropic pentachloronitrobenzene has a layered structure of rhombohedral parallel planes in which the molecules execute large-amplitude in-plane as well as concurrent out-of-plane librational motions. Our study reveals that low-temperature glassy anomalies can be found in a system with minimal disorder due to the freezing of (mostly in-plane) reorientational jumps of molecules between equivalent crystallographic positions with partial site occupation. Our findings will pave the way to a deeper understanding of the origin of the above-mentioned universal glassy properties at low temperature.

Thermodynamic and Kinetic Fragility of Freon 113: The Most Fragile Plastic Crystal

We present a dynamic and thermodynamic study of the orientational glass former Freon 113 (1,1,2-trichloro-1,2,2-trifluoroethane, CCl_{2}F-CClF_{2}) in order to analyze its kinetic and thermodynamic fragilities. Freon 113 displays internal molecular degrees of freedom that promote a complex energy landscape. Experimental specific heat and its microscopic origin, the vibrational density of states from inelastic neutron scattering, together with the orientational dynamics obtained by means of dielectric spectroscopy have revealed the highest fragility value, both thermodynamic and kinetic, found for this orientational glass former. The excess in both Debye-reduced specific heat and density of states (boson peak) evidences the existence of glassy low-energy excitations. We demonstrate that early proposed correlations between the boson peak and the Debye specific heat value are elusive as revealed by the clear counterexample of the studied case.

[Sphincterotomy followed by papillary large balloon in the management of cholecolithiasis. Therapeutic success and safety in a Lima-Peru hospital]

OBJECTIVE

We present a descriptive analysis of our cases of sphincterotomy followed by papillary large balloon dilation in a single session (ES-LBD) in the management of difficult to extract calculi, with the objective of assessing rates of therapeutic success and complications in local experience.

MATERIAL AND METHODS

ERCP procedures with ES-LBD performed for choledocholithiasis between January 2009 and December 2014 in patients older than 18 years and without preexistent sphincterotomy were selected from records of the Gastroenterology Service at Cayetano Heredia National Hospital. A descriptive analysis of therapeutic success and complications was performed.

RESULTS

73 procedures in 73 patients were included (65.8% female, 34.2% male). Patient's average age was 59.4±19.8 years. Average diameter of calculi was 14.6±3.3mm. Average diameter of dilations was 14.6±2.27 mm. In 8 cases mechanical lithotripsy was performed. Complete calculi extraction was achieved in 56 procedures (76.7%). Complications occurred in 4 cases (5.5%). There were no deaths.

CONCLUSION

Our figures of therapeutic success and complications with ES-LBD for difficult to extract calculi are similar to those reported in literature. ES-LBD is an effective and safe technique for management of choledocholithiasis.

Determining the effects and challenges of incorporating genetic testing into primary care management of hypertensive patients with African ancestry

People of African ancestry (Blacks) have increased risk of kidney failure due to numerous socioeconomic, environmental, and clinical factors. Two variants in the APOL1 gene are now thought to account for much of the racial disparity associated with hypertensive kidney failure in Blacks. However, this knowledge has not been translated into clinical care to help improve patient outcomes and address disparities. GUARDD is a randomized trial to evaluate the effects and challenges of incorporating genetic risk information into primary care. Hypertensive, non-diabetic, adults with self-reported African ancestry, without kidney dysfunction, are recruited from diverse clinical settings and randomized to undergo APOL1 genetic testing at baseline (intervention) or at one year (waitlist control). Providers are educated about genomics and APOL1. Guided by a genetic counselor, trained staff return APOL1 results to patients and provide low-literacy educational materials. Real-time clinical decision support tools alert clinicians of their patients' APOL1 results and associated risk status at the point of care. Our academic-community-clinical partnership designed a study to generate information about the impact of genetic risk information on patient care (blood pressure and renal surveillance) and on patient and provider knowledge, attitudes, beliefs, and behaviors. GUARDD will help establish the effective implementation of APOL1 risk-informed management of hypertensive patients at high risk of CKD, and will provide a robust framework for future endeavors to implement genomic medicine in diverse clinical practices. It will also add to the important dialog about factors that contribute to and may help eliminate racial disparities in kidney disease.

Growth, immune responses and intestinal morphology of rainbow trout (Oncorhynchus mykiss) supplemented with commercial probiotics

The influence of two commercial probiotics on the growth, innate immune parameters and intestinal morphology of rainbow trout (Oncorhynchus mykiss) juveniles (initial weight: 16.4 ± 0.4 g) was evaluated. Two probiotic types: A, multi-species (Bacillus sp., Pedicoccus sp., Enterococcus sp., Lactobacillus sp.) and B, mono-species (Pediococcus acidilactici) were tested at two levels each (A1: 1.5 g kg(-1), 8.6 × 10(5) CFU g(-1); A2: 3 g kg(-1), 1.6 × 10(6) CFU g(-1); B1: 0.1 g kg(-1), 2.6 × 10(4) CFU g(-1); B2: 0.2 g kg(-1), 7.2 × 10(4) CFU g(-1)) versus an unsupplemented diet (C). Diets were distributed to sextuplicate tanks, three times a day to visual satiation for 8 weeks. Growth performance and immune responses (plasma lysozyme, ACH50, peroxidase and head kidney respiratory burst) were determined at 4 and 8 weeks of feeding. Body composition and intestine morphology were determined at the end of the feeding trial. At 8 weeks, the lower dose of multi-species probiotic (A1) improved growth rate, while both probiotic types improved feed conversion rate compared to the control animals, at the lower dose of multi-species (A1) and at the higher dose of mono-species (B2) probiotics. Body composition did not vary between treatments. At 4 weeks, ACH50 activity was significantly higher in fish fed higher dose of B probiotic (B2, 123.7 ± 50.6 vs 44.1 ± 7.7 U.ml(-1) in control). At 8 weeks, lysozyme activity was higher in fish fed A1 (13.1 ± 5.2 μg ml(-1)) diet compared to fish fed control diet (7.8 ± 1 μg ml(-1)). Plasma peroxidase and head-kidney respiratory burst did not differ among the dietary treatments. Villi length and integrity and goblet cell counting of a cross section of the anterior intestine were not significantly different between groups. Results suggest benefits in zootechnical performance and immune humoral responses using both probiotic types, in a dose dependent manner, without apparent alterations in intestinal morphology.

