Alcohol consumption and its relation to risk factors for cardiovascular disease in the north-west of Russia: the Arkhangelsk study

BACKGROUND: To explore indicators and levels of alcohol consumption in a Russian population, and to elaborate these in relation to risk factors for cardiovascular disease. METHODS: A total of 1963 men and 1734 women, aged 18-75 years, consecutively recruited at their compulsory annual medical check-up at the Semashko outpatient clinic, Arkhangelsk, participated in a cross-sectional health survey. The survey comprised a physical examination, a six-page questionnaire on health and lifestyle, and blood tests. RESULTS: Gamma-glutamyltransferase (GGT) levels in both sexes were more than twice as high as found in comparable studies. Elevated GGT-levels were 4-5 times more frequent than found in Norwegian studies. Alcohol Use Disorder Identification Test (AUDIT) identified up to 75% of male workers and 47% of female workers as hazardous or harmful alcohol drinkers. The traditional risk factors for cardiovascular disease were significantly higher in subjects with a high level of GGT. CONCLUSION: The findings indicate an extremely high level of alcohol consumption in this population. Elevation in GGT was significantly associated with increased risk for cardiovascular disease.     

Stuck bioprosthetic aortic valve--a new entity? A case report

We describe herein a case of bioprosthetic valve malfunction, which closely imitates a stuck valve. Although the term "stuck" was used originally for the immovable mechanical valve leaflets, the echocardiographic manifestation of this malfunction is similar to those of a mechanical one. The clinical presentation of the stuck bioprosthesis is, however, far more benign than a stuck mechanical valve. Familiarity with this entity is important.     

Timing of chest tube removal after coronary artery bypass surgery

AIM: Assessing the impact of chest tube removal timing following a coronary artery bypass grafting surgery on the clinical outcome. METHODS: Eighty-three consecutive patients were randomly assigned to either have the chest tube removed 24 hours (Group A) or 48 hours (Group B) postoperatively. Chest tubes were removed on the condition that drainage was less than 100 cc for the last 8 hours. Pre- and postoperative data were analyzed. RESULTS: The following preoperative and intraoperative risk factors were more prevalent among Group A patients: previous MI (60.5% vs 40.7%, p = 0.11), previous CVA (9.1% vs 0%, p = 0.11), hypertension (72.7% vs 55.6%, p = 0.14), pump time (111.6 min vs 96.8 min, p = 0.07), and cross-clamp time (73.8 min vs 64.4 min, p = 0.07). Postoperatively, there was a lower demand for analgesics in Group A (2.1 times for 12 hours at 36 hours vs 3.6 p = 0.09), lower white blood cell count (10,947 at 48 hours vs 11,576, p = 0.39) a higher oxygen saturation (91.9% at 48 hours vs 88.9%, p = 0.07), higher expiratory volumes (594 mL at 36 hours vs 514 mL p = 0.08) and earlier mobilization (23% walking at 48 hours vs 4%, p = 0.01). Pleural effusion and atelectasis were less frequent in Group A in both chest X-rays (66% vs 73%, p = 0.6 and 64% vs 75%, p = 0.47, respectively) and CT scans (19% vs 41%, p = 0.1 and 84% vs 96%, p = 0.42, respectively). There was no difference between the two groups in the prevalence of serous wound discharge and the length of hospital stay and there were no reported cases of pneumonia throughout the study. CONCLUSION: In cases where no excessive drainage accumulates, early removal of the chest tubes was found to be a policy that improves the postoperative outcome and decreases the need for supportive treatment such as analgetics, physiotherapy, nurse care, and oxygen. This policy did not involve significant residual effusions.     

Optimal design of structured nanospheres for ultrasharp light-scattering resonances as molecular imaging multilabels

Optical molecular imaging could potentially enable noninvasive high-resolution characterization and diagnosis of living tissue. The capability to image multiple molecular targets simultaneously is particularly important. Currently this task cannot be achieved using conventional optical contrast agents, due to their broad spectral responses (approximately 80 to 200 nm). Developments in research on semiconductor nanocrystals (quantum dots) provide one possible solution. We describe a different concept of multilabel molecular imaging that utilizes resonant light-scattering spectroscopy of multilayered nanospheres to achieve tunable ultrasharp resonance peaks with widths as narrow as 10 nm. Our theoretical study demonstrates that dozens of molecular targets can potentially be imaged simultaneously using this approach.     

Multiple projection optical diffusion tomography with plane wave illumination

We describe a new data collection scheme for optical diffusion tomography in which plane wave illumination is combined with multiple projections in the slab imaging geometry. Multiple projection measurements are performed by rotating the slab around the sample. The advantage of the proposed method is that the measured data are more compatible with the dynamic range of most commonly used detectors. At the same time, multiple projections improve image quality by mutually interchanging the depth and transverse directions, and the scanned (detection) and integrated (illumination) surfaces. Inversion methods are derived for image reconstructions with extremely large data sets. Numerical simulations are performed for fixed and rotated slabs.     

