Effects of pulmonary rehabilitation on cardiac magnetic resonance parameters in patients with persistent dyspnea following pulmonary embolism.

Background: Persistent dyspnea and reduced exercise capacity is common in pulmonary embolism (PE) survivors. Although improved right ventricular function after pulmonary rehabilitation has been demonstrated in chronic thromboembolic pulmonary hypertension, it is still unknown whether a similar effect also occurs in other patients with dyspnea after pulmonary embolism. Purpose: The aim of this study was to explore potential effects of a pulmonary rehabilitation program on cardiac structure and function as assessed with cardiac magnetic resonance (CMR). Material and methods: Twenty-six PE survivors with persistent dyspnea were included. Right and left ventricular assessment with CMR was performed before and after an eight-week pulmonary rehabilitation program. Results: Dyspnea as measured by the Shortness of Breath Questionnaire improved significantly after rehabilitation: 15 (IQR: 7-31) versus 8 (IQR: 3-17). Absolute right ventricular global longitudinal strain by CMR was reduced from 19% to 18% (95% CI of difference: 0-3 percent points), and absolute RV lateral strain from 26% to 24% (95% CI of difference: 1-4 percent points). Right ventricular mass was reduced after rehabilitation from 49 g to 44 g (95% CI of difference: 2-8 g). Conclusion: Although there was a substantial improvement in dyspnea after rehabilitation, we found only a minor reduction in absolute right ventricular longitudinal strain and right ventricular mass. No other CMR parameter changed. We therefore suggest that rehabilitation effect of in this patient group was not primarily mediated by cardiac adaptions.

Sunflower germin-like protein HaGLP1 promotes ROS accumulation and enhances protection against fungal pathogens in transgenic Arabidopsis thaliana.

KEY MESSAGE: The novel sunflower gene HaGLP1 is the first germin-like protein characterized from the family Asteraceae. It alters the host redox status and confers protection against Sclerotinia sclerotiorum and Rhizoctonia solani. Germin-like proteins (GLPs) are a large, diverse and ubiquitous family of plant glycoproteins belonging to the Cupin super family. These proteins have been widely studied because of their diverse roles in important plant processes, including defence. The novel sunflower gene HaGLP1 encodes the first germin-like protein characterized from the family Asteraceae. To analyse whether constitutive in vivo expression of the HaGLP1 gene may lead to disease tolerance, we developed transgenic Arabidopsis plants that were molecularly characterized and biologically assessed after inoculation with Sclerotinia sclerotiorum or Rhizoctonia solani. HaGLP1 expression in Arabidopsis plants conferred tolerance to S. sclerotiorum at the first stages of disease and interfered with R. solani infection, thus giving rise to significant protection against the latter. Furthermore, HaGLP1 expression in Arabidopsis plants elevated endogenous ROS levels. HaGLP1-induced tolerance does not appear to be related to a constitutive induction of the plant defence or the ROS-related genes examined here. In conclusion, our data suggest that HaGLP1 is an interesting candidate for the engineering of plants with increased fungal tolerance and that this gene could also be useful for the selection of naturally overexpressing sunflower genotypes for conventional breeding purposes.

Long-term results after intracoronary injection of autologous mononuclear bone marrow cells in acute myocardial infarction: the ASTAMI randomised, controlled study.

OBJECTIVE: To investigate long-term safety and efficacy after intracoronary injection of autologous mononuclear bone marrow cells (mBMCs) in acute myocardial infarction (AMI). DESIGN: Randomised, controlled trial. SETTING: Two university hospitals in Oslo, Norway. PATIENTS: Patients from the Autologous Stem cell Transplantation in Acute Myocardial Infarction (ASTAMI) study were re-assessed 3 years after inclusion. INTERVENTIONS: 100 patients with anterior wall ST-elevation myocardial infarction treated with acute percutaneous coronary intervention (PCI) were randomised to receive intracoronary injection of mBMCs (n = 50) or not (n = 50). MAIN OUTCOME MEASURES: Change in left ventricular (LV) ejection fraction (primary). Change in exercise capacity (peak VO(2)) and quality of life (secondary). Infarct size (additional aim), and safety. RESULTS: The rates of adverse clinical events in the groups were low and equal. There were no significant differences between groups in change of global LV systolic function by echocardiography or magnetic resonance imaging (MRI) during the follow-up. On exercise testing, the mBMC-treated patients had larger improvement in exercise time from 2-3 weeks to 3 years (1.5 minutes vs 0.6 minutes, p = 0.05), but the change in peak oxygen consumption did not differ (3.0 ml/kg/min vs 3.1 ml/kg/min, p = 0.75). CONCLUSION: The results indicate that intracoronary mBMC treatment in AMI is safe in the long term. A small improvement in exercise time in the mBMC group was found, but no other effects of treatment could be identified 3 years after cell therapy.

