Age-matched Control Patients Research Articles

Glucose-6-phosphate-dehydrogenase Deficiency as a Risk Factor for Pterygium

Glucose-6-phosphate dehydrogenase (G6PD) is an important site of metabolic control in the pentose phosphate pathway (PPP), providing reducing power (NADPH) and pentose phosphates. The purpose of this study was to investigate the possible involvement of G6PD deficiency (G6PD-) in the pathogenesis of pterygium. Erythrocyte G6PD activity was evaluated in 123 pterygium patients and in 112 age-matched control patients. Enzyme activity, mRNA, rate of growth, green autofluorescence, response to oxidative stress, and cholesterol metabolism were determined in pterygium fibroblasts (PFs) and in normal conjunctival fibroblasts (NCFs) isolated from G6PD normal (NCFs+ and PFs+) and G6PD- (NCFs- and PFs-) patients. Higher prevalence of G6PD- was found in patients affected by primary pterygium than in control subjects, both men and women, suggesting that this enzymatic defect may be a predisposing factor for pterygium. G6PD activity was significantly lower in NCFs- than in NCFs+, but not in PFs- than in PFs+. In PFs-, G6PD mRNA levels were significantly higher than in PFs+. Growth-stimulated NCFs- grew at half the rate of NCFs+, although PFs- and PFs+ grew at the same rate. Increased green autofluorescence and susceptibility to oxidative stress were observed in PFs (+/-) and in NCFs-, but not in NCFs+. Moreover, ex vivo PFs (+/-) accumulated more lipids than corresponding NCFs. The results of this study, although restricted to a limited group of subjects (i.e., those of Sardinian ancestry), suggest that G6PD- not only does not protect against pterygium, but may even be considered a risk factor for the development of this disorder.

Loss of epidermal growth factor regulation by cobalamin in multiple sclerosis

We investigated whether the physiological regulation of cerebrospinal fluid (CSF) levels of tumor necrosis factor (TNF)-α, epidermal growth factor (EGF), and nerve growth factor (NGF) by cobalamin (Cbl) that is observed in rat and human central nervous system (CNS) is retained in the CSF of patients with multiple sclerosis (MS). The study involved 158 MS patients grouped on the basis of the different clinical courses (relapsing–remitting (RR), secondary-progressive (SP), and primary-progressive (PP)), and 76 gender- and age-matched control patients with other non-inflammatory and non-neoplastic neurological diseases. The MS patients were therapy-free at the time of lumbar puncture. CSF Cbl and EGF were blindly measured by means of radioimmunoassays, and CSF TNF-α, and NGF by means of highly sensitive enzyme-linked immunosorbent assays. Serum EGF was also measured in 38 of the MS patients and 20 healthy controls. CSF Cbl levels were significantly higher (RR patients 27.9 ± 9.7 pg/ml, p < 0.0001 vs . C; SP patients 25.4 ± 8 pg/ml, p < 0.02 vs . C), and CSF TNF-α and EGF levels significantly lower in the patients with the RR (TNF-α 28.3 ± 23.4 × 10 − 3 pg/ml, p < 0.0001 vs . C; EGF 129.9 ± 44.8 pg/ml, p < 0.02 vs . C) or SP (TNF-α 20.5 ± 20.5 × 10 − 3 pg/ml, p < 0.001 vs . C; EGF 116.5 ± 24.8 pg/ml, p < 0.05 vs . C) clinical course than in controls (Cbl 21 ± 4.6 pg/ml; TNF-α 75.6 ± 34.7 × 10 − 3 pg/ml; EGF 170.2 ± 54.8 pg/ml). There were no differences in CSF NGF or serum EGF levels between any of the MS clinical courses and controls. Our results indicate that: (a) the positive Cbl-mediated regulation of myelino- and oligodendrocyte-trophic EGF is lost in the CSF of RR- or SP-MS patients; (b) the decrease in EGF levels in the CSF may be one factor impeding CNS remyelination in MS; and (c) the PP clinical course may have different pathogenetic mechanism(s) also on the basis of the molecules investigated in this study.

