Impaired Mitogen-Induced Interferon-γ Production in Rheumatoid Arthritis and Related Diseases

Peripheral blood lymphocytes from patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), progressive systemic sclerosis (PSS), Reiter's disease, osteoarthritis, and from healthy volunteers were investigated for interferon-gamma (IFN-gamma) production after mitogen activation. Phytohaemagglutinin stimulation revealed an impaired IFN-gamma production in RA, SLE, and PSS but normal levels in Reiter's disease and osteoarthritis. In RA this deficiency was also seen after pokeweed mitogen, OKT3, and concanavalin A activation. No major differences were found in interleukin 2 (IL-2) production and cell proliferation. The IL-2 receptor expression was reduced on stimulated RA lymphocytes. The deficient IFN-gamma production was compensated in RA by co-stimulation of PHA or OKT3 with phorbol myristic acetate (PMA). In addition, the combination of the calcium ionophore A 23187 and PMA induced a strong IFN-gamma secretion in all patient groups and in the controls.     

Affinity enhancement of complementary peptide recognition

A peptide hydropathically complementary to Big Endothelin [Big ET] residues 16-29 has been synthesized in a multimeric form starting from an octadentate poiylysine core, essentially in a way similar to the procedure used for the production of multiple antigenic peptides [MAP's], Interaction between the multimeric complementary peptide [8δET] and the Big ET fragment 16-32 containing the target complementary region, also synthesized in a multimeric form [8ET], was evaluated by analytical high performance affinity chromatography and solid phase binding assays. While the binding interaction between the monomerics peptide pair was in the micromolar range, the recognition between the corresponding multimeric form was characterized by enhanced binding affinity of at least two orders of magnitude. In solution, complex formation between multimeric complementary peptide and target Big ET sequence in the monomeric and multimeric form was accompanied by precipitation at concentrations higher than 0.5 mg/mL and 0.1 mg/mL, respectively. Polyclonal antibodies raised against the multimeric target sequence recognized multimeric and monomeric ET target sequences with binding affinities similar to binding affinities exhibited by the multimeric complementary peptide. Multimerization of hydropathically complementary peptides could provide an improved opportunity to measure and thus probe quantitative binding properties of complementary peptides.     

Electrocardiographic Monitoring During Coloscopy

Electrocardiographic abnormalities were observed in 15 of 23 patients (65%), five with known heart disease, who were monitored for one hour prior to, during and for one hour after coloscopy. In one patient, ischemic S-T depression, 2 mm. below the resting level, persisted during the one hour following coloscopy. In all other patients, the electrocardiographic abnormalities disappeared before the end of the monitoring period.     

Bile lipid composition and haemostatic variables in a case of high density lipoprotein deficiency (Tangier disease)

A 62-year-old man with clinical and biochemical findings consistent with homozygous Tangier disease is presented. Widespread atherosclerosis was present. Bile lipid analysis showed a low molar percentage of cholesterol with a low saturation index. The data suggest that high density lipoprotein cholesterol may act as a preferential precursor of biliary cholesterol. Coagulation and platelet studies indicated that the patient's platelets were hyper-responsive to aggregating agents and produced an increased amount of thromboxane B2. A platelet storage pool deficiency was also found.     

Time- and Dose-Dependent Effects of Chronic Wound Fluid on Human Adult Dermal Fibroblasts

BACKGROUND Wound healing is a biologic process that is altered in patients affected by chronic venous ulcers. The wound microenvironment is reflected in the chronic wound fluid (CWF), an exudate containing serum components and tissue-derived proteins.
OBJECTIVES We investigated the effects of increasing doses of CWF collected from patients suffering from chronic venous ulcers on human adult dermal fibroblasts cultured in vitro and the relationship among CWF effects and treatment length.
METHODS Fibroblasts were treated with 60, 240, and 720 μg/mL CWF for 3 and 7 days. We evaluated cell proliferation and viability by MTT and Trypan blue assay, cell morphology by light microscopy, F-actin microfilaments organization by tetramethylrhodamine B isothiocyanate-conjugated phalloidin, α-smooth muscle actin expression by immunofluorescence, and senescence-associated β-galactosidase activity.
RESULTS CWF induced an increase in cell proliferation in the first 3 days of treatment. In contrast, at 7 days, a strong decrease in cell viability was observed. These changes were related to a cytoskeletal F-actin reorganization and not to fibroblast–myofibroblast differentiation nor to changes in cellular senescence.
CONCLUSIONS This study shows a dose-dependent and biphasic effect of CWF on dermal fibroblasts, suggesting that a continuous exposure to chronic wounds microenvironment may induce late cellular dysfunctions possibly involved in the delayed wound healing.     

