Epicardial Adipose Tissue Changes After Bariatric and Metabolic Surgery: a Systematic Review and Meta-analysis

Epicardial adipose tissue (EAT) is a visceral fat depot located between the myocardium and visceral epicardium. Emerging evidence suggests that excessive EAT is linked to increased risk of cardiovascular conditions and other metabolic diseases. A literature search was conducted from the earliest studies to the 26th of November 2022 on PubMed, Embase, and the Cochrane. All the studies evaluating changes in EAT, pericardial adipose tissue (PAT), or total cardiac fat loss before and after BS were included. From 623 articles, 35 were eventually included in the systematic review. Twenty-one studies showed a significant reduction of EAT after BS, and only one study showed a non-significant reduction (p = 0.2).

Botulinum toxin treatment of the buccinator muscle facial synkinesis: A systematic review

BACKGROUND

The purpose of this review is to provide an overview of the available literature assessing the treatment of botulinum toxin injections for the treatment of synkinesis of the buccinator muscle in patients with peripheral facial palsy (PFP).

MATERIALS AND METHODS

A multi database search was performed, including the following databases: Pubmed, Medline, Embase, and the Cochrane Library. Each database was searched from its earliest date until 8 June 2023. The following outcome measures were extracted from the articles when available: subjective, somatic, and psychological effects on the patients and objective outcomes such as the House-Brackmann, Sunnybrook and Sydney scores. The methodological quality of the included studies was rated using the Newcastle-Ottawa scale for nonrandomised trials.

RESULTS

The primary literature search generated 37 articles. After removing duplicates, 25 articles remained for abstract appraisal, of which 20 underwent full-text appraisal, resulting in 3 studies for analysis. All of these studies showed (significant) improvement in synkinesis either measured using the Synkinesis Assessment Questionnaire or subjectively measured by asking treated patients.

CONCLUSION

The available literature supports the finding that botulinum toxin treatment of the buccinator muscle could be a welcome addition to facial synkinesis treatment and could significantly improve patient outcomes. In future studies, the efficacy of EMG-guided buccinator injections, optimal dose, and a validated measuring method could be beneficial in optimising treatment for patients with a PFP and synkinesis.

Evaluation of spinosad for the oral treatment and control of flea infestations on cats in Europe

METHODS

An ectoparasiticide containing spinosad was evaluated as an oral formulation for cats. Two European laboratory studies and a European multicentre field efficacy and safety study assessed the use of a chewable tablet formulation of spinosad at a dose range of 50-75 mg/kg for treatment and control of flea infestations on cats.

RESULTS

The studies with experimentally infested cats consistently demonstrated persistent activity against Ctenocephalides felis with >98 per cent efficacy at four weeks post-treatment. In the field study with naturally infested client-owned cats from 18 clinics across Germany and Italy, two monthly doses of spinosad were administered; selamectin was the comparator product. Safety was evaluated in 226 cats, each receiving at least one dose of spinosad or selamectin; both products were well tolerated. 113 spinosad-treated cats and 71 selamectin-treated cats showed >97 per cent reductions in geometric mean flea counts within 14 days post-treatment and at 60 days post-treatment efficacy was >98 per cent in both groups. Analysis of success rates showed 96 per cent in spinosad-treated cats compared with 90.9 per cent in selamectin-treated cats at day 60. The spinosad tablets were successfully administered to over 98 percent of cats. These studies indicate that this formulation of spinosad is safe and efficacious for treatment and prevention of flea infestations in cats.

MRI lesions after invasive therapy of carotid artery stenosis: a risk-modeling analysis

BACKGROUND

Diffusion-weighted imaging (DWI) abnormalities can frequently be detected after carotid endarterectomy (CEA) and carotid angioplasty with stent placement (CAS) of the carotid arteries. We looked for possible predictors for the development of DWI lesions during the intervention.

METHODS

We investigated 41 patients who underwent CAS without protection devices and 93 patients who underwent CEA. DWI studies were performed 1 day before and after the intervention.

