Postmortem angiography after vascular perfusion with diesel oil and a lipophilic contrast agent.

OBJECTIVE: The objective of our study was to establish optimal perfusion conditions for high-resolution postmortem angiography that would permit dynamic visualization of the arterial and venous systems. MATERIALS AND METHODS: Cadavers of two dogs and one cat were perfused with diesel oil through a peristaltic pump. The lipophilic contrast agent Lipiodol Ultra Fluide was then injected, and angiography was performed. The efficiency of perfusion was evaluated in the chick chorioallantoic membrane. RESULTS: Vessels could be seen up to the level of the smaller supplying and draining vessels. Hence, both the arterial and the venous sides of the vascular system could be distinguished. The chorioallantoic membrane assay revealed that diesel oil enters microvessels up to 50 microm in diameter and that it does not penetrate the capillary network. CONCLUSION: After establishing a postmortem circulation by diesel oil perfusion, angiography can be performed by injection of Lipiodol Ultra Fluide. The resolution of the images obtained up to 3 days after death is comparable to that achieved in clinical angiography.

Enhanced recovery pathway for urgent colectomy.

BACKGROUND: Enhanced recovery protocols have been proven to decrease complications and hospital stay following elective colorectal surgery. However, these principles have not yet been reported for urgent surgery procedures. We aimed to assess our initial experience with urgent colectomies performed within an established enhanced recovery pathway. METHODS: In a prospective cohort study, all patients undergoing colonic resection between April 2012 and March 2013 were treated according to a standardized enhanced recovery protocol. Urgent surgeries were compared with the elective procedures with regards to baseline characteristics, compliance with enhanced recovery items, and clinical outcome. RESULTS: Patients (N = 28) requiring urgent colonic resection were included and compared with patients undergoing elective colectomy (N = 63). Overall compliance with the protocol was 57% for the urgent compared with 77% for the elective procedures (p = 0.006). The pre-operative compliance was 64 versus 96% (p < 0.001), the intra-operative compliance was 77 versus 86% (p = 0.145), and the post-operative compliance was 49 versus 67% (p = 0.015), for the urgent and elective resections, respectively. Overall, 18 urgent patients (64%) and 32 elective patients (51%) developed postoperative complications (p = 0.261). Median postoperative length of stay was 8 days in the urgent setting compared with 5 days in the elective setting (p = 0.006). CONCLUSIONS: Many of the intra-operative and post-operative enhanced recovery items can also be applied to urgent colectomy, entailing outcomes that approach the results achieved in the elective setting.

Sublimation of new matrix candidates for high spatial resolution imaging mass spectrometry of lipids: enhanced information in both positive and negative polarities after 1,5-diaminonapthalene deposition.

Matrix sublimation has demonstrated to be a powerful approach for high-resolution matrix-assisted laser desorption ionization (MALDI) imaging of lipids, providing very homogeneous solvent-free deposition. This work presents a comprehensive study aiming to evaluate current and novel matrix candidates for high spatial resolution MALDI imaging mass spectrometry of lipids from tissue section after deposition by sublimation. For this purpose, 12 matrices including 2,5-dihydroxybenzoic acid (DHB), sinapinic acid (SA), α-cyano-4-hydroxycinnamic acid (CHCA), 2,6-dihydroxyacetphenone (DHA), 2',4',6'-trihydroxyacetophenone (THAP), 3-hydroxypicolinic acid (3-HPA), 1,8-bis(dimethylamino)naphthalene (DMAN), 1,8,9-anthracentriol (DIT), 1,5-diaminonapthalene (DAN), p-nitroaniline (NIT), 9-aminoacridine (9-AA), and 2-mercaptobenzothiazole (MBT) were investigated for lipid detection efficiency in both positive and negative ionization modes, matrix interferences, and stability under vacuum. For the most relevant matrices, ion maps of the different lipid species were obtained from tissue sections at high spatial resolution and the detected peaks were characterized by matrix-assisted laser desorption ionization time-of-flight/time-of-flight (MALDI-TOF/TOF) mass spectrometry. First proposed for imaging mass spectrometry (IMS) after sublimation, DAN has demonstrated to be of high efficiency providing rich lipid signatures in both positive and negative polarities with high vacuum stability and sub-20 μm resolution capacity. Ion images from adult mouse brain were generated with a 10 μm scanning resolution. Furthermore, ion images from adult mouse brain and whole-body fish tissue sections were also acquired in both polarity modes from the same tissue section at 100 μm spatial resolution. Sublimation of DAN represents an interesting approach to improve information with respect to currently employed matrices providing a deeper analysis of the lipidome by IMS.

