Four-corner fusion: comparison of patient satisfaction and functional outcome of conventional K-wire technique vs. a new locking plate.

BACKGROUND: Four-corner fusion is a standard procedure for advanced carpal collapse. Several operative techniques and numerous implants for osseous fixation have been described. Recently, a specially designed locking plate (Aptus©, Medartis, Basel, Switzerland) was introduced. The purpose of this study was to compare functional results after osseous fixation using K-wires (standard of care, SOC) with four-corner fusion and locking plate fixation. METHODS: 21 patients who underwent four-corner fusion in our institution between 2008 and 2013 were included in a retrospective analysis. In 11 patients, osseous fixation was performed using locking plates whereas ten patients underwent bone fixation with conventional K-wires. Outcome parameters were functional outcome, osseous consolidation, patient satisfaction (DASH- and Krimmer Score), pain and perioperative morbidity and the time until patients returned to daily work. Patients were divided in two groups and paired t-tests were performed for statistical analysis. RESULTS: No implant related complications were observed. Osseous consolidation was achieved in all cases. Differences between groups were not significant regarding active range of motion (AROM), pain and function. Overall patient satisfaction was acceptable in all cases; differences in the DASH questionnaire and the Krimmer questionnaire were not significant. One patient of the plate group required conversion to total wrist arthrodesis without implant-related complications. CONCLUSION: Both techniques for four-corner fusion have similar healing rates. Using the more expensive locking implant avoids a second operation for K-wire removal, but no statistical differences were detected in functional outcome as well as in patient satisfaction when compared to SOC.

Different neural and cognitive response to emotional faces in healthy monozygotic twins at risk of depression.

BACKGROUND: Negative cognitive bias and aberrant neural processing of emotional faces are trait-marks of depression. Yet it is unclear whether these changes constitute an endophenotype for depression and are also present in healthy individuals with hereditary risk for depression. METHOD: Thirty healthy, never-depressed monozygotic (MZ) twins with a co-twin history of depression (high risk group: n = 13) or without co-twin history of depression (low-risk group: n = 17) were enrolled in a functional magnetic resonance imaging (fMRI) study. During fMRI, participants viewed fearful and happy faces while performing a gender discrimination task. After the scan, they were given a faces dot-probe task, a facial expression recognition task and questionnaires assessing mood, personality traits and coping strategies. RESULTS: High-risk twins showed increased neural response to happy and fearful faces in dorsal anterior cingulate cortex (ACC), dorsomedial prefrontal cortex (dmPFC), pre-supplementary motor area and occipito-parietal regions compared to low-risk twins. They also displayed stronger negative coupling between amygdala and pregenual ACC, dmPFC and temporo-parietal regions during emotional face processing. These task-related changes in neural responses in high-risk twins were accompanied by impaired gender discrimination performance during face processing. They also displayed increased attention vigilance for fearful faces and were slower at recognizing facial expressions relative to low-risk controls. These effects occurred in the absence of differences between groups in mood, subjective state or coping. CONCLUSIONS: Different neural response and functional connectivity within fronto-limbic and occipito-parietal regions during emotional face processing and enhanced fear vigilance may be key endophenotypes for depression.

Paradoxical effects of short-term antidepressant treatment in fMRI emotional processing models in volunteers with high neuroticism.

BACKGROUND: Short-term antidepressant administration has been reported to decrease amygdala response to threat in healthy volunteers and depressed patients. Neuroticism (N) is a risk factor for depression but has also been associated with slow or incomplete remission with antidepressant drug treatment. Our aim was to investigate early selective serotonin reuptake inhibitor (SSRI) administration neural effects on implicit processing of fearful facial expressions in volunteers with high levels of N. METHOD: Highly neurotic subjects received 20 mg/day citalopram versus placebo for 7 days in a double-blind, between-groups design. On the last day haemoperfusion and functional magnetic resonance imaging (fMRI) data during a gender discrimination task with fearful and happy faces were acquired. A control group of non-neurotic volunteers was also tested. RESULTS: High-N volunteers had reduced responses to threatening facial expressions across key neural circuits compared to low-N volunteers. SSRI treatment was found to elevate resting perfusion in the right amygdala, increase bilateral amygdalae activation to positive and negative facial expressions and increase activation to fearful versus happy facial expressions in occipital, parietal, temporal and prefrontal cortical areas. CONCLUSIONS: These results suggest that 7 days of SSRI administration can increase neural markers of fear reactivity in subjects at the high end of the N dimension and may be related to early increases in anxiety and agitation seen early in treatment. Such processes may be involved in the later therapeutic effects through decreased avoidance and increased learning about social 'threat' cues.

