Degradation of dibutyl phthalate by Paenarthrobacter sp. Shss isolated from Saravan landfill, Hyrcanian Forests, Iran

Phthalic acid esters are predominantly used as plasticizers and are industrially produced on the million ton scale per year. They exhibit endocrine-disrupting, carcinogenic, teratogenic, and mutagenic effects on wildlife and humans. For this reason, biodegradation, the major process of phthalic acid ester elimination from the environment, is of global importance. Here, we studied bacterial phthalic acid ester degradation at Saravan landfill in Hyrcanian Forests, Iran, an active disposal site with 800 tons of solid waste input per day. A di-n-butyl phthalate degrading enrichment culture was established from which Paenarthrobacter sp. strain Shss was isolated. This strain efficiently degraded 1 g L^-1 di-n-butyl phthalate within 15 h with a doubling time of 5 h. In addition, dimethyl phthalate, diethyl phthalate, mono butyl phthalate, and phthalic acid where degraded to CO₂, whereas diethyl hexyl phthalate did not serve as a substrate. During the biodegradation of di-n-butyl phthalate, mono-n-butyl phthalate was identified in culture supernatants by ultra-performance liquid chromatography coupled to electrospray ionization quadrupole time-of-flight mass spectrometry. In vitro assays identified two cellular esterase activities that converted di-n-butyl phthalate to mono-n-butyl phthalate, and the latter to phthalic acid, respectively. Our findings identified Paenarthrobacter sp. Shss amongst the most efficient phthalic acid esters degrading bacteria known, that possibly plays an important role in di-n-butyl phthalate elimination at a highly phthalic acid esters contaminated landfill.

Prevalence and differences of ideal cardiovascular health in urban and rural adolescents in the Region of Tyrol: results from the EVA Tyrol study

Purpose

Early adoption of a healthy lifestyle has positive effects on cardiovascular health (CVH) in adulthood. In this study, we aimed to assess CVH metrics in a cohort of healthy teenagers with focus on differences between rural and urban areas.

Methods

The Early Vascular Aging (EVA) Tyrol study is a population-based non-randomized controlled trial, which prospectively enrolled 14- to 19-year-old adolescents in North Tyrol, Austria and South Tyrol, Italy between 2015 and 2018. Data from the baseline and control group (prior to health intervention) are included in the current analysis. CVH determinants (smoking, body mass index, physical activity, dietary patterns, systolic and diastolic blood pressure, total cholesterol and fasting blood glucose) were assessed and analyzed for urban and rural subgroups separately by univariate testing. Significant variables were added in a generalized linear model adjusted for living in urban or rural area with age and sex as covariates. Ideal CVH is defined according to the guidelines of the American Heart Association.

Results

2031 healthy adolescents were enrolled in the present study (56.2% female, mean age 16.5 years). 792 adolescents (39.0%) were from urban and 1239 (61.0%) from rural areas. In 1.3% of adolescents living in urban vs. 1.7% living in rural areas all CVH determinants were in an ideal range. Compared to the rural group, urban adolescents reported significantly longer periods of moderate to vigorous-intensive activity (median 50.0 min/day (interquartile range 30–80) vs. median 40.0 min/day (interquartile range 25–60), p < 0.01). This observation remained significant in a generalized linear model (p < 0.01). There were no significant differences between the study groups regarding all other CVH metrics.

Conclusion

The low prevalence of ideal CVH for adolescents living in urban as well as rural areas highlights the need for early health intervention. Geographic differences must be taken into account when defining targeted subgroups for health intervention programs.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12872-021-02156-6.

Tailoring Multiloop Atom Interferometers with Adjustable Momentum Transfer

Multiloop matter-wave interferometers are essential in quantum sensing to measure the derivatives of physical quantities in time or space. Because multiloop interferometers require multiple reflections, imperfections of the matter-wave mirrors create spurious paths that scramble the signal of interest. Here, we demonstrate a method of adjustable momentum transfer that prevents the recombination of the spurious paths in a double-loop atom interferometer aimed at measuring rotation rates. We experimentally study the recombination condition of the spurious matter waves, which is quantitatively supported by a model accounting for the coherence properties of the atomic source. We finally demonstrate the effectiveness of the method in building a cold-atom gyroscope with a single-shot acceleration sensitivity suppressed by a factor of at least 50. Our study will impact the design of multiloop atom interferometers that measure a single inertial quantity.

A fibered laser system for the MIGA large scale atom interferometer

We describe the realization and characterization of a compact, autonomous fiber laser system that produces the optical frequencies required for laser cooling, trapping, manipulation, and detection of 87Rb atoms - a typical atomic species for emerging quantum technologies. This device, a customized laser system from the Muquans company, is designed for use in the challenging operating environment of the Laboratoire Souterrain à Bas Bruit (LSBB) in France, where a new large scale atom interferometer is being constructed underground - the MIGA antenna. The mobile bench comprises four frequency-agile C-band Telecom diode lasers that are frequency doubled to 780 nm after passing through high-power fiber amplifiers. The first laser is frequency stabilized on a saturated absorption signal via lock-in amplification, which serves as an optical frequency reference for the other three lasers via optical phase-locked loops. Power and polarization stability are maintained through a series of custom, flexible micro-optic splitter/combiners that contain polarization optics, acousto-optic modulators, and shutters. Here, we show how the laser system is designed, showcasing qualities such as reliability, stability, remote control, and flexibility, while maintaining the qualities of laboratory equipment. We characterize the laser system by measuring the power, polarization, and frequency stability. We conclude with a demonstration using a cold atom source from the MIGA project and show that this laser system fulfills all requirements for the realization of the antenna.