Photodynamic therapy for enhanced drug delivery to tumor

Photodynamic therapy (PDT) has been used as an adjunct to cytoreductive surgery in patients with malignant pleura mesothelioma (MPM). However, it was associated with substantial side effects and found to be only of modest clinical benefit. In contrast, Visudyne®-mediated low-dose PDT has been shown to selectively increase the concentration of macromolecular cytostatic compounds in various tumors grown subpleurally on rodent lungs. Consequently, it was thought that PDT-assisted enhanced tumor penetration for cytostatic agents might be better suited to achieve additional tumor control after cytoreductive surgery for mesothelioma. This effect seems to be mainly related to PDT-mediated modulations of tumor vessels which improve the distribution of circulating, systemically administered chemotherapeutic macromolecular agents. However, the mechanisms involved and the optimization of this effect for therapeutic implications remain to be solved. By using the dorsal skin fold chamber method we demonstrated that both angiogenesis and microcirculation of human mesothelioma xenografts can be continuously assessed in vivo by intravital microscopy. We described a new, simple, reproducible and reliable scoring system for the assessment of tumor angiogenesis and microcirculation in this model, thereby allowing the quantitative description of the neo-vascular network development while avoiding a complicated technical setup. This method can serve as a useful tool for the assessment of novel vessel-targeted therapies against MPM. We then applied this newly established model so as to elucidate the underlying mechanisms of PDT-induced extravasation of macromolecular compounds across the endothelial barrier in tumors and surrounding normal tissue. We found that low-dose PDT selectively enhanced the uptake of macromolecular compounds in human mesothelioma xenografts compared to surrounding normal tissue. Interestingly, this increase of effective permeability of tumor vasculature was not related to the inflammatory stimuli generated by PDT such as the mobilization of leucocytes and their adhesion and penetration of the injured vessel wall. We then used the model for optimizing the drug-light conditions of low- dose PDT in order to obtain maximal leakage of the macromolecular compounds in the tumor with minimal uptake in normal surrounding tissue and we were able to identify such a therapeutic window. With these optimized PDT treatment conditions, we assessed the therapeutic effect of this new treatment concept in vivo by measuring tumor growth rates on subcutaneously grown mesothelioma xenografts in nude mice after low-dose PDT of the tumors following systemically administered liposomal (macromolecular) cisplatin, a cytostatic compound commonly used in clinical practice. We were able to demonstrate that low-dose PDT with optimized drug-light conditions combined with systemic chemotherapy indeed resulted in a reduction in tumor growth compared to chemotherapy or PDT alone. In conclusion, our work demonstrates that low-dose PDT may selectively enhance the uptake of macromolecular cytostatic drugs in superficially growing tumors such as mesotheliomas and opens new perspectives for the treatment of these diseases. - Les effets cytotoxiques de la thérapie photodynamique (PDT) sur le mésothéliome pleural malin (MPM) n'ont pas apporté de bénéfice clinique significatif. Toutefois, une application innovante non cytotoxique de la PDT serait la bienvenue en supplément des chimiothérapies pour améliorer le contrôle local de la tumeur. Le prétraitement des néovaisseaux tumoraux par une PDT à bas régime, qui améliorerait la distribution d'une chimiothérapie administrée par voie systémique de façon concomitante, a attiré une attention particulière pour de futures applications cliniques. Toutefois, les mécanismes impliqués dans cet événement et les implications thérapeutiques de ces changements physiopathologiques restent non résolus. Dans cette thèse, nous avons observé en premier que l'angiogenèse et la microcirculation dans les xénogreffes de mésothéliomes humains peuvent être observées et analysées in vivo par microscopie intravitale. Le nouveau système de score appliqué pour l'évaluation de l'angiogenèse et de la microcirculation tumorale dans cette étude est une méthode simple, reproductible et fiable servant à décrire de manière quantitative le réseau néo-vasculaire en développement, tout en évitant d'utiliser une installation technique compliquée. Ce modèle sert de nouvel outil pour l'évaluation des thérapies anti-vasculaires dirigées contre le MPM. Le modèle animal nouvellement établi a alors été utilisé pour élucider les mécanismes sous-jacents de Γ extravasation d'agents macromoléculaires induite par PDT dans les vaisseaux tumoraux et normaux. Nous avons trouvé que la PDT à fable dose améliore la distribution ciblée de drogues macromoléculaires dans des greffes de mésothéliome humain, de manière sélective pour la tumeur. La perméabilité vasculaire tumorale n'est pas influencée par les stimuli inflammatoires générés par la PDT, ce qui joue un rôle important dans la sélectivité de notre photodynamic drug delivery. Ensuite, nous avons recherché la fenêtre thérapeutique optimale de la PDT pour obtenir une accumulation sélective du colorant macromoléculaire dans le tissu tumoral ainsi qu'une efficacité de la PDT combinée avec une chimiothérapie macromoléculaire sur la croissance tumorale. Nous avons démontré que la PDT à faible dose combinée avec une administration systémique de cisplatine liposomale mène à un ralentissement de la croissance tumorale dans notre modèle de mésothéliome malin humain. En conclusion, l'utilisation de la PDT comme prétraitement pour améliorer sélectivement la distribution d'agents thérapeutiques dans des tumeurs poussant superficiellement est prometteuse. Cette observation fourni une preuve du concept remarquable et garanti la suite des investigations, éventuellement ayant pour but de développer de nouveaux concepts de thérapie pour les patients atteints de mésothéliome. Une PDT intra cavitaire à faible dose après pleuro- pneumonectomie pourrait améliorer la pénétration des agents cytostatiques administrés de façon concomitante par voie systémique dans les îlots tumoraux résiduels, et ainsi améliorer le contrôle local.

