The phageome in normal and inflamed human skin

Dysbiosis of skin microbiota drives the progression of atopic dermatitis (AD). The contribution of bacteriophages to bacterial community compositions in normal and inflamed skin is unknown. Using shotgun metagenomics from skin swabs of healthy individuals and patients with AD, we found 13,586 potential viral contiguous DNA sequences, which could be combined into 164 putative viral genomes including 133 putative phages. The Shannon diversity index for the viral metagenome-assembled genomes (vMAGs) did not correlate with AD. In total, we identified 28 vMAGs that differed significantly between normal and AD skin. Quantitative polymerase chain reaction validation of three complete vMAGs revealed their independence from host bacterium abundance. Our data indicate that normal and inflamed skin harbor distinct phageomes and suggest a causative relationship between changing viral and bacterial communities as a driver of skin pathology.

[Hypernatremia and polyuria in a female patient with an initial diagnosis of secondary acute myeloid leukemia]

A 66-year-old female patient with the initial diagnosis of acute myeloid leukemia is reported. Paraneoplastic syndrome manifested as hypernatremia due to central diabetes insipidus (CDI), which could be controlled with the administration of desmopressin. After initiation of the induction therapy, the required desmopressin administration could be reduced and terminated. In the further course, the early increasing polyuria and hypernatremia indicated the primary refractory acute myeloid leukemia.

Synergistic PXT3003 therapy uncouples neuromuscular function from dysmyelination in male Charcot-Marie-Tooth disease type 1A (CMT1A) rats

Charcot-Marie-Tooth disease 1 A (CMT1A) is caused by an intrachromosomal duplication of the gene encoding for PMP22 leading to peripheral nerve dysmyelination, axonal loss, and progressive muscle weakness. No therapy is available. PXT3003 is a low-dose combination of baclofen, naltrexone, and sorbitol which has been shown to improve disease symptoms in Pmp22 transgenic rats, a bona fide model of CMT1A disease. However, the superiority of PXT3003 over its single components or dual combinations have not been tested. Here, we show that in a dorsal root ganglion (DRG) co-culture system derived from transgenic rats, PXT3003 induced myelination when compared to its single and dual components. Applying a clinically relevant ("translational") study design in adult male CMT1A rats for 3 months, PXT3003, but not its dual components, resulted in improved performance in behavioral motor and sensory endpoints when compared to placebo. Unexpectedly, we observed only a marginally increased number of myelinated axons in nerves from PXT3003-treated CMT1A rats. However, in electrophysiology, motor latencies correlated with increased grip strength indicating a possible effect of PXT3003 on neuromuscular junctions (NMJs) and muscle fiber pathology. Indeed, PXT3003-treated CMT1A rats displayed an increased perimeter of individual NMJs and a larger number of functional NMJs. Moreover, muscles of PXT3003 CMT1A rats displayed less neurogenic atrophy and a shift toward fast contracting muscle fibers. We suggest that ameliorated motor function in PXT3003-treated CMT1A rats result from restored NMJ function and muscle innervation, independent from myelination.

Elimination von rekombinantem Hirudin aus der Blutzirkulation mittels Hämofiltration

