Association of factor V Leiden mutation with delayed graft function, acute rejection episodes and long-term graft dysfunction in kidney transplant recipients

We analysed whether the factor V Leiden mutation--the most common hereditary predisposing factor for venous thrombosis--is associated with early and long-term graft dysfunction after kidney transplantation in 394 Caucasian kidney transplant recipients. The presence of factor V Leiden mutation was identified by allele specific PCR. The prevalence of the factor V Leiden mutation was compared to 32216 unselected neonates. The prevalence of the factor V Leiden mutation (GA genotype) was similar in 394 kidney transplant recipients and 32216 neonates. The frequency of known factors predicting long-term graft function were similar in patients with the GA genotype and with the normal factor V gene (GG genotype). The GA genotype was associated with the occurrence of no primary graft function (risk: 2.87: 95% confidence interval: 1.01-8.26; p < 0.05), the number of dialysis after transplantation in patients with no primary graft function until graft function (7.5 +/- 2.06 dialysis in GA patients; 4.2 +/- 0.36 dialyses in GG patients; p < 0.05), and the risk for at least one acute rejection episode (risk: 3.83; 95% confidence interval: 1.38-10.59; p < 0.02). The slope of l/creatinine per year was significantly lower in patients with the GA genotype (GA patients: -0.0204 +/- 0.008 dl/mg per year; GG patients: 0.0104 +/- 0.004 dl/mg per year; p < 0.02). The annual enhancement of the daily protein excretion rate was elevated in patients with the GA genotype (GA patients: 38.5 +/- 16.6 mg/24 h per year; GG patients: 4.9 +/- 4.4 mg/24 h per year; p < 0.02). Our study showed that the factor V Leiden mutation is associated with the occurrence of delayed graft function, acute rejection episodes and chronic graft dysfunction after kidney transplantation.     

Pet birds and risk of lung cancer in North-Western Germany

The relationship between non-small cell lung cancer and platelet counts, serum levels of vascular endothelial growth factor (VEGF) and endostatin, is unclear. Platelet counts and serum VEGF and endostatin levels were measured preoperatively in 99 patients with non-small cell lung cancer, and the relationship between these factors and clinicopathological features, including prognosis, was examined. Mean serum VEGF level was slightly higher in patients than in healthy subjects (P=0.23). Mean serum endostatin level was 42.4+/-40.4 ng/ml in patients compared to 16.3+/-10.3 ng/ml in healthy subjects (P=0.0003). Serum endostatin levels were significantly higher in patients with involvement greater than T2 or stage IB, compared to other patients. Platelet count and serum endostatin level greater than the median were associated with poor prognosis. Our results suggested that platelet count and serum endostatin level may be useful markers for non-small cell lung cancer.     

High expression of DNA topoisomerase IIalpha and Ki-67 antigen is associated with prolonged survival in glioblastoma patients

Assessment of tumour cell proliferation in glioblastoma (GB) has been a topic of considerable research interest over the past decade. However, the correlation of tumour proliferation and patient outcome has yielded controversial results. In this study, we examined immunohistochemically, using paraffin-embedded tissue, the expression of the proliferation-related markers DNA topoisomerase IIalpha (TIIalpha) and Ki-67 antigen in a cohort of 114 GB patients treated consecutively with surgery and radiochemotherapy, and correlated the expression with patient outcome. The TIIalpha labelling index (LI) ranged between 5.2 and 87.2% (median: 25.6%). Survival analysis disclosed an association between high TIIalpha expression levels and prolonged survival (P=0.040, log-rank test). TIIalpha expression correlates closely with Ki-67 labelling index (R=0.927, P<0.001), which itself is predictive of patient survival (P=0.044). However, in multivariate analysis, only the Karnofsky performance status remained predictive of patient survival. We conclude that high expression of TIIalpha and Ki-67 appears to be associated with a prolonged survival in our cohort of GB patients.     

Increased risk for cervical disease progression of French women infected with the human papillomavirus type 16 E6-350G variant.

To test the significance of human papillomavirus (HPV) type 16 and HPV16 E6 variants as risk factors for viral persistence and progression to high-grade lesion, we did a nested case-control study within a cohort study of >15,000 Caucasian French women. Three groups infected with high-risk HPV were compared: (a) women with cleared infection (controls, n = 201), (b) women with persistent infection (cases, n = 87), and (c) women who progressed into high-grade lesion (cases, n = 58). Women with persistent HPV infection and those that progressed into high-grade lesions were likelier to harbor HPV16 than other high-risk HPV types [odds ratio (OR), 2.4; 95% confidence interval (95% CI), 1.3-4.3 and OR, 4.2; 95% CI, 2.2-8.1, respectively]. Notably, especially elevated ORs of persistence (3.0; 95% CI, 1.4-6.7) and progression (6.2; 95% CI, 2.7-14.3) were found among women who harbored the HPV16 350G variant. Thus, HPV type and HPV16 variant seem to be risk factors for viral persistence and progression of infections into high-grade cervical lesions.     

Clinical features of the spinal form of multiple sclerosis

Out of a data pool of 1271 patients with Multiple Sclerosis (MS) a total of 109 cases are selected having a sole spinal symptomatology throughout the course of the disease. This group differs in three particular features from the non-spinal forms of MS: In this group there is a higher percentage of females, the age at onset of the disease is higher, and the course of the disease is more often chronic progressive from the beginning. After the mean duration of 11 years, the spinal and the non-spinal cases show the same grade of disability. The ability to work is slightly better for spinal cases; office workers are able to keep their jobs longer after the onset to the disease than patients with any other occupation. The spinal form of MS is discussed in respect to its relationship to the classical form of MS and as a differential diagnosis to other spinal processes.     