Probing cooperative liquid dynamics with the mean square displacement

Literature data for picosecond mean square displacements show that the anharmonicity explains only about half of the fragility (with different fractions for different glass formers). The other half must be ascribed to the Adam-Gibbs mechanism of a growing cooperatively rearranging region. One can measure both influences separately by a simultaneous measurement of liquid and crystal in the coexistence region.

Structural and thermodynamic studies of n-butanol

We have conducted x-ray diffraction, calorimetric and Brillouin-scattering experiments on n-butanol between 77 and 300 K, aiming to explore the physical nature of the so-called 'glacial state' previously found in n-butanol as well as in triphenyl phosphite. In addition to our structural and thermodynamic studies of the liquid-glass transition and of the stable crystal state in n-butanol, we have found that the metastable 'glacial state' that can be obtained in the temperature range 125-160 K is not a second amorphous state, but rather the result of a frustrated or aborted crystallization process that produces plenty of nanocrystallites embedded in a disordered matrix. The crystalline order of these nanocrystallites of the 'glacial phase' is exactly the same as that well observed in the fully ordered stable crystal into which it transforms by heating above 160 K.

Concentration and temperature dependence of the refractive index of ethanol-water mixtures: influence of intermolecular interactions

The temperature and concentration dependence of the refractive index, nD(x, T), in ethanol-water mixtures agrees with previous data in the ethanol-rich concentration range. The refractive index versus concentration x determined at 20 degrees C shows the expected maximum at about 41 mol% water (22 mass% water). The temperature derivative of the refractive index, dnD/dT, shows anomalies at lower water concentrations at about 10 mol% water but no anomaly at 41 mol% water. Both anomalies are related to intermolecular interactions, the one in nD seems to be due to molecular segregation and cluster formation while the origin of the second one in dnD/dT is still not clear.

Thermal expansion of silver iodide-silver molybdate glasses at low temperatures

Ionic glasses obtained combining silver iodide and silver molybdate are characterized by quite low values of the glass transition temperature T(g) around 320-350 K, by high values of the dc ionic conductivity even at room temperature and by a peculiar behavior of the mechanical response at ultrasonic frequencies. In fact, at temperatures well below their glass transition temperature, these glasses exhibit an intense peak of acoustic attenuation well described by two different and almost overlapping relaxational contributions. Considering also that negative thermal expansion has been reported for some molybdate crystalline compounds, we have investigated in this work the thermal expansion of two silver iodomolybdate glasses (AgI)(1-x)(Ag(2)MoO(4))(x) for x=0.25 and x=0.33 in a wide temperature range (4.2-300 K) from cryogenic temperatures up to some 20 K below T(g) using a precision capacitance dilatometer aiming to understand whether the expansivity shows some possible fingerprint corresponding to the above-mentioned mechanical response. Two different measuring methods, a quasiadiabatic and a continuous one, have been used for the thermal expansion measurements. The results are discussed in comparison with the information obtained from previous investigations based on the extended x-ray absorption fine structure (EXAFS) technique and with the behavior of other ionic glasses.

Ram effect: Adult rams induce a greater reproductive response in anestrous ewes than yearling rams

The introduction of rams to previously isolated anestrous ewes ensures induction of ovulation and estrus in part of the flock, and allows for the potential to conceive. However, there is little known about the desirable characteristics of the rams used to induce these behavioral and physiological responses. Adult rams may be more effective than young rams in induction of these responses. The primary aim of the present study was to compare the response in ewes stimulated by adult or yearling rams. During the non-breeding season, two groups of 121 ewes were stimulated with adult (AR) or yearling (YR) rams. When adult rams were used, significantly more ewes had ovulations (78.5 compared with 61.1%) and came into estrus (47.9 compared with 35.5%). There were more corpora lutea per ewe exposed to rams (0.95+/-0.59 compared with 0.65+/-0.51) and per ewe that had ovulations (1.18+/-0.41 compared with 1.06+/-0.25) and a greater conception rate (58.6 compared with 20.9%) as a result. Subsequently, to determine what signals led to the greater response to adult rams, the courtship behavior of adult and yearling rams toward anestrous ewes was compared in 46 pen tests. There were no significant differences in the frequency of any of the recorded courtship behaviors (anogenital sniffing: 21.9+/-3.4 versus 25.7+/-3.2; lateral approaches: 7.1+/-1.5 compared with 9.9+/-2.9; flehmen: 2.1+/-0.4 compared with 2.2+/-0.4; mount attempts: 0.1+/-0.1 compared with 0.1+/-0.1, for AR and YR, respectively), latency to the onset of courtship behavior (13.1+/-7.0 compared with 17.3+/-6.2s) or the time engaged in courtship behavior (173.1+/-24.6 compared with 199.0+/-26.5s). The difference in the signals produced by adult and yearling rams skin glands was assessed by stimulating ewes with masks containing wool from adult (n=45) or yearling (n=48) rams. More ewes had ovulations (24/45 compared with 11/48) and came into estrus (21/45 compared with 10/48) when wool from adult rams was used. As in Experiment 1, pregnancy and conception rates were greater when adult rams were used, another trial was designed to determine if there were differences in mating and mounting frequency between adult and yearling rams. Seven adult and six yearling rams were subjected to three pen tests each with three estrual ewes. Adult rams mounted more (21.7+/-4.5 compared with 9.8+/-0.7) and tended to ejaculate more frequently (2.9+/-0.5 compared with 1.8+/-0.4) than yearling rams. It is concluded that adult rams induce a greater reproductive response in anestrous ewes than yearling rams, inducing a greater ovulation percentage and estrous response in ewes, resulting in greater ovulation numbers, pregnancy and conception rates. This greater stimulation is, in part, explained by differences in the signals provided in the wool (presumably odors) produced by adult rams. The lesser percentage of pregnancies obtained when yearling rams are used may be explained by differences in mounting behaviors and ejaculation frequency.