In vorangegangenen tierexperimentellen Untersuchungen konnte mit rekombinantem (r) Hirudin eine sichere und effektive Antikoagulation für den kardiopulmonalen Bypass in der offenen Herzchirurgie durchgeführt werden. Bis heute gibt es kein klinisch erprobtes Antidot für r-Hirudin, welches dessen antikoagula-torische Wirkung aufhebt. Daher war es das Ziel dieser Studie zu untersuchen, ob r-Hirudin durch Hämofiltration aus der Blutzirkulation nephrektomierter Schweine entfernt werden kann. Acht Göttinger Minipigs wurden anästhesiert und bilateral nephrektomiert. Die Schweine erhielten einen intravenösen Bolus an r-Hirudin (1 mg/kg) und eine r-Hirudin-lnfusion (1 mg/kg/h) für die Dauer von 1 h. Die Tiere wurden in zwei Gruppen randomisiert. Tiere der Gruppe A (n = 4) wurden bis zu 4 h arteriovenös hämofiltriert. Tiere der Gruppe B (n = 4, Kontrollen) wurden nicht hämofiltriert. Nach der Applikation des r-Hirudin-Bolus stieg die aPTT in beiden Gruppen von einem mittleren Ausgangswert von 16 s auf Werte von > 200 s an. Nach 60 min Hämofiltration war die mittlere aPTT in Gruppe A auf 35 s und nach 3 weiteren Stunden auf 25 s abgefallen. Dieses Ergebnis korreliert gut mit der Plasmakonzentration an freiem r-Hirudin; Am Beginn der Hämofiltration lag die r-Hirudin-Konzentration bei 8,8 ± 2,2 μg/ml, betrug nach 60 min Hämofiltration 3,1 ± 0,5 μg/ml und lag nach 4 h Hämofiltration bei 1,5 ± 0,3 μg/ml. Diese Ergebnisse zeigen, daß Hämofiltration eine schnelle und effektive Elimination von r-Hirudin aus der Blutzirkulation ermöglicht, und daß diese Methode eine wirksame Behandlung von möglichen Blutungskomplikationen im Rahmen von Überdosierungen und/oder eingeschränkter Nierenfunktion darstellen könnte.

Stellenwert der bildgebenden Sonographie und Duplex-Sonographie für die Diagnostik der Venenthrombose

Mit der Duplex-Sonographie steht eine neue, nichtinvasive Untersuchungsmethode zur Diagnose der tiefen Venenthrombose zur Verfügung. Die gezielte Venenkompression durch die Schallsonde des konventionellen Ultraschallgerätes erlaubt bereits in vielen Fällen die Diagnose, die zusätzliche Ableitung gepulster Doppler-Signale verbessert jedoch die diagnostische Aussagekraft beträchtlich. Die Einführung der farbkodierten Duplex-Sonographie hat die Untersuchungstechnik erleichtert und zur derzeitigen Beliebtheit beigetragen. 35 Studien mit insgesamt 4747 phlebographisch kontrollierten Extremitäten berichten durchwegs über eine hohe Sensitivität (Median 95%) und Spezifität (Median 97%). Bei isolierter Unterschenkelvenenthrombose sind Sensitivität (89%) und Spezifität (92%) weniger günstig. Die diagnostische Treffsicherheit ist signifikant besser als mit den konventionellen nichtinvasiven Untersuchungstechniken (Plethysmographie, CW-Doppler), ist jedoch vergleichbar mit jener der invasiven Phlebographie. Die Duplex-Sonographie ist der Phlebographie in verschiedenen klinischen Situationen, ebenso wie bei der differentialdiagnostischen Abgrenzung, überlegen. Im Gegensatz zum Einsatz bei klinischem Verdacht auf TVT hat sich die Duplex-Sonographie jedoch als ScreeningMethode noch nicht eindeutig bestätigen können.

Corticofugal Modulation of DPOAEs in Gerbils

Efferent auditory feedback on cochlear hair cells is well studied regarding olivocochlear brainstem mechanisms. Less is known about how the descending corticofugal system may shape efferent feedback and modulate cochlear mechanics. Distortion-product otoacoustic emissions (DPOAEs) are a suitable tool to assess outer hair cell function, as they are by-products of the nonlinear cochlear amplification process. The present project investigates the effects of cortical activity on cubic and quadratic DPOAEs in mongolian gerbils, Meriones unguiculatus, through cortical deactivation using the sodium-channel blocker lidocaine. Contralateral cortical microinjections of lidocaine can lead to either an increase or decrease of median DPOAE levels of up to 10.95 dB. The effects are reversible and comparable at all tested frequencies (0.5-40 kHz). They are not restricted to the preferred frequency of the cortical site of injection. Recovery times are between 20 and 120 min depending on stimulation levels and emission type. When the injection is performed in the ipsilateral hemisphere, DPOAE level shifts are lower in amplitude compared to those after injection in the contralateral hemisphere. No significant changes in DPOAE levels are obtained after saline microinjections. Results indicate that deactivation of auditory cortex activity through lidocaine has a considerable impact on peripheral auditory responses in form of DPOAEs, probably through cortico-olivocochlear pathways.

