Apollo, sudden death, and Homer's "Odyssey": a warning from the past that we may be unable to eradicate coronary artery disease

Over recent years there has been a gratifying decrease in the incidence of recorded deaths from coronary artery disease in the Western world. The common view is that coronary artery disease is a recent phenomenon, that we have been subject to an epidemic in the mid-20th century that is now tailing off, and that with appropriate risk modification we may eradicate this disease or make it very rare. However, this article examines the cases of sudden, nontraumatic death described in Homer's Odyssey, which dates from c. 800 BCE. The results suggest that a high incidence of death from coronary artery disease may not be a recent phenomenon. Together with other described evidence, this study casts doubt on the view that coronary artery disease is a modern epidemic that can be eradicated.     

Effects of chemical control agents and microbial biocontrol agents on numbers of non-target microbial soil organisms: a meta-analysis

Our aim was to investigate the non-target effects on soil micro-organisms in agricultural environments caused by chemical control agents (CCAs) and microbial biocontrol agents (mBCAs), including the recovery from these effects. This was a desk study in which quantifiable endpoints, such as numbers of colony forming units (CFU), were derived from a series of studies and the combined data then analysed with a meta-regression analysis. Three analyses of the same dataset were performed. The first analysis, which was performed at the level of the CCAs and mBCAs in general, revealed that the effects of CCAs differed significantly from those of mBCAs. The second analysis, which included the type of non-target group (bacteria, fungi, actinomycetes, and protozoa) as additional input, revealed that mBCAs have greater effects than CCAs on fungi at study initiation, that CCAs had greater effects than mBCAs on bacteria and protozoa and that when effects were measured, recovery occurred within 100 days post-treatment initiation. The final analysis, which included the type of CCA (fungicide, insecticide, herbicide) or mBCA (antagonist) as additional input, revealed that (1) antagonists had a greater effect on fungi than insecticides and fungicides, (2) insecticides and to a lesser extent fungicides had a larger effect on bacteria than fungicides and antagonists, and (3) recovery of the CFU occurred within 100 days for all types of pesticides, mBCAs as well as CCAs, and for all non-target groups. The findings are discussed in view of the regulatory context of admittance of mBCAs to the market.     

Clonal and non-clonal chromosome aberrations and genome variation and aberration.

The theoretical view that genome aberrations rather than gene mutations cause a majority of cancers has gained increasing support from recent experimental data. Genetic aberration at the chromosome level is a key aspect of genome aberration and the systematic definition of chromosomal aberrations with their impact on genome variation and cancer genome evolution is of great importance. However, traditionally, efforts have focused on recurrent clonal chromosome aberrations (CCAs). The significance of stochastic non-clonal chromosome aberrations (NCCAs) is discussed in this paper with emphasis on the simple types of NCCAs that have until recently been considered "non-significant background". Comparison of various subtypes of transitional and late-stage CCAs with simple and complex types of NCCAs has uncovered a dynamic relationship among NCCAs, CCAs, overall genomic instability, and karyotypic evolution, as well as the stochastic nature of cancer evolution. Here, we review concepts and methodologies to measure NCCAs and discuss the possible causative mechanism and consequences of NCCAs. This study raises challenging questions regarding the concept of cancer evolution driven by stochastic chromosomal aberration mediated genome irregularities that could have repercussions reaching far beyond cancer and organismal genomes.     

Noninvasive determination of spatial distribution and temporal gradient of wall shear stress at common carotid artery

Wall shear stress (WSS) has been proved to play a critical role in formation and development of atherosclerotic plaques. Our objective was to quantify local WSS in vivo in normal subjects, and to analyze spatial distribution patterns and determine the temporal gradient of WSS. Seventy-eight CCAs of 42 healthy volunteers at common carotid arteries (CCAs) were studied. Cine phase-contrast MR sequence was used to acquire the flow velocity information. Three-dimensional paraboloid modeling was applied to fit the velocity profiles and WSS values were calculated. Mean WSS value for CCAs was 0.783+/-0.209, with the range of WSS value from -0.541 to 3.464 N/m(2). The 95% confidence interval for mean WSS value in CCA was (0.736-0.830) N/m(2). Different WSS spatial distribution patterns were classified into three types according to the location of low WSS values during a cardiac cycle. Mean value of maximum temporal gradient of WSS was 14.12+/-5.46, with the range from 5.87 to 33.23 N/m(2)s(-1). Skewed velocity profiles were displayed in most CCAs, indicating the flow patterns in CCA were more complicated than commonly assumed. Obvious inter-subject variation were found in magnitude, spatial distribution and the temporal gradient of WSS in CCAs, and the blood flow patterns as well.     

