Glass transition temperature variation, cross-linking and structure in network glasses

We give general topological rules which very accurately predict the chemical trends in glass transition temperature $T_g$ variation as a function of cross-linking. In multicomponent glasses, these chemical trends permit to distinguish homogeneous compositions (random network) from inhomogeneous ones (local phase separation). The stochastic origin of the Gibbs-Di Marzio equation is predicted at low connectivity and the analytical expression of its parameter emerges naturally from the calculation.Comment: 5 pages, Revtex, accepted for publication in Europhysics Letters, 2 figures not included, available at http://www.gcr.jussieu.fr/matthieu.htm#Researc

Risk of Kaposi's sarcoma and of other cancers in Italian renal transplant patients

A follow-up study of 1844 renal transplant patients in Italy showed a 113-fold increased risk for Kaposi's sarcoma. Kaposi's sarcoma risk was higher in persons born in southern than in northern Italy. Significant increases were also observed for cancers of the lip, liver, kidney and for non-Hodgkin's lymphoma

Efficiency and efficacy of LDL-apheresis performed at different intervals

Five heterozygous familial hypercholesterolemia patients have been treated with LDL-apheresis for a period of three months. The apheretic procedure was repeated four times at both biweekly and weekly intervals. A dextran-sulfate cellulose regenerating unit was used, processing one plasma volume at each time. The efficiency of the apheretic procedure was similar at both weekly and biweekly intervals, removing 60\u201370% of total cholesterol (TC), LDL cholesterol (LDL-C) and apo B. Weekly treatment was however more effective in lowering plasma lipid-lipoprotein levels: pre-apheresis TC, LDL-C and apo B levels were, in fact, 23\u201325% higher during the biweekly treatment

APHERETIC TREATMENT OF SEVERE FAMILIAL HYPERCHOLESTEROLEMIA - COMPARISON OF DEXTRAN SULFATE CELLULOSE AND DOUBLE MEMBRANE FILTRATION METHODS FOR LOW-DENSITY LIPOPROTEIN REMOVAL

The two more widely available techniques for the extracorporeal removal of low density lipoproteins (LDL), dextran sulfate cellulose column and double membrane filtration, were comparatively tested in severe familial hypercholesterolemic patients, both acutely and during a continued 3-month treatment. The selective dextran sulfate procedure removed close to 60% of LDL and 16% of high density lipoproteins (HDL) upon each apheresis, vs. 42% and 32%, respectively, in the case of the semi-selective double membrane filtration. Upon long term biweekly treatments, LDL-cholesterol (LDL-C) decreased, with the selective procedure, from a pre-treatment level of 406.0 \ub1 40.7 mg/dl to a value fluctuating between 295.4 \ub1 33.8 mg/dl and 116.9 \ub1 22.0 mg/dl (highest vs. lowest levels) whereas, in the case of double membrane filtration, LDL-C levels ranged between 334.8 \ub1 39.8 mg/dl and 192.3 \ub1 49.9 mg/dl. HDL-cholesterol levels were somewhat raised, to a higher extent with dextran sulfate apheresis. The LDL/HDL-cholesterol "atherogenic ratio", decreased from a pre-treatment value of 10.27 \ub1 3.04 to values ranging between 3.61 and 6.82 with dextran sulfate and between 6.70 and 7.68 with double membrane plasmapheresis

Impaired efficacy of selective LDL-apheresis in primary biliary cirrhosis

Low-density lipoprotein apheresis (LDL-apheresis) was done with either cascade filtration (DF) or dextran sulfate cellulose adsorption (DSC) in a patient with primary biliary cirrhosis who developed severe dyslipidemia associated with cholestasis and accumulation of lipoprotein-X (LP-X). The extracorporeal treatment was initially performed weekly, and resulted in a sharp drop in total cholesterol from 1038 to 430 mg/dl. During the next four months the patient was treated every 10-15 days, and pre-apheresis cholesterol levels were maintained between 438 and 505 mg/dl, until an orthotopic liver transplantation was successfully performed. With semi-selective DF a mean 47.1% of total cholesterol was removed per procedure compared to 30.0% with DSC, although the volume of treated plasma was 38.0 vs 49.9 ml/kg body weight. The changes in plasma cholesterol levels during DSC and DF showed that the kinetics of cholesterol removal were similar with both techniques, but the efficacy differed; DF removed both LDL and LP-X from plasma, whereas DSC selectively lowered the LDL content. Cascade filtration may therefore be considered as a first-choice treatment for patients with LP-X accumulation due to cholestasis

PREDICTABILITY OF LOW-DENSITY-LIPOPROTEIN LEVELS DURING APHERETIC TREATMENT OF HYPERCHOLESTEROLEMIA

The efficiency and efficacy of low-density lipoprotein (LDL) apheresis performed with a dextran sulphate cellulose (DSC) regenerating unit were tested in five familial hypercholesterolaemic patients. LDL apheresis was repeated four times at both bi-weekly and weekly intervals, processing one plasma volume each time. The efficiency of the procedure (i.e., the extent of lipoprotein removal) was nearly identical with both schedules. Efficacy parameters, i.e., decreases of plasma total and LDL cholesterol (TC and LDL-C) and apo B, were highly correlated (r > 0.96) with pre-apheresis levels, allowing an accurate prediction of the absolute lipid removal in the single individual. Plasma triglycerides, high-density lipoprotein cholesterol, apo A-I and apo A-II recovered rather rapidly, reaching 91-96% of the pre-apheresis values in 48 hours; the recovery of TC, LDL-C and apo B was much slower, with a relatively rapid early phase (80% recovery after about 7 days) followed by a successive slower rise. This pattern was highly reproducible in the single patient, allowing the definition of a simple mathematical model for an accurate (error < 20%) prediction of the individual process. Based on this model one can design the treatment schedule necessary to maintain lipid levels within the desired range in the single individual. The hypolipidaemic efficacy of DSC apheresis appears, otherwise, not to be dependent upon the procedure per se, but on other individual factors, e.g. the amount of removable lipoproteins and the rate of lipid recovery; both can be predicted with sufficient accuracy

ALTERATIONS IN THE HDL SYSTEM AFTER RAPID PLASMA-CHOLESTEROL REDUCTION BY LDL-APHERESIS

Changes in high density lipoprotein (HDL) subfraction structure and composition were analyzed during and after extracorporeal removal of apo B containing lipoproteins in seven familial hypercholesterolemic (FH) patients. After the apheretic procedure, carried out with dextran-sulfate-cellulose columns, the plasma levels of very low density lipoproteins (VLDL), low density lipoproteins (LDL), and HDL decreased by 72%, 50%, and 19%, respectively. The free cholesterol to esterified cholesterol ratio in plasma increased, with a 26% drop in the lecithin: cholesterol acyl transferase (LCAT) activity. In the ensuing 24 hours, VLDL, HDL, and LCAT activity approached the pretreatment levels. During this phase, possibly as a consequence of increased cholesterol esterification and exchange of cholesteryl esters for triglycerides between HDL and VLDL, HDL2a particles were detected in plasma. However, these metabolic changes did not result in clearcut modifications in the HDL2-HDL3 subfraction distribution. These findings clearly demonstrate that rapid changes in the plasma VLDL-LDL levels affect several processes involved in the HDL metabolism, but confirm that the HDL system, in spite of a considerable plasticity, displays a marked stability of the HDL2-HDL3 subfraction distribution