Using the comet assay to assess the combined and separate genotoxic effects of Cd and Zn in Eisenia andrei (Oligochaeta) at different temperatures.

Using the comet assay, the genotoxicity of Cd, Zn and Cd/Zn mixtures in Eisenia andrei was assessed after 4 weeks of exposure at 15, 20 and 25 °C. Relative to the controls, significant increases in TDNA% were observed in exposures to Cd alone at 500 and 1,000 mg/kg soil at both 20 and 25 °C, while a general decrease occurred at 15 °C. For Zn alone, a decreasing trend in TDNA% occurred at all three temperatures with increasing Zn concentration. For the Cd/Zn mixtures at 15 °C, genotoxicity was reduced at all mixture concentrations relative to the control. At 20 °C, the genotoxic response was similar to the control at all exposures. At 25 °C, the response was elevated at the 50 + 50 and 250 + 250 mg/kg mixture concentrations. In the remaining treatments at 25 °C, TDNA% was similar to the values in the respective control. The lack of consistently significant mixture genotoxicity may indicate antagonistic interactions between Cd and Zn in the mixtures. However, this was not conclusively determined because temperature alone had an inconsistent effect upon TDNA% readings in the control exposures.

Using estimates of metal bioavailability in the soil and genetic variation of allozymes to investigate heavy metal tolerance in the earthworm Eisenia fetida (Oligochaeta).

In a recent study, we showed that the earthworm species Eisenia fetida, inhabiting an extremely high metal polluted compost heap on a wine farm, did not have elevated body loads of the metals but exhibited genotoxic tolerance when exposed to Cd in the laboratory (Voua Otomo and Reinecke, 2010). To unravel the mechanism behind the surprisingly low metal body burdens on one hand and genotoxic tolerance on the other hand, we investigated the estimated bioavailability of these metals (Cu, Zn, Pb and Cd) using sequential extraction methods with CaCl(2) and di-ethylene-triamine-pentaacetic acid (DTPA) and allozyme polymorphism in this field population, a laboratory control as well as a long-term Cd exposed population. The amounts of mobile (extracted with CaCl(2)) and mobilizable (extracted with DTPA) metals in relation to the total (extracted with nitric acid) metals were all below 0.05% for all four metals, suggesting low availability for uptake. The low availability of these metals could not be explained by physico-chemical properties of soil but by the phenomenon of aging of the metals. There was no difference in allozyme frequency between metal tolerant and non-metal tolerant populations of E. fetida. This suggested that the tolerance found in earlier studies could be a mere physiological adaptation.

Outbreak of Salmonella Montevideo associated with a dietary food supplement flagged in the Rapid Alert System for Food and Feed (RASFF) in Germany, 2010.

In March 2010 the Rapid Alert System for Food and Feed (RASFF) was used to inform about Salmonella Montevideo in a herbal food supplement, formulated in capsules, distributed under a Dutch label in Germany. Simultaneous to the first RASFF notice, in the last two weeks of March 2010 an unusual number of 15 infections with S. Montevideo was notified within the electronic reporting system for infectious diseases at the Robert Koch Institute. Adult women (median age: 43, range: 1-90 years) were mainly affected. An outbreak was suspected and the food supplement hypothesised to be its vehicle. Cases were notified from six federal states throughout Germany, which required efficient coordination of information and activities. A case-control study (n=55) among adult women showed an association between consumption of the specific food supplement and the disease (odds ratio (OR): 27.5, 95% confidence interval (CI): 3.1-infinity, p-value=0.002). Restricting the case-control study to the period when the outbreak peaked (between 29 March and 11 April 2010) resulted in an OR of 43.5 (95% CI: 4.8-infinity, p-value=0.001). Trace-back of the supplement's main ingredient, hemp seed flour, and subsequent microbiological testing by pulsed-field gel electrophoresis supported its likely role in transmission. This outbreak investigation illustrates that information from RASFF may aid in hypothesis generation in outbreak investigations, though likely late in the outbreak.