Lipoproteínas modificadas como marcadores de riesgo cardiovascular en la diabetes mellitus

Prevention of high incidence of cardiovascular disease in diabetes is one of the challenges of endocrinology. Validation of new biomarkers that may contribute to a better assessment of cardiovascular risk and help implement treatment strategies is one of the promising approaches in research on prevention and reduction of cardiovascular risk. Modification of low density lipoprotein (LDL) is a key element in development of atherosclerotic lesions. Several pathophysiological characteristics of diabetes are crucial for the LDL of these patients to have higher modification rates as compared to the healthy population. Diabetic dyslipidemia, hyperglycemia, and oxidative stress synergistically promote the occurrence of lipoperoxidation, glycosylation and glycoxidation processes, which will generate modified lipoproteins that stimulate development of atherosclerosis. This article reviews the role of different types of modified LDL in development of atherosclerosis in diabetes, as well as the possibility of using its quantification in cardiovascular risk prediction.     

Stochastic cancer progression driven by non-clonal chromosome aberrations

Cancer research has previously focused on the identification of specific genes and pathways responsible for cancer initiation and progression based on the prevailing viewpoint that cancer is caused by a stepwise accumulation of genetic aberrations. This viewpoint, however, is not consistent with the clinical finding that tumors display high levels of genetic heterogeneity and distinctive karyotypes. We show that chromosomal instability primarily generates stochastic karyotypic changes leading to the random progression of cancer. This was accomplished by tracing karyotypic patterns of individual cells that contained either defective genes responsible for genome integrity or were challenged by onco-proteins or carcinogens that destabilized the genome. Analysis included the tracing of patterns of karyotypic evolution during different stages of cellular immortalization. This study revealed that non-clonal chromosomal aberrations (NCCAs) (both aneuploidy and structural aberrations) and not recurrent clonal chromosomal aberrations (CCAs) are directly linked to genomic instability and karyotypic evolution. Discovery of "transitional CCAs" during in vitro immortalization clearly demonstrates that karyotypic evolution in solid tumors is not a continuous process. NCCAs and their dynamic interplay with CCAs create infinite genomic combinations leading to clonal diversity necessary for cancer cell evolution. The karyotypic chaos observed within the cell crisis stage prior to establishment of the immortalization further supports the ultimate importance of genetic aberrations at the karyotypic or genome level. Therefore, genomic instability generated NCCAs are a key driving force in cancer progression. The dynamic relationship between NCCAs and CCAs provides a mechanism underlying chromosomal based cancer evolution and could have broad clinical applications.     

Acetone-soluble cellulose acetates prepared by one-step homogeneous acetylation of cornhusk cellulose in an ionic liquid 1-allyl-3-methylimidazolium chloride (AmimCl)

Cellulose samples extracted from cornhusk have been successfully acetylated in an ionic liquid 1-allyl-3-methylimidazolium chloride (AmimCl). Without using any catalyst, cornhusk cellulose acetates (CCAs) with the degree of substitution (DS) in a range from 2.16 to 2.63 were prepared in one-step. Under the homogeneous state, the DS value of CCAs was easily controlled by the acetylation time. The obtained CCAs were characterized by means of FT-IR, ¹³C NMR, DSC, TGA, and a mechanical test. The NMR results showed that the distribution of the acetyl moiety among the three OH groups of the anhydroglucose unit shows a preference at the C₆ position. The CCAs exhibited good solubility in some organic solvents, such as acetone and DMSO. The cast CCA films from their acetone solutions had good mechanical properties. At the end of each acetylation of cornhusk cellulose, the ionic liquid AmimCl could be effectively recovered. Therefore, this study presents a promising approach and “green process” to make use of crop by-products.     