RESULTS

Ischemic complications consisted of two strokes (2.2%) in the CEA group and one stroke (2.4%) in the CAS group. DWI lesions were detected in 28.0% of all patients after intervention. Using a multivariate regression analysis, diabetes mellitus (DM), hyperlipidemia, symptomatic stenosis, age and CAS were found to be significant predictors for the occurrence of DWI lesions.

CONCLUSIONS

DWI is an objective and highly sensitive method for monitoring interventions of the carotid arteries. Our results point to an increased risk of patients with diabetes and hyperlipidemia to develop DWI lesions during invasive therapy of the ICA.

Doping and quantum confinement effects in single Si nanocrystals observed by scanning tunneling spectroscopy

We have applied scanning tunneling spectroscopy in studies of the electronic level structure of surface-functionalized colloidal Si nanocrystals (Si-NCs) as a function of their size for various capping ligands. The energy gaps extracted from the tunneling spectra increase with decreasing NC size, manifesting the effect of quantum confinement. This is consistent with the blueshift revealed by photoluminescence (PL) from dodecene functionalized Si-NCs. The tunneling spectra measured on NCs functionalized with NH4Br or allylamine show band-edge shifts toward higher energies, akin to p-type doping. This behavior can be accounted for by the combined contributions of the ligands' dipole moments and charge transfer between a Si-NC and its surface groups. Concomitantly, size-independent PL spectra, which cannot be associated with NC band gap variations, were observed for the latter Si-NCs.

The optimal timing of baseline radiostereometric analysis of uncemented press fit cups

BACKGROUND AND AIMS

The baseline radiostereometric analysis (RSA) is usually performed during the first postoperative week. We investigated the micromotion of two uncemented press fit acetabular cups during the first week after total hip arthroplasty.

MATERIAL AND METHODS

All study patients had unilateral osteoarthritis of the hip and received an uncemented THA combination consisting of a CLS stem and either an Allofit or an Interop acetabular cup. The study group consisted of 24 patients who underwent RSA within 1 hour after skin closure, and at 1 and 7 days after surgery.

RESULTS

The upper limit of the 95% confidence interval for micromotion was less than or close to the precision of the method for all studied directions during the first week after surgery. Mean values indicate proximal and medial translation of the uncemented cup at one week.

CONCLUSIONS

We found only minimal micromotion, barely above the precision limit, measured as medial and proximal translations of these uncemented cups. This indicates that the first postoperative RSA measurement following a primary THA with an uncemented press fit ace-tabular cup should be made as early as possible after the first postoperative day.

Detection of unstable carotid artery stenosis using MRI

BACKGROUND AND PURPOSE

Carotid artery stenosis can be classified by magnetic resonance imaging (MRI) as lesion types I-VIII according to a modified histological scheme based on American Heart Association (AHA) guidelines. Lesion types IV-V and VI are regarded as high-risk plaques.We aimed to evaluate the clinical relevance of this classification for identifying unstable plaques.

METHODS

Eighty-five patients (29 female) with severe carotid artery stenosis (diagnosed by Doppler and duplex ultrasonography) were imaged using a 1.5 T scanner with bilateral phased-array carotid coils. T1-, T2-, time-offlight (TOF) and proton-density (PD)-weighted studies were obtained. The carotid plaques were classified as lesion types III-VIII according to the MRI-modified AHA criteria.

RESULTS

Thirty-five patients presented with a recently symptomatic stenosis; 50 patients were asymptomatic. Lesion types IV-V (51.4 % vs. 22 %) and VI (20 % vs. 4%; P < 0.0001) were found significantly more often in symptomatic patients compared to those without a history of cerebral ischemia.

CONCLUSIONS

The distribution of lesion types differs significantly between symptomatic and asymptomatic carotid artery stenosis. High-risk lesion types IV-V and VI were overrepresented in recently symptomatic patients. MRI according to the modified AHA-criteria may be a suitable tool for detection of unstable carotid lesions.

The Relationship Between Volume and Outcome Following Elective Open Repair of Abdominal Aortic Aneurysms (AAA) in 131 German Hospitals

OBJECTIVES

Several studies indicate that high-volume hospitals have better results in open repair of unruptured abdominal aortic aneurysms (AAA). Up to now no studies had addressed this question in German hospitals.

