Quantitation of hepatitis C virus RNA by third generation branched DNA-based signal amplification assay

Quantitation of hepatitis C virus (HCV) RNA has become an important tool in different clinical settings and is used extensively for pretreatment evaluation of patients infected chronically with HCV. In this study, the performance characteristics of the third generation branched DNA-based signal amplification assay (bDNA 3.0) for HCV RNA quantitation were established. The new assay version showed an analytical specificity of 98%. Mean intra- and between-run imprecisions were 6.8 and 11.2%, respectively. The assay was linear over its entire dynamic range. Quantitation appeared to be unaffected by the genotypic variability of HCV. A comparison of bDNA 3.0 with the second generation bDNA assay calibrated against the international WHO HCV RNA standard, and the PCR-based Cobas Amplicor HCV Monitor 2.0 revealed a fairly good correlation among the assays. Twenty-nine and 11% of the paired quantitative results differed by more than log(10)0.5 (i.e. three-fold). All three assays after calibration against the WHO standard also yielded clinically comparable results with regard to the tailoring of interferon alpha/ribavirin treatment duration in patients infected by HCV genotypes 1, 4, and 5.     

Endothelial-derived lipoprotein lipase is bound to postprandial triglyceride-rich lipoproteins and mediates their hepatic clearance in vivo

Lipoprotein lipase (LPL) is the key enzyme in the intravascular hydrolysis of triglyceride-rich lipoproteins (TRL). Furthermore, it has been shown that inactive LPL can mediate cellular binding and uptake of TRL in vitro. This study investigated whether LPL is bound to postprandial human TRL in vivo, and whether it plays a role in the hepatic clearance of these particles independent of its catalytic activity. LPL was found to bind to postprandial TRL in preheparin plasma of healthy young men. To study the effect of inactive LPL on particle uptake, TRL isolated from patients with inactive LPL (LPL or apoC-II mutations) were used before and after heparin administration. These model particles allow one to study the bridging effect of LPL independent of its enzymatic activity. Organ uptake studies with these particles in mice revealed that inactive LPL increases the hepatic clearance of TRL significantly while uptake into other organs remains largely unaffected. Further evidence that endothelial-derived LPL directs TRL to the liver in vivo was gained with transgenic mice that express inactive LPL exclusively in muscle, revealing greater hepatic uptake than in wild-type mice. In conclusion, these data demonstrate for the first time that LPL is a structural component of postprandial TRL which facilitates hepatic TRL clearance from the circulation independent of its catalytic function.     

Pulmonale alveol?re Mikrolithiasis - eine seltene Ursache bilateraler ausgedehnter pulmonaler Infiltrate

Zusammenfassung Hintergrund: Die pulmonale alveoläre Mikrolithiasis ist eine seltene Erkrankung, die durch die pulmonale Ablagerung von Calciumphosphatkonkrementen in den Alveolen charakterisiert ist. Diagnostisch richtungsweisend ist das Röntgenbild mit einer typischen "Sandsturm"artigen Verschattung des Lungengewebes. Fallbeschreibung: Ein 29-jähriger Marokkaner stellte sich erstmals 1988 wegen atypischer linkstorakaler Schmerzen vor. Anamnestisch waren eine Nephrokalzinose und eine Lungenerkrankung bekannt. Die körperliche Untersuchung und die Laborbefunde waren unauffällig. Im Röntgenbild des Thorax fielen ausgedehnte pulmonale Infiltrate beidseitig mit einem "Sandsturm"-artigen Aspekt auf. Sonographisch zeigte sich auf beiden Seiten eine medulläre Nephrokalzinose. Mittels transbronchialer Biopsie wurde die Diagnose einer pulmonalen alveolären Mikrolithiasis gesichert. Im Verlauf von 13 Jahren kam es zu einer leichten Zunahme der pulmonalen Infiltrate und zu beginnender restriktiver Ventilationsstörung bei subjektiv weitgehend beschwerdefreien Patienten. Schlussfolgerung: Bei ausgedehnten pulmonalen Infiltraten beidseitig mit Nachweis intrapulmonaler Verkalkungen sollte als Differentialdiagnose an die seltene pulmonale alveoläre Mikrolithiasis gedacht werden. Dies gilt insbesondere für Patienten aus Ländern mit hoher Sonnenlichtexposition. In seltenen Fällen findet man auch Verkalkungen in extrapulmonalen Organen. Abstract Background: Pulmonary alveolar microlithiasis is a rare disease, which is characterized by pulmonary deposition of calcium phosphate microliths. The radiographic features can be pathognomonic wit a "sandstorm"-like opacification throughout the lungs. Case Report: A 29-year-old Moroccan presented for the first time 1988 with atypical chest pain. His history was characterized by nephrocalcinosis and pulmonary disease. Physical examination and laboratory values were unremarkable. Chest X-ray revealed extensive bilateral pulmonary infiltrates with "sandstorm"-like opacifications. Sonography showed medullary nephrocalcinosis. The diagnosis of pulmonary alveolar microlithiasis was confirmed ty transbronchial biopsy. Over the next 13 years there was only a moderate expansion of the pulmonary infiltrates and a beginning restrictive pattern, whereas the patient was almost symptom-free. Conclusion: Pulmonary alveolar microlithiasis is a rare cause of bilateral pulmonary infiltrates and should be considered in the differential diagnosis. In some cases there is also an association with calcifications of extrapulmonary organs.     