Interleaved atom interferometry for high-sensitivity inertial measurements

Cold-atom inertial sensors target several applications in navigation, geoscience, and tests of fundamental physics. Achieving high sampling rates and high inertial sensitivities, obtained with long interrogation times, represents a challenge for these applications. We report on the interleaved operation of a cold-atom gyroscope, where three atomic clouds are interrogated simultaneously in an atom interferometer featuring a sampling rate of 3.75 Hz and an interrogation time of 801 ms. Interleaving improves the inertial sensitivity by efficiently averaging vibration noise and allows us to perform dynamic rotation measurements in a so far unexplored range. We demonstrate a stability of 3 × 10^-10 rad s^-1 , which competes with the best stability levels obtained with fiber-optic gyroscopes. Our work validates interleaving as a key concept for future atom-interferometry sensors probing time-varying signals, as in on-board navigation and gravity gradiometry, searches for dark matter, or gravitational wave detection.

Exploring gravity with the MIGA large scale atom interferometer

We present the MIGA experiment, an underground long baseline atom interferometer to study gravity at large scale. The hybrid atom-laser antenna will use several atom interferometers simultaneously interrogated by the resonant mode of an optical cavity. The instrument will be a demonstrator for gravitational wave detection in a frequency band (100 mHz–1 Hz) not explored by classical ground and space-based observatories, and interesting for potential astrophysical sources. In the initial instrument configuration, standard atom interferometry techniques will be adopted, which will bring to a peak strain sensitivity of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\bf{2}}\cdot {\bf{1}}{{\bf{0}}}^{-{\bf{13}}}/\sqrt{{\bf{H}}{\bf{z}}}$$\end{document}2⋅10−13/Hz at 2 Hz. This demonstrator will enable to study the techniques to push further the sensitivity for the future development of gravitational wave detectors based on large scale atom interferometers. The experiment will be realized at the underground facility of the Laboratoire Souterrain à Bas Bruit (LSBB) in Rustrel–France, an exceptional site located away from major anthropogenic disturbances and showing very low background noise. In the following, we present the measurement principle of an in-cavity atom interferometer, derive the method for Gravitational Wave signal extraction from the antenna and determine the expected strain sensitivity. We then detail the functioning of the different systems of the antenna and describe the properties of the installation site.

Continuous Cold-Atom Inertial Sensor with 1 nrad/sec Rotation Stability

We report the operation of a cold-atom inertial sensor which continuously captures the rotation signal. Using a joint interrogation scheme, where we simultaneously prepare a cold-atom source and operate an atom interferometer (AI), enables us to eliminate the dead times. We show that such continuous operation improves the short-term sensitivity of AIs, and demonstrate a rotation sensitivity of 100  nrad/sec/sqrt[Hz] in a cold-atom gyroscope of 11  cm^{2} Sagnac area. We also demonstrate a rotation stability of 1  nrad/sec at 10^{4}  sec of integration time, which represents the state of the art for atomic gyroscopes. The continuous operation of cold-atom inertial sensors will lead to large area AIs at their full sensitivity potential, determined by the quantum noise limit.

Validation of the GeneXpert® CT/NG Assay for use with Male Pharyngeal and Rectal Swabs

OBJECTIVES

The GeneXpert^® CT/NG (Cepheid, Sunnyvale, CA) assay is a point-of-care (POC) molecular diagnostic assay designed to rapidly test for the presence of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC). However, the test is only approved for vaginal swabs, urine, and endocervical swabs. Here, we performed an evaluation of the GeneXpert^® CT/NG assay to detect the presence of CT and GC on male pharyngeal and rectal swabs.

METHODS

Men who have sex with men participating in an HIV and Sexually Transmitted Infection (STI) screening program providing consent were enrolled into the study. Participants were asked to self-collect two pharyngeal and two rectal swabs. One set was tested on site using GeneXpert^® and the other was sent to a reference lab for molecular testing using the APTIMA^® system (Hologic, San Diego, CA).

RESULTS

A total of 570 swabs were collected from 144 patients. GeneXpert^® detected 13/15 rectal swabs testing CT positive by the APTIMA^® assay (relative sensitivity=88.2%), 1/2 pharyngeal swabs testing CT positive (relative sensitivity=50%), and 7/9 pharyngeal swabs testing NG positive (relative sensitivity =77.8%). No discordance was observed for rectal NG swabs.

CONCLUSIONS

Although less sensitive than the APTIMA^® assay for the molecular detection of NG and CT, GeneXpert^®'s potential as a rapid POC diagnostic still make it a viable diagnostic test for STI screening. Molecular POC diagnostics, such as this, will allow more thorough screening of at risk individuals, and enhance the ability of clinics to provide same-day diagnosis and treatment.

Cooling of a One-Dimensional Bose Gas

We experimentally study the dynamics of a degenerate one-dimensional Bose gas that is subject to a continuous outcoupling of atoms. Although standard evaporative cooling is rendered ineffective by the absence of thermalizing collisions in this system, we observe substantial cooling. This cooling proceeds through homogeneous particle dissipation and many-body dephasing, enabling the preparation of otherwise unexpectedly low temperatures. Our observations establish a scaling relation between temperature and particle number, and provide insights into equilibration in the quantum world.

Haemodynamic characterisation and heart catheterisation complications in children with pulmonary hypertension: Insights from the Global TOPP Registry (tracking outcomes and practice in paediatric pulmonary hypertension)

BACKGROUND

The TOPP Registry has been designed to provide epidemiologic, diagnostic, clinical, and outcome data on children with pulmonary hypertension (PH) confirmed by heart catheterisation (HC). This study aims to identify important characteristics of the haemodynamic profile at diagnosis and HC complications of paediatric patients presenting with PH.

