RESUMO
G protein-coupled receptors (GPCRs) are the most abundant receptor family encoded by the human genome and are the targets of a high percentage of drugs currently in use or in clinical trials for the treatment of diseases such as diabetes and its associated complications. Thus, orphan GPCRs, for which the ligand is unknown, represent an important untapped source of therapeutic potential for the treatment of many diseases. We have identified the previously orphan GPCR, GPR146, as the putative receptor of proinsulin C-peptide, which may prove to be an effective treatment for diabetes-associated complications. For example, we have found a potential role of C-peptide and GPR146 in regulating the function of the retinal pigment epithelium, a monolayer of cells in the retina that serves as part of the blood-retinal barrier and is disrupted in diabetic macular oedema. However, C-peptide signalling in this cell type appears to depend at least in part on extracellular glucose concentration and its interaction with insulin. In this review, we discuss the therapeutic potential of orphan GPCRs with a special focus on C-peptide and GPR146, including past and current strategies used to 'deorphanize' this diverse family of receptors, past successes and the inherent difficulties of this process.
Assuntos
Peptídeo C/metabolismo , Complicações do Diabetes/tratamento farmacológico , Diabetes Mellitus/tratamento farmacológico , Receptores Acoplados a Proteínas G/efeitos dos fármacos , Animais , Peptídeo C/efeitos dos fármacos , Diferenciação Celular , Complicações do Diabetes/metabolismo , Diabetes Mellitus/metabolismo , Glucose/farmacologia , Humanos , Hipoglicemiantes/farmacologia , Insulina/farmacologia , Receptores Acoplados a Proteínas G/metabolismo , Epitélio Pigmentado da Retina/metabolismo , Transdução de Sinais/efeitos dos fármacosRESUMO
Cancer survivors often experience poor post-treatment musculoskeletal health. This study examined the feasibility of combined aerobic and resistant training (CART) for improving strength, skeletal health and balance. Cancer survivors (n = 24) were identified by convenience sampling in Los Angeles County with 11 survivors consenting to 13 weeks of CART. Pre- and post-intervention assessments of bone mineral density (BMD), strength, flexibility and biomarker analysis were performed. Paired t-test analysis suggested increases in lower and upper body strength. The average T-score for BMD at the femoral neck improved from -1.46 to -1.36 and whole body BMD improved from -1.65 to -1.55. From baseline to follow-up, participants also displayed decreases in sway velocity on the eyes open (7%) and eyes closed (27%) conditions. Improvement in lower body strength was associated with increases in lean body mass (LBM) (r = 0.721) and an inverse association was observed between sway velocity and LBM (r = 0.838). Age and time since last treatment were related with biomarkers of anabolic growth (IGF-1, IGFbp-3) and bone (DPD, BAP). In summary, observed physiological changes were consistent with functional improvements, suggesting that isometric and dynamic exercise prescription may reduce the risk for falls and fall-related fractures among survivors.
Assuntos
Densidade Óssea , Terapia por Exercício/métodos , Força Muscular , Neoplasias/reabilitação , Equilíbrio Postural , Amplitude de Movimento Articular , Treinamento Resistido , Sobreviventes , Absorciometria de Fóton , Acidentes por Quedas/prevenção & controle , Adulto , Idoso , Biomarcadores/metabolismo , Neoplasias da Mama/reabilitação , Neoplasias do Colo/reabilitação , Exercício Físico , Estudos de Viabilidade , Feminino , Doença de Hodgkin/reabilitação , Humanos , Proteína 3 de Ligação a Fator de Crescimento Semelhante à Insulina/metabolismo , Fator de Crescimento Insulin-Like I/metabolismo , Pessoa de Meia-Idade , Neoplasias Ovarianas/reabilitação , Projetos Piloto , Estudos ProspectivosRESUMO
BACKGROUND: Transport statistics classify bicyclists in a separate road user collective. For medical reasons, this differentiation is applied as well. Much literature is published in this field. Nevertheless there is a lack of literature regarding the overall injury patterns in a defined injury severity collective. Most literature is about isolated injured regions in combination with a heterogeneous injury severity. Further parameters, such as injury patterns, epidemiological aspects, treatment focal points and characteristic outcomes, have also been studied. The aim of the present study was to evaluate and characterize injury patterns in a standardized and representative collective of severely injured bicyclists. Methods We analysed data from the Traumaregister DGU® from 2002 to 2010. In total, 2817 severely injured (ISS ≥ 9 and additional intensive/intermediate care unit) bicyclists were included. The primary endpoint was evaluation of injury patterns and injury focal points. In addition to that we analysed parameters like epidemiological aspects, circumstances of accident, treatment focal points and outcome. RESULTS: The mean age was 50.3 ± 20.9 years. Males accounted for 68.9 % (n = 1940). The mean ISS was 23.7 ± 12.6. The mean AIS regions were the head 71.9 % (n = 2025), the chest with 44.9 % (n = 1264) and the upper extremities 33.6 % (947). In 68.2 % of all cases an ISS ≥ 9 was achieved by a traumatic brain injury; 21.1 % of all cases were mono-injuries. A characteristic distribution of age and a characteristic prevalence of the accidents in relation to the weekday and the month could be shown. CONCLUSION: The present study analysed the largest ever published collective of severely injured bicyclists. Traumatic brain injury could clearly be shown as the main injury in this collective. Moreover, one of five cases achieved the state "severely injured" due to mono-injury.
