Dietary patterns and the risk of pregnancy-associated hypertension in the Danish National Birth Cohort: a prospective longitudinal study.

OBJECTIVE: To examine the association between mid-pregnancy dietary patterns and pregnancy-associated hypertension (PAH). DESIGN: A prospective longitudinal cohort study. SETTING: Denmark. POPULATION: About 55 139 Danish women with single enrolments and recorded food frequency questionnaire dates with complete information on dietary intake. METHODS: Women were eligible if they could speak Danish and were planning to carry to term. Diet was assessed using a validated semi-quantitative 360-item food frequency questionnaire and dietary patterns were derived using factor analysis. MAIN OUTCOME MEASURES: Gestational hypertension (GH) and pre-eclampsia (PE). RESULTS: Disease prevalence was 14% for GH (5491/39 362); 2% for PE (1168/54 778), and 0.4% for severe PE (234/55 086). Seven dietary patterns were characterised in the population, of which two were associated with PAH. The Seafood diet characterised by high consumption of fish and vegetables was inversely associated with the odds of developing GH [odds ratio (OR) 0.86; 95% CI 0.77-0.95)] and PE (OR 0.79; 95% CI 0.65-0.97). The Western diet characterised by high consumption of potatoes (including French fries), mixed meat, margarine and white bread increased the odds of developing GH (OR 1.18; 95% CI 1.05-1.33) and PE (OR 1.40; 95% CI 1.11-1.76). No association was seen with severe PE. CONCLUSIONS: We found protective associations of Seafood diet and harmful associations of Western diet with PAH. Dietary interventions encouraging the reduction of Western diet may contribute to a decrease of PAH. TWEETABLE ABSTRACT: Western diet increases (Seafood diet decreases) the likelihood of developing pre-eclampsia among Danish pregnant women.

[Pattern electroretinogram and macular perfusion in glaucoma]. / Pattern-élektroretinogramma i makuliarnaia gemoperfuziia pri glaukome.

PURPOSE: To study microcirculatory and functional changes in macula in patients with Primary Open-Angle Glaucoma (POAG). MATERIAL AND METHODS: The study included 95 POAG patients and 42 healthy control subjects. Whole en face image vessel density (wiVDRetina) was measured both in fovea and in parafovea using OCT-angiography (OCT-A) by means of SD-OCT AngioVue on Avanti RtVue xR (Optovue Inc., U.S.A.). Macular thickness and parameters of macular ganglion cell complex (GCC) were measured on the same day. Blood flow in the retrobulbar vessels was evaluated by means of Color Doppler Imaging (CDI). Pattern electroretinogram (PERG) was also taken from the study eyes. Correlations between PERG, SD-OCT GCC, macular thickness, and the parameters of OCT-A and CDI were studied. RESULTS: The amplitude of t-PERG P50 decreased from 6.1±1.3 µV in normal eyes to 2.8±1.6 µV (p<0.0001) in early glaucoma and to 2.3±1.5 µV (p=0.93) in advanced stages. Relative vessel density of the capillary bed decreased from 51.3±3.0% in normal eyes to 45.9±5.0% (p<0.001) and to 41.8±5.0% (p=0.023) in early and advanced glaucoma respectively. The parameters of OCT-A and CDI correlated with morphological and functional parameters in normal and early glaucomatous eyes. CONCLUSION: The study revealed reduction of macular microcirculation and decrease of PERG in early glaucoma. Correlations between the circulatory parameters and functional changes were found in early stages of the disease.

[Pattern visual evoked potentials and their relation to the peripapillary and retrobulbar blood flow in glaucoma]. / Patternzritel'nye vyzvannye potentsialy i ikh sviaz' s peripapilliarnym i retrobul'barnym krovotokom pri glaukome.