METHODS AND RESULTS

HC data sets underwent a blinded review for confirmation of PH (defined as mean pulmonary arterial pressure ≥ 25 mmHg, pulmonary capillary wedge pressure ≤ 12 mmHg and pulmonary vascular resistance index [PVRI] of >3 WU × m(2)). Of 568 patients enrolled, 472 who fulfilled the inclusion criteria and had sufficient data from HC were analysed. A total of 908 diagnostic and follow-up HCs were performed and complications occurred in 5.9% of all HCs including five (0.6%) deaths. General anaesthesia (GA) was used in 53%, and conscious sedation in 47%. Complications at diagnosis were more likely to occur if GA was used (p=0.04) and with higher functional class (p=0.02). Mean cardiac index (CI) was within normal limits at diagnosis when analysed for the entire group (3.7 L/min/m(2); 95% confidence interval 3.4-4.1), as was right atrial pressure despite a severely increased PVRI (16.6 WU × m(2,) 95% confidence interval 15.6-17.76). However, 24% of the patients had a CI of <2.5L/min/m(2) at diagnosis. A progressive increase in PVRI and decrease in CI was observed with age (p<0.001).

CONCLUSION

In TOPP, haemodynamic assessment was remarkable for preserved CI in the majority of patients despite severely elevated PVRI. HC-related complication incidence was 5.9%, and was associated with GA and higher functional class.

Power-dependent Raman analysis of highly strained Si nanobridges

Strain analysis of complex three-dimensional nanobridges conducted via Raman spectroscopy requires careful experimentation and data analysis supported by simulations. A method combining micro-Raman spectroscopy with finite element analysis is presented, enabling a detailed understanding of strain-sensitive Raman data measured on Si nanobridges. Power-dependent measurements are required to account for the a priori unknown scattering efficiency related to size and geometry. The experimental data is used to assess the validity of previously published phonon deformation potentials.

Multimode dynamics and emergence of a characteristic length scale in a one-dimensional quantum system

We study the nonequilibrium dynamics of a coherently split one-dimensional Bose gas by measuring the full probability distribution functions of matter-wave interference. Observing the system on different length scales allows us to probe the dynamics of excitations on different energy scales, revealing two distinct length-scale-dependent regimes of relaxation. We measure the crossover length scale separating these two regimes and identify it with the prethermalized phase-correlation length of the system. Our approach enables a direct observation of the multimode dynamics characterizing one-dimensional quantum systems.

[Use of a mechatronic robotic camera holding system in head and neck surgery]

BACKGROUND

It has been shown that a third hand is useful for holding the endoscope during endoscopic surgery so that both hands of the surgeon are free for instrumentation.

MATERIAL AND METHODS

Experimental tests were performed with the mechatronic robotic camera holding system Soloassist on anatomical specimens in the area of the nose, nasopharynx and larynx.

RESULTS

An ergonomic set-up and the practical application are easily possible. The third hand enables a still and clear picture without undesired camera movement and all instruments can be controlled by the surgeon. There would appear to be some room for improvement as the working area is limited due to an additional instrument. The camera holding system shows a very high velocity for head and neck surgery.

CONCLUSION

Until the active holder can be used regularly in clinical practice in the field of head and neck surgery, more technical modifications have to be implemented.

Dual-wavelength laser source for onboard atom interferometry

We present a compact and stable dual-wavelength laser source for onboard atom interferometry with two different atomic species. It is based on frequency-doubled telecom lasers locked on a femtosecond optical frequency comb. We take advantage of the maturity of fiber telecom technology to reduce the number of free-space optical components, which are intrinsically less stable, and to make the setup immune to vibrations and thermal fluctuations. The source provides the frequency agility and phase stability required for atom interferometry and can easily be adapted to other cold atom experiments. We have shown its robustness by achieving the first dual-species K-Rb magneto-optical trap in microgravity during parabolic flights.

Signal enhancement in nano-Raman spectroscopy by gold caps on silicon nanowires obtained by vapour-liquid-solid growth

Silicon nanowires grown by the vapour-liquid-solid growth mechanism with gold as the catalyst show gold caps approximately 50-400 nm in diameter with an almost ideal hemispherical shape atop a silicon column. These gold caps are extremely well suited for exploiting the tip or surface enhanced Raman scattering effects since they assume the right size on the nanometre scale and a reproducible, almost ideal hemispherical shape. On attaching a nanowire with a gold cap to an atomic force microscopy (AFM) tip, the signal enhancement by the gold nanoparticle can be used to spatially resolve a Raman signal. Applications of this novel nanowire based technical tip enhanced Raman scattering solution are widespread and lie in the fields of biomedical and life sciences as well as security (e.g. detection of bacteria and explosives) and in the field of solid state research, e.g. in silicon technology where the material composition, doping, crystal orientation and lattice strain can be probed by Raman spectroscopy. A prerequisite for obtaining this spatial resolution in nano-Raman spectroscopy is the attachment of a nanowire with a gold cap to an AFM tip. This attachment by welding a nanowire in a scanning electron microscope to an AFM tip is demonstrated in this paper.