DESIGN

Post-hoc-analysis from a prospective physician-led registry.

MATERIAL AND METHODS

Since 1999, the German Society for Vascular Surgery has conducted a prospective registry for open and endovascular repair of AAAs. This study includes 131 hospitals who conducted n=10163 elective open repairs for unruptured AAA between 1999 to 2004. All perioperative variables including annual volume as a continuous variable were analysed in a step-wise logistic regression model. In order to define a threshold annual volume an additional logistic regression analysis was performed by use of annual volume groups (0-9, 10-19, 20-29, 30-39, 40-49, 50 or more). The relationship between annual volume and further outcome parameters (length of procedure, blood transfusion, length of stay) were also analyzed.

RESULTS

The overall mortality rate was 3.2%. The stepwise logistic regression model identified the following predictors of an increased perioperative mortality: age (OR 1.084, 95% CI 1.066-1.102), AAA diameter (OR 1.008, 95% CI 1.001-1.016), length of procedure (OR 1.008, 95% CI 1.006-1.009), ASA-Score (OR 2.636, 95% CI 2.129-3.264), suprarenal clamping (OR 1.447, 95% CI 1.008-2,078), blood transfusion (OR 1.786, 95% CI 1.268-2.514). Annual volume was moderately predictive (OR 1.003, 95% CI 1-1.006) but failed to reach statistical significance (p=0.07). The analysis of volume groups identified a significantly higher risk for hospitals with an annual volume of 1-9 AAA-repairs by comparison to hospitals with an annual volume of 50 or more AAA-repairs (OR 1.903, 95% CI 1.124-3.222). Operations at low volume hospitals were also longer (p<0.001), with an extended postoperative stay (p<0.001) and a higher transfusion rate (p<0.001).

CONCLUSIONS

Patient's age, ASA classification, AAA diameter, length of procedure, suprarenal clamping and blood transfusion are predictive variables for an increased perioperative mortality in elective open AAA repair. Mortality is also increased by a low annual volume. Further studies are needed to examine whether these data are applicable to all German hospitals.

Association of Circulating Transforming Growth Factor beta, Tumor Necrosis Factor alpha and Basic Fibroblast Growth Factor with Restenosis after Transluminal Angioplasty

OBJECTIVES

To assess prospectively the early time course of Transforming Growth Factor beta-1 (TGFbeta-1), basic Fibroblast Growth Factor (bFGF) and Tumor Necrosis Factor alpha (TNFalpha) as possible contributors to restenosis development after angioplasty.

DESIGN

Prospective Study.

METHODS

The levels of the soluble forms of these factors in the early response to Percutaneous Transluminal Angioplasty (PTA) in the arteries of the lower limb were prospectively assessed. 32 patients with peripheral arterial occlusive disease (PAOD), presenting with intermittent claudication (Fontaine stage IIb) were scheduled for angioplasty treatment. Serum levels of TGFbeta-1, TNFalpha and bFGF were assessed before intervention, 15 and 60 minutes after, 24 hours after as well as 2 and 4 weeks after intervention. We compared the distribution patterns between patients treated with balloon angioplasty and patients who required secondary stent implantation. Endpoint was the development of restenosis within 6 months after interventional treatment, defined as a lumen diameter reduction of more than 50% by ultrasound measurement compared to the result after PTA.

RESULTS

The patients who later developed restenosis had significantly higher levels of TGFbeta-1 at 15 minutes, 24 hours and 2 weeks after PTA (p<0.05). TNFalpha and bFGF were only detected in a few patients and no significant change of serum levels was observed.

CONCLUSION

The results demonstrate a possible role of TGFbeta-1 in the formation of restenosis after PTA.

Aneurysmen und Dissektionen der thorakalen und abdominellen Aorta

One to four per cent of all deaths in patients over 65 are caused by aneurysmatic diseases of the abdominal or thoracic aorta. For elective surgery in abdominal aneurysms, open surgery and endovascular treatment both demonstrate brilliant overall results. In the thoracic aorta, new endovascular procedures have led to considerable reductions of postoperative morbidity and mortality. Nevertheless, in view of the endovascular procedure's high cost and the still unclear long-term behaviour of the stent device, a second opinion from a specialised centre is an absolute necessity.