Negative Ionen durch Elektronenstoß an einigen organischen Schwefelverbindungen

Negative ion formation by electron impact has been studied in hydrogen sulphide, methylmercaptan, phenylmercaptan, benzylmercaptan, allylmercaptan, dimethylthioether, dimethyldisulphide and diallyldisulpbide. Appearance potentials, ionization efficiency curves and the kinetic energies of negative ions were measured by using a Fox ion source. The energies of various dissociative electron capture processses are discussed and electron affinities of some radicals of the types RS and RS2 are derived. Two chemical reactions of the CH2S- ion with dimethyldisulphide have been detected.

Die Bildung negativer Ionen aus SiCl4 und organischen Siliciumchloriden durch Elektronenstoß

Appearance potentials and ionization efficiency curves of negative ions formed in SiCl4, CH3SiCl3, (CH3)2SiCl2, (CH3)3) 3SiCl, C2H3SiCl3, and C6H5SiCl3 by electron impact have been measured by using a Fox ion source. Negative molecular ions were observed in SiCl4, C2H3SiCl3 and C6H5SiCl3 besides several fragment ions. The electron affinity of the SiCl3 radical was found to be about equal to the electron affinity of the chlorine atom. The electron affinity of SiCl2 is shown to be higher than 2.5 eV.

Dissociative electron capture processes from SF6 – have been found in mixtures of SFe and silicon compounds (such as SF6 –+SiCl4 ➝ Cl–+SiCl3+SF6). It is concluded that in these processes the electron in SF6 – behaves like a free electron of zero kinetic energy. Various reactions of the O–-ion with the silicon compounds have also been observed.

Notizen:Die Ionisationsausbeute-Kurve von OH- asus Wasser

Die Ionen H~ und 0~ sind bisher als einzige negative Bruchstücke beim Elektronenbeschuß von Wasser be­ obachtet worden. OH-fand man als sekundäres Pro­ dukt der Reaktion H" + H20 — > H2 + OH" 2. Bei Ver­ suchen mit einem CH4-Atlas-Massenspektrometer mit Fox-Ionenquelle ließ sich OH-als primäres Ion mit etwa 10-mal kleinerer Intensität als 0~ nachweisen. Abb. 1 und 2 zeigen die Ionisationsausbeutekurven beider Ionen. In Abb. 1 wird außerdem die Ausbeute­ kurve für SF6" aus SF6 gezeigt, um ein Maß für die Auflösung der Apparatur zu geben. Die Intensität aller Ionen war dem Gasdruck proportional. Die O'-Kurve stimmt mit der von anderen Autoren gemessenen hinsichtlich ihres allgemeinen Verlaufes überein. Das erste Auftrittspotential beträgt (6,4+ 0,1) eV. Dieser Wert liegt um 1,5 eV höher als von C o m p ­

Negative Ionen durch Elektronenstoß aus organischen Nitroverbindungen, Äthylnitrit und Äthylnitrat

Negative ion formation by electron impact has been studied in nitromethane, nitroethane, nitrobenzene, tetranitromethane, ethylnitrite and ethylnitrate. Appearance potentials, ionization efficiency curves and kinetic energies of negative ions were measured by using a Fox ion source. The electron affinities of C2H5O and of C (NO2)3 are discussed as well as the energetics of processes which yield NO2 -. The electron capture in nitrobenzene and tetranitromethane leads to molecular ions [C6H5NO2~ in high, C (NO2)4 in very low intensity] besides many fragment ions. A number of product ions from negative ion-molecule reactions has also been found.