The SERS and TERS effects obtained by gold droplets on top of Si nanowires

We show that hemispherical gold droplets on top of silicon nanowires when grown by the vapor-liquid-solid (VLS) mechanism, can produce a significant enhancement of Raman scattered signals. Signal enhancement for a few or even just single gold droplets is demonstrated by analyzing the enhanced Raman signature of malachite green molecules. For this experiment, trenches (approximately 800 nm wide) were etched in a silicon-on-insulator (SOI) wafer along <110> crystallographic directions that constitute sidewalls ({110} surfaces) suitable for the growth of silicon nanowires in <111> directions with the intention that the gold droplets on the silicon nanowires can meet somewhere in the trench when growth time is carefully selected. Another way to realize gold nanostructures in close vicinity is to attach a silicon nanowire with a gold droplet onto an atomic force microscopy (AFM) tip and to bring this tip toward another gold-coated AFM tip where malachite green molecules were deposited prior to the measurements. In both experiments, signal enhancement of characteristic Raman bands of malachite green molecules was observed. This indicates that silicon nanowires with gold droplets atop can act as efficient probes for tip-enhanced Raman spectroscopy (TERS). In our article, we show that a nanowire TERS probe can be fabricated by welding nanowires with gold droplets to AFM tips in a scanning electron microscope (SEM). TERS tips made from nanowires could improve the spatial resolution of Raman spectroscopy so that measurements on the nanometer scale are possible.

Rinderpest surveillance performance monitoring using quantifiable indicators

This paper describes an objective system of monitoring the performance of disease surveillance. The system was developed through dialogue with a number of countries in Africa and adopted as part of the Global Rinderpest Eradication Programme of the Food and Agriculture Organization of the United Nations. The performance monitoring system uses a clinical stomatitis-enteritis case definition, an outbreak investigation classification scheme, and a series of eight performance indicators to measure the sensitivity, specificity and timeliness of the surveillance system. Field-testing indicates that the approach is successful when good record-keeping is practiced and highlights the importance of dialogue in helping to ensure that the system is simple and acceptable. The system provides a quantitative measure of the efficacy of national disease surveillance programmes and of the quality of data derived from such programmes for use in international disease control, animal health information exchange and trade risk analysis.

[Blood pressure difference between upper arm and thigh, and aortic stiffness in healthy subjects and in patients after coarcectomy]

BACKGROUND

The blood pressure difference between the right arm and the legs is often used as an estimate of a possible gradient across a coarctation or recoarctation aortae. We wanted to test the reliability of this hypotheses while estimating the local stiffness of the aortae ascendens and abdominalis.

PATIENTS

We examined 50 healthy children and adolescents as well as 50 patients of a similar age after repair of an coarctation aortae. There was no relevant recoarctation on echocardiography or magnet resonance tomography.

METHODS

We measured in all patients the blood pressure by oscillometry three times on the right upper arm and thigh. At the same time we measured the systolic and diastolic diameter of the aorta before the branching of the truncus brachiocephalicus and the branching of the truncus coeliacus. The local stiffness was calculated, using the stiffness index b, from the aortic diameter and the corresponding blood pressure.

RESULTS

The systolic blood pressure difference showed in healthy subjects and patients after coarctation a wide range (about 60 mm Hg). The diastolic and mean blood pressure showed a slightly smaller range. There was no significant difference in this respect between the two groups. The stiffness index beta was elevated after coarcectomy in the aorta ascendens compared to healthy subjects. The local stiffness of the abdominal aortae were similar in both groups and showed a similar increase with advancing age.

DISCUSSION

The blood pressure difference between the upper arm and thigh showed a wide range. Therefore is the blood pressure difference an unreliable tool to estimate the severity of a re-coarctation. The local stiffness of the aorta ascendens was elevated after coarctation and implied at least a partial loss of the Windkessel. The local stiffness in the aorta abdominalis was normal after coarctation repair.

Altered Arterial Expression Patterns of Inducible and Endothelial Nitric Oxide Synthase in Pulmonary Plexogenic Arteriopathy Caused by Congenital Heart Disease

Flow-associated pulmonary hypertension leads to pulmonary plexogenic arteriopathy (PPA), a specific pulmonary vascular disease that includes vascular lesions characterized by abnormal vasodilatation and endothelial cell proliferation. Increased local production of NO has been suggested in this condition. Because reported data on the expression of endothelial NO-synthase (ecNOS) have been contradictory, we speculated that the expression of the inducible isoform of NOS (iNOS) is enhanced in this form of pulmonary hypertension. We investigated immunohistochemically the expression of ecNOS and iNOS in lung tissue of patients with flow-associated pulmonary hypertension (n = 18) and compared the findings with those in patients with increased pulmonary blood flow but normal pulmonary artery pressure (n = 10), with congestive vasculopathy (n = 6) and control subjects (n = 4). Immunoreactivity for ecNOS and iNOS was present both in normal and diseased pulmonary arteries. Marked immunoreactivity to both isoforms was present within the advanced lesions of PPA, including plexiform lesions. Semiquantitative analysis of immunoreactivity, both for ecNOS and iNOS, showed no correlation with the severity of morphologic vascular lesions (p = 0.29 and p = 0.23, respectively). In contrast to ecNOS, immunoreactivity for iNOS was increased in patients with flow-associated pulmonary hypertension compared with other patients (p = 0.02). The present study has demonstrated enhanced expression of iNOS in patients at risk for advanced PPA, but not in patients with other forms of pulmonary arteriopathy. Moreover, high expression of both ecNOS and iNOS were present in advanced lesions of PPA. These data suggest differentiated roles for different isoforms of NOS in the pathogenesis of this specific pulmonary arteriopathy.

