Management of Leg Ulcers Using Combined PRP Therapy on a Nanofiber Carrier: Results of a Pilot Study.

PURPOSE OF THE STUDY Population aging is connected with an increased incidence of chronic diseases. A common related problem is chronic skin ulcers, which, while not life-threatening, can significantly decrease the quality of the patient's life. The present study aims to evaluate new materials and methods to improve and accelerate the treatment of leg ulcers. MATERIAL AND METHODS Twenty-five patients with chronic ulcers treated using autologous growth factors applied on a nanofiber carrier were included in the cohort. The control group consisted of 15 patients treated using standard moist wound therapy. The surface area of the ulcer was measured on the 0th, 14th, 28th, 56th, 84th, 112th, 140th, 140th, and 168th day of treatment. Ulcer depth was measured on the 0th, 5th, 28th, 84th, and 168th day of treatment. Results were statistically processed and evaluated. RESULTS During the study, the defect area decreased in both the control and experimental group. Statistically significantly better results were observed in the experimental group relative to the progress of ulcer depth. The experimental group also had more healed ulcers. DISCUSSION Moistness is necessary for chronic wounds to heal; it is needed to ensure optimal cell growth, angiogenesis, and fibrinolysis. Wounds can be treated using non-active dressings with high absorption qualities; however, these do not guarantee optimal conditions for healing, or wounds can be treated with an interactive dressing that interacts with the wound surface. The third option for treatment is the use of bioactive materials that adhere to the wound and participate directly in the individual stages of healing. CONCLUSIONS The study found that autologous growth factors had statistically significant effects on the treatment of chronic ulcers. The authors believe that this method can accelerate the healing of primary post-injury or secondary postoperative wounds of lower leg soft tissues. Key words: trophic ulcer, autologous growth factors, microangiopathy, polyneuropathy, diabetes mellitus.

Occurrence of 3-MCPD fatty acid esters in human breast milk.

A series of twelve breast milk samples were analysed by gas chromatography-mass spectrometry (GC/MS) operated in selected ion monitoring mode for 3-chloropropane-1,2-diol (3-MCPD). Whilst none of the samples contained 3-MCPD above the limit of detection of 3 microg kg(-1) milk, all contained high amounts of 3-MCPD esterified with higher fatty acids. The levels of 3-MCPD released by hydrolysis of these esters (bound 3-MCPD) ranged from the limit of detection (300 microg kg(-1), expressed on a fat basis) to 2195 microg kg(-1); with a mean level of bound 3-MCPD of 1014 microg kg(-1), which corresponded to 35.5 microg kg(-1) milk. The presence of bound 3-MCPD was confirmed using orthogonal gas chromatography coupled with high-speed time-of-flight mass spectrometry analysis for four randomly selected breast milk samples. Six breast milks collected from one of the nursing mothers 14-76 days after childbirth contained bound 3-MCPD within the range of 328-2078 microg kg(-1) fat (mean 930 microg kg(-1) fat). The calculated bound 3-MCPD content of these samples was within the range of 6 and 19 microg kg(-1) milk (mean of 12 microg kg(-1) milk). The major types of 3-MCPD esters were the symmetric diesters with lauric, palmitic, and oleic acids, and asymmetric diesters with palmitic acid/oleic acid among which 3-chloro-1,2-propanediol 1,2-dioleate prevailed.

Application of head-space solid-phase microextraction coupled to comprehensive two-dimensional gas chromatography-time-of-flight mass spectrometry for the determination of multiple pesticide residues in tea samples.

A new method has been developed to detect 36 pesticides that may contaminate tea samples (green, black and fruit tea). The hyphenation of solid-phase microextraction in head-space mode with a comprehensive two-dimensional gas chromatography coupled with high-speed time-of-flight mass spectrometry (HS-SPME-GCxGC/TOF MS) proved to be a quick alternative to conventional GC/MS methodology which employs solvent-based extraction. The key parameters for controlling HS-SPME performance were optimized, including fiber coating type, temperature and absorption time settings and tea matrix modification by adding water. Quantification was carried out using matrix-matched calibration. The repeatability of measurements, expressed as relative standard deviation (R.S.D.), was less than 24% for all analytes. The limits of quantification ranged from 1 to 28 microgkg(-1). The optimized method was applied to analyze real life samples obtained from a retail market. Results generated by the new SPME procedure and those obtained by using a conventional one involving ethyl acetate extraction and high-performance gel permeation chromatography (HPGPC) clean up agreed with each other for positive (containing residue) samples.

