Prävalenz der pulmonalen Hypertonie bei Patienten mit terminaler und präterminaler Niereninsuffizienz : eine prospektive, monozentrische Studie mit Rechtsherzkatheteruntersuchungen

Die chronische Niereinsuffizienz ist eine zunehmend häufige Erkrankung und geht mit einer Vielzahl vor allem kardiovaskulärer Begleiterkrankungen einher. In diesem Zusammenhang ist die pulmonale Hypertonie ein unabhängiger Faktor in der Vorher-sage der Sterblichkeit bei Patienten mit dialysepflichtiger Niereninsuffizienz. Trotzdem sind die Pathophysiologie der veränderten pulmonalen Hämodynamik, der Einfluss der Hämodialysetherapie und die Prävalenz der pulmonalen und pulmonalarteriellen Hypertonie bislang nicht invasiv an Patientenkollektiven mit chronischer Nieren-insuffizienz und Dialysepatienten untersucht worden. Wir führten bei Patienten mit dialysepflichtiger Niereninsuffizienz (Gruppe 1) und mit prä-terminaler Niereninsuffizienz (Gruppe 2) eine Herzultraschall- und ggf. eine Rechtsherzkatheter-Untersuchung vor und nach Hämodialyse (HD) durch. Die PH/PAH Diagnostik erfolgte entsprechen den geltenden Diagnosestandards der Fachgesellschaften. Die Prävalenz einer präkapillären PH ohne eruierbare zugrunde liegende Erkrankung unter den untersuchten Dialysepatienten lag bei 10 %, die einer PH lag in beiden Gruppen zwischen 70 und 80 %. Daher ist bei chronisch Nierenkranken und Dialyse-patienten, die unter anderweitig nicht erklärbarer Atemnot leiden, die Durchführung einer Herzultraschalluntersuchung und ggf. eines Rechtsherzkatheters vor und nach der HD zu erwägen, um eine spezifische Therapie zum frühest möglichen Zeitpunkt zu beginnen und so die Prognose der Patienten zu verbessern

Fatty acid composition of Turbatrix aceti and its use in feeding regimes of Coregonus maraena (Bloch, 1779): is it really a suitable alternative to Artemia nauplii?

By incorporating the free-swimming nematode Turbatrix aceti into early feeding regimes of the European whitefish Coregonus maraena, the suitability of this nematode species was investigated as an alternative to Artemia nauplii. During a 14-day feeding trial in a total of 25 aquaria each 1.7 L (each treatment n = 5, 255 larvae/tank) T. aceti was used either as the sole live food or in combination with Artemia nauplii or microdiet to determine the effect of T. aceti on growth performance and survival rate of C. maraena. By analysing the fatty acid composition of T. aceti prior to and after enrichment with INVE spresso® it was investigated whether the amount of n3-polyunsaturated fatty acids (n3-PUFA) in T. aceti could be further enhanced. Supplementation of Artemia nauplii with T. aceti increased growth significantly within the first 5 days of rearing in comparison to the non-supplemented food treatments (14.39 ± 0.15 mm compared to 13.44 ± 0.18 mm; mean ± SE). However, growth and survival of juvenile C. maraena on nematode-supplemented Artemia nauplii did not differ significantly from non-supplemented Artemia nauplii at the end of the 14-day rearing period (15.22 ± 0.15 mm compared to 14.86 ± 0.24 mm). All feeding treatments containing Artemia nauplii showed significantly higher growth and lower mortality at the end of the experiment in comparison to diets containing only the microdiet or T. aceti or a combination thereof. The overall low performance of T. aceti alone can most likely be explained by an insufficient capacity of C. maraena to digest this nematode species efficiently. Enrichment with INVE spresso® successfully increased the proportion of DHA in the T. aceti tissue. The results reveal that T. aceti cannot be considered a full alternative to Artemia nauplii, at least not in the rearing of C. maraena, but might be a useful vector of essential fatty acids within the early rearing period of this and potentially other fish species when provided as live food along with Artemia nauplii

PSGL-1 engagement by E-selectin signals through Src kinase Fgr and ITAM adapters DAP12 and FcRγ to induce slow leukocyte rolling

