The value of ventricular gradient for predicting pulmonary hypertension and mortality in hemodialysis patients.

Pulmonary hypertension (PHT) is associated with increased mortality in hemodialysis (HD) patients. The ventricular gradient optimized for right ventricular pressure overload (VG-RVPO) is sensitive to early changes in right ventricular overload. The study aimed to assess the ability of the VG-RVPO to detect PHT and predict all-cause and cardiac mortality in HD patients. 265 selected HD patients were enrolled. Clinical, biochemical, electrocardiographic, and echocardiographic parameters were evaluated. Patients were divided into normal and abnormal VG-RVPO groups, and were followed-up for 3 years. Abnormal VG-RVPO patients were more likely to be at high or intermediate risk for PHT, were older, had longer HD vintage, higher prevalence of myocardial infarction, higher parathormone levels, shorter pulmonary flow acceleration time, lower left ventricular ejection fraction, higher values of left atrial volume index, left ventricular mass index, and peak tricuspid regurgitant velocity. Both all-cause and CV mortality were higher in abnormal VG-RVPO group. In multivariate Cox analysis, VG-RVPO remained an independent and strong predictor of all-cause and CV mortality. In HD patients, abnormal VG-RVPO not only predicts PHT, but also all-cause and CV mortality.

Associations Between Vaspin Rs2236242 Gene Polymorphism, Walking Time and the Risk of Metabolic Syndrome.

The associations between serum vaspin levels and metabolic or coronary artery disease (CAD) and polycystic ovary syndrome (PCOS) is under the scope of current researchers. Therefore, this adipokine can be considered as a biomarker of metabolic syndrome (MetS). The aim of the study was to analyze the associations between the vaspin rs2236242 polymorphism and physical activity in relation to MetS and its components. The analysis involved the genetic material and clinical data of 108 individuals with MetS and 110 controls. Vaspin rs2236242 polymorphism was detected using the tetra-primer amplification-refractory mutation system polymerase chain reaction (T-ARMS PCR) method. The TA genotype of vaspin rs2236242 was associated with a greater risk of MetS and its components compared with the TT genotype. The analysis of interactions between genotype and walking time revealed that a walking time longer than 60 min./day significantly decreased the risk of MetS in the TA carriers (p = 0.007). The obtained results suggest that any unfavorable effect of the TA genotype of the vaspin rs2236242 polymorphism can be essentially reduced, or even reversed, in a case of individuals walking longer than 60 min. a day. The analysis of the interaction between vaspin rs2236242 polymorphism and walking showed that a walking time of longer than 1 hour a day significantly reduced the risk of MetS, elevated blood pressure and triglycerides concentration.

Acardius acephalus fetus--report of distinctive anatomical anomalies with regards to pathophysiology of TRAP sequence.

Acardiac fetuses are consequences of twin reversed arterial perfusion (TRAP). Here the authors present a case of 40-year-old gravida IX who gave birth to a healthy, 2,900 g female child by a cesarean section. Additionally amorphic 1,020 g maldeveloped fetus was removed. There was a diamnion monochorionic type of twin placenta with incorrect single umbilical arteries (SUA) both in umbilical cord of healthy fetus and in atrophic second umbilical cord. A malformed fetus developed a rather well formed lower leg with four digital foot and oval shape amorphous body mass with omphalocele and eventration of the intestines. X-ray picture showed well visible metatarsal and femur bone and anatomically undefined bones cluster in the central part. A cavity of fetal body contained intestines--the only one well-formed organ, nests of heterotopic pilosebaceous residues, remnants of adrenal glands, well-formed ganglia, and nests of neural tissue covered by neuroepithelium.

Is there a place for practical chemoprevention of colorectal cancer in light of COX-2 heterogeneity?

COX-2 overexpression is widely recognized as an accidental and relatively important factor in the progress of colon neoplasia, but the practical significance of it has not yet been defined. As such, the purposes of the study were: an analysis of the changes of COX-2 expression within colon adenomas in the dependence of progress of dysplastic level within colon adenomas, the analysis of COX-2 expression in cryptal and superficial parts of polyp and, additionally, the analysis of the COX-2 heterogeneity between colon adenomas. One hundred and four cases with completely resected adenomas with high-grade epithelial dysplasia were included in the research. Each polyp had persistent low-grade dysplasia and normal colon mucosa at the base as an internal control. Immunohistochemical analysis with monoclonal COX-2 antibody was performed. Regression of COX-2 expression in high-grade colon intraepithelial lesions (HGCoIN) compared with low-grade colon intraepithelial lesions (LGCoIN) (p = 0.00001) was observed. No correlation between stromal COX-2 expression and either LGCoIN or HGCoIN was found (p > 0.05). The next important observation was a difference in superficial and cryptal COX-2 expression (p < 0.001) and the evident heterogeneity of COX-2 expression among adenomas at LGCoIN as well HGCoIN foci (p < 0.01). The regression of COX-2 expression in high-grade parts of adenomas which we described may result in a reduction of the role of chemoprevention by the use of NSAIDs.

A massive binary black-hole system in OJ 287 and a test of general relativity.

Tests of Einstein's general theory of relativity have mostly been carried out in weak gravitational fields where the space-time curvature effects are first-order deviations from Newton's theory. Binary pulsars provide a means of probing the strong gravitational field around a neutron star, but strong-field effects may be best tested in systems containing black holes. Here we report such a test in a close binary system of two candidate black holes in the quasar OJ 287. This quasar shows quasi-periodic optical outbursts at 12-year intervals, with two outburst peaks per interval. The latest outburst occurred in September 2007, within a day of the time predicted by the binary black-hole model and general relativity. The observations confirm the binary nature of the system and also provide evidence for the loss of orbital energy in agreement (within 10 per cent) with the emission of gravitational waves from the system. In the absence of gravitational wave emission the outburst would have happened 20 days later.