[Metastatic malignant melanoma with spinal cord compression and resulting recumbency ante partum in a mare. A case report]

The case report describes a narrowing of the spinal canal in the lumbar and sacroiliac regions with entailing acute recumbency in a nearterm 17-year-old Welsh B Pony mare. The reason for recumbency was metastases of a malignant melanoma in the spinal canal of the lumbo-sacral region, where the tumour had invaded the dura mater and applied severe pression on the spinal cord over a length of 10 cm. Clinical findings, laboratory diagnostics, pathological-anatomical and histopathological findings are presented.

Metastasierendes malignes Melanom mit Festliegen ante partum infolge Rückenmarkskompression bei einer Stute

Der Fallbericht beschreibt die Einengung des Rückenmarkskanals durch ein malignes Melanom mit resultierendem akutem Festliegen bei einer hochtragenden, 17 Jahre alten Welsh-B-Ponystute. Als ursächlich für das akute Festliegen war der Einbruch von Metastasen des malignen Melanoms in den Wirbelkanal im Bereich der letzten Lendenwirbel und des Kreuzbeins anzusehen, wo der Tumor die Dura mater infiltriert und das Lenden- sowie Sakralmark auf einer Länge von 10 cm mittelgradig komprimiert hatte. Dargestellt werden neben dem klinischen Bild labordiagnostische, pathologisch-anatomische und histopathologische Befunde.

New phenotypes of the drought-tolerant cbp20 Arabidopsis thaliana mutant have changed epidermal morphology

This paper provides a detailed phenotypic analysis of the abscisic acid (ABA) hypersensitive Cap Binding Protein 20 (cbp20) mutant. Some hitherto undescribed changes were found in the tissue structure and epidermal morphology of this mutant. These include more and smaller cells in the epidermis, a thicker cuticle and more frequent occurrence of trichomes on leaf surfaces. Some of these traits may contribute to the physiological processes responsible for the water-saving behaviour of the mutant. Abnormal spatial patterns between stomatal pore complexes were also found on various organs of the mutant. All these observations indicate profoundly disturbed development of epidermal tissue in the cbp20 mutant, which has not previously been reported for this class of mutants. A potential connection between the new phenotypes and disturbed miRNA metabolism and mRNA splicing of the mutant is discussed.

Simultaneous water withholding and elevated temperature alters embryo and endosperm development in wheat

Drought-tolerant Plainsman V and drought-sensitive Cappelle Desprez winter wheat genotypes were subjected to heat stress at 34/24°C combined with water withholding during early seed development in order to identify the joint effect of the stressors on embryo and endosperm development. During and after five days of treatment histological observations were made on the developing kernels and compared to yield data. Combined stress shortened the duration of the grain fill. With regard to kernel abortion, thousand-kernel weight and yield per spike, Plainsman V tolerated simultaneous elevated temperature and water withdrawal better than Cappelle Desprez. As a consequence of the stress the accumulation of B-type starch granules was almost completely absent in the endosperms of the sensitive genotype. The results indicate that compared to the drought-sensitive genotype, the tolerant genotype also showed increased tolerance of simultaneous drought and heat stress.

Changes in the spleen and liver of pregnant sows and full-term piglets after feeding diets naturally contaminated with deoxynivalenol and zearalenone

Wheat contaminated naturally with the Fusarium toxins deoxynivalenol (DON) and zearalenone (ZON) was fed to pregnant Landrace sows for 35days. On day 110, caesarean section was carried out, the offspring were killed immediately after birth, and their livers and spleens examined. At necropsy there were no macroscopic lesions observed in any organ of either sows or piglets. Histopathological evaluation of tissues from sows of the treated group revealed changes in liver and spleen tissues, whereas no significant changes were observed in these tissues in their piglets. Liver damage, as measured by prominent elevated transaminase activities, was not detected in the serum of the sows. In pregnant sows there were individual variations in sensitivity to the Fusarium toxins. In conclusion, it can be assumed that there are no adverse effects on the liver and spleen of full-term piglets when their mothers consumed diets containing up to 9570 and 358mug DON/ZON per kg diet.