Disruption of spatial memory in visual search in the left visual field in patients with hemispatial neglect

Spatial working memory during an ongoing visual search trial was tested in both visual fields for right-brain damaged patients with contralesional spatial neglect, as well as age-matched control patients with right-hemisphere lesions but no neglect. We examined within-trial spatial memory by using a relocation search paradigm introduced by Kristjansson (2000) (modified from Horowitz & Wolfe, 1998), in which the display items traded places every 110 ms so that the target was never to be found in the same location from one moment to the next (the relocation condition), as compared with a static condition where the display items remained in place for the whole trial duration. To equate appearance between the two conditions, all items changed orientation every 110 ms in both conditions, and were masked after each of the briefly presented visual arrays. The results showed that search was disrupted by item relocation for both patients and controls, but importantly this disruption was only seen in the right visual field for the patients, not the left, indicating that their spatial working memory in left visual space is already severely disrupted, and to a greater degree than for their right visual space, in contrast to what has been previously argued.

The relationship between hepatitis B virus infection and the incidence of pancreatic cancer: a retrospective case-control study

An association between past history of hepatitis B virus (HBV) infection and pancreatic cancer (PC) has recently been reported. We investigated whether HBV and hepatitis C virus (HCV) infections are associated with the development of PC in Korea. We retrospectively recruited patients with PC and sex- and, age-matched control patients with stomach cancer (SC) during the previous 5 years. Serum HBsAg and anti-HCV were examined, and data on smoking, alcohol intake, diabetes, and the history of chronic pancreatitis (CP) were collected. A total of 506 PC and 1008 SC were enrolled, with respectively 58.1% and 97.3% of these cases being confirmed histologically. The mean age and sex ratio (male:female) were 63.5 years and 1.5:1 in the PC patients and 63.9 years and 1.5:1 in the SC patients respectively (P>0.05). The odds ratios (95% confidence interval, 95% CI) in univariate analysis were 0.90 (0.52-1.56; P=0.70) for HBsAg, 1.87 (0.87-4.01; P=0.11) for anti-HCV, 2.66 (2.04-3.48; P<0.001) for the presence of diabetes, 2.30 (1.83-2.90; P<0.001) for smoking, 1.14 (0.89-1.46; P=0.31) for alcohol intake, and 4.40 (1.66-11.66; P=0.003) for the history of CP. Independent risk factors for PC were presence of diabetes (OR, 2.67; 95% CI, 2.00-3.56; P<0.001), smoking (OR, 2.49; 95% CI, 1.93-3.21; P<0.001) and history of CP (OR, 4.60; 95% CI, 1.56-13.53; P=0.006). There was no significant association between seropositivity for HBsAg or anti-HCV and PC. Further studies are warranted to clarify the association between HBV infection and PC in regions where HBV is endemic.

Increased Amount of Visceral Fat in Patients with Psoriasis Contributes to Metabolic Syndrome

Background: Psoriasis is associated with obesity and metabolic syndrome. Metabolic syndrome is associated with visceral fat accumulation. There is no study on the accumulation of visceral fat in patients with psoriasis. Objective: The aim of this study was to compare the visceral fat accumulation in patients with psoriasis and controls. Subjects and Methods: 46 patients with psoriasis and 46 sex- and age-matched control patients were included in this study. The abdominal fat area [visceral fat area (VFA), subcutaneous fat area (SFA) and total fat area (TFA)] at the level of the umbilicus was evaluated by computed tomography. Results: The mean VFA value and VFA/SFA ratio of the psoriasis patients were significantly higher compared with the control patients (123.4 ± 80.3 vs. 81.2 ± 59.8 cm² and 0.734 ± 0.593 vs. 0.491 ± 0.336; p = 0.005 and p = 0.017, respectively). Fasting blood sugar levels were also found to be significantly higher in psoriasis patients, compared with the control patients (101.8 ± 43.5 vs. 83.4 ± 9.1 mg/dl; p = 0.005). Multiple linear regression analysis indicated that waist-to-hip ratio, age, body weight, the presence of psoriasis and metabolic syndrome were significantly associated with VFA. Conclusion:Psoriasis patients had a higher amount of VFA, compared with the control patients.