Perivascular gene transfer of NADPH oxidase inhibitor suppresses angioplasty-induced neointimal proliferation of rat carotid artery

Vascular stretch induces NADPH oxidase-derived superoxide anion (O2-), which has been implicated in hypertrophy and cell proliferation. We hypothesized that targeted delivery of an NADPH oxidase inhibitor to the adventitia would reduce stretch-induced vascular O2- and attenuate neointima formation. We designed a novel replication-deficient adenovirus containing a fibroblast-active promoter driving expression of NADPH oxidase inhibitory sequence gp91ds (Ad-PDGFbetaR-gp91ds/eGFP). 1) We characterized the specificity of this promoter using pPDGFbetaR-luciferase by showing induction of luciferase in cultured rat aortic fibroblasts but not in vascular smooth muscle cells. 2) Using RT-PCR, we observed expression of gp91ds and the reporter gene in fibroblasts after infection with Ad-PDGFbetaR-gp91ds/eGFP. 3) Using Ad-CMV-eGFP as a control, we delivered Ad-PDGFbetaR-gp91ds/eGFP to the adventitia of the rat common carotid artery (CCA). Immunohistochemistry confirmed localized delivery of the inhibitor to the adventitia. After CCAs were injured with an embolectomy catheter, we observed a significant increase in neointima-to-media area ratio in control CCAs, which was significantly attenuated in CCAs treated with the gp91ds-expressing virus. In a second group of rats, we detected a 10-fold increase in distension-stimulated O2-, which was significantly reduced in CCAs infected with gp91ds-expressing virus. These data demonstrate that localized adventitial delivery of an NADPH oxidase inhibitor is effective in reducing overall vascular O2- and neointima formation, suggesting that adventitial NADPH oxidase plays a functional role in development of neointimal hyperplasia.     

Helicobacter pylori and peptic ulcer disease.

Medical therapy for duodenal or gastric ulcer disease has traditionally involved gastric acid antisecretory therapy for 4 to 8 weeks to promote initial healing and indefinitely to prevent recurrences of ulcer. The discovery of Helicobacter pylori in most patients with peptic ulcer disease has led to a change in this approach. Therapy designed to eradicate H pylori may facilitate ulcer healing with acid antisecretory agents and, more important, may greatly reduce the incidence of ulcer recurrence, obviating the need for maintenance antisecretory therapy. Regimens designed to eradicate H pylori are difficult to comply with, however, and are associated with adverse effects in some patients. In this article we review the diagnosis and treatment of H pylori infection in patients with peptic ulcer disease and make recommendations regarding the use of conventional ulcer therapies and therapies designed to eradicate H pylori.     

Development of a whole cell vaccine for acute myeloid leukaemia

We describe the modification of tumour cells to enhance their capacity to act as antigen presenting cells with particular focus on the use of costimulatory molecules to do so. We have been involved in the genetic modification of tumour cells to prepare a whole cell vaccine for nearly a decade and we have a particular interest in acute myeloid leukaemia (AML). AML is an aggressive and difficult to treat disease, especially, for patients for whom haematopoietic stem cell (HSC) transplant is not an option. AML patients who have a suitable donor and meet HSC transplant fitness requirements, have a 5-year survival of 50%; however, for patients with no suitable donor or for who age is a factor, the prognosis is much worse. It is particularly poor prognosis patients, who are not eligible for HSC transplant, who are likely to benefit most from immunotherapy. It would be hoped that immunotherapy would be used to clear residual tumour cells in these patients in the first remission following standard chemotherapy treatments and this will extend the remission and reduce the risk of a second relapse associated with disease progression and poor mortality rates. In this symposia report, we will focus on whole cell vaccines as an immunotherapeutic option with particular reference to their use in the treatment of AML. We will aim to provide a brief overview of the latest data from our group and considerations for the use of this treatment modality in clinical trials for AML. This article is a symposium paper from the conference “Progress in Vaccination against Cancer 2004 (PIVAC 4)”, held in Freudenstadt-Lauterbad, Black Forest, Germany, on 22–25 September 2004     

Carotid artery mechanical properties and stresses quantified using in vivo data from normotensive and hypertensive humans

The goal of this study was to model the in vivo non-linear mechanical behavior of human common carotid arteries (CCAs) and then to compare wall stresses and associated contributions of micro-constituents in normotensive (NT) and treated hypertensive (HT) subjects. We used an established theoretical model of 3D arterial mechanics that assumes a hyperelastic, anisotropic, active–passive, and residually stressed wall. In vivo data were obtained non-invasively from CCAs in 16 NT (21–64 years old) and 25 treated HT (44–69 years old) subjects. The associated quasi-static boundary value problem was solved semi-analytically over a cardiac cycle while accounting for surrounding perivascular tissue. Best-fit values of model parameters, including those describing contributions by intramural elastin, fibrillar collagen, and vascular smooth muscle, were estimated by a non-linear least-squares method. The model (1) captured temporal changes in intraluminal pressure, (2) estimated wall stress fields that appeared to reflect the presence or absence of age and disease, and (3) suggested changes in mechanical characteristics of wall micro-constituents despite medical treatment of hypertension. For example, age was positively correlated with residual stresses and altered fibrillar collagen in NT subjects, which indirectly validated the modeling, and HT subjects had higher levels of stresses, increased smooth muscle tone, and a stiffer elastin-dominated matrix despite treatment. These results are consistent with prior reports on effects of age and hypertension, but provide increased insight into evolving contributions of cell and matrix mechanics to arterial behavior in vivo.     

