Renal function and morphology in Sudanese patients with advanced hepatosplenic schistosomiasis and portal hypertension

The association between glomerular disease and hepatosplenic schistosomiasis is well documented in reports from South America. During the present hospital investigation in Sudan, 58 patients admitted for intercurrent complications of advanced hepatosplenic schistosomiasis were studied. The patients, median age 35 years, had no concurrent Schistosoma haematobium infection. Diagnostic criteria included an enlarged spleen (n = 58), at least 1 episode of hematemesis (n = 55) and/or melena (n = 36), endoscopical demonstration of gastroesophageal varices (29/29 studied), ultrasonographical imaging of hepatic periportal fibrosis (18/18 studied), and intraoperative liver biopsy with characteristic histological findings (11/16 biopsied). Serum creatinine, urea, electrolytes, cholesterol, total protein, and electrophoresis were within normal limits. Median urinary protein/creatinine ratio was 0.06 and thereby not significantly different from European reference values. Only 1 patient had proteinuria of 1.7 g/l. Minimal hematuria was found in 5 patients. Ten kidney biopsies were taken intraoperatively during a portal decompression procedure (Hassab operation). Light, immunofluorescence, and electron microscopy produced no evidence of glomerulonephritis. These findings indicate that S. mansoni induced nephrotic syndrome may be less frequent in Sudan than in South America. Renal involvement due to S. mansoni infection may therefore encompass geographical variances.     

Differences in the reactivities of human urokinase and the porcine tissue plasminogen activator.

It has previously been shown, that large differences exist between the effects of 6-aminohexanoic acid or alpha1-antitrypsin on fibrinolysis caused by a porcine tissue plasminogen activator or by human urokinase, while insignificant differences exist between the effects of a number of natural protease inhibitors on fibrinolysis caused by the two types of plasminogen activator. The present study shows that changes in substrate composition (pH, ionic strength fibrinogen concentration, plasminogen concentration) may influence to different degrees the fibrinolytic activities of human urokinase and the porcine tissue plasminogen activator. It is suggested, that this finding is partly related to marked differences in affinity for fibrin of the two activators.     

Degenerate mode band-pass birdcage coil for accelerated parallel excitation.

An eight-rung, 3T degenerate birdcage coil (DBC) was constructed and evaluated for accelerated parallel excitation of the head with eight independent excitation channels. Two mode configurations were tested. In the first, each of the eight loops formed by the birdcage was individually excited, producing an excitation pattern similar to a loop coil array. In the second configuration a Butler matrix transformed this "loop coil" basis set into a basis set representing the orthogonal modes of the birdcage coil. In this case the rung currents vary sinusoidally around the coil and only four of the eight modes have significant excitation capability (the other four produce anticircularly polarized (ACP) fields). The lowest useful mode produces the familiar uniform B(1) field pattern, and the higher-order modes produce center magnitude nulls and azimuthal phase variations. The measured magnitude and phase excitation profiles of the individual modes were used to generate one-, four-, six-, and eightfold-accelerated spatially tailored RF excitations with 2D and 3D k-space excitation trajectories. Transmit accelerations of up to six-fold were possible with acceptable levels of spatial artifact. The orthogonal basis set provided by the Butler matrix was found to be advantageous when an orthogonal subset of these modes was used to mitigate B(1) transmit inhomogeneities using parallel excitation.     

Exercise behavior in cancer survivors and associated factors

Introduction  

Physical activity is an important component in promoting a healthy life style in cancer survivors. We estimated the proportion of cancer survivors who are physically active, defined as meeting public health exercise guidelines, and changes in level of physical activity (LPA) from before diagnosis to after treatment. We also identified medical and demographic factors associated with LPA and its changes.     

