Mass Spectrometry-Based Lipidomics Reveals Differential Changes in the Accumulated Lipid Classes in Chronic Kidney Disease.

Chronic kidney disease (CKD) is characterized by the progressive loss of functional nephrons. Although cardiovascular disease (CVD) complications and atherosclerosis are the leading causes of morbidity and mortality in CKD, the mechanism by which the progression of CVD accelerates remains unclear. To reveal the molecular mechanisms associated with atherosclerosis linked to CKD, we applied a shotgun lipidomics approach fortified with standard laboratory analytical methods and gas chromatography-mass spectrometry technique on selected lipid components and precursors to analyze the plasma lipidome in CKD and classical CVD patients. The MS-based lipidome profiling revealed the upregulation of triacylglycerols in CKD and downregulation of cholesterol/cholesteryl esters, sphingomyelins, phosphatidylcholines, phosphatidylethanolamines and ceramides as compared to CVD group and controls. We have further observed a decreased abundance of seven fatty acids in CKD with strong inter-correlation. In contrast, the level of glycerol was elevated in CKD in comparison to all analyzed groups. Our results revealed the putative existence of a functional causative link-the low cholesterol level correlated with lower estimated glomerular filtration rate and kidney dysfunction that supports the postulated "reverse epidemiology" theory and suggest that the lipidomic background of atherosclerosis-related to CKD is unique and might be associated with other cellular factors, i.e., inflammation.

Simulating the origins of life: The dual role of RNA replicases as an obstacle to evolution.

Despite years of study, it is still not clear how life emerged from inanimate matter and evolved into the complex forms that we observe today. One of the most recognized hypotheses for the origins of life, the RNA World hypothesis, assumes that life was sparked by prebiotic replicating RNA chains. In this paper, we address the problems caused by the interplay between hypothetical prebiotic RNA replicases and RNA parasitic species. We consider the coexistence of parasite RNAs and RNA replicases as well as the impact of parasites on the further evolution of replicases. For these purposes, we used multi-agent modeling techniques that allow for realistic assumptions regarding the movement and spatial interactions of modeled species. The general model used in this study is based on work by Takeuchi and Hogeweg. Our results confirm that the coexistence of parasite RNAs and replicases is possible in a spatially extended system, even if we take into consideration more realistic assumptions than Takeuchi and Hogeweg. However, we also showed that the presence of trade-off that takes into the account an RNA folding process could still pose a serious obstacle to the evolution of replication. We conclude that this might be a cause for one of the greatest transitions in life that took place early in evolution-the separation of the function between DNA templates and protein enzymes, with a central role for RNA species.

GeVaDSs - decision support system for novel Genetic Vaccine development process.

BACKGROUND: The lack of a uniform way for qualitative and quantitative evaluation of vaccine candidates under development led us to set up a standardized scheme for vaccine efficacy and safety evaluation. We developed and implemented molecular and immunology methods, and designed support tools for immunization data storage and analyses. Such collection can create a unique opportunity for immunologists to analyse data delivered from their laboratories. RESULTS: We designed and implemented GeVaDSs (Genetic Vaccine Decision Support system) an interactive system for efficient storage, integration, retrieval and representation of data. Moreover, GeVaDSs allows for relevant association and interpretation of data, and thus for knowledge-based generation of testable hypotheses of vaccine responses. CONCLUSIONS: GeVaDSs has been tested by several laboratories in Europe, and proved its usefulness in vaccine analysis. Case study of its application is presented in the additional files. The system is available at: http://gevads.cs.put.poznan.pl/preview/(login: viewer, password: password).

Treatment for periprosthetic infection with two-stage revision arthroplasty with a gentamicin loaded spacer. The clinical outcomes.