The Three Cities Test: Preliminary Validation of a Short Bedside Memory Test in Persons with Acute Stroke

Screening tests for memory can be administered more quickly than standard tests of memory. They can be particularly useful with patients with acute medical illness or with the elderly who are unable to tolerate complex or lengthy memory testing, such as patients with acute stroke. However, screening measures for memory often lack validation and may have significant psychometric limitations. The purpose of this study was to validate and determine the psychometric properties of the Three Cities Test (TCT), a short test of memory that uses a selective reminding paradigm and the names of well-known cities as stimuli. The TCT was administered to 115 subjects: 60 patients with acute cerebrovascular accidents (Stroke group) and 55 age-matched orthopedic control patients (Ortho group). Results show that the TCT was significantly correlated with general measures of cognition (MMSE), another well-validated measure of learning and memory (HVLT-R), and clinical variables such as length of hospitalization and functional recovery. Compared to the Ortho group, the Stroke group had significantly worse performance on the TCT in terms of number of trials to criterion, delayed recall, and recognition discrimination. Preliminary results suggest that this instrument is well-received by patients with acute medical illness and cognitive impairment and that it possesses good construct and discriminative validity. Sensitivity and specificity performance as well as recommended cut scores are offered for the TCT.

Blunted frequency-dependent upregulation of cardiac output is related to impaired relaxation in diastolic heart failure.

AimsWe tested the hypothesis that, in heart failure with normal ejection fraction (HFNEF), diastolic dysfunction is accentuated at increasing heart rates, and this contributes to impaired frequency-dependent augmentation of cardiac output.Methods and resultsIn 17 patients with HFNEF (median age 69 years, 13 female) and seven age-matched control patients, systolic and diastolic function was analysed by pressure–volume loops at baseline heart rate and during atrial pacing to 100 and 120 min−1. At baseline, relaxation was prolonged and end-diastolic left ventricular stiffness was higher in HFNEF, whereas all parameters of systolic function were not different from control patients. This resulted in smaller end-diastolic volumes, higher end-diastolic pressure, and a lower stroke volume and cardiac index in HFNEF vs. control patients. During pacing, frequency-dependent upregulation of contractility indices (+dP/dtmax and Ees) occurred similarly in HFNEF and control patients, but frequency-dependent acceleration of relaxation (dP/dtmin) was blunted in HFNEF. In HFNEF, end-diastolic volume and stroke volume decreased with higher heart rates while both remained unchanged in control patients.ConclusionIn HFNEF, frequency-dependent upregulation of cardiac output is blunted. This results from progressive volume unloading of the left ventricle due to limited relaxation reserve in combination with increased LV passive stiffness, despite preserved force–frequency relation.

A comparative study of synchrony measures for the early diagnosis of Alzheimer's disease based on EEG

It is well known that EEG signals of Alzheimer's disease (AD) patients are generally less synchronous than in age-matched control subjects. However, this effect is not always easily detectable. This is especially the case for patients in the pre-symptomatic phase, commonly referred to as mild cognitive impairment (MCI), during which neuronal degeneration is occurring prior to the clinical symptoms appearance. In this paper, various synchrony measures are studied in the context of AD diagnosis, including the correlation coefficient, mean-square and phase coherence, Granger causality, phase synchrony indices, information-theoretic divergence measures, state space based measures, and the recently proposed stochastic event synchrony measures. Experiments with EEG data show that many of those measures are strongly correlated (or anti-correlated) with the correlation coefficient, and hence, provide little complementary information about EEG synchrony. Measures that are only weakly correlated with the correlation coefficient include the phase synchrony indices, Granger causality measures, and stochastic event synchrony measures. In addition, those three families of synchrony measures are mutually uncorrelated, and therefore, they each seem to capture a specific kind of interdependence. For the data set at hand, only two synchrony measures are able to convincingly distinguish MCI patients from age-matched control patients, i.e., Granger causality (in particular, full-frequency directed transfer function) and stochastic event synchrony. Those two measures are used as features to distinguish MCI patients from age-matched control subjects, yielding a leave-one-out classification rate of 83%. The classification performance may be further improved by adding complementary features from EEG; this approach may eventually lead to a reliable EEG-based diagnostic tool for MCI and AD.