PURPOSE: To examine the relationship between the development of bioelectric response of retinal cell elements to pattern stimulus and the ocular blood flow. MATERIAL AND METHODS: Electrophysiological studies, including pattern-reversal visual evoked potentials (VEP) with large 1 degree (1°) and small 0.25° checks, Color Doppler imaging (CDI) of the retrobulbar vessels, and OCT Angiography in the area of the optic disc and peripapillary retina were performed in 48 patients with initial primary open-angle glaucoma (POAG), 47 patients with advanced POAG, and 42 control subjects. Authors also studied the correlations between VEP values and the parameters used in CDI and OCT-A examination. RESULTS: The most noticeable differences between the study groups were the amplitudes of P100 pattern VEP values for small and large patterns and the OCT-A parameters: Whole-image Disc Vessel Density (widVD), Peripapillary Vessel Density (pVD), Peripapillary Vessel Density Inferior Temporalis (pVD IT). In initial glaucoma, a strong correlation was observed between the amplitude of P100 pattern VEP 1° and pVD IT (r=0.75; p<0.0001); the blood flow rates in ophthalmic artery, central retinal artery, central retinal vein and short posterior ciliary arteries were below normal, while the blood flow in these vessels had statistically reliable correlation with the amplitude of P100 pattern VEP (p<0.05). No correlation was found in patients with advanced stages of glaucoma. CONCLUSION: Pattern VEP is an informative method of glaucoma diagnostics which accuracy can be enhanced by combining it with OCT-A blood flow examination.

[Macular blood flow in glaucoma]. / Osobennosti makuliarnogo krovotoka pri glaukome.

AIM: to assess macular blood flow in primary open-angle glaucoma (POAG) patients using optical coherence tomography angiography (OCT-A). MATERIAL AND METHODS: The study included 65 POAG patients and 22 age-matched healthy volunteers. Using OCT-A, blood flow parameters (Flow Area, Flow Index, and Vessel Density) were assessed in the para- and perifovea (0.6-2.5 mm and 2.5-5.5 mm, respectively) at the level of both superficial and deep vascular pexuses. Statistical analysis was performed with SPSS version 21 and MASS library of the R language. RESULTS: All the studied parameters were decreased in glaucoma patients as compared to healthy participants: Index superficial parafovea was 0.03±0.01 and 0.04±0.01 (p<0.001), respectively; Index superficial perifovea - 0.02±0.01 and 0.04±0.01 (p<0.001), respectively; Flow superficial parafovea area - 1.57±0.85 mm2 and 2.53±0.53 mm2 (p<0.001), respectively; Index deep parafovea - 0.02±0.02 and 0.03±0.01 (p<0.001), respectively; Index deep perifovea - 0.01 ±0.01 and 0,03±0.01 (p<0.001), respectively; and Flow deep parafovea area 1.02±0.9 mm2 and 1.97±0.82 mm2 (p<0.001), respectively. The differences were statistically significant between glaucoma patients and the controls, but not between glaucoma patients at different disease stages. CONCLUSION: Decreased OCT-A parameters in non-advanced glaucoma indicate an early reduction of blood supply to the macula and explain the involvement of the latter in the pathological process in POAG.

Prenatal exposure to persistent organic pollutants and offspring allergic sensitization and lung function at 20 years of age.

BACKGROUND: Prenatal exposures to persistent organic pollutants (POPs) have been associated with asthma medication use and self-reported symptoms, but associations with lung function and allergic sensitization have been minimally explored. The aim of the study was to examine the associations between prenatal exposures to POPs and allergic sensitization and lung function in 20-year-old offspring. METHODS: In a Danish cohort of 965 pregnant women established in 1988-1989, six polychlorinated biphenyl (PCB) congeners, hexachlorobenzene (HCB), and dichlorodiphenyldichloroethylene (p,p'-DDE) were quantified in archived maternal serum drawn in gestational week 30 (n = 872). Among those with available maternal exposure information, at age 20, 421 offspring attended attended a clinical examination including measurements of allergic sensitization (serum-specific IgE ≥ 0.35 kUA /L) (n = 418) and lung function [forced expiratory volume in one second (FEV1 ) and forced vital capacity (FVC)] (n = 414). RESULTS: There were no associations between maternal concentrations of POPs and offspring allergic sensitization at 20 years of age. Maternal concentrations of POPs were, however, positively associated with offspring airway obstruction (FEV1 /FVC < 75%). Compared to offspring in the first tertile of exposure, offspring in the third tertile of dioxin-like PCB exposure had an OR of 2.96 (95% CI: 1.14-7.70). Similar associations for non-dioxin-like PCBs, HCB, and p,p'-DDE were 2.68 (1.06-6.81), 2.63 (1.07, 6.46), and 2.87 (1.09, 7.57), respectively. No associations were observed with reduced lung function (FEV1 % of predicted value < 90%). CONCLUSION AND CLINICAL RELEVANCE: Our data indicate that prenatal exposure to POPs appears to be associated with airway obstruction but not allergic sensitization at 20 years of age. The findings support that chronic obstructive lung diseases may have at least part of their origins in early life.

