The importance of ST elevation in V2-4 ECG leads in athletes.

BACKGROUND: Early repolarization in the anterior ECG leads (ERV2-4) is considered to be a sign of right ventricular (RV) remodeling, but its etiology and importance are unclear. METHODS: A total of 243 top-level endurance-trained athletes (ETA; 183 men and 60 women, weekly training hours: 15-20) and 120 leisure-time athletes (LTA; 71 men and 49 women, weekly training hours: 5-6) were investigated. The ERV2-4 sign was evaluated concerning type of sport, gender, transthoracic echocardiographic parameters, and ECG changes, which can indicate elevated RV systolic pressure [left atrium enlargement (LAE), right atrium enlargement (RAE), RV conduction defect (RVcd)]. RESULTS: Stroke volume and left ventricular mass were higher in ETAs vs. LTAs in both genders (p < 0.01). Prevalence of the ERV2-4 sign was significantly higher in men than in women [p = 0.000, odds ratio (OR) = 36.4] and in ETAs than in LTAs (p = 0.000). The highest ERV2-4 prevalence appeared in the most highly trained triathlonists and canoe and kayak paddlers (OR = 13.8 and 5.2, respectively). Within the ETA group, the post-exercise LAE, RAE, and RVcd changes developed more frequently in cases with than without ERV2-4 (LAE: men: p < 0.05, females: p < 0.005; RAE: men: p < 0.05, females: p < 0.005; RVcd: N.S.). These post-exercise appearing LAE, RAE, and RVcd are associated with the ERV2-4 sign (OR = 4.0, 3.7, and 3.8, respectively). CONCLUSIONS: According to these results, ERV2-4 develops mainly in male ETAs due to long-lasting and repeated endurance training. The ERV2-4 sign indicates RV's adaptation to maintain higher compensatory pulmonary pressure and flow during exercise but its danger regarding malignant arrhythmias is unclear.

Analyzing Raman - Infrared spectral correlation in the recently found meteorite Csátalja.

Correlating the Raman and infrared spectra of shocked minerals in Csátalja ordinary chondrite (H4, S2, W2) with controlling the composition by EPMA measurements, we identified and improved various shock indicators, as infrared spectro-microscopic analysis has been poorly used for shock impact alteration studies of meteorites to date. We also provide reference spectra as SOM for the community with local mineralogical and shock alteration related context to support further standardization of the IR ATR based measurements. Raman band positions shifted in conjunction with the increase in full width half maximum (FWHM) with shock stage in olivine minerals while in the infrared spectra when comparing the IR band positions and IR maximal absorbance, increasing correlation was found as a function of increasing shock effects. This is the first observational confirmation with the ATR method of the already expected shock related disordering. In the case of shocked pyroxenes the well-known peak broadening and peak shift was confirmed by Raman method, beyond the level that could have been produced by only chemical changes. With increasing shock level the 852-864cm-1 and 1055-1071cm-1 FTIR bands finally disappeared. From the shock effect occasionally mixed mineral structures formed, especially feldspars together with pyroxene. Feldspars were only present in the shock melted volumes, thus produced by the shock effect itself. Based on the above mentioned observations in Csátalja meteorite the less shocked (only fractured) part witnessed 2-6GPa shock pressure with temperature below 100°C. The moderately shocked parts (minerals with mosaicism and mechanical twins) witnessed 5-10GPa pressure and 900°C temperature. The strongly shocked area (many olivine and pyroxene grains) was subject to 10-15GPa and 1000°C. The existence of broad peak near 510cm-1 and disappearance of other peaks of feldspar at 480 and 570cm-1 indicate the presence of maskelynite, which proposes that the peak shock pressure could reach 20GPa at certain locations. We identified higher shock levels than earlier works in this meteorite and provided examples how heterogeneous the shock effect and level could be at small spatial scale. The provided reference spectra support the future improvement for the standardization of infrared ATR based methods and the understanding of shock-related mineral alterations beyond the optical appearance.

NUT Carcinoma of the Sublingual Gland.

NUT carcinoma (NC) is a recently described, rare and extremely aggressive cancer primarily located to supradiaphragmatic structures and affecting young individuals. NC is characterized by translocations involving the NUT gene on 15q14 with the most common translocation partner gene being BRD4 on 19p13, resulting in the t(15;19)(q14;p13) karyotype. NC is poorly differentiated and is likely to be overlooked and misdiagnosed as poorly differentiated squamous cell carcinoma (SCC) when immunohistochemical evaluation of NUT protein expression is omitted. Previously, NC has been found in the parotid and submandibular glands and we present the first case in the sublingual gland arising in a 40-year-old woman. We discuss the diagnostic considerations for poorly differentiated carcinomas of the salivary glands and advocate the inclusion of NUT immunohistochemistry in this setting. Not only does the NC diagnosis confer a grave prognosis when treated as SCC as illustrated by the present case, but is important for the inclusion of patients in ongoing clinical trials.