Predicting Response to Cardiac Resynchronization Therapy with Cross-Correlation Analysis of Myocardial Systolic Acceleration: A New Approach to Echocardiographic Dyssynchrony Evaluation

We tested the ability of cross-correlation analysis of myocardial systolic acceleration (XCA), a new marker of dyssynchrony based on tissue Doppler echocardiography, to predict long-term outcome of cardiac resynchronization therapy (CRT) and to discriminate between control patients and patients with dyssynchrony. XCA was performed by off-line analysis of digitally stored myocardial velocity curves in 44 patients treated with CRT and followed for 13 +/- 2 months. We tested the ability of preimplant XCA to identify long-term responders to CRT (defined by a decrease in left ventricular end-systolic volume > 15%). Dyssynchrony findings were compared between CRT responders and 83 age-matched control patients with narrow QRS complexes and different levels of systolic cardiac dysfunction. XCA was compared with conventional dyssynchrony analysis based on differences in time-to-peak myocardial velocity. XCA was able to discriminate between long-term responders and nonresponders to CRT (area under the curve [AUC] = 0.66), but not significantly better than conventional analysis (AUC = 0.58). XCA showed large differences between the control groups and the CRT group (P < .01 for all), and had a higher discriminatory ability between normal controls and responders to CRT than conventional analysis (AUC = 0.95 vs 0.75, P < .01). XCA significantly improves the assessment of intraventricular dyssynchrony, and dyssynchrony by this method is associated with positive long-term response to CRT.

Serum melatonin levels in adolescent idiopathic scoliosis prediction and prevention for curve progression – a prospective study

The correlation of serum melatonin levels and curve progression in adolescent idiopathic scoliosis, and the effects of melatonin therapy in scoliotic patients with reduced levels of endogenous melatonin were studied in 40 adolescent patients with moderate to severe idiopathic scoliosis. Of the scoliotic subjects, 28 had stable scoliosis and 12 had progressive scoliosis. Normal melatonin levels were derived from 25 age-matched control patients. Serum melatonin levels were monitored yearly in scoloiotic patients for a period ranging from 3 to 6 yr, revealing a diurnal pattern with low values during the day and high at night. Scoliotic patients with normal levels were not treated or were treated with a brace, and all but two patients with low endogenous melatonin were treated with oral supplements of the indole. Of the 22 patients with a normal melatonin level, 16 had stable scoliosis and six had progressive scoliosis. Of the 16 patients treated for a low melatonin level, 12 had stable scoliosis and four had a progressive course. The two untreated cases had a progressive course. Of the 12 patients who had progressive scoliosis, nine had >35 degrees of curve at initial examination. These findings suggest that melatonin deficiency plays a role in the prognosis of idiopathic scoliosis. Therefore, melatonin supplements may prevent the progression of scoliosis, especially in mild cases with less than a 35 degrees curve.