[Optical coherence tomography angiography in glaucoma diagnosis]. / Opticheskaia kogerentnaia tomografiia s funktsiei angiografii v diagnostike glaukomy.

According to literature data, vascular dysfunction may well contribute to the development of glaucomatous optic neuropathy, which makes it reasonable to search for new imaging techniques capable of early diagnosis and monitoring of glaucoma through assessment of retinal, optic nerve head (ONH), and choroidal perfusion. Optical coherence tomography angiography (OCTA), a recently introduced method based on the split-spectrum amplitude-decorrelation angiography (SSADA) algorithm, enables evaluation of both retinal and choroidal blood flow in peripapillary and macular areas. The first studies involving OCTA have revealed a decrease in retinal blood flow in glaucoma. It has also been shown that visual field indices correlate better with the peripapillary flow index than with morphometric parameters of the optic nerve head (ONH) and peripapillary retina. OCT angiography has great potential for ONH blood flow assessment during physiological tests, which is an important step towards understanding pathogenesis of glaucoma.

Gestational weight gain in normal weight women and offspring cardio-metabolic risk factors at 20 years of age.

OBJECTIVE: Limited knowledge exists on the long-term implications of maternal gestational weight gain (GWG) on offspring health. Our objective was to examine whether high GWG in normal weight women is associated with adult offspring cardio-metabolic risk factors. METHODS: We used a cohort of 308 Danish women who gave birth in 1988-89 and whose offspring participated in a clinical examination at 20 years of age. Main outcome measures were offspring body mass index (BMI), waist circumference, weight-regulating hormones, blood lipids and glucose metabolism. Associations were assessed using multivariable linear and logistic regression models. RESULTS: A weak positive association was observed between GWG during the first 30 weeks and offspring anthropometry. Each 1-kg increase in maternal GWG was associated with 0.1-kg m(-2) higher (95% confidence interval (CI): 0.01, 0.2) offspring BMI and 10% (95% CI: 0.1%, 20%) higher odds of offspring overweight at the age of 20 years, with similar associations observed in both sexes. However, sex differences were observed for the association between maternal GWG and specific cardio-metabolic risk factors. Hence, a 1-kg increase in GWG was associated with 3.4% (95% CI; 0.8, 6.0%) higher homeostasis model assessment-estimated insulin resistance (HOMA-IR), 3.7% (95% CI: 1.4%, 6.2%) higher insulin and 10.7% (95% CI: 5.7%, 15.9%) higher leptin levels in male offspring. These associations were not observed in females, which may partly be explained by more frequent reports of dieting and physical exercise at follow-up among female offspring. CONCLUSIONS: In normal-weight women, high GWG may have modest long-term implications on offspring cardio-metabolic risk factors at adult age.

Enrichment of umbilical cord blood mononuclears with hemopoietic precursors in co-culture with mesenchymal stromal cells from human adipose tissue.

We demonstrated the possibility of enrichment of umbilical cord blood mononuclear fraction with early non-differentiated precursors under conditions of co-culturing with mesenchymal stromal cells from the human adipose tissue. It was established that umbilical cord blood mononuclear cells adhered to mesenchymal stromal cell feeder and then proliferate and differentiate into hemopoietic cells. In comparison with the initial umbilical cord blood mononuclear fraction, the cell population obtained after 7-day expansion contained 2-fold more CFU and 33.4 ± 9.5 and 24.2 ± 11.2% CD34(+) and CD133(+) cells, respectively, which corresponds to enrichment of precursor cell population by 148 ± 60. The proposed scheme of expansion of hemopoietic cells from umbilical cord blood is economically expedient and can widely used in biology and medicine.