Monitoring urinary bladder volume and detecting post-operative urinary retention in children with an ultrasound scanner.

BACKGROUND: Post-operative urinary retention (PUR) is associated with a risk of over-distension and permanent detrusor damage. The prevention of PUR by routine catheterization may increase the risk of urinary tract infection. Post-operative monitoring of the bladder volume is a reliable method in adults, but has not been evaluated for reliability in children. METHODS: Forty-eight patients who, according to current clinical guidelines, required urinary bladder emptying were scanned before catheterization using the Bladderscan. Volumes estimated with ultrasound were compared with volumes measured after emptying the bladder with a catheter. Bladder emptying was controlled by concomitant fluoroscopy in 20 children. RESULTS: The mean difference between the ultrasound estimates and the catheter-emptied urine volumes was 4 ml [standard deviation (SD) = 25 ml] in 26 children above the age of 3 years and -18 ml (SD = 19 ml) in 22 younger children. In the subpopulation in whom complete bladder emptying could be confirmed by fluoroscopy (14 children; median age, 3 years; range, 1-11 years), the mean difference between the ultrasound estimates and the catheter-emptied volumes was -11 ml (SD = 24 ml). CONCLUSIONS: This study confirms agreement between the ultrasound scanner estimates of urinary bladder volume and the urine volume measured by emptying the bladder. Reliability was good in children above the age of 3 years. The volume was underestimated in younger children. Thus, routine monitoring of urinary bladder volume with an ultrasound scanner is a non-invasive, pain-free and reliable way of preventing over-distension of the urinary bladder in children after surgery and other procedures under general anaesthesia.

Mylohyoid herniation of the sublingual gland diagnosed by magnetic resonance imaging.

Mylohyoid herniation of the sublingual gland has been a frequent finding at dissection of adult human cadavers and at retrospective studies of computed tomography (CT) and magnetic resonance imaging (MRI) of the floor of the mouth. Even so, very few clinical reports exist. The present report describes an adolescent boy with a suspected submental tumour, which at MRI was shown to be caused by a mylohyoid hernia of part of an enlarged, but otherwise normal sublingual gland.

Rheumatoid arthritis: a complication of interferon therapy.

A case report of rheumatoid arthritis developing during alpha-interferon therapy of chronic hepatitis C is reported. The rheumatoid arthritis was severe, being non-responsive to the use of nonsteroidal anti-inflammatory drugs, and persisted despite discontinuation of the interferon therapy. The literature relative to this case suggesting an association between rheumatoid arthritis and interferon therapy is presented. This case suggests that interferon therapy may precipitate subclinical rheumatoid arthritis in an individual without pre-existing clinical arthritis.

Ligament injuries associated with tibial plateau fractures.

Thirty-nine patients with tibial plateau fractures and concomitant ligament injury were evaluated at least one year after injury. Ligamentous injury was determined by stress roentgenograms, plain roentgenograms, operative findings, and Pelle-grini-Stieda's ossification. There were 22 isolated medial collateral, eight lateral collateral, one isolated anterior cruciate, and eight combined ligament injuries. All types of tibial plateau fractures were associated with ligamentous injury, although split compression and local compression were most common. Twenty patients (Group 1) did not have operative repair of the injured ligaments, and 19 patients (Group 2) had primary repair of the injured ligaments. Open reduction and internal fixation of the plateau fracture(s) were performed in 13 patients in Group 1 and 19 patients in Group 2. Follow-up evaluation (100-point scale), including subjective, functional, and anatomic factors, revealed 12 excellent and good, four fair, and three poor results in the 19 patients with ligamentous repair. There were ten excellent and good, two fair, and eight poor results in those without ligament repair. Ten of the 12 patients with 10 degrees or more of instability had poor results. These poor results included five unrepaired medial collateral ligaments, two unrepaired lateral collateral ligaments, and three patients with cruciate ligament injury. This study confirms the view that instability is a major cause of unacceptable results in tibial plateau fractures. Operative repair of medial and lateral collateral ligaments, with appropriate treatment of the bony plateau fracture, may reduce late instability and may improve overall morbidity in these concomitant injuries. Cruciate ligament injury associated with a tibial plateau fracture carries a poor prognosis.