Risk factors for croup in children with recurrent respiratory infections: a case‐control study

Croup accounts for approximately 15% of all lower respiratory disease in children, but little is known about risk factors or its recurrence rate. The aim of this study was to determine the risk factors for croup and recurrent croup and to find out whether it is possible to predict the course of the disease. We considered croup patients who visited the Paediatric Department of Oulu University Hospital as primary health care patients at night during 1996-2000. For most analyses we used sex- and age-matched control patients who had had other respiratory infection but for environmental factors we used population controls. We performed conditional logistic regression analysis on data applying to 182 pairs of patients and controls. The recurrence rate was high, as 61% of the croup patients had had at least three episodes. Family history of croup was the most significant risk factor for both croup itself and recurrent croup. In multivariable analysis the odds ratio (OR) for the parents having a history of croup was 3.2 (95% CI 1.5, 7.1, P < 0.01) and 4.1 (95% CI 1.4, 11.7, P < 0.01) for recurrent croup. Parental smoking appeared to be a risk factor for respiratory infections but not for croup. Patients with croup had a cat as a pet less often than the controls, with OR 0.5 (95% CI 0.2, 1.0, P = 0.04). Family history appeared to be an exceptionally strong predictive factor for croup and its recurrence. In this patient series prone to respiratory infections recurrence of croup was common.

Safety of intravenous use of ketorolac in infants following cardiothoracic surgery

To evaluate the impact of intravenous ketorolac on renal function and haematologic values in patients less than six months old following cardiothoracic surgery. Ketorolac is a potent nonsteroidal anti-inflammatory drug indicated for short term management of moderate to severe post-operative pain. Little data is available related to its safety in infants less than six months of age. This was a retrospective, case-control chart review of 19 patients aged less than six months of age with biventricular circulations who received intravenous ketorolac following cardiothoracic surgery. They were compared with 19 age-matched control patients. Those with functionally univentricular anatomy were excluded due to their higher risk for renal impairment following surgery. Student's t-test was used to compare the incidence of renal impairment and haematologic complications between the groups, as well as the number of analgesic doses administered. Charts were reviewed for number of blood transfusions. Patients receiving intravenous ketorolac had no statistically significant changes in pre-operative versus post-treatment renal function or haematologic effects compared to the control group. No statistically significant differences were detected for number of post-operative blood transfusions or additional analgesic administration between groups. Intravenous ketorolac appears to be safe when used in infants less than six months of age with biventricular circulations following cardiothoracic surgery. Ketorolac as used in these patients does not decrease the use of standard analgesic therapy.

Autoantibodies against β‐amyloid are common in Alzheimer's disease and help control plaque burden

Active or passive immunization of Alzheimer's disease (AD) patients leads to targeting of beta-amyloid plaques by immunoglobulins (IgG) and their subsequent removal by microglia. Here, we investigate whether naturally occurring autoantibodies to beta-amyloid contribute to beta-amyloid plaque removal in nonimmunized AD patients. We generated an AD tissue microarray with 2,325 tissue specimens from 3 defined central nervous system regions of 48 AD patients and 48 age-matched control patients. Absolute quantification of beta-amyloid, beta-amyloid plaque-bound IgG, and phagocytic, resting, and activated microglia and microhemorrhages was done using a standardized, highly reproducible scoring system. The majority of neuritic plaques are decorated by IgG. AD patients with prominently IgG-labeled neuritic plaques have a significantly reduced plaque burden and an increase in phagocytic microglia, yet no increase in microhemorrhages. Autoantibodies directed against beta-amyloid are common in AD patients and may contribute in controlling plaque burden.

Diabetes mellitus exacerbates motor and sensory impairment in CMT1A

Charcot-Marie-Tooth disease type 1A (CMT1A) is caused by a duplication of PMP22 on chromosome 17 and is the most commonly inherited demyelinating neuropathy. Diabetes frequently causes predominantly sensory neuropathy. Whether diabetes exacerbates CMT1A is unknown. We identified 10 patients with CMT1A and diabetes and compared their impairment with 48 age-matched control patients with CMT1A alone. Comparisons were made with the Charcot-Marie-Tooth disease (CMT) neuropathy score (CMTNS) and by electrophysiology. The CMTNS was significantly higher in patients with diabetes (20.25 +/- 2.35) compared with controls (15.19 +/- 0.69; p = 0.01). Values were particularly higher for motor signs and symptoms. Seven of the 10 diabetic patients had CMTNS >20 (severe CMT), while only 7 of the 48 age-matched controls had scores >20. There was a trend for CMT1A patients with diabetes to have low compound muscle action potentials and sensory nerve action potentials, although nerve conduction velocities were not slower in diabetic patients compared with controls. Diabetes was associated with more severe motor and sensory impairment in patients with CMT1A.