Physicochemical and kinetic characteristics of isoforms of isocitrate lyase from corn.

Three electrophoretically homogeneous isocitrate lyase (ICL) isoforms were obtained by 4-step purification from corn scutellum (ICL(1) and ICL(2)) and green leaves (ICL). Their physicochemical, kinetic, and regulatory properties were analyzed. The molecular masses of ICL(1), ICL(2) , and ICL isoforms determined by gel filtration are 164, 207, and 208 kDa, respectively. The proteins have homotetrameric quaternary structure with subunit molecular masses of 43, 48, and 47 kDa for ICL(1), ICL(2), and ICL, respectively. We found some differences in pH optimum, K(m), and regulation by divalent metal cations between ICL(1) and ICL(2) and significant similarity of ICL(2) and ICL. Based on these data, we suggest the participation of these isoforms in metabolic regulation of the glyoxylate cycle, organic acid metabolism during photorespiration in leaves and acidosis in corn seeds.

[Differentiation of two hemp nettle species (Galeopsis bifida Boenn. and G. tetrahit L.) inferred from morphological characters and DNA markers].

Two species of the genus Galeopsis L., G. tetrahit L. and G. bifida (family Lamiaceae), are problematic to distinguish often wrongly recognized, and treated by some taxonomists as a single species. Morphological diagnostical characters of these species are variable and partly overlap. Species independence of G. tetrahit and G. bifida was evaluated and their diagnostic characters verified using ISSR and RAPD markers. A total of 57 ISSR and 28 RAPD fragments were obtained providing distinct subdivision of the accessions examined into two groups. Analysis of molecular data using the neighbor-joining method showed that the accessions studied fell into two clades in the same way as demonstrated by the analysis of 20 morphological characters using single linkage method. The morphological characters were found to be more variable compared to the molecular markers, although the combined of these characters provided differentiation of the species.

[Downstream migration and feeding of young coho salmon Oncorhynchus kisutch in the northern part of the range in Kamchatka].

Downstream migration of young coho salmon in the northern part of the range is observed at different ontogenetic stages. Three migration periods were identified: passive migration of yearlings within the spawning river; migration of parr older than 1 year from the spawning tributary to the main river; and migration of smoltifying fish from the river to the sea. The smoltification and seaward migration of the bulk of young salmons from the Kalkaveem River takes place at the age of 2 years. Mass downstream migration of young coho salmons starts in early June at 9 degrees C. No clear diel pattern was observed in the migration of young coho salmon. The lowest migration activity was observed from sunrise to noon (3:00-12:00) when the feeding activity of young salmons increases.

Childhood leukaemia in Belarus, Russia, and Ukraine following the Chernobyl power station accident: results from an international collaborative population-based case-control study.

BACKGROUND: There is little evidence regarding the risk of leukaemia in children following exposure to radionuclides from the Chernobyl Nuclear Power Plant explosion on April 26, 1986. METHODS: This population-based case-control study investigated whether acute leukaemia is increased among children who were in utero or <6 years of age at the time of the Chernobyl accident. Confirmed cases of leukaemia diagnosed from April 26, 1986 through December 31, 2000 in contaminated regions of Belarus, Russia, and Ukraine were included. Two controls were matched to each case on sex, birth year, and residence. Accumulated absorbed radiation dose to the bone marrow was estimated for each subject. RESULTS: Median estimated radiation doses of participants were <10 mGy. A significant increase in leukaemia risk with increasing radiation dose to the bone marrow was found. This association was most evident in Ukraine, apparent (but not statistically significant) in Belarus, and not found in Russia. CONCLUSION: Taken at face value, these findings suggest that prolonged exposure to very low radiation doses may increase leukaemia risk as much as or even more than acute exposure. However the large and statistically significant dose-response might be accounted for, at least in part, by an overestimate of risk in Ukraine. Therefore, we conclude this study provides no convincing evidence of an increased risk of childhood leukaemia as a result of exposure to Chernobyl radiation, since it is unclear whether the results are due to a true radiation-related excess, a sampling-derived bias in Ukraine, or some combination thereof. However, the lack of significant dose-responses in Belarus and Russia also cannot convincingly rule out the possibility of an increase in leukaemia risk at low dose levels.