A late Eemian aridity pulse in central Europe during the last glacial inception

Investigating the processes that led to the end of the last interglacial period is relevant for understanding how our ongoing interglacial will end, which has been a matter of much debate (see, for example, refs 1, 2). A recent ice core from Greenland demonstrates climate cooling from 122,000 years ago driven by orbitally controlled insolation, with glacial inception at 118,000 years ago. Here we present an annually resolved, layer-counted record of varve thickness, quartz grain size and pollen assemblages from a maar lake in the Eifel (Germany), which documents a late Eemian aridity pulse lasting 468 years with dust storms, aridity, bushfire and a decline of thermophilous trees at the time of glacial inception. We interpret the decrease in both precipitation and temperature as an indication of a close link of this extreme climate event to a sudden southward shift of the position of the North Atlantic drift, the ocean current that brings warm surface waters to the northern European region. The late Eemian aridity pulse occurred at a 65 degrees N July insolation of 416 W m(-2), close to today's value of 428 W m(-2) (ref. 9), and may therefore be relevant for the interpretation of present-day climate variability.

Effect of cyanobacterial and microalgal biomass on anther culture response of wheat (Triticum aestivum L.)

In the present work the effect of microalgal and cyanobacterial biomass on anther cultures of wheat (Triticum aestivum L.) was studied. Investigations were made on the influence of media supplemented with a biomass of four terrestrial and fresh-water microalgal and cyanobacterial strains (1-2 g l-1) on the androgenic response, frequency of microspore-derived embryo-like structures, and their regeneration capacity in anther cultures of wheat. The addition of 1 g L-1 of cyanobacterium biomass MACC 643 to the induction and regeneration media significantly improved the androgenic response by 50% in the genotype Mv Pálma, and reduced the requirement for the synthetic auxin 2,4-D.

HcwA, an autolysin, is required for heterocyst maturation in Anabaena sp. strain PCC 7120

In many filamentous cyanobacteria, vegetative cells can differentiate into heterocysts, cells that are specialized for aerobic fixation of N(2). Synthesis of the heterocyst envelope polysaccharide is dependent on the gene hepA in Anabaena sp. strain PCC 7120. In search of genes that are involved in the regulation of hepA, we transposon mutagenized strain DR1069, which bears a chromosomal hepA::luxAB fusion. One resulting mutant, designated HNL3, grows normally in medium with nitrate and shows poor induction of hepA in response to nitrogen deprivation. In HNL3, transposon Tn5-1058 is inserted within gene hcwA, a constitutively expressed open reading frame whose predicted product resembles N-acetylmuramoyl-L-alanine amidases. Reconstruction of the mutation confirmed that the mutant phenotype resulted from the insertion of the transposon. The induction of hepA in HNL3 is partially restored upon recombination of HNL3 with plasmid-borne, wild-type hcwA. Moreover, HcwA expressed in Escherichia coli exhibits wall-lytic activity. These results suggest that the degradation, or possibly reconstruction, of the cell peptidoglycan layer is a prerequisite for heterocyst maturation.

Disturbed ratio of erythrocyte and plasma S-adenosylmethionine/S-adenosylhomocysteine in peripheral arterial occlusive disease

