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Funding Acknowledgements Type of funding sources: None. Introduction Prevalence of mitral annulus calcification (MAC) and degenerative mitral stenosis thus elevated transmitral gradient (TMG) is increased with age and multivalve involvement. The management of degenerative multivalve disease is challenging, as is identification of the presence of multivalve involvement and its hemodynamic impact because of interaction between two or more valve lesions especially in degenerative valve disease. Hemodynamic interaction between significant aortic stenosis and mitral annular calcification is often combined with diastolic disfunction which can result in LA enlargement and abnormal atrioventricular coupling and left atrial and ventricular remodeling. Purpose Study aimed to assess the effect of MAC on mitral valve stenosis in patients with multiple valve disease of degenerative origin. Method We retrospectively analyzed 78 patients with elevated transmitral gradient defined as an elevated TMG >4mmHg, MAC in multivalve involvement, mainly degenerative significant aortic valve stenosis who were treated in our clinic from 2018 to 2021. We excluded patients with prior cardiac surgery, congenital heart disease, hypertrophic obstructive cardiomyopathy and with heart rate >100 bpm at time of study and significant mitral regurgitation. Baseline demographic data were extracted from the electronic medical record and echocardiographic data were analyzed from electronic saved data. Results Study identified a total of 78 patients (average age 71,89 years, 64% females). Of 57 analyzed patients 32% patients had severe MAC and calcification of chordae, and 68% patients had MAC and mild or no significant chordae calcification. Patients with aortic gradients, severe aortic stenosis (AVAi 0,80 cm/m2) were observed more often in patients with severe MAC and significant chordae calcification than in those with nonsevere MAC (p Conclusion Result suggest that increasing transmitral gradient if superimposed on severe MAC with only modest mitral stenosis will result in a high mean transmitral gradient. The presence of elevated pressure transmitral gradient in patients with more severe aortic stenosis and more severe MAC combined with chordae calcification may imply hemodynamic effect or stress on mitral valve degeneration in multiple valve involvement. Other imaging modalities and further investigation for better understanding effect of hemodynamic stress in multiple valve disease are needed. These observations need to be evaluated on larger cohorts of patients during a longer period of time.

This paper deals with structural issues concerning wavelet frames and their dual frames. It is known that there exist wavelet frames { a j / 2 ψ ( a j ⋅ − k b ) } j , k ∈ Z in L 2 ( R ) for which no dual frame has wavelet structure. We first generalize this result by proving that there exist wavelet frames for which no approximately dual frame has wavelet structure. Motivated by this we show that by imposing a very mild decay condition on the Fourier transform of the generator ψ ∈ L 2 ( R ) , a certain oversampling { a j / 2 ψ ( a j ⋅ − k b / N ) } j , k ∈ Z indeed has an approximately dual wavelet frame; most importantly, by choosing the parameter N ∈ N sufficiently large we can get as close to perfect reconstruction as desired, which makes the approximate dual frame pairs perform equally well as the classical dual frame pairs in applications.

Background: Cytomegalovirus (CMV) infection, neutropenia occurrence and mycophenolate (MMF) dose reduction are associated with an increased risk of acute kidney graft rejection. The aim of our retrospective clinical study was to evaluate the association of CMV associated neutropenia with a consequent MMF dose reduction and acute kidney graft rejection. Method: 161 patients transplanted from January 2005 till December 2010, who received anti-CD25 antibodies induction, MMF, calcineurin inhibitor and steroids, were retrospectively analyzed for the incidence of neutropenia (leucocyte count 150 virus copies/mL detected by polymerase chain reaction), MMF dose modification, granulocyte colony-stimulating factor (G-CSF) therapy and rejection episodes. Results: Neutropenia was detected in 41 (25.5%) patients. It was associated with CMV viremia (p

In this work we propose the use of the topographic position index (TPI), which takes into account the local topography for a given neighborhood, to delineate management units (MU) for site-specific systems. This study was performed in the province of La Pampa, in central Argentina, an area with sandy soils where the main limiting condition for crops is soil moisture. Usually, multi-annual yield maps are used for the delineation of MU. However, those are strongly influenced by issues that could be related to un-calibrated data and previous agronomical practices. Thus, there was a need for a methodology based on stable and unbiased parameters. The methodology was developed for a representative 100 ha field. The average size and orientation of the topographic structures were characterized applying the autocorrelation function on the topographic data, which was then used to determine an optimum neighborhood size for the TPI. TPI performed better than the topographic map to characterize the variability of the field. The correlation between yield and TPI was higher (r = 0.74) than that between yield and topography (r = 0.54). The resulting management units were delineated using an unsupervised classification approach on the TPI maps. From the confusion matrices, the overall accuracy was higher for the TPI derived maps than for the topography derived maps (62% against 47%) when compared to a yield map used as reference. We estimate that this methodology could be used for operational applications, the only requirement being topographic data for a given field, since it is simple, the algorithms used are unbiased and it could be performed using free software. Fil: Mieza, María Soledad. Universidad Nacional de la Pampa. Facultad de Ingeniería; Argentina Fil: Cravero, Walter Ruben. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Física del Sur. Universidad Nacional del Sur. Departamento de Física. Instituto de Física del Sur; Argentina Fil: Kovac, Federico Dario. Universidad Nacional de la Pampa. Facultad de Ingeniería; Argentina Fil: Bargiano, Pablo Gastón. DM Consultora Agropecuaria S.A.; Argentina

