Reference values from M-mode and Doppler echocardiography for normal Syrian hamsters.

AIMS: Echocardiography has recently been introduced to small animal research, allowing serial measurements of cardiac diseases. In addition, the hamster model has been increasingly used, as it mimics many human heart conditions. However, no reference range of echocardiographic values reflecting normal left ventricular (LV) function exists for hamsters. The purpose of this study was to provide one. METHODS AND RESULTS: The study group consisted of 118 10-week-old, female, Syrian golden hamsters, which underwent high-resolution echocardiography. LV mass was calculated using the corrected cube formula, and LV systolic and diastolic function were assessed by fractional shortening and mitral inflow pulsed-wave Doppler, respectively. The myocardial performance index (MPI) measured the time spent in isovolumic activity and reflected both systolic and diastolic function. The mean+/-SD LV mass, fractional shortening, and MPI were 0.19+/-0.04 g, 44.7+/-6.6%, and 0.39+/-0.1, respectively. E and A waves were differentiated in 52% of all animals. Logistic regression adjusted with a cutoff of 378 bpm revealed that the risk of E/A wave fusion was 35 times greater (95% CI: 12.6; 98.4) in animals with a heart rate >378 bpm. CONCLUSION: This study documents echocardiographic characteristics in normal Syrian hamsters, which can be used as control values for future studies.     

Two- and three-dimensional prenatal sonographic diagnosis of hepatic cysts

We describe the 2-dimensional and 3-dimensional multiplanar sonographic diagnosis and characterization of isolated hepatic cysts in 2 fetuses. Two-dimensional imaging of a fetus at 36 weeks' gestation revealed 2 right upper quadrant cystic masses anterior to the gallbladder, demonstrating no peristalsis or blood flow. Postnatal sonographic examination confirmed 2 simple hepatic cysts. Two- and three-dimensional sonograms suggested 2 hepatic cysts in a 23-week-old fetus that resolved by 33 weeks' gestation. In reporting 2 unusual cases of prenatally diagnosed fetal hepatic cysts, we also demonstrate the diagnostic use of 3-dimensional multiplanar imaging.     

Locus on chromosome 6p linked to elevated HDL cholesterol serum levels and to protection against premature atherosclerosis in a kindred with familial hypercholesterolemia

Heterozygous familial hypercholesterolemia (FH) is a highly atherogenic genetic disorder leading to premature coronary heart disease (CHD), usually before 60 years of age. We studied an extended multigenerational kindred with FH linked to chromosome 1p32 in which atherosclerotic complications were either delayed or prevented in individuals with elevated HDL cholesterol (HDL-C) levels or hyperalphalipoproteinemia (HA). Premature CHD was observed in FH individuals without HA. The study of this family established that the HA trait in the family also followed an autosomal dominant mode of inheritance with a pattern of segregation independent from FH. We identified a locus on chromosome 6 linked to elevated HDL-C levels (HA) in this family. Haplotype analysis refined the localization to a 7.32-cM interval (73 to 80 cM from pter) flanked by markers D6S1280 and D6S1275. Parametric 2-point and multipoint analyses yielded maximum LOD scores of 3.05 and 3.17, respectively. This finding was confirmed with a nonparametric multipoint score of 3.78 (P=0.0009). We propose that this locus, linked to elevated HDL-C levels, confers protection against premature CHD within an FH context.     

Myeloma management guidelines: a consensus report from the Scientific Advisors of the International Myeloma Foundation

These consensus guidelines have been compiled with input from the Scientific Advisors of the International Myeloma Foundation. Their production involved several steps including: A 3-day Scientific Advisors meeting, during which each specific area was presented and discussed (May 2002). Review of key literature, especially randomized study results, but also Medline, Internet, Cochrane database searches, and prior guidelines (Br J Haematol 115: 522-540, 2001). Feedback from patients participating in the International Myeloma Foundation, patient programs. These guidelines encompass both the published literature and expert opinions. Recommendations based upon expert opinions are identified as such. The intent is for the guidelines to be international in scope, plus provide recommendations for both clinical practice and research approaches. 'Consensus' reflects general, although not necessarily unanimous, agreement. Details are discussed as appropriate. For convenience, the recommendations are divided into: 1. Diagnostic criteria. 2. Staging and prognostic factors. 3. Frontline therapy. 4. High-dose therapy and transplant. 5. Maintenance therapy. 6. Supportive care and management of specific complications. 7. Novel therapies and new technologies.     