Altered homocysteine metabolism associated with peripheral arterial occlusive disease (PAOD) may lead to impairment of vital methylation reactions through accumulation of S-adenosylhomocysteine (AdoHcy) as well as through alteration of the ratio S-adenosylmethionine (AdoMet)/AdoHcy. We determined AdoMet, AdoHcy, their ratio, and homocysteine in plasma as well as AdoMet, AdoHcy, and their ratio in erythrocytes of 61 patients with PAOD (age 49-93) and 50 healthy controls (age 41-87). Geometric mean values of plasma homocysteine, AdoMet, and AdoHcy were significantly increased in patients compared with controls (15.5 vs. 10.4 micromol/l**; 107 vs. 52.3* nmol/l; 55. 0 vs. 23.1** nmol/l, respectively; *P<0.01, **P<0.001), while the ratio of AdoMet/AdoHcy was decreased in patients (1.92 vs. 2.52*). In erythrocytes patients exhibited increased levels of AdoHcy compared with controls (309 vs. 205 nmol/l**) whereas AdoMet (3351 vs. 3732 nmol/l*) and the ratio of AdoMet/AdoHcy (11.8 vs. 19.1**) were decreased. The odds ratio (OR) for developing PAOD with decreased AdoMet/AdoHcy ratio after adjustment for kidney function was significant for erythrocyte levels < or =14.2 (OR, 7.1 (6.9-7.2, 95% CI). In addition, hematocrit levels were found to be significantly decreased in patients versus controls (0.35 vs. 0.42 l/l**) and were significantly correlated with the ratio of AdoMet/AdoHcy in erythrocytes of the patients. Since the ratio of AdoMet/AdoHcy is closely linked with the activity of numerous enzymatic methylation reactions, these results suggest that methylation may be impaired in these patients.

Takayasu disease with predominant pulmonary involvement

We report a case of Takayasu's arteritis with predominant pulmonary involvement, which led eventually to complete obliteration of the right pulmonary artery. Subsequently, cavitation and chronic inflammation developed in the nonperfused right lung. A right pneumonectomy was performed to control the infectious process, leading to functional improvement and better control of the underlying immunologic disorder.

[Diagnosis and significance of psychiatric disorders in physically ill geriatric patients]

Psychic disorders were studied with a naturalistic design in 125 consecutive patients of a medical-geriatric department in a general hospital. Based on the clinical examination and the values of the Mini-Mental-State-Examination (2), 51 patients were classified as unable for diagnostic procedures concerning psychic state. The other 74 patients underwent these diagnostic procedures including clinical investigation and three screening-scales (Geriatric Depression Scale (11); Hospital Anxiety and Depression-Scale (4)). If these examinations led to the suspicion that a patient suffered from a psychic disorder, an interview was performed by a psychotherapist with experience in gerontopsychosomatic treatment and information was collected from the medical and nursing staff. Dementia was detected or excluded by neuropsychological tests. Psychic disorders were found in 41 patients, mostly adaptation disorders and depressions. In more than half of the patients, the disorder was estimated to be relevant for the whole hospital therapy. The screening instruments turned out to be reliable, so they can be recommended for further use. Difficult to answer remains the question, how the treatment of the psychic disorders--in our sample necessary for each 5th to 6th patient--can be implemented in a medical-geriatric department.

First searchable database for DNA profiles of human cell lines: sequential use of fingerprint techniques for authentication

The authenticity and freedom from cross-contaminants of a cell line are important prerequisites for any research, development or production programs involving cell lines. Mini- and microsatellites in the human genome harboring variable-numbers of tandem repeat (VNTR) DNA markers allow individualization at the DNA level and are of practical value for genetic linkage mapping, forensic legal medicine, paternity testing, monitoring of bone marrow transplants, and individualization of established cell lines. We have validated fingerprint techniques of different single- and multiple-locus VNTRs enabling the establishment of a searchable database of DNA profiles. As a result, multiplexed polymerase chain reaction amplification fragment length polymorphism (AmpFLP) of four prominent and highly polymorphic minisatellite VNTR loci was proven as the best tool for screening the uniqueness of DNA profiles in a fingerprint database. In order to avoid false positivity, identical or similar DNA profiles based on AmpFLP VNTR were tested further using a multi-locus fingerprint system. Our data demonstrate that misidentification remains a chronic problem among human continuous cell lines (detailed information at URL http://www.dsmz.de). The combination of rapidly generated DNA profiles based on single-locus VNTR loci, their authentication by screening the fingerprint database, and confirmation of duplicate banding patterns using multilocus fingerprints constitute a highly reliable and robust method, which enables high fidelity and quality of maintenance independent from the quantity of individual cell lines.

