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2.
Oncogene ; 25(49): 6544-53, 2006 Oct 19.
Article in English | MEDLINE | ID: mdl-16702952

ABSTRACT

We analysed chromosome 16q in 106 breast cancers using tiling-path array-comparative genomic hybridization (aCGH). About 80% of ductal cancers (IDCs) and all lobular cancers (ILCs) lost at least part of 16q. Grade I (GI) IDCs and ILCs often lost the whole chromosome arm. Grade II (GII) and grade III (GIII) IDCs showed less frequent whole-arm loss, but often had complex changes, typically small regions of gain together with larger regions of loss. The boundaries of gains/losses tended to cluster, common sites being 54.5-55.5 Mb and 57.4-58.8 Mb. Overall, the peak frequency of loss (83% cancers) occurred at 61.9-62.9 Mb. We also found several 'minimal' regions of loss/gain. However, no mutations in candidate genes (TRADD, CDH5, CDH8 and CDH11) were detected. Cluster analysis based on copy number changes identified a large group of cancers that had lost most of 16q, and two smaller groups (one with few changes, one with a tendency to show copy number gain). Although all morphological types occurred in each cluster group, IDCs (especially GII/GIII) were relatively overrepresented in the smaller groups. Cluster groups were not independently associated with survival. Use of tiling-path aCGH prompted re-evaluation of the hypothetical pathways of breast carcinogenesis. ILCs have the simplest changes on 16q and probably diverge from the IDC lineage close to the stage of 16q loss. Higher-grade IDCs probably develop from low-grade lesions in most cases, but there remains evidence that some GII/GIII IDCs arise without a GI precursor.


Subject(s)
Breast Neoplasms/genetics , Carcinoma, Ductal, Breast/genetics , Carcinoma, Lobular/genetics , Chromosomes, Human, Pair 16 , Neoplasm Invasiveness/genetics , Nucleic Acid Hybridization/methods , Tissue Array Analysis/methods , Chromosome Aberrations , Chromosome Breakage , Cluster Analysis , DNA, Neoplasm , Gene Amplification , Gene Deletion , Genetic Linkage , Humans , Loss of Heterozygosity , Models, Statistical , Neoplasm Staging
3.
J Med Genet ; 43(2): 180-6, 2006 Feb.
Article in English | MEDLINE | ID: mdl-15980116

ABSTRACT

BACKGROUND: The underlying causes of mental retardation remain unknown in about half the cases. Recent array-CGH studies demonstrated cryptic imbalances in about 25% of patients previously thought to be chromosomally normal. OBJECTIVE AND METHODS: Array-CGH with approximately 3500 large insert clones spaced at approximately 1 Mb intervals was used to investigate DNA copy number changes in 81 mentally impaired individuals. RESULTS: Imbalances never observed in control chromosomes were detected in 20 patients (25%): seven were de novo, nine were inherited, and four could not have their origin determined. Six other alterations detected by array were disregarded because they were shown by FISH either to hybridise to both homologues similarly in a presumptive deletion (one case) or to involve clones that hybridised to multiple sites (five cases). All de novo imbalances were assumed to be causally related to the abnormal phenotypes. Among the others, a causal relation between the rearrangements and an aberrant phenotype could be inferred in six cases, including two imbalances of the X chromosome, where the associated clinical features segregated as X linked recessive traits. CONCLUSIONS: In all, 13 of 81 patients (16%) were found to have chromosomal imbalances probably related to their clinical features. The clinical significance of the seven remaining imbalances remains unclear. The limited ability to differentiate between inherited copy number variations which cause abnormal phenotypes and rare variants unrelated to clinical alterations currently constitutes a limitation in the use of CGH-microarray for guiding genetic counselling.


Subject(s)
Allelic Imbalance/genetics , Gene Rearrangement/genetics , In Situ Hybridization, Fluorescence , Intellectual Disability/genetics , Child , Chromosomes, Human, Pair 2/genetics , Humans
4.
J Med Genet ; 43(4): 353-61, 2006 Apr.
Article in English | MEDLINE | ID: mdl-16199537