Low latitude Paleocene to early Eocene radiolarian systematics, biochronology and paleoenvironmental analysis

Highly diverse radiolarian faunas of latest Maastrichtian to early Eocene age have been recovered from the low latitude realm in order to contribute to the clarification of radiolarian taxonomy, construct a zonation based on a discrete sequence of co-existence intervals of species ranging from the late Paleocene to early Eocene and to describe a rich low latitude latest Cretaceous to late Paleocene fauna. 225 samples of late Paleocene to early Eocene age have been collected from ODP Leg 171 B-Hole 1051 A (Blake Nose), DSDP Leg 43-Site 384 (Northwest Atlantic) and DSDP Leg 10-Sites 86, 94, 95, 96. Sequences consist of mainly pelagic oozes and chalks, with some clay and ash layers. A new imaging technique is devised to perform (in particular on topotypic material) both transmitted light microscopy and SEM imaging on individual radiolarian specimens. SEM precedes transmitted light imaging. Radiolarians are adhered to a cover slip (using nail varnish) which is secured to a stub using conductive levers. Specimens are then photographed in low vacuum (40-50Pa; 0.5mbar), which enables charge neutralization by ionized molecules of the chamber atmosphere. Thus gold coating is avoided and subsequently this allows transmitted light imaging to follow. The conductive levers are unscrewed and the cover slip is simply overturned and mounted with Canada balsam. In an attempt towards a post-Haeckelian classification, the initial spicule (Entactinaria), micro- or macrosphere (Spumellaria) and initial spicule and cephalis (Nassellaria) have been studied by slicing Entactinaria and Spumellaria, and by tilting Nassellaria in the SEM chamber. A new genus of the family Coccodiscidae is erected and Spongatractus HAECKEL is re-located to the subfamily Axopruinae. The biochronology has been carried out using the Unitary Association Method (Guex 1977, 1991). A database recording the occurrences of 112 species has been used to establish a succession of 22 Unitary Associations. Each association is correlated to chronostratigraphy via calcareous microfossils that were previously studied by other authors. The 22 UAs have been united into seven Unitary Associations Zones (UAZones) (JP10- JE4). The established zones permit to distinguish supplementary subdivisions within the existing zonation. The low-latitude Paleocene radiolarian zonation established by Sanfilippo and Nigrini (1998a) is incomplete due to the lack of radiolarian-bearing early Paleocene sediments. In order to contribute to the study of sparsely known low latitude early Paleocene faunas, 80 samples were taken from the highly siliceous Guayaquil Formation (Ecuador). The sequence consists of black cherts, shales, siliceous limestones and volcanic ash layers. The carbonate content increases up section. Age control is supplied by sporadic occurrences of silicified planktonic foraminifera casts. One Cretaceous zone and seven Paleocene zones have been identified. The existing zonation for the South Pacific can be applied to the early-early late Paleocene sequence, although certain marker species have significantly shorter ranges (notably Buryella foremanae and B. granulata). Despite missing marker species in the late Paleocene, faunal distribution correlates reasonably to the Low-Latitude zonation. An assemblage highly abundant in Lithomelissa, Lophophaena and Cycladophora in the upper RP6 zone (correlated by the presence of Pterocodon poculum, Circodiscus circularis, Pterocodon? sp. aff. P. tenellus and Stylotrochus nitidus) shows a close affinity to contemporaneous faunas reported from Site 1121, Campbell Plateau. Coupled with a high diatom abundance (notably Aulacodiscus spp. and Arachnoidiscus spp.), these faunas are interpreted as reflecting a period of enhanced biosiliceous productivity during the late Paleocene. The youngest sample is void of radiolarians, diatoms and sponge spicules yet contains many pyritized infaunal benthic foraminifera which are akin to the midway-type fauna. The presence of this fauna suggests deposition in a neritic environment. This is in contrast to the inferred bathyal slope depositional environment of the older Paleocene sediments and suggests a shoaling of the depositional environment which may be related to a coeval major accretionary event. RESUME DE LA THESE Des faunes de radiolaires de basses latitudes très diversifiées d'âge Maastrichtien terminal à Eocène inférieur, ont été étudiées afin de contribuer à la clarification de leur taxonomie, de construire une biozonation basée sur une séquence discrète d'intervalles de coexistence des espèces d'age Paléocène supérieur à Eocène inférieur et de décrire une riche faune de basse latitude allant du Crétacé terminal au Paléocène supérieur. L'étude de cette faune contribue particulièrement à la connaissance des insaisissables radiolaires de basses latitudes du Paléocène inférieur. 