表观遗传学修饰在血液肿瘤中的研究进展

血液肿瘤作为一类常见恶性肿瘤疾病主要包括各类白血病、多发性骨髓瘤以及恶性淋巴瘤.随着现代社会高速发展,人群发病率呈逐年升高趋势,且发病年龄逐渐低龄化,发病原因与环境因素以及遗传因素密不可分.近年来研究发现,表观遗传学修饰在血液肿瘤发生发展的过程中扮演了重要角色,一些相关修饰基因作为血液肿瘤的治疗靶点在临床应用上取得了重要进展.针对近年来表观遗传学修饰在血液肿瘤中的研究新进展,本文将系统综述DNA甲基化、组蛋白修饰、非编码RNA及RNA修饰等在血液肿瘤发病机制方面的研究进展.     

Adventitial delivery of dominant-negative p67phox attenuates neointimal hyperplasia of the rat carotid artery

Several essential components of NADPH oxidase, including p22phox, gp91phox (nox2) and its homologs nox1 and nox4, p47phox, p67phox, and rac1, are present in the vasculature. We previously reported that p67phox is essential for adventitial fibroblast NADPH oxidase O2- production. Thus we postulated that inhibition of adventitial p67phox activity would attenuate angioplasty-induced hyperplasia. To test this hypothesis, we treated the adventitia of carotid arteries with a control adenovirus (Ad-control), a virus expressing dominant-negative p67phox (Ad-p67dn), or a virus expressing a competitive peptide (gp91ds) targeting the p47phox-gp91phox interaction (Ad-gp91ds). Common carotid arteries (CCAs) from male Sprague-Dawley rats were transfected with Ad-control, Ad-p67dn, or Ad-gp91ds in pluronic gel. After 2 days, a 2-F (Fogarty) catheter was used to injure CCAs in vivo. After 14 days, CCAs were perfusion-fixed and analyzed. In 13 experiments, digital morphometry suggested a reduction of neointimal hyperplasia with Ad-p67dn compared with Ad-control; however, the reduction did not reach statistical significance (P = 0.058). In contrast, a significant reduction was achieved with Ad-gp91ds (P = 0.006). No changes in medial area or remodeling were observed with either treatment. Moreover, adventitial fibroblast proliferation in vitro was inhibited by Ad-gp91ds but not by Ad-p67dn, despite confirmation that Ad-p67dn inhibits NADPH oxidase in fibroblasts. These data appear to suggest that a multicomponent vascular NADPH oxidase plays a role in neointimal hyperplasia. However, inhibition of p47phox may be more effective than inhibition of p67phox at attenuating neointimal growth.     

脐带血干细胞移植治疗非恶性血液病进展

异基因造血干细胞移植（allo-HSCT）是治愈多种非恶性病的有效方法。脐带血干细胞（UCB）具有免疫原性低、人类白细胞抗原不合耐受性好、移植物抗宿主反应发生率低以及获取相对快捷等特点,可作为非恶性血液疾病患者allo-HSCT的来源。本文简要综述脐血干细胞移植在原发性免疫缺陷病、遗传性骨髓衰竭、遗传代谢病以及自身免疫性疾病等非恶性血液疾病的治疗效果。     

Spatial correlated incidence modeling with zero inflation

Disease mapping models have been popularly used to model disease incidence with spatial correlation. In disease mapping models, zero inflation is an important issue, which often occurs in disease incidence datasets with high proportions of zero disease count. It is originated from limited survey coverage or unadvanced testing equipment, which makes some regions have no observed patients. Then excessive zeros recorded in the disease incidence dataset would mess up the true distributions of disease incidence and lead to inaccurate estimates. To address this issue, a zero-inflated disease mapping model is developed in this work. In this model, a zero-inflated process using Bernoulli indicators is assumed to characterize whether the zero inflation occurs for each region. For regions without zero inflation, a coherent and generative disease mapping model is applied for mapping the spatially correlated disease incidence. Independent spatial random effects are incorporated in both processes to account for the spatial patterns of zero inflation and disease incidence. External covariates are also considered in both processes to better explain the disease count data. To estimate the model, a Markov chain Monte Carlo algorithm is proposed. We evaluate model performance via a variety of simulation experiments. Finally, a Lyme disease dataset of Virginia is analyzed to illustrate the application of the proposed model.     