E-selectin binding to P-selectin glycoprotein ligand-1 (PSGL-1) can activate the β2 integrin lymphocyte function-associated antigen-1 by signaling through spleen tyrosine kinase (Syk). This signaling is independent of Gαi-protein–coupled receptors, results in slow rolling, and promotes neutrophil recruitment to sites of inflammation. However, the signaling pathways linking E-selectin engagement of PSGL-1 to Syk activation are unknown. To test the role of Src family kinases and immunoreceptor tyrosine-based activating motif (ITAM)–containing adaptor proteins, we used different gene-deficient mice in flow chamber, intravital microscopy, and peritonitis studies. E-selectin–mediated phosphorylation of Syk and slow rolling was abolished in neutrophils from fgr−/− or hck−/− lyn−/− fgr−/− mice. Neutrophils from Tyrobp−/− Fcrg−/− mice lacking both DAP12 and FcRγ were incapable of sustaining slow neutrophil rolling on E-selectin and intercellular adhesion molecule-1 and were unable to phosphorylate Syk and p38 MAPK. This defect was confirmed in vivo by using mixed chimeric mice. Gαi-independent neutrophil recruitment into the inflamed peritoneal cavity was sharply suppressed in Tyrobp−/− Fcrg−/− mice. Our data demonstrate that an ITAM-dependent pathway involving the Src-family kinase Fgr and the ITAM-containing adaptor proteins DAP12 and FcRγ is involved in the initial signaling events downstream of PSGL-1 that are required to initiate neutrophil slow rolling

The transmembrane protein LRIG2 increases tumor progression in skin carcinogenesis

Over the last few decades, the number of cases of non‐melanoma skin cancer (NMSC) has risen to over 3 million cases every year worldwide. Members of the ERBB receptor family are important regulators of skin development and homeostasis and, when dysregulated, contribute to skin pathogenesis. In this study, we investigated leucine‐rich repeats and immunoglobulin‐like domains 2 (LRIG2), a transmembrane protein involved in feedback loop regulation of the ERBB receptor family during NMSC. LRIG2 was identified to be up‐regulated in various types of squamous cell carcinoma (SCC), but little is known about LRIG2 in cutaneous SCC (cSCC). To investigate the function of LRIG2 in cSCC in vivo, we generated a skin‐specific LRIG2 overexpressing transgenic mouse line (LRIG2‐TG) using the Tet‐Off system. We employed the 7,12‐dimethylbenz(a)anthracene/12‐O‐tetra‐decanoylphorbol‐13‐acetate (DMBA/TPA) two‐stage chemical carcinogenesis model and analyzed the skin during homeostasis and tumorigenesis. LRIG2‐TG mice did not exhibit alterations in skin development or homeostasis but showed an interaction between LRIG2 and thrombospondin‐1, which is often involved in angiogenesis and tumorigenesis. However, during carcinogenesis, transgenic animals showed significantly increased tumor progression and a more rapid development of cSCC. This was accompanied by changes in the ERBB system. After a single TPA application, inflammation of the epidermis was enhanced during LRIG2 overexpression. In human skin samples, LRIG2 expression was identified in the basal layer of the epidermis and in hair follicles of normal skin, but also in cSCC samples. In conclusion, epidermal LRIG2 excess is associated with activated EGFR/ERBB4‐MAPK signaling and accelerated tumor progression in experimentally induced NMSC, suggesting LRIG2 as a potential oncoprotein in skin

SOAT1: a suitable target for therapy in high-grade astrocytic glioma?

Targeting molecular alterations as an effective treatment for isocitrate dehydrogenase-wildtype glioblastoma (GBM) patients has not yet been established. Sterol-O-Acyl Transferase 1 (SOAT1), a key enzyme in the conversion of endoplasmic reticulum cholesterol to esters for storage in lipid droplets (LD), serves as a target for the orphan drug mitotane to treat adrenocortical carcinoma. Inhibition of SOAT1 also suppresses GBM growth. Here, we refined SOAT1-expression in GBM and IDH-mutant astrocytoma, CNS WHO grade 4 (HGA), and assessed the distribution of LD in these tumors. Twenty-seven GBM and three HGA specimens were evaluated by multiple GFAP, Iba1, IDH1 R132H, and SOAT1 immunofluorescence labeling as well as Oil Red O staining. To a small extent SOAT1 was expressed by tumor cells in both tumor entities. In contrast, strong expression was observed in glioma-associated macrophages. Triple immunofluorescence labeling revealed, for the first time, evidence for SOAT1 colocalization with Iba1 and IDH1 R132H, respectively. Furthermore, a notable difference in the amount of LD between GBM and HGA was observed. Therefore, SOAT1 suppression might be a therapeutic option to target GBM and HGA growth and invasiveness. In addition, the high expression in cells related to neuroinflammation could be beneficial for a concomitant suppression of protumoral microglia/macrophages

