Troponin T elevation and prognosis after multivessel compared with single-vessel elective percutaneous coronary intervention

Background. Although techniques for percutaneous coronary intervention (PCI) have improved, patients with PCI of more vessels may still have an increased risk. We performed a prospective observational study evaluating the differences between multivessel and single-vessel procedures according to postprocedural troponin T (TnT) elevation and events during follow-up. Methods. The study included 713 patients without elevated TnT (<0.05 ng/ml) before PCI. Primary endpoint was the combined endpoint of death, myocardial infarction, stroke, repeat coronary angiography and readmission for anginal symptoms during the mean follow-up of 10.9 months. Results. TnT after PCI was elevated in 150 patients (21%) and was significantly associated with an increased incidence of the primary endpoint (RR 1.55, 95% CI 1.01 to 2.38). PCI of more than one vessel was performed in 146 patients (20%). These patients more often had increased TnT levels after the procedure (31.5 vs. 18.3%, p=0.001) and an increased incidence of the primary endpoint during follow-up (28 vs. 19%, p=0.01). After multivariable analysis, multivessel PCI was a statistically significant predictor of postprocedural TnT increase (OR 1.90, 95% CI 1.17 to 3.06). Multivessel PCI was also associated with an increased risk of the primary endpoint (OR 1.73, 95% CI 1.18 to 2.52), but after adjusting for multivessel disease this association was not statistically significant (OR 1.42, 95% CI 0.92 to 2.19). Conclusion. Elective PCI of more vessels in one session is, in comparison with single-vessel PCI, more often associated with postprocedural troponin T rise and a (nonsignificantly) higher incidence of cardiac events during follow-up. Whether staged PCI is associated with less morbidity has to be assessed. (Neth Heart J 2007;15:178-83.)     

Causes of the eelgrass wasting disease: Van der Werff's changing theories

The 1930's wasting disease among the North Atlantic population of eelgrass,Zostera marina, is still an ecological and historical enigma, despite several attractive theories. Van der Werff investigated the die-back of eelgrass in the thirties in the Dutch Wadden Sea, and he considered the micro-organismLabyrinthula as the possible cause of the disease. In 1980, Grevelingen lagoon, harbouring an extensive population ofZostera marina, experienced a major decline of the area covered by the submerged macrophyte. Speculations about the cause of this dramatic decline induced us to think that the wasting disease had struck again. Van der Werff investigated the Grevelingen population and found bothLabyrinthula and a Chaetophoracean endophytic alga to be presumably responsible for the decline. During the quest for the ultimate cause of the wasting disease the question remains whether both micro-organisms are the cause of the disease or simply an effect of decomposition processes triggered by other factors.     

Purification of the human NF-E2 complex: cDNA cloning of the hematopoietic cell-specific subunit and evidence for an associated partner.

The human globin locus control region-binding protein, NF-E2, was purified by DNA affinity chromatography. Its tissue-specific component, p45 NF-E2, was cloned by use of a low-stringency library screen with murine p45 NF-E2 cDNA (N. C. Andrews, H. Erdjument-Bromage, M. B. Davidson, P. Tempst, and S. H. Orkin, Nature [London] 362:722-728, 1993). The human p45 NF-E2 gene was localized to chromosome 12q13 by fluorescent in situ hybridization. Human p45 NF-E2 and murine p45 NF-E2 are highly homologous basic region-leucine zipper (bZIP) proteins with identical DNA-binding domains. Immunoprecipitation experiments demonstrated that p45 NF-E2 is associated in vivo with an 18-kDa protein (p18). Because bZIP proteins bind DNA as dimers, we infer that native NF-E2 must be a heterodimer of 45- and 18-kDa subunits. Although AP-1 and CREB copurified with NF-E2, no evidence was found for heterodimer formation between p45 NF-E2 and proteins other than p18. Thus, p18 appears to be the sole specific partner of p45 NF-E2 in erythroid cells. Cloning of human p45 NF-E2 should permit studies of the role of NF-E2 in globin gene regulation and erythroid differentiation.     

Decoding Sensorimotor Rhythms during Robotic-Assisted Treadmill Walking for Brain Computer Interface (BCI) Applications

Locomotor malfunction represents a major problem in some neurological disorders like stroke and spinal cord injury. Robot-assisted walking devices have been used during rehabilitation of patients with these ailments for regaining and improving walking ability. Previous studies showed the advantage of brain-computer interface (BCI) based robot-assisted training combined with physical therapy in the rehabilitation of the upper limb after stroke. Therefore, stroke patients with walking disorders might also benefit from using BCI robot-assisted training protocols. In order to develop such BCI, it is necessary to evaluate the feasibility to decode walking intention from cortical patterns during robot-assisted gait training. Spectral patterns in the electroencephalogram (EEG) related to robot-assisted active and passive walking were investigated in 10 healthy volunteers (mean age 32.3±10.8, six female) and in three acute stroke patients (all male, mean age 46.7±16.9, Berg Balance Scale 20±12.8). A logistic regression classifier was used to distinguish walking from baseline in these spectral EEG patterns. Mean classification accuracies of 94.0±5.4% and 93.1±7.9%, respectively, were reached when active and passive walking were compared against baseline. The classification performance between passive and active walking was 83.4±7.4%. A classification accuracy of 89.9±5.7% was achieved in the stroke patients when comparing walking and baseline. Furthermore, in the healthy volunteers modulation of low gamma activity in central midline areas was found to be associated with the gait cycle phases, but not in the stroke patients. Our results demonstrate the feasibility of BCI-based robotic-assisted training devices for gait rehabilitation.     