Activity of phosphatidylethanolamine-N-methyltransferase in brain affected by Alzheimer's disease

To determine whether phospholipid abnormality in Alzheimer's disease is associated with modification of phosphatidylethanolamine-N-methyltransferase, the activity of the enzyme was analysed in the frontal and occipital cortex of the brain from patients with Alzheimer's disease and from aged-matched control. The optimum pH for phosphatidylethanolamine-N-methyltransferase in human brain was 9.0. The enzyme activity was stimulated by detergent TWEEN 20 but inhibited by Triton X-100. Neither magnesium dependence nor chemical methylation was found. A decrease in activity of phosphatidylethanolamine-N-methyltransferase was observed in the frontal cortex of brain affected with Alzheimer's disease. The addition of exogenous phosphatidylethanolamine resulted in no modification in the methylation rate as compared with that of endogenous PE. The addition of phosphatidyl-N-monomethylethanolamine and phosphatidyl-N,N-dimethylethanolamine resulted in significantly increased rates of methylation in brain tissues. However, the increased rate of phosphatidylethanolamine-N-methyltransferase activity stimulated by exogenous phospholipids was lower in the frontal cortex of brains with Alzheimer's disease when compared to the normals and there was no difference in the occipital cortex between Alzheimer's disease and the control. It is plausible that the decreased activity of phosphatidylethanolamine-N-methyltransferase and its low compensating ability could relate to the modification of phosphatidylcholine in brain tissues from Alzheimer's disease patients.     

多囊卵巢综合症与心血管疾病相关性的探讨

多囊卵巢综合症(Polycystic ovary syndfome,PCOS)是一种育龄期妇女常见病,临床上常伴有月经稀少、不孕、多毛和肥胖等症状,双侧卵巢呈囊性增大,女性内分泌出现紊乱,PCOS中有50%妇女表现为肥胖,尽管多数妇女以不孕和月经异常就诊,但有研究表明PCOS患者的远期并发症如心血管疾病的发生率远远高于正常人群。本文主要探讨了PCOS与心血管疾病的相关性。     

Prevention of Deep Vein Thrombosis by Intermittent Pneumatic Compression of Calf

A consecutive, randomly allocated, controlled clinical trial of the prophylactic effect of intermittent pneumatic compression of the calf on the incidence of postoperative deep vein thrombosis showed that in patients without malignant disease there was a highly significant reduction in the incidence of thrombosis. In patients with malignant disease the incidence of thrombosis was higher than in those without, and there was no reduction in incidence by the application of intermittent compression. In the absence of malignant disease, severity of operation and the age of the patient were the most significant aetiological factors. We found no relation between the incidence of deep venous thrombosis and obesity, length of preoperative stay, location of hospital, or duration of anaesthesia. We suggest that intermittent pneumatic compression as used in this trial is a safe, effective, and extremely practical method of preventing postoperative deep vein thrombosis in patients not suffering from malignant disease.     

Bayesian modeling of time-varying and waning exposure effects

In epidemiologic studies, there is often interest in assessing the association between exposure history and disease incidence. For many diseases, incidence may depend not only on cumulative exposure, but also on the ages at which exposure occurred. This article proposes a flexible Bayesian approach for modeling age-varying and waning exposure effects. The Cox model is generalized to allow the hazard of disease to depend on an integral, across the exposed ages, of a piecewise polynomial function of age, multiplied by an exponential decay term. Linearity properties of the model facilitate posterior computation via a Gibbs sampler, which generalizes previous algorithms for Cox regression with time-dependent covariates. The approach is illustrated by an application to the study of protective effects of breastfeeding on incidence of childhood asthma.     

Disease transmission models with density-dependent demographics

The models considered for the spread of an infectious disease in a population are of SIRS or SIS type with a standard incidence expression. The varying population size is described by a modification of the logistic differential equation which includes a term for disease-related deaths. The models have density-dependent restricted growth due to a decreasing birth rate and an increasing death rate as the population size increases towards its carrying capacity. Thresholds, equilibria and stability are determined for the systems of ordinary differential equations for each model. The persistence of the infectious disease and disease-related deaths can lead to a new equilibrium population size below the carrying capacity and can even cause the population to become extinct.Research supported in part by Centers for Disease Control contract 200-87-0515