Relationship between male-male and male-female sexual behavior in 5-6-month-old male lambs

To characterize male-male sexual behavior during lamb development, to relate it with lamb body and testicular growth, and with sexual behavior toward estrual ewes, 40 Milchschaf male lambs, weaned at 45 days of age, were kept with ewes that were nursing younger lambs. Experimental lambs were weighed and scrotal circumference was measured every 2 weeks. Male-male sexual behavior was observed during 1-2 h every 2 weeks after birth until 7 months of age. Observations were recorded more intensively (3-4 h on five different days) for 2 weeks (5-6 months of age) as male-male sexual behavior increased during that period. Both mounting and mounted lambs were identified. An individual mounting index (MI) was calculated. To study male-female sexual behavior, lambs were individually located with two estrual ewes, and during 5 min the number of ano-genital sniffing, lateral approaches, mounts, and mounts with ejaculation were recorded. From those data, a libido index was also calculated. Male-male mounts (n=308) were observed. Courtship behavior was displayed in 25% of interactions; mounts were accepted in 72.1% of attempted mounts. Mounts without previous courtship were accepted more frequently than mounts with previous courtship (P=0.002). Lamb weight and scrotal circumference were not different according to MI groups. Lambs that mounted more times estrual ewes (first tertile) had greater (P=0.04) MI (0.61+/-0.10) than lambs with medium (0.27+/-0.09) and less (0.30+/-0.10) MI. The regression between MI and heterosexual libido index was r=0.33 (P<0.05). In summary, intensive male-male sexual activity during a short period of male lamb development was observed. There was a positive relationship between sexual behavior of male lambs towards other male lambs and towards estrual ewes.

Structural analysis of dextran-based hydrogels obtained chemoenzymatically

This work reports the results of structural analysis in novel dextran-acrylate (dexT70-VA) hydrogels generated chemoenzymatically. Porous structure as well as hydrogel surface and interior morphologies were evaluated by mercury intrusion porosimetry (MIP), nitrogen adsorption (NA), and scanning electron microscopy (SEM) analyses, as a function of the degree of substitution (DS), and initial water content used in the preparation of the hydrogel. MIP analysis showed that the overall networks were clearly macroporous with pore sizes ranging from 0.065 to 10 microm. As expected, the average pore size decreased as DS increased and as initial water content decreased. Moreover, the porosity values ranged from 75 up 90%, which shows that these hydrogels present an interconnected pore structure. Nitrogen adsorption analyses showed that the specific surface area of dexT70-VA hydrogels increased either by increasing the DS or by decreasing the initial water content of the hydrogel. SEM results revealed that the surface of hydrogels with lower DS presented either a porous structure or a polymeric "skin" covering the pores, whereas hydrogels with higher DS were totally porous. Furthermore, the interior morphology varied according to the DS and the initial water content of the hydrogels. Finally, the average pore size was also determined from the swelling of hydrogel using a theoretical model developed by Flory-Rehner. The comparison of the SEM and MIP results with the ones obtained by the equilibrium swelling theory of Flory-Rehner shows that this approach highly underestimates the average pore size.

Preliminary estimation of the rainfall chemical composition evaluated through the scavenging modeling for north-eastern Amazonian region (Amapá state, Brazil)

Numerical modeling of scavenging processes has been compared with data obtained for rainwater and aerosol chemistry at Serra do Navio, in the state of Amapá in the Brazilian Amazon region. Sulfate, nitrate and ammonium concentrations were determined in rainwater samples collected from May 1995 until June 1997. The levels of these same chemicals were also determined in aerosols for the same period and region. Scavenging processes have been evaluated on a rainfall event basis, via numerical modeling, in order to simulate the rainwater concentrations and compare them with the observed data. RAMS (Regional Atmospheric Modeling System) was used to simulate cloud structures. A model of below-cloud scavenging was evaluated, as well. The determinations made from the results of the scavenging model are the following: a) aerosol vertical profiles are quite important to rainwater concentrations; b) modeled sulfate in rainwater is a better fit to the observed data values than ammonium and nitrate; c) the obtained sulfate aerosol concentrations samples are similar to ones found in the literature, although the sulfate concentrations in rainwater are much lower than other studies in the literature; d) the in-cloud scavenging process dominates, e) our modeled results, using an input gas vertical profile extracted from the ABLE2B experimental data set, present a smaller ratio between gas and aerosol scavenging than found in other studies in the literature, other studies may have had larger rainfall times, which increase the importance of gas phase scavenging.