[Inappropriate lactation syndrome in goats--case collection and experiences with mastectomy]. / Lactatio falsa bei der Ziege - Fallsammlung und Erfahrungen mit der Amputation des Gesäuges.

OBJECTIVE: Hobby keeping of goats and sheep confronts veterinarians with new challenges that rarely have to be faced in livestock husbandry. During the last five years five goats were presented to the Clinic for Animal Reproduction, Faculty of Veterinary Medicine, Freie Universität Berlin, Germany, with inappropriate lactation syndrome. Four of these animals had been previously treated with cabergoline without enduring success. According to the request of the owners (informed consent) and the clinical severity of the cases, a mastectomy was performed in all five animals. MATERIAL AND METHODS: Surgery was performed under general anaesthesia using ketamine and xylazine, and with the patients in a recumbent position. RESULTS: Mastectomy in small ruminants requires knowledge of the anatomy of the udder and the possible positions of the supplying blood vessels. Our patients displayed a variety of dispositions of the Vena epigastrica caudalis superficialis. Special attention should be paid to a careful and blunt dissection of the mammary gland, and immediate control of haemorrhage, to maintain a clear view on the anatomic structures. Furthermore, dissection of the glandular tissue should be strictly avoided to prevent milk contamination of the surgical area. A sufficient skin flap has to be left to cover the surgical area after removal of the udder. CONCLUSION AND CLINICAL RELEVANCE: Even though udder amputation appears to be a radical and high-risk procedure, all five goats survived the surgery. The wound healing occurred in a reasonable time without any severe complications. In goats that are kept as "hobby animals" and in which an inappropriate lactation syndrome cannot be treated conservatively, mastectomy is a reasonable and promising therapy.

Role of clay content in partitioning, uptake and toxicity of zinc in the earthworm Eisenia fetida.

We studied the effect of clay content on the bioavailability of zinc to pre-clitellate earthworm, Eisenia fetida in the laboratory using OECD artificial soil adjusted to 5%, 20%, and 40% clay. Batches of worms were exposed to a wide range of zinc concentrations. Mortality, growth, maturation (% clitellate), cocoon production, and body zinc concentrations were assessed over and after a period of 4 weeks. Total, DTPA, and CaCl(2) extractable zinc in the substrates were also determined. The results of the biological responses showed that interaction of clay and zinc had a significant influence on mortality but not on the other biological parameters. None of the three extraction methods showed consistent and significant effect of clay content on zinc partitioning. Although total, DTPA, and CaCl(2) extracts of zinc correlated strongly with one another and were in similar relation with the observed biological responses, only the CaCl(2) extract revealed a time dependent availability of this metal. It is concluded that clay content had no significant influence on sub-lethal toxicity of zinc to this earthworm over the range of exposure concentrations.

Quantitative changes in digestive gland cells and oocytes of Helix aspersa, as biomarkers of copper oxychloride exposure under field conditions.

This study investigated the effects of accumulated copper, on digestive epithelium height and percentage area, and on oocyte numbers of the snail Helix aspersa, in a vineyard where copper oxychloride is sprayed. The ultimate aim was to determine the usefulness of these cellular responses as biomarkers. Results showed that snails collected 2 months after fungicide application, had a significantly lower mean digestive epithelium height and percentage area, as well as significantly fewer oocytes per 1 mm(2) of ovotestis, compared to snails collected only 1 week after fungicide application and those from a control vineyard. It was concluded that these cellular responses are clear, measurable responses to copper oxychloride exposure and copper accumulation. However, they do not provide an early warning of copper exposure, which impacts on their usefulness as biomarkers.

Upregulation of osteopontin expression in renal cortex of streptozotocin-induced diabetic rats is mediated by bradykinin.