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Traumatismos do Braço/epidemiologia , Ciclismo/lesões , Ciclismo/estatística & dados numéricos , Lesões Encefálicas Traumáticas/epidemiologia , Traumatismo Múltiplo/epidemiologia , Traumatismos Torácicos/epidemiologia , Distribuição por Idade , Traumatismos do Braço/diagnóstico , Traumatismos do Braço/terapia , Lesões Encefálicas Traumáticas/diagnóstico , Lesões Encefálicas Traumáticas/terapia , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismo Múltiplo/diagnóstico , Traumatismo Múltiplo/terapia , Prevalência , Fatores de Risco , Distribuição por Sexo , Traumatismos Torácicos/diagnóstico , Traumatismos Torácicos/terapia , Índices de Gravidade do TraumaRESUMO
Acute posterior dislocation of the sternoclavicular (SC) joint is rare but can lead to life-threatening vascular injuries of the mediastinum; however, diagnosis is difficult and the injury can be initially overlooked so that surgical treatment is delayed. Although a variety of different treatment modalities have been published, the ideal fixation technique has not yet been identified. We report the case of a patient suffering from a locked posterior SC joint dislocation caused by a skiing accident. The injury was treated by transarticular endobutton fixation. This article describes the technique and highlights its advantages and disadvantages in comparison to previously published treatment options.
Assuntos
Artroplastia/instrumentação , Fixadores Internos , Luxações Articulares/diagnóstico , Luxações Articulares/cirurgia , Articulação Esternoclavicular/lesões , Articulação Esternoclavicular/cirurgia , Adolescente , Artroplastia/métodos , Humanos , Masculino , Desenho de Prótese , Esqui/lesões , Resultado do TratamentoRESUMO
PURPOSE: In anterior cruciate ligament (ACL) revision surgery, refilling of misplaced or enlarged tunnels frequently requires bone harvesting from the iliac crest. Unfortunately, donor-site pain displays a relevant complication. In order to optimize patients' comfort, we developed a procedure combining minimally invasive intramedullary bone harvesting from the femur with arthroscopic tunnel refilling. METHODS: Patients with ACL reconstruction failure that were not eligible for one-step revision surgery but required tunnel refilling prior to the next ACL reconstruction were enrolled prospectively. Cancellous bone was harvested intramedullarily from the ipsilateral femur using the reamer-irrigator-aspirator system in a minimally invasive manner. Afterwards, the femoral and tibial tunnels were arthroscopically refilled using cones and push rods. Computer tomography (CT) analyses were carried out before and after the filling procedure. Pain levels were assessed during the entire follow-up. Patients undergoing iliac crest bone harvesting for other reasons served as a control group. Finally, the quality of the newly formed bone stock was evaluated in the subsequent ACL reconstruction procedure. RESULTS: Five patients were included during a 6-month period. Prior to refilling, tunnel analysis revealed a mean tunnel volume of 7.9 cm(3) at the femur [SD ± 5.3 cm(3)] and of 6.7 cm(3) [SD ± 5.1 cm(3)] at the tibia. The CT analyses further revealed that graft failure was predominantly caused by tunnel misplacement. Post-operatively, pain levels due to intramedullary bone harvesting were significantly lower compared to iliac crest bone harvesting at every analysed time point. Three to five months after tunnel filling, CT analyses showed sufficiently incorporated bone stocks with filling rates of 75 % femoral and 94 % tibial. ACL revision surgery was performed 4-5 months after tunnel filling without any complication. CONCLUSION: Intramedullary bone harvesting from the ipsilateral femur combined with arthroscopic refilling of the bone tunnels ensures a high-quality bone stock for further ACL reconstruction. The clinical relevance is shown by the feasibility of this technique and the significantly reduced pain levels during post-operative recovery.