225 échantillons d'âge Paléocène supérieur à Eocène inférieur provenant des ODP Leg 171B-Site 1051A (Blake Nose), Leg DSDP 43-Site 384 (Atlantique Nord -Ouest) et des DSDP Leg 10 -Sites 86, 94, 95, 96, ont été étudiés. Ces séquences sont constituées principalement de « ooze » et de « chalks »pélagiques ainsi que de quelques niveaux de cendres et d'argiles. Une nouvelle technique d'imagerie a été conçue afin de pouvoir prendre conjointement des images en lumière transmise et au Microscope Electronique à Balayage (MEB) de spécimens individuels. Ceci à été particulièrement appliqué à l'étude des topotypes. L'imagerie MEB précède l'imagerie en lumière transmise. Les radiolaires sont collés sur une lame pour micropaléontologie (au moyen de vernis à ongles) qui est ensuite fixée à un porte-objet à l'aide de bras métalliques conducteurs. Les spécimens sont ensuite photographiés en vide partiel (40-50Pa; 0.5mbar), ce qui permet la neutralisation des charges électrostatiques dues à la présence de molécules ionisées dans l'atmosphère de la chambre d'observation. Ainsi la métallisation de l'échantillon avec de l'or n'est plus nécessaire et ceci permet l'observation ultérieure en lumière transmise. Les bras conducteurs sont ensuite dévissés et la lame est simplement retournée et immergée dans du baume du Canada. Dans une approche de classification post Haeckelienne, le spicule initial (Entactinaires), la micro- ou macro -sphère (Spumellaires) et le spicule initial et cephalis (Nassellaires) ont été étudiés. Ceci a nécessité le sectionnement d'Entactinaires et de Spumellaires, et de pivoter les Nassellaires dans la chambre d'observation du MEB. Un nouveau genre de la Famille des Coccodiscidae a été érigé et Spongatractus HAECKEL à été réassigné à la sous-famille des Axopruninae. L'analyse biostratigraphique à été effectuée à l'aide de la méthode des Associations Unitaires {Guex 1977, 1991). Une base de données enregistrant les présences de 112 espèces à été utilisée poux établir une succession de 22 Associations Unitaires. Chaque association est corrélée à la chronostratigraphie au moyen de microfossiles calcaires précédemment étudiés par d'autres auteurs. Les 22 UAs ont été combinées en sept Zones d'Associations Unitaires (UAZones) (JP10- JE4). Ces Zones permettent d'insérer des subdivisions supplémentaires dans la zonation actuelle. La zonation de basses latitudes du Paléocène établie par Sanfilippo et Nigrini (1998a) est incomplète due au manque de sédiments du Paléocène inférieur contenant des radiolaires. Afin de contribuer à l'étude des faunes peu connues des basses latitudes du Paléocène inférieur, 80 échantillons ont été prélevés d'une section siliceuse de la Formation de Guayaquil (Equateur). La séquence est composée de cherts noirs, de shales, de calcaires siliceux et de couches de cendres volcaniques. La fraction carbonatée augmente vers le haut de la section. Des contraintes chronologiques sont fournies par la présence sporadique de moules de foraminifères planctoniques. Une zone d'intervalles du Crétacé et sept du Paléocène ont été mises en évidence. Bien que certaines espèces marqueur ont des distributions remarquablement plus courtes (notamment Buryella foremanae et B. granulata), la zonation existante pour le Pacifique Sud est applicable à la séquence d'age Paléocène inférieure à Paléocène supérieur basal étudiée. Malgré l'absence d'espèces marqueur du Paléocène supérieur, la succession faunistique se corrèle raisonnablement avec la zonation pour les basses latitudes. Un assemblage contenant d'abondants représentant du genre Lithomelissa, Lophophaena et Cycladophora dans la zone RP6 (correlée par la présence de Pterocodon poculum, Circodiscus circularis, Pterocodon? sp. aff. P. tenellus et Stylotrochus nitidus) montre une grande similitude avec certaines faunes issues des hauts latitudes et d'age semblable décrites par Hollis (2002, Site 1121, Campbell Plateau). Ceci, en plus d'une abondance importante en diatomés (notamment Aulacodiscus spp. et Arachnoidiscus spp.) nous mènent à interpréter