Exudative pericarditis due to secondary kidney amyloidosis--a case report

Non-infective pericarditis in some cases may be caused by secondary amyloidosis. Amyloidosis is a metabolic disorder in which amyloid protein is deposited in various organs and destroys them. The most frequent location of systemic amyloidosis are the kidneys. In this case study we report a 74-year-old man who was admitted to hospital due to very poor condition, generalised oedema and severe dyspnoea. Since 2003 the patient had been hospitalised many times due to pericarditis of unknown aetiology. In this case we diagnosed exudative pericarditis due to nephrotic syndrome caused by secondary kidney amyloidosis which occurs very rarely.     

Congestive heart failure and continuous murmur in patient after lumbar disc surgery--a case report

We present a case of a 61-year-old female who was admitted to the hospital with symptoms of congestive heart failure. Diagnosis of arteriovenous fistula was suggested by the echocardiographic signs of high-output state and a continuous murmur heard especially close to the surgical scar from an intervention on the L4-L5 disc that the patient had undergone eight months before. Aortography confirmed arteriovenous fistula between the right common iliac artery and inferior vena cava. After surgical closure of the fistula, normal cardiac function was restored.     

Intraneuronal Aβ immunoreactivity is not a predictor of brain amyloidosis-β or neurofibrillary degeneration

Amyloid β (Aβ) immunoreactivity in neurons was examined in brains of 32 control subjects, 31 people with Down syndrome, and 36 patients with sporadic Alzheimer’s disease to determine if intraneuronal Aβ immunoreactivity is an early manifestation of Alzheimer-type pathology leading to fibrillar plaque formation and/or neurofibrillary degeneration. The appearance of Aβ immunoreactivity in neurons in infants and stable neuron-type specific Aβ immunoreactivity in a majority of brain structures during late childhood, adulthood, and normal aging does not support this hypothesis. The absence or detection of only traces of reaction with antibodies against 4–13 aa and 8–17 aa of Aβ in neurons indicated that intraneuronal Aβ was mainly a product of α- and γ-secretases (Aβ_17–40/42). The presence of N-terminally truncated Aβ_17–40 and Aβ_17–42 in the control brains was confirmed by Western blotting and the identity of Aβ_17–40 was confirmed by mass spectrometry. The prevalence of products of α- and γ -secretases in neurons and β- and γ-secretases in plaques argues against major contribution of Aβ-immunopositive material detected in neuronal soma to amyloid deposit in plaques. The strongest intraneuronal Aβ_17–42 immunoreactivity was observed in structures with low susceptibility to fibrillar Aβ deposition, neurofibrillary degeneration, and neuronal loss compared to areas more vulnerable to Alzheimer-type pathology. These observations indicate that the intraneuronal Aβ immunoreactivity detected in this study is not a predictor of brain amyloidosis or neurofibrillary degeneration. The constant level of Aβ immunoreactivity in structures free from neuronal pathology during essentially the entire life span suggests that intraneuronal amino-terminally truncated Aβ represents a product of normal neuronal metabolism. This study was supported in part by funds from the New York State Office of Mental Retardation and Developmental Disabilities and grants from the National Institutes of Health (The National Institute of Child Health and Human Development R01 HD43960 and PO1 HD35897; and the National Institute of Aging P30 AG08051, AG03051, and PO1 AG11531).     

Inversion recovery single-shot TurboFLASH for assessment of myocardial infarction at 3 Tesla