Assuntos
Reconstrução do Ligamento Cruzado Anterior/métodos , Artroscopia/métodos , Coleta de Tecidos e Órgãos/métodos , Adulto , Ligamento Cruzado Anterior/cirurgia , Artroscopia/instrumentação , Medula Óssea , Feminino , Fêmur/cirurgia , Humanos , Masculino , Reoperação , Tomografia Computadorizada por Raios XRESUMO
Tuberculosis is an infectious disease with a decreasing incidence in Germany. In particular, the occurrence of reinfections and possible complications associated with this disease, such as tuberculous meningitis/encephalitis and Landouzy sepsis are rare in industrial countries. In this article the intensive care treatment of a patient who initially underwent surgery for spinal stenosis is reported. Due to recurrent appearance of neurological symptoms with increasing severity and abscess formation in the spine, further surgery was performed. Additionally, the patient developed sepsis and meningitis. At this time an infection with Mycobacterium tuberculosis could be detected in both cerebrospinal fluid and abscess material of the spine suggesting a Landouzy sepsis, tuberculous meningitis/encephalitis and the suspicion of an underlying Pott's disease.
Assuntos
Encefalite/terapia , Complicações Pós-Operatórias/terapia , Sepse/terapia , Estenose Espinal/cirurgia , Tuberculose da Coluna Vertebral/complicações , Tuberculose da Coluna Vertebral/terapia , Antituberculosos/uso terapêutico , Cuidados Críticos , Encefalite/etiologia , Encefalite/fisiopatologia , Escala de Coma de Glasgow , Humanos , Pressão Intracraniana/fisiologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Mycobacterium tuberculosis , Paralisia/etiologia , Reação em Cadeia da Polimerase , Complicações Pós-Operatórias/fisiopatologia , Sepse/etiologia , Sepse/fisiopatologia , Tuberculose da Coluna Vertebral/etiologia , Tuberculose da Coluna Vertebral/microbiologia , Tuberculose da Coluna Vertebral/fisiopatologiaRESUMO
BACKGROUND: Treatment of open fractures remains an interdisciplinary challenge. Even success and evidence of infection prevention especially of new treatment options is not clear. METHOD: A systematic search in available electronic databases over the years 1974 until 2011 was conducted. Only clinical analyses with more than 5 adult patients in the German, English or French languages were included. All studies were rated according to Centre for Evidence-Based Medicine (CEBM) criteria. RESULTS: Over 855 articles were found due to the search and after applying the exclusion and inclusion criteria 49 studies were finally assessed to contribute to the evidence-based recommendations. Grade A recommendation: early application of antibiotics against gram-positive organisms for all open fracture types, additional coverage of gram-negative organisms for type III open fractures. Early surgical debridement should be performed. Grade B recommendation: type III open fractures should be treated with antibiotics for a minimum of 72 h but not longer than 24 h after wound closure. Vacuum treatment is justified and beneficial if wound closure is not achieved. Grade C recommendation: additional local antibiotic treatment in combination with systematic antibiotics may be of benefit. Definitive wound closure should be achieved within 1 week. DISCUSSION: This evidence-based analysis shows that there is good evidence for the treatment of open fractures with antibiotics and surgical debridement. Vacuum treatment can be recommended if wound closure is not possible.
