Percutaneous balloon mitral valvuloplasty in patients with severe mitral stenosis and low transmitral diastolic pressure gradient

An elevated left atrial pressure and high diastolic pressure gradient (DPG) across the mitral valve are the major hemodynamic abnormalities in mitral stenosis (MS). However, a subgroup of patients with severe MS is characterized by low initial DPG. The authors reviewed the clinical, echocardiographic and hemodynamic data as well as procedural results in 180 patients who underwent percutaneous balloon mitral valvuloplasty (PBMV). An initial mean DPG > 10 mmHg was found in 144 patients (80%) (group A) and mean DPG < or = 10 mmHg in 36 patients (20%) (group B). Patients in group A had higher left ventricular ejection fraction (LVEF) than in group B (61 +/- 5% versus 42 +/- 6%, respectively) and higher cardiac index (2.8 +/- 0.4 versus 2.0 +/- 0.3 l/min/m(2) ). In group B 12 patients (33%) had normal LVEF, whereas 24/36 (67%) had reduced LVEF. All the latter had wall motion abnormalities on ventriculography. Unlike group A, intraprocedural echocardiography was essential for monitoring and evaluating immediate results of PBMV in group B. On follow-up of three years, 75% of group A patients and 55% in group B were in functional class I (p < 0.05). PBMV did not significantly improve symptoms in patients in group B who had preprocedure LVEF < or = 35%.     

The Role of Soil Nutrients in Boundaries between Mangrove and Herbaceous Assemblages in a Tropical Estuary

We aimed to determine the role of soil nutrients in the herbaceous‐tree boundary in a tropical mangrove forest. We assembled plots in this boundary such that each was initially covered by ~50% of each life form. We added NPK to three of the plots monthly and monitored them, along with the control plots, for 18 mo. In plots with added NPK, mangrove branches grew over and shaded the herbaceous plants, resulting in the presence of mostly bare soil. The mangrove trees eventually covered ~80% of the experimental plots, but the proportion of cover in the control plots remained unaltered. We conclude that soil nutrient level modulates the mangrove‐herbaceous plant interaction in steps, and from a given level there is a shift in the dominant life form. This mechanism leads to a sharp transition over a smooth nutritional gradient.     

The effects of ten weeks of lower-body unstable surface training on markers of athletic performance

Initially reserved for rehabilitation programs, unstable surface training (UST) has recently grown in popularity in strength and conditioning and general exercise scenarios. Nonetheless, no studies to date have examined the effects of UST on performance in healthy, trained individuals. The purpose of this study was to determine the effects of 10 weeks of lower-body UST on performance in elite athletes. Nineteen healthy, trained members (ages 18-23 years) of a National Collegiate Athletic Association Division I collegiate men's soccer team participated. The experimental (US) group (n = 10) supplemented their normal conditioning program with lower-body exercises on inflatable rubber discs; the control (ST) group (n = 9) performed the same exercises on stable surfaces. Bounce drop jump (BDJ) and countermovement jump (CMJ) heights, 40- and 10-yard sprint times, and T-test (agility) times were assessed before and after the intervention. The ST group improved significantly on predicted power output on both the BDJ (3.2%) and CMJ (2.4%); no significant changes were noted in the US group. Both groups improved significantly on the 40- (US = -1.8%, ST = -3.9%) and 10-yard sprint times (US = -4.0%, ST = -7.6%). The ST group improved significantly more than the US group in 40-yard sprint time; a trend toward greater improvement in the ST group was apparent on the 10-yard sprint time. Both groups improved significantly (US = 2.9%, ST = -4.4%) on T-test performance; no statistically significant changes were apparent between the groups. These results indicate that UST using inflatable rubber discs attenuates performance improvements in healthy, trained athletes. Such implements have proved valuable in rehabilitation, but caution should be exercised when applying UST to athletic performance and general exercise scenarios.     

Biosynthesis and immunobiochemical characterization of gp17/GCDFP-15. A glycoprotein from seminal vesicles and from breast tumors, in HeLa cells and in Pichia pastoris yeast.

