POS1109 MULTIVARIATE ANALYSIS OF RISK FACTORS FOR REDUCED BONE MINERAL DENSITY ASSESSED WITH RADIOFREQUENCY ECHOGRAPHIC MULTI SPECTROMETRY (REMS)

Background:

Radiofrequency echographic multi spectrometry (REMS) is an innovative radiation-free approach for the assessment of bone mineral density (BMD) at axial sites. The principle of this technology is based on the analysis of native raw unfiltered ultrasound signals, the so called radiofrequency ultrasound signals, acquired during an echographic scan of the lumbar spine and/or femoral neck. [1]. A previous published study showed a high degree of correlation between the T-score values provided by the two techniques-REMS and dual energy X-ray absorptiometry for both lumbar spine and femoral neck [2]. REMS software outputs information about BMD (g/cm2), T-scores, Z-scores [standard deviations (SD)], percentage of body fat and basal metabolic rate [BMR (kcal/daily)] [3].

Objectives:

The aim of the current study is to investigate the multivariate significant risk factors for reduced BMD through REMS technology.

Methods:

In this study, a total of 273 women with mean age 62 years (yrs.) ± 12 yrs. (range 25-88 yrs.) underwent REMS assessments. Subjects were divided into two groups after acquiring information about the spinal T-scores: 1st group with T-scores ≥-1 SD and 2nd group with T-scores <-1 SD. Age, weight, height, body mass index (BMI), basal metabolic rate (BMR), body fat and menopausal status were the risk factors included in the multivariate statistical analyses. Binary logistic regression was used to assess which are the significant risk factors for T-score <-1 SD. Youden’s indices were calculated for selecting the cut-off points for each risk factor.

Results:

273 women had mean weight of 70.5 kg. ± 15.7 kg. (range 39.4-127 kg.), mean height 157.1 cm. ± 8.8 cm. (range 100-182 cm.) and mean body mass index (BMI) 28.6 kg/cm2 ± 6.1 kg/cm2 (range 14.9-47.5 kg/cm2). The mean body fat of the subjects was 37.8% ± 8.8% (range 9-52%) and the mean BMR was 1274.01 kcal/daily ± 163.17 kcal/daily (range 929.7-1908.4 kcal/daily). 260 women (95.2%) were attributed to postmenopausal. Age (p=0.000), BMI (p=0.015), menopause (p=0.006) and BMR (p=0.000) were the multivariate significant risk factors for T-score <-1 SD. Odds ratio for the risk factor age was 1.16, so each added year of the women’s age increased the risk for T-score <-1 SD by 1.16%. Women over the age of 65 yrs. showed the highest risk for spinal T-score <-1 SD. The odds ratio of the menopause as a risk factor for spinal T-score <-1 SD was 9.54, so postmenopausal women showed about 9.5 times higher risk of T-score <-1 SD of the lumbar spine than women who still have their period. The increase of BMI by one kg/cm2 decreased the probability of spinal T-score <-1 SD by 0.15% and the increase of BMR by one kcal/daily decreased this probability by 0.02%. Women with BMI above 28.63 kg/cm2 and those with BMR >1331.75 kcal/daily were unlikely to develop spinal T-score <-1 SD.

Conclusion:

In the current study, multivariate regression analysis was used to develop a specific REMS-based risk prediction model for spinal BMD, corresponding to T-score <-1 SD. Postmenopausal women over age of 65 yrs. with BMI lower than 28.63 kg/cm2 and BMR <1331.75 kcal/daily were at the highest risk for T-score <-1 SD of the lumbar spine.

References:

[1]Pisani P, Renna MD, Conversano F, Casciaro E, Muratore M, et al. (2013) Screening and early diagnosis of osteoporosis through X-ray and ultrasound-based techniques. World J Radiol 5(11): 398-410.

[2]Kirilov N. Analysis of dual-energy x-ray absorptiometry images using computer vision methods. (2020) Trakia Journal of Sciences, Vol. 18, Suppl. 1, pp 114-117.

[3]Kirilova E, Kirilov N, Popov I, Vladeva S. (2019) Bone mineral density of lumbar spine and femoral neck assessed by novel echographic approach-Radiofrequency Echographic Multi Spectrometry (REMS). Clin. Cases Miner. Bone Metab., 16 (1), pp. 14-17.

Disclosure of Interests:

None declared.

SAT0473 COMPARSION OF THE FRACTURE RISK IN WOMEN WITH AND WITHOUT SCOLIOSIS THROUGH DUAL-ENERGY X-RAY ABSORPTIOMETRY

Background:

Osteoporosis is known to be a risk factor for fragility fractures [4, 5]. On one hand, vertebral body fragility fractures often lead to additional spine deformity [2]. On the other hand, it was found that with the progression of the spinal curvature in osteoporotic patients, the fragility fractures develop more frequently. The increased incidence of these fractures could be explained with a predominance of the mechanical forces on the one side of the already weakened osteoporotic vertebrae [3].