The potential role of HLA-DRB1*11 in the development and outcome of haematopoietic stem cell transplantation-associated thrombotic microangiopathy.

Transplantation-associated thrombotic microangiopathy (TA-TMA) is a serious complication of allogeneic haematopoietic stem cell transplantation (allo-HSCT) with high mortality rate. We retrospectively studied the frequency, clinical and genetic associations and prognostic effect of TA-TMA, in a total of 425 consecutive adult patients, who underwent allo-HSCT for a malignant haematological condition between 2007 and 2013 at our single centre. TA-TMA developed in 19% of the patients. Unrelated donor type (P<0.001), acute GvHD grades II-IV (P<0.001), myeloablative conditioning regimens (P=0.003), tacrolimus-based GvHD prophylaxis (P=0.003), CMV infection (P=0.003) and carriership for HLA-DRB1*11 (P=0.034) were associated with the development of TA-TMA. Survival was adversely affected by the presence of TA-TMA (P<0.001). Among patients with TA-TMA, the outcome of HLA-DRB1*11 carriers was significantly better compared with non-carriers (P=0.003). As a new finding, our observations suggest that the presence of HLA-DRB1*11 antigen contributes to the development of TA-TMA and affects the outcome.

HLA genetic diversity in Hungarians and Hungarian Gypsies: complementary differentiation patterns and demographic signals revealed by HLA-A, -B and -DRB1 in Central Europe.

Systematic analyses of human leukocyte antigen (HLA) profiles in different populations may increase the efficiency of bone marrow donor selection and help reconstructing human peopling history. We typed HLA-A, -B, and -DRB1 allele groups in two bone marrow donor cohorts of 2402 Hungarians and 186 Hungarian Gypsies and compared them with several Central-European, Spanish Gypsy, and Indian populations. Our results indicate that different European Gypsy populations share a common origin but diverged genetically as a consequence of founder effect and rapid genetic drift, whereas other European populations are related genetically in relation to geography. This study also suggests that while HLA-A accurately depicts the effects of genetic drift, HLA-B, and -DRB1 conserve more signatures of ancient population relationships, as a result of balancing selection.

Increasing incidence of base of tongue cancers from 2000 to 2010 due to HPV: the largest demographic study of 210 Danish patients.

BACKGROUND: We assessed the development in the number of new base of tongue squamous-cell carcinoma (BSCC) cases per year in eastern Denmark from 2000 to 2010 and whether HPV may explain any observable increased incidence. METHODS: We performed HPV DNA PCR and p16 immunohistochemistry analysis for all (n=210) BSCCs registered in the Danish Head and Neck Cancer Group (DAHANCA) and the Danish Pathology Data Bank, and genotyped all HPV-positive specimens with amplicon-based next-generation sequencing. RESULTS: The overall crude incidence of BSCCs increased significantly (5.4% per year) during the study period. This was explained by a significant increase in the number of HPV-positive BSCCs (8.1% per year), whereas the number of HPV-negative BSCCs did not increase significantly. The overall HPV prevalence was 51%, with HPV16 as the predominant HPV type. CONCLUSIONS: The increased number of HPV-positive BSCCs may explain the increasing incidence of BSCCs in eastern Denmark, 2000-2010.

Primary temporal region squamous cell carcinoma diagnosed by a superficial temporal artery biopsy.

BACKGROUND: Superficial temporal artery biopsy is a frequent procedure performed in the diagnosis of giant cell arteritis. METHODS AND RESULTS: An otherwise healthy 69-year-old man presented with 2months complaint of right temporal region pain. Giant cell arteritis was suspected and a temporal artery biopsy was performed. The histopathology revealed perineural invasion of squamous cell carcinoma (SCC). A thorough investigation revealed no other primary site for the SCC and the patient was treated with surgical excision. CONCLUSION: Malignancy is rarely found in superficial temporal artery biopsies and lymphoma is the most common malignancy reported. In this rare case, the patient had right temporal pain explained by perineural invasion of a primary SCC in the right temporal region, which was treated with surgical excision guided by perioperative fresh frozen histology.