Early endothelial and haematological response to cryoplasty compared with balloon angioplasty of the superficial femoral artery – a pilot study

The purpose of the present study was to assess the course of adhesion molecules (intercellular adhesion molecule (ICAM), vascular cell adhesion molecule (VCAM), e-selectin, p-selectin and monocyte chemoatlractant protein 1 (MCP-1)), growth factors (transforming growth factor beta (TGFbeta) and basic fibroblast growth factor (bFGF)) and the cytokine tumour necrosis factor alpha (TNFalpha) after both angioplasty and cryoplasty. Recently cryoplasty has been suggested as a new method to oppose neointimal hyperplasia resulting in restenosis formation. While in vitro models have shown that the application of cryothermal energy to the endothelium during angioplasty leads to apoptosis induction and reduced proliferation rates, no human in vivo proof for an inhibition of neointimal hyperplasia exists. For restenosis initiation adhesion molecules, growth factors and cytokines play an important role. One possibility to investigate the endothelial response to angioplasty is the measurement of the soluble forms of adhesion molecules, growth factors and cytokines that are released into the circulation after denuding the vessel wall. In the present study we assessed the distribution pattern of the soluble forms of e-selectin, p-selectin, ICAM, VCAM, MCP-1, TGFbeta, bFGF and TNFalpha after angiography, angioplasty and cryoplasty of the femoropopliteal artery in the early course of 4 weeks in 29 patients with peripheral arterial occlusive disease. During the 4 weeks after intervention levels of e-selectin, ICAM, VCAM and MCP-1 increased after both angioplasty and cryoplasty. The course of the screened biomarkers was similar between angioplasty and cryoplasty. P-selectin and TGFbeta both decreased after cryoplasty, but not significantly. The present results show that the release of adhesion molecules, growth factors and cytokines is similar between balloon angioplasty and cryoplasty.

Kontroversen in der Behandlung von Karotisstenosen

Endarterectomy for extracranial carotid stenosis has proven to be effective in the prophylaxis of carotid-related strokes by prospective, randomised trials (ECST, NASCET, ACAS, ACST). The safety and efficiency of carotid stenting has to be proven in prospective randomised trials comparing surgery and endovascular treatment.

The density of epidermal p53 clones is higher adjacent to squamous cell carcinoma in comparison with basal cell carcinoma

BACKGROUND

It is well accepted that ultraviolet radiation from the sun can induce and promote growth of skin tumours. Skin cancer develops as a consequence of multiple genetic hits, where an initial, important step includes proliferation of cells susceptible to malignant transformation. Foci of morphologically normal epidermal keratinocytes overexpressing p53 protein are common in chronically sun-exposed skin. Such foci have previously been shown to represent expanding clones of p53-mutated keratinocytes. Although several characteristics concerning epidermal p53 clones remain to be resolved, an important role in skin carcinogenesis is anticipated. The density of epidermal p53 clones in human skin is largely unknown.

OBJECTIVES

To compare the occurrence of epidermal p53 clones in skin surrounding cancers with that in skin surrounding benign melanocytic naevi. To assess the influence of age on frequency and size of epidermal p53 clones in human facial skin.

METHODS

We have analysed the number and sizes of epidermal p53 clones in skin specimens from patients with squamous cell carcinoma (SCC), basal cell carcinoma (BCC) and benign melanocytic naevi. Cases included normal facial skin from four different age groups. Tissue sections were immunohistochemically stained and the presence of p53 clones was recorded. Approximately 1.4 m of epidermis from a total of 112 biopsies was analysed.

RESULTS

We found 128 epidermal p53 clones in biopsy specimens from 112 patients. The results showed that the number and size of p53 clones increase with age. In normal skin adjacent to SCC p53 clones were significantly more numerous and greater in size in comparison with those in normal skin both adjacent to benign naevi and adjacent to BCC. Interestingly, normal skin in the close vicinity of BCC and melanocytic naevi showed similar results regarding both number and size of epidermal p53 clones.