Objectives:

The aim of this study is to compare the fracture risk (FRAX) for major osteoporotic fractures (MOF) and for hip fractures (HF) in women with and without scoliosis through dual-energy X-ray absorptiomentry (DXA)

Methods:

In the current study, 59 women underwent DXA scans. Scoliosis was defined as Cobb’s angle ≥ 5◦ according to the Chaklin’s classification [6, 7]. Cobb’s angle was measured from DXA images with DICOM software. We evaluated the following risk factors: previous fractures, parental hip fractures, secondary osteoporosis, rheumatoid arthritis, use of corticosteroids, current smoking and alcohol consumption more than 3 units daily. We estimated FRAX MOF and FRAX HF on the basis of these risk factors and on the basis of the femoral neck bone mineral density (BMD). The calculations were done through FRAX tool published on the website of the University of Sheffield [1].

Results:

The mean age of the women was 63 years (yrs.) ± 10 yrs. (range 43 yrs. – 89 yrs.). Subjects with scoliosis were significantly older (67 yrs.) than those without scoliosis (59 yrs.), (p = 0.004). Mean weight and height didn’t differ between the groups with- and without scoliosis. Mean lumbar spine BMD and T-score differed significantly between the groups, (p = 0.02). Women with scoliosis had lower mean BMD (0.786 g/cm2) and lower mean T-score (-2.1 standard deviations (SDs)) compared to those without scoliosis (mean BMD: 0.912 g/cm2 and mean T-score: 0.9 SDs). The mean FRAX MOF (19.3%) and FRAX HF (5.9%) of the subjects with scoliosis were significantly higher than those of the women without scoliosis (FRAX MOF: 14.9% and FRAX HF: 3.1%), (p = 0.004 for FRAX MOF and p = 0.010 for FRAX HF).

Conclusion:

Women with scoliosis showed significantly higher fracture risk for major osteoporotic fractures and for hip fractures compared to those without scoliosis.

References:

[1]https://www.sheffield.ac.uk/FRAX/index.aspx

[2]Mao YF, Zhang Y, Li K, et al. Discrimination of vertebral fragility fracture with lumbar spine bone mineral density measured by quantitative computed tomography. J Orthop Translat. 2018;16:33–39. Published 2018 Oct 10. doi:10.1016/j.jot.2018.08.007.

[3]Sabo A, Hatgis J, Granville M, Jacobson RE. Multilevel Contiguous Osteoporotic Lumbar Compression Fractures: The Relationship of Scoliosis to the Development of Cascading Fractures. Cureus. 2017;9(12):e1962. Published 2017 Dec 19. doi:10.7759/cureus.1962.

[4]Kirilova E, Cherkezov D, Gonchev B, Zheleva Z. OSIRIS Index for the assessment of the risk for osteoporosis in menopausal women, National conference with international participation, 6-7 october 2019, Kardzhali “Science and society 2019”, RKR print OOD ISSN 1314-3425

[5]Madzharova R, Kirilova E, Petranova T, Nikolova M. Assessment of the activity for self care in women with osteoporosis, Science and TechnologieVolume VIII, 2018, Number 1: MEDICAL BIOLOGY STUDIES, CLINICAL STUDIES, SOCIAL MEDICINE AND HEALTH CARE,1-6.

[6]Chaklin VD, Orthopedy - Moscow: Medgiz – 1965 – C. 209

[7]Chaklin VD. Pathology, clinical manifestation and treatment of the scoliosis, 1stcongress of the union of the orthopedists and traumatologists, Moscow: Medgiz, 1957 – T.2. – p 798

Disclosure of Interests:

None declared

AB0908 ASSESSMENT OF THE IMPACT OF THE LEAN MASS WITH BODY COMPOSITION BY DUAL-ENERGY X-RAY ABSORPTIOMETRY ON THE BONE MINERAL DENSITY

Background:

Lean mass, mainly composed of muscle, has been correlated to bone mineral density (BMD) [4]. Studies reported that lean mass has an important impact on BMD not only in young women but also in postmenopausal women [1]. High lean mass is more favorable for the BMD than low lean mass. Some studies suggested that genetic factors responsible for both lean mass and BMD are shared [3]. Low muscle mass and low BMD could impair the quality of the patient’s life [2, 5].

Objectives:

The aim of this study is to assess the impact of the lean mass with body composition by dual-energy X-ray absorptiometry on the bone mineral density.

Methods:

107 women underwent body composition analysis by dual-energy X-ray absorptiometry (DXA). Lean mass in kg and BMD in kg/cm2 were analyzed. Normal BMD was defined as T-score > -1.0 standard deviation (SD). Osteopenia was defined as T-score between -1.0 SDs and -2.5 SDs and osteoporosis was defined as T-score ≤ - 2.5 SDs.