Heat Shock Protein Localisation in Chronic Lymphatic Leukaemia.

Heat Shock Proteins (Hsps) are a highly conserved group of molecular chaperones, the over-expression of which has been well documented in many cancer types. However, the location of these proteins within the cancer cell appears to be crucial in terms of tumour progression. Intracellular Hsp70 expression in particular appears to confer resistance to apoptosis, while surface Hsp70 expression has been shown to aid immune recognition of the cancer cell by NK cells. High intracellular levels of Hsp90 and Hsp27 also contribute to cell survival, while surface Hsp90 and Hsp27 have been shown to be required for tissue invasion and metastasis. However, the importance of these stress proteins in CLL progression is still poorly understood.Using flow cytotmetry, we show that CLL patients express significantly higher levels of iHsp90 in lymphocytes (mean MFI CLL = 2463, Control = 748) and significantly higher levels of iHsp27 in lymphocytes (mean MFI CLL = 2138, Control = 760) than that expressed by age-matched control patients. The expression of iHsp90, but not Hsp27, in these patients was shown to be related to the stage of disease, and patients in Binet stage A appear to have a significantly higher expression than those in Binet stage C (p<0.001).Hsp70 expression in CD5+/CD19+ cells, both intracellular and extracellular, showed either a very high level or a very low level of Hsp70 (see figure below). The high expressing groups were found also to be significantly different (p<0.01) from both the non-malignant cells from the same patients, and normal lymphocytes from age-matched controls. This was not the case for the low expressing groups. iHsp70 expression was also seen to be related to stage of disease as patients in Binet stages A and B were found to express significantly lower levels than those patients in Binet stage C.Hsp expression was shown not to be associated with the apoptotic condition of the cell as analysis of active caspase-3 in CLL patients proved that the majority of the leukocytes were not apoptotic. Furthermore, the mean of fluorescence was significantly less in lymphocytes from CLL patients (mean MFI = 139) than those from control patients (mean MFI = 278).Taken together these results show that Hsp expression changes with the natural progression of the disease and therefore manipulation of Hsps may be beneficial in the treatment of CLL. [Display omitted]

Increased TDP-43 protein in cerebrospinal fluid of patients with amyotrophic lateral sclerosis

There is mounting pathological, biochemical and genetic evidence that the metabolism and aggregation of the 43-kDa transactive response (TAR)-DNA-binding protein (TDP-43) play a crucial role in the pathogenesis of sporadic and some forms of familial amyotrophic lateral sclerosis (ALS). Recently, it was reported using an ELISA system that elevated levels of TDP-43 were detected in plasma samples from patients with Alzheimer's disease and frontotemporal dementia, compared to healthy controls. To determine whether quantification of TDP-43 in cerebrospinal fluid (CSF) is potentially informative in the diagnosis of ALS, we measured the concentration, by a similar ELISA method, of TDP-43 in CSF from 30 patients with ALS (diagnosed according to the revised El Escorial criteria) and 29 age-matched control patients without any neurodegenerative disease. We found that, as a group, the ALS patients had significantly higher levels of TDP-43 in their CSF than the age-matched controls (6.92 +/- 3.71 ng/ml in ALS versus 5.31 +/- 0.94 ng/ml in controls, p < 0.05), with levels of TDP-43 in CSF elevated beyond 95% upper confidence level for the control group in six (20%) of the patients with sporadic ALS. All the six patients with higher levels of CSF TDP-43 were examined within 10 months of the onset of illness. The patients examined within 10 months of onset showed significantly higher levels of CSF TDP-43 (8.24 +/- 4.72 ng/ml) than those examined after 11 months or more of onset (5.41 +/- 0.66 ng/ml, p < 0.05). These results suggest that the levels of TDP-43 in CSF may increase in the early stage of ALS. We also confirmed the existence of the TDP-43 protein in CSF from some patients with ALS, and a control subject, by western blotting of proteins immunocaptured from the CSF samples. Raised TDP-43 levels in the CSF may preempt the formation of TDP-43 pathology in the central nervous system, or correlate with early-stage TDP-43 pathology, and accordingly be a biomarker for the early stage of ALS.