The model of streptozotocin (STZ)-induced diabetes in Wistar rats was used to study the expression of osteopontin during development of diabetic nephropathy. Diabetes was confirmed by serum glucose levels exceeding 16 mmol/l during the experimental period of 12 weeks. During this period of time, diabetic nephropathy developed, as characterized by a reduced glomerular filtration rate (2.7 +/- 0.3 ml/min in controls vs. 1.7 +/- 0.1 ml/min in diabetic rats) and proteinuria (8.3 +/- 1.7 mg/24 h in controls vs. 22.0 +/- 4 mg/24 h in diabetic rats). Northern blot analysis revealed a time-dependent upregulation of renal cortical osteopontin expression reaching 138 +/- 6% of control levels after 2 weeks and 290 +/- 30% (mean +/- SE, n = 6-9) after 12 weeks. By immunostaining, the increased osteopontin expression could be located to the tubular epithelium of the renal cortex. Chronic treatment of animals with ramipril (3 mg/kg) during the 12-week experimental period led to a further increase in osteopontin mRNA expression in diabetic animals, amounting to 570 +/- 73% (mean +/- SE, n = 6) of controls. Increased levels of osteopontin were not associated with accumulation of monocyte/macrophages that were identified by the cell type specific monoclonal antibody ED-1. The increased osteopontin expression in ramipril-pretreated rats was abolished by application of the bradykinin B2-receptor antagonist, icatibant (0.5 mg/kg). In addition, increased osteopontin expression in diabetic rats, which did not receive any treatment after STZ injection, could as well be reduced by icatibant given for the final 2 weeks of the experimental period. These data suggest that a strong bradykinin B2-receptor-mediated upregulation of osteopontin occurs during the pathogenesis of experimental diabetic nephropathy in rats.

Cardioprotective effects of the Na(+)/H(+)-exchange inhibitor cariporide in infarct-induced heart failure.

OBJECTIVE: We investigated the effect of chronic treatment with the new Na(+)/H(+)-exchange inhibitor, cariporide, on cardiac function and remodelling 6 weeks after myocardial infarction (MI) in rats. METHODS: Treatment with cariporide was commenced either 1 week pre or 30 min, 3 h, 24 h or 7 days after ligation of the left ventricular artery and was continued until haemodynamic parameters were obtained 6 weeks after MI in conscious rats. RESULTS: Compared to sham animals, untreated MI-controls developed pronounced heart failure after 6 weeks. Basal left ventricular end-diastolic pressure (in mmHg) was reduced in the groups in which cariporide was started 1 week pre (16.0+/-1.7) or 30 min (12.5+/-1.1), 3 h (11.8+/-1.0) and 24 h (13.0+/-2.5) after MI compared to untreated MI-controls (22. 4+/-1.5; P<0.01). Basal myocardial contractility (in 1000 mmHg/s) was only increased when treatment was initiated after 30 min (9. 0+/-0.7), 3 h (8.5+/-0.3) and 24 h (8.0+/-0.7) compared to untreated MI-controls (5.8+/-0.7; P<0.05-0.01). Infarct size (in % of left ventricular circumference) was 40.0+/-2.1 in MI-controls and was decreased when treatment was begun after 30 min (32.6+/-2.7) or 3 h (32.4+/-2.3) (P<0.05). In animals, in which cariporide was started 3 h after induction of MI, heart weight/body weight ratio was significantly decreased, indicating reduced cardiac hypertrophy. When treatment started 7 days after MI, cariporide did not exert any beneficial actions on structural and functional cardiac parameters. CONCLUSION: Our results show for the first time that chronic treatment with the Na(+)/H(+)-exchange inhibitor cariporide engendered marked cardioprotective effects when commenced before and up to 24 h after MI. The optimal time for the start of treatment was between 30 min and 3 h post MI.

Effective emotion regulation strategies improve fMRI and ECG markers of psychopathology in panic disorder: implications for psychological treatment action.