Assuntos
Antibacterianos/administração & dosagem , Fraturas Expostas/epidemiologia , Fraturas Expostas/cirurgia , Infecções por Bactérias Gram-Positivas/epidemiologia , Infecções por Bactérias Gram-Positivas/prevenção & controle , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Adulto , Comorbidade , Medicina Baseada em Evidências , Humanos , Prevalência , Medição de Risco , Fatores de RiscoRESUMO
BACKGROUND: The optimal treatment strategy for unstable trochanteric fractures in the elderly is still controversial because of the frequent failure of osteosynthesis. METHODS: A cohort of patients with unstable trochanteric fractures who were treated with cemented hemiarthroplasty and presented in our department during the period 2003-2009 was analyzed. Complications, reoperations, walking ability and full weight bearing were documented. RESULTS: A total of 91 patients were included (mean age 87.7±6.8 years) and predominantly 31A2 fractures (89%) were treated. There were 3.3% reoperations in the cohort and the 30 day mortality was 5.5%. At least 1 general complication occurred in over 50% of the patients. However, 30% of the patients had lower urinary tract infections, disturbances of electrolyte balance or transitory psychotic symptoms. On average full weight bearing could be performed at 3.5 (±3) days after the operation. CONCLUSION: Cemented hemiarthroplasty is a safe treatment strategy for unstable trochanteric fractures in the elderly, which allows early full weight bearing. Because of frequent general complications, more interdisciplinary units and centres of excellence are needed to handle this challenging cohort.
Assuntos
Cimentação/estatística & dados numéricos , Fraturas do Fêmur/mortalidade , Fraturas do Fêmur/cirurgia , Prótese de Quadril/estatística & dados numéricos , Instabilidade Articular/mortalidade , Instabilidade Articular/cirurgia , Complicações Pós-Operatórias/mortalidade , Idoso de 80 Anos ou mais , Estudos de Coortes , Comorbidade , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Prevalência , Medição de Risco , Fatores de Risco , Análise de Sobrevida , Taxa de Sobrevida , Resultado do TratamentoRESUMO
Breakage or deformity of intramedullary nails of the lower extremities is the result of subsequent high energy trauma, falling or noncompliance of the patient in partial weight bearing. We describe the removal of a bent tibia nail in a young patient who sustained another high energy trauma on the same limb. Different surgical options are discussed on the basis of the current literature. Possible removal strategies could be: drilling half diameter of the nail and then straighten it backwards, cutting the nail with a burr or removing the nail without any manipulation of the nail itself. The most customized procedure depends on the available capabilities and the individual case because of the rare occurrence of bent nails. Soft tissue damage, degree of bending and re-osteosynthesis must be considered in individual treatment strategies.
Assuntos
Pinos Ortopédicos , Remoção de Dispositivo/instrumentação , Remoção de Dispositivo/métodos , Fixação Intramedular de Fraturas/instrumentação , Falha de Prótese , Adolescente , Humanos , MasculinoRESUMO
INTRODUCTION: The physical examination of the knee in cases of suspected meniscal tears serves to increase the probability of a correct diagnosis. Although there is a large variety of functional tests, the quality of each diagnostic test is controversially discussed. MATERIALS AND METHODS: Through a systematic literature search in Medline and the Cochrane Database two reviewers independently screened publications, evaluated each study for methodological quality and categorized them into levels of evidence (CEBM). Sensitivity, specificity, positive and negative predicted value, as well as positive and negative likelihood ratio (LR+/LR-) values were calculated in order to render the quality threshold of the physical examination in meniscus impairment. RESULTS: The Thessaly test (sensitivity: 91%, specificity: 97%, PPV: 97%, NPV: 91% LR+: 31.1, LR-: 0.1) revealed the highest test quality. Limited quality was shown for the Mc Murray test (sensitivity: 51%, specificity: 78%, PPV: 70%, NPV: 61%, LR+: 2.3, LR-: 0.6), "joint line tenderness" (sensitivity: 64%, specificity: 61%, PPV: 62%, NPV: 63%, LR+: 1.6, LR-: 0.6), the Apley-Grinding test (sensitivity: 38%, specificity: 84%, PPV: 71%, NPV: 58%, LR+: 2.4, LR-: 0.7) and the Ege test (sensitivity: 66%, specificity: 86%, PPV: 83%, NPV: 72%, LR+: 4.7, LR-: 0.4). Evidence for Steinman's test, Bragard's test and the meniscal signs of Böhler or Payr could not be tested. CONCLUSION: Meniscal injury can be detected by several functional tests. Using the Thessaly test can improve the physical examination by means of probability of the correct diagnosis, but the results are based on a single study. In patients with ambiguous findings in the physical examination or with suspected combined injury, further diagnostic procedures such as magnetic resonance imaging are necessary to confirm the diagnosis. In clinically certain cases the use of additional diagnostic imaging procedures should be avoided as other authors have shown that with few exceptions this has no influence on the therapy.