Comparison of pilot plant partial oxidation of meal rape and hydrocarbon oil mixture with process simulation using equilibrium reactor model by process simulator Aspen Plus resulted in a good agreement. The application of representative compounds method for simulation of such complex mixture was found as a useful tool for optimal process conditions prediction. Based on this procedure the ratio feed to both oxygen and steam were proposed for prediction of good experimental parameters for good process yield of hydrogen. It was stated that key parameter lambda (or analogously oxygen to feed ratio) controlling the partial oxidation process in optimal regime should be in the interval 0.6–0.8, i.e. under reduction conditions.

The paper deals with the general analysis of one part of the electromagnetic compatibility (EMC) problem - the electromagnetic coupling applied in the field of power electrical systems. The verification simulation analyses and practical measurements of the electromagnetic coupling, which are confirming the correctness of results obtained from theoretical analyses (part I.), are presented in part II. So they can be used for predictive stating of EMC quality of individual new electrotechnical products.

After traumatic brain lesion, microglial cells are rapidly activated, migrate toward the sites of injury, and cause secondary damage that accounts for most of the loss of brain function. In the present study, we have characterized a new macrophage/microglia activation factor (MAF). Using the monocytic cell line U937, we were able to demonstrate that MAF is upregulated after TPA-induced differentiation into macrophages. We have generated a specific antibody against MAF. In BV-2 microglial cells, MAF is partially co-localized with IB4, a classical microglial marker. In addition, we have analyzed the in vivo expression patterns of MAF after entorhinal cortex lesion. We were able to show a substantial upregulation of MAF on selected CD11b(+) and IB4(+) macrophages/microglial cells in the deafferented hippocampus and in the perilesional region, while no MAF expression was detectable on the contralateral side. Confocal microscopy revealed a lysosome-like expression pattern in BV-2 cells, as well as in ECL-associated macrophages/microglial cells in vivo. Furthermore, we were able to demonstrate that U937 cells with downregulated MAF converted slower and to a significantly reduced extent to the macrophageal phenotype after TPA treatment. In addition, MAF downregulation in BV-2 microglial cells substantially reduced the phagocytotic uptake of dextran beads. Our data indicate that MAF is expressed in selected macrophages/microglial cells around the lesion and in the degenerating hippocampus after ECL. Furthermore, MAF expression in monocytic cells seems to play a functional role in the differentiation to a phagocytosing phenotype and may be, at least partially, required for phagocytotic activity, specifically in lesioned tissue after brain trauma.

In this study, we demonstrate the infiltration of blood-derived monocytic cells and their morphologic transformation into microglia in zones of acute, anterograde (Wallerian) axonal degeneration induced by entorhinal cortex lesion (ECL). ECL was performed in mice which had received green fluorescent protein (GFP)-transduced bone marrow grafts allowing identification of blood-derived elements within the brain. While in the unlesioned hemisphere GFP+ cells were restricted to perivascular and leptomeningeal sites, many round fluorescent cells appeared in hippocampal zones of axonal degeneration at 24 h post lesion (hpl). Within 72 hpl, these GFP+ cells acquired ramified, microglia-like morphologies, which persisted for at least 7 days post ECL. Differentiation of GFP+ cells into glial fibrillary acidic protein (GFAP)+ astrocytes was never observed. To exclude that this recruitment is an artifact of irradiation or bone marrow transplantation, the fluorescent cell tracker 6-carboxylfluorescein diacetate (CFDA) was injected into spleens of normal mice 1 day before ECL. Again, fluorescent cells appeared at the lesion site and along the layers of axonal degeneration at 48 hpl and CFDA+/MAC-1+, cells exhibited amoeboid and ramified morphologies. Thus, blood-derived cells infiltrate not only the site of mechanical lesion, but also the layers of anterograde axonal degeneration, where they readily transform into microglia-like elements. A role for infiltrating leukocytes in facilitating or modulating postlesional plasticity, e.g., by phagocytosis of growth-inhibiting myelin should now be considered. Moreover, monocytic cells may serve as vehicles to transport therapeutic substances such as neurotrophic factors or caspase inhibitors to zones of axonal degeneration.