Behandlungsergebnisse bei Aplasien im Frontzahngebiet

Zusammenfassung Bei einer Patietenzahl von 3055 wurden in 133 Fällen, das sind 4,35%, Nichtalagen einer oder mehrerer Frontzähne festgestellt. Die verschiedenen Behandlungsmöglickeiten, die ausschließlich kieferorthopädische und die kieferorthopädisch-prothetische, fanden Berücksichtigung. Es zeigte sich, daß nicht tramer die rein kieferorthopädische Therapie zum besten Behandlungsergebnis geführt hat, sondern daß man der Stellung des Eckzahnes besondere Beachtung schenken muß. Die Frage der Ausgleichsextraktion muß ebenso sorgfiltig bei der Planung bedacht werden. Verzichter man auf diese, sollte eine Distalokklusion von 1 Pb angestrebt werden. Ziel einer jeden Behandlung sollte die geschlossene Zahnreihe, vergesellschaftet mit einem funtkionellen und ästischen Optimum, sein.

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Summary Follwing a survey of 3.055 patients, 133 or 4,35% were found to have one or more front teeth missing. When comparing the different prosthetic and orthodontic methods used, it was found that orthodontic arethods by themselves do not always show the best results. The position of the canines is especially importaut as also is the question of balancing extractions when considering the functional and aesthetic reslts.

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Résumé Parmi 3.0355 patients, on a décelé chez 133 d'entre eux (soit le 4,35 %) l'absence d'une ou plusieurs dents antérieures. On aussi envisagé les différentes possibilités de traitement, soit exclusivement orthopodique dento-fciale, soit mi-orthopédique. Ce n'est pas toujours la seule orthopédie dento-faciale qui a donné les meilleurs résultats d'une part, et il faut faire bien attention à la position de la canine d'autre part. La question d'une extraction compensatoire doit être bien étudiée dans le plan de traitement. Y renonce-t-on, qu'il devient avantageux de recourir à une distoclusion d'une largeur de prémolatre. Le but de traitement tend à supprimer toute solution de continuité au niveau de l'arcade dentaire et à obtenir le meilleur résultat fonctionnel et esthétique.

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Mit 10 Abbildungen     

Differential alterations by chronic treatment with morphine of pro-opiomelanocortin mRNA levels in anterior as compared to intermediate pituitary lobes of rats

Chronic treatment of rats with morphine by implantation of pellets over a period of 10 days resulted in a differential alteration of pro-opiomelanocortin (POMC) mRNA levels in individual pituitary lobes: Hybridisation studies using a 32P-labelled mouse POMC cDNA fragment of 150 bases as a probe revealed that chronic morphine treatment causes about 50% enhancement of POMC mRNA levels in the anterior lobe and about 40% decrease in the intermediate lobe of the pituitary. Significant changes were observed 3 days following commencement of administration and persisted over the rest of the morphine treatment.     

The limbus spiralis and its relationship to the developing tectorial membrane in the cochlear duct of the guinea pig fetus

Summary The development of the interdental cells of the limbus spiralis and of the inner spiral sulcus cells as well as the formation of the mesenchymal teeth of Huschke are described during fetal life up to the day of birth in the guinea pig. Additionally, the changes of the developing tectorial membrane are studied. The ultrastructural observations allow the conclusion that during fetal development at least a considerable part of the material of the tectorial membrane is secreted by the interdental cells of the limbus spiralis.Supported by Deutsche Forschungsgemeinschaft     

Inhalation of concentrated particulate matter produces pulmonary inflammation and systemic biological effects in compromised rats

Although significant progress has been made over the past few years, there is still debate on the causal fractions that are responsible for particulate matter (PM)-associated adverse health effects. A series of 1-d inhalation exposures to concentrated ambient particles (CAPs) were performed in compromised rats, focusing on pulmonary inflammation and changes in blood factors as biological outcomes. Studies were carried out in The Netherlands at an urban background location in Bilthoven, an industrialized location in the city of Utrecht, as well as at a location that is heavily dominated by freeway emissions. It was hypothesized that exposure to CAPs resulted in oxidative stress in the lung, producing a release of inflammatory mediators, which in turn can result in cardiovascular effects. Both spontaneously hypertensive rats and rats preexposed to ozone were studied. The effects were studied at 2d postexposure, focusing on pathology and cell proliferation, bronchoalveolar lavage fluid (BALF) analysis (including cytokines, biochemistry, cell differentials, cell viability and proliferation, and Clara-cell 16 protein), and blood analyses (fibrinogen, Clara-cell 16 protein, Von Willebrand factor, and cell differentials). Using CAPs exposures as a binary term, mild inflammation (increased numbers of neutrophils) and increased lung permeability (protein and albumin leakage in BALF) were evident. In addition, CAPs also produced increased fibrinogen concentrations in blood of spontaneously hypertensive rats. In conclusion, inhalation up to 3700 microg/m3 CAPs in the size range of 0.15-2.5 microm did induce statistically significant effects in the lung and blood, but the effects observed may not potentially be very biologically relevant. PM mass concentrations and lung permeability were weakly associated. This suggests that other PM metrics might be more appropriate.