cette faune comme témoin d'un épisode de productivité biosiliceuse accrue dans le Paléocène supérieur. L'échantillon le plus jeune, dépourvu de radiolaires, de diatomés et de spicules d'éponge contient de nombreux foraminifères benthiques infaunaux pyritisés. Les espèces identifiées sont caractéristiques d'une faune de type midway. La présence de ces foraminifères suggère un environnement de type néritique. Ceci est en contraste avec l'environnement de pente bathyale caractérisent les sédiments sous-jacent. Cette séquence de diminution de la tranche d'eau peut être associée à un événement d'accrétion majeure. RESUME DE LA THESE (POUR LE GRAND PUBLIC) Les radiolaires constituent le groupe de plancton marin le plus divers et le plus largement répandu de l'enregistrement fossile. Un taux d'évolution rapide et une variation géographique considérable des populations font des radiolaires un outil de recherche sans égal pour la biostratigraphie et la paléocéanographie. Néanmoins, avant de pouvoir les utiliser comme outils de travail, il est essentiel d'établir une solide base taxonomique. L'étude des Radiolaires peut impliquer plusieurs techniques d'extraction, d'observation et d'imagerie qui sont dépendantes du degré d'altération diagénétique des spécimens. Le squelette initial, qu'il s'agisse d'un spicule initial (Entactinaria), d'une micro- ou macro -sphère (Spumellaria) ou d'un spicule initial et d'un cephalis (Nassellaria), est l'élément le plus constant au cours de l'évolution et devrait représenter le fondement de la systématique. Des échantillons provenant de carottes de basses latitudes du Deep Sea Drilling Project et de l' Ocean Drilling ont été étudiés. De nouvelles techniques d'imagerie et de sectionnement ont été développées sur des topotypes de radiolaires préservés en opale, dans le but d'étudier les caractéristiques de leur squelette initial qui n'étaient pas visibles dans leur illustration originale. Ceci aide entre autre à comparer des spécimens recristallisés en quartz, provenant de terrains accrétés, avec les holotypes en opale de la littérature. La distribution des espèces étudiés a fourni des données biostratigraphiques qui ont été compilées à l'aide de la méthode des Associations Unitaires (Guez 1977, 1991). Il s'agit d'un modèle mathématique déterministe conçu pour exploiter la totalité de l'assemblage plutôt que de se confiner à l'utilisation de taxons marqueurs individuels. Une séquence de 22 Associations Unitaires a été établie pour la période allant du Paléocène supérieur à l'Éocène inférieur. Chaque Association Unitaire a été corrélée à l'échelle de temps absolue à l'aide de microfossiles calcaires. Les 22 UAs ont été combinées en sept Zones d'Associations Unitaires (JP10- JE4). Ces Zones permettent d'insérer des subdivisions supplémentaires dans la zonation actuelle. Les radiolaires du Paléocène inférieur à moyen des basses latitudes sont rares. Les meilleures sections connues se trouvent dans les hautes latitudes (Nouvelle Zélande). Quelques assemblages épars ont été mentionnés par le passé en Californie, en Équateur et en Russie. Une séquence siliceuse de 190 mètres dans la Formation de Guayaquil (Équateur), s'étendant du Maastrichtien supérieur au Paléocène supérieur, a fourni des faunes relativement bien préservées. L'étude de ces faunes a permis de mettre en évidence la première séquence complète de radiolaires de basses latitudes dans le Paléocène inférieure. Huit zones allant du Crétacé terminal au Paléocène supérieur ont pu être appliqués et la présence de foraminifères planctoniques a fournie plusieurs points d'attache chronologiques. Dans le Paléocène supérieur, un riche assemblage contenant d'abondants diatomés et radiolaires ayant des similitudes faunistiques marquantes avec des assemblages de hautes latitudes de Nouvelle Zélande, témoigne d'un épisode de productivité biosiliceuse accrue pendant cette période. Étant donné que la pointe du continent sud-américain et l'Antarctique étaient plus proches au cours du Paléocène, ce phénomène peut être expliqué par le transport, le long de la côte ouest de l'Amérique du Sud, d'eaux riches en nutriments en provenance de l'Océan Antarctique. Suite à cet épisode, l'enregistrement en radiolaires est interrompu. Ceci peut être associé à des événements tectoniques régionaux qui ont eu pour effet de diminuer la tranche d'eau relative, rendant l'environnement plus favorable aux foraminifères benthiques qui sont abondamment présents dans l'échantillon le plus jeune de la séquence.