The gp17 factor is a secretory product of human seminal vesicle cells which binds to CD4 and acts as a potent inhibitor of T lymphocyte apoptosis induced by CD4 crosslinking and subsequent T-cell receptor (TCR) activation. The protein is identical to gross cystic disease fluid protein-15 (GCDFP-15), a breast tumor secretory marker PIP (prolactin inducible protein), a prolactin-controlled and androgen-controlled protein; secretory actin binding protein (SABP), a seminal plasma actin binding protein and extra-parotid glycoprotein (EP-GP), a secretory protein from the salivary gland. The structure of this protein has not yet been elucidated and no biological function has been clearly attributed to date. Expression of recombinant gp17/GCDFP-15 cDNA in bacteria and insect cells leads to the production of a misfolded insoluble protein. In this study, we describe the production of gp17/GCDFP-15 in two different eukaryotic systems, namely HeLa cells and the Pichia pastoris yeast. Using constructs in which gp17/GCDFP-15 was tagged with enhanced green fluorescent protein (EGFP) in various combinations, we observed expression only when the fusion protein was directed to the secretory compartment by the correct signal peptide. The resulting fluorescent protein was inefficiently secreted, thus suggesting that gp17/GCDFP-15 is not appropriately post-translationally processed and/or transported in HeLa cells. The use of the P. pastoris secretory pathway allowed instead the accumulation in the culture medium of a GCDFP-15/gp17 species which retained the ability to bind to CD4 and also most of the biochemical and immunological properties of the native protein. The production of an active recombinant molecule opens the way to correlate the structural properties of this peculiar factor to its ability to bind several proteins, including CD4, and to block CD4-mediated T cell programmed death.     

Nesting Habitat of the Lilac-crowned Parrot in a Modified Landscape in Mexico

Parrot populations are being increasingly pressured to occupy modified or fragmented landscapes, yet little is known of the habitat requirements of most species, particularly with regard to the effects on breeding habitat. We evaluated nesting habitat of the lilac-crowned parrot Amazona finschi in the modified landscape of coastal Michoacan in Mexico. We located 90 parrot nests in 12 tree species in Michoacan, with lilac-crowned parrots presenting a narrow niche-breadth of tree species used for nesting. Considering an additional 82 nest trees recorded for lilac-crowned parrots in Jalisco, we determined a 51 percent similarity in cavity resource use by parrots in the two dry forest regions. Overall, the predominant nest tree species with 76 percent of nests were Astronium graveolens , Piranhea mexicana , Brosimum alicastrum , and Tabebuia spp., all characteristic of semi-deciduous forest. Only 8 percent of nests occurred in trees characteristic of deciduous forest. Parrots utilized large trees with canopy level cavities as nest sites, and preferred conserved semi-deciduous forest for nesting, with fewer nests than expected in deciduous forest and transformed agricultural land. Nest areas in semi-deciduous forest occurred on significantly steeper terrain, as remnant semi-deciduous forest is restricted to steep ridges and canyons. Those parrot nests in modified habitats and forest patches were located near to continuous forest, with nest trees in open agricultural land being significantly closer to continuous forest than nests in disturbed forest patches. These results demonstrate the importance of conserved semi-deciduous forest as breeding habitat for the threatened, endemic lilac-crowned parrot, making wild populations of the species vulnerable to the high rate of transformation and fragmentation of tropical dry forest.     

