Biological detection of low radiation doses by combining results of two microarray analysis methods.

The accurate determination of the biological effects of low doses of pollutants is a major public health challenge. DNA microarrays are a powerful tool for investigating small intracellular changes. However, the inherent low reliability of this technique, the small number of replicates and the lack of suitable statistical methods for the analysis of such a large number of attributes (genes) impair accurate data interpretation. To overcome this problem, we combined results of two independent analysis methods (ANOVA and RELIEF). We applied this analysis protocol to compare gene expression patterns in Saccharomyces cerevisiae growing in the absence and continuous presence of varying low doses of radiation. Global distribution analysis highlights the importance of mitochondrial membrane functions in the response. We demonstrate that microarrays detect cellular changes induced by irradiation at doses that are 1000-fold lower than the minimal dose associated with mutagenic effects.

Diagnostic value of procalcitonin, interleukin-6, and interleukin-8 in critically ill patients admitted with suspected sepsis.

To assess the diagnostic value of procalcitonin (PCT), interleukin (IL)-6, IL-8, and standard measurements in identifying critically ill patients with sepsis, we performed prospective measurements in 78 consecutive patients admitted with acute systemic inflammatory response syndrome (SIRS) and suspected infection. We estimated the relevance of the different parameters by using multivariable regression modeling, likelihood-ratio tests, and area under the receiver operating characteristic curves (AUC). The final diagnosis was SIRS in 18 patients, sepsis in 14, severe sepsis in 21, and septic shock in 25. PCT yielded the highest discriminative value, with an AUC of 0.92 (CI, 0.85 to 1.0), followed by IL-6 (0.75; CI, 0.63 to 0.87), and IL-8 (0.71; CI, 0.59 to 0.83; p < 0.001). At a cutoff of 1.1 ng/ml, PCT yielded a sensitivity of 97% and a specificity of 78% to differentiate patients with SIRS from those with sepsis-related conditions. Median PCT concentrations on admission (ng/ ml, range) were 0.6 (0 to 5.3) for SIRS; 3.5 (0.4 to 6.7) for sepsis; 6.2 (2.2 to 85) for severe sepsis; and 21.3 (1.2 to 654) for septic shock (p < 0.001). The addition of PCT to a model based solely on standard indicators improved the predictive power of detecting sepsis (likelihood ratio test; p = 0.001) and increased the AUC value for the routine value-based model from 0.77 (CI, 0.64 to 0.89) to 0.94 (CI, 0.89 to 0.99; p = 0.002). In contrast, no additive effect was seen for IL-6 (p = 0.56) or IL-8 (p = 0.14). Elevated PCT concentrations appear to be a promising indicator of sepsis in newly admitted, critically ill patients capable of complementing clinical signs and routine laboratory parameters suggestive of severe infection.

Macrophage migration inhibitory factor and innate immune responses to bacterial infections.

OBJECTIVES: To review the role of macrophage migration inhibitory factor (MIF) in host responses to infection and to explore the potential of MIF as a novel target for therapeutic intervention in patients with severe sepsis and septic shock. DATA SOURCES: Published articles on the role of MIF in innate immune responses against microbial pathogens. DATA SUMMARY: MIF has emerged recently as an important effector molecule of the innate immune system. MIF is expressed constitutively by monocytes/macrophages, T cells, B cells, endocrine cells, and epithelial cells. Microbial toxins and cytokines are powerful inducers of MIF release by immune cells. MIF expression is up-regulated during the course of inflammatory and infectious diseases and was found to play an important role in the pathogenesis of sepsis and septic shock. CONCLUSION: Given the role of MIF in innate immune responses against microbial pathogens and in the regulation of inflammatory responses, modulation of MIF production or neutralization of its activity may offer new therapeutic options for the management of patients with sepsis.

[Aerodynamic analysis of a new sterile operating enclosure, and comparative bacteriologic testing between a conventional operating theatre and a sterile enclosure during sham operations (author's transl)]. / Strömungstechnische Analyse einer neuen Sterilboxe und vergleichende bakteriologische Untersuchungen von Sterilboxe und konventionell belüftetem Operationsraum während Scheinoperationen

An aerodynamic and bacteriological evaluation of a new sterile operating enclosure has been undertaken, comparing it with a conventional operating theatre under sham operating conditions with or without coincident use of either a surgical helmet or surgical face mask. Statistical analysis of these studies show the bacterial level in the sterile enclosure at the wound site is significantly lower than in ordinary operating theatre conditions whereas the use of a helmet with evacuating ducts effects these findings insignificantly.