Correlation between human papillomavirus and p16 overexpression in oropharyngeal tumours: a systematic review.

BACKGROUND: A significant proportion of squamous cell carcinomas of the oropharynx (OP-SCC) are related to human papillomavirus (HPV) infection and p16 overexpression. This subgroup proves better prognosis and survival but no evidence exists on the correlation between HPV and p16 overexpression based on diagnostic measures and definition of p16 overexpression. We evaluated means of p16 and HPV diagnostics, and quantified overexpression of p16 in HPV-positive and -negative OP-SCCs by mode of immunohistochemical staining of carcinoma cells. METHODS: PubMed, Embase, and the Cochrane Library were searched from 1980 until October 2012. We applied the following inclusion criteria: a minimum of 20 cases of site-specific OP-SCCs, and HPV and p16 results present. Studies were categorised into three groups based on their definition of p16 overexpression: verbal definition, nuclear and cytoplasmatic staining between 5 and 69%, and ≥70% staining. RESULTS: We identified 39 studies with available outcome data (n=3926): 22 studies (n=1980) used PCR, 6 studies (n=688) used ISH, and 11 studies (n=1258) used both PCR and ISH for HPV diagnostics. The methods showed similar HPV-positive results. Overall, 52.5% of the cases (n=2062) were HPV positive. As to p16 overexpression, 17 studies (n=1684) used a minimum of 5-69% staining, and 7 studies (n=764) used ≥70% staining. Fifteen studies (n=1478) referred to a verbal definition. Studies showed high heterogeneity in diagnostics of HPV and definition of p16. The correlation between HPV positivity and p16 overexpression proved best numerically in the group applying ≥70% staining for p16 overexpression. The group with verbal definitions had a significantly lower false-positive rate, but along with the group applying 5-69% staining showed a worse sensitivity compared with ≥70% staining. CONCLUSIONS: There are substantial differences in how studies diagnose HPV and define p16 overexpression. Numerically, p16 staining is better to predict the presence of HPV (i.e. larger sensitivity), when the cutoff is set at ≥70% of cytoplasmatic and nuclear staining.

New skeletal tuberculosis cases in past populations from Western Hungary (Transdanubia).

The distribution, antiquity and epidemiology of tuberculosis (TB) have previously been studied in osteoarchaeological material in the eastern part of Hungary, mainly on the Great Plain. The purpose of this study is to map the occurrence of skeletal TB in different centuries in the western part of Hungary, Transdanubia, and to present new cases we have found. Palaeopathological analysis was carried out using macroscopic observation supported by radiographic and molecular methods. A large human osteoarchaeological sample (n=5684) from Transdanubian archaeological sites ranging from the 2nd to the 18th centuries served as a source of material. Spinal TB was observed in seven individuals (in three specimens with Pott's disease two of which also had cold abscess) and hip TB was assumed in one case. The results of DNA for Mycobacterium tuberculosis were positive in seven of the eight cases identified by paleopathology, and negative in the assumed case of hip TB. However, the molecular results are consistent with highly fragmented DNA, which limited further analysis. Based on the present study and previously published cases, osteotuberculosis was found in Transdanubia mainly during the 9th-13th centuries. However, there are no signs of TB in many other 9th-13th century sites, even in those that lie geographically close to those where osteotuberculous cases were found. This may be due to a true absence of TB caused by the different living conditions, way of life, or origin of these populations. An alternative explanation is that TB was present in some individuals with no typical paleopathology, but that death occurred before skeletal morphological features could develop.

Importance of acidic phosphatase activity in P supply and Gonyostomum semen Ehrenbergh (Raphidophyta) occurrence in a Hungarian peat bog, Keleméri Kis-Mohos (Ne Hungary).

Phosphatase enzymes are capable of releasing phosphate through cleavage of phosphoester bonds. The seasonal importance of this process was examined by using a model substrate paranitrophenylphosphate and the Michaelis-Menten equation to estimate the release rate of PO 4 -P from phosphomonoesters. The seasonal occurrence of phosphomonoesters and acid phosphatase activity was used to estimate the velocity of phosphate release from these compounds. Filter fractionation of phosphatase activity demonstrated that most activity (>60%) was in size fractions less than 0.45 microm. The release rates were highest in May and June (15 to 25 nmol L -1 min -1 ) during the Gonyostomum semen (Raphidophyta) bloom and decreased to less than 2 nmol L -1 min -1 in two weeks and remained low throughout the summer and the fall. Fractionation of 32 P-H 3 PO 4 labelled dissolved organic phosphorus showed this fraction to vary considerably through the year. Potential phosphate release declined through the summer and into the fall. Significance of the co-occurrence of phosphomonoesters and acid phosphatase activity maxima and Gonyostomum semen (Raphidophyta) bloom is discussed.

