Lungenembolierisiko nach intravenöser Heparin-Prophylaxe beim polytraumatisierten Patienten

Zusammenfassung Das Risiko thromboembolischer Komplikationen ist beim Polytrauma infolge verschiedener pathophysiologischer Vorgänge erhöht. Ziel dieser Studie war es den Einfluß einer kontinuierlichen IV Heparin-Prophylaxe (10 000 IE/24h) beim Polytrauma zu untersuchen. Retrospektiv wurden 72 obduzierte Todesfälle von 373 Polytraumen aus den Jahren 1984 und 1985 analysiert. Bei einem Patienten waren multiple periphere Makrolungenembolien für den Tod mitverantwortlich. Fulminante Lungenembolien, Becken- und tiefe Beinvenenthrombosen wurden im Sektionsgut nicht gefunden.

---

Rate of pulmonary embolism after IV heparin prophylaxis in multiple trauma patients

Summary The risk of thrombo-embolic complications in multiple injured patients is increased due to several pathophysiological factors. The purpose of this study was to analyse the effect of a continuous IV heparin prophylaxis (10000IE/24h) in polytraumatized patients. A post-mortem evaluation of 72 deceased patients out of 373 multiple trauma patients treated during 1984–1985 was performed. In one patient multiple major pulmonary emboli were found to contribute to his death. No deep vein thrombosis as well as no fulminant pulmonary embolism were found in any case.

     

Transgenic flavonoid tomato intake reduces C-reactive protein in human C-reactive protein transgenic mice more than wild-type tomato

The increased consumption of fruits and vegetables is associated with reduced cardiovascular disease. The molecular basis of this health effect is not fully understood, yet dietary flavonoids are thought to play an important role. Genetic engineering has enabled us to overexpress specific flavonoids (flavones and flavonols) in tomato fruit. Human C-reactive protein transgenic (CRPtg) mice express markers of cardiovascular risk that allow us to study of the putative health effects of wild-type tomato (wtTom) and flavonoid-enriched tomato (flTom). In this study, we analyzed whether consumption of wtTom, at a dose achievable with a human diet, has beneficial effects on cardiovascular risk markers and whether flTom may enhance such effects. CRPtg mice were fed a diet containing 4 g/kg wtTom, flTom peel, vehicle, or 1 g/kg fenofibrate, which reportedly reduces cardiovascular risk, for 7 wk. Markers of general health (bodyweight, food intake, and plasma alanine aminotransferase activities) and of cardiovascular risk (plasma CRP, fibrinogen, E-selectin, and cholesterol levels) were analyzed. All groups had comparable food intakes and body-weight gains. Plasma alanine aminotransferase activities increased significantly in vehicle and fenofibrate-treated mice. Compared with baseline, wtTom and flTom significantly reduced basal human CRP concentrations by 43 and 56%, respectively. The CRP-lowering effect of flTom significantly exceeded that of wtTom. The effects of flTom on CRP were reversed within a 2-wk washout period. WtTom and flTom did not affect fibrinogen, but comparably repressed E-selectin expression and upregulated HDL cholesterol. Tomato peel consumption improved cardiovascular risk factors in CRPtg mice, a beneficial effect that was further enhanced by enrichment of the flavonoid content.     

Electrolyzed-reduced water reduced hemodialysis-induced erythrocyte impairment in end-stage renal disease patients

Chronic hemodialysis (HD) patients increase erythrocyte susceptibility to hemolysis and impair cell survival. We explored whether electrolyte-reduced water (ERW) could palliate HD-evoked erythrocyte impairment and anemia. Forty-three patients undergoing chronic HD were enrolled and received ERW administration for 6 month. We evaluated oxidative stress in blood and plasma, erythrocyte methemoglobin (metHb)/ferricyanide reductase activity, plasma metHb, and proinflammatory cytokines in the chronic HD patients without treatment (n=15) or with vitamin C (VC)- (n=15), vitamin E (VE)-coated dialyzer (n=15), or ERW treatment (n=15) during an HD course. The patients showed marked increases (15-fold) in blood reactive oxygen species, mostly H(2)O(2), after HD without any treatment. HD resulted in decreased plasma VC, total antioxidant status, and erythrocyte metHb/ferricyanide reductase activity and increased erythrocyte levels of phosphatidylcholine hydroperoxide (PCOOH) and plasma metHb. Antioxidants treatment significantly palliated single HD course-induced oxidative stress, plasma and RBC PCOOH, and plasma metHb levels, and preserved erythrocyte metHb /ferricyanide reductase activity in an order VC>ERW>VE-coated dialyzer. However, ERW had no side effects of oxalate accumulation easily induced by VC. Six-month ERW treatment increased hematocrit and attenuated proinflammatory cytokines profile in the HD patients. In conclusion, ERW treatment administration is effective in palliating HD-evoked oxidative stress, as indicated by lipid peroxidation, hemolysis, and overexpression of proinflammatory cytokines in HD patients.     

