A congenital defect of the pericardium

Ten patients with congenital defects of the pericardium were treated in Departments of Cardiac Surgery, Silesian School of Medicine in Zabrze and Katowice between 1989 and 1998. There were eight children and two adults, eight males and two females. In each case the pericardial defect was discovered intraoperatively during surgery for congenital heart defect. There were no cases with clinical symptoms that could be clearly related to the defect of the pericardial sac. In the case of a child with a complete absence of the left pericardial wall the heart was significantly rotated contrary to the defect. The final outcome of the congenital heart defect surgery was satisfactory in each case. An abbreviated historical review of the diagnosis and treatment of the pericardial defects is presented with special attention placed on therapeutic management. Surgical correction of pericardial defects is concluded to be justified in patients with clinical symptoms. In most cases pericardial defects are discovered intraoperatively, but when they are large the said defects do not require any treatment.     

Fast approach for clarification of chromosomal aberrations by using LM-PCR and FT-CGH in leukaemic sample

Chromosomal abnormalities, like deletions, amplifications, inversions or translocations, are recurrent features in haematological malignancies. However, the precise molecular breakpoints are frequently not determined. Here we describe a rapid analysis of genetic imbalances combining fine tiling comparative genomic hybridization (FT-CGH) and ligation-mediated PCR (LM-PCR). We clarified an inv(14)(q11q32) in a case of T cell acute lymphoblastic leukaemia with a breakpoint in the TRA/D in 68% of cells detected by fluorescence in situ hybridization. FT-CGH showed several mono- and biallelic losses within TRA/D. LM-PCR disclosed a TRA/D rearrangement on one allele. The other allele revealed an inv(14)(q11q32), joining TRDD2 at 21,977,000 of 14q11 together with the IGH locus at 105,948,000 and 3'-sequence of TRAC at 22,092,000 joined together with IGHV4-61 at 106,166,000. This sensitive approach can unravel complex chromosomal abnormalities in patient samples with a limited amount of aberrant cells and may lead to better diagnostic and therapeutic options.     

Restricted T cell receptor delta chain genes repertoire in peripheral blood of multiple sclerosis patients

Multiple sclerosis (MS) is a chronic inflammatory disease characterized by focal demyelination of central nervous system (CNS). Susceptibility to MS is thought to be affected by multiple genes including HLA and T cell receptor (TCR) genes. In view of the recent evidence, that in addition to α/β T lymphocytes also γ/δ T cells may have autoreactive potential, TCR delta repertoire in peripheral blood of MS patients has been studied. TCR delta repertoire, as assessed by Vδ-Jδ rearrangements, has been analysed in 13 MS cases and in 30 healthy individuals by seminested PCR technique. Oligonucleotide primers specific for six Vδ regions and for Jδ1 gene were used for amplification of Vδ-Jδ junctional region responsible for the diversity of γ/δ TCR. In the majority of MS patients PAGE analysis of Vδ1-Jδ1, Vδ3-Jδ1 and Vδ5-Jδ1 rearrangements showed single-band or two-band pattern. The most striking result has been observed in Vδ5-Jδ1 rearrangement, where in nine cases studied single band and in four patients two bands have been found. In all but one MS cases multi-band pattern of Vδ2-Jδ1 rearrangement was obtained. None of the 13 MS patients showed single-band rearrangement pattern of Vδ4-Jδ1 and Vδ6-Jδl. Contrary to the MS group almost all healthy individuals produced smear-like or multi-band pattern of Vδ1-Vδ5 to Jδ1 rearrangements. On the basis of the banding pattern produced by Vδ-Jδ rearrangement in MS, it can be suggested that T lymphocytes had undergone clonal expansion in vivo, most likely due to stimulation by antigen related to CNS. In particular a very consistent single-band pattern of Vδ5-Jδ1 rearrangement observed in almost all MS patients studied, argues very strongly for a significant role of γ/δ T cells with Vδ5 rearrangement in the pathogenesis of MS. However, it cannot be excluded that the observed patterns of TCR δ gene rearrangement in MS patients may represent secondary changes to CNS damage.     