ABSTRACT

BACKGROUND: Karyotype analysis has been the standard method for prenatal cytogenetic diagnosis since the 1970s. Although highly reliable, the major limitation remains the requirement for cell culture, resulting in a delay of as much as 14 days to obtaining test results. Fluorescent in situ hybridisation (FISH) and quantitative fluorescent PCR (QF-PCR) rapidly detect common chromosomal abnormalities but do not provide a genome wide screen for unexpected imbalances. Array comparative genomic hybridisation (CGH) has the potential to combine the speed of DNA analysis with a large capacity to scan for genomic abnormalities. We have developed a genomic microarray of approximately 600 large insert clones designed to detect aneuploidy, known microdeletion syndromes, and large unbalanced chromosomal rearrangements. METHODS: This array was tested alongside an array with an approximate resolution of 1 Mb in a blind study of 30 cultured prenatal and postnatal samples with microscopically confirmed unbalanced rearrangements. RESULTS: At 1 Mb resolution, 22/30 rearrangements were identified, whereas 29/30 aberrations were detected using the custom designed array, owing to the inclusion of specifically chosen clones to give increased resolution at genomic loci clinically implicated in known microdeletion syndromes. Both arrays failed to identify a triploid karyotype. Thirty normal control samples produced no false positive results. CONCLUSIONS: Analysis of 30 uncultured prenatal samples showed that array CGH is capable of detecting aneuploidy in DNA isolated from as little as 1 ml of uncultured amniotic fluid; 29/30 samples were correctly diagnosed, the exception being another case of triploidy. These studies demonstrate the potential for array CGH to replace conventional cytogenetics in the great majority of prenatal diagnosis cases.


Subject(s)
Chromosome Aberrations , Fetal Diseases/diagnosis , Oligonucleotide Array Sequence Analysis/methods , Prenatal Diagnosis/methods , Female , Fetal Diseases/genetics , Genome, Human , Humans , Pregnancy , Sensitivity and Specificity
5.
Oncogene ; 25(8): 1261-71, 2006 Feb 23.
Article in English | MEDLINE | ID: mdl-16205629

ABSTRACT

Deletions of chromosome 6 are a common abnormality in diverse human malignancies including astrocytic tumours, suggesting the presence of tumour suppressor genes (TSG). In order to help identify candidate TSGs, we have constructed a chromosome 6 tile path microarray. The array contains 1,780 clones (778 P1-derived artificial chromosome and 1,002 bacterial artificial chromosome) that cover 98.3% of the published chromosome 6 sequences. A total of 104 adult astrocytic tumours (10 diffuse astrocytomas, 30 anaplastic astrocytomas (AA), 64 glioblastomas (GB)) were analysed using this array. Single copy number change was successfully detected and the result was in general concordant with a microsatellite analysis. The pattern of copy number change was complex with multiple interstitial deletions/gains. However, a predominance of telomeric 6q deletions was seen. Two small common and overlapping regions of deletion at 6q26 were identified. One was 1,002 kb in size and contained PACRG and QKI, while the second was 199 kb and harbours a single gene, ARID1B. The data show that the chromosome 6 tile path array is useful in mapping copy number changes with high resolution and accuracy. We confirmed the high frequency of chromosome 6 deletions in AA and GB, and identified two novel commonly deleted regions that may harbour TSGs.


Subject(s)
Astrocytoma/genetics , Chromosome Deletion , Chromosomes, Human, Pair 6/genetics , Glioblastoma/genetics , Nucleic Acid Hybridization , Oligonucleotide Array Sequence Analysis , Astrocytoma/pathology , Brain Neoplasms/genetics , Brain Neoplasms/pathology , Chromosomes, Artificial, Bacterial , DNA, Neoplasm/analysis , Gene Dosage , Glioblastoma/pathology , Humans , Microsatellite Repeats , Telomere/genetics
6.
Eur J Med Genet ; 48(3): 232-40, 2005.
Article in English | MEDLINE | ID: mdl-16179219

ABSTRACT

Microscopic karyotype analysis of cultured cells has been regarded as the gold standard for prenatal diagnosis for over 30 years. Since the first application of this technique to prenatal testing in the early 1970's, this procedure has proved to be highly reliable for identifying chromosome copy number abnormalities (aneuploidy) and large structural rearrangements in foetal cells obtained invasively by either amniocentesis or chorionic villus sampling (CVS). Recognising the need for more rapid testing methods which do not require cell culture, fluorescence in situ hybridisation (FISH) and quantitative fluorescence PCR (QF-PCR) have been introduced to this field in order to answer specific diagnostic questions. However, both FISH and QF-PCR suffer the disadvantage in that they are difficult to scale to a comprehensive, genome-wide screen. Array-comparative genomic hybridisation (array-CGH) in contrast is a comprehensive, genome-wide screening strategy for detecting DNA copy number imbalances which can be rapid, less labour-intensive than karyotype banding analysis and is highly amenable to automation. Array-CGH has the potential to be used for prenatal diagnosis and may address many of the limitations of both conventional microscopic cytogenetic analyses and the more recently employed rapid-screening strategies.