[Detection of minimal residual disease in patients with acute myeloid leukemia]. / Vyiavlenie minimal'noi ostatochnoi bolezni u bol'nykh ostrymi mieloidnymi leikozami.

AIM: Detection of minimal residual disease (MRD) in patients with acute myeloid leukemia (AML) and the study of its correlations with duration of recurrence-free interval. MATERIAL AND METHODS: Bone marrow samples obtained from 37 AML patients before treatment were studied at two-color flow cytometry. The panel of monoclonal antibodies to T- and B-cell, myeloid antigens was used. The residual cells were estimated in 20 patients in remission. RESULTS: 78% cases were diagnosed to have an anomalous immunophenotype including coexpression of lymphoid and myeloid antigens, asynchronous expression of myeloid antigens. In the first remission the residual cells were detected in 20 patients due to aberrant antigen expression. The presence of MRD was stated if bone marrow contained more than 0.12% leukemic cells. The duration of the first remission and MRD correlated. 8 patients with MRD had remission for 3 to 6 months (median 4.7 months). 12 patients free of MRD were in remission for more than 6 months (for 8 to 26 months, median 19.7 months). The threshold level of the residual cells (0.12%) was confirmed statistically using the three-parameter probability model. CONCLUSION: This study confirms feasibility of using flow cytometry for detection of residual cells. MRD and duration of the first remission correlate. Long-term observation of large groups of AML patients will try the validity of the above statistical model.

[Clinical variants of joint hypermobility syndrome in respect to age]. / Klinicheskie varianty proiavleniia sindroma gipermobil'nosti sustavov v vozrastnom aspekte.

Joint hypermotility syndrome (JHMS) was studied in 304 patients (255 women, 49 men, age 16-50 years) divided by age into four groups (16-20, 21-30, 31-40, 41-50). It was found that the incidence rate of such symptoms as polyarthralgia, recurrent exudates and incomplete joint dislocations with age lowers while that of dorsalgia, oligoarthralgia, soft tissue rheumatic syndromes, fibromyalgia rises. A monosymptom variant was characteristic for patients of the age 16-20 years. It manifested with one of the above symptoms (polyarthralgia, dorsalgia, recurrent exudates and incomplete joint dislocations). A syndrome variant, manifesting with combination of several clinical symptoms, was typical for patients over 30. This reflects systemic involvement of connective-tissue structures in the pathological process in JHMS and accumulation of degenerative alterations in the locomotor system with age.

[Effectiveness of cyclosporin A in the treatment of adult patients with aplastic anemia]. / Effektivnost' tsiklosporina A v lechenii vzroslykh bol'nykh aplasticheskoi anemiei.

AIM: To evaluate the efficacy of cyclosporin A (CyA) at different stages of immunosuppressive therapy (IST) in patients with aplastic anemia (AA). MATERIALS AND METHODS: The efficacy of CyA was studied in 56 patients with AA. The agent was orally given in an initial dose of 10 mg/kg as solution or capsules. Its daily dose during a treatment course varies with the serum CyA levels and clinical tolerance. CyA was used in 17 patients at the first stage of treatment, in 8 with recurrent AA, and in 31 after ineffective previous therapy (antilymphocytic globulin therapy--ALGT, splenectomy). Erythropoiesis was evaluated by the count of erythrokaryocytes and by relative erythroid hyperplasia of the bone marrow and by using erythrokaryocytic PAS reaction, by calculating the total count of sideroblasts and ringed sideroblasts. RESULTS: A positive response was obtained in 41% of the patients with AA. Its pattern depended on the severity of AA, on CyA use regimens, and treatment duration: when treatment with CyA lasted 6-12 months, its efficacy considerably increased (positive responses in severe AA and mild AA being in 64 and 94%, respectively). It has been found that high (over 6%) baseline bone marrow ringed sideroblasts in patients with AA may be regarded as a poor predictor in the context of the efficacy of this agent. CONCLUSION: CyA is recommended for combined IST in patients with AA at the second stage of treatment (after antilymphocytic globulin administration) in order to perform long-term (12-month) immunosuppression by choosing the optimum dose on an individual basis and by continuously monitoring the quality of a response.