Effect of a toothpaste containing triclosan on dental plaque,gingivitis, and bleeding on probing--an investigation in periodontitis patients over 28 weeks

The aim of this double-blind, 28-week study was to evaluate the plaque-inhibitory and antigingivitis efficacy of a fluoride toothpaste containing 0.3% triclosan and essential oil (Dental Kosmetik, Dresden, Germany) in comparison with a control toothpaste. One hundred twenty subjects previously treated for chronic periodontitis were included in the study. At baseline, 8, 18, and 28 weeks, plaque accumulation (PlI) and gingival status (GI) were assessed. Probing pocket depth (PD) and bleeding on probing (BOP) were measured at baseline and week 28 using a Florida probe. No professional hygiene was delivered during the study period. Mean plaque scores decreased between baseline and week 8 in both groups. At the end of the study, a significant increase of mean PlI compared to baseline could be observed in the test and in the control groups. Comparing the two groups, the PlI in the triclosan group was significantly lower than in the control group. Mean gingival scores decreased significantly during the first 8-week period in both groups. This reduction was followed by an increase of GI in the control, while the GI in the test group reached a significantly lower value than in controls after 28 weeks. Furthermore, at week 28, in both groups the PD were decreased as compared to the pre-study data. It is concluded that the triclosan/essential oil additive in a fluoride-containing dentifrice exhibited distinctive antigingivitis as well as plaque-inhibitory effects during a 28-week maintenance period in periodontitis patients.     

Aussagekraft panendoskopischer Untersuchungen im Rahmen der Ausbreitungsdiagnostik bei Mundhöhlenkarzinomen

Background. In our department panendoscopic examinations of the tracheobronchial system, the epi-, meso,- and hypopharynx, and the upper gastrointestinal tract are obligatory with regard to the staging of oral squamous cell carcinomas, the main interest being the exclusion of synchronous secondary carcinomas. The aim of this study was to present the pathological findings in 160 panendoscopies of patients with previously untreated oral squamous cell carcinomas. Study. A total of 17 synchronous carcinomas were found in 13 (8.2%) of all cases studied. They were situated in the esophagus (n=9), the stomach (n=1), the duodenum (n=1), the hypopharynx (n=1), the trachea (n=1), and the lung (n=4). Multiple carcinomas were found in three patients. The survival time of patients with a secondary carcinoma proved to be significantly worse than that of the other patients. The abuse of alcohol and tobacco causes a high amount of inflammatory changes in the aerodigestive system. In 27 cases (17%) ulcers of the stomach or duodenum were found, although the majority of the patients had large inflammatory mucosal alterations. In 49 cases (34.5%) a chronic tracheobronchitis could be found. Discussion. In our opinion there is an absolute indication for panendoscopic examinations of patients with oral squamous cell carcinomas. In cases with dysplastic mucosal findings these endoscopies have to be repeated on a regular basis.