Clinical significance of serum gastrin levels in patients with colorectal cancer

AIMS: An association between elevated serum gastrin levels and the presence of human colorectal cancer has been reported, and gastrin has been shown to stimulate the growth of experimentally induced colon neoplasia. The aim of this study was to determine the preoperative and postoperative concentrations of serum gastrin in 53 patients with colorectal cancer and to assess the correlation between gastrin levels and tumor characteristics and prognosis. MATERIALS AND METHODS: A prospective study was performed over a six-year period during which 53 patients received potentially curative surgery for colorectal cancer. The prognostic variables used for the analysis included age, sex, tumor site, stage and degree of differentiation, preoperative and postoperative serum values of carcinoembryonic antigen (CEA) and gastrin, cancer-related mortality, and survival. CEA and gastrin serum values were determined using radioimmunological methods. Follow-up was carried out with clinical and radiological tests. RESULTS: The mean preoperative gastrin concentration was 51.2+/-27.4 pg/mL (range 12-146). Significantly increased serum gastrin concentrations, which returned to normal after surgery, were detected only in patients with well-differentiated cancer (74.2+/-28.3 pg/mL; moderately differentiated, 52.1+/-23.8; poorly differentiated, 29.9+/-12.3, p=0.02). The prognosis was unrelated to serum gastrin level; instead, tumor stage, preoperative CEA value, and degree of differentiation affected patient survival. CONCLUSIONS: This study showed that the serum gastrin concentration is not an appropriate clinical oncogenic factor. Although occurring only in well-differentiated tumors, serum gastrin is unrelated to the prognosis of patients with colorectal cancer.     

Perceptions on LCA implementation: evidence from a survey on adopters and nonadopters in Italy

Purpose

This paper introduces the results of an Italian survey on the implementation of life cycle assessment (LCA). Both LCA adopters and nonadopters were involved, in order to understand the main benefits and barriers to the adoption of LCA and how the experiences of LCA adopters differ from the expectations of nonadopters.

Methods

Approximately 2000 Italian companies were contacted and 122 companies participated in the online survey, which represent the 6.5 % of the statistical population of our study. To define the statistical population, firms that had implemented an LCA or an environmental initiative according to an official international standard were only considered. Statistically significant differences in answers between LCA adopters and nonadopters were tested by performing the Mann–Whitney test.

Results and discussion

Companies recognize that LCA can provide useful information to drive strategic decisions and product design, and it is perceived as an opportunity to improve the current monitoring systems. In addition, companies recognize the potential of LCA in marketing, making the communication of green attributes more substantial and robust. Focusing on the barriers experienced by LCA adopters, data collection can be cited. Communication issues also pose a barrier to the further implementation of LCA. The analysis of the results and the comparison of the results for the two groups of respondents highlight that on average, the difficulties are considered as more important than the benefits and that nonadopters tend to overestimate the difficulties and underestimate the benefits connected to the implementation of LCA.

Conclusions

The findings shed light on LCA-related issues both for companies and public servants. The misconception of LCA by nonadopters suggests that an increased awareness is the key to the success of LCA and to its more widespread adoption by companies. It is essential to create and disseminate know-how and sensitize companies to the real barriers and benefits of adopting an LCA. The awareness of potential LCA adopters can be raised by training and education initiatives, as well as by increased possibilities to experiment with these kinds of tools (public programs for financial support, fiscal incentives). On the other hand, market and communication research would contribute to better understand how the environmental impacts of products can be more effectively communicated to clients and consumers.

     

Heterogeneous expression of toll-like receptors in lymphatic endothelial cells derived from different tissues

As lymphatic endothelial cells (LECs) express different lymphatic and vascular markers depending on the organ they are derived from, we analysed whether they also show a heterogeneity of response against pathogens. To this end we analysed, for the presence of mRNA encoding for all human toll-like receptor (TLR), LECs isolated from lymph nodes and thymuses. RNA for TLR1-6 and 9 was identified in thymus-derived cells, whereas cells derived from lymph nodes contained mRNA for TLR1-4, 6 and 9, but failed to express mRNA specific for TLR5. The differential expression of TLRs was confirmed by the phosphorylation of nuclear factor-κB p65 only when the two types of LECs were incubated with the appropriate TLR agonists. The stimulation with specific agonists gives rise to a heterogeneous pattern of cytokine and chemokine secretion: thymus-derived LECs produced preferentially interleukin-6, interferon-inducible protein (IP)-10 and tumour necrosis factor-α, whereas cells prepared from lymph nodes mainly released interleukin-8, monocyte chemotactic protein-1, RANTES and (IP)-10. Finally, cells purified from lymph nodes expressed a higher level of intercellular adhesion molecule-1 than did cells prepared from the thymus when stimulated with several TLR agonists. The expression of a large set of TLRs and the responsiveness to specific agonists suggest that LECs are able to respond to pathogens, and the observed differences reflect specialized functions, redundancy and/or roles of LECs of different origin.