Variability in apoptotic response to poliovirus infection

In several cell types, poliovirus activates the apoptotic program, implementation of which is suppressed by viral antiapoptotic functions. In such cells, productive infection leads to a necrotic cytopathic effect (CPE), while abortive reproduction, associated with inadequate viral antiapoptotic functions, results in apoptosis. Here, we describe two other types of cell response to poliovirus infection. Murine L20B cells expressing human poliovirus receptor responded to the infection by both CPE and apoptosis concurrently. Interruption of productive infection decreased rather than increased the proportion of apoptotic cells. Productive infection was accompanied by the early efflux of cytochrome c from the mitochondria in a proportion of cells and by activation of DEVD-specific caspases. Inactivation of caspase-9 resulted in a marked, but incomplete, prevention of the apoptotic response of these cells to viral infection. Thus, the poliovirus-triggered apoptotic program in L20B cells was not completely suppressed by the viral antiapoptotic functions. In contrast, human rhabdomyosarcoma RD cells did not develop appreciable apoptosis during productive or abortive infection, exhibiting inefficient efflux of cytochrome c from mitochondria and no marked activation of DEVD-specific caspases. The cells were also refractory to several nonviral apoptosis inducers. Nevertheless, typical caspase-dependent signs of apoptosis in a proportion of RD cells were observed after cessation of viral reproduction. Such "late" apoptosis was also observed in productively infected HeLa cells. In addition, a tiny proportion of all studied cells were TUNEL positive even in the presence of a caspase inhibitor. Degradation of DNA in such cells appeared to be a postmortem phenomenon. Biological relevance of variable host responses to viral infection is discussed.     

Spontaneous development of bilateral subdural hematomas in an infant with benign infantile hydrocephalus: color Doppler assessment of vessels traversing extra-axial spaces

We present an infant with macrocrania, who initially demonstrated prominent extra-axial fluid collections on sonography of the brain, compatible with benign infantile hydrocephalus (BIH). Because of increasing macrocrania, a follow-up sonogram of the brain was performed; it revealed progressive enlargement of the extra-axial spaces, which now had echogenic debris. Color Doppler US showed bridging veins traversing these extra-axial spaces, so it was initially thought that these spaces were subarachnoid in nature (positive cortical vein sign). However, an arachnoid membrane was identified superior to the cortex, and there was compression of true cortical vessels beneath this dural membrane. An MRI of the brain showed the extra-axial spaces to represent bilateral subdural hematomas. The pathogenesis of spontaneous development of the subdural hematomas, in the setting of BIH, is discussed. We also emphasize that visualizing traversing bridging veins through extra-axial spaces does not necessarily imply that these spaces are subarachnoid in origin.     

Regulation of synaptic plasticity in a schizophrenia model

The pathology of schizophrenia is characterized by increased hippocampal activity at baseline and during auditory hallucinations. Animal-model studies in which the flow of activity to the hippocampus is increased through decreased amygdalar GABAergic inhibition have shown alterations of hippocampal circuitry similar to schizophrenia, but the functional importance of this phenomenon remains unclear. We provide evidence of decreased hippocampal feed-forward and tonic GABA-mediated inhibition in this animal model, complementing increased hippocampal activity seen in neuroimaging and postmortem studies. We demonstrate that GABA dysfunction increases long-term potentiation through activation of the cholinergic system, offering a new mechanism for pharmacological strategies of this disorder.     

Sequence-specific DNA strand cleavage by <Superscript>111</Superscript>In-labeled peptide nucleic acids

Peptide nucleic acids (PNAs) bind tightly and sequence-specifically to single- and double-stranded nucleic acids, and are hence of interest in the design of gene-targeted radiotherapeutics that could deliver the radiodamage to designated DNA and/or RNA sites. As a first step towards this goal, we developed a procedure for incorporation of Auger electron-emitting radionuclide (indium-111) into PNA oligomers and studied the efficiency of PNA-directed cleavage of single-stranded DNA targets. Accordingly, diethylene triamine penta-acetic acid (DTPA) was conjugated to the lysine-appended mixed-base PNAs and sequence-homologous DNA oligomer with a proper linker for comparative studies. By chelation of PNA-DTPA and DNA-DTPA conjugates with ¹¹¹In³⁺ in acidic aqueous solutions, ¹¹¹In-labeled PNA and DNA oligomers were obtained. Targeting of single-stranded DNA with PNA-DTPA-[¹¹¹In] conjugates yielded highly localized DNA strand cleavage; the distribution of breaks along the target DNA strand has two maxima corresponding to both termini of PNA oligomer. After 10–14 days, the overall yield of breaks thus generated within the PNA-targeted DNA by ¹¹¹In decay was 5–7% versus 2% in the case of control oligonucleotide DNA-DTPA-[¹¹¹In]. The estimated yield of DNA strand breaks per nuclear decay is ~0.1 for the PNA-directed delivery of ¹¹¹In, which is three times more than for the DNA-directed delivery of this radionuclide. This in vitro study shows that ¹¹¹In-labeled PNAs are much more effective than radiolabeled DNA oligonucleotides for site-specific damaging of DNA targets. Accordingly, we believe that PNA oligomers are promising radionuclide delivery tools for future antisense/antigene radiotherapy trials.