Results:

The mean age of the women was 57 years (yrs.) ± 11 yrs. (range 41 yrs. – 80 yrs.). Subjects had mean weight of 75 kg ± 12 kg (range 50 kg – 110 kg) and mean height of 156 cm ± 9 cm (range 151 cm – 172 cm). 73/107 women (68.2%) were with normal BMD, 24/107 women (22.4%) were with osteopenia and 10/107 women (9.4%) were with osteoporosis. Lean mass differed significantly between the groups (p = 0.000). Women with normal BMD had the highest mean lean mass (58.47 kg) and the mean lean mass of the women with osteopenia and osteoporosis decreased as follow: 47.56 kg for women with osteopenia and 36.22 kg for women with osteoporosis.

Conclusion:

Women with osteoporosis have the lowest lean mass compared to the women with osteopenia and osteoporosis.

References:

[1]Ilesanmi-Oyelere BL, Coad J, Roy N, Kruger MC. Lean Body Mass in the Prediction of Bone Mineral Density in Postmenopausal Women. Biores Open Access. 2018;7(1):150–158. Published 2018 Oct 10. doi:10.1089/biores.2018.0025.

[2]Kirilov N., Vladeva SG, Kirilova E. Assessment on the Improvement of the Quality of Life after One Year of Regular Physical Activity and Treatment in Patients with Postmenopausal OsteoporosisCOR 2017: 19th International Conference on Orthopedics and Rheumatology Miami, USA March 9 - 10, 2017, WASET, Paper Code 17US030051.

[3]Nguyen TV, Howard GM, Kelly PJ, Eisman JA. Bone mass, lean mass, and fat mass: same genes or same environments? Am J Epidemiol. 1998 Jan 1;147(1):3-16.

[4]Patel HP, Dawson A, Westbury LD, et al. Muscle Mass, Muscle Morphology and Bone Health Among Community-Dwelling Older Men: Findings from the Hertfordshire Sarcopenia Study (HSS). Calcif Tissue Int. 2018;103(1):35–43. doi:10.1007/s00223-018-0388-2.

[5]Kirilova E, Kirilov N, Vladeva S. A study on the physical activity in women with decreased bone mineral density. Abstract book 13thscience conference MC, Pleven

Disclosure of Interests:

None declared

Removing Critical Gaps in Chemical Test Methods by Developing New Assays for the Identification of Thyroid Hormone System-Disrupting Chemicals-The ATHENA Project

The test methods that currently exist for the identification of thyroid hormone system-disrupting chemicals are woefully inadequate. There are currently no internationally validated in vitro assays, and test methods that can capture the consequences of diminished or enhanced thyroid hormone action on the developing brain are missing entirely. These gaps put the public at risk and risk assessors in a difficult position. Decisions about the status of chemicals as thyroid hormone system disruptors currently are based on inadequate toxicity data. The ATHENA project (Assays for the identification of Thyroid Hormone axis-disrupting chemicals: Elaborating Novel Assessment strategies) has been conceived to address these gaps. The project will develop new test methods for the disruption of thyroid hormone transport across biological barriers such as the blood-brain and blood-placenta barriers. It will also devise methods for the disruption of the downstream effects on the brain. ATHENA will deliver a testing strategy based on those elements of the thyroid hormone system that, when disrupted, could have the greatest impact on diminished or enhanced thyroid hormone action and therefore should be targeted through effective testing. To further enhance the impact of the ATHENA test method developments, the project will develop concepts for better international collaboration and development in the area of thyroid hormone system disruptor identification and regulation.

METHODS OF MENTAL HEALTH MAINTENANCE IN TEACHERS EXPERIENCING EMOTIONAL STRESS

Aim. The article deals with justifying theoretically and describing the authors’ methods of mental health maintenance in teachers experiencing emotional stress. Materials and methods. The proposed methods of mental health maintenance in teachers are based on the ideas of psychosomatics (S. Freud and I. Malkina-Pykh) and non-directive psychotherapy (C. Rogers). Three groups of methods have been described: self-analysis of a current life situation, energy recovery in teachers, and self-regulation of emotions in group interaction. Results. The authors studied neuro-psychological stress in teachers using Nemchin’s method. At the summative stage of the experiment, it was established that 56% of teachers experienced high neuro-psychological stress, and 26% – average. In 2018, the methods described were implemented at one of the comprehensive schools of the Russian Federation. The results of control diagnostics demonstrate a significant decrease in neuro-psychological stress in teachers who implemented these methods of mental health maintenance. This proves the effectiveness of the solutions proposed. Conclusion. This article contributes to the theoretical data on mental health maintenance in modern teachers. The scientific novelty and practical importance of this study are connected with the developed methods of mental health maintenance in teachers. The methods proposed can be used in practice for improving teachers’ expertise both in Russia and abroad.