Comparison between c-ELISA and CFT in detecting antibodies to Mycoplasma mycoides mycoides biotype SC in cattle affected by CBPP in Botswana

Contagious bovine pleuropneumonia (CBPP), caused by Mycoplasma mycoides mycoides biotype small colony (SC) (MmmSC) appears to be making a serious comeback in Africa after successful control programs in many parts of the continent during the 1960s and 1970s. Botswana, a country that has been free from the disease for more than 50 years, was affected in 1995. An eradication policy was adopted by the Government of Botswana in which 320,000 cattle in the affected district of Ngamiland, Northwestern Botswana were slaughtered. This was followed by a restocking exercise in which 70,000 cattle were sent to the outbreak areas as replacement stock. It became necessary to carry out serosurveillance in order to ensure that the disease did not reenter Botswana and to ensure that the replacement stock remained free from the disease. The specificity and sensitivity of the complement fixation test (CFT) in Botswana was assessed in 82 cattle affected by the disease and held in a double fenced quarantine camp. The newly developed competitive ELISA was made available to the National Veterinary Laboratory (NVL) through the FAO/IAEA Joint Division in Vienna, Austria. Using postmortem lesions as the gold standard and a 2 x 2 contingency table, the two tests were compared in terms of their sensitivity and specificity in detecting antibodies to MmmSC. The CFT was found to be slightly more sensitive than the c-ELISA, and this could be related to the stage of the disease. A long-term study comparing the progression of the disease with the two tests is, therefore, essential.

Enhanced expression of vascular endothelial growth factor in pulmonary plexogenic arteriopathy due to congenital heart disease

Congenital heart disease (CHD) leading to increased pulmonary blood pressure and flow is an important cause of pulmonary plexogenic arteriopathy (PPA). This type of arteriopathy tends to progress to an irreversible stage, hallmarked histologically by the emergence of a number of characteristic lesions, which include concentric laminar intimal proliferation and fibrosis, and plexiform lesions. The pathogenesis of these lesions, which connote a very poor prognosis, is not well understood. Since endothelial cell proliferation has been demonstrated in these lesions, it was hypothesized that vascular endothelial growth factor (VEGF), a key mediator of angiogenesis, might play a role in their pathogenesis. Thirty-nine patients with various types of CHD, who underwent cardiac catheterization and subsequent cardiac surgery, were studied prospectively. On the basis of a detailed assessment of the type of cardiac defect, the haemodynamic abnormalities, and the histopathological features evident from open lung biopsies, taken in all instances, patients were histologically grouped into cases with moderate PPA (n=18), advanced PPA (n=7), pulmonary congestive vasculopathy (PCV, n=5), and controls lacking pulmonary hypertension or increased pulmonary blood flow (n=4). Five patients were excluded from analysis because of inadequate sample size or quality. The presence of VEGF was assessed immunohistochemically using standard procedures and was correlated with haemodynamic and histological data. Immunoreactive VEGF was detected in pulmonary arterial smooth muscle cells and endothelial cells in 13 out of 34 cases and was more frequent and more pronounced in patients with the histological lesions of advanced PPA than in those with moderate PPA (p<0.01). VEGF positivity was particularly prominent in the lesions characteristic of advanced PPA. No difference in VEGF expression was observed between controls, PVC, and moderate PPA cases. Measured haemodynamic parameters did not differ significantly between VEGF-positive and VEGF-negative cases. We conclude that VEGF may play a role in the angioproliferative changes of advanced PPA.

Interleukin-1 receptor antagonist and interleukin-6 for early diagnosis of neonatal sepsis 2 days before clinical manifestation

BACKGROUND

Neonatal sepsis is a common and life-threatening disorder, particularly among preterm infants. Early initiation of antibiotic therapy is frequently delayed because the first clinical signs of sepsis are non-specific and there are no reliable early laboratory indicators. We investigated the time course of expression and the prognostic power of the early inflammatory mediators interleukin-1 receptor antagonist (IL-1ra), interleukin-6 (IL-6), and circulating intercellular adhesion molecule-1 (cICAM-1) before clinical diagnosis of sepsis.

METHODS

In a prospective multicentre study, we monitored 182 very-low-birthweight infants in six intensive-care units for occurrence of sepsis. During routine or clinically indicated blood sampling, an additional sample was collected for measurement of IL-1ra, IL-6, cICAM-1, and C-reactive protein (CRP). Infants were grouped into those with proven sepsis, no infection, or unclassified. The mean study duration was 34 days. Whenever sepsis occurred, a study period of 10 days was defined: day 0 was the day of clinical diagnosis of sepsis; days -4 to -1 were the 4 days before diagnosis; days +1 to +5 were the 5 days after. We compared the concentrations of the immune mediators during the 10-day study period with group-specific baseline values from before day -4.

FINDINGS

101 infants were included in the analysis: 21 with proven sepsis, 20 with no infection, and 60 unclassified. We excluded 57 because of incomplete datasets and 24 who had early-onset sepsis. IL-1ra and IL-6 increased significantly 2 days before diagnosis of sepsis; maximum median increases within the study period were 15-fold for IL-1ra and 12-fold for IL-6. The diagnostic sensitivities of IL-1ra, IL-6, and CRP concentrations on day 0 of diagnosis were 93%, 86%, and 43%, respectively; corresponding values on day -1 were 64%, 57%, and 18%. The specificities of IL-1ra, IL-6, and CRP concentrations were 92%, 83%, and 93%. cICAM-1 had a specificity of only 64%.

INTERPRETATION

IL-1ra and IL-6 are superior to cICAM-1 and CRP as predictors of sepsis 1 or more days before clinical diagnosis. Ad-hoc measurement of these cytokines could allow earlier initiation of antibiotic therapy with corresponding improvement in outcome in very-low-birthweight infants with sepsis.

Hepatitis caused by antidepressive therapy with maprotiline and opipramol

There are few published reports of antidepressive therapy induced hepatotoxicity. In most cases antidepressants cause only slight elevation of liver enzymes without clinical relevance. However, our patient with recidivation of unipolar depressive disorder developed severe laboratory abnormalities and clinical symptoms during therapy with maprotiline (Ludiomil) and opipramol (Insidon). To our knowledge, this is the first case report of bioptically proven severe acute hepatitis caused by these antidepressants. After their withdrawal, the patient's fatigue symptoms, scleric jaundice, and marked increase of liver enzymes completely disappeared. Hepatic side effects should be considered during antidepressive therapy with maprotiline and opipramol especially when additional clinical symptoms emerge.