Impairments in emotion regulation are thought to have a key role in the pathogenesis of anxiety disorders, but the neurobiological underpinnings contributing to vulnerability remain poorly understood. It has been a long-held view that exaggerated fear is linked to hyperresponsivity of limbic brain areas and impaired recruitment of prefrontal control. However, increasing evidence suggests that prefrontal-cortical networks are hyperactive during threat processing in anxiety disorders. This study directly explored limbic-prefrontal neural response, connectivity and heart-rate variability (HRV) in patients with a severe anxiety disorder during incidental versus intentional emotion regulation. During 3 Tesla functional magnetic resonance imaging, 18 participants with panic disorder and 18 healthy controls performed an emotion regulation task. They either viewed negative images naturally (Maintain), or they were instructed to intentionally downregulate negative affect using previously taught strategies of cognitive reappraisal (Reappraisal). Electrocardiograms were recorded throughout to provide a functional measure of regulation and emotional processing. Compared with controls, patients showed increased neural activation in limbic-prefrontal areas and reduced HRV during incidental emotion regulation (Maintain). During intentional regulation (Reappraisal), group differences were significantly attenuated. These findings emphasize patients' ability to regulate negative affect if provided with adaptive strategies. They also bring prefrontal hyperactivation forward as a potential mechanism of psychopathology in anxiety disorders. Although these results challenge models proposing impaired allocation of prefrontal resources as a key characteristic of anxiety disorders, they are in line with more recent neurobiological frameworks suggesting that prefrontal hyperactivation might reflect increased utilisation of maladaptive regulation strategies quintessential for anxiety disorders.

Contribution of human papilloma virus to the incidence of squamous cell carcinoma of the head and neck in a European population with high smoking prevalence.

BACKGROUND: Increases in incidence of oropharyngeal squamous cell carcinoma (OPSCC) in countries with falling tobacco use have been attributed to a growing role of human papilloma virus (HPV) in the carcinogenesis. Trends of HPV prevalence in populations with persistently high portions of smokers are poorly characterised. PATIENTS AND METHODS: Registry data from East Germany were used to determine incidence trends between 1998 and 2011. Data from patients treated at the Charité University Medicine Berlin between 2004 and 2013 (cohort 1, N=436) were used for estimation of trends in HPV prevalence, smoking and survival. HPV prevalence was prospectively confirmed in cohort 2 (N=213) comprising all primary HNSCC cases at the Charité in 2013. RESULTS: Between 1998 and 2011 incidence of both OPSCC and non-OPSCC increased. An increase in HPV prevalence (% of HPV+ cases in 2004-2006 versus 2012-2013: 27% versus 59%, P=0.0004) accompanied by a moderate decrease in the portion of current smokers was observed in OPSCC but not in non-OPSCC. The change in disease epidemiology in OPSCC was associated with significant improvement in overall survival. Increased HPV prevalence in OPSCC (48%) compared to non-OPSCC (11%) was confirmed in cohort 2. CONCLUSIONS: Despite clear differences to the United States in terms of tobacco use, the increase in OPSCC incidence in a European population was also mainly attributed to HPV, and the HPV status significantly affected prognosis. For clinical trial design it is important to consider the large group of smokers within HPV-induced OPSCC.

Dynamics of the cytoskeleton in Amoeba proteus. III. Influence of microinjected antibodies on the organization and function of the microfilament system.

Affinity-purified antibodies against actin, myosin, alpha-actinin and vinculin cross-reacted with corresponding proteins from Amoeba proteus in immunoblotting experiments. Antibody staining of cells fixed during locomotion revealed different distribution patterns with a local concentration of anti-actin in the intermediate and of anti-myosin in the uroid region. Anti-alpha-actinin labeled a thin layer at the internal face of the plasma membrane, whereas anti-vinculin was distinctly concentrated at the base of advancing pseudopodia. Microinjection of different control solutions or antibodies against actin, myosin and alpha-actinin neither influenced the normal morphology and motile activity of amoebae nor changed the cellular distribution pattern of complementary antigens. However, antibodies against vinculin disorganized controlled locomotion and altered the spatial morphology of the microfilament system as well as the localization of the vinculin antigen thus pointing to a function of this protein in adhesion and locomotion of A. proteus. The results of the present paper show similarities to observations on mammalian tissue culture cells.

Tissue-specific expression of a rat renin transcript lacking the coding sequence for the prefragment and its stimulation by myocardial infarction.