Platelet-induced inhibition of adrenomedullin secretion.

Adrenomedullin is a biologically active peptide released from the vascular wall, which increases blood flow through its vasorelaxant effects and prevents platelet activation by stimulation of nitric oxide synthesis. The present study demonstrates that activated platelets suppress adrenomedullin secretion from vascular endothelial cells by releasing a factor that was identified as transforming growth factor (TGF)-beta1. Adrenomedullin levels were reduced by up to 40% and this effect was completely abrogated by the addition of latency-associated protein (LAP) or TGF-beta1-neutralizing antibody. Inhibition of adrenomedullin secretion in response to platelet aggregation may be an important mechanism in the induction of hemostasis.

Systemic inflammatory parameters in patients with atherosclerosis of the coronary and peripheral arteries.

Plasma concentration of markers of inflammation are increased in patients with atherosclerosis. However, it is unclear whether the pattern and magnitude of this increase vary with the site and extent of disease. In 147 patients undergoing semiquantitative coronary angiography, we measured the acute-phase reactants C-reactive protein (CRP) or serum amyloid A (SAA); the proinflammatory cytokine interleukin 6 (IL-6); the active and total fractions of the anti-inflammatory cytokine transforming growth factor-beta (TGF-beta); the macrophage activation marker neopterin; and the infection marker procalcitonin. Compared with 62 patients without either coronary artery disease (CAD) or peripheral artery disease (PAD), 57 patients with CAD but no PAD showed greater median CRP (0. 4 versus 0.2 mg/dL, P=0.004) and IL-6 (3.8 versus 1.6 pg/mL, P=0. 007) levels and a lower level of active-TGF-beta (57 versus 100 ng/mL, P=0.038). Moreover, CRP, IL-6, and neopterin levels showed a positive and the active TGF-beta level a negative correlation with the extent of coronary atherosclerosis. Compared with these 57 patients with CAD alone, 15 patients with PAD and CAD had higher median levels of SAA (17 versus 7 mg/mL, P=0.008), IL-6 (12 versus 4 pg/mL, P=0.002), neopterin (14 versus 11 mg/dL, P=0.006), and total TGF-beta (11834 versus 6417 ng/L, P=0.001). However, these strong univariate associations of markers of inflammation and atherosclerosis were lost in multivariate analysis once age, sex, and high density lipoprotein cholesterol or fibrinogen were taken into account. Increased plasma levels of CRP, SAA, IL-6, TGF-beta, neopterin, and procalcitonin constitute an inflammatory signature of advanced atherosclerosis and are correlated with the extent of disease but do not provide discriminatory diagnostic power over and above established risk factors.

Immunological measurement of transforming growth factor-beta 1 (TGF-beta1) in blood; assay development and comparison.

Development of a new, sensitive immunoassay for measuring transforming growth factor beta 1 (TGF-beta1) is described and compared with four commercially available TGF-beta1 immunoassays. Preanalytical conditions were evaluated. The nonlinearity found in serum or plasma is due to masking of TGF-beta1 by binding proteins in blood. Mixing TGF-beta1 with latency-associated peptide or alpha2-macroglobulin at physiological concentrations suppressed most of the TGF-beta1 signal. Plasma fibronectin showed no effect, even at concentrations exceeding its physiological range. Equilibrium concentrations computed from a model system confirmed the experimental results. Dilutional nonlinearity could be markedly reduced by an appropriately designed activation procedure that minimized the effects of reassociation between TGF-beta1 and its binding partners during restoration of a neutral pH. Plasma should be used for measuring TGF-beta1 in blood. Because serum TGF-beta1 is highly significantly correlated with the platelet count, probably most of the TGF-beta1 is released by platelet degranulation.