Human anterior and posterior cervical longitudinal ligaments possess similar tensile properties

One hundred bone-ligament-bone complexes were isolated from the cervical spines of 20 fresh-frozen human cadavers and mechanically tested in uniaxial tension. Load-elongation curves representing the structural properties of the complex were obtained, and stiffness, ultimate load, energy at failure, and elongation were determined from the curves. Stress-strain curves representing the mechanical properties of the ligament substance were also obtained, and elastic modulus was determined from these curves. Comparisons were made between anterior and posterior longitudinal ligaments and among cervical levels. The cross-sectional area of the anterior ligament was smaller at the C2-C3 level than at subaxial levels. There was a trend toward less stiffness but more energy at failure and greater elastic modulus for the anterior compared with the posterior ligaments at subaxial levels, although the differences were not statistically significant (p > 0.05).     

Carotid and aortic bodies in chronically anemic normotensive and spontaneously hypertensive rats

Overactivity of the carotid body chemoreceptors along with the enlargement of chemoreceptor tissue were found in spontaneously hypertensive rats of Okamoto-Aoki strain (SHR). The purpose of the present study was to answer the question whether the aortic bodies were also enlarged in SHR. However, because aortic bodies, unlike carotid ones, are sensitive to oxygen content another question arose: do aortic bodies undergo hypertrophy in chronic anemia? Twenty-three spontaneously hypertensive rats of Okamoto-Aoki strain (SHR) and 24 normotensive Wistar rats (NCR) were maintained on low-iron food from the age of 3 weeks. In seven 10-week-old anemic SHR regular diet was substituted (transiently anemic SHR). Blood pressure measurements and hemoglobin were measured every second week. The animals were killed at the age of 18 weeks. Light microscopic studies of the carotid and aortic bodies were performed and volumes of chemoreceptor tissues were determined from serial sections. The eight SHR on low-iron diet exhibited lower hemoglobin concentration than their normotensive counterparts. In the anemic SHR blood pressure was lower than in control SHR, whereas blood pressure did not differ between the anemic and control NCR. Restoration of normal values of hemoglobin in the anemic SHR was followed by only a slight increase in blood pressure. The carotid bodies volumes were 2.5-3 times larger in the SHR than in NCR. The volumes of carotid bodies both of the SHR and NCR were influenced neither by blood pressure nor by hemoglobin concentration.(ABSTRACT TRUNCATED AT 250 WORDS)     

Do arterial chemoreceptors play a role in the pathogenesis of hypertension?

Although the arterial chemoreflex exerts a powerful influence upon the cardiovascular system, this reflex has until now been a disregarded factor in hypertension research. By comparing the physiological effects of chemoreceptor excitation to disarrangements present during the early labile phase of hypertension in spontaneously hypertensive rats, we found remarkable similarities. A search through the literature as well as our experimental data fully confirm this association. Many factors, among them decreased blood flow through the glomic tissue, lead to chemoreceptor stimulation. The origins of the chemoreceptor arteries are located in areas very susceptible to atherosclerotic changes which can lead to ischemia of chemoreceptor tissue. We are led to hypothesize that arterial chemoreflex is a significant factor in the etiology of essential hypertension.     

B淋巴细胞肿瘤患者胸腺近期的输出功能

本研究了解B细胞肿瘤患者胸腺近期输出naiveT细胞的水平,以评价其T细胞免疫潜能。利用实时定量PCR(TaqMan)方法检测61例B细胞肿瘤患者(成人B-ALL20例,儿童B-ALL6例,B-CLL4例,B-NHL17例,MM14例)外周血单个核细胞(PBMNC)中T细胞受体重排删除DNA环(T-cell receptor rearrangement excision circles,TREC)的含量,并根据外周血中CD3阳性率计算CD3细胞中TREC水平。5例ALL-CR病人和17例正常人外周血作为对照。实验结果显示,正常人外周血中TREC拷贝数为3.76±3.42/1000PBMNC和5.87±4.96/1000CD3 细胞,而各B细胞肿瘤组的TREC水平均显著低于正常人水平,其TREC水平在成人B-ALL为0.53±1.52拷贝/1000PBMNC和2.01±3.93拷贝/1000CD3 细胞(p=0.0005和p=0.0123),在B-CLL为0.11±0.15拷贝/1000PBMNC,0.23±0.27拷贝/1000CD3 细胞(p=0.0015和p=0.0381),在B-NHL为0.71±1.34拷贝/1000PBMNC(p=0.0017),在MM为0.53±0.90拷贝/1000PBMNC(p=0.0018)。ALL-CR组TREC水平同样低于正常人水平,儿童B-ALL组TREC水平明显高于成人组。结论:各类B细胞肿瘤胸腺近期输出naiveT细胞功能均明显降低,个体差异较大,在病人达到完全缓解期时,胸腺近期输出功能仍没有得到恢复,提示对病人有动态观察的必要性。     