PURPOSE: The aim of the study was to assess the diagnostic accuracy of imaging myocardial infarction with a single-shot inversion recovery turbofast low-angle shot (SS IR turboFLASH) sequence at 3.0 Tesla in comparison with an established segmented inversion recovery turboFLASH sequence at 1.5 Tesla. MATERIALS AND METHODS: Fifteen patients with myocardial infarction were examined at a 1.5 Tesla magnetic resonance (MR) System (Avanto, Siemens, Medical Solutions) and at a 3.0 Tesla MR system (TIM Trio, Siemens, Medical Solutions). Imaging delayed enhancement was started 15 minutes after application of contrast material. A SS IR turboFLASH was performed at 3.0 Tesla and compared with a segmented IR turboFLASH sequence at 1.5 and at 3.0 Tesla. The IR turboFLASH sequence at 1.5 Tesla served as reference method. Infarct volumes, contrast/noise ratio (CNR) of infarcted and normal myocardium were compared with the reference method. RESULTS: The Single-Shot IR turboFLASH technique allows imaging 9 slices during a single breath-hold. The CNR between infarction and normal myocardium of the reference method was 6.4 at 1.5 Tesla. The mean value of CNR of the IR turboFLASH sequence was 7.3 at 3.0 Tesla for the single-shot technique and 14.1 at 3.0 Tesla for the segmented technique. No significant difference was found for the CNR values of the reference technique at 1.5 Tesla and the single-shot technique at 3.0 Tesla, however for the comparison of the segmented technique at 1.5 and at 3 Tesla (P = 0.0001). The correlation coefficients of the infarct volumes, determined with the Single-Shot IR turboFLASH and the segmented IR turboFLASH technique at 3.0 compared with the reference method, were r = 0.95 (P < 0.0001) and r = 0.95 (P < 0.0001). CONCLUSION: The loss of CNR, which is caused by replacement of the segmented technique by the single-shot technique, is completely compensated by the approximately 2-fold CNR increase at the higher field strength. The IR turboFLASH technique at 3.0 Tesla IR can be used as a single-shot technique with acquisition of 9 slices during a single breath-hold without loss of diagnostic accuracy compared with the segmented technique at 1.5 Tesla.     

L-carnitine--metabolic functions and meaning in humans life

L-Carnitine is an endogenous molecule involved in fatty acid metabolism, biosynthesized within the human body using amino acids: L-lysine and L-methionine, as substrates. L-Carnitine can also be found in many foods, but red meats, such as beef and lamb, are the best choices for adding carnitine into the diet. Good carnitine sources also include fish, poultry and milk. Essentially, L-carnitine transports the chains of fatty acids into the mitochondrial matrix, thus allowing the cells to break down fat and get energy from the stored fat reserves. Recent studies have started to shed light on the beneficial effects of L-carnitine when used in various clinical therapies. Because L-carnitine and its esters help reduce oxidative stress, they have been proposed as a treatment for many conditions, i.e. heart failure, angina and weight loss. For other conditions, such as fatigue or improving exercise performance, L-carnitine appears safe but does not seem to have a significant effect. The presented review of the literature suggests that continued studies are required before L-carnitine administration could be recommended as a routine procedure in the noted disorders. Further research is warranted in order to evaluate the biochemical, pharmacological, and physiological determinants of the response to carnitine supplementation, as well as to determine the potential benefits of carnitine supplements in selected categories of individuals who do not have fatty acid oxidation defects.     

Prognostic Significance of Carbonic Anhydrase IX (CA-IX), Endoglin (CD105) and 8-hydroxy-2′-deoxyguanosine (8-OHdG) in Breast Cancer Patients

The aim of this study was to examine the prognostic significance of carbonic anhydrase IX (CA-IX), an endogenous marker for tumor hypoxia; endoglin (CD105), a proliferation-associated and hypoxia-inducible glycoprotein and 8-hydroxy-2′-deoxyguanosine (8-OHdG), an oxidative DNA lesion, in breast cancer patients. Immunohistochemical expressions of CA-IX, CD105 and 8-OHdG, analyzed on paraffin-embedded tumor tissues from forty female breast cancer patients, were used to assess their prognostic implication on overall survival (OS) and relapse-free survival (RFS). Patients with high CA-IX expression (above cut-off value) had a higher occurrence of relapse (P = 0.002). High CA-IX expression was significantly associated with shorter RFS (P < 0.001, hazard ratio (HR) 0.21) and shorter OS (P < 0.001, HR 0.19). Lymph node negative patients with high CA-IX expression had worse RFS (P = 0.031, HR 0.14) and OS (P = 0.005, HR 0.05). Patients with grade I&II tumors and high CA-IX expression showed shorter RFS (P = 0.028, HR 0.28) and OS (P = 0.008, HR 0.20). Worse OS (P = 0.046, HR 0.28) was found in subgroup of patients with grade II tumors and high CA-IX expression. Among all three markers, only high CA-IX expression was strong independent prognostic indicator for shorter OS (HR 4.14, 95% CI 1.28–13.35, P = 0.018) and shorter RFS (HR 3.99, 95% CI 1.38–11.59, P = 0.011). Elevated expression of CA-IX was an independent prognostic factor for decreased RFS and OS and a significant marker for tumor aggressiveness. CD105 had week prognostic value; whereas, 8-OHdG, in this study, did not provide sufficient evidence as a prognostic indicator in breast cancer patients.     