Case-oriented computer-based-training in radiology: concept, implementation and evaluation

BACKGROUND: Providing high-quality clinical cases is important for teaching radiology. We developed, implemented and evaluated a program for a university hospital to support this task. METHODS: The system was built with Intranet technology and connected to the Picture Archiving and Communications System (PACS). It contains cases for every user group from students to attendants and is structured according to the ACR-code (American College of Radiology) [2]. Each department member was given an individual account, could gather his teaching cases and put the completed cases into the common database. RESULTS: During 18 months 583 cases containing 4136 images involving all radiological techniques were compiled and 350 cases put into the common case repository. Workflow integration as well as individual interest influenced the personal efforts to participate but an increasing number of cases and minor modifications of the program improved user acceptance continuously. 101 students went through an evaluation which showed a high level of acceptance and a special interest in elaborate documentation. CONCLUSION: Electronic access to reference cases for all department members anytime anywhere is feasible. Critical success factors are workflow integration, reliability, efficient retrieval strategies and incentives for case authoring

Genetic Associations and Differential mRNA Expression Levels of Host Genes Suggest a Viral Trigger for Endemic Pemphigus Foliaceus

The long search for the environmental trigger of the endemic pemphigus foliaceus (EPF, fogo selvagem) has not yet resulted in any tangible findings. Here, we searched for genetic asso ciations and the differential expression of host genes involved in early viral infections and innate antiviral defense. Genetic variants could alter the structure, expression sites, or levels of the gene products, impacting their functions. By analyzing 3063 variants of 166 candidate genes in 227 EPF patients and 194 controls, we found 12 variants within 11 genes associated with differential suscepti bility (p < 0.005) to EPF. The products of genes TRIM5, TPCN2, EIF4E, EIF4E3, NUP37, NUP50, NUP88, TPR, USP15, IRF8, and JAK1 are involved in different mechanisms of viral control, for example, the regulation of viral entry into the host cell or recognition of viral nucleic acids and proteins. Only two of nine variants were also associated in an independent German cohort of sporadic PF (75 patients, 150 controls), aligning with our hypothesis that antiviral host genes play a major role in EPF due to a specific virus–human interaction in the endemic region. Moreover, CCL5, P4HB, and APOBEC3G mRNA levels were increased (p < 0.001) in CD4+ T lymphocytes of EPF patients. Because there is limited or no evidence that these genes are involved in autoimmunity, their crucial role in antiviral responses and the associations that we observed support the hypothesis of a viral trigger for EPF, presumably a still unnoticed flavivirus. This work opens new frontiers in searching for the trigger of EPF, with the potential to advance translational research that aims for disease prevention and treatment

Real-time monitoring of nucleation-growth cycle of carbon nanoparticles in acetylene plasmas

Quantum cascade laserabsorption spectroscopy was used to measure the absolute concentration of acetylene in situ during the nanoparticle growth in Ar + C2H2 RF plasmas. It is demonstrated that the nanoparticle growth exhibits a periodical behavior, with the growth cycle period strongly dependent on the initial acetylene concentration in the chamber. Being 300 s at 7.5% of acetylene in the gas mixture, the growth cycle period decreases with the acetylene concentration increasing; the growth eventually disappears when the acetylene concentration exceeds 32%. During the nanoparticle growth, the acetylene concentration is small and does not exceed 4.2% at radio frequency (RF) power of 4 W, and 0.5% at RF power of 20 W. An injection of a single acetylene pulse into the discharge also results in the nanoparticlenucleation and growth. The absorption spectroscopy technique was found to be very effective for the time-resolved measurement of the hydrocarbon content in nanoparticle-generatingplasmas