Abstract 2361: Bone Marrow Dysfunction In Chronic Heart Failure Patients Contributes To Impaired Erythropoiesis

Background: We hypothesised that anemia in chronic heart failure (CHF) patients is caused by bone marrow dysfunction. Methods: Bone marrow was harvested during cardiac surgery from 17 patients with CHF (LVEF 32 ± 1.8 %) and 17 age matched control patients with normal cardiac function (LVEF ≥ 55%). Early hematopoietic progenitor cells (CD34 + ) and committed erythroid cells (CD71 bright ), apoptosis (Annexin-V + /DAPI + ) and EPO-receptor (EPO-R) density were quantified by FACS. Erythroid and myeloid colony formation of isolated CD34 + cells was assessed in methylcellulose containing incrementing doses of erythropoietin (EPO) or myeloid cytokines. After 14 days Burst Forming Units Erythroid (BFU-E) or granulocyte and monocyte colonies were quantified. Results: Patients with CHF had lower hemoglobin levels and 35% of CHF patients had anemia. The numbers of CD34 + and CD71 bright cells were 2 fold lower in CHF patients (P &lt; 0.05). Throughout the EPO dose-response range, CD34+ cells of CHF patients produced a 3-fold lower number of BFU-E colonies than controls (figure 1 , P &lt; 0.02). Concomittantly, myeloid colony formation was 2 fold lower in CHF patients as well (P &lt; 0.05). This was associated with markedly increased apoptosis (P &lt; 0.01), but equivalent EPO-receptor expression. Lower BFU-E numbers were independently associated with higher NTproBNP levels (R = − 0.5, P = 0.03). However, BFU-E formation was comparable in anemic and non-anemic CHF patients (P = 0.8). Conclusions : General bone marrow dysfunction in CHF patients contributes to impaired erythropoiesis. Although this might render patients more susceptible to anemia, it does not exclusively explain its occurrence. Impaired erythropoiesis in heart failure patients

Differences in Computed Tomography Density of the Renal Papillae of Stone Formers and Non-Stone-Formers: A Pilot Study

It is thought that Randall's plaques, calcium deposits in the renal papillae of patients with nephrolithiasis, may serve as a nidus for stone formation. We examined the density of renal papillae in patients with stones and control patients using attenuation measurements (HU) on Computed Tomography (CT) to determine whether nephrolithiasis is associated with radiographic changes in renal papillae. Hounsfield density measurements of a 0.2 cm2 area of the renal papillae of 17 patients with a single renal calyceal calculus and 15 age-matched control patients were performed. Measurements were done for renal papillae upper, middle, and lower pole calyces for all patients. Statistical comparisons were made using the student's t-test. Patients with nephrolithiasis and control patients were similar with respect to mean age (41.2 years versus 42.2 years, p=0.82) and baseline serum creatinine (0.86 mg/dl versus 0.93 mg/dl, p=0.21). Mean Hounsfield density of renal papillae of stone patients in calyces with stones was significantly greater than that of location-matched papillae from control patients (54.4 versus 36.6, p<0.0001). Mean Hounsfield density of all papillae of the affected kidney (i.e., kidney with stone) in stone patients was significantly greater than that of control patients (50.9 versus 36.4, p<0.0001). Mean Hounsfield density of all papillae in the stone-free kidney of stone patients was significantly greater than that of control patients (50.0 versus 36.1, p<0.0001). In stone patients, when comparing the affected kidney with the stone-free kidney, there was no difference in mean papilla Hounsfield density (50.3 versus 50.9, p=0.59). Hounsfield density of the renal papilla is significantly increased in patients with nephrolithiasis when compared with age-matched controls. This is true of calyces with stones, calyces without stones in kidneys with stones, and calyces of the contralateral stone-free kidney. There is no difference in renal papilla Hounsfield density between kidneys with and without stones in patients with nephrolithiasis. In the future, this information may be useful in predicting which patients may develop nephrolithiasis.