Fitness and nutritional status of female medical university students.

The aim of this comparison was to evaluate the nutritional status and cardio-respiratory fitness of future health professionals, namely university students engaged in medical studies. It was assumed that the lifestyle of such students would be reflected by healthy body composition and fitness performance indicators. Altogether 1,560 volunteer, female, university students of three institutions were investigated in 2008. Height, body weight, BMI, body fat content and 800 m run test means were compared.The height, weight and BMI means did not differ significantly but PE students recorded the lowest mean body fat (18.34% vs. 24.37 and 25.12%) and shortest mean running time (203 s vs. 239 and 243 s). Among the medical (11.23%) and technical university students (19.95%) statistically the same prevalence of obesity was observed.High body fat content and low running performance of medical students were in contrast with our hypothesis. Their prevalence of overweight/obesity and low fitness did not differ from that of relatively sedentary technical university students and the average Hungarian young adult population. Thus, it is questionable how young health professionals will promote the necessity and positive effects of regular physical activity if they do not apply them to their own lifestyle.

Physical and physiological performances in 10-year-old obese boys.

Fatness generally has a negative influence on the performance of a variety of motor and cardiorespiratory fitness tests. The aim of this comparison was to analyse the effects of three grades of obesity on somatic growth, physical performance and oxygen consumption during exercise. Volunteer boys with definitely different grades of obesity were recruited for the comparison. In the group of mildly obese children (G1; n=23) BMI ranged between 24 kg.m -2 and 26 kg.m -2 ; and individual percent body fat was between 33% and 33.5%. In the case of moderate obesity (G2; n=23) BMI ranged between 26.5 kg.m -2 and 28.5 kg.m -2 ; and percent body fat was between 35% and 36%. In the extremely obese group (G3; n=20) BMI was greater than 31 kg.m -2 ; percent body fat was greater than 37.5%. Oxygen consumption during the 1,200 m run-test was measured by VIMEX-ST-type (USA) telemetric equipment.The greatest absolute aerobic power referred to the G3 boys, and the lowest oxygen consumption was characteristic of the mildly obese group. The very high differences between the body mass means resulted in a more marked inter-group variability in mean relative oxygen uptake.The predicted relative fat and high body fat content observed on the trunk, and the elevated level of resting blood pressure may indicate serious risks for the development of cardio-respiratory and metabolic disease. The very low oxygen consumption relative to body mass and poor physical performance are expected consequences of physiologic and environmental influences on the obese population.

Repair of thirty-six fractures in dogs using the Mennen clamp-on plate: preliminary results.

OBJECTIVE: To report the use of a human fixation device, the Mennen clamp-on plate (MCOP), for fracture repair in dogs as the sole method of fixation, or in combination with another fixation method such as an intramedullary pin. METHODS: The study, which was performed to evaluate the use of the MCOP in fracture repair in dogs, included 36 cases that were selected between 2004 and 2008. The selected cases were all closed diaphyseal fractures, in which sufficient plate prongs could engage the bone on either side of the fracture. RESULTS: Of the 36 cases, 32 had excellent outcomes, and four had complications; these were two cases of fixation failure, one case of osteomyelitis, and one with mild sciatic nerve deficits. DISCUSSION: The MCOP is a promising method for fracture repair on its own for young puppies (six months or less), and in conjunction with other fixation methods in older dogs. It is quick to apply, as no screw holes are created and it achieved a successful outcome in 95% of the cases, provided the cases were appropriately selected for this method. CONCLUSIONS: Using the MCOP has produced promising preliminary results in this study and warrants further evaluation.

Effects of attending elevated level school physical education in 7 to 11-year-old boys.