Subject(s)
Gene Dosage , Oligonucleotide Array Sequence Analysis/methods , Prenatal Diagnosis/methods , Chromosomes, Human/genetics , DNA/analysis , Female , Genomics/methods , Humans , Nucleic Acid Hybridization/methods , Pregnancy
8.
J Med Genet ; 42(1): 8-16, 2005 Jan.
Article in English | MEDLINE | ID: mdl-15635069

ABSTRACT

OBJECTIVE: To describe the systematic analysis of constitutional de novo apparently balanced translocations in patients presenting with abnormal phenotypes, characterise the structural chromosome rearrangements, map the translocation breakpoints, and report detectable genomic imbalances. METHODS: DNA microarrays were used with a resolution of 1 Mb for the detailed genome-wide analysis of the patients. Array CGH was used to screen for genomic imbalance and array painting to map chromosome breakpoints rapidly. These two methods facilitate rapid analysis of translocation breakpoints and screening for cryptic chromosome imbalance. Breakpoints of rearrangements were further refined (to the level of spanning clones) using fluorescence in situ hybridisation where appropriate. RESULTS: Unexpected additional complexity or genome imbalance was found in six of 10 patients studied. The patients could be grouped according to the general nature of the karyotype rearrangement as follows: (A) three cases with complex multiple rearrangements including deletions, inversions, and insertions at or near one or both breakpoints; (B) three cases in which, while the translocations appeared to be balanced, microarray analysis identified previously unrecognised imbalance on chromosomes unrelated to the translocation; (C) four cases in which the translocation breakpoints appeared simple and balanced at the resolution used. CONCLUSIONS: This high level of unexpected rearrangement complexity, if generally confirmed in the study of further patients, will have an impact on current diagnostic investigations of this type and provides an argument for the more widespread adoption of microarray analysis or other high resolution genome-wide screens for chromosome imbalance and rearrangement.


Subject(s)
Congenital Abnormalities/genetics , Translocation, Genetic , Cell Line , Chromosome Aberrations , Chromosomes, Artificial, Bacterial , Cloning, Molecular , Female , Gene Rearrangement , Genome, Human , Humans , In Situ Hybridization, Fluorescence , Incidence , Male , Oligonucleotide Array Sequence Analysis , Phenotype
9.
J Med Genet ; 41(4): 241-8, 2004 Apr.
Article in English | MEDLINE | ID: mdl-15060094

ABSTRACT

The underlying causes of learning disability and dysmorphic features in many patients remain unidentified despite extensive investigation. Routine karyotype analysis is not sensitive enough to detect subtle chromosome rearrangements (less than 5 Mb). The presence of subtle DNA copy number changes was investigated by array-CGH in 50 patients with learning disability and dysmorphism, employing a DNA microarray constructed from large insert clones spaced at approximately 1 Mb intervals across the genome. Twelve copy number abnormalities were identified in 12 patients (24% of the total): seven deletions (six apparently de novo and one inherited from a phenotypically normal parent) and five duplications (one de novo and four inherited from phenotypically normal parents). Altered segments ranged in size from those involving a single clone to regions as large as 14 Mb. No recurrent deletion or duplication was identified within this cohort of patients. On the basis of these results, we anticipate that array-CGH will become a routine method of genome-wide screening for imbalanced rearrangements in children with learning disability.


Subject(s)
Chromosome Aberrations , Chromosome Disorders/genetics , Cytogenetic Analysis/methods , Intellectual Disability/genetics , Learning Disabilities/genetics , Oligonucleotide Array Sequence Analysis/methods , Adolescent , Adult , Child , Child, Preschool , Chromosome Deletion , Female , Humans , Male
10.
Chromosome Res ; 12(1): 35-43, 2004.
Article in English | MEDLINE | ID: mdl-14984100

ABSTRACT

The sequencing of the human genome has led to the availability of an extensive mapped clone resource that is ideal for the construction of DNA microarrays. These genomic clone microarrays have largely been used for comparative genomic hybridisation studies of tumours to enable accurate measurement of copy number changes (array-CGH) at increased resolution. We have utilised these microarrays as the target for chromosome painting and reverse chromosome painting to provide a similar improvement in analysis resolution for these studies in a process we have termed array painting. In array painting, chromosomes are flow sorted, fluorescently labelled and hybridised to the microarray. The complete composition and the breakpoints of aberrant chromosomes can be analysed at high resolution in this way with a considerable reduction in time, effort and cytogenetic expertise required for conventional analysis using fluorescence in situ hybridisation. In a similar way, the resolution of cross-species chromosome painting can be improved and we present preliminary observations of the organisation of homologous DNA blocks between the white cheeked gibbon chromosome 14 and human chromosomes 2 and 17.