Synthesis and Cytotoxic Activity of Novel Amidine Analogues of Bis(2‐chloroethyl)amine

Novel nitrogen mustard agents 7 – 12 involving 4‐(N,N‐bis(2‐chloroethyl)aminophenyl)propylamine linked to a 5‐(4‐N‐alkylamidinophenyl)‐2‐furancarboxylic acid moiety by the formation of an amide bond have been synthesized, characterized, and evaluated for their in‐vitro cytotoxic activity against MDA‐MB‐231 and MCF‐7 human breast cancer cells. Evaluation of the cytotoxicity of 7 – 12 employing a MTT assay and inhibition of [³H]thymidine incorporation into DNA demonstrated that these compounds exhibit remarkable cytotoxic effects in comparison with 4‐[bis(2‐chloroethyl)amino]benzenebutanoic acid. Compounds 7 and 9 , which possess a cationic amidine and 4,5‐dihydro‐1H‐imidazol function moiety are approximately ten times more potent than 4‐[bis(2‐chloroethyl)amino]benzenebutanoic acid. The new compounds were evaluated as DNA topoisomerase II inhibitors. The cytotoxicity of the compounds 7 – 12 correlates with their DNA‐binding affinities and their relative potency as topoisomerase II inhibitors.     

Gene expression profile as a prognostic factor in high-grade gliomas

Some clinical factors have been useful in predicting prognosis in high-grade gliomas, however, unexpected differences in survival time have generated attempts to search for more precise parameters. It is clear that tumour behaviour depends mostly on gene alterations. Known single gene alterations failed to accurately define survival time, however, recently, the gene profiling based on microarray technology has raised hopes. Our aim was to assess whether the genetic predictor exceeds clinical parameters in the prognosis of malignant gliomas. We performed gene expression analysis of 28 gliomas (3 grade II, 10 grade III and 15 grade IV, according to WHO classification), and 5 control, normal brain samples, using Clontech oligonucleotide arrays with 3,757 known genes. The signal-to-noise statistics was used to separate classes, and the leave-one-out method was used to assess the smallest number of genes make it clear with a minimal cross-validation error. All gliomas, or only high-grade tumours, were clearly separated from the normal brain samples using 7 or 9 most differentially expressed genes. Hierarchical clustering failed, but the fuzzy c-means method was useful in high-grade gliomas to find a gene prediction model, which, with clinical factors, was assessed in survival analysis. Univariate analysis demonstrated that age, WHO grade (IV vs. III), radiation dose (> or = 50 Gy vs. 42 Gy), postoperative KPS score (100 points vs. others), neurological deficit as the first sign of the disease vs. others, and gene expression profile were significant predictors of survival. In multivariate analysis, the gene expression profile remained the only independent predictor (p = 0.007). Thus, our conclusion is that gene expression pattern predicts outcome in high-grade gliomas independently of other factors.     

Common-path intrinsically achromatic optical diffraction tomography

In this work we propose an open-top like common-path intrinsically achromatic optical diffraction tomography system. It operates as a total-shear interferometer and employs Ronchi-type amplitude diffraction grating, positioned in between the camera and the tube lens without an additional 4f system, generating three-beam interferograms with achromatic second harmonic. Such configuration makes the proposed system low cost, compact and immune to vibrations. We present the results of the measurements of 3D-printed cell phantom using laser diode (coherent) and superluminescent diode (partially coherent) light sources. Broadband light sources can be naturally employed without the need for any cumbersome compensation because of the intrinsic achromaticity of the interferometric recording (holograms generated by –1^st and +1^st conjugated diffraction orders are not affected by the illumination wavelength). The results show that the decreased coherence offers much reduced coherent noise and higher fidelity tomographic reconstruction especially when applied nonnegativity constraint regularization procedure.