A common 936 C/T gene polymorphism of vascular endothelial growth factor is associated with decreased breast cancer risk

A common 936 C/T polymorphism in the gene for the vascular endothelial growth factor (VEGF) has been associated with VEGF plasma levels. In our case-control study, we investigated the role of this polymorphism for breast cancer risk. VEGF genotype was determined in 500 women with breast cancer and 500 sex- and age-matched healthy control subjects. Carriers of a 936T-allele were more frequent among controls (29.4%) than among patients (17.6%; p = 0.000014). The odds ratio for carriers of a 936T-allele for breast cancer was 0.51 (95% confidence interval 0.38-0.70). Additionally, VEGF plasma levels were determined in 21 nonsmoking post-menopausal controls; carriers of a 936T allele had significantly lower levels (median 23 pg/ml; range 6-50 pg/ml) than noncarriers (37; 21-387; p = 0.034). We conclude that carriers of a VEGF 936T-allele are at decreased risk for breast cancer, this, however, requiring further confirmation in a larger study.     

A review of 507 off-pump coronary bypass patients: a single center experience

This retrospective study evaluates perioperative results of 'Off-pump' coronary artery bypass surgery (OPCAB) experience in a single center. Five hundred and seven patients were operated (median sternotomy) from 1998 to 2002 using OPCAB. Patient data were registered and risk prediction calculated using the full logistic version of EuroSCORE. Overall, 1091 distal anastomoses were performed and only five (1%) patients required conversion to cardiopulmonary bypass. The predicted mortality was 3.8+/-4.5%, the observed mortality was 2.37%. OPCAB technique has become a standard approach in our department with low mortality and morbidity rates even in treatment of multivessel disease or high-risk patients.     

Angiogenesis: molecular mechanisms and functional interactions--2nd Kloster Seeon Meeting of the German Priority Research Grant "Angiogenesis"

The German Priority Research Program "Angiogenesis" (www.angiogenese.de) hosts a biannual meeting in the Kloster Seeon in Southern Germany. The 2nd Kloster Seeon Meeting "Angiogenesis: Molecular Mechanisms and Functional Interactions" was held in September 2002. It included sessions on hypoxia, the biology of endothelial precursor cells, angiogenic growth factors including VEGFs, the angiopoietins, ephrins, and FGFs, mechanisms of vascular sprouting and cell-cell contacts during angiogenesis, angiogenic signaling, lymphangiogenesis, angiogenesis during tumor invasion and metastasis, and on novel angiomanipulatory therapies. This report summarizes the key findings reported during the platform presentations of the meeting.     

Expression of the Proto-oncogene c-myc in Human Stenotic Aortocoronary Bypass Grafts

Proliferation and differentiation of vascular smooth muscle cells (VSMC) are central events in vascular pathobiology and play a major role in the development of stenotic and restenotic lesions [15, 27]. The proto-oncogene c-myc and other early cell cycle-regulating genes have been implicated in the induction of cell proliferation and differentiation under diverse pathophysiological conditions [11, 13]. In the present study we analyzed c-myc mRNAexpression by indirect nonradioactive in situ hybridization technique (NISH) in human stenotic venous bypass grafts (n = 32) retrieved during re-do operations of coronary artery disease and compared the results with 28 native veins (vena saphena magna) from the same patients.Stenotic bypass grafts showed enhanced c-myc expression located predominantly in VSMCin the media and neointima (severity score: ++–+++, 32/32 stenotic veins). In native veins we observed only low levels of – c-myc mRNA(severity score: +, 28/28 native veins), all signals were restricted to endothelial cells of either the innermost intimal layer or of the vasa vasorum.Our in situ hybridization studies demonstrate enhanced mRNAexpression of the proto-oncogene c-myc in stenotic venous bypass grafts. These results suggest that – in analogy to other pathophysiological conditions – c-myc exerts essential regulatory functions in cellular events operative during the initiation and progression of venous bypass graft disease.     

Quantitative Erfassung von Ver?nderungen der thorakalen Aorta bei Patienten mit chronischer Aortendissektion mittels trans?sophagealer Echokardiographie

The aim of this serial 3 year follow-up study in 42 clinically stable patients with chronic aortic dissection was to assess quantitatively morphologic changes of the descending thoracic aorta (AD) using transesophageal echocardiography (TEE). Communicating dissections (ca) were present in 16/19 patients with operated type I and in 11/23 patients with type III AD whereas 12/23 type III AD according to De Bakey were non-communicating (nc). Diametral enlargement of the disc. thoracic aorta was 4 mm (mean value) at 1 year in all patients, 5.9 mm in type I ca, 7.2 mm in type III ca but only 3.1 mm in type III nc at 3 years. The ratio between true lumen and false lumen (FL) changed in ca AD from 1:2 to 1:3 over the period of 3 years but remained constant at 1:1 in ncAD. Progressive thrombosis of the false lumen (FL) occurred in 76% of patients but complete thrombosis of the FL occurred in only 6% of type I ca, 18% type III ca but in 84% of type III nc patients. Our results confirm observations that non-communicating dissections seem to have a more favorable outcome and less aneurysmal dilatation compared to ca dissection.     

Zur Kenntnis der Wirkungen des Imidazols

Ohne ZusammenfassungMit 24 Kurven.     

Untersuchung eines durch Operation entfernten Thoracopagus parasiticus

Ohne ZusammenfassungMit 38 Textabbildungen.     

Cardiac valve replacement. Problems solved and unsolved.

In this review the present state of cardiac valve replacement is summarized on the basis of the literature and personal experience in approximately 1500 cases, using various prosthetic models. Durability, hemodynamic performance at rest and during exercise, and thromboembolic risk are considered in particular and our choice of the various valve models is discussed on these grounds. The long-term durability has been significantly improved and has possibly been solved in the more advanced mechanical valves, while this question is still open in the present biological prostheses. Hemodynamic performance is considered less than optimal in all conventional mechanical prostheses and in the xenografts. Pressure gradients are abnormal in all mechanical as well as in stented biological prostheses, the latter being less likely to solve the problem of a narrow aortic root. The significantly lower incidence of thromboembolism and total valve thrombosis and the absence of anticoagulation accidents in patients with bioprostheses has tipped the balance for the present in favor of the latter, particularly in mitral valve replacement and certainly in all those patients in whom anticoagulation in impossible, unlikely, or undesirable.