CD4+ Th2 cells are directly regulated by IL-10 during allergic airway inflammation

Interleukin-10 (IL-10) is an important regulatory cytokine required to control allergy and asthma. IL-10-mediated regulation of T cell-mediated responses was previously thought to occur indirectly via antigen-presenting cells. However, IL-10 can act directly on regulatory T cells and T helper type 17 (Th17) cells. In the context of allergy, it is therefore unclear whether IL-10 can directly regulate T helper type 2 (Th2) cells and whether this is an important regulatory axis during allergic responses. We sought to determine whether IL-10 signaling in CD4⁺ Th2 cells was an important mechanism of immune regulation during airway allergy. We demonstrate that IL-10 directly limits Th2 cell differentiation and survival in vitro and in vivo. Ablation of IL-10 signaling in Th2 cells led to enhanced Th2 cell survival and exacerbated pulmonary inflammation in a murine model of house dust mite allergy. Mechanistically, IL-10R signaling regulated the expression of several genes in Th2 cells, including granzyme B. Indeed, IL-10 increased granzyme B expression in Th2 cells and led to increased Th2 cell death, identifying an IL-10-regulated granzyme B axis in Th2 cells controlling Th2 cell survival. This study provides clear evidence that IL-10 exerts direct effects on Th2 cells, regulating the survival of Th2 cells and severity of Th2-mediated allergic airway inflammation.

10% liquid human immunoglobulin (KIOVIG®) for immunomodulation in autoimmune disorders

Intravenous immunoglobulins have been used to treat autoimmune disorders (ADs) for over 50 years. The etiologies of various ADs are not fully understood and although intravenous immunoglobulin treatment has proved its immunomodulatory properties, the roles of proposed mechanisms of action also remain a matter of speculation. A systemic search of the literature regarding KIOVIG® (Baxalta US, Inc., MA, USA) use in clinical trials on patients with ADs and a detailed review of retrieved articles revealed eight relevant publications. These articles reported KIOVIG use in multifocal motor neuropathy, chronic inflammatory demyelinating polyneuropathy, idiopathic thrombocytopenic purpura, Kawasaki disease, Guillain–Barré syndrome and other autoimmune and neurologic disorders and showed that KIOVIG is an effective, safe and well-tolerated treatment in the studied populations. Nevertheless, further studies on larger patient cohorts are needed.

Human immunoglobulin (KIOVIG®/GAMMAGARD LIQUID®) for immunodeficiency and autoimmune diseases: an observational cohort study

AIM

To document the therapeutic efficacy and safety of Human Normal Immunoglobulin 10% Liquid (KIOVIG(®)/GAMMAGARD LIQUID(®) [IVIG 10%]) under clinical routine conditions.

PATIENTS & METHODS

Subjects received IVIG 10% according to the prescribing information and were followed for 6 ± 1 weeks to 12 ± 2 months depending on indication. Efficacy, adverse events, infusion rates and duration and dose were recorded.

RESULTS

Overall efficacy of IVIG 10% was rated as good or very good by the investigator in 81.8% of subjects; overall tolerability was good or very good in 87.5%. One serious adverse drug reaction (ADR) occurred (urticaria); no severe ADRs occurred.

CONCLUSION

In this observational study, the efficacy and safety of IVIG 10% in routine clinical practice was similar to that previously reported in clinical studies.

[Preplacentation pregnancy loss in cases of angiotensin-converting enzyme insertion/deletion polymorphism]

The balance between coagulation and fibrinolysis processes is critical for establishment and development of early pregnancy. Angiotensin-converting enzyme (ACE) is related with plasminogen activator inhibitor-1 activity which is a key regulator in embryo implantation. Therefor polymorphisms in ACE gene and variation in ACE activity could be associated with an early pregnancy wastage risk. This study investigated carrier status for insertion/deletion (I/D) polymorphism in introne 16 of ACE gene in 71 women with two or more pregnancy loss in preplacentation period (between 10 and 14 weeks of gestation) and 75 women without pregnancy complications. DD genotype for I/D polymorphism was found respectively in 31% and 24% in patients and controls. Heterozygosity of D allele was found correspondingly in 47.9% and 54.7%. The dominant genetic model was used for allele prevalence comparison. D allele in DD genotype was not significantly prevalent in women with early pregnancy wastage compared with the control subjects, OR = 1.42, 95% CI (0.64-3.15). The study found a weak association between I/D polymorphism and preplacentation pregnancy loss. The additive effect over the pregnancy loss risk of I/D polymorphism could be supposed in a presence of other inherited or acquired factors connected with endometrial receptivity and implantation process.

Accessing and using chemical databases

Computer-based representation of chemicals makes it possible to organize data in chemical databases-collections of chemical structures and associated properties. Databases are widely used wherever efficient processing of chemical information is needed, including search, storage, retrieval, and dissemination. Structure and functionality of chemical databases are considered. The typical kinds of information found in a chemical database are considered-identification, structural, and associated data. Functionality of chemical databases is presented, with examples of search and access types. More details are included about the OASIS database and platform and the Danish (Q)SAR Database online. Various types of chemical database resources are discussed, together with a list of examples.