Subject(s)
Chromosome Painting/methods , Oligonucleotide Array Sequence Analysis/methods , Cell Line , Chromosome Aberrations , Chromosomes, Human, Pair 14 , Chromosomes, Human, Pair 17 , Chromosomes, Human, Pair 2 , Flow Cytometry , Humans , Karyotyping , Models, Molecular , Translocation, Genetic
12.
J Med Genet ; 40(9): 664-70, 2003 Sep.
Article in English | MEDLINE | ID: mdl-12960211

ABSTRACT

OBJECTIVE: The authors describe a method, termed array painting, which allows the rapid, high resolution analysis of the content and breakpoints of aberrant chromosomes. METHODS: Array painting is similar in concept to reverse chromosome painting and involves the hybridisation of probes generated by PCR of small numbers of flow sorted chromosomes on large insert genomic clone DNA microarrays. RESULTS: and CONCLUSIONS: By analysing patients with cytogenetically balanced chromosome rearrangements, the authors show the effectiveness of array painting as a method to map breakpoints prior to cloning and sequencing chromosome rearrangements.


Subject(s)
Chromosome Aberrations , Oligonucleotide Array Sequence Analysis/methods , Adult , Cell Line , Child , Child, Preschool , Chromosome Disorders/genetics , Chromosome Disorders/pathology , Chromosomes, Human, Pair 11/genetics , Chromosomes, Human, Pair 12/genetics , Chromosomes, Human, Pair 17/genetics , Chromosomes, Human, Pair 22/genetics , Female , Flow Cytometry , Humans , In Situ Hybridization, Fluorescence/methods , Karyotyping/methods , Male , Translocation, Genetic
13.
Cytogenet Genome Res ; 102(1-4): 254-60, 2003.
Article in English | MEDLINE | ID: mdl-14970712

ABSTRACT

As with many human cancers, canine tumors demonstrate recurrent chromosome aberrations. A detailed knowledge of such aberrations may facilitate diagnosis, prognosis and the selection of appropriate therapy. Following recent advances made in human genomics, we are developing a DNA microarray for the domestic dog, to be used in the detection and characterization of copy number changes in canine tumors. As a proof of principle, we have developed a small-scale microarray comprising 87 canine BAC clones. The array is composed of 26 clones selected from a panel of 24 canine cancer genes, representing 18 chromosomes, and an additional set of clones representing dog chromosomes 11, 13, 14 and 31. These chromosomes were shown previously to be commonly aberrant in canine multicentric malignant lymphoma. Clones representing the sex chromosomes were also included. We outline the principles of canine microarray development, and present data obtained from microarray analysis of three canine lymphoma cases previously characterized using conventional cytogenetic techniques.


Subject(s)
Dogs/genetics , Gene Expression Profiling/methods , Gene Expression Profiling/veterinary , Genes, Neoplasm/genetics , Oligonucleotide Array Sequence Analysis/methods , Oligonucleotide Array Sequence Analysis/veterinary , Animals , Chromosomes, Artificial, Bacterial/genetics , DNA, Neoplasm/genetics , Dog Diseases/genetics , Female , Gene Expression Profiling/statistics & numerical data , Gene Expression Regulation, Neoplastic/genetics , In Situ Hybridization, Fluorescence/methods , In Situ Hybridization, Fluorescence/statistics & numerical data , In Situ Hybridization, Fluorescence/veterinary , Lymphoma, B-Cell/genetics , Lymphoma, B-Cell/veterinary , Lymphoma, Non-Hodgkin/genetics , Lymphoma, Non-Hodgkin/veterinary , Male , Metaphase/genetics , Nucleic Acid Hybridization , Oligonucleotide Array Sequence Analysis/statistics & numerical data , Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics , Precursor Cell Lymphoblastic Leukemia-Lymphoma/veterinary
14.
Cytometry ; 49(2): 43-8, 2002 Oct 01.
Article in English | MEDLINE | ID: mdl-12357458