An alternative transcript of the rat renin gene was recently characterized in the adrenal gland, in addition to the known messenger RNA (mRNA) coding for preprorenin. In the alternative transcript, exon 1 is replaced by exon 1A, a domain originating in intron 1. The reading frame of this mRNA, termed exon 1A-renin transcript, codes for a truncated prorenin that presumably remains intracellular, in contrast to preprorenin, which is targeted to the secretory pathway by its prefragment. We here demonstrate the tissue-specific regulation of expression of both transcripts by RT and PCR. In many tissues both transcripts are present, for example in the adrenal gland, spleen, liver, and hypothalamus. In some organs, however, only one of the renin mRNAs is found. In the kidney only the full-length mRNA coding for preprorenin is detected. In the heart exclusively the exon 1A-mRNA is expressed, but not the preprorenin transcript. After myocardial infarction, which is known to activate the intracardiac renin-angiotensin system, expression of exon 1A-renin mRNA in the left ventricle was stimulated about 4-fold, compared with that in sham-operated animals, whereas no mRNA corresponding to preprorenin was detectable. These findings may have implications for the current concepts of local extrarenal renin-angiotensin systems, as they provide the molecular basis for a possible intracellular function of renin and exclude a role for locally produced secretory renin in the heart.

Opposite regulation of brain and C-type natriuretic peptides in the streptozotocin-diabetic cardiopathy.

C-type natriuretic peptide (CNP), a recent addition to the family of natriuretic peptides including atrial and brain natriuretic peptide (ANP, BNP), is believed to be an endothelium-derived vasodilator and to have an antimitotic effect. ANP and BNP concentrations are increased in conditions such as congestive heart failure, but cardiac CNP concentrations have not been investigated in this connection. Diabetes mellitus also involves myocardial dysfunctions without coronary artery disease or systemic hypertension. We therefore investigated the cardiac expression of CNP mRNA compared with that of BNP mRNA in streptozotocin (STZ)-diabetic rats. STZ- diabetic male Wistar rats (n=6) were studied in comparison with controls (n=6). The animals were characterised by their mean arterial blood pressure and plasma glucose concentrations. After extraction of total cardiac RNA, a specific cDNA probe of BNP was used for northern blot analysis, whereas myocardial CNP expression was analysed by an RNase-protection assay. Twelve weeks after diabetes was induced, the rats were normotensive (96.4+/-2.0 compared with 95.1+/-1.9 mmHg) and hyperglycaemic (615+/-61 compared with 165+/-21 mg/dl; P<0.001). Left ventricular pressure was significantly impaired (76.8+/-6.4 compared with 51.2+/-3.6 mmHg). STZ-diabetic rats had a 3.2-fold increase in cardiac BNP expression compared with controls. In contrast, cardiac CNP mRNA concentrations were decreased 2.6-fold. CNP seems to be downregulated like other peptides with antimitotic and vasodilator activities (nitric oxide, prostacyclin, kinins). This may contribute to cardiac dysfunction in diabetes mellitus and suggests that stimulation of CNP expression could provide cardiac protection in such cases.

Renal expression of two rat kallikrein genes under diabetic conditions.

OBJECTIVE: We have reported that bradykinin (BK) excretion is increased in severely diabetic rats, independent of the activity of the main renal kinin-forming enzyme, true kallikrein (KLK). To further investigate the relationship between renal BK excretion and renal KLK in diabetes we studied the regulation of the renal kallikrein-like gene, rat kallikrein 7 (rKLK7), as well as of the KLK encoding gene, rKLK1, in streptozotocin-induced (STZ) diabetic rats. METHODS: Experiments were performed in STZ-induced diabetic male Wistar rats and their non-diabetic controls (n = 7 each group). Twelve weeks after STZ injection, urinary KLK activity, glomerular filtration rate and total protein excretion were determined. After extraction of total renal cortical RNA, specific oligonucleotides were used to generate a reverse transcription-polymerase chain reaction (RT-PCR) products of renal cortical rKLK1 and rKLK7 messenger (m)RNA. Southern blot analysis of these RT-PCR products were hybridized with appropriate gene-specific oligonucleotide probes. RESULTS: After 12 weeks, the rats showed hyperglycemia, proteinuria and a reduced glomerular filtration rate. Renal kininogenase was reduced, as indicated by a reduction in the expression of rKLK1, as well as of the KLK-related gene, rKLK7. CONCLUSIONS: Our data show that the expression of the two principal renal KLK genes is downregulated in the renal cortex of STZ-diabetic rats. We suggest that under severe diabetic conditions the rise in urinary BK excretion is not related to activation of the renal kinin-forming enzyme system.

Effects of a novel angiotensin AT(1) receptor antagonist, HR720, on rats with myocardial infarction.