Expression and release of the latent transforming growth factor beta binding protein by hepatocytes from rat liver.

In very recent studies it was established that transforming growth factor beta (TGF-beta), likely to be the most relevant fibrogenic cytokine and regulator of cell proliferation, differentiation, and matrix metabolism, is expressed by hepatocytes (parenchymal cell [PC]) and secreted from cultured PC in a latent form incapable of receptor binding. The structural composition of the latent TGF-beta complex secreted by cultured PC is unknown. In some TGF-beta expressing cell types this cytokine is released as a large molecular weight complex containing in addition to the TGF-beta latency associated peptide (LAP) a disulfide bonded latent TGF-beta binding protein (LTBP), of which the existence and function in liver is hitherto unknown. This study is directed to the identification of LTBP expression in rat PC. Cells were isolated from rat liver with the collagenase method and analyzed for LTBP before and during culture under standard conditions using alkaline phosphatase anti-alkaline phosphatase (APAAP) immunostainings, metabolic labeling, messenger RNA (mRNA) detection (reverse-transcription polymerase chain reaction [RT-PCR]) and sequencing, and immunoblotting of gel chromatographically separated cell extracts and conditioned media, respectively. APAAP immunostainings applying a specific polyclonal LTBP-antiserum (ab 39) indicated expression of LTBP in PC of liver in situ and freshly isolated PC but a strong expression in cultured PC. Transcripts of LTBP-1 were detected by RT-PCR and confirmed by sequence analyses. Metabolic labeling of PC with [35S]-Met/Cys followed by immunoprecipitation of cell lysates with LTBP antiserum confirmed the synthesis of the high molecular mass complex of 250 kd containing LTBP with a molecular mass of 160 kd. Latent TGF-beta complexes, associated with LTBP related proteins, could be separated from both extracts and conditioned media of PC by gel filtration chromatography. They confirmed the release of the large latent TGF-beta complex from PC. Investigations of immunocytochemical LTBP staining under different culture conditions (TGF-beta supplementation, extracellular matrices) point to concordant variations of LTBP and TGF-beta expression. The results suggest a role for PC in paracrine- and autocrine-mediated effects of TGF-beta, which might be important for various cell activities in healthy and diseased liver.

Long-term results of the Ivalon baffle mitral valve repair.

In the evolution of mitral valve surgery, Ivalon sponge was sutured to the posterior leaflet of the mitral valve to obtain competency. Between August 1959 and October 1962, 18 patients had this procedure. All patients were discharged home. Three patients were lost to follow-up 5 to 10 years after operation. Valve replacement was necessary in 7 patients 10.4 +/- 8.5 years after repair. Bacterial endocarditis causing late death occurred in 5 patients within 4 years. Five embolic episodes occurred. The estimated probability of survival and need for valve replacement at 28 years were 29.2% +/- 12.3% and 12.4% +/- 6.7%, respectively.

Distribution analyses of chain substituents of lipoteichoic acids by chemical degradation.

The lipoteichoic acid from Lactococcus lactis Kiel 48337 was analyzed. It had 61% of its glycerophosphate residues substituted with alpha-D-galactopyranosyl residues. Non-substituted glycerophosphate residues were split off by two alkaline hydrolyses and an intermediate enzymatic phosphomonoester cleavage. The resulting (GalGroP)nGroGal and (GalGroP)nGlc2Gro oligomers were separated by chromatography on DEAE-Sephadex into 10 pairs of molecular species with n from 1 to 10. The relative frequencies of GalGro and these oligomers were close to the values calculated by computer simulation for a random distribution of chain substituents. A similar series of oligomers was obtained in one step by hydrolysis of the lipoteichoic acid with 98% (by vol.) acetic acid. Due to side reactions, the picture was less precise but nevertheless indicative of the same distribution pattern. The data provide indirect evidence that the alanine ester substituents of the native lipoteichoic acid (Ala/P = 0.38) occupy the free positions between the galactosylated oligomers and are therefore themselves distributed randomly.