Diagnosing osteomyelitis in the diabetic foot: a pilot study to examine the sensitivity and specificity of Tc99mwhite blood cell‐labelled single photon emission computed tomography/computed tomography

Diabetic foot ulceration poses a significant threat of osteomyelitis (OM) and subsequent amputation. The diagnosis of OM via imaging studies is difficult as radiographic findings do not present immediately and advanced imaging studies may be contraindicated or unavailable. A novel diagnostic tool has been developed which synthesises technetium‐99 white blood cell‐labelled single‐photon emission computed tomography and computed tomography (Tc^99mWBC labelled‐SPECT/CT) imaging, effectively enhancing anatomic detail. The aim of this pilot study was to determine the validity and reliability of this novel imaging technique in patients with diabetic foot ulcers in a Veterans Affairs healthcare facility. A retrospective review was performed on consecutive patients who met the inclusion criteria (n = 14) and underwent Tc^99mWBC‐labelled SPECT/CT for suspected OM. Histopathologic analysis of bone specimen (when available) and International Working Group on the Diabetic Foot consensus criteria were used as a reference standard. The sensitivity and specificity of Tc^99mWBC‐labelled SPECT/CT were 87·50% [confidence interval (CI): 64·58–110·42%] and 71·43% (CI: 37·96–104·90%), respectively. Negative predictive value (NPV) and positive predictive value (PPV) were 83·33% (CI: 53·51–113·15%) and 77·78% (CI: 50·62–104·94%), respectively, with a likelihood ratio (LR) of 3·063 and an accuracy of 80%. These findings suggest Tc^99mWBC‐labelled SPECT/CT can be useful in imaging OM in patients with diabetic foot ulcers.     

The influence of physical exercise on the generation of TGF-β1, PDGF-AA,and VEGF-A in adipose tissue

Adipose tissue is an important organ that produces and secretes hormones and cytokines, including TGF-β1, PDGF-AA, and VEGF-A. The goal of the present study was to investigate the influence of a single session of acute exercise, as well as the prolonged endurance training on the production of TGF-β1, PDGF-AA, and VEGF-A in the subcutaneous white adipose tissue in rats. Rats were randomly divided into two groups: untrained (UT, n = 30) and trained rats (T, subjected to 6-week endurance training with increasing load, n = 29). Both groups were subjected to an acute exercise session with the same work load. The rats were killed before (UTpre, Tpre), immediately after (UT0h, T0h), or 3 h (UT3h, T3h) after exercise and adipose tissue samples collected. Growth factor mRNA was evaluated using RT-PCR; the protein levels were measured before and after training (UTpre and Tpre) using the immunoenzymatic method. TGF-β1 and PDGF-AA mRNA levels were decreased in the UT3h rats compared to the UTpre rats (P = 0.0001 and P = 0.03, respectively), but the VEGF-A mRNA level remained unchanged in the UT0h and UT3h rats compared to UTpre rats. TGF-β1, PDGF-AA and VEGF-A mRNA levels were decreased in the T3h rats compared to Tpre (P = 0.0002, P = 0.02, and P = 0.03, respectively). TGF-β1, PDGF-AA and VEGF-A mRNA levels significantly increased in the Tpre rats compared to UTpre (all P = 0.0002). However, the protein levels remained constant. In conclusion, prolonged physical exercise increases growth factor mRNA in adipose tissue but not protein levels.