BACKGROUND: With the increasing number of total joint replacement procedures, the number of complications from that surgery has also been on the rise. Although quite rare (<1%), a PPI may ruin even the best and technically excellent joint replacement procedure, causing extensive damage and loss of bone and periprosthetic tissues, which makes subsequent restoration surgery extremely difficult. At present, a two-stage revision arthroplasty seems to be the best solution for PPI patients [4,9,15]. In the first stage, implant removal and radical débridement of infected tissues is performed and an antibiotic-loaded spacer is inserted. After a few months, the second stage is performed where the spacer is removed and a revision endoprosthesis is implanted. The aim of the study was to evaluate the effectiveness of treatment for periprosthetic infections with a two-stage revision arthroplasty. MATERIAL AND METHODS: Forty-one patients diagnosed with PPI were treated at the Department of Orthopedic and Trauma Surgery, Silesian Medical University in Katowice, between January 2007 and March 2010. PPI was a complication of knee arthroplasty (12 patients, 29%) and hip replacement (29 patients, 71%). During the first stage of the treatment, intraoperative cultures were negative in 17 patients (41%) and positive in 24 (59%). RESULTS: Cultures obtained in patients with reinfection after revision endoprosthesoplasty (second stage of the treatment) grew no pathogen in 1 patient, MSSA (1), E. faecalis (1), and A. baumanii with MSSA and MRSE (1). After the first stage of the treatment (spacer implantation), infection was not cured in one patient (2.5%). In 4 patients (10%), there was reinfection after the implantation of a revision endoprosthesis. CONCLUSIONS: Our analysis provides evidence to suggest that two-stage revision endoprosthesoplasty is an effective method of treatment of periprosthetic infections.

Minimally invasive approaches in total hip replacement.

Hip Osteoarthritis has always been a challenge for the orthopaedic community and, in the present age of increasing life expectancy and quality, it has become one of the most common causes for orthopaedic surgery. Nowadays, the development of THR focuses on refining the surgical technique, especially on minimising operative tissue injury. Convencional approaches in THR surgery preserve main vessels and nerves and provide excellent visualisation of the operative field but at the expense of muscle attachments and ligaments which are inevitably injured. The authors of MIS concept underline the idea of minimising injury inflicted on the muscle-tendon unit. There are a lot of evidence that the MIS procedures allow for early rehabilitation, shorter in-hospital stay and hasten full functional recovery. They are also associated with decreased perioperative blood loss, reduced postoperative pain and decreased risk of infections.

Operative treatment (subtotal resection) of cavernous hemangioma of forearm. A case report.

We present a case of cavernous hemangioma of a rare location within forearm muscles. The diagnosis was established on the basis of Magnetic Resonance Imaging and histological study of the specimen taken intraoperatively. A subtotal excision of the tumour was performed, followed by muscle reconstruction so that the hand function was preserved. After a follow-up period of five years, there were no clinical or MRI signs of recurrence.

Minimally invasive approaches in total hip arthroplasty.

The success of operative treatment depends on a quick recovery of limb function. Every injury to a muscle or its attachment is associated with decreased muscle strength and disturbed proprioception, which impedes functional recovery. Minimally Invasive Surgery (MIS) is defined as a surgical technique performed through a short skin incision to avoid injury to muscles and tendons. The advantages of MIS over the classic technique in Total Hip Arthroplasty include: faster recovery, shorter rehabilitation and hospital stay, decreased blood loss, less pain and a shorter scar. The anterior approach to the hip, first described by Robert Judet in 1947 as a modified Smith-Petersen approach, follows the principles of MIS. Other approaches advertised as minimally invasive (posterior, lateral, or double incision approach) are associated with muscle and/or tendon injury. Therefore, they should be referred to as Less Invasive Surgery (LIS). Complications of THA performed with the MIS technique occur most often in women with osteoporosis, above 65 years of age, or with a BMI of more than 32. The rate of complications doubles with surgeons performing less than 50 THAs per year. A special set of instruments facilitates implantation of the endoprosthesis and reduces the number of complications. The anterior approach allows for implantation of an endoprosthesis without damage to muscles and their insertions, reduces tissue damage and, more importantly, decreases the intensity of postoperative pain. Should complications occur, the anterior approach has the advantage of allowing simple access to the proximal femur by extending the approach distally, as in the Smith-Petersen technique. However, the technical challenges of MIS and the risk of complications warrant caution.