Personality and metabolic syndrome

The prevalence of metabolic syndrome has paralleled the sharp increase in obesity. Given its tremendous physical, emotional, and financial burden, it is of critical importance to identify who is most at risk and the potential points of intervention. Psychological traits, in addition to physiological and social risk factors, may contribute to metabolic syndrome. The objective of the present research is to test whether personality traits are associated with metabolic syndrome in a large community sample. Participants (N = 5,662) from Sardinia, Italy, completed a comprehensive personality questionnaire, the NEO-PI-R, and were assessed on all components of metabolic syndrome (waist circumference, triglycerides, high-density lipoprotein cholesterol, blood pressure, and fasting glucose). Logistic regressions were used to predict metabolic syndrome from personality traits, controlling for age, sex, education, and current smoking status. Among adults over age 45 (n = 2,419), Neuroticism and low Agreeableness were associated with metabolic syndrome, whereas high Conscientiousness was protective. Individuals who scored in the top 10% on Conscientiousness were approximately 40% less likely to have metabolic syndrome (OR = 0.61, 95% CI = 0.41–0.92), whereas those who scored in the lowest 10% on Agreeableness were 50% more likely to have it (OR = 1.53, 95% CI = 1.09–2.16). At the facet level, traits related to impulsivity and hostility were the most strongly associated with metabolic syndrome. The present research indicates that those with fewer psychological resources are more vulnerable to metabolic syndrome and suggests a psychological component to other established risk factors.     

Hydrogen Embrittlement of the Additively Manufactured High-Strength X3NiCoMoTi 18-9-5 Maraging Steel

The main aim of this study was to determine the susceptibility of the additively manufactured high strength X3NiCoMoTi 18-9-5 maraging steel to hydrogen embrittlement. For this purpose, samples produced by selective laser melting technology, before and after heat treatment, were used. The examined samples were electrochemically charged with hydrogen in NaCl + NH₄SCN solution at a current density of 50 mA/cm² for 24 h. The H content increased from about 1 to 15 ppm. Heat treatment did not affect the amount of H trapped in the maraging steel. Tensile testing revealed that the tensile strength of the H-charged samples was much lower than that of the uncharged samples. Moreover, the material became brittle after charging compared to the ductile as-printed and heat-treated samples with elongation values of 7% and 2%, respectively. The loss of plasticity was confirmed by fractography, which revealed transformation of the fracture surface morphology from dimple-like in the as-produced state to a brittle one with smooth facets in the H-charged state.     

Safety and feasibility of transradial coronary angioplasty in elderly patients.

BACKGROUND: The aim of this study was to assess the safety, feasibility and efficacy of transradial coronary angioplasty in elderly (> or = 70 years) vs younger patients (< 70 years). METHODS: We studied 1125 consecutive patients submitted to transradial coronary angioplasty by a single operator. An angiography of the arteries of the upper limbs was performed before and after the procedure. The presence of the radial pulse was assessed at 1 month of follow-up. RESULTS: At angiography, elderly patients (n = 323) were found to have a higher incidence of radial and brachiocephalic trunk anatomical tortuosity compared to younger subjects (35.3 vs 17.3%, p < 0.05; 10.5 vs 5.3%, p < 0.05, respectively). Radial access was successful in 98.8% of elderly and in 99% of younger patients (p = NS). The procedural success by radial access did not significantly differ between the two groups (97.5 vs 98.7%; p = NS). The cannulation time (from skin anesthesia to arterial cannulation) and the total procedure time (from patient arrival at the catheterization room to the completion of the procedure) were not significantly different between the two groups (1.5 +/- 0.8 vs 1.6 +/- 0.4 min, p = NS; 57 +/- 23 vs 56 +/- 12 min, p = NS, respectively). There were no access site bleeding complications in younger and only one (0.4%) such a complication in elderly patients. In all patients, there was no case of forearm ischemia and the incidence of asymptomatic loss of the radial pulse during the 30-day follow-up period was not different between the two groups (1.5 vs 1.4%, p = NS). CONCLUSIONS: Performed by experienced operators, transradial access constitutes a safe and feasible approach for coronary angioplasty in elderly patients. The results are similar to those observed in younger patients.     

