Polychlorinated Biphenyl Congeners in Adipose Tissue Lipid and Serum of Past and Present Transformer Repair Workers and a Comparison Group

Polychlorinated Biphenyl Congeners in Adipose Tissue Lipid andSerum of Past and Present Transformer Repair Workers and a ComparisonGroup. FAIT, A., GROSSMAN, E., SELF, S., JEFFRIES, J., PELLIZZARI,E. D., AND EMMETT, E. A. (1989). Fundam. Appl. Toxicol 12, 42-55. The concentrations of individual PCB's were determined inboth serum and adipose tissue lipid from 35 transformer repairworkers currently exposed to PCBs, mainly Aroclor 1260, 17 previoustransformer repair workers, and 56 comparison workers neveroccupationally exposed to PCBs. The analysis used fused-silicacapillary gas chromatography with electron capture detector(FSCGC/ECD) and FSCGC with negative ion chemical ionizationmass spectrometry to verify PCB congener levels. Eighty-ninePCB peaks were identified and confirmed. More congeners weredetected in adipose tissue. In serum approximately 50% of peakswere below the level of detection. Statistical techniques toaccount for left and interval censoring allowed comparison ofconcentration distributions even where data were incomplete.We found that unquantifiable levels were unlikely to contributesubstantially to the true values for total [PCBs] over and beyondthe contribution of the measured values. However, the totalserum [PCBs] determined by FSCGC/ECD greatly exceeded that fromstandard packed cell gas chromatography (PCGC/ECD). The underestimationwas less marked for adipose samples. In serum the total [PCBs]was highest in currently exposed workers and lowest in unexposedworkers, with past-exposed workers clearly intermediate. Inadipose tissue [PCBs] in the currently exposed group was muchhigher than in the other two groups, in whom the distributionof results was broadly similar. In all worker groups hexachlorinatedand heptachlorinated species predominated followed by octachlorinatedand pentachlorinated. The relative distribution of individualPCB congeners in the three groups was similar although the amountsvaried. The seven major peaks in serum and adipose tissue were2,3,5,6,3',4',5'/2,3,4,5,2',4',5' hepta-CB; 2,3,4,2',3',5' hexa-CB;2,4,6,3',4',5'/ 2,4,5,2',4',5'/2,3,4,5,2',5' hexa-CB; 2,3,4,5,2',3',4'hepta-CB; 2,3,4,5,2',3',5',6'/2,3,4,5,6,2',3',5', octa-CB; 2,4,5,3',4',/3,4,5,2',3'penta-CB; and 2,3,4,2',3',4'/2,3,5,6,2',4',5'/2,3,4,5,2',4',6'multi-CB. The distribution of PCB peaks in our populations differsfrom that in capacitor workers (exposed to less highly chlorinatedPCBs) and from Yu-Cheng patients suggesting differing toxicpotentials from PCBs in these three circumstances.     

Interventional Catheterization after Total Cavopulmonary Connection: Experience in 68 Patients

Background: Total cavopulmonary connection (TCPC) is performed in patients having a single ventricle to allow the passive flow of systemic venous blood to the lungs. Interventional catheterization is needed to treat residual defects or complications. Aims: We discuss our results concerning 68 patients who had had TCPC from January 1995 to December 2010. Methods: Initial and follow‐up catheterization data were reviewed retrospectively. Mid ‐ term results were evaluated by means of angiography and/or CT scan. Results: Mean age at TCPC was 5 years (2.5–18); mean interval between TCPC and catheterization was 5.6 years (1.5–15). Sixty‐nine catheterizations were performed in 53 patients. Eleven patients (21%) had low venous pressure, did not display a right‐to‐left shunt, and did not need any intervention. Fifteen patients (28%) had low venous pressure and only needed the closure of the fenestration. The remaining 27 patients (51%) needed the following interventions: embolization of venous vessels prompting right‐to‐left shunt (n = 15), stenting or reconnection of pulmonary arteries (n = 5), stenting or recanalization of systemic veins (n = 11), other procedures (n = 5). In 3 patients the fenestration could not be closed due to high venous pressure. After the interventions oxygen saturation increased from 90.5%± 4.8% to 94.7%± 3.6% (P = 0.002). Conclusions: Our data show that 49% of patients with TCPC are in good condition late after surgery. However, half of these patients continue to need interventions generally aimed at suppressing stenoses at various levels of TCPC or at occluding vessels prompting right‐to‐left shunt. This population should enter a multicenter program aimed at identifying patients at risk. (J Interven Cardiol 2012;25:622–627)     