Stridor as the major presenting symptom in riboflavin-responsive multiple acyl-CoA dehydrogenation deficiency

Inspiratory stridor of unknown origin was the leading clinical symptom in an 11-month-old boy. The stridor increased over a period of 4 weeks, and assisted ventilation became necessary. Selective urinary screening by gas chromatography/mass spectrometry analysis revealed excretion of ethylmalonic and 3-OH-isovaleric acid and of N-isobutyryl-, N-2-methylbutyryl-, N-isovaleryl-, N-hexanoyl- and N-suberylglycine. Neither hypoglycaemia nor metabolic acidosis were noticed. Treatment with 200 mg of riboflavin per day led to a dramatic clinical improvement with restoration of normal respiration and an increase in muscular tone within 2 months. During this period, metabolite excretion in urine completely normalized. Riboflavin-sensitive multiple acyl-CoA dehydrogenation deficiency was confirmed in cultured fibroblasts. With riboflavin supplementation, the development of the child has been favourable, with normal school attendance now at an age of 9 years.

CONCLUSION

As respiratory symptoms might precede other symptoms in disorders of mitochondrial oxidation, we propose determination of urinary organic acids in all cases of unexplained laryngeal stridor.

Changes in left ventricular function in shocked newborns

OBJECTIVE

To assess whether the change in cardiac output after volume replacement is due to elevation of stroke volume or heart rate and to determine the effect of mechanical ventilation on the hemodynamic situation.

DESIGN

Prospective study.

SETTING

A ten-bed neonatal intensive care unit (level III) at a university hospital.

PATIENTS

15 consecutive newborns with blood pressure below the 10th percentile related to age and weight.

INTERVENTIONS

Volume replacement with Ringer's lactate 20 ml/kg body weight.

MEASUREMENTS AND RESULTS

Before and after volume replacement, arterial pressure recordings, blood gas analysis, and an echocardiographic study were carried out. Left ventricular and aortic diameters were measured by the two-dimensional M-mode technique and velocity time integral of aortic flow by the pulsed color Doppler technique. From these data, stroke volume and cardiac output were calculated. Cardiac output (703 +/- 204 vs 826 +/- 166 ml/ min, p < 0.005) and cardiac index (267 +/- 69 vs 302 +/- 55 ml/min per kg body weight, p < 0.01) changed significantly due to an appreciable elevation in stroke volume (5.2 +/- 1.7 vs 5.8 +/- 1.7 ml, p < 0.05), whereas heart rate was unaltered (140 +/- 12 vs 142 +/- 20 beats/min; NS). The change in blood pressure (32 +/- 5 vs 38 +/- 8 mm Hg, p < 0.01) was also significant. Cardiac index before and after volume replacement showed a significant inverse correlation with the severity of respiratory disease expressed as alveolar-arterial oxygen difference (A-aDO2) (A-aDO2 vs cardiac index before volume replacement: r = -0.77, p < 0.001; after volume replacement: r = -0.73, p < 0.005) or oxygenation index (oxygenation index vs cardiac index before volume replacement: r = -0.73, p < 0.005; after volume replacement: r = -0.73, p < 0.005). Changes in left ventricular diastolic diameter, left ventricular systolic diameter, and fractional shortening were not significant.

CONCLUSIONS

These results indicate that the major regulator of left ventricular output in newborns with hypovolemic or cardiogenic shock is stroke volume and not heart rate and that cardiac output depends on the severity of the respiratory disease.

Comparative genomic hybridization reveals a partial de novo trisomy 6q23-qter in an infant with congenital malformations: delineation of the phenotype

We report the use of comparative genomic hybridization (CGH) to define the origin of a small extra segment (unidentifiable by classical cytogenetics) present in a de novo add(13)q34 chromosome that we found in the karyotype of a newly born boy with congenital heart defects, brain anomalies and dysmorphic signs. Initial investigation with fluorescence in situ hybridization (FISH) and a chromosome-13-specific library revealed that the excess material was not derived from chromosome 13. To uncover the origin of the unknown chromosome material, CGH was carried out on DNA isolated from blood lymphocytes of the patient. By using a conventional fluorescence microscope with no digital imaging devices, a single distinct region with gain of fluorescent intensity was observed on distal chromosome 6q. Confirmation of this finding by FISH with a chromosome-6-specific paint and a subtelomeric yeast artificial chromosome clone from 6q26-q27, in combination with the band morphology of the small extra chromosomal segment, allowed us to diagnose the additional material as being derived from chromosome 6q23-qter. FISH with a telomere 13q probe detected a terminal deletion of 13q34-qter on the derivative chromosome 13, indicating that the der(13) was a result of a translocation event. Genotyping of the hypervariable apolipoprotein (a) gene, which lies within 6q26-q27, showed that the additional chromosome 6 material was inherited from the mother. The karyotype of the proposita is therefore: 46,XY,-13,+der(13)t(6;13)(q23;q34) de novo (mat). Our results confirm the usefulness of CGH as an attractive alternative method for the characterization of constitutional small genetic imbalances and contribute to the delineation of the trisomy 6q23-qter phenotype.

Randomised trial of transjugular-intrahepatic-portosystemic shunt versus endoscopy plus propranolol for prevention of variceal rebleeding

BACKGROUND

The transjugular-intrahepatic-portosystemic shunt is a new interventional treatment for portal hypertension. The aim of our study was to compare the transjugular shunt with endoscopic treatment for the prophylaxis of recurrent variceal bleeding.