Microglia are the resident macrophage population of the CNS and are considered its major immunocompetent elements. They are activated by any type of brain pathology and can migrate to the lesion site. The chemokine CXCL10 is expressed in neurons in response to brain injury and is a signaling candidate for activating microglia and directing them to the lesion site. We recently identified CXCR3, the corresponding receptor for CXCL10, in microglia and demonstrated that this receptor system controls microglial migration. We have now tested the impact of CXCR3 signaling on cellular responses after entorhinal cortex lesion. In wild-type mice, microglia migrate within the first 3 d after lesion into the zone of axonal degeneration, where 8 d after lesion denervated dendrites of interneurons are subsequently lost. In contrast, the recruitment of microglia was impaired in CXCR3 knock-out mice, and, strikingly, denervated distal dendrites were maintained in zones of axonal degeneration. No differences between wild-type and knock-out mice were observed after facial nerve axotomy, as a lesion model for assessing microglial proliferation. This shows that CXCR3 signaling is crucial in microglia recruitment but not proliferation, and this recruitment is an essential element for neuronal reorganization.

During brain development, the majority of neurons undergo programmed cell death. It is now clear that caspases are involved in this process of selective induction of neuronal apoptosis, yet the signals for this caspase activation remain undefined. As an upstream activator of these enzymes, the death receptor CD95 (Fas, APO1) was recently shown on neurons in the cornu ammonis (CA)2 and CA3 hippocampal subfields of early postnatal mice and rats. In vitro, cortical neuroblast cells are susceptible to CD95 ligand (CD95L, FasL, APO-1 L)-induced apoptosis. It was therefore suggested that the CD95/CD95L system is involved in neuronal apoptosis during hippocampal development. We therefore performed a blinded study comparing field size and neuronal density in the hippocampi of p20 CD95-deficient (lpr), CD95L-deficient (gld) and C57 mice. Whereas field sizes did not differ significantly between these strains, paired Mann-Whitney analyses revealed an increased number of neurons in the CA2 regions of CD95-deficient mice (P = 0.008), and minor, yet at 1% nonsignificant, differences between gld, lpr and C57 strains in the CA1 and CA3 regions. However, joint comparison of the three strains using the Kruskal-Wallis test rendered all differences insignificant. We conclude that the CD95/CD95L system is either not involved, or can be replaced by alternate mechanisms in the control of neuronal populations during hippocampal development.

Brain perivascular spaces harbor a population of cells which exhibit high phagocytic capacity. Therefore, these cells can be labeled by intraventricular injection of tracers. Such perivascular cells at the interface between blood and brain are believed to belong to the monocyte/macrophage lineage and to be involved in antigen presentation. Currently, it is unclear whether these cells undergo a continuous turnover by entering and leaving the bloodstream. Using bone-marrow-chimeric animals, migration of donor macrophages into brain perivascular spaces has been reported. On the other hand, following intracerebral injection of india ink into nontransplanted animals, ink-labeled perivascular cells were still found 2 years after injection, suggesting a high stability of this cell pool. Thus, the turnover of perivascular cells observed in chimeras might be a result of bone marrow transplantation rather than a physiological occurrence. To address this issue, we monitored de novo invasion of macrophages into perivascular spaces of apparently healthy adult rats by applying techniques other than bone marrow transplantation, (i) consecutive injections of different tracers and (ii) ex vivo isolation of macrophages from the blood, cell labeling, and reinjection into the same animal to avoid MHC mismatch. Both approaches revealed vivid de novo invasion of macrophages into perivascular spaces, but not into brain parenchyma, rendering untenable the concept of perivascular cells forming a stable population of macrophages in the brain. Thus, brain perivascular spaces are under permanent immune surveillance of blood borne macrophages in normal adult rats.

The aim of the present study was to examine the prevalence of Enterococcus faecalis and Candida albicans in endodontic infections.Samples for microbiological examination were collected from 32 patients with deep dental caries, infected dental root canal, or periapical infection.Cultivation of the dental samples yielded four strains of Enterococcus faecalis (12.5 %), and three strains of Candida albicans (9.4 %). All Enterococcus faecalis isolates were susceptible to ampicillin, one isolate was resistant to tetracycline, two to erythromycin and azithromycin (additional 2 had intermediate susceptibility), and one strain had intermediate susceptibility to ciprofloxacin and moxifloxacin.We conclude that Enterococcus faecalis and Candida albicans can participate in the dental root canal and periapical infections, and the use of effective irrigant solutions and intracanal medicaments active against these microbes is important in order to prevent endodontic therapy failures. Unexpected was the isolation of C. albicans from a nine-year-old child with periodontitis apicalis. This finding must draw attention to the possibility that even at such a young age, this microorganism could be a potential etiological agent in endodontic infections (Tab. 2, Ref. 34). Text in PDF www.elis.sk.