Assuntos
Traumatismos do Joelho/diagnóstico , Lesões do Menisco Tibial , Artroscopia/normas , Estudos de Coortes , Diagnóstico Diferencial , Medicina Baseada em Evidências/normas , Humanos , Traumatismos do Joelho/cirurgia , Imageamento por Ressonância Magnética , Meniscos Tibiais/cirurgia , Exame Físico/normas , Garantia da Qualidade dos Cuidados de Saúde/normas , Padrões de Referência , Sensibilidade e EspecificidadeRESUMO
INTRODUCTION: Patients with widened or misplaced tunnels may require bone grafting prior to revision anterior cruciate ligament (ACL) reconstruction. Utilising reamer-irrigator-aspirator (RIA) harvested bone from the femur showed promising filling rates. Nevertheless, the procedure has neither been validated in a larger population nor been assessed with regards to radiological and clinical outcome of the subsequently conducted revision ACL reconstruction. Therefore, the aim of this study was to evaluate tunnel filling rates, positioning of the revision tunnels and outcome parameters of such two-staged revision ACL reconstructions. MATERIAL AND METHODS: A total of 15 consecutive patients were prospectively enrolled in this case series. CT scans were analysed before and after autologous RIA harvested bone grafting. Tunnel volumes and filling rates were calculated based on manual segmentation of axial CT scans. Revision ACL reconstruction was carried out after a mean interval of 6.2 months (±3.7) and positioning of the revision tunnels was assessed by plane radiographs. The mean follow-up was 19.8 months (±8.4) for objective evaluation and 37.1 months (±15.4) for patient reported outcomes. The clinical outcome was assessed by the quantification of the anterior tibial translation, the IKDC objective score, the Tegner activity scale and the Lysholm score. RESULTS: Initial CT scans revealed mean tunnel volumes of 3.8cm3 (±2.7) femoral and 6.1cm3 (±2.4) tibial. Filling rates of 76.1% (±12.4) femoral and 87.4% (±5.9) tibial were achieved. Postoperative radiographs revealed significantly improved tunnel positioning with anatomical placement in all but one case at the femur and in all cases at the tibia. At follow up, patients showed significantly improved anterior tibial translations with residual side-to-side differences of 1.7 mm (±0.8) and significantly improved IKDC objective scores. Furthermore, significantly higher values were achieved on the Tegner activity scale (5.3 ± 1.4 vs. 2.8 ± 0.5) and the Lysholm score (85.4 ± 7.9 vs. 62.5 ± 10.5) compared to the preoperative status. CONCLUSION: Autologous RIA harvested bone grafting ensures sufficient bone stock consolidation allowing for anatomical tunnel placement of the subsequently conducted revision ACL reconstruction. The two-staged procedure reliably restores stability and provides satisfying subjective and objective outcomes. Thus, RIA harvested bone grafting is an eligible alternative to autologous iliac crest or allogenic bone grafting.
Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior , Transplante Ósseo/métodos , Coleta de Tecidos e Órgãos/métodos , Adulto , Lesões do Ligamento Cruzado Anterior/diagnóstico por imagem , Lesões do Ligamento Cruzado Anterior/patologia , Reconstrução do Ligamento Cruzado Anterior/métodos , Feminino , Fêmur/transplante , Humanos , Masculino , Estudos Prospectivos , Reoperação/estatística & dados numéricos , Tíbia/transplante , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Adulto JovemRESUMO
The levels of 5-hydroxytryptamine have been measured in 33 areas of the human brain and these levels compared in depressed suicides, in alcoholic suicides, and in controls. The values obtained for control brains ranged from 5.3 mumole 5-HT/kg wet weight in substantia nigra to 0.4 mumole 5-HT/kg wet weight in frontal gray. No significant differences were found among diagnostic groups in any of the areas studied.