ABSTRACT

BACKGROUND: Array-comparative genomic hybridization (CGH), although providing much higher resolution compared with conventional CGH, has not yet become a widely applied method for the analysis of genomic gains and losses. METHODS: In January 2002, the Wellcome Trust sponsored a workshop where many of the laboratories developing this technology met to compare different methodologies for array-CGH. Fourteen groups participated, comprising 11 from Europe and 3 from the United States. To facilitate objective analysis, each laboratory constructed arrays using the same anonymous clones and performed a series of test hybridizations using identical genomic DNAs. RESULTS: A figure of merit (FM) was developed to summarize entire collections of data from each laboratory in a single measurement. The FMs consistently showed that a few groups produced quantitative array hybridization data of high quality, whereas a majority achieved a lower standard. CONCLUSIONS: The conclusions of the workshop were that polymerase chain reaction-based methods for the amplification of large insert clones for arraying were effective for array-CGH. It was also concluded that hybridizations performed under coverslips or in automated hybridization apparatus were less effective than hybridizations performed in simple wells with gentle rocking. A common experience by the participants was the batch-to-batch variability of commercial Cot1 preparations in their ability to suppress hybridization to repeat sequences. (Supplementary material for this article can be found in the online issue, which is available at http://www.interscience.wiley.com/jpages/0196-4763/suppmat/49_2/v49.43.html or at http://www.sanger.ac.uk/HGP/Cytogenetics/Publications/Cytometry Sept 2002/Supplemental.pdf.)


Subject(s)
Genetics, Medical/trends , Genomics , Nucleic Acid Hybridization/methods , Oligonucleotide Array Sequence Analysis/methods , Technology Assessment, Biomedical , Animals , Drosophila/genetics , Education , Female , Humans , Male , Nucleic Acid Hybridization/immunology , Polymerase Chain Reaction
15.
Br J Haematol ; 110(3): 674-81, 2000 Sep.
Article in English | MEDLINE | ID: mdl-10997980

ABSTRACT

This work aimed to provide a means of assaying directly the effects of transient expression of introduced genes on the survival, proliferation, lineage commitment and differentiation of haemopoietic progenitor cells. For this purpose, we have developed a system that allows isolation of productively transfected, mulitipotent haemopoietic cells within a few hours of the introduction of test genes. We have shown that FDCP-mix cells productively transfected with expression plasmids encoding green fluorescent protein (GFP) differentiate normally and retain colony-forming potential. We constructed an expression vector consisting of a bicistronic cassette in which a GFP marker gene and a test gene are driven from the same promoter. The vector design has been optimized for co-expression and the test gene was shown to be biologically active. The expression profile from a transiently transfected template under different growth conditions reveals that active expression continues for at least 2 d after transfection. The transient transfection of FDCP-mix cells with the vectors described provides a powerful tool for analysis of the immediate early effects of test gene overexpression during haemopoietic differentiation.


Subject(s)
Genes, Regulator , Hematopoietic Stem Cells/metabolism , Animals , Cell Culture Techniques , Cell Differentiation/genetics , Cell Line , Cell Survival/genetics , Colony-Forming Units Assay , Electroporation , Gene Expression , Genetic Vectors/genetics , Green Fluorescent Proteins , Humans , Luminescent Proteins/genetics , Mice , Receptors, Granulocyte-Macrophage Colony-Stimulating Factor/analysis
16.
J Bacteriol ; 181(16): 4929-36, 1999 Aug.
Article in English | MEDLINE | ID: mdl-10438764