Direct comparison of 3D spiral vs. Cartesian gradient-echo coronary magnetic resonance angiography.

While 3D thin-slab coronary magnetic resonance angiography (MRA) has traditionally been performed using a Cartesian acquisition scheme, spiral k-space data acquisition offers several potential advantages. However, these strategies have not been directly compared in the same subjects using similar methodologies. Thus, in the present study a comparison was made between 3D coronary MRA using Cartesian segmented k-space gradient-echo and spiral k-space data acquisition schemes. In both approaches the same spatial resolution was used and data were acquired during free breathing using navigator gating and prospective slice tracking. Magnetization preparation (T(2) preparation and fat suppression) was applied to increase the contrast. For spiral imaging two different examinations were performed, using one or two spiral interleaves, during each R-R interval. Spiral acquisitions were found to be superior to the Cartesian scheme with respect to the signal-to-noise ratio (SNR) and contrast-to-noise-ratio (CNR) (both P < 0.001) and image quality. The single spiral per R-R interval acquisition had the same total scan duration as the Cartesian acquisition, but the single spiral had the best image quality and a 2.6-fold increase in SNR. The double-interleaf spiral approach showed a 50% reduction in scanning time, a 1.8-fold increase in SNR, and similar image quality when compared to the standard Cartesian approach. Spiral 3D coronary MRA appears to be preferable to the Cartesian scheme. The increase in SNR may be "traded" for either shorter scanning times using multiple consecutive spiral interleaves, or for enhanced spatial resolution.

Genome-wide association study identifies six new loci influencing pulse pressure and mean arterial pressure.

Numerous genetic loci have been associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP) in Europeans. We now report genome-wide association studies of pulse pressure (PP) and mean arterial pressure (MAP). In discovery (N = 74,064) and follow-up studies (N = 48,607), we identified at genome-wide significance (P = 2.7 × 10(-8) to P = 2.3 × 10(-13)) four new PP loci (at 4q12 near CHIC2, 7q22.3 near PIK3CG, 8q24.12 in NOV and 11q24.3 near ADAMTS8), two new MAP loci (3p21.31 in MAP4 and 10q25.3 near ADRB1) and one locus associated with both of these traits (2q24.3 near FIGN) that has also recently been associated with SBP in east Asians. For three of the new PP loci, the estimated effect for SBP was opposite of that for DBP, in contrast to the majority of common SBP- and DBP-associated variants, which show concordant effects on both traits. These findings suggest new genetic pathways underlying blood pressure variation, some of which may differentially influence SBP and DBP.

RpoN (sigma54) controls production of antifungal compounds and biocontrol activity in Pseudomonas fluorescens CHA0.

Pseudomonas fluorescens CHA0 is an effective biocontrol agent of root diseases caused by fungal pathogens. The strain produces the antibiotics 2,4-diacetylphloroglucinol (DAPG) and pyoluteorin (PLT) that make essential contributions to pathogen suppression. This study focused on the role of the sigma factor RpoN (sigma54) in regulation of antibiotic production and biocontrol activity in P. fluorescens. An rpoN in-frame-deletion mutant of CHAO had a delayed growth, was impaired in the utilization of several carbon and nitrogen sources, and was more sensitive to salt stress. The rpoN mutant was defective for flagella and displayed drastically reduced swimming and swarming motilities. Interestingly, the rpoN mutant showed a severalfold enhanced production of DAPG and expression of the biosynthetic gene phlA compared with the wild type and the mutant complemented with monocopy rpoN+. By contrast, loss of RpoN function resulted in markedly lowered PLT production and plt gene expression, suggesting that RpoN controls the balance of the two antibiotics in strain CHA0. In natural soil microcosms, the rpoN mutant was less effective in protecting cucumber from a root rot caused by Pythium ultimum. Remarkably, the mutant was not significantly impaired in its root colonization capacity, even at early stages of root infection by Pythium spp. Taken together, our results establish RpoN for the first time as a major regulator of biocontrol activity in Pseudomonas fluorescens.