Teeth that are present at birth are called natal teeth, and teeth that emerge through the gingiva during the first 4 weeks of life are called neonatal teeth. The incidence of the appearance of natal and neonatal teeth has been reported to be between once every 800 and once every 6000 births. Natal and neonatal teeth may be uncomfortable for a nursing mother and present a risk of aspiration and swallowing by the infant if they are loose. Also, they may cause irritation and trauma to the infant's soft tissues. Under these circumstances, natal and neonatal teeth need to be extracted. In this article, a case report of two neonatal teeth in a five week old girl is presented. The teeth were present in the mandibular incisor region and were excessively mobile and caused discomfort for the nursing mother. They were extracted because of the fear of aspiration (Fig. 4, Ref. 10).

The primary goal of endodontic therapy is the reduction or elimination of micro-organisms and their by-products from the root canal system. Although a number of instrumentation and irrigation techniques exist, debris is often left behind in the root canal system, therefore proper canal cleaning, shaping and irrigation is essential to significantly reduce and sometimes eliminate bacteria from canals. However, complete elimination of bacteria is not always achieved in clinical practice due to the anatomical complexities of root canals and consequent limitations of access by instruments and irrigators, the use of antimicrobial medication has been advocated to disinfect the root canal system and because root tissues are closely related to the periodontal apparatus. The aim of this paper is to review current information on the topic of bacterial infection in endodontics with an emphasis on combined mechanical and chemical treatment of root canals. It focuses on available irrigation agents, provides their short overview, mechanism of action and possible unwanted side effects on periodontal tissues (Fig. 2, Ref. 19).

(1993). Managed care: hassle-free medical practice? Postgraduate Medicine: Vol. 94, No. 4, pp. 87-91.

The Southeast Asian antTetraponera sp. nearattenuata F. Smith inhabits internodes of large bamboo species that it shares with symbiotic pseudococcids. It finds access to this nesting habitat via small holes made by wood-boring insects. During heavy rain, runoff water collects in these punctured internodes. TheTetraponera workers remove the water by ingesting it, walking to the entrance hole, and regurgitating it to the outside. In this way, they 1) reduce the danger of colony members drowing, 2) enable their symbionts to feed also on the internode floor, and 3) prevent excessive growth of microbes in the nest.

El objetivo del trabajo es lograr una articulación vertical entre asignaturas básicas y tecnológicas en los primeros años de la carrera de ingeniería, de tal forma que los estudiantes dejen de ver a las mismas como compartimientos estancos, relacionando la matemática con áreas tecnológicas utilizando un software de simulación. La actividad en aula involucra docentes de distintas asignaturas, quienes conjuntamente presentan un sistema físico que debe ser modelado, resuelto mediante Transformada de Laplace y simulado. Una encuesta en sala muestra que la propuesta resulta de utilidad, y contribuye a la comprensión e internalización entre el concepto matemático y su aplicación. Se concluye que la experiencia logra internalizar e integrar conceptos matemáticos y tecnológicos. Además, la simulación permite visualizar respuestas y variar parámetros realizando un análisis crítico, actividades que despiertan interés en los estudiantes y motivan su proceso de aprendizaje.

The majority of the corixids investigated in the present study from time to time rub the metathoracic gland secretion over the body parts covered with hydrofuge hairs (Diaprepocorinae, Cymatiainae, Corixinae). In most genera the grooming act (‘secretion-grooming’) is performed while floating on the water surface and takes only 2–3 seconds. Diaprepocoris, unlike other corixids, grooms on land. The secretions contain unsaturated aldehydes which have strong antibacterial properties in two tested species. From the results obtained, it seems probable that the metathoracic secretion has the same function as in the water bug family Pleidae: it prevents the contamination of the hydrofuge hairs by killing attached microorganisms. Thus, it prevents the loss of the air store, which is held by hydrofuge hairs when submerged. In Micronecta and in all corixid nymphs no secretion-grooming occurs, although abdominal scent glands are present. Other additional functions of the corixid scent gland secretions and some aspect...

Contactless credit cards as a sub-division of smart cards offer a promising new market for RFID technologies. We consider in simulations, verified with experimental results, the way from the electrical supply power as required for the operation of contactless payment terminals to the card performance as required to allow a payment transaction within a limited time. For this purpose, we consider the paypass reference equipment, which is similar to a typical use case and specified to test product compliance.