Self-consistent tilted-axis-cranking study of triaxial strongly deformed bands in 158Er at ultrahigh spin

Stimulated by recent experimental discoveries, triaxial strongly deformed (TSD) states in (158)Er at ultrahigh spins have been studied by means of the Skyrme-Hartree-Fock model and the tilted-axis-cranking method. Restricting the rotational axis to one of the principal axes--as done in previous cranking calculations--two well-defined TSD minima in the total Routhian surface are found for a given configuration: one with positive and another with negative triaxial deformation γ. By allowing the rotational axis to change direction, the higher-energy minimum is shown to be a saddle point. This resolves the long-standing question of the physical interpretation of the two triaxial minima at a very similar quadrupole shape obtained in the principal-axis-cranking approach. Several TSD configurations have been predicted, including a highly deformed band, which is a candidate for the structure observed in experiment.

Epizooic metazoan meiobenthos associated with tubeworm and mussel aggregations from cold seeps of the northern Gulf of Mexico

The abundance and higher taxonomic composition of epizooic metazoan meiobenthic communities associated with mussel and tubeworm aggregations of hydrocarbon seeps at Green Canyon, Atwater Valley, and Alaminos Canyon in depths between 1400 and 2800 m were studied and compared to the infaunal community of non-seep sediments nearby. Epizooic meiofaunal abundances of associated meiobenthos living in tubeworm bushes and mussel beds at seeps were extremely low (usually <100 ind. 10 cm(-2)), similar to epizooic meiofauna at deep-sea hydrothermal vents, and the communities were composed primarily of nematodes, copepods, ostracods, and halacarids. In contrast, epizooic meiobenthic abundance is lower than previous studies have reported for infauna from seep sediments. Interestingly, non-seep sediments contained higher abundances and higher taxonomic diversity than epizooic seep communities, although in situ primary production is restricted to seeps.

QSAR models for P450 (2D6) substrate activity

Human Cytochrome P450 (CYP) is a large group of enzymes that possess an essential function in metabolising different exogenous and endogenous compounds. Humans have more than 50 different genes encoding CYP enzymes, among these a gene encoding for the CYP isoenzyme 2D6, a CYP able to metabolise drugs and other chemicals. A training set of 747 chemicals primarily based on in vivo human data for the CYP isoenzyme 2D6 was collected from the literature. QSAR models focusing on substrate/non-substrate activity were constructed by the use of MultiCASE, Leadscope and MDL quantitative structure-activity relationship (QSAR) modelling systems. They cross validated (leave-groups-out) with concordances of 71%, 81% and 82%, respectively. Discrete organic European Inventory of Existing Commercial Chemical Substances (EINECS) chemicals were screened to predict an approximate percentage of CYP 2D6 substrates. These chemicals are potentially present in the environment. The biological importance of the CYP 2D6 and the use of the software mentioned above were discussed.

Minds That Matter: 2007 Gairdner International Awards Lectures

On October 25 and 26, 2007, at the University of Toronto, the Gairdner Foundation in partnership with Canadian Institutes of Health Research presented a two-day international symposium titled Minds That Matter. The symposium featured academic lectures by Gairdner Award winners past and present and by other leading biomedical scientists. These distinguished researchers share many characteristics in common: creativity, vision, tenacity, and driving curiosity to illuminate discovery with high degree of relevance. The present article summarizes the 2007 Gairdner Award lectures.

Minds That Matter: 2007 Gairdner International Awards Lectures

On October 25 and 26, 2007, at the University of Toronto, the Gairdner Foundation in partnership with Canadian Institutes of Health Research presented a two-day international symposium titled Minds That Matter. The symposium featured academic lectures by Gairdner Award winners past and present and by other leading biomedical scientists. These distinguished researchers share many characteristics in common: creativity, vision, tenacity, and driving curiosity to illuminate discovery with high degree of relevance. The present article summarizes the 2007 Gairdner Award lectures.

Comparison of different stomatal conductance algorithms for ozone flux modelling

A multiplicative and a semi-mechanistic, BWB-type [Ball, J.T., Woodrow, I.E., Berry, J.A., 1987. A model predicting stomatal conductance and its contribution to the control of photosynthesis under different environmental conditions. In: Biggens, J. (Ed.), Progress in Photosynthesis Research, vol. IV. Martinus Nijhoff, Dordrecht, pp. 221-224.] algorithm for calculating stomatal conductance (g(s)) at the leaf level have been parameterised for two crop and two tree species to test their use in regional scale ozone deposition modelling. The algorithms were tested against measured, site-specific data for durum wheat, grapevine, beech and birch of different European provenances. A direct comparison of both algorithms showed a similar performance in predicting hourly means and daily time-courses of g(s), whereas the multiplicative algorithm outperformed the BWB-type algorithm in modelling seasonal time-courses due to the inclusion of a phenology function. The re-parameterisation of the algorithms for local conditions in order to validate ozone deposition modelling on a European scale reveals the higher input requirements of the BWB-type algorithm as compared to the multiplicative algorithm because of the need of the former to model net photosynthesis (A(n)).