Postdecompression lumbar instability.

In the last two decades, the concept of spinal stenosis and its treatment by surgical decompression has been widely accepted. Complications such as olisthy, disc rupture, facet fracture, and intractable back pain began to appear postoperatively, suggesting instability as their cause. A retrospective study of 344 patients treated surgically for lumbar stenosis revealed a 17% reoperation rate for complications resulting from obvious or suspected instability. Sixteen cases of postdecompression olisthy, 14 cases of fresh disc herniation, and 27 cases of intractable back pain required further surgery. Preoperative indicators of potential instability are degenerated discs as evidenced by traction spurs or diminished disc height, olisthy, and scoliosis or asymmetrically narrowed discs. Total facetectomy and pars excision at surgery destabilize the spine and must be added to the preoperative risk factors for instability. Calcified annulus, capsule and ligamentum flavum, or complete disc resorption may offer some protection from postoperative instability. The level of instability may be preselected by the proximity to the intercrestal line. It is recommended that during surgical decompression for spinal stenosis, the posterior elements be spared as much as possible to avoid instability after surgery. Factors suggesting instability noted preoperatively or decompression which produces instability suggest that fusion should be combined with decompression. Spinal fusion is the treatment for postoperative instability.

Molecular cloning of rotavirus genome

Los rotavirus son los principales agentes responsables de las gastroenteritis virales humanas y animales. La identificación y caracterización de su genoma es necesaria para la comprensión de esta patología así como para el desarrollo de nuevos métodos de diagnóstico y, eventualmente, para la preparación de antígenos virales utilizando técnicas de DNA recombinante. Estos virus poseen un genoma formado por once fragmentos de RNA doble cadena (cd). Aquí se describe la construcción de bancos de cDNA para rotavirus bovino y humano, ambos purificados de materia fecal. Los cDNA fueron preparados por síntesis in vitro utilizando transcriptasa reversa sobre los RNAs genómicos virales, previamente poliadenilados en sus extremos 3. Los cDNAs fueron ligados a un vector plasmídico y propagados en E. coli. Se obtuvieron genotecas correspondientes a los virus bovino y humano con 500 y 100 recombinantes respectivamente. Análisis de restricción de algunos clones permitieron establecer el tamaño de los insertos correspondientes a los distintos segmentos genómicos virales. Dos de estos clones fueron caracterizados, determinándose que contienen las secuencias completas de los fragmentos 10 y 8 del virus bovino. La utilización de estos clones como sondas radioactivas nos permitió diagnosticar la presencia de rotavirus en muestras de materia fecal mediante la detección de los correspondientes RNAs. Este ensayo pudo ser utilizado para la detección viral en muestras infectadas provenientes de distintas especies (AU)

Molecular cloning of rotavirus genome

Los rotavirus son los principales agentes responsables de las gastroenteritis virales humanas y animales. La identificación y caracterización de su genoma es necesaria para la comprensión de esta patología así como para el desarrollo de nuevos métodos de diagnóstico y, eventualmente, para la preparación de antígenos virales utilizando técnicas de DNA recombinante. Estos virus poseen un genoma formado por once fragmentos de RNA doble cadena (cd). Aquí se describe la construcción de bancos de cDNA para rotavirus bovino y humano, ambos purificados de materia fecal. Los cDNA fueron preparados por síntesis in vitro utilizando transcriptasa reversa sobre los RNAs genómicos virales, previamente poliadenilados en sus extremos 3. Los cDNAs fueron ligados a un vector plasmídico y propagados en E. coli. Se obtuvieron genotecas correspondientes a los virus bovino y humano con 500 y 100 recombinantes respectivamente. Análisis de restricción de algunos clones permitieron establecer el tamaño de los insertos correspondientes a los distintos segmentos genómicos virales. Dos de estos clones fueron caracterizados, determinándose que contienen las secuencias completas de los fragmentos 10 y 8 del virus bovino. La utilización de estos clones como sondas radioactivas nos permitió diagnosticar la presencia de rotavirus en muestras de materia fecal mediante la detección de los correspondientes RNAs. Este ensayo pudo ser utilizado para la detección viral en muestras infectadas provenientes de distintas especies