Expression of the growth arrest-specific gene 6 (GAS6) in leukemia and lymphoma cell lines

The initial identification of GAS6 as a protein expressed in response to growth arrest suggested that it might function as a negative regulator of cell proliferation. Since the transforming activity of the GAS6 receptor (AXL/UFO) was documented, GAS6 might stimulate rather than inhibit proliferation. In order to detect aberrant expression of GAS6 we examined gene expression in 46 cell lines of precursor B-, B- and T-cell origin as well as from Hodgkin's disease and cell lines established from various myeloproliferative disorders. In our study, the expression of GAS6 reveals a constitutive transcriptional activation in 8/46 cases of proliferating cell lines. The GAS6 mRNA expression could be shown in 4/22 cell lines of the lymphoid arm and in 4/17 of the myeloid lineages of the hematopoietic system. No transcripts could be detected in the CD30+ Hodgkin and anaplastic large cell lymphomas (0/7). Interestingly, the steady state mRNA levels showed neglectable GAS6 expression in precursor B and B-cell lines (1/9), but could be detected in terminally differentiated plasma cell lines (4/4). The predominantly GAS6-expressing cell lines of non-lymphoid origin have been established from acute myeloid leukemias of the M4 subtype (3/4). In order to demonstrate evidence for an autocrine regulation of growth in permanent hematopoietic cell lines, we measured the GAS6 expression in cell lines with strong positivity for the AXL/UFO receptor mRNA. Constitutive basal levels of GAS6 mRNA and protein expression could be only detected in 3/23 AXL/UFO expressing cell lines. Although a general mechanism seems most unlikely, further studies are necessary to demonstrate the involvement of GAS6 in single cases of disordered growth or chemotaxis/adhesion of leukemia and lymphomas.

Physiological reflux and venous diameter change in the proximal lower limb veins during a standardised Valsalva manoeuvre

OBJECTIVES

the aim of this study was to provide normal values for venous diameter at rest, and venous diameter and physiologic venous reflux during a standardised Valsalva manoeuvre. The impact of the patient's sex, body mass index (BMI), and family history was investigated.

MATERIAL AND METHODS

eighty legs of 40 healthy volunteers were investigated in a supine position. The median age was 28 years (range 20-66 years). The common femoral vein (CFV), the proximal superficial femoral vein (SFV) and the proximal long saphenous vein (LSV) were investigated by duplex sonography. The following parameters were assessed: resting diameter (VDrest) and maximum diameter (VDmax) as well as reflux time (tr) during the Valsalva manoeuvre. The Valsalva manoeuvre was elicited by a forceful expiration into a tube system. The standard values used were a pressure of 30 mmHg, established within 0.5 seconds (s) and maintained over a time period of at least 3 s.

RESULTS

mean VDrest and VDmax were 8.3+/-2.2 and 11.1+/-2.8 mm in the CFV, 5.9+/-1. 3 and 7.2+/-1.6 mm in the SFV and 3.5+/-0.9 and 4.3+/-1.4 mm in the LSV. Mean values for tr were 0.61+/-0.63 s in the CFV, 0.25+/-0.26 s in the SFV and 0.28+/-0.40 s in the LSV. A BMI >22.5 kg/m2 was associated with statistically significant larger values for VDrest and tr. If adjusted for BMI, tr in the SFV and the LSV did not differ by sex. For healthy subjects with first-degree relatives suffering from varicose veins (n=19), mean VDrest in the SFV as well as VD in the LSV was significantly larger (p=0.02, 0.05, respectively). Coefficients of variation for repeated measurements (VDrest, VDmax, tr) in the same segment varied between 3.3% and 16. 4% for the three investigated sites.

CONCLUSIONS

normal values for VDrest and VDmax as well as reflux time during a standardised Valsalva manouevre were assessed in the proximal lower limb veins. The influences of BMI, sex and family history were investigated. The described standardised Valsalva manoeuvre led to highly reproducible results and can be recommended for further research projects or as a routine procedure for the assessment of venous reflux.