Glochidium metamorphosis in the endangered freshwater mussel Margaritifera auricularia (Spengler, 1793): a histological and scanning electron microscopy study

The metamorphosis of the glochidium of the critically endangered Margaritifera auricularia in the gills of a host is studied here for the first time. Siberian sturgeon, Acipenser baeri, were infected with glochidia and regularly inspected using scanning and optical microscopy. The mature glochidia immediately attach to the epithelium of the sturgeon gill filaments, piercing the secondary lamellae and the connective tissues, blood cells, and vessels within the lamellae. Once the epithelium is pierced, overlapping host lamellae cover the glochidium and form a cyst. Metamorphosis takes place inside the cyst. Sixteen days after infection the glochidium becomes spherical in shape and the larval muscle is reabsorbed. The two adductor muscles of the juvenile are observed 34 days after infection at 16-20 degrees C. Metamorphosis is complete in approximately 51 days at 18-22 degrees C and in 65 days at 16-17 degrees C. Released juveniles have a spherical shell with a thin rim of new shell material and a finely ciliated foot. Juvenile mean measurements are: length = 190 microm, width = 193 microm, and height = 210 microm.

Exquisite regioselectivity and increased transesterification activity of an immobilized Bacillus subtilis protease

Commercially available proteases and lipases were screened for their ability to acylate regioselectively sucrose with divinyladipate either in pyridine or dimethylformamide (DMF). The protease (EC 3.4.21.62) from Bacillus subtilis (Proleather FG-F) exhibited the highest conversion (100% in 24 h of reaction in DMF) yielding sucrose 2-O-vinyladipate as main product. The enzyme preference for a secondary hydroxyl group is a distinct feature of this biocatalyst compared to others described in the literature. Two sets of chemically distinct silica supports were used for Proleather immobilization presenting terminal amino (S(APTES)) or hydroxyl groups (S(TESPM)(-)(pHEMA)). The percentage of immobilized enzyme was smaller in S(APTES) (7-17%) than in S(TESPM)(-)(pHEMA) (52-56%), yet Proleather immobilized into S(APTES) supports presented higher total and specific hydrolytic activity. The highest total and specific activities were obtained with S(TESPM)(-)(pHEMA) and S(APTES), respectively. Silicas with large pore (bimodal distribution of pores, 130/1200 A, denoted as S(1000)) presented higher specific activities relative to those with smaller pore sizes. Furthermore, the synthetic specific activity of S(1000)S(APTES) immobilized protease was ca. 10-fold higher than that of the free enzyme. In addition to sucrose, the immobilized protease was used to acylate methyl alpha-D-glucopyranoside, trehalose, and maltose in nearly anhydrous DMF. Finally, immobilized Proleather was reasonably stable, retaining ca. 55% activity after six reaction cycles.

Chemical isomerism as a key to explore free-energy landscapes in disordered matter

The effects of a minor chemical modification on the microscopic structure of a material in its glass and crystal phases are investigated by the concurrent use of neutron diffraction and computer simulation. Significant changes in short-, intermediate-, and long-range order are found, resulting from the change in molecular structure. These differences are explainable by a shift in the balance between directional and excluded-volume interactions.

Development and validation of a cholate binding capacity method for DMP 504, a bile acid sequestrant

DMP 504, a highly cross-linked insoluble polymer, is a bile acid sequestrant developed by the DuPont Pharmaceuticals Company for serum cholesterol reduction. Since DMP 504 is insoluble, it was necessary to develop unique specific analytical methods to measure and control the quality of different lots of the drug. Since the mechanism of action of DMP 504 is believed to be by sequestration of bile acids, the in-vitro binding capacity of the polymer for cholic acid was chosen as a surrogate of in-vivo performance and used to assess potency of the compound. In this method, individual aliquots of DMP 504 at three different levels were incubated with a cholate solution of known concentration. The residual cholate solution was filtered and analyzed by a reversed-phase HPLC method using refractive index detection. When the bound cholate was plotted versus the mass of DMP 504, the resulting curve was linear. The slope of this curve is the cholate binding capacity of DMP 504. This method has been shown to be precise and robust. Precision of the method was shown to have an RSD of 2.0% with injection precision of 0.4% and stability of cholate solutions up to 73 h. It is also a unique binding capacity method due to its multi-point determination, and it has been shown to be a suitable quality control method for ensuring lot-to-lot consistency of drug substance.

VEGF Protects Against Oxidized LDL Toxicity to Endothelial Cells by an Intracellular Glutathione-Dependent Mechanism Through the KDR Receptor

Abstract —Although the accumulation of vascular endothelial growth factor (VEGF) has been observed in human atherosclerotic lesions, the exact role of this growth factor in atherogenesis remains unknown. We hypothesized that VEGF in the vascular wall might have a preventive effect on endothelial cell damage during atherosclerosis. To test our hypothesis, we examined whether VEGF protects against the toxicity of oxidized low density lipoprotein (Ox-LDL) in cultured endothelial cells derived from bovine aortas (BAECs). Preincubation of BAECs with VEGF prevented Ox-LDL–induced toxicity in a preincubation time– and VEGF concentration–dependent manner. Addition of N ω -nitro- l -arginine methyl ester, a nitric oxide synthase inhibitor, did not reverse the protective effect of VEGF on Ox-LDL toxicity. Incubation of BAECs with VEGF increased intracellular glutathione (GSH) content in a time-dependent manner. Combined addition of VEGF and l -buthionine sulfoximine, a GSH synthesis inhibitor, reversed both GSH levels and the protective effect of VEGF on Ox-LDL–induced cytotoxicity. Placenta growth factor, which ligates to the VEGF Flt-1 receptor but not KDR/Flk-1, failed to prevent Ox-LDL toxicity and had no effect on intracellular GSH levels. An anti-KDR antibody completely blocked these beneficial activities of VEGF. These results suggest that VEGF prevents Ox-LDL–induced endothelial cell damage via an intracellular GSH-dependent mechanism through the KDR/Flk-1 receptor.