Analysis of genes encoding laminin β2 and related proteins in patients with Galloway–Mowat syndrome

Galloway-Mowat syndrome (GMS) is a rare autosomal recessive disorder characterized by early onset nephrotic syndrome and microcephaly with various anomalies of the central nervous system. GMS likely represents a heterogeneous group of disorders with hitherto unknown genetic etiology. The clinical phenotype to some extent overlaps that of Pierson syndrome (PS), which comprises congenital nephrotic syndrome and distinct ocular abnormalities but which may also include neurodevelopmental deficits and microcephaly. PS is caused by mutations of LAMB2, the gene encoding laminin beta2. We hypothesized that GMS might be allelic to PS or be caused by defects in proteins that interact with laminin beta2. In a cohort of 18 patients with GMS or a GMS-like phenotype we therefore analyzed the genes encoding laminin beta2 (LAMB2), laminin alpha5 (LAMA5), alpha3-integrin (ITGA3), beta1-integrin (ITGB1) and alpha-actinin-4 (ACTN4), but we failed to find causative mutations in these genes. We inferred that LAMA5, ITGA3, ITGB1, and ACTN4 are not directly involved in the pathogenesis of GMS. We excluded LAMB2 as a candidate gene for GMS. Further studies are required, including linkage analysis in families with GMS to identify genes underlying this disease.     

Preterm Birth in Caucasians Is Associated with Coagulation and Inflammation Pathway Gene Variants

Spontaneous preterm birth (<37 weeks gestation—PTB) occurs in ~12% of pregnancies in the United States, and is the largest contributor to neonatal morbidity and mortality. PTB is a complex disease, potentially induced by several etiologic factors from multiple pathophysiologic pathways. To dissect the genetic risk factors of PTB a large-scale high-throughput candidate gene association study was performed examining 1536 SNP in 130 candidate genes from hypothesized PTB pathways. Maternal and fetal DNA from 370 US Caucasian birth-events (172 cases and 198 controls) was examined. Single locus, haplotype, and multi-locus association analyses were performed separately on maternal and fetal data. For maternal data the strongest associations were found in genes in the complement-coagulation pathway related to decidual hemorrhage in PTB. In this pathway 3 of 6 genes examined had SNPs significantly associated with PTB. These include factor V (FV) that was previously associated with PTB, factor VII (FVII), and tissue plasminogen activator (tPA). The single strongest effect was observed in tPA marker rs879293 with a significant allelic (p=2.30×10⁻³) and genotypic association (p=2.0×10⁻⁶) with PTB. The odds ratio (OR) for this SNP was 2.80 [CI 1.77–4.44] for a recessive model. Given that 6 of 8 markers in tPA were statistically significant, sliding window haplotype analyses were performed and revealed an associating 4 marker haplotype in tPA (p=6.00×10⁻³). The single strongest effect in fetal DNA was observed in the inflammatory pathway at rs17121510 in the interleukin-10 receptor antagonist (IL-10RA) gene for allele (p=0.01) and genotype (p=3.34×10⁻⁴). The OR for the IL-10RA genotypic additive model was 1.92 [CI 1.15–3.19] (p=2.00×10⁻³). Finally, exploratory multi-locus analyses in the complement and coagulation pathway were performed and revealed a potentially significant interaction between a marker in FV (rs2187952) and FVII (rs3211719) (p<0.001). These results support a role for genes in both the coagulation and inflammation pathways, and potentially different maternal and fetal genetic risks for PTB.     

Enhancement of Isometric Ankle Dorsiflexion by Automyoelectrically Controlled Functional Electrical Stimulation on Subjects with Upper Motor Neuron Lesions

The objective of this study was to test myoelectrically controlled functional electrical stimulation of the same muscle (AutoMCS) on patients with either stroke or spinal cord injury. The paretic anterior tibialis (TA) muscle was stimulated with an amplitude controlled continuously by the volitional myoelectric signal from the same muscle. Surface electrodes were used and volitional myoelectric signals were extracted by analog/digital signal processing techniques. Isometric dorsiflexion torque of the foot was displayed on a screen and the subjects were asked to track a sinusoidal curve. Subjects with dropped foot, as a result of a stroke (CVA, n = 9) or spinal cord lesion (SCI, n = 4), performed tests without and then with AutoMCS applied to the muscle. Subjects were their own control and tracking tests without and with AutoMCS. Changes in torque range, tracking delay, and tracking control accuracy have been evaluated. A significant (p < 0.05) increase of dorsiflexion torque by AutoMCS was found. An immediate carryover effect was seen in one stroke subject. The analysis of the tracking control showed only little loss of controllability with the system. We conclude that for selected subjects this method can instantly increase the muscle force of the anterior tibialis without significantly compromising tracking control or tracking delay.