YKL-40, a Novel Marker of Cardiovascular Complications,Is Related to Kidney Function in Heart Transplant Recipients

Background

YKL-40 is an inflammatory glycoprotein involved in endothelial dysfunction and expressed in macrophages in the earliest lesions of atherosclerosis. Elevated serum YKL-40 levels are independently associated with the presence and extent of coronary artery disease and cardiovascular mortality. Because there are no data on heart transplant recipients and because they are prone to cardiovascular complications, the aim of this study was to assess YKL-40 in this population with particular attention to its relationship with endothelial damage. We studied 84 patients after heart transplantation. Healthy volunteers served as control subjects.

Methods

Complete blood count, urea, creatinine, lipids, fasting glucose, N-terminal pro–B-type natriuretic peptide (NT-proBNP), and iron status were studied with the use of standard laboratory methods. We assessed YKL-40, copeptin, markers of inflammation high sensitivity C-reactive protein (hsCRP) and interleukin (IL) 6, and markers of endothelial cell injury von Willebrand factor (vWF) and midkine with the use of commercially available assays.

Results

Mean levels of YKL-40, IL-6, vWF, and hsCRP were significantly higher in heart allograft recipients than in the control group (P < .001). In univariate analysis, YKL-40 was related to kidney function (creatinine, r = 0.63 [P < .001]; estimated glomerular filtration rate, r = −0.44 [P < .001]), NT-proBNP (r = 0.45; P < .001), age (r = 0.33; P < .01), time after transplantation (r = 0.23; P < .05), copeptin (r = −0.42; P < .001), soluble transferrin receptor (r = 0.24; P < .05), hemoglobin (r = −0.42; P < .001), transferrin (r = −0.31; P < .01), haptoglobin (r = 0.39; P < .001), cystatin C (r = 0.55; P < .001), ejection fraction (r = −0.28; P < .05), New York Heart Association functional class (r = −0.41; P < .01), hsCRP (r = 0.26; P < .05), IL-6 (r = 0.23; P < .05), vWF (r = −0.40; P < .001), and midkine (r = 0.33; P < .01). In multivariate analysis, only creatinine was found to be a predictor of YKL-40 (β = 0.59; P = .02), explaining 56% of the variation in YKL-40 levels in heart allograft recipients.

Conclusions

YKL-40 may contribute to the enhanced risk of cardiovascular complications mainly owing to impaired renal function in patients after heart transplantation.     

Contamination Resulting From Aerosolized Fluid During Laparoscopic Surgery

Background and Objectives:

Aerosolized droplets of blood can travel considerable distances on release of intra-abdominal pressure during laparoscopic surgery. This creates an environmental hazard for members of the surgical team. This study describes and provides a method of measurement of aerosolized blood contamination during evacuation of the pneumoperitoneum in laparoscopic surgery.

Methods:

Samples were measured by removing a trocar from the abdomen while a pneumoperitoneum of 15 mm Hg was present. A white poster board was placed 24 inches above the incision to catch the released blood spatter. By use of machine vision, luminol fluorescence, and computerized spatial analysis, data from the boards were recorded, analyzed, and scored based on the distance, size, and quantity of particulate contamination.

Results:

We analyzed 27 boards. Spatter was present on every board. The addition of luminol to the boards increased the amount of visible spatter. Most tests created <1000 blood spatters. Fluids are typically ejected as a fine mist. Every test included at least 1 blood spatter. The range of the average blood spatter size was 0.53 × 10^–3 to 7.11 × 10^–3 sq in. The amount of spatter detected did not show any apparent correlation with the patient''s body mass index, the estimated blood loss, or the type of operation performed.

Conclusions:

Evacuation of the pneumoperitoneum during laparoscopic surgery results in consistent contamination. Most blood spatter is not visible to the naked eye. Our results suggest that all surgical participants should wear appropriate protective barriers and conscious measures should be undertaken to prevent environmental contamination during pneumoperitoneal evacuation.     

Electrical Property Analysis of Textured Ferroelectric Polycrystalline Antimony Sulfoiodide Using Complex Impedance Spectroscopy

Antimony sulfoiodide (SbSI) is a ferroelectric semiconductor with many interesting physical properties (optical, photoconductive, ferroelectric, piezoelectric, etc.). The electrical properties of textured polycrystalline SbSI obtained by the rapid cooling of a melted mass in liquid nitrogen are presented in this work using ac impedance spectroscopy over a wide temperature range (275–500 K) in the frequency range of 1 Hz to 100 kHz. Detailed studies of the impedance Z*(ω), conductivity σ*(ω), electric modulus M*(ω), and dielectric permittivity ε*(ω) of this material were performed using complex impedance spectroscopy for the first time. This study showed that the impedance and related parameters are strongly dependent on temperature. The internal domain structure and the presence of grain boundaries in textured polycrystalline SbSI explain the obtained results.     

Dehydroxylation of Perlite and Vermiculite: Impact on Improving the Knock-Out Properties of Moulding and Core Sand with an Inorganic Binder

The article presents the results of research aimed at examining the type of swelling material introduced into moulding or core sand to improve their knock-out properties. Tests on Slovak perlite ore (three grain sizes), Hungarian perlite ore and ground vermiculite (South Africa) were carried out. For this purpose, thermal and structural analyses (FTIR—Fourier Transform Infrared Spectroscopy), a chemical composition test (XRF-X-Ray Fluorescence), phase analysis (XRD—X-Ray Diffraction), and scanning electron microscopy (SEM—Scanning Electron Microscope) as well as final strength tests of moulding sands with the addition of perlite ore and vermiculite were carried out. The results of thermal studies were related to IR (Infrared Spectroscopy) spectra and XRD diffractograms. It has been shown that the water content in the pearlite ore is almost three times lower than in vermiculite, but the process of its removal is different. Moreover, the chemical composition of the perlite ore, in particular the alkali content and its grain size, may influence its structure. The phenomena of expansion (perlite) and peeling (vermiculite) have a positive effect on the reduction of the final sand strength and eliminate technological inconveniences (poor knocking out) that significantly limit the wide use of moulding sands with inorganic binders.     

Malignant neoplasms of the pancreas. A study based on autopsy data from 1953 to 1982 in Bialystok, Poland. II. A survey of 195 cases

Among 195 malignant neoplasms of the pancreas (MNP) diagnosed at autopsy in 1953--1982 the exocrine carcinomas comprised 85.6% and inmular carcinomas 13.8% of cases. MNP were localized most frequently in the head of the pancreas (54.4%), then in the whole pancreas in 14.9%, in the head and the body or in the body and the tail in 20.5%, in the body or in the tail in 10.3% of MNP. There were no infiltrations and no metastases in other organs only in 16 patients (8.2% of MNP). The biliary tracts and duodenum were the most frequent sites of secondary infiltrations. Metastases were most frequent in the liver, then in the liver hilus and mesentery lymph nodes. The concordance of clinical and post mortem diagnosis of MNP was stated in 40.5% cases.