[The use of computer electronystagmography in the assessment of optokinetic nystagmic reactions]. / Primenenie komp'iuternoi élektronistagmografii v otsenke optokineticheskikh nistagmennykh reaktsii.

A novel technique of computer-assisted electronystagmography (CENG) has been used in 90 patients with vertigo. Two variants of optokinetic nystagmus (cortical and subcortical) were analysed. Registration of optokinetic nystagmus (OKN) was carried out using original devices for CENG. Right- and left-directed nystagmic reactions and their quantitation were performed according to specially devised registering and analysing programs. In one-sided vestibular disorders cases of cross-over OKN asymmetry prevailed in affection of the cerebellopontine angle (neurinoma of the VIII nerve) compared to labyrinthine disturbances (one-sided Meniere's disease). In 90% of patients with vertebrobasillar deficiency OKN asymmetry was found even in a straight position of the head. OKN asymmetry was less pronounced or disappeared in the OKN test performed with the head turned right or left by 90 degrees.

[Results of clinical trials in the treatment of acute myeloid leukemia in adults during a 7-year period]. / Rezul'taty provodimykh v techenie 7 let klinicheskikh issledovanii po lecheniiu ostrykh mieloidnykh leikozov vzroslykh.

AIM: Comparison of effectiveness of induction regimens varying in intensity and maintenance variants in patients with acute myeloid leukemia (AML) included in a randomised multicenter trial. MATERIALS AND METHODS: Clinical trial 1 enrolled 185 AML patients. Vepesid-free induction was used in 85 patients (group 1), induction with vepesid--in 99 patients (group 2). 223 AML patients entered trial 2. Of them 37 patients were treated for 3 years 7 + 3 with daunorubicin in the dose 45 mg/m2 in the induction phase (group 1), 85 and 101 patients received 7 + 3 with daunorubicin for a year in the dose 45 mg/m2 and 60 mg/m2, respectively, (group 2 and 3). RESULTS: For group 1 in trial 1 the remission rate, early lethality, resistance were, respectively, 60, 20 and 20%, respectively. For group 2 in trial 1--66, 22 and 12%, respectively. 5-year recurrence-free survival reached 32 and 37% for group 1 and 2, respectively. For trial 2 relevant figures made up 75.5, 16.2, 8.1% for group 1; 60, 17.6 and 22.4% for group 2; 63, 20.8 and 16% for group 3, respectively. The 3.5-year recurrence-free survival in groups 1, 2 and 3, was 16, 46 and 50%, respectively. For both trials, the differences between the groups were insignificant. CONCLUSION: The results evidence that the treatment can be shorter (not 3 but 1 year or even 6 months), the induction more intensive (the dose of anthracycline antibiotics can be elevated up to 60 mg/m2 without a rise in early lethality).

[Fevers of unknown origin: new aspects of an old problem]. / Likhoradki neiasnoi étiologii: novye aspekty staroi problemy.

Fever is an important component of immune response of the organism to various stimulating effects (trauma, infection, inflammation). This complex process comprises activation of monocytes/ macrophages, their synthesis and secretion of proinflammatory cytokines and realization of multiple biological effects of cytokines including growth stimulation and differentiation of hemopoietic cells. Recently, there has appeared a trend to growing number of cases with uncommon hyperthermia and 2-3 germ cytopenia in the blood. Activation of the macrophage system and hyperproduction of proinflammatory cytokines can be viewed not only as an essential mechanism of hemopoiesis stimulation but also as a potential cause of hemodepression. The paper analyzes the relations between high functional activity of the macrophage system and development of cytopenia in patients with persistent fever. Functional activity of the macrophage system was studied on the model of patients with tumors or reactive proliferations of monocytes-macrophages as the latter are the main sources of IL-1-cytokine--a mediator of human fever. To prove the suggested correlation and its significance, a correlation analysis was made of 29 clinical and laboratory parameters in 184 patients and 100 controls.