CONCLUSIONS

Our findings suggest a connection between development of epidermal p53 clones and SCC.

Frequency, Clinical Significance and Course of Cerebral Ischemic Events after Carotid Endarterectomy Evaluated by Serial Diffusion Weighted Imaging

OBJECTIVES

Neurological deficit defines the outcome of Carotid Endarterectomy (CEA) that is mainly caused by cerebral ischemia. Diffusion-weighted imaging (DWI) is a sensitive method for demonstrating even small ischemic lesions. The aim of this study was to evaluate the frequency, clinical significance and course of ischemic lesions after CEA using serial DWI.

METHODS

DWI was performed within 1 day before and after CEA in 88 patients. Postoperative lesions were analyzed by their quantity, volume and distribution. To differentiate temporary ischemia from definite cerebral infarction (blood brain barrier disruption) all patients with a positive postoperative DWI were reexamined with contrast-enhanced T1-MRI 7-10 days after the procedure. All patients were examined by a neurologist within 2 days before and after CEA.

RESULTS

Two patients showed a postoperative neurological deficit. Postoperative DWI revealed ipsilateral ischemic lesions in 15 patients. In seven of these patients a brain infarction was diagnosed on the T1-MRI during follow-up. A significant correlation between the number of DWI lesions (p=0.031) as well as the volume of DWI lesions (p=0.023) and definite infarction was found. Symptomatic patients preoperatively showed significantly more DWI lesions (p=0.036) and cerebral infarcts (p=0.003).

CONCLUSION

DWI is a sensitive method of demonstrating ischemic events after CEA. The number and volume of DWI lesions after CEA are highly predictive of brain infarction.

Blutwerte beim Wisent (Bison bonasus) in Abhängigkeit von Geschlecht, Alter und Balanoposthitis bei Bullen

Gegenstand und Ziel: Zur klinischen Beurteilung innerer Erkrankungen von Haus-, Zoo- und Wildtieren sind Blutparameter ein wichtiges diagnostisches Hilfsmittel. Ziel dieser Untersuchungen war die Erarbeitung verlässlicher hämatologischer Referenzwerte für den Wisent (Bison bonasus). Gleichzeitig sollten die Werte gesunder männlicher Tiere mit denen an Balanoposthitis erkrankter Bullen verglichen werden. Material und Methoden: Von 170 gesunden und 52 an Balanoposthitis erkrankten Wisenten wurde Blut aus der Vena jugularis entnommen. Von diesen Tieren lebten 179 in freier Wildbahn und 43 im Zuchtreservat der Nationalparkverwaltung des Urwaldes von Bialowieza bzw. in verschiedenen deutschen Zoos. Letztere wurden vor der Probennahme immobilisiert. Die Untersuchung umfasste folgende Parameter: Hämatokrit, Differenzialblutbild, Kalzium, Phosphor, Aspartataminotransferase, Kreatinkinase, Harnstoff, Kreatinin und Bilirubin. Ergebnisse: Bei den Parametern Kreatinin und Phosphat konnten statistisch signifikante Altersunterschiede festgestellt werden. Statistisch signifikante geschlechtsspezifische Unterschiede wurden nicht gefunden. Es gab ferner keinerlei signifikante Unterschiede zwischen gesunden und an Balanoposthitis erkrankten männlichen Tieren. Schlussfolgerung und klinische Relevanz: Zur Abklärung des Gesundheitsstatus von Wisenten sind neben der klinischen Untersuchung verlässliche Blutwerte notwendig. Diese stehen mit der vorgelegten Untersuchung zur Verfügung. Der Vergleich der Werte gesunder Tiere mit den an Balanoposthitis erkrankten Tieren zeigt keine signifikanten Unterschiede der Blutwerte, was möglicherweise bedeutet, dass durch die Balanoposthitis keine generalisierte, sondern nur eine lokale Immunreaktion ausgelöst wird.