Dietary restriction affects lifespan but not cognitive aging in Drosophila melanogaster.

Summary Dietary restriction extends lifespan in a wide variety of animals, including Drosophila, but its relationship to functional and cognitive aging is unclear. Here, we study the effects of dietary yeast content on fly performance in an aversive learning task (association between odor and mechanical shock). Learning performance declined at old age, but 50-day-old dietary-restricted flies learned as poorly as equal-aged flies maintained on yeast-rich diet, even though the former lived on average 9 days (14%) longer. Furthermore, at the middle age of 21 days, flies on low-yeast diets showed poorer short-term (5 min) memory than flies on rich diet. In contrast, dietary restriction enhanced 60-min memory of young (5 days old) flies. Thus, while dietary restriction had complex effects on learning performance in young to middle-aged flies, it did not attenuate aging-related decline of aversive learning performance. These results are consistent with the hypothesis that, in Drosophila, dietary restriction reduces mortality and thus leads to lifespan extension, but does not affect the rate with which somatic damage relevant for cognitive performance accumulates with age.

Did tool-use evolve with enhanced physical cognitive abilities?

The use and manufacture of tools have been considered to be cognitively demanding and thus a possible driving factor in the evolution of intelligence. In this study, we tested the hypothesis that enhanced physical cognitive abilities evolved in conjunction with the use of tools, by comparing the performance of naturally tool-using and non-tool-using species in a suite of physical and general learning tasks. We predicted that the habitually tool-using species, New Caledonian crows and Galápagos woodpecker finches, should outperform their non-tool-using relatives, the small tree finches and the carrion crows in a physical problem but not in general learning tasks. We only found a divergence in the predicted direction for corvids. That only one of our comparisons supports the predictions under this hypothesis might be attributable to different complexities of tool-use in the two tool-using species. A critical evaluation is offered of the conceptual and methodological problems inherent in comparative studies on tool-related cognitive abilities.

KIR-associated protection from CMV replication requires pre-existing immunity: a prospective study in solid organ transplant recipients.

Previous studies have associated activating Killer cell Immunoglobulin-like Receptor (KIR) genes with protection from cytomegalovirus (CMV) replication after organ transplantation. Whether KIR-associated protection is operating in the context of primary infection, re-activation, or both, remains unknown. Here we correlated KIR genotype and CMV serostatus at the time of transplantation with rates of CMV viremia in 517 heart (n=57), kidney (n=223), liver (n=165) or lung (n=72) allograft recipients reported to the Swiss Transplant Cohort Study. Across the entire cohort we found B haplotypes-which in contrast to A haplotypes may contain multiple activating KIR genes-to be protective in the most immunosuppressed patients (receiving anti-thymocyte globulin induction and intensive maintenance immunosuppression) (hazard ratio after adjustment for covariates 0.46, 95% confidence interval 0.29-0.75, P=0.002). Notably, a significant protection was detected only in recipients who were CMV-seropositive at the time of transplantation (HR 0.45, 95% CI 0.26-0.77, P=0.004), but not in CMV seronegative recipients (HR 0.59, 95% CI 0.22-1.53, P=0.28). These data indicate a prominent role for KIR-and presumably natural killer (NK) cells-in the control of CMV replication in CMV seropositive organ transplant recipients treated with intense immunosuppression.

Viral- and myelin-specific cellular immune response in patients treated with natalizumab: a cross-sectional and a longitudinal prospective study