Serum Amyloid Beta Peptides in Patients with Dementia and Age-Matched Non-Demented Controls as Detected by Surface-Enhanced Laser Desorption Ionisation-Time of Flight Mass Spectrometry (SELDI-TOF MS)

By using surface enhanced laser desorption/ionisation- time of flight mass spectrometry (SELDI-TOF MS) an amyloid beta (Abeta) profile was shown in cerebrospinal fluid (CSF) of patients with dementia. To investigate the Abeta-profile in serum with SELDI-TOF MS, to evaluate if this profile resembles CSF profiles and to investigate the correlation between intensity of Abeta-peptide-peaks in serum and clinical, demographical and genetic variables. Duplicate profiling of Abeta by an SELDI-TOF MS immunocapture assay was performed in 106 patients, suffering from Alzheimer's Disease or Vascular Dementia and age-matched non-demented control patients. Linear regression analyses were performed to investigate the intensities of four selected Abeta peaks as dependent variables in relation to the independent clinical, demographic or genetic variables. Abeta37, Abeta38 and Abeta40 were found among additional unidentified Abeta peptides, with the most pronounced Abeta peak at a molecular mass of 7752. This profile partly resembled the CSF profile. The clinical diagnosis was not a predictive independent variable, however ABCB1 genotypes C1236T, G2677T/A, age and creatinine level showed to be related to Abeta peak intensities in multivariate analyses. We found an Abeta profile in serum that partly resembled the CSF profile in demented patients. Age, creatinine levels, presence of the APOE epsilon4 allele and ABCB1 genotypes (C1236T and G2677T/A) were correlated with the Abeta serum profile. The role of P-gp as an Abeta transporter and the role of ABCB1 genotypes deserves further research. The investigated serum Abeta profile is probably not useful in the diagnosis of dementia.

Unilateral axial length elongation with chronic traumatic cataracts in young Kenyans

To assess whether unilateral axial elongation in chronic traumatic cataract is associated with the time interval from trauma to surgery. PCEA Kikuyu Hospital Eye Unit, Nairobi, Kenya. This retrospective cohort study analyzed patients with traumatic cataract operated on between 1998 and 2007. Study patients (n = 13) had a delay from trauma to surgery of more than 1 year and an interocular axial length (AL) difference greater than 1.0 mm. Randomly selected age-matched control patients (n = 14) had less than 1 year delay between trauma and surgery. The correlation between interocular AL difference and surgical delay was calculated in each group. The median interval from trauma to surgical treatment in study patients was 8 years (range 1 to 27 years). Study patients had a significantly higher median interocular AL difference (3.09 mm; interquartile range [IQR] 2.45 to 4.13 mm) than control patients (0.24 mm; IQR 0.15 to 0.30 mm) (P = .000). The length of delay from trauma to surgical treatment did not correlate strongly with the interocular AL difference in study or control patients (R(2) = 0.0143 and R(2) = 0.1697, respectively). Unilateral AL elongation may occur in young adults with chronic traumatic cataract. Delay of more than 1 year from trauma to surgery was associated with axial elongation, although the degree of elongation did not correlate with duration of delay. Surgeons are advised to implant lower-power intraocular lenses in such patients based on biometry readings to avoid postoperative refractive surprises.