Representation of Chemical Information in OASIS Centralized 3D Database for Existing Chemicals

The present inventory of existing chemicals in regulatory agencies in North America and Europe, encompassing the chemicals of the European Chemicals Bureau (EINECS, with 61 573 discrete chemicals); the Danish EPA (159 448 chemicals); the U.S. EPA (TSCA, 56 882 chemicals; HPVC, 10 546 chemicals) and pesticides' active and inactive ingredients of the U.S. EPA (1379 chemicals); the Organization for Economic Cooperation and Development (HPVC, 4750 chemicals); Environment Canada (DSL, 10851 chemicals); and the Japanese Ministry of Economy, Trade, and Industry (16811), was combined in a centralized 3D database for existing chemicals. The total number of unique chemicals from all of these databases exceeded 185 500. Defined and undefined chemical mixtures and polymers are handled, along with discrete (hydrolyzing and nonhydrolyzing) chemicals. The database manager provides the storage and retrieval of chemical structures with 2D and 3D data, accounting for molecular flexibility by using representative sets of conformers for each chemical. The electronic and geometric structures of all conformers are quantum-chemically optimized and evaluated. Hence, the database contains over 3.7 million 3D records with hundreds of millions of descriptor data items at the levels of structures, conformers, or atoms. The platform contains a highly developed search subsystem--a search is possible on Chemical Abstracts Service numbers; names; 2D and 3D fragment searches; structural, conformational, or atomic properties; affiliation in other chemical databases; structure similarity; logical combinations; saved queries; and search result exports. Models (collections of logically related descriptors) are supported, including information on a model's author, date, bioassay, organs/tissues, conditions, administration, and so forth. Fragments can be interactively constructed using a visual structure editor. A configurable database browser is designed for the inspection and editing of all types of data items. Database statistics are maintained on the number and quality of structures, conformers, and descriptors. Reports can be generated presenting any chosen subset of structures and descriptors into different formats suitable for inclusion into documents. In addition to fixed report formats, there is a powerful report template designer module with a visual report template editor to produce a customized page layout. The database is compatible at the import/export level with SDF, MOL, SMILES, and other known formats. The precalculated centralized 3D database could be useful for quantitative structure-activity relationship developers avoiding the time-consuming and cumbersome 3D calculation phase of model development.

Multivariate statistical assessment of the pollution sources along the stream of Kamchia River, Bulgaria

Sixteen sampling sites along the stream of Kamchia River were considered as environmental objects in the multivariate statistical study aimed to identify and apportion patterns of sampling sites, latent factors responsible for the data structure and their relation to the emitter industrial and anthropogenic sources in the vicinity of the sampling sites. As variables 11 surface water parameters monitored for a long time period (up to 11 years) were used. Four main site patterns were revealed by cluster analysis (urban, rural, near-to dam and estuary) and for each site latent factors were identified and apportioned (among them "metallurgical", "food production", "winery", domestic wastes", "natural"). The relative contribution of each identified pollution source to the formation of the total concentration of each chemical species or physicochemical parameter was determined and compared to the real emitters in the region of interest.

[Assessment of irregular uterine bleeding in premenopausal women]

The aim of the present study was to investigate by diagnostic curettage the endometrial histological findings in women with irregular uterine bleeding in premenopause.

MATERIALS AND METHODS

Two hundred and thirty women between 40 to 54 wears (mean 48.13) with history of irregular genital bleeding in premenopause were investigated. The classic dilatation and curettage of endometrial cavity was performed and histological results were analyzed.

RESULTS AND DISCUSSION

The histological examination of the curettage material shows--normal endometrium in 32 (13.9%) women, anovulatory endometrium in 59 (26.6%), cystic hyperplasia and/or polyposis in 91 (39.6%), atrophic endometrium in 20 (8.7%), atypical hyperplasia in 15 (6.5%), endometrial cancer in 7 (3.1%) women and without adequate material were 6 (2.6%) cases.

CONCLUSION

This study pointed out, that women with irregular uterine bleeding in premenopause still remain serious diagnostic and therapeutic problem. Nevertheless, the separate curettage keeps its important role in assessment of health status of these women.

[Diagnostic modalities of endometrial ultrasonography in women with irregular bleeding in menopause]

The aim of the present study was to investigate the diagnostic possibilities of the endovaginal sonography for the assessment of the state of the endometrium in women with irregular bleeding in climax.

MATERIALS AND METHODS

Fifty women between 40 to 60 years (mean 47.8) with irregular genital bleeding were investigate. Using transvaginal ultrasound, anterior-posterior, length and width dimensions of the uterus were measured and echostructure of the endometrium was defined. The dilatation and curettage of endometrial cavity was performed subsequently.

RESULTS AND DISCUSSION

The histological examination of the curettage material shows - normal endometrium in 15 women, cystic hyperplasian in 16, atrophic endometrium in 11, atypical hyperplasia in 5 and endometrial cancer in 3 women. The correlation of these findings with the results from ultrasound investigation shows, that the degree of the endometrial thickness play a role as a criteria to establish the diagnostic protocol.