Inhibition of gene expression in Entamoeba histolytica with antisense peptide nucleic acid oligomers

Peptide nucleic acids (PNAs) may be a potent tool for gene function studies in medically important parasitic organisms, especially those that have not before been accessible to molecular genetic knockout approaches. One such organism is Entamoeba histolytica, the causative agent of amebiasis, which infects about 500 million people and is the cause of clinical disease in over 40 million each year, mainly in the tropical and subtropical world. We used PNA antisense oligomers to inhibit expression of an episomally expressed gene (neomycin phosphorotransferase, NPT) and a chromosomal gene (EhErd2, a homolog of Erd2, a marker of the Golgi system in eukaryotic cells) in axenically cultured trophozoites of E. histolytica. Measurement of NPT enzyme activity and EhErd2 protein levels, as well as measurement of cellular proliferation, revealed specific decreases in expression of the target genes, and concomitant inhibition of cell growth, in trophozoites treated with micromolar concentrations of unmodified antisense PNA oligomers.

Left ventricular diastolic dysfunction secondary to hyperglycemia in patients with type II diabetes

Diabetes mellitus type II, a cause of preclinical left ventricular dysfunction that can progress to cardiac insufficiency ventricular dysfunction in diabetic patients, is attributed to systemic arterial hypertension, or ischemic cardiopathy. Diastolic ventricular dysfunction takes place during the course of diabetes mellitus. The purpose of the present article is to report on the influence of hyperglycemia on the left ventricular diastolic dysfunction independently of dyslipidemia, obesity, and systemic arterial hypertension, usually present in diabetic patients. Left ventricular diastolic function was studied by Doppler echocardiography in asymptomatic type II diabetic patients without ischemic or valvular cardiopathies, cardiomegaly, or systemic arterial hypertension. Two groups of patients were integrated: patients with and without left ventricular diastolic dysfunction, i.e., groups A and B, respectively. Glycemia, cholesterol, triglycerides, and body mass index (BMI) were determined in each subject. Bivariate statistical tests (Student t, chi-square, or Mann-Whitney U tests) were applied to study the influence of the previously mentioned variables on the ventricular diastolic function. To evaluate the influence of hyperglycemia on ventricular diastolic function separately from dyslipidemia, systemic arterial hypertension, and the influence of obesity, logistic regression, and multivariate statistical analysis were applied. Independently of dyslipidemia and obesity, a relationship was found between hyperglycemia and diastolic dysfunction of the left ventricle in patients belonging to group A (p <0.05, odds ratio [OR] 12.1). No statistical significance was found between glycemia and the diastolic function of the left ventricle in group B patients. Even in type II diabetic patients without cardiopathy, uncontrolled hyperglycemia provokes diastolic left ventricular dysfunction.

Matrix metalloproteinase and alphavbeta3 integrin-dependent vascular smooth muscle cell invasion through a type I collagen lattice

Smooth muscle cell (SMC) migration from the tunica media to the intima is a key event in the development of atherosclerotic lesions and in restenosis after angioplasty. SMCs require not only migratory but also degradative abilities that enable them to migrate through extracellular matrix proteins, which surround and embed these cells. We used a collagen type I lattice as a coating on top of a porous filter as a matrix barrier in a chamber to test the invasive behavior of SMCs in response to a chemoattractant (invasion assay) and compared that behavior with simple SMC migration through collagen type I-coated filters (migration assay). Inhibitors of matrix metalloproteinase, KB-R8301, tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), TIMP-2, and peptide 74, attenuated platelet-derived growth factor-BB (PDGF-BB)-directed SMC invasion across the collagen lattice, whereas no effect was seen with these inhibitors on simple SMC migration through collagen-coated filters. RGD peptide inhibited SMC invasion but did not affect SMC migration. Anti-alphavbeta3 integrin antibody attenuated PDGF-BB-directed SMC invasion, whereas other antibodies against RGD-recognizing integrins, namely alphavbeta5 and alpha5, had no effect. None of these antibodies had any effect on simple SMC migration. RGD peptide and anti-alphavbeta3 antibody inhibited the attachment and spreading of SMCs on denatured collagen but not on native collagen. These findings indicate that there is a difference in the mechanisms between simple SMC migration across a collagen-coated filter and SMC invasion through a fibrillar collagen barrier. A proteolytic process is required for SMC invasion, and the degradation of matrix proteins alters the relationship between matrix protein molecules and SMC surface integrins.

B lymphopenia in uremia is related to an accelerated in vitro apoptosis and dysregulation of Bcl-2

BACKGROUND

Lymphopenia has been described in patients with chronic renal failure (CRF). It is postulated that the decline in lymphocytes is due to accelerated apoptosis. We investigated whether dysregulation of programmed cell death plays a role in the immunodeficiency described in CRF.