Assuntos
Alcoolismo/metabolismo , Encéfalo/metabolismo , Depressão/metabolismo , Serotonina/metabolismo , Suicídio , Adulto , Idoso , Tonsila do Cerebelo/metabolismo , Animais , Química Encefálica , Núcleo Caudado/metabolismo , Cerebelo/metabolismo , Córtex Cerebral/metabolismo , Feminino , Globo Pálido/metabolismo , Giro do Cíngulo/metabolismo , Hipocampo/metabolismo , Humanos , Hipotálamo/metabolismo , Masculino , Pessoa de Meia-Idade , Ponte/metabolismo , Putamen/metabolismo , Ratos , Substância Negra/metabolismo , Teto do Mesencéfalo/metabolismo , Tegmento Mesencefálico/metabolismo , Tálamo/metabolismoRESUMO
Spinocerebellar ataxia type 7 (SCA7) is one member of a growing list of neurodegenerative disorders that are all caused by CAG repeat expansions that produce disease by encoding elongated polyglutamine tracts in a variety of apparently unrelated proteins. In this review, we provide an overview of our efforts to determine the molecular basis of polyglutamine neurotoxicity in SCA7 by modeling this polyglutamine repeat disorder in mice. We discuss how our SCA7 mouse model develops a phenotype that is reminiscent of the retinal and cerebellar disease pathology seen in human patients. All of these findings are considered in the context of numerous other models of polyglutamine disease pathology in mice and other organisms, together with various other in vitro and biochemical studies. We present the competing hypotheses of polyglutamine disease pathogenesis, and explain how our studies of SCA7 brainstem and retinal degeneration using this mouse model have yielded insights into possible mechanisms and pathways of polyglutamine disease pathology. In addition to illustrating how our SCA7 mouse model has allowed us to develop and advance notions of disease pathogenesis, we propose a model of polyglutamine molecular pathology that attempts to integrate the key observations in the field. We close by describing why our SCA7 mouse model should be useful for the next phase of polyglutamine disease research--the development of therapies, and predict that this stage of experimentation will continue to rely heavily on the mouse.
Assuntos
Modelos Animais de Doenças , Proteínas do Tecido Nervoso/genética , Ataxias Espinocerebelares/genética , Expansão das Repetições de Trinucleotídeos/genética , Ataxina-7 , Tronco Encefálico/metabolismo , Tronco Encefálico/patologia , Tronco Encefálico/ultraestrutura , Transtornos Heredodegenerativos do Sistema Nervoso/genética , Transtornos Heredodegenerativos do Sistema Nervoso/patologia , Peptídeos/genética , Degeneração Retiniana/genética , Degeneração Retiniana/patologia , Ataxias Espinocerebelares/patologiaRESUMO
Both zinc and neuropeptide Y (NPY) have been implicated as playing a role in seizures and feeding behavior. We investigated the hypothesis that zinc could regulate levels of NPY, and found that chronic exposure to 50-100 microM zinc increased levels of cellular NPY in cultured PC12 cells grown in the presence of nerve growth factor. Zinc's effect on NPY was specific, time- and concentration-dependent, and independent of inhibition of NPY release secondary to blockade of dihydropyridine-sensitive calcium channels. These results are consistent with a role for zinc in regulating hippocampal NPY following high-frequency neuronal activity.