The aim of the present longitudinal study of four years was to analyse differences in growth patterns, age-related changes in body fat and physical performance in schoolchildren taking part either in normal or in elevated level physical education at school.Nine data collection sessions were carried out between 2002 and 2006 in 18 schools. The sample consisted of 521 non-athletic volunteer boys (PE=116, contrast = 405).The inter-group differences between mean height, body weight, body mass index, relative body fat content, mean scores in 30 m dash, 400 m run, and standing long jump as well as the patterns of change with age were analysed in this comparison. Between-observation differences were tested by repeated measures ANOVA. In case of a significant F-test Tukey's post-hoc tests were used. Age dependence was also studied by linear regression analysis.The between-group differences in mean height were not significant, but the slope of height increase with age was significantly greater in the PE boys. The PE boys were significantly lighter through all the nine observations and the slope of age-related weight increase was statistically faster in the group of contrast subjects. Both the BMI means and percent body fat means were consistently and significantly greater in the contrast group and faster increases were found in the group of the less active boys. The mean physical performances of the PE boys were consistently and significantly better. Their slopes of increase were statistically different.

Longitudinal differences in running endurance and body mass index--a 25-year comparison.

Long-range repeated-measure sample differences in body dimensions, body composition and physical performance help to describe the changes in a population's lifestyle. The aim of our study was to analyse such changes in longitudinal studies repeated after a 25-year interval. Data collections repeated every six months for the periods 1977-1981 (n=152) and 2002-2006 (n=158) were carried out in nonathletic boys aged between 6.51 and 11.50 years from the same districts of Budapest. Means for height, body mass, BMI, body fat percentage, and distance covered during a running endurance test, as well as the slopes of the changes were compared. The children of the second series of studies were significantly taller and heavier, had more depot fat and showed poorer cardio-respiratory endurance than their peers 25 years before. The increases with age in weight, BMI and depot fat were steeper in the second series. The significant differences that developed in anthropometric traits and physical performance during these 25 years are regarded as indirect evidence for how severely the average physical condition had declined, as well as how health risks of the schoolchildren had increased.

Role of phospholipase C-gamma in NGF-stimulated differentiation and gene induction.

The PC12 phaeochromocytoma cell line provides a useful model to study nerve growth factor-induced neuronal differentiation. The central signaling route of this process is mediated by the Ras-dependent extracellular signal-regulated kinase cascade. However, Ras-independent pathways are also stimulated by nerve growth factor and may contribute to differentiation signaling. One mediator for Ras-independent signal transduction in PC12 cells is phospholipase C-gamma that generates the second messengers diacylglycerol and inositol-trisphosphate. To probe the possible involvement of this enzyme in nerve growth factor-promoted differentiation, we used the phospholipase C inhibitor U73122 and the inositol-trisphosphate-receptor inhibitor Xestospongin C. Our results show that both chemicals block nerve growth factor-promoted neurite outgrowth, but the blockage of phospholipase C does not inhibit nerve growth factor-induced expression of c-fos, zif268 and transin genes. In addition, induction of these genes by nerve growth factor plus dibutyryl-cAMP is comparable in wild-type PC12 cells as well as in cells in which both Ras- and phospholipase C-gamma-mediated pathways are inhibited. The phospholipase C-gamma pathway thus belongs to those nerve growth factor receptor-originated signaling routes that contribute to the biological response of PC12 cells to nerve growth factor, but its gene activating potential does not have a major role in its neuritogenic effect.

Sodium salicylate inhibits NF-kappaB and induces apoptosis in PC12 cells.

Sodium salicylate (NaSal) is an effective analgetic and antiinflammatory drug. Beside its well-known inhibitory effect on the cyclooxigenase enzymes, it influences the activity of other signal transduction proteins including nuclear factor kappa B (NF-kappaB) transcription factor. NF-kappaB is found in the cytoplasm bound to an inhibitory protein, inhibitory kappa B (IkappaB). After its phosphorylation, IkappaB is degraded and the released NF-kappaB translocates into the nucleus. Sodium salicylate inhibits the degradation of IkappaB, thus, NF-kappaB activation cannot occur. According to previous observations, the inhibition of this activation can lead to apoptosis. The main goals of this study were to demonstrate that inhibition of NF-kappaB by sodium salicylate decreases the viability of rat phaeochromocytoma PC12 cells and to investigate the nature of cell damage and death. PC12 cells were treated with different concentrations of sodium salicylate (1-20 mM). Higher concentrations (10-20 mM) killed PC12 cells in a dose-dependent manner. The assessments were done by direct cell counting in a Burker chamber and by the WST-1 cytotoxicity assay. We also found a decreased NF-kappaB activity after sodium salicylate treatment by electrophoretic mobility shift assay (EMSA). The cells treated with sodium salicylate were undergoing apoptosis as seen on our records obtained by time-lapse videomicroscopy as well as shown by DNA fragmentation experiments. The decreased DNA binding activity of NF-kappaB indicates that the inhibition of NF-kappaB can play a role in these processes.