Polymorphism at the 5'' end flanking region of the insulin gene is associated with reduced insulin secretion in healthy individuals

Sixty-four unrelated healthy subjects were studied for the detection of a DNA polymorphism at the 5' end of the insulin gene. No significant difference between the groups was found in blood glucose values at fasting and after an oral glucose load. A significant association was found between fasting (P less than 0.05) and after load plasma C-peptide levels (P less than 0.01) and the presence of a 1.6 Kb insertion at the 5' end of the insulin gene. A gene dose-dependent effect was noted, class 3/3 individuals having the lowest after-load C-peptide concentration and class 1/3 an intermediate level (F for the linear trend: P = 0.007). This might suggest that insulin gene polymorphism affects insulin secretion in healthy individuals. In order to confirm this, a subgroup of six class 3/3 and eight class 1/1 individuals subsequently underwent a hyperglycaemic clamp. The tissue sensitivity to insulin was similar in the two groups but glucose-stimulated insulin secretion was markedly impaired in homozygotes for the class 3 allele. In this group, insulin secretion was, on average, only one-third of that in class 1/1 individuals (P less than 0.02). Similarly impaired in class 3/3 persons was the glucose + arginine-stimulated insulin secretion (P less than 0.05). We conclude that the polymorphism at the 5' end of the insulin gene is associated with variations in insulin secretion in healthy humans.     

Implications of gluten exposure period,CD clinical forms,and HLA typing in the association between celiac disease and dental enamel defects in children. A case–control study

International Journal of Paediatric Dentistry 2010; 20: 119–124 Background. The association between coeliac disease (CD) and dental enamel defects (DED) is well known. Aim. The aim of this study was to investigate the prevalence of DED in children with CD and to specifically find the association of DED and gluten exposure period, CD clinical forms, HLA class II haplotype. Design. This study was designed as a matched case–control study: 250 children were enrolled (125 coeliac children – 79 female and 46 male, 7.2 ± 2.8 years and 125 healthy children). Data about age at CD diagnosis, CD clinical form, and HLA haplotype were recorded. Results. Dental enamel defects were detected in 58 coeliac subjects (46.4%) against seven (5.6%) controls (P < 0.005). We found an association between DED and gluten exposure period, as among CD subjects the mean age at CD diagnosis was significantly (P = 0.0004) higher in the group with DED (3.41 ± 1.27) than without DED (1.26 ± 0.7). DED resulted more frequent (100%) in atypical and silent CD forms than in the typical one (30.93%). The presence of HLA DR 52‐53 and DQ7antigens significantly increased the risk of DED (P = 0.0017) in coeliac children. Conclusions. Our results confirmed a possible correlation between HLA antigens and DED.     

Immunomodulation and Sézary syndrome: experience with thymopentin (TP-5)

The clinical, histological and immunological effects of long-term treatment with thymopentin (TP-5), administered 50 mg i.v. three times a week on alternate days, in four patients with Sézary syndrome is reported. In all four cases reduction of itching, oedema, scaling and thickening, and clearing of erythroderma were noted after 2 months treatment. Peripheral blood Sézary cells decreased in three cases. Reduction or suspension of the drug was followed by a clinical relapse. A loss of epidermotropism and a reduction in cell infiltrates were observed together with a dramatic reduction in epidermal and dermal Langerhans cells. An increase in the proliferative response to mitogens and in IFN-gamma production, and the expression of activation antigens in PHA stimulated cultures occurred after 3 months. HNK-I+ cells increased both in the peripheral blood and in the dermis following a transient increase in IL-2 receptors, suggesting that clinical response in TP-5 treated patients may be mediated by an increased production of IL-2 and consequent generation of cytotoxic cells or release of lymphokines able to augment NK activity.     

Efficacy of Ivabradine in a Case of Inappropriate Sinus Tachycardia and Ventricular Dysfunction

Ivabradine in IST . We present a case of a 49‐year‐old man with inappropriate sinus tachycardia and ventricular dysfunction. The conventional treatment (ace‐inhibitor and beta‐blockers) was not well tolerated by the patient, so Ivabradine, a specific inhibitor of If current in the sinus node, was started. After 3 months of using this medication, we observed an improvement of ejection fraction and quality of life. (J Cardiovasc Electrophysiol, Vol. pp. 815‐817, July 2010)