Endoscopy of intracranial cysts in the adult patient

In this study we report about our experience in surgical therapy of patients with intracranial supratentorial cysts. The main interest herein lies in the difference between conventional surgery and the endoscopic approach. Since 1997 in the Unfallkrankenhaus Berlin 4 male and 4 female patients with intracranial cysts aged between 21 and 66 have been treated surgically. The intracranial endoscopy was performed in 6 patients. The initially complained, mostly unspecific, symptoms diminished post operatively and in the follow-up. As complications a transient hemiparesis and an aseptic bone necrosis have to be mentioned, the latter after use of conventional surgery. In clear diagnostic cases an operation of intracranial cysts seems appropriate. Both surgical methods, open and endoscopic approach, are appropriate. To avoid complications due to greater surgical wounds the endoscopic method should be preferred.

Necrobacillosis in free-living male European bison in Poland

In the Bialowieza Primeval Forest (Poland) a chronic disease of the external genital organs has been observed in free-living male European bison (Bison bonasus) since 1980. Investigations on this disease started in the late 1980s. The most striking findings are necrotic and ulcerative lesions of the prepuce and penis of bison aged from 6 mo to >10 yr. Histologic examination of tissue samples from the prepuce of six bison (9-mo- to 8-yr-old), and from the penis of two bison (3- and 8-yr-old), were characteristic of necrobacillosis. Masses of slender, Gram-negative, rod-like or filamentous bacteria occurred in necrotic tissue. At the periphery of necrotic tissue filamentous bacteria were often arranged in large clusters and strands that advanced towards healthy tissue. Immunolabeling and electron microscopy also suggest that these organisms are Fusobacterium sp.

[First experiences using microsurgical techniques for minimally invasive ventral interbody fusion of the lumbar spine (MINI-ALIF)]

Minimal invasive techniques recently have become more important in spine surgery. Ventral approaches for lumbar fusion techniques are known for a long time. Their disadvantages are their size and the associated trauma. Since the early nineties two schools of minimal invasive procedures were developed. On one hand surgeons developed laparascopic methods, on the other hand traditional ventral approaches were minimized and combined with microsurgical techniques, in a way that they offer all advantages of minimal invasive procedures. This technique widely known under the acronym MINI-ALIF, which stands for MINImal invasive Antero-Lumbar Interbody Fusion, was developed for retroperitoneal approaches to the segments L2/3, L3/4, L4/5 and for the transperitoneal approach to the segment L5/S1. Its advantages include reduced technical and personnel effort, minimal traumatized tissue, low blood-loss, short operating times and reduced rates of complications. Additionally the surgeon does not need to be experienced in laparascopic methods. The operation technique is explained and discussed from the neurosurgical point of view.

[Cystic echinococcosis of the spleen]

Based on the portal infection root, the hydatid disease of the spleen represents a rarity. Because of a lack of prospective studies, spleen-preserving procedures and splenectomies were published as surgical therapy in case reports. In this report, the case of a 72-year-old woman with symptomatic hydatid disease of the spleen will be reported. Surgical and pharmaceutical strategy to minimize the risk of an OPSI syndrome as well as the value of adjuvant therapy with Albendazole will be discussed.

Endorectal ultrasound and leiomyosarcoma of the rectum

Leiomyosarcomas of the rectum are uncommon neoplasms accounting for fewer than 1% of all malignancies of the colon and rectum. Approximately 215 cases have been described in the literature. Distinction from leiomyoma is often difficult, but regarding dignity is important. The case reported is that of a 68-year-old man in whom a 2.2-cm rectal mass covered by mucosa was diagnosed by rectoscopy and endorectal ultrasound. After treatment by wide local excision the histological specimen revealed a low-grade, highly differentiated leiomyosarcoma. Due to the lack of a large series of this disease, there is disagreement over the therapeutic strategy. At the moment a selective treatment approach seems to be the most frequently advocated. Large tumors and those extending beyond the rectal wall are treated by radical surgical resection. Leiomyosarcomas less than 2.5 cm in size and confined to the bowel wall can be treated by wide local excision. Endosonography can provide exact assessment of tumor size and expansion and is of great value in selecting the appropriate treatment.