Potentiality of embryonic stem cells: an ethical problem even with alternative stem cell sources

The recent discussions about alternative sources of human embryonic stem cells (White Paper of the US President's Council on Bioethics, 2005), while stirring new interest in the developmental potential of the various abnormal embryos or constructs proposed as such sources, also raise questions about the potential of the derived embryonic stem cells. The data on the developmental potential of embryonic stem cells that seem relevant for ethical considerations and aspects of patentability are discussed. Particular attention is paid to the meaning of "totipotency, omnipotency and pluripotency" as illustrated by a comparison of the developmental potential of three-dimensional clusters of blastomeres (morula), embryonic stem cells, somatic or (adult) stem cells or other somatic (non-stem) cells. This paper focuses on embryoid bodies and on direct cloning by tetraploid complementation. Usage and patenting of these cells cannot be considered to be ethically sound as long as totipotency and tetraploid complementability of embryonic stem cells are not excluded for the specific cell line in question. Testing this poses an ethical problem in itself and needs to be discussed in the future.     

Epidermal-skin-test 1,000 (EST-1,000)--a new reconstructed epidermis for in vitro skin corrosivity testing.

The determination of a possible corrosive or irritative potential of certain products and ingredients is necessary for their classification and labeling requirements. Reconstructed skin as a model system provides fundamental advantages to single cell culture testing and leads to promising results as shown by different validation studies (for review: Fentem, J.H., Botham, P.A., 2002. ECVAM's activities in validating alternative tests for skin corrosion and irritation. ATLA 30(Suppl. 2), 61-67). In this study we introduce our new reconstructed epidermis "Epidermal-Skin-Test" (EST-1,000). This fully grown epidermis consists of proliferating as well as differentiating keratinocytes. EST-1,000 shows a high comparability to normal human skin as shown by histological and immunohistochemical data. Characteristic markers (KI-67, CK 1/10/5/14, transglutaminase, collagen IV, involucrin, beta 1 integrin) can be identified easily. The main focus of this work was to characterize EST-1,000 especially with respect to its barrier function by testing several substances of known corrosive potential. Skin corrosion was detected by the cytotoxic effect of the substances on a reconstructed epidermis after short-term application to the stratum corneum. The effect was determined by standard MTT assay and accompanying histological analysis. Hence EST-1,000 shows a very high predictive potential and closes the gap between animal testing and the established full-thickness model Advanced-Skin-Test 2,000 (AST-2,000) (Noll, M., Merkle, M.-L., Kandsberger, M., Matthes, T., Fuchs, H., Graeve, T., 1999. Reconstructed human skin (AST-2,000) as a tool for pharmaco-toxicology. ATLA 27, 302).     

Computed tomographic virtual cardioscopy in a case of left atrial myxoma

Computed tomographic virtual cardioscopy was used to provide clear and precise visualisation of a myxoma with a stalk arising from the interatrial septum. This technique permits the safe, reliable, and non-invasive diagnosis of intracardiac lesions. This case is presented to assist the cardiovascular surgeon in preoperative planning or in developing a simulation of robotic cardiac surgery.     

Genetic and environmental correlations between obesity phenotypes and age at menarche

OBJECTIVE: To assess the extent that the genetic and environmental factors contribute to the phenotypic correlations between obesity traits and age at menarche (AAM), and also to examine the influence of AAM on obesity in both pre- and postmenopausal women. METHODS:F ive hundred and twelve pedigrees with 2667 Caucasian female subjects from two to four generations were recruited. Fat mass and lean mass (both in kg) were measured by dual-energy X-ray absorptiometry scanner. Body mass index (BMI) (kg/m(2)) was calculated. We performed bivariate quantitative genetic analyses in the total sample containing 2667 Caucasian women. We also selected 206 unrelated premenopausal women and 140 unrelated postmenopausal women from the total sample, and computed the respective phenotypic correlation between obesity and AAM in these two subgroups. RESULTS: For fat mass, lean mass and BMI, we detected their significant negative genetic correlations with AAM after adjustment for significant covariates, which were -0.3170 (P<0.001), -0.1721 (P<0.05) and -0.3665 (P<0.001), respectively. However, their environmental correlations with AAM were all nonsignificant (P>0.05), ranging from -0.0016 to 0.0192. In the premenopausal subgroup, significant associations were observed between fat mass and AAM (rho=-0.231, P<0.01) as well as between BMI and AAM (rho=-0.257, P<0.01). In the postmenopausal subgroup, no such associations were observed. CONCLUSION: Our results for the first time suggested that significant phenotypic association between obesity phenotypes and AAM is mainly attributable to shared genetic rather than environmental factors, and AAM may have stronger effects on obesity phenotypes in pre- than in postmenopausal women.