Cardiac remodeling after myocardial infarction is associated with impaired ventricular function and heart failure and has important implications for survival. The purpose of the present study was to assess the effects of chronic treatment with a novel angiotensin AT(1) receptor antagonist 2-butyl-4-(methylthio-)-1-[[2'[[[(propylamino)carbonyl]amino]sulfonyl ](1,1'-biphenyl)-4-yl]methyl]-1H-imidazole-5-carboxylate (HR720), on cardiac remodeling and left ventricular dysfunction in a rat model of large myocardial infarction. Rats were subjected to permanent ligation of the left coronary artery and were treated for six weeks with placebo or HR720 (3 mg/kg/day) initiated 24 h after surgery. Sham-operated rats served as normal controls. Mean arterial blood pressure, the maximum rate of rise of the left ventricular systolic pressure (dP/dt(max)), left ventricular end-diastolic pressure, left ventricular inner diameter and circumference, septal thickness, left ventricular collagen content and heart weight were measured at the end of the treatment. HR720 treatment versus placebo attenuated the cardiac hypertrophy (heart weight/body weight: 2.88+/-0.08 mg/g vs. 3.16+/-0.09 mg/g, P<0.05), reduced interstitial collagen content (3. 47+/-0.28% vs. 5.25+/-0.45%, P<0.01), limited infarct size (33.0+/-3. 0% vs. 41.5+/-2.3%, P<0.05), decreased left ventricular end-diastolic pressure (13.7+/-2.2 vs. 21.4+/-1.6 mm Hg, P<0.01) and improved dP/dt(max) (9000+/-430 vs. 6000+/-840 mm Hg/s, P<0.05). The present results demonstrate that chronic treatment with the angiotensin AT(1) receptor antagonist HR720 can limit infarct size, partially prevent cardiac hypertrophic remodeling and improve left ventricular function in rats with myocardial infarction.

Diabetes and cardiovascular risk evaluation and management in primary care: progress and unresolved issues - rationale for a nationwide primary care project in Germany.

This review highlights established and more recently recognized risk factors for coronary heart disease (CHD) relevant for patients seen in primary care, emphasizing the key role of diabetes mellitus type 2. Recent trends in risk factor research as well as current methods of risk stratification, and new systemic markers are discussed. Beyond the need for more forceful public health strategies to improve early recognition and intervention, the necessity of an integrated comprehensive investigation of the overall characteristics of cardiovascular disease, especially in primary care patients as a prerequisite for future concerted actions is pointed out. Based on this, a large-scale epidemiological investigation focusing on CHD and diabetes in the primary care sector is suggested.

Spray deposition of two insecticides into surface waters in a South African orchard area.

Drift from pesticide spray application can result in contamination of nontarget environments such as surface waters. Azinphos-methyl (AZI) and endosulfan (END) deposition in containers of water was studied in fruit orchards in the Western Cape, South Africa. Additionally, attention was given to the contamination in farm streams, as well as to the resulting contamination of the subsequent main channel (Lourens River) approx. 25 km downstream of the tributary stream inlets. Spray deposit decreased with increasing distance downwind and ranged from 4.7 mg m(-2) within the target area to 0.2 mg m(-2) at 15 m downwind (AZI). Measured in-stream concentrations of both pesticides compared well with theoretical values calculated from deposition data for the respective distances. Furthermore, they were in the range of values predicted by an exposure assessment based on 95th-percentile values for basic drift deposition (German Federal Biological Research Centre for Agriculture and Forestry [BBA] and USEPA). Pesticide deposition in the tributaries was followed by a measurable increase of contamination in the Lourens River. Mortality of midges (Chironomus spp.) exposed for 24 h to samples obtained from the AZI trials decreased with decreasing concentrations (estimated LC50 from field samples = 10 microg L(-1) AZI; lethal distance: LD50 = 13 m). Mortality in the tributary samples averaged 11% (0.5-1.7 microg L(-1) AZI), while no mortality was discernible in the Lourens River samples (0.041 microg L(-1)). The sublethal endpoint failure to form tubes from the glass beads provided was significantly increased at all sites in comparison with the control (analysis of variance [ANOVA], Fisher's protected least significant difference [PLSD], p < 0.01).