The traumatic dural sinus injury--a clinical study

In a period of 13 years 978 cases of severe head injuries were operated on in our clinic. An analysis of the medical reports includes injuries of the superficial dural sinus (39 cases = 4%): among these injuries of the anterior and central part of the superior sagittal sinus (66 per cent), injuries of the transverse sinus (18 per cent), injuries of the posterior part of the superior sagittal sinus (8 per cent), and combined injuries of different dural sinuses (8 per cent). Clinical data, i.e. the causes of accident, radiological examination results, intracranial lesions, operation techniques and outcome are analysed and discussed. The analysis of cases with dural sinus injuries shows a high mortality rate (total mortality rate: 16 patients = 41%; intra-operative mortality rate: 8 patients = 20%).

[Results of multistep oxygen therapy in the treatment of sudden hearing loss]

Oxygen multistep therapy (von Ardenne) was applied in 28 patients suffering from an idiopathic sudden hearing loss. The oxygen therapy consisted of a multistep short procedure, each of which lasted for 15 minutes. The results of our study were evaluated by means of standardised statistics confirming the effectiveness and even the superiority of the oxygen multistep therapy in comparison with any other treatment, and also in view of the spontaneous remission rate in cases of sudden hearing loss.

Atherosclerosis in the aorta of hypercholesterolemic rabbits and the influence of daltroban

These studies have examined aortic atherogenesis in cholesterol-fed rabbits and have correlated the effects of daltroban to the pathomechanism of the vessel wall lesions. After feeding a 0.5% cholesterol-enriched diet for 96 d atherosclerotic alterations were seen, which exhibited a proximo-distal pattern, to which the branching of the aorta contributed considerably. Depending on their localization and size a varying cellular constitution of the plaques was obvious. Large plaques, which were mainly seen in the aortic arch and the proximal descending thoracic aorta, consisted of numerous proliferating cells, masses of fibrillar ground substance, clusters of foam cells, and rarely contained cholesterol crystals and necroses. Emerging plaques mainly found in distal thoracic and abdominal aorta imposed as fatty streaks. Daltroban treatment, used in a clinically relevant doses of 10 mg/kg b. wt. per day, reduced extension and protrusional area of plaques to about 40%, which was evaluated using a newly developed computerized morphormetric method, in association with significant reductions in free cholesterol content within the aorta. The results suggest that daltroban inhibits the progression of atherosclerosis in cholesterol-fed rabbits. This effect may be related to its antagonistic interaction with the thromboxane A2 receptor and also to an inhibition of the cholesterol metabolism.

Chemotactic response of osteoblastlike cells to transforming growth factor beta

Transforming growth factor beta (TGF-beta) has multiple effects on bone cell metabolism in vitro but its exact role in bone remodeling still needs to be defined. Here we demonstrate that TGF-beta is chemotactic for osteoblastlike cells from fetal rat calvariae and osteoblastlike ROS 17/2.8 osteosarcoma cells. Maximal chemotaxis occurred at 5-15 pg/ml of TGF-beta and was observed with TGF-beta 1 and TGF-beta 2 at equivalent concentrations. Conditioned medium from osteoblastlike cells containing latent TGF-beta failed to stimulate chemotactic migration. However, chemotactic activity was observed in conditioned medium that had been transiently acidified. Since acidification is known to activate TGF-beta, these results suggest that only active TGF-beta is capable of inducing a chemotactic response. Preincubation of osteoblastlike cells with TGF-beta in concentrations from 10 pg/ml to 1 ng/ml for 48 h abolished a subsequent chemotactic response of these cells to TGF-beta, indicating that TGF-beta-induced chemotaxis is a transient phenomenon. Since TGF-beta may be released from the bone matrix and/or activated during bone resorption, the chemotactic activity of TGF-beta for osteoblastlike cells may be important for the recruitment of osteoblastlike cells to sites of bone remodeling.