CONCLUSION

The summarized data from our study shows, that in the limit of 8 mm, the diagnostic accuracy of the method - sensitivity - 75% specificity - 73.8% amd efficacy - 74% give us cause to recommend the transvaginal sonography of the endometrium in women in climax, as a screening tool in the diagnostic protocol for endometrial cancer.

Environmetric approaches to estimate pollution impacts on a coastal area by sediment and river water studies

This paper represents an effort to demonstrate the opportunities of some environmetric methods like regression analysis, cluster analysis and principal components analysis. Their role for data modeling is stressed and the basic theoretical principles are given. The application of the multivariate statistical methods is illustrated by two major examples: Assessment of metal pollution based on multivariate statistical modeling of "hot spot" sediments from the Black Sea; and a trend study of Kamchia River water quality. In the first part of the study the environmetric approach makes it possible to separate three zones of the marine environment with different levels of pollution (Bourgas gulf, Varna gulf and lake buffer zone). Further, the extraction of four latent factors offers a specific interpretation of the possible pollution sources and separates the natural factors from the anthropogenic ones, the latter originating from contamination by chemical and steel-works and an oil refinery. In the second part of the study nine sampling sites along Kamchia River were considered as sources for water quality monitoring data. Trends for all parameters are calculated by the use of linear regression analysis and special attention is paid to a specific coastal site. Then five latent factors were extracted from the monitoring data set in order to gain information about some structural characteristics of the set.

Disturbances in rat smooth-muscle induced by a substance with fungicide action

The fungicide substance QAS [N,N,N',N'-tetramethyl-N,N'-di(8,15-dichloropentadeca-5,10- dien)ethylenediamine methylsulphate] has a biphasic effect on the spontaneous electrical and mechanical activity of smooth-muscle samples of rat corpus and guinea-pig taenia coli. During the first phase of QAS application membrane depolarization and increased spontaneous spike frequency were recorded. The tone of the preparations (resting tone) increased transiently. Calcium ion-entry blockers did not affect the contractile effect of QAS, but K(+)-channel blockers and some modulators of the second messenger system abolished or decreased it. During the second phase depolarization increased progressively, spike frequency decreased and the increase in resting tone recorded during the first phase was eliminated. The results reveal that the long-lasting depolarizing effect of QAS (in concentrations used for plant protection) probably inactivates the entry of Ca2+ into the smooth-muscle cells and disturbs Ca2+ homeostasis.

Hb Icaria-Hb H disease: identification of the Hb Icaria mutation through analysis of amplified DNA

Hb Icaria-Hb H disease was observed in a Yugoslavian teenager who exhibited moderate anaemia with severe microcytosis and hypochromia and 16% Hb H. Four of his relatives were Hb Icaria heterozygotes; their haematological data were comparable to those with a deletional type of alpha-thalassaemia-2. The patient also had an additional alpha-thalassaemia-1 deletion, an approximately 20.5 kb deletion, common among Mediterranean populations. The Hb Icaria mutation, i.e. the TAA----AAA mutation at codon 142, was identified by hybridization of amplified DNA with specific probes. The mutation is located on the alpha 2-globin gene; the one remaining alpha 1-globin gene is apparently able to compensate sufficiently for the loss of the three alpha-globin genes to maintain a haemoglobin level of 8-9 g/dl.

Beta-thalassemia in Yugoslavia

This study concerned the evaluation of beta-thalassemia alleles in nearly 50 patients with beta-thalassemia major and in 130 -thalassemia heterozygotes using gene amplification and dot-blot hybridization with synthetic probes. Fourteen different mutations were observed; of these, three (IVS-I-110; IVS-I-6; IVS-I-1) account for some 75% of all beta-thalassemia alleles. Newly discovered variants, i.e. T----C in the initiation codon and AATAAA----AATGAA in the poly A site were observed in a few patients. The poly A mutation with classical beta-thalassemia alleles result in thalassemia intermedia. Hb Lepore is a rather common abnormality and combinations of this variant with beta-thalassemia often result in severe disease; a search for beta-thalassemia mutations among patients affected with this disease should include an analysis to detect this hemoglobin abnormality.

Captopril in treatment of hypertensive diabetic patients. Preliminary study

This investigation was performed in 15 adult patients: 6 with type I and 9 with type II diabetes mellitus, all with arterial hypertension. Captopril (12.5 to 100 mg daily, mean 34 mg) was administered for a month and was effective as monotherapy in all patients. The supine arterial pressure changed from: 177 +/- 19 mm Hg to 141.7 +/- 7.7 mm Hg systolic and 106 +/- 7.6 mm Hg to 87.3 +/- 5.3 mm Hg diastolic; and upright: from 162.7 +/- 16 mm Hg to 139 +/- 11.4 mm Hg systolic and from 101.7 +/- 11.6 mm Hg to 87.3 +/- 6.5 mm Hg diastolic. The differences were statistically significant (p less than 0.001). The mean blood glucose was changed significantly at the end of the study (from 11.1 +/- 3.4 mmol.l-1 to 8.1 +/- 1.0 mumol.l-1, p less than 0.001), while the daily insulin dose (respectively glybenclamide) remained unchanged. No alterations in serum creatinine, HbA1 (glycohemoglobin), urinary excretion rate of albumin, beta 2-microglobulin, glomerular filtration rate were observed during follow-up. No important change in plasma aldosterone was found, while plasma renin activity was significantly increased (p less than 0.05) as expected. No side effects were reported during the therapy. Captopril appears to be an effective and safe drug for lowering blood pressure in diabetic patients without affecting renal function.