Circulating cell adhesion molecules and endothelial markers before and after transluminal angioplasty in peripheral arterial occlusive disease

In the present study, the levels of soluble adhesion molecules P- and E-selectin, intercellular adhesion molecule-1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1) and of other markers of endothelial activation or injury, such as thrombomodulin, von Willebrand factor (vWF), as well as homocysteine, were prospectively investigated in 71 patients (21 women, 50 men, age 68+/-13) with predominantly femoropopliteal peripheral arterial occlusive disease (PAOD, stage II-IV, Fontaine) before and after percutaneous transluminal angioplasty (PTA). Thirty patients (42.3%) developed restenosis within 6 months, defined as a > 50% reduction of the lumen diameter at the site of PTA. At entry in the study, 46% and 58% of all patients had higher than normal levels of soluble P-selectin and VCAM-1, respectively. Thrombomodulin (P < 0.01) measured at entry, was significantly higher in patients who developed late restenosis, with trends for higher values for P-selectin, VCAM-1 and vWF. The relative risks for developing restenosis were 2.41 (CI95%: 1.23-4.75) and 1.54 (CI95%: 0.98-2.72) for thrombomodulin and P-selectin, respectively. Soluble P-selectin and the severity of PAOD (Fontaine stage III/IV) were found to be statistically indicative factors for late restenosis in a logistic regression risk factor analysis with an overall predictive value of 72%. At 6 months, those who developed restenosis had also higher soluble P-selectin (P < 0.01), VCAM-1 (P < 0.05) and a trend for higher thrombomodulin. Homocysteine was elevated in 52% of the patients at entry but neither was it associated with higher restenosis rates nor did it correlate with the levels of thrombomodulin or the other adhesion molecules. These findings indicate that patients with PAOD have to a significant proportion, elevated levels of circulating soluble adhesion molecules and markers of endothelial activation occurring in concert with an ongoing atherosclerotic process.

Regulation of an osmoticum-responsive gene in Anabaena sp. strain PCC 7120

Salt-induced genes in the cyanobacterium Anabaena sp. strain PCC 7120 were identified by use of a Tn5-based transposon bearing luxAB as a reporter. The genomic sequence adjacent to one site of insertion of the transposon was identical in part to the sequence of the lti2 gene, which was previously identified in a differential screen for cold-induced transcripts in Anabaena variabilis. The lti2-like gene was induced by sucrose and other osmotica and by low temperature, in addition to salt. Regulatory components necessary for the induction of this gene by osmotica were sought by a further round of transposon mutagenesis. One mutant that displayed reduced transcriptional activity of the lti2-like gene in response to exposure to osmotica had an insertion in an open reading frame, which was denoted orrA, whose predicted product showed sequence similarity to response regulators from two-component regulatory systems. The corresponding mutation was reconstructed and was shown, like the second-site transposon mutation, to result in reduced response to osmotic stress. Induction of the lux reporter gene by osmotica was restored by complementation with a genomic fragment containing the entire open reading frame for the presumptive response regulator, whereas a fragment containing a truncated copy of the open reading frame for the response regulator did not complement the mutation.

Assessment of the subclavian vein in patients with transvenous pacemaker leads

Thrombosis of the subclavian vein can occur after the implantation of transvenous pacemaker electrodes. Although this is seldom followed by thromboembolic complications, it can cause problems when replacing the leads. To assess the impact of the pacemaker leads on the subclavian vein, a study using noninvasive duplex sonography was performed on 56 patients at an average of 41 months after the implantation. Forty-three percent of the patients were found to have a normal function of the subclavian vein, 46% developed pathological changes of the vessel wall, and 11% occluded. These changes rarely caused symptoms, and, therefore, had little clinical significance. Moreover, the occlusion rate was found independent of the patient's age, the patient's sex, the number of electrodes, the procedure of implantation, and even the time from implantation. As a result, the clinical diagnosis of occlusion is uncertain. Therefore, duplex sonography is recommended as an easy means of excluding a totally thrombosed subclavian vein prior to replacing pacemaker leads.