Human T cell lymphotropic virus (HTLV) type-1-specific CD8+ T cells: frequency and immunodominance hierarchy

Human T cell lymphotropic virus type 1 (HTLV-1) causes HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). We used interferon- gamma enzyme-linked immunospot assays with overlapping peptides spanning the entire HTLV-1 proteome to test whether the HTLV-1-specific CD8(+) T cells differed significantly in frequency or immunodominance hierarchy between patients with HAM/TSP and asymptomatic carriers and whether the frequency correlated with provirus load. Tax was the immunodominant target antigen. There was no significant qualitative or quantitative difference in the HTLV-1-specific CD8(+) T cell response between the 2 groups. Virus-specific CD8(+) T cell frequency alone does not indicate the effectiveness of the cytotoxic T lymphocyte response in controlling provirus load at equilibrium.     

A comparison of the effects of raloxifene and conjugated equine estrogen on bone and lipids in healthy postmenopausal women

BACKGROUND: Although many studies have assessed the effects of estrogen and raloxifene hydrochloride on bone mineral density and serum lipid concentrations, there are few direct comparative data. METHODS: Randomized placebo-controlled trial for 3 years, intention-to-treat analysis. Six hundred nineteen postmenopausal women with prior hysterectomy (mean age, 53.0 years) were studied in 38 centers in Europe, North America, Australasia, and South Africa. They were randomized to 60 mg/d or 150 mg/d of raloxifene, 0.625 mg/d of conjugated equine estrogen (CEE), or placebo. Bone density of the lumbar spine and proximal femur, biochemical markers of bone turnover, and fasting serum lipid concentrations were assessed for 3 years. RESULTS: Compared with baseline, bone density in the lumbar spine progressively declined by 2.0% in the placebo group (P <.05), was stable in the 2 raloxifene groups, and increased 4.6% in the subjects receiving CEE (P <.001). Effects in both raloxifene groups were different from those observed in the CEE and placebo groups (P <.001). Bone density in the total hip showed similar results. Conjugated equine estrogen produced significantly greater depression of serum osteocalcin, bone-specific alkaline phosphatase, and urine C-telopeptide, compared with raloxifene. Each of the active treatments caused comparable depression of low-density lipoprotein cholesterol below placebo levels (P <.001 at most time points). Raloxifene did not affect high-density lipoprotein cholesterol, whereas CEE increased it by 13.4% compared with placebo at 3 years (P <.001). Triglyceride concentrations increased 24.6% in the CEE group at 3 years (P <.003), a significantly greater change than in the raloxifene groups, which were 4.9% and 8.0% above baseline (P < or =.002) but not different from placebo. Urinary incontinence was reported in 11 women receiving CEE, but in only 1 or 2 in each of the other groups (P < or =.01 compared with the other groups). Hernias occurred less frequently in those receiving 150 mg/d of raloxifene or CEE (P =.03 vs placebo). CONCLUSIONS: Raloxifene and CEE have beneficial effects on bone density and bone turnover, although effects of CEE are more marked. Raloxifene and CEE produce different patterns of lipid responses and have distinct adverse effect profiles.