To model the cytogenetic evolution in gastrointestinal stromal tumour (GIST), an oncogenetic tree model was reconstructed using comparative genomic hybridization data from 203 primary GISTs (116 gastric and 87 intestinal GISTs, including 151 newly analysed cases), with follow-up available in 173 cases (mean 40 months; maximum 133 months). The oncogenetic tree model identified three major cytogenetic pathways: one initiated by − 14q, one by − 1p, and another by − 22q. The − 14q pathway mainly characterized gastric tumours with predominantly stable karyotypes and more favourable clinical course. On the other hand, the − 1p pathway was more characteristic of intestinal GISTs, with an increased capacity for cytogenetic complexity and more aggressive clinical course. Loss of 22q, more closely associated with − 1p than − 14q, appeared to initiate the critical transition to an unfavourable cytogenetic subpathway. This − 22q pathway included accumulation of + 8q, − 9p, and − 9q, which could all predict disease-free survival in addition to tumour site. Thus, insights into the cytogenetic evolution obtained from oncogenetic tree models may eventually help to gain a better understanding of the heterogeneous site-dependent biological behaviour of GISTs. Copyright © 2007 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

The aim of the study was to analyze whether immunosuppressive treatment with basiliximab and mycophenolate mofetil (MMF), allowed a reduction in methylprednisolone and cyclosporine dosages without increasing the incidence of acute rejection episodes, reducing 1-year graft and patient survivals, or increasing the rates of infections and malignancy in the first year. The two groups were group A (n = 72), treated with methylprednisolone and cyclosporine and in the first 2 weeks with azathioprine; group B (n = 72), treated with basiliximab, MMF, and low-dose cyclosporine and methylprednisolone. The patients were followed for 1 year. The incidence of acute rejection episodes in the first year was significantly lower in group B (2.8%) than group A (12.5%; P < .05). The cumulative methylprednisolone dose, the daily dose, and the average cyclosporine trough blood level were significantly lower in group B (P < .001). One-year serum creatinine was significantly lower in group B (112 +/- 45 micromol/L) than group A (138 +/- 51 micromol/L; P < .01). One-year graft survival was 91.7% in group A and 98.6% in group B. One-year patient survival was 98.6% in group A and 100% in group B. The groups did not differ significantly in the incidence of bacterial, viral, or fungal infections. Immunosuppression with basiliximab and MMF allowed a reduction in cyclosporine and methylprednisolone dosages and was associated with significantly lower incidences of acute rejections episodes with better graft function in the first year as opposed to immunosuppression with higher doses of cyclosporine and methylprednisolone alone. Both immunosuppressive regimens showed the same infection rates and did not differ significantly in the occurrence of malignant diseases within the first year.

A patient presented with recurrent syncope and episodes of AV block preceded by asymptomatic ST segment elevation on ambulatory monitoring. Coronary angiography revealed a severe stenosis in the midsegment of the right coronary artery (RCA). Successful PTCA and stent insertion abolished further episodes of syncope.

Entorhinal cortex lesion (ECL) is a well described model of anterograde axonal degeneration, subsequent sprouting and reactive synaptogenesis in the hippocampus. Here, we show that such lesions induce transsynaptic degeneration of the target cells of the lesions pathway in the dentate gyrus. Peaking between 24 and 36 hours post-lesion, dying neurons were labeled with DeOlmos silver-staining and antisera against activated caspase 3 (CCP32), a downstream inductor of programmed cell death. Within caspase 3-positive neurons, fragmented nuclei were co-localized using Hoechst 33342 staining. Chromatin condensation and nuclear fragmentation were also evident in semithin sections and at the ultrastructural level, where virtually all caspase 3-positive neurons showed these hallmarks of apoptosis. There is a well-described upregulation of the apoptosis-inducing CD95/L system within the CNS after trauma, yet a comparison of caspase 3-staining patterns between CD95 (Ipr)- and CD95L (gld)-deficient with non-deficient mice (C57/b16) provided no evidence for CD95L-mediated neuronal cell death in this setting. However, inhibition of NMDA receptors with MK-801 completely suppressed caspase 3 activation, pointing to glutamate neurotoxicity as the upstream inducer of the observed cell death. Thus, these data show that axonal injury in the CNS does not only damage the axotomized neurons themselves, but can also lethally affect their target cells, apparently by activating glutamate-mediated intracellular pathways of programmed cell death.

From an immunological perspective the placenta is an allograft and therefore requires a special immune suppressive status termed immune privilege. Other organs of the body, which possess poor regenerative capacity share this special status, e.g. the brain, the eye and the gonads. The biological function of immune privilege in all these tissues is to protect them from inflammation-mediated injury. The mechanism maintaining immune privilege are poorly understood and are apparently site-specific. In the placenta, inhibition of IDO leads to spontaneous abortion, showing the crucial role of this enzyme for the maintenance of immune privilege. By catabolizing extracellular tryptophan IDO inhibits local T cell proliferation thereby preventing placental rejection. Here, we show that this mechanism can also be active in suppressing inflammatory responses in the CNS, where inflammations must be tightly regulated to prevent the loss of irreplaceable neurons. Employing RT-PCR and Western blot analysis we could show that, upon activation with the pro-inflammatory cytokine interferon-gamma, astrocytes and microglia are capable of expressing IDO in vitro and in vivo. To test the functional capacity of IDO in the CNS, we performed blockade experiments using actively induced experimental autoimmune encephalomyelitis (EAE), a T cell-mediated autoimmune disease which correlates to the human disease multiple sclerosis (MS). Inhibition of IDO activity by daily subcutaneous administration of the specific IDO inhibitor 1-methyl-DL-tryptophan during EAE significantly exacerbates EAE, shown by comparing clinical disease scores. Thus, local expression of IDO during inflammation is apparently a self-protection mechanism which limits antigen-specific immune responses in the CNS.