METHODS

Between March, 1993, and March, 1996, 126 patients with variceal bleeding were randomly assigned either transjugular shunt (n = 61) or endoscopic treatment (n = 65). Patients were followed up for a median of 14 (IQR 8-25) months and 13 (8-25) months, respectively. In 31 (51%) of the shunted patients, simultaneous transjugular-variceal embolisation was done at the time of shunt placement. Endoscopic treatment consisted of sclerotherapy and/or banding ligation and was combined with propranolol medication.

FINDINGS

Technical success was achieved in all patients assigned to the shunt group. During follow-up, the cumulative 1-year variceal rebleeding rates in the shunted and endoscopically treated patients were 15% and 41% and the 2-year rates were 21% and 52% (p = 0.001), respectively. In nine (12%) patients from the endoscopic group treatment failed and the patients received the transjugular-shunt treatment. A total of 19 bleeding episodes from any source occurred in 15 patients in the shunt group compared with 100 episodes in 33 patients in the endoscopic group. There was no difference in survival with estimated 1-year survival rates for shunted and endoscopically treated patients of 90% and 89%, and 2-year survival rates of 79% and 82%, respectively. The incidence of clinically significant hepatic encephalopathy after 1 year was higher in the shunt group (36% vs 18%, p = 0.011).

INTERPRETATION

These results suggest, that the transjugular shunt is more effective than endoscopic treatment in prevention of variceal rebleeding but has a considerable risk of hepatic encephalopathy. Survival is similar in the two groups.

Circulating interleukin-1 receptor antagonist levels in neonates

Circulating interleukin-1 receptor antagonist (IL-1 Ra) levels have been shown to reflect disease activity in certain conditions in adults. We determined circulating IL-1Ra references values for healthy neonates (healthy preterms and term infants with mild disease only) on days 2 (n = 17) and 4 of life (n = 23). Mean gestational age was 35 +/- 2.6 weeks. On the 2nd day of life IL1-Ra levels were 0.78 ng/ml (0.49/2.65), on day 4 0.38 ng/ml (0.20/0.48) (median, 25th/75th percentile, P = 0.01). The values were not influenced by gender. In neonates with severe illness (septicaemia, asphyxia, neonatal respiratory distress syndrome), who received invasive intensive care, circulating IL-1Ra levels were significantly higher than in the reference group of healthy newborns. On the 2nd day of life (14.72 ng/ml (4.38/18.67) versus 0.78 ng/ml (0.49/2.65), P < 0.0001; on day 4 of life, 3.38 ng/ml (0.80/11.99) versus 0.38 ng/ml (0.20/0.48), P < 0.005 (values are median; 25th/75th percentile, Mann-Whitney U-Wilcoxon Rank Sum W Test, two-tailed P).

CONCLUSION

Compared to healthy individuals beyond the neonatal period, Il-1Ra concentrations are physiologically elevated within the first days of life and decline to low levels within days. In contrast, IL-1Ra levels are strikingly elevated in sick neonates.

Persistent rubella infection after erroneous vaccination in an immunocompromised patient with acute lymphoblastic leukemia in remission

A 16-year-old male patient with acute lymphoblastic leukemia in complete remission and on maintenance treatment with weekly oral methotrexate and daily oral 6-mercaptopurine for 3 months was immunized in error with the WI-RA 27/3-HDC live attenuated rubella vaccine. Increasing rubella HAI antibodies were noted from 3 to 7 months post-vaccination as well as high levels of IgM antibody up to 8 months in three different tests. High HAI antibody titers persisted for 12-18 months after vaccination. Persisting rubella virus was indicated by PCR detection of rubella-specific nucleic acid in whole blood, non-stimulated and stimulated mononuclear cells 8 months following vaccination. Further attempts to detect rubella virus RNA in two subsequent blood samples were negative. Since acute arthritis and arthralgia occurred in the second month (days 51-63) after vaccination, antileukemic chemotherapy had to be interrupted. Evidence of higher risk for chronic or relapsing rubella-associated arthropathy in immunologically compromised patients and the need to interrupt antileukemic chemotherapy should warrant immunoprophylaxis with polyvalent immune globulin in rubella-susceptible patients who are immunocompromised.

A novel bioluminogenic assay for alpha-chymotrypsin

The use of 6-(N-acetyl-L-phenylalanyl)-aminoluciferin as a novel substrate for alpha-chymotrypsin has been demonstrated. The kinetic parameters determined are KM = 0.38 mmol/L, kcat = 6.5 s-1 and kcat/kM = 17,100 (L/mol s). The test principle of the coupled assay is the release of aminoluciferin by enzymatic cleavage of 6-(N-acetyl-L-phenylalanyl)-aminoluciferin. Aminoluciferin is oxidized, with light emission, by firefly luciferase (Photinus pyralis) and can be quantified in a luminometric assay. The detection limit for chymotrypsin was found to be 0.3 ng per assay. 6-(N-acetyl-L-phenylalanyl)-aminoluciferin has been synthesized as an example for a new class of highly sensitive substrates. By modification of the peptide residue these new substrates may be suitable for ultrasensitive detection of different proteinases.

Synthesis and characterization of a bioluminogenic substrate for alpha-chymotrypsin

6-(N-Acetyl-L-phenylalanyl)-aminoluciferin as an example for a new class of highly sensitive bioluminogenic substrates that has been synthesized and characterized. These peptide derivatives can be used regarding to the peptide residue as highly sensitive substrates for different proteinases. Here we demonstrate the use of 6-(N-acetyl-L-phenylalanyl)-aminoluciferin as a novel bioluminogenic substrate for alpha-chymotrypsin. The kinetic parameters determined for 6-(N-acetyl-L-phenylalanyl)-aminoluciferin are Km = 0.38 mmol/liter, kcat = 6.5 s-1, and kcat/Km = 17,100 (liter/mol.s). The test principle of the coupled bioluminogenic assay is the release of aminoluciferin by enzymatic cleavage of 6-(N-acetyl-L-phenylalanyl)-aminoluciferin. Aminoluciferin is a very sensitive substrate of firefly luciferase and can be easily quantified in a luminometric assay. Amounts of chymotrypsin down to 0.3 ng per assay can be routinely determined.