Assuntos
Neuritos/efeitos dos fármacos , Neuropeptídeo Y/efeitos dos fármacos , Zinco/farmacologia , Animais , Bloqueadores dos Canais de Cálcio/farmacologia , Canais de Cálcio Tipo L/efeitos dos fármacos , Canais de Cálcio Tipo L/fisiologia , Neuritos/metabolismo , Neuropeptídeo Y/metabolismo , Nifedipino/farmacologia , Células PC12/efeitos dos fármacos , Células PC12/metabolismo , RatosAssuntos
Corpos Estranhos/cirurgia , Vidro , Pele/lesões , Lesões dos Tecidos Moles/cirurgia , Ferimentos Penetrantes/cirurgia , Procedimentos Cirúrgicos Ambulatórios , Árvores de Decisões , Procedimentos Cirúrgicos Dermatológicos , Corpos Estranhos/diagnóstico por imagem , Alemanha , Humanos , Admissão do Paciente , Radiografia , Lesões dos Tecidos Moles/diagnóstico por imagem , Ferimentos Penetrantes/diagnóstico por imagemAssuntos
Traumatismos do Tornozelo/diagnóstico por imagem , Radiografia/normas , Entorses e Distensões/diagnóstico por imagem , Adulto , Articulação do Tornozelo/diagnóstico por imagem , Pé/diagnóstico por imagem , Humanos , Masculino , Metanálise como Assunto , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Fatores de TempoRESUMO
Proteolytic cleavage of factor Va, caused by activated protein C, is an important mechanism in limiting clot formation in normal haemostasis. A single point mutation in the factor V gene has been demonstrated to cause resistance of factor Va to proteolytic cleavage by activated protein C. With an 8-fold increased risk of thrombosis and a 2 to 13% prevalence in the Caucasian population for the heterozygous state of this mutation, knowledge of the patient's genetic disposition is of great importance in conditions such as pregnancy, surgery, use of oral contraceptives and immobilization. Therefore we have developed an automated test for the detection of the factor V mutation. This PCR based test makes use of the disappearance of an Mnl 1 restriction site if the mutation is present. The assay has been developed for the widely used ES-systems of Boehringer Mannheim. The test discriminates between the heterozygous and the homozygous state. Because of its low costs and easy handling the assay can be used as a screening test and can be performed in routine clinical laboratories.
Assuntos
Resistência à Proteína C Ativada/genética , Fator V/genética , Sequência de Bases , Testes de Química Clínica/economia , Custos e Análise de Custo , DNA , Enzimas de Restrição do DNA , Humanos , Hidrólise , Dados de Sequência Molecular , Mutação Puntual , Reação em Cadeia da Polimerase , Reprodutibilidade dos TestesRESUMO
For the purpose of evaluating the stress on citydwellers by pollutants emanating from traffic sources the contents of lead and 3,4-benzpyrene in sedimentable city dust were determined in samples collected at 46 sites with different traffic densities in a city of medium size but considerable overall traffic volume (Erlangen, Bavaria). To estimate the effect of the gasoline-lead-law of Aug 5, 1971, determinations were carried out both in 1971, i.e. before this law came into effect, and in 1977 when the lead content in gasoline was finally limited to 0.15 g/1. The following results were obtained: - In city areas with dense traffic, the medium lead content dropped from 4.2 to 2.2 mg/g of dust, and the medium 3,4-benzpyrene concentration dropped from 1.3 to 0.5 microgram/g of dust. This amounts to a reduction of both the lead and 3,4-benzpyrene contents in city dust by about one half. - In the city periphery with lesser traffic density, the lead and benzpyrene contents, resp., were originally lower by about one half. In the case of lead, the concentration dropped from 1.9 mg to 1.2 mg/g dust, while 3,4-benzpyrene dropped from 0.6 to 0.4 microgram/g dust. Thus, the beneficial effect of the gasoline-lead-law was less obvious in these low-traffic parts of the city area. - The decrease in 3,4-benzpyrene with decreasing lead content is remarkable (striking, a striking pheromeron) and may be explained by lesser emission of this pollutant when burning gasoline low in lead.
Assuntos
Benzopirenos/análise , Poeira/análise , Poluentes Ambientais/análise , Gasolina/normas , Chumbo/análise , Petróleo/normas , Automóveis , Alemanha Ocidental , Legislação como AssuntoRESUMO
A method is described for the observation of live mammalian cells in culture with an incubated phase-contrast microscope. A sample of plated cells may be watched and their respective capacities to form a colony measured by daily cell counts. The method has first been used to make direct estimations of the plating efficiency of the diploid line of Syrian hamster fibroblasts, BHK 21 C13, and then to observe the response of synchronous samples of these cells to 220 kV X-rays. A dose of 1.4 Gy given in Gl has no immediate detectable effect on cell or unclear morphology, and cell capacity to reach post-irradiation mitosis in unimpaired apart from delay. In contrast, after this mitosis is completed, descendant cells from some mitoses retain a normal form and clonogenic capacity, whereas the cells from other mitoses show varying degrees of abnormality and produce either slow-growth or stop-growth (micro-) colonies.