Parasites affect a majority of the world's population. Despite this fact, dreams of developing vaccines remain far off. Scientists have long studied gene expression as a hallmark of gene activities reflecting current cell conditions. Analyzing differentially expressed genes is a major initiative, and most labs recoil at the amount of time and high costs required obtaining results. By employing microarrays, researchers can decrease their reliance upon time consuming techniques; consequently, microarray is beginning to dominate other molecular diagnostic technologies. Moreover, the ability of microarrays to monitor simultaneous gene expression of thousands of genes and to produce broad arrays of data has the potential to shift the resources of the scientists from data gathering to analyzing data that are already available. As microarray technology improves and its cost decreases, the role of ability to "see" the molecular biology pathways involved in parasite host relationships will place this technology at the forefront of parasite research.

To study alterations in the morphology of spinal perivascular macrophages (SPM) during experimental allergic encephalomyelitis (EAE), we labelled SPM by intracerebroventricular (i.c.v.) injection of horseradish peroxidase (HRP). As earlier electron microscopical analysis had shown severely damaged SPM, we suspected that each inflammatory process is accompanied by the death of SPM. To prove this hypothesis, we compared the numerical density of resident SPM (i.c.v. labelled in red by Fluoro-Ruby) with that of monocytes/macrophages recruited to the perivascular space (i.c.v. labelled in green by Fluoro-Emerald). At the peak of paraparesis, the density of resident SPM was reduced by 33%. Since this reduction contrasted sharply with earlier data indicating a massive increase in the density of SPM during EAE, we checked our findings after general or selective suppression of the immune response to myelin autoantigens with the drugs dexamethasone and copaxone, respectively. Dexamethasone treatment commenced after evident paraparesis accelerated recovery, but did not influence SPM density. Immunisation with copaxone completely prevented the occurrence of EAE (monitored by video-based motion analysis of tail motility); the subsequent histological analysis revealed no reduction in SPM density. Based on this inverse correlation between the severity of EAE and the density of resident macrophages, we conclude that SPM plays an important role in the pathogenesis of EAE.

Presented at the annual conference of the American Association of Public Opinion Research, Nashville, TN.

From an immunological perspective the placenta is an allograft and therefore requires a special immune suppressive status termedimmune privilege.Other organs of the body, which possess poor regenerative capacity share this special status, e.g. the brain, the eye and the gonads. The biological function of immune privilege in all these tissues is to protect them from inflammation-mediated injury. The mechanism maintaining immune privilege are poorly understood and are apparently site-specific. In the placenta, inhibition of IDO leads to spontaneous abortion, showing the crucial role of this enzyme for the maintenance of immune privilege. By catabolizing extracellular tryptophan IDO inhibits local T cell proliferation thereby preventing placental rejection. Here, we show that this mechanism can also be active in suppressing inflammatory responses in the CNS, where inflammations must be tightly regulated to prevent the loss of irreplaceable neurons. Employing RT-PCR and Western blot analysis we could show that, upon activation with the pro-inflammatory cytokine interferon-y, astrocytes and microglia are capable of expressing IDOin vitroandin vivo.To test the functional capacity of IDO in the CNS, we performed blockade experiments using actively induced experimental autoimmune encephalomyelitis (EAE), a T cell-mediated autoimmune disease which correlates to the human disease multiple sclerosis (MS). Inhibition of IDO activity by daily subcutaneous administration of the specific IDO inhibitor 1-methyl-DLtryptophan during EAE significantly exacerbates EAE, shown by comparing clinical disease scores. Thus, local expression of IDO during inflammation is apparently a self-protection mechanism which limits antigen-specific immune responses in the CNS.