METHODS

Peripheral blood lymphocytes (PBL) from pre-dialysis uraemic patients (nHD) and haemodialysed patients (HD) were cultured with no stimulus for 96 h. Apoptosis of lymphocytes was measured by propidium iodide staining and flow cytometry. Expression of Fas and Bcl-2 was also analysed by flow cytometry.

RESULTS

Peripheral blood B cells were significantly lower in pre-dialysis and haemodialysis uraemic patients compared to control. Lymphocytes from both groups of patients had a higher rate of apoptosis in vitro than those from healthy controls. This effect was more pronounced in B lymphocytes and a significant correlation between the B lymphopenia and the percentage of apoptotic B cells after 48 h of culture without stimulus was observed. The increased lymphocyte apoptosis in CRF was accompanied by a significantly lower in vitro Bcl-2 expression. However, Fas did not seem to play a role in spontaneous lymphocyte apoptosis in end-stage renal disease.

CONCLUSIONS

Our data indicate that B lymphopenia in CRF may be partially attributed to an increased susceptibility to cell death by apoptosis that is associated with a decreased expression of Bcl-2.

Induction of apoptotic cell death in vascular endothelial cells cultured in three-dimensional collagen lattice

Endothelial cells derived from fetal bovine aorta (BAECs) undergo apoptosis in three-dimensional (3-D) type I collagen lattice in the absence of specific angiogenic factor. In the presence of angiogenic factor, BAECs survive and form a capillary-like tube structure in 3-D culture. In the present study we elucidate the mechanisms of BAECs apoptosis or survival and tube formation in 3-D culture. When BAECs embedded in collagen lattice were cultured with angiogenic factor (fibroblast growth factor-2 (FGF-2) or 4beta-phorbol 12-myristate 13-acetate (PMA)) in the presence of PD98059, a specific inhibitor of mitogen-activated protein kinase kinase, BAECs did not form tube structures and underwent apoptosis in collagen lattice. Function-blocking antibody against alphavbeta3 integrin also inhibited tube formation and induced apoptosis in 3-D culture in the presence of angiogenic factors. Exposure of BAECs to FGF-2 and PMA had no effect on the alphavbeta3 integrin expression but induced the activation of alphavbeta3 integrin. PD98059 attenuated alphavbeta3 integrin activation in response to angiogenic factor. KB-R8301, a hydroxamic acid-based matrix metalloproteinase (MMP) inhibitor, prevented apoptotic cell death in the absence of angiogenic factor in 3-D culture and enhanced capillary-like tube formation in the presence of angiogenic factor, which was not inhibited by the anti-alphavbeta3 integrin antibody. The results suggest that angiogenic factor-induced alphavbeta3 integrin activation through the MEK-ERK pathway regulates the BAEC fate between apoptosis and angiogenesis in collagen lattice. MMP derived from BAECs seems to play a key role in the release of cryptic ligands for alphavbeta3 integrin from intact collagen.

Partial Xp duplication due to a translocation t(X;15) in two male and two female patients: a familial case report and review of the literature

A three generation familial translocation (X;15)(p22;p11) is responsible for duplication (X)(pter-->p22) in two male and two female patients. It is present in a balanced state in the mothers and with the derivative chromosome 15 in the children. The Xp segment of the derivative chromosome 15 is separated from the X inactivation center and cannot undergo X inactivation. As a result, there is functional disomy of Xp in the male and female patients that is responsible for mental retardation and other phenotypic findings.

[Bacterial meningitis in emergency medicine. Factors associated with delay of antimicrobial therapy]

BACKGROUND

Bacterial meningitis is a severe infection. Outcome might be improved if diagnosis and therapy are achieved promptly. We studied the time elapsed until antimicrobial therapy and analyzed factors associated to delay.

METHODS

We performed a retrospective study of bacterial meningitis diagnosed in a hospital emergency medicine department in two consecutive years. Dependent variable was time since admission to antimicrobial therapy; delay was defined as time to administration longer than 2 h. The relationship between clinical variables and delay was studied with bivariate analysis. Significative variables were included in a multivariate analysis using multiple logistic regression.

RESULTS

We studied 40 cases of bacterial meningitis (67.5% female, mean age 25.2 years). The mean time to antibiotic therapy was 127 min; in 16 patients (40%; 95% confidence interval: 25-56%) delay was 2 h or more. In bivariate analysis differences were observed for age (15.5 +/- 24.2 vs 39.7 +/- 28.7 years; p < 0.01), temperature (38.7 +/- 1 vs 38 +/- 1.1 degrees C; p < 0.05), mean blood pressure (77 +/- 14 vs 91 +/- 20 mmHg; p < 0.05), headache (29% vs 75%; p < 0.01), meningeal signs (63% vs 19%; p < 0.01), skin lesions (60% vs 13%; p < 0.01), "sick" presentation (67% vs 19%; p < 0.01), performance of CT scan (8% vs 38%; p < 0.05) and appropriateness of management (96% vs 44%; p < 0.001). In multivariate analysis only absence of skin lesions and inappropriate management remained significative. Mortality was higher when there was a delay of more than 2 h in antimicrobial therapy (25% vs 0%; p < 0.05).

CONCLUSIONS

Factors associated with delay of antimicrobial therapy were the absence of skin lesions and inappropriate management.