[Results of the analysis of a regional noise-exposure outpatient unit]

An evaluation of our regional register of noise-exposed persons comprehended within the framework of medical ability and control examinations of workers was given here. On the occasion of medical ability examinations of workers at the beginning of their employment 448 persons were examined. 49 of them had to undergo an additional ENT investigation because working under noise conditions in future. 5.4 p.c. of those were not passed as fit for working in noise environment. On the occasion of medical control examinations of workers during their employment 1893 persons were examined now. 184 of them had to undergo an additional ENT investigation because of their exposition to noise. Following that, it was necessary for 1.4 p.c. of the latter to change their working place, but for 0.6 p.c. of them an announcement to suspicion of occupational hearing damage must be made. In connection with the data above mentioned great attention must be payed to early ear diseases on the one hand, and to hearing damages existing before on the other hand.

[Comparison of plethysmography findings before and following varicose vein surgery]

In the chronic venous insufficiency on the basis of a primary varicosis the occlusion plethysmography of the veins is a suitable remedy in the positioning trial before and after a combined phlebectomy to determine the capacity of the venous part of the circulation on the lower extremity. In altogether 160 patients the functional capacity of the venous valves with the initial inclination to swelling St as well as the capacity of the venous vascular system on the calf and the ankle were established by the determination of the maximal venous capacity Vmax. It could be proved that particularly in stage III of the chronic venous insufficiency the haemodynamically most effective efficacy can be achieved by an operation of the varices.

Expression of the gene for the beta subunit of mouse thyrotropin results in multiple mRNAs differing in their 5'-untranslated regions

The gene encoding the beta subunit of mouse thyrotropin (TSH beta) has been isolated from a mouse genomic library, and its nucleotide sequence has been determined. Blot hybridization analysis of restriction enzyme digests of mouse DNA indicates that there is a single mouse TSH beta gene. The gene is 4.8 kilobases in length and contains five exons, which are 27, 47, 41, 163, and 328 base pairs long. Exons 1, 2, and 3 encode only 5'-untranslated mRNA sequences and are separated by introns that are 150 and 380 base pairs long. The protein-coding mRNA sequences are found in exons 4 and 5 and are interrupted by a 460-base pair intron. The position of this intron, between the codons for amino acids 34 and 35, has been conserved in all the known glycoprotein hormone beta subunit genes. Exons 3 and 4 are separated by a large 3.2-kilobase intron. When primer extension analysis, using an oligonucleotide primer complementary to exon 4 sequences, was employed to locate the transcription start site, four products were obtained. Nucleotide sequencing of these products showed that they were derived from separate TSH beta mRNAs that differed in the lengths of their 5'-untranslated regions. These 5'-untranslated mRNA sequences are derived from different combinations of exons 1, 2, and 3, each spliced to exons 4 and 5. The longest 5'-untranslated sequence, 116 nucleotides long, includes exons 1, 2, and 3 and the first base of exon 4; the shorter 5'-untranslated regions, 75, 69, and 28 nucleotides long, arise by splicing out the second and/or the third exon sequences. In contrast to the mouse TSH beta gene, transcription of the rat TSH beta gene from the analogous start site has been reported to give only a single mRNA, with a 5'-untranslated region of 28 nucleotides. Divergence of the mouse and rat TSH beta gene sequences at RNA splice sites can account for the absence of exon 2, but not exon 3, sequences in rat TSH beta mRNA. Primer extension and RNase protection analyses also showed that the mouse TSH beta gene contains a second transcription start site, located 43 base pairs upstream of the first start site, in a position corresponding to that in the rat TSH beta gene. Each start site in the mouse gene is flanked by characteristic TATAA box and CAAT box sequences.(ABSTRACT TRUNCATED AT 400 WORDS)

[111Indium-thrombocyte scintigraphy and percutaneous transluminal dilatation (angioplasty) of supra-aortic vascular stenoses. A new method for deciding therapy and for follow-up control]

Scintigraphy with 111indium-marked autologous platelets has been used during percutaneous transluminal dilatation of supra-aortic arterial stenoses; there were 14 successful dilatations and one attempted dilatation. The material consisted of nine stenoses of the internal carotid artery, two stenoses at the origin of the vertebral artery and four stenoses of the first part of the left subclavian artery. Deposition of thrombi could be demonstrated by scintigraphy, both before and after catheter dilatation. The value of this method for deciding on the type of treatment and for observing the course of percutaneous dilatation of cerebral vessels is discussed.