Upon peripheral immunization with myelin epitopes, susceptible rats and mice develop T cell-mediated demyelination similar to that observed in the human autoimmune disease multiple sclerosis (MS). In the same animals, brain injury does not induce autoimmune encephalomyelitis despite massive release of myelin antigens and early expansion of myelin specific T cells in local lymph nodes, indicating that the self-specific T cell clones are kept under control. Using entorhinal cortex lesion (ECL) to induce axonal degeneration in the hippocampus, we identified possible mechanisms of immune tolerance after brain trauma. Following ECL, astrocytes upregulate the death ligand CD95L, allowing apoptotic elimination of infiltrating activated T cells. Myelin-phagocytosing microglia express MHC-II and the costimulatory molecule CD86, but lack CD80, which is found only on activated antigen presenting cells (APCs). Restimulation of invading T cells by such immature APCs (e.g. CD80 negative microglia) may lead to T cell anergy and/or differentiation of regulatory/Th3-like cells due to insufficient costimulation and presence of high levels of TGF-β and IL-10 in the CNS. Thus, T cell -apoptosis, -anergy, and -suppression apparently maintain immune tolerance after initial expansion of myelin-specific T lymphocytes following brain injury. This view is supported by a previous metastatistical analysis which rejected the hypothesis that brain trauma is causative of MS (Goddin et al., 1999). However, concomitant trauma-independent proinflammatory signals, e.g., those evoked by clinically quiescent infections, may trigger maturation of APCs, thus shifting a delicate balance from immune tolerance and protective immune responses to destructive autoimmunity.

During brain development, the majority of neurons undergo programmed cell death. It is now clear that caspases are involved in this process of selective induction of neuronal apoptosis, yet the signals for this caspase activation remain undefined. As an upstream activator of these enzymes, the death receptor CD95 (Fas, APO1) was recently shown on neurons in the cornu ammonis (CA)2 and CA3 hippocampal subfields of early postnatal mice and rats. In vitro, cortical neuroblast cells are susceptible to CD95 ligand (CD95L, FasL, APO-1 L)-induced apoptosis. It was therefore suggested that the CD95/CD95L system is involved in neuronal apoptosis during hippocampal development. We therefore performed a blinded study comparing field size and neuronal density in the hippocampi of p20 CD95-deficient (lpr), CD95L-deficient (gld) and C57 mice. Whereas field sizes did not differ significantly between these strains, paired Mann-Whitney analyses revealed an increased number of neurons in the CA2 regions of CD95-deficient mice (P = 0.008), and minor, yet at 1% nonsignificant, differences between gld, lpr and C57 strains in the CA1 and CA3 regions. However, joint comparison of the three strains using the Kruskal-Wallis test rendered all differences insignificant. We conclude that the CD95/CD95L system is either not involved, or can be replaced by alternate mechanisms in the control of neuronal populations during hippocampal development.

Welfare reform in Iowa succeeded in getting welfare recipients into training and then into jobs. However, the reforms did not always succeed in raising family income and may have reduced it for some families. Furthermore, researchers noted negative impacts on some measures of family and child well-being, including less marriage among those who started receiving welfare after the reforms started.

The aim of the study was to introduce an alternative surgical procedure for the treatment of primary volvuius of the sigmoid colon. Sigmoid colon plication was performed in 42 dogs, and afterwards in six patients. The procedure consists of systematic plaiting the sigmoid colon wall with interrupted serosubmucosal 3/0 Vicryl sutures along the whole circumference, except on the mesenteric border. Five parallel circular folds were done in dogs, and 20-30 folds in patients, with appropriate bowel length reduction. In the experimental study, dogs were randomly divided into three experimental and one control group of 14 animals each. The group 1 dogs were sacrificed on day 8, group 2 dogs on day 15, and group 3 and control group dogs on day 30 postoperatively. On exploration, sigmold colon adhesions were found in 6 (14.3%) animals. Intestinal wall and lumen were normal. In the clinical study, six patients with sigmoid volvulus were operated on within 6-8 hours of admission. A viable colon was a prerequisite for the sigmoid plication procedure. The operating time was 60-90 minutes. Recovery was uneventful, with average hospitalization 11 (range 8-15) days. No volvulus recurrence was recorded during the three-year follow-up. Based on our experimental and clinical data, we believe that the plication procedure could be appropriate treatment in some selected patients with volvulus of the sigmold colon.

In a 7-year period (1988-1995) a series of 55 patients was surgically treated at our Department for lumbar disk herniation following a certain sports activity, i.e. sports injury. The above number accounts for 2% of the total number of lumbar disk patients operated upon at our Department. The majority of patients in our series were amateur athletes, whereas a few of them were active or professional athletes. The most common cause of disk herniation among our patients was playing soccer (13 cases), which is followed by basketball (8), field athletics (7), tennis (6) and handball (4). In most cases our surgical method of choice was flavectomy (interlaminectomy). Most commonly seen intraoperative finding was intervertebral disk extrusion. In some athletes the onset of symptoms was due to a change of their usual sports activity, for example a tennis player who was injured in skiing. We believe that the onset of disk herniation in athletes is a consequence of numerous micro traumas of the intervertebral disk which are further compounded by the syndrome of overstraining. In the case of a positive indication, surgical treatment leads to a faster recovery in professional athletes.