Induction of macrophage VEGF in response to oxidized LDL and VEGF accumulation in human atherosclerotic lesions

The interaction between macrophages and oxidatively modified low density lipoprotein (Ox-LDL) appears to play a central role in the development of atherosclerosis, not only through foam cell formation but also via the induction of numerous cytokines and growth factors. The current study demonstrated that Ox-LDL upregulated vascular endothelial growth factor (VEGF) mRNA expression in RAW 264 cells, a monocytic cell line, in a time- and concentration-dependent manner and that Ox-LDL stimulated VEGF protein secretion from the cells. Lysophosphatidylcholine, a component of Ox-LDL, also enhanced VEGF mRNA expression in RAW 264 cells and VEGF secretion from RAW 264 cells, with a maximal effect at a concentration of 10 micromol/L lysophosphatidylcholine. Immunohistochemical studies showed that human early atherosclerotic lesions exhibited intense VEGF immunoreactivity in subendothelial macrophage-rich regions of the thickened intima. In atherosclerotic plaques, VEGF staining was also observed in foam cell-rich regions adjacent to the lipid core or the neovascularized basal regions of plaque consisting predominantly of smooth muscle cells. High-power-field observation revealed that VEGF was localized in the extracellular space as well as at the macrophage cell surface. These observations suggest the possible involvement of Ox-LDL in the development of human atherosclerosis through VEGF induction in macrophages.

Inhibition of angiogenesis on glycated collagen lattices

Advanced glycation endproduct (AGE) accumulation in extracellular matrix proteins has been demonstrated in diabetic patients with a significant correlation with the severity of diabetic complications. AGE accumulation induces matrix protein cross-link formation, resulting in an increased stiffness of matrix fibres and the reduction of the susceptibility of matrix proteins to proteolytic degradation. We examined whether glycation-induced collagen cross-linking may affect vascular endothelial cell behaviours such as invasion, proliferation and differentiation, using the in vitro angiogenesis model of capillary-like structure formation in three-dimensional matrices of collagen type I. Endothelial cells cultured on collagen gel with angiogenic factors (the combination of fibroblast growth factor-2 and vascular endothelial growth factor) invaded the underlying collagen matrix, and organized capillary-like cord structures in the gel. We found that endothelial cell invasion into glycated collagen gel was significantly attenuated without any effect on proteinase activity including cell-associated plasminogen activator and matrix metalloproteinase in the conditioned medium. In addition, subsequent capillary-like cord formation was also inhibited in glycated collagen gel. In contrast, endothelial cell proliferation was enhanced on glycated collagen gel with or without angiogenic factors compared with control collagen gel. These results suggest that the structural alterations of extracellular matrix proteins through the glycation-induced cross-link formation affect the interaction between endothelial cell and extracellular matrix, resulting in the impairment of an adequate neovascularization in diabetic patients.

Angiogenic stimuli are essential for survival of vascular endothelial cells in three-dimensional collagen lattice

Cultured vascular endothelial cells derived from bovine aorta (BAECs) can survive and proliferate in the condition of two-dimensional monolayer culture in the presence of serum without any specific growth factors. When BAECs were embedded in collagen lattice, they underwent apoptotic death within 2 days unless the cultures were repeatedly supplied with angiogenic growth factor such as fibroblast growth factor-2 (FGF-2). Supplementation with FGF-2 induced endothelial cell differentiation, resulting in capillary-like tube formation inside collagen lattice. Following tube formation, withdrawal of FGF-2 induced disruption of the tube structures associated with the characteristic apoptotic cell death. These effects of FGF-2 were regulated by tyrosine phosphorylation, but not mediated through protein kinase C pathway. This model of endothelial cell apoptosis inside collagen lattice may represent in vivo endothelial cell-matrix interaction during angiogenesis process, indicating that apoptotic death of endothelial cells may regulate angiogenesis and the regression of vessels.

Up-regulation of vascular endothelial growth factor in response to glucose deprivation

Vascular endothelial growth factor (VEGF), also known as a vascular permeability factor (VPF), is an endothelial specific mitogen and is a potent inducer of angiogenesis. Recently it has been reported that hypoxia induces VEGF mRNA expression in various cells. Since both oxygen and glucose are required for efficient production of energy, we examined the effect of glucose deprivation on VEGF mRNA expression and VEGF protein production in U-937 (a human monocytic cell line) cells. Both the mRNA expression and secretion of VEGF increased after exposure to low glucose. Addition of L-glucose, the L-stereoisomer of D-glucose, did not prevent the up-regulation of VEGF expression. The conditioned medium from glucose-deprived cells, followed by supplementation with glucose, did not up-regulate VEGF mRNA expression in U-937 cells. The low glucose-induced VEGF mRNA expression returned to the control level after supplementation with D-glucose. Furthermore, oligomycin, a mitochondrial ATP synthase inhibitor, increased VEGF protein production. The results suggest that the up-regulation of VEGF mRNA in U-937 cells in response to glucose deprivation is not mediated by autocrine factors from the cells nor is the osmotic change of the medium mediated by the deficiency of glucose metabolism in the cells. Our results also suggest that the intracellular ATP depletion due to glucose deprivation may be one of the causes for increased VEGF mRNA expression. We speculate that local hypoglycemia may act as an essential trigger for angiogenesis through the VEGF gene expression.