Quantitative cytochemical study of some enzymatic activities in preovulatory bovine oocytes after in vitro maturation

In the present study quantitative cytochemical assays were used to measure some enzymatic activities in situ in bovine meiotically immature oocytes and oocytes matured in vitro, since the special metabolic activity of the growing oocytes may be a pivotal factor in stabilizing the meiotically arrested oocytes. Modifications of this particular metabolism might destabilize the arrested meiosis. Preovulatory oocytes, mostly at the germinal vesicle stage, were obtained by puncturing follicles ranging from 2 to 6 mm in diameter with a hypodermic needle. A group of collected oocytes was incubated in maturation medium CRML 1066 to obtain metaphase II oocytes. Succinate, lactate and glucose-6-phosphate dehydrogenase activities in just collected meiotically immature and in vitro matured oocytes were assayed cytochemically. Microdensitometric measurements were made with a Vickers M85a scanning microdensitometer. Our findings show that: 1) succinate dehydrogenase activity was significantly increased in matured oocytes; 2) lactate dehydrogenase activity was present and very strong in immature oocytes but was detectable in only about 50% of matured oocytes, with significantly lower integrated optical density values; 3) glucose-6-phosphate dehydrogenase activity was very high in immature oocytes but significantly decreased after in vitro maturation; 4) there was no linear correlation between the integrated optical densities of the three enzymatic activities and the diameters of the oocytes. We suggest that the ability to utilize glucose may appear earlier in bovine oocytes than in other species and takes place at the time of maturation.

Bioluminescence-enhanced immunoassays: an ultrasensitive method

Ultrasensitive bioluminescence immunoassays for the determination of peptides and proteins are illustrated in this paper with the enzyme immunological determination of total IgE in human serum. The usable range of standard curves is from 5 pg to 5000 pg per liter. The intra- and interassay coefficients of variation of this test are in the same range as obtained for chromogenic enzyme immunoassays.

Plasmid instabilities of single and three-plasmid systems in Escherichia coli during continuous cultivation

Plasmid instabilities in E. coli JM103 carrying three plasmids (pRK248cI, pMTC48, pEcoR4) and a single plasmid system (pTG206) for the production of fusion EcoRI (SPA::EcoRI) and catechol 2,3-dioxygenase, respectively, were investigated in continuous cultures under selective and non-selective conditions. In a three-plasmid system, pRK248cI was lost gradually together with pMTC48 from the host under non-selective conditions. The selective pressure against pRK248cI stabilized the pMTC48. This indicates that the loss of pMTC48 under non-selective conditions was caused by the loss of cI857 gene (coded by pRK248cI) which resulted in the overproduction of the toxic gene product (coded by pMTC48). In the case of single plasmid (pTG206) system, the plasmid lost from the host under non-selective conditions. This plasmid was stabilized in the host growing under selective conditions. During this period we obtained some ampicillin resistant colonies which gave low levels of enzyme activities compared to the normal plasmid bearing cells. Plasmid analysis from the above cells showed that the plasmid has undergone structural instability. Further, restriction analysis of this plasmid exhibited an additional PvuII site in a 0.9 kbp fragment that was integrated near the tet promoter which controls the expression of the xyl E gene, thereby resulting low levels of enzyme activities. Our results indicate that some of the IS elements which are present in the host chromosome were responsible for such instabilities to turn off the synthesis by inserting into the tet promoter region to lower the protein formation during the bioprocess.

A new ultrasensitive bioluminogenic enzyme substrate for beta-galactosidase

A derivative of D-luciferin, D-luciferin-O-beta-galactoside, was synthesized and used as highly sensitive substrate for beta-galactosidase. The substrate was physicochemically characterized. Enzymatic cleavage of the new compound by beta-galactosidase was demonstrated and kinetic constants Km, Vmax, kcat and kcat/Km have been determined. The compound has been proved to be a highly sensitive substrate for beta-galactosidase, permitting a limit of detection of 3.7 x 10(-19) mol of enzyme per assay.

Determination of human mast cell tryptase by bioluminescence-enhanced two-site immunometric assay

A highly sensitive bioluminescence-enhanced two-site immunometric assay for human mast cell tryptase was developed. The usable range of the standard curve was from 10 ng to 10 micrograms per litre. The intra-assay coefficient of variation of the test was between 8.0 and 12.3%, and the inter-assay coefficient of variation between 8.3 and 13.5%. Recovery of human mast cell tryptase in human serum was 100% (fraction of serum in the test sample: 0.30).

[Fine structure of the raphe nuclei of sheep and goats]

The medullary raphe system of sheep and goat can be divided in the solitary nuclei raphe magnus and pallidus besides the impaired Nucleus raphe paramedianus. The nucleus raphe magnus begins in the caudal end of the medulla oblongata running far to the pons. On the other hand you can follow the nucleus raphe pallidus and paramedianus only in distinct area near the obex. Different types of neurons are isolated and described in light- and electronmicroscopical investigations. All three nuclei are poor of synapses.

Pycnodysostosis. Orthopedic aspects with a description of 14 new cases

Pycnodysostosis is an uncommon form of osteosclerosing bone disease. The orthopedic aspects are illustrated by 14 new cases.