ABSTRACT

By transposon Tn917 mutagenesis, two mutants of Staphylococcus xylosus were isolated that showed higher levels of beta-galactosidase activity in the presence of glucose than the wild type. Both transposons integrated in a gene, designated glcU, encoding a protein involved in glucose uptake in S. xylosus, which is followed by a glucose dehydrogenase gene (gdh). Glucose-mediated repression of beta-galactosidase, alpha-glucosidase, and beta-glucuronidase activities was partially relieved in the mutant strains, while repression by sucrose or fructose remained as strong as in the wild type. In addition to the pleiotropic regulatory effect, integration of the transposons into glcU reduced glucose dehydrogenase activity, suggesting cotranscription of glcU and gdh. Insertional inactivation of the gdh gene and deletion of the glcU gene without affecting gdh expression showed that loss of GlcU function is exclusively responsible for the regulatory defect. Reduced glucose repression is most likely the consequence of impaired glucose uptake in the glcU mutant strains. With cloned glcU, an Escherichia coli mutant deficient in glucose transport could grow with glucose as sole carbon source, provided a functional glucose kinase was present. Therefore, glucose is internalized by glcU in nonphosphorylated form. A gene from Bacillus subtilis, ycxE, that is homologous to glcU, could substitute for glcU in the E. coli glucose growth experiments and restored glucose repression in the S. xylosus glcU mutants. Three more proteins with high levels of similarity to GlcU and YcxE are currently in the databases. It appears that these proteins constitute a novel family whose members are involved in bacterial transport processes. GlcU and YcxE are the first examples whose specificity, glucose, has been determined.


Subject(s)
Glucose/pharmacokinetics , Monosaccharide Transport Proteins/genetics , Staphylococcus/enzymology , Staphylococcus/genetics , Bacillus subtilis/enzymology , Bacillus subtilis/genetics , Bacterial Proteins/genetics , Bacterial Proteins/metabolism , Cloning, Molecular , DNA Mutational Analysis , DNA Primers , DNA Transposable Elements , Gene Deletion , Gene Expression Regulation, Bacterial , Gene Expression Regulation, Enzymologic , Genetic Complementation Test , Glucose 1-Dehydrogenase , Glucose Dehydrogenases/genetics , Glucose Dehydrogenases/metabolism , Glucosidases/metabolism , Glucuronidase/metabolism , Lactose/pharmacokinetics , Monosaccharide Transport Proteins/metabolism , Mutagenesis , RNA, Bacterial/genetics , Sucrose/pharmacokinetics , Transcription, Genetic/genetics , beta-Galactosidase/metabolism
17.
FEMS Microbiol Lett ; 148(2): 181-7, 1997 Mar 15.
Article in English | MEDLINE | ID: mdl-9084146

ABSTRACT

A transposon Tn917-induced mutant strain of Staphylococcus xylosus was isolated that required exogenous cysteine for growth. The transposon was found to reside within a gene, designated cysE, encoding a protein of 216 amino acids with a high level of similarity to bacterial serine acetyltransferases. The cysE::Tn917 mutant completely lost serine acetyltransferase activity, which is easily detectable in the wild-type strain. In addition, the mutant strain could no longer grow in minimal medium without cysteine. Therefore, the cysE gene product is essential for the de novo synthesis of cysteine via O-acetyl-L-serine in S. xylosus. The cysE gene is surrounded by genes encoding glutamyl-tRNA synthetase (gltX) and cysteinyl-tRNA synthetase (cysS), as deduced from sequence comparisons. The genetic organisation in S. xylosus, gltX-cysE-cysS, is identical to that found in Bacillus subtilis and Bacillus stearothermophilus.


Subject(s)
Acetyltransferases/genetics , Bacterial Proteins/genetics , Genes, Bacterial , Staphylococcus/genetics , Acetyltransferases/chemistry , Amino Acid Sequence , Base Sequence , Escherichia coli Proteins , Gene Expression Regulation, Enzymologic , Genetic Complementation Test , Molecular Sequence Data , Mutation , Serine O-Acetyltransferase , Staphylococcus/enzymology , Staphylococcus/growth & development
18.
Z Alternsforsch ; 44(5): 293-7, 1989.
Article in German | MEDLINE | ID: mdl-2815848

ABSTRACT

In a prospective study of 150 patients with definite myocardial infarction (WHO) risk group assignment in the acute phase was done based on lactate dehydrogenase isoenzyme monitoring. 28% of the patients were older than 60 years. The informative functional exercise test was performed by the end of the hospital phase according to three risk groups at different times. Low risk on the 14th day, medium risk on the 21st day, and patients at highest risk on the 28th day after the infarction at the earliest. In connection there this test lactate was determined. In older patients, upper age limit 75 years, any severe complications did not occur during exercise. High-risk patients were objectified by the lactate dynamism, and the decision was made on the further individual outpatient design of physical conditioning by means of low level exercise training.


Subject(s)
Exercise Test , L-Lactate Dehydrogenase/blood , Myocardial Infarction/rehabilitation , Aged , Early Ambulation , Female , Follow-Up Studies , Humans , Isoenzymes , Male , Middle Aged , Myocardial Infarction/enzymology , Risk Factors
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