Entamoeba histolytica contains a gene encoding a homologue to the 54 kDa subunit of the signal recognition particle

We have determined the nucleotide sequence and predicted amino acid sequence of the 54 kDa subunit of the signal recognition particle (SRP54) from the amitochondrial protist Entamoeba histolytica. The SRP54 gene was isolated from a genomic library using a polymerase chain reaction (PCR) probe. Nucleotide sequence analysis of a 2.3 kb fragment, derived from a 7 kb genomic clone, revealed an open reading frame encoding a protein of 487 amino acids (MW 53.8 kDa). The identities of the predicted amino acid sequence with its homologues from other species were between 24 and 47%. Functional domains previously defined for the SRP54-type proteins were present in the entamoebal sequence, such as the amino-terminal GTP binding domain (G domain) and the carboxy-terminal methionine rich domain (M domain). SRP54 mRNA contains an extra G residue at the 5' end, suggesting that capping of poly-A(+) transcripts is present in E. histolytica. Evolutionary analysis of the SRP54 based on phylogenetic inference placed the E. histolytica sequence as an early divergence of the eukaryotic tree. Although the function of the entamoebal homologue remains to be elucidated, the identification of the SRP54 gene constitutes the first evidence for SRP related proteins in protozoans.

[Acute myocardial infarction with normal coronary arteries as initial manifestation of polyarteritis nodosa. A case report]

A thirty four-year-old-white man in good health developed an acute anterior wall myocardial infarction (AMI), Killip II with normal coronary arteries. No thrombolytic therapy was given. Selective angiography revealed multiple aneurysms in mesenteric and renal arteries. The diagnosis of polyarteritis nodosa (PAN) was performed. AMI in PAN is secondary to arteritis with thrombosis, or to atherosclerosis due to steroid therapy. This case, having multiorgan vascular aneurysms involvement without previous cardiac symptomatology nor steroid therapy, presented as his first cardiac complication an AMI with normal coronary arteries probably due to selective arteritis.

The role of menopause in the development of chronic mountain sickness

The objective of this study was to investigate the role of menopause in the appearance of the physiopathological sequence that leads to chronic mountain sickness (CMS) in a high-altitude female population. The females studied are 30-54 yr old (n = 152) and have permanent residence in Cerro de Pasco (Pasco, Peru; 4,300 m). The sample was divided into postmenopausal and premenopausal groups for comparison. Blood oxygen saturation (SaO2), excessive erythrocytosis [EE, measured by the level of hematocrit (Het)], peak expiratory flow rates (PEFR), and a score that represents the main signs and symptoms of CMS (CMSscore) were measured. Postmenopausal women had higher Het (50.2 +/- 4.04 vs. 47.4 +/- 4.13%, P < 0.001), lower SaO2 (81.9 +/- 4.12 vs. 84.7 +/- 3.14%, P < 0.001) and PEFR values (489 +/- 101 vs. 534 +/- 90 l/min, P < 0.02), and slightly higher CMSscore (19.1 +/- 3.37 vs. 17.9 +/- 3.48, P < 0.06) than premenopausal women. The prevalence of women with EE (EE = Hct > 56%) was found to be 8.8%. Forty-five percent of the postmenopausal subjects presented a high CMSscore (> 21), whereas only 22% of the premenopausal subjects presented this high value (P < 0.02). We can therefore conclude that menopause may represent a contributing factor for the development of CMS.

[Epidemiology of neurosensorial deafness in the Foral Community of Navarra]

Congenital deafness is a relatively frequent disorder that shows a heterogeneous aetiology. Knowledge and the control of some risk factors have decreased the incidence of acquired deafness and increased the relative importance of genetic cause. In an attempt to investigate the clinical relevance of congenital deafness and the mechanisms of prevention in our population, a clinical and genetic study of cases with neurosensorial deafness born in Navarra between 1975 and 1990 was carried out. A total of eighty-one cases were identified, giving an incidence of 0.8 per thousand. Thirty per cent of the cases showed deafness associated with defects. Cause of deafness was identified in seventy per cent of the cases with whom a detailed clinical and genetic study could be performed (n=50). Genetic factors were responsible for the disorder in more than half of these cases. The most frequent hereditary factor was of the autosomic recessive type. This was associated with a more severe form of hearing loss.

MRI of congenital pituitary insufficiency

We compared 1.5 T magnetic resonance (MR) image findings in 193 patients with congenital pituitary insufficiency. One hundred and thirty nine of the MR studies were obtained in patients who had isolated growth hormone deficiency (GHD). Other fifty-four patients had multiple pituitary hormone deficiency (MPHD). On MR images, normal anterior and posterior lobes of the pituitary gland can be clearly differentiated because the posterior lobe has a characteristic high intensity on T1-weighted images. In fifty-four patients, the high-intensity of the posterior lobe was not seen, but a similar high signal intensity was observed at the proximal stump in fifty-one patients. This high-intensity area is the newly formed ectopic posterior lobe, which also secrets anti-diuretic hormone just as the posterior lobe would. MR imaging can demonstrate the transection of the pituitary stalk and the formation of the ectopic lobe, revealing to be a usefull diagnostic tool in the definition of the type of alteration in growth defects of endocrine origin.

Prenatal diagnosis of Friedreich ataxia: improved accuracy by using new genetic flanking markers

Friedreich ataxia is a neurodegerative disorder with autosomal recessive inheritance. Since the gene causing mutation has not yet been identified, prenatal, predictive, and carrier diagnoses are based on indirect haplotype analysis with closely linked markers. Until recently, only distal markers were available and their physical distance to the Friedreich ataxia (FRDA) gene remained elusive. The identification of close flanking markers that mark out the boundaries of the FRDA locus and reduce the critical genomic region which contains the gene allows for the first time misdiagnosis due to undetectable recombination to be avoided and diagnosis accuracy to be greatly improved. In this sense, we have verified a prenatal diagnosis in which the fetus was diagnosed as an unaffected carrier last year with a confidence of 95 per cent. By using the new flanking markers, the diagnosis improved and confidence reached almost 100 per cent.