EFFECTS OF PHOTOPERIOD AND VERNALIZATION ON THE NUMBER OF LEAVES AT FLOWERING IN 32 ARABIDOPSIS THALIANA (BRASSICACEAE) ECOTYPES

The extent of natural variation among wild type Arabidopsis thaliana L. Heynh for response to environmental stimuli that affect flowering is poorly documented. The effects of photoperiod and vernalization on the number of rosette leaves at the time of anthesis was measured for 32 Arabidopsis ecotypes. All ecotypes were vernalized 24 days at 4 C under continuous illumination. Vernalized and nonvernalized plants were transplanted into 8- (short-day) and 20-hour (long-day) photoperiods in controlled environment growth chambers. Two ecotypes failed to flower after 110 days. Mean leaf number was less for all ecotypes under long day compared to short day. Sixteen ecotypes responded to vernalization; eight had reduced leaf number regardless of photoperiod, and eight had reduced leaf number only under short day. Two ecotypes required vernalization to flower in this study. For three ecotypes, vernalization and short day resulted in a reduction in leaf number whereas vernalization and long day resulted in increased leaf number. Documentation of the effects and interactions of photoperiod and vernalization across many ecotypes provides a broader range of described natural variation for genetic and physiologic study.     

Water and Values: Ecological Research as the Basis for Water Management and Nature Management

Over the past 50 years ecology has developed into a mature branch of the natural sciences, comprising firm concepts (e.g. for rivers River Continuum Concept and Flood Pulse Concept) and extensive empirical surveys (sophisticated lab and field experiments, simulation models, GIS). Estuaries and rivers are continuously threatened ecosystems, considering the massive expansion of man’s economic activities. I focus on rivers and estuaries in the Netherlands (W. Europe), where recent public interest has mainly been determined by two flooding disasters (mega-disaster in 1953; near-disaster in 1995). The measures taken to enhance the safety of the human population were adequate: building of large closure dams, and storm surge barriers in the estuaries, and heightening of levees along the rivers. Eventually these measures were detrimental for what was left of the dynamic river ecosystems from the past. This paper focuses on two ecosystem studies. (1) An ecosystem study in Grevelingen lagoon, a large embanked estuary that changed into a brackish water lagoon. Predictive ecological models (e.g. for the wax and wane of Eelgrass, Zostera marina) were inadequate because of the exceptional characteristics of the lagoon: the ecosystem appeared to be instable, and not resilient. (2) An ecosystem study at Afferdensche and Deestsche Waarden, a floodplain area along the river Waal, strongly affected by toxicants deposited before 1980. We studied the functioning and eco-toxicology of floodplain food webs, deteriorated by pollutants. Fine-tuned spatial components were introduced in ecological risk assessment models of several trophic levels (e.g. a top predator, the Little Owl, Athena noctua). Safety for the human population, living below sea level, and below the level of the main rivers, must be improved, but overhasty technocratic measures deteriorating the remaining semi-natural, highly appreciated landscapes, should be avoided. Stakeholder interests must be adapted to sustainable ecological river management, and not the other way round, as has been done for the past ten centuries.     

Regulation of spatial and seasonal variation of macroalgal biomass in a brackish, eutrophic lake

Processes leading to biomass variation of Ulva were investigated at two contrasting sites in the eutrophic Veerse Meer (The Netherlands). Ulva species dominated at the Middelplaten site, while at the Kwistenburg site a mixture of Ulva spp. and Chaetomorpha linum dominated. Total summer macroalgal biomass was higher at Middelplaten than at Kwistenburg (282 and 79 g DW m^–2, respectively). Growth rates of Ulva spp. were high at both sites in May 1992 (cage mean 0.28–0.30 day^–1), but quickly dropped to lower values (0.05–0.10 day^–1). In May, growth rates were significantly highest at Kwistenburg, while during the rest of the season growth rates were similar for both sites. Temperature, pH, dissolved oxygen, salinity, light attenuation, phytoplankton and nutrient concentrations did not differ between sites. The relation between variation in Ulva spp. growth rates and environmental parameters was analysed using stepwise multiple regression, showing that light and temperature were the main variables regulating Ulva spp. growth rates. As Ulva growth rates were similar for both sites but biomass was much lower at Kwistenburg it was concluded that a large amount of produced biomass was lost at Kwistenburg. Although the exact reason for this remains unclear, it seems most likely that transport of macroalgae by wind and waves is a very important factor. This study shows the importance of simultaneously measuring growth rates and biomass at a high temporal resolution to reveal the mechanisms responsible for spatial variation in macroalgal biomass in shallow coastal areas. Electronic Publication