Optimized Measurement of Activation Rate at Left Atrial Sites with Complex Fractionated Electrograms During Atrial Fibrillation

Local Activation Rate in Atrial Fibrillation. Background: Complex fractionated atrial electrograms (CFAE) have become targets for catheter ablation of atrial fibrillation (AF). Frequency components of AF signals have also become important markers for identifying potential mechanisms of AF, yet inaccuracies exist, particularly in standard dominant frequency (SDF) calculations especially at CFAE sites. We developed new methodology to improve accuracy of AF rate determinations at such recording sites. Objective: To develop optimal methods for estimating activation rates in paroxysmal and persistent AF. Methods: Electrograms were obtained from one right atrial, coronary sinus, and 6 left atrial (LA) endocardial regions manifesting CFAEs in paroxysmal (N = 7) and persistent (N = 7) AF patients. SDF was measured from 8.4 s intervals and compared to (1) optimized DF (ODF) calculated by optimizing the filter coefficients which maximized dominant frequency power, (2) autocorrelation (AC), with the rate estimated as the inverse of the signal phase shift generating the largest autocorrelation coefficient, and (3) ensemble average (EA), with the rate estimated by summing successive signal segments and selecting segment length yielding maximum power. Rate measurements were compared between groups, at baseline and with additive interference, having similar frequency content to the electrograms, to test the robustness of the different methods. Results: From pooled data (N = 168 recording sites), a significantly higher LA dominant frequency was found in persistent versus paroxysmal patients using each method (P < 0.001), with a mean value for all methods of 6.23 ± 0.08 Hz versus 5.32 ± 0.10 Hz, respectively. At the highest additive interference level, the rate measurement error was significantly greater in SDF as compared with EA (P = 0.010) and ODF (P = 0.035), and at all interference levels SDF had the largest error of any method. Conclusions: SDF appears less robust to additive interference, compared to the ODF and EA methods of estimating the activation rate at CFAE sites in this small group of patients. Use of optimized filter coefficients for DF measurement, or use of correlative methods such as EA, that reinforce the signal rather than filtering the noise, may improve calculation of activation rates. (J Cardiovasc Electrophysiol, Vol. 21, pp. 133‐143, February 2010)     

INTRAVESICAL BACILLUS CALMETTE-GUERIN (BCG) AS INDUCER OF TUMOR-SUPPRESSING PROTEINS P53 AND P21 DURING TREATMENT OF SUPERFICIAL BLADDER CANCER

PURPOSE: Previous in vitro investigations recorded an inhibition of cell proliferation by BCG when added to different cell cultures. The induction of apoptosis by BCG is controversial. Our study aimed to evaluate the influence of BCG on the expression of tumor suppressing proteins p53 and p21Waf1-Cip1 and apoptosis of the urothelial cells in vivo. MATERIALS AND METHODS: Twenty-one cases of superficial bladder cancer, treated with TUR and subsequent intravesical BCG, were studied retrospectively. The assays evaluated the expression of p53 and p21Waf1-Cip1 by immunochemistry (IHC), and the presence of apoptosis by TUNEL assay. The estimates were performed, in each case, on the following specimens: one tumor sample and one non-neoplastic sample collected during the TUR which preceded the administration of BCG; one non-neoplastic sample collected 3 months after the diagnosis; and one non-neoplastic sample collected in the first 2 weeks after the completion of the treatment. Samples of 6 cancer recurrences detected during BCG were examined too. RESULTS: As usual for non-neoplastic urothelium, the pre-BCG samples displayed poor p53 and p21Waf1-Cip1 immunoreactivity. By contrast, the samples collected during and in the aftermath of BCG showed an overall increase of the expression of both proteins. The rare occurrence of apoptosis proved to be chronologically unrelated to the BCG treatment. DISCUSSION: The relationship between changes of the IHC features and BCG suggests that BCG, at least under some circumstances, can induce the activation of wild type p53 and p21Waf1-Cip1 in the urothelium. The mechanism of the BCG-p53 status interaction and its role in the antitumor activity of BCG remain to be clarified.     

Clinical Evaluation of Morphology Discrimination: An Algorithm for Rhythm Discrimination in Cardioverter Defibrillators

The aim of this study was to test the new morphology discrimination diagnostic algorithm for ICDs that differentiates supraventricular tachycardias (SVTs) from VTs by analysis of ventricular depolarization complexes morphology. Twenty-five patients implanted with a St. Jude Ventritex single chamber ICD were studied during electrophysiological evaluation at predischarge and were followed for 7 +/- 4 months. Sensitivity and specificity for VT detection and overall diagnostic accuracy of the morphology discrimination algorithm were calculated on 326 detected events. At electrophysiological evaluation, the algorithm was tested during 67 episodes of right atrial pacing, during 119 episodes of RV pacing (at basal interventricular septum and RV apex) and during 27 episodes of sustained AF: specificity was 98%, sensitivity was 66%, and diagnostic accuracy was 80%. All episodes of AF were correctly diagnosed as SVT. Exclusion of detections related to pacing at the basal interventricular septum, resulted in a specificity of 98%, a sensitivity of 85%, and a diagnostic accuracy of 93%. During follow-up, evaluation of the morphology discrimination algorithm on 113 spontaneous episodes (31 VTs, 31 AF, 7 SVTs, and 44 sinus tachycardias) exhibited a specificity of 89%, a sensitivity of 100%, and a diagnostic accuracy of 92%. In conclusion, the morphology discrimination algorithm exhibits a high specificity in discriminating VTs from SVTs, although with a corresponding reduction in sensitivity. The preliminary experience on spontaneous episodes is promising. To correct for the reduction in sensitivity, it is advisable to use this algorithm in parallel with other algorithms for rhythm discrimination (sudden onset, stability) coupled with extended high rate.