[Hemoglobin O Arab in interaction with beta 0-thalassemia]

Clinical, hematologic and hemoglobin composition data on the first case of Hb 0-Arab in association with beta 0-thalassemia in Yugoslavia are reported here. The propositus was a 26-years-old female from Strumica who was admitted to the hospital for several times because of anemia, hepatosplenomegaly, occasional abdominal pains, malaise and fatigue. Laboratory results presented: Hb 10.0 g/dl, RBC 3.84.10(12)/L, PCV 0.260 l/l, MCV 68 fl, MCH 26 pg, reticulocyte count 1.8%, anisopoikilocytosis, polychromasis, numerous target cells, total bilirubin 2.1 mg/dl, (indirect 1.7 mg/dl), serum-Fe 32.3 microM/L. A starch gel electrophoresis of hemolysate provided evidence for the presence of abnormal hemoglobin (approximately 85%) and Hb F (approximately 15%); the Hb A was absent. Familial screening showed her father was heterozygous for the abnormal hemoglobin, whereas the mother was heterozygous for beta-thalassemia. In vitro biosynthesis disclosed a total absence of beta globin and reduced synthesis of beta x x and gamma globin. The alpha/beta x + gamma-globin ratio was 1.77 (normal, 1.0 + 0.1). Amino acid analysis revealed that lysine substituted for glutamic acid at the position one hundred twenty-one of the beta chain (= Hb 0-Arab or beta 121 Glu----Lys).

[Surgical interventions on the stomach during a glucagon-induced decrease in its tonus]

Different operations were performed on 15 patients with the Glucagon decreased tonus of the stomach and intestine. The drug was injected in doses 0.2, 0.3 and 0.5 mg. The resulting hypotonia of the stomach and duodenum facilitated performing the operations. No complications were noted.

The 18- to 23-kb deletion of the Macedonian delta beta-thalassemia includes the entire delta and beta globin genes

Restriction endonuclease mapping analyses were made of DNA from a few members of a Macedonian family with hematological characteristics of delta beta-thalassemia, ie, microcytosis, normal HbA2 levels, and elevated levels of HbF (7% to 14%) with G gamma (average 40.5%) and A gamma T chains (average 59.5%). A large deletion of 18 to 23 kb was present with a 5' breakpoint within a 670-bp segment of DNA between the HpaI and NcoI restriction sites 5' to the delta globin gene, and a 3' breakpoint between the BamHI and HpaI restriction sites located some 9 to 13 kb 3' to the beta globin gene. This deletion is different from those present in other types of G gamma A gamma(delta beta)zero-thalassemia. The similarity of the hematological expression of these delta beta-thalassemic conditions which have somewhat comparable 5' breakpoints supports the idea that an important fetal hemoglobin-controlling region lies between the psi beta and delta globin genes.

Haplotypes and levels of fetal hemoglobin and G gamma to A gamma ratios in Mediterranean patients with thalassemia minor and major

This study concerned the gamma chain composition of Hb F and the haplotypes of 44 patients with beta-thalassemia major or intermedia and many of their relatives. Seventeen patients came from Northern (Turkish) Cyprus, 12 from the Istanbul area, and 15 from Macedonia and Bulgaria. Analysis of the A gamma T-G gamma-A gamma I ratio was made by HPLC, while haplotyping involved seven restriction sites. Specific haplotypes were present in certain populations; haplotype I [1] is the dominant type among North Cypriot thalassemia patients. Numerous types were seen in the patients from the Balkan countries. A direct relationship between the A gamma to G gamma ratios and the haplotypes, which exists among black beta-thalassemia heterozygotes [3], was also observed among these Mediterranean patients, although such analyses were considerably complicated by extensive blood transfusion therapy. Haplotypes without the Hinc II restriction site within the psi beta gene were associated with lower G gamma values than those that had this polymorphic site. The A gamma T chain was observed in a small number of beta-thalassemia homozygotes and heterozygotes. Three thalassemia chromosomes with slightly different haplotypes and one normal chromosome with a related haplotype were associated with the gamma 75 Ile----Thr substitution. A few patients with a thalassemia intermedia were heterozygotes for beta-thalassemia with either haplotypes V or VII [1] while the "nonthalassemic" chromosome had a haplotype I, which is the most common "beta-thalassemic" haplotype among the Mediterranean population(s). Detailed analyses of this chromosome have not been completed.