Shock is a consequence of disturbed circulation and decreased blood perfusion of tissues which, on the whole, cause functional and morphological impairments of organic systems. Occurrence of shock is not high, but it is significant due to bad prognosis and high mortality rate.This is one of the classifications of shock: cardiogenic, extracardiogenic-obstructive, oligentic and distributive shock. PATHOPHYSIOLOGIC MECHANISMS OF SHOCK: Regardless of the cause of shock, the clinical picture is dominated by hypotension mostly caused by decrease of minute volume (septic shock may be an exception--minute volume might be high). Due to hypotension a lot of compensatory mechanisms are activated and in the beginning showing the compensatory phase of disease and if nothing is done decompensatory and in the end irreversible phase of shock occurs with fatal outcome. The clinical picture depends on the etiology of shock, type of shock, but it also has certain specificities.The prognosis depends on the clinical picture dominated by the following symptoms: hypotension, decreased diuresis, acidosis, consciousness disorders, tachypnea, peripheral cyanosis, cold and damp skin.These patients are managed in intensive care units, where the following parameters are followed-up: arterial pressure, central venous pressure, minute heart volume, systemic vascular resistance, diuresis, continual follow-up of heart rate, breathing and consciousness. In treatment of shock it is necessary to: normalize the circulatory volume, establish electrolyte balance, regulate glycemia and acid-base status, compensate the volume, calm the patient and alleviate pain.

A patient admitted to our hospital because of diarrhea and hematochesia is presented. These complaints appeared eight months before, and were not accompanied by other disturbances. All hematological, biochemical and microbiological findings were normal, but endoscopic, x-ray and histologic examination of the gastrointestinal tract showed nodular lymphoid hyperplasia of the colon and terminal ileum. Since an immunological derangement was not verified, this seems to be a rare benign disorder as a response to repeated antigenic stimuli. In our patient these were recurrent parasitoses. The treatment is not needed, but due to the possibility of late onset hypogammaglobulinemia. Long-term patient follow up is required.

Azithromycin is a new generation, acid stable, macrolide antibiotic that achieves remarkably high concentrations in gastric tissue (above the minimal inhibitory concentration for Helicobacter pylori) after oral administration.To establish whether azithromycin plus omeprazole in association with either amoxycillin or metronidazole are useful in curing H. pylori infection in patients with a duodenal ulcer.One hundred patients with active duodenal ulcers and H. pylori infection were treated with omeprazole (days 1-10, 40 mg b.d.; days 11-24, 40 mg o.m.; days 25-42, 20 mg o.m.) plus azithromycin 500 mg o.m. for the first 6 days. Patients were randomly assigned to receive either amoxycillin 1 g b.d. (OAzA group: n = 50) or metronidazole 400 mg t.d.s. (OAzM group: n = 50) during the first 10 days of treatment. H. pylori status was determined by urease test and histology before the treatment and 6 weeks after completion of therapy.Ninety-seven patients completed the study. H. pylori infection was eradicated in 85% (41/48) of patients in the OAzA group (intention-to-treat analysis 82%) vs. 74% (36/49) of patients in the OAzM group (intention-to-treat analysis: 72%) (N.S.). All ulcers had healed after 6 weeks of omeprazole treatment. Side-effects, usually minor, were recorded in 13% (OAzA group) and 47% (OAzM group) of patients (P0.001), but therapy was discontinued for only one patient in the OAzA group (N.S.).Ten days of treatment with omeprazole plus (for the first 6 days) azithromycin and either amoxycillin or metronidazole provides effective regimens to cure H. pylori infection in patients with duodenal ulcer disease.

The purpose of this study was the analysis of the etiology, clinical and phonatory characteristics in the subjects with Reinke's oedema. The research was done on 105 subjects, of whom 95 women and 10 men of the age between 28 and 83. The results show that according to the sex, the frequency of the Reinke's oedema is higher in women than in men. The disturbances, not according to the sex, appear mostly in the age between 40 and 60. The voice disturbances last usually for some years. Most of the subjects were smokers (80%) which confirms that smoking (with great intensity and for many years) is the main etiological factor in the development of Reinke's oedema. Less important are considered the voice loadings of long duration, while allergy and acute respiratory infection are mentioned as the possible factors. The values of the phonatory index show less effective air usage during the phonation in the subjects. From the tridimensional spectral analysis of voice that was done on 44 women and 4 men, the data about the frequency of the fundamental laryngeal tone (f degree) were taken. Analysing these data, the lower values of the frequency of the fundamental laryngeal tone were found. The elaboration with the Student's t-test was obtained a statistically important difference of the mentioned parameter in both sexes among the subjects and persons with normal voice. We can conclude that the alteration of the phonatory function is present and in consequence of that, the voice is not effective in communication and less valorous in the media.