Introduction: Natalizumab, a monoclonal antibody binding to the alpha4 integrins, is efficient in preventing relapses and progression of disability in multiple sclerosis (MS) patients. However, a total of seven MS patients treated with natalizumab suffered from progressive multifocal leukoencephalopathy (PML), on a total of 53?000 patients (data of March 6, 2009) treated with this drug. PML is a disease affecting immunosuppressed people, which is caused by the polyomavirus JC (JCV). This virus produces a lytic infection of the oligodendrocytes. Yet, natalizumab cannot be considered as a classical immunosuppressant, such as suggested by the fact that no increased incidence of other opportunistic infections was reported with this drug. It has been postulated that, by closing the blood-brain, natalizumab might prevent JCV-specific CD8_ T cells to reach the CNS and perform immune surveillance. Alternatively, it has been suggested that this drug acts by releasing JCV from the bone marrow, one of its site of latency. In this study, we address the question whether there is an increased activity of JCV in the blood of natalizumab-treated MS patients. Material and Methods: In this prospective longitudinal study, we are following a cohort of 24 MS patients receiving monthly injections of natalizumab. Blood and urine are drawn every one to three months, up to 12 months. As a control group, we follow 16 MS patients treated with IFN-beta. For this control group, there are two time-points: before and 1094 months after treatment onset. We are analysing the viral (JCV-, EBV- and CMV-) as well as the myelin- (MOG-, MOBP-) specific cellular immune responses using proliferation and ELISPOT (IFNgamma) assays. For JCV, we study the response against VP1, the major capsid protein. For JCV VP1, MOG and MOBP, we use 15-mer peptides overlapping by 10 amino acids, thus eliciting CD4_ as well as CD8_ T cell response. These peptides encompasse the whole sequence of the proteins. For EBV and CMV, we use pools of immunodominant 8- to 10-mer peptides eliciting CD8_ T cells. At the same time-points, using RTPCR, we determine the presence of JCV DNA coding for the VP1 protein in the PBMC, plasma, and urine. Results: At the time of writing this abstract, 16 patients have reached the 9-month (T9), and 11 the T12 time-point. We expect that by the ISNV meeting in June 2009, 18 and 14 patients will be at T9 and T12, respectively. Virological and immunological results will be presented. 9th International Symposium on NeuroVirology 2_6 June 2009 39 J Neurovirol Downloaded from informahealthcare.com by Cantonale et Universitaire on 06/25/10 For personal use only. Conclusions: This ongoing longitudinal prospective study should tell us whether there is an enhanced JCV activity in the peripheral blood of patients on natalizumab. This work is supported by the FNS (PP00B-106716), the Swiss MS Society and a research grant from Biogen Dompe.

Image quality assessment in digital mammography: part II. NPWE as a validated alternative for contrast detail analysis.

Assessment of image quality for digital x-ray mammography systems used in European screening programs relies mainly on contrast-detail CDMAM phantom scoring and requires the acquisition and analysis of many images in order to reduce variability in threshold detectability. Part II of this study proposes an alternative method based on the detectability index (d') calculated for a non-prewhitened model observer with an eye filter (NPWE). The detectability index was calculated from the normalized noise power spectrum and image contrast, both measured from an image of a 5 cm poly(methyl methacrylate) phantom containing a 0.2 mm thick aluminium square, and the pre-sampling modulation transfer function. This was performed as a function of air kerma at the detector for 11 different digital mammography systems. These calculated d' values were compared against threshold gold thickness (T) results measured with the CDMAM test object and against derived theoretical relationships. A simple relationship was found between T and d', as a function of detector air kerma; a linear relationship was found between d' and contrast-to-noise ratio. The values of threshold thickness used to specify acceptable performance in the European Guidelines for 0.10 and 0.25 mm diameter discs were equivalent to threshold calculated detectability indices of 1.05 and 6.30, respectively. The NPWE method is a validated alternative to CDMAM scoring for use in the image quality specification, quality control and optimization of digital x-ray systems for screening mammography.

AltitudeOmics: enhanced cerebrovascular reactivity and ventilatory response to CO2 with high-altitude acclimatization and reexposure.

The present study is the first to examine the effect of high-altitude acclimatization and reexposure on the responses of cerebral blood flow and ventilation to CO2. We also compared the steady-state estimates of these parameters during acclimatization with the modified rebreathing method. We assessed changes in steady-state responses of middle cerebral artery velocity (MCAv), cerebrovascular conductance index (CVCi), and ventilation (V(E)) to varied levels of CO2 in 21 lowlanders (9 women; 21 ± 1 years of age) at sea level (SL), during initial exposure to 5,260 m (ALT1), after 16 days of acclimatization (ALT16), and upon reexposure to altitude following either 7 (POST7) or 21 days (POST21) at low altitude (1,525 m). In the nonacclimatized state (ALT1), MCAv and V(E) responses to CO2 were elevated compared with those at SL (by 79 ± 75% and 14.8 ± 12.3 l/min, respectively; P = 0.004 and P = 0.011). Acclimatization at ALT16 further elevated both MCAv and Ve responses to CO2 compared with ALT1 (by 89 ± 70% and 48.3 ± 32.0 l/min, respectively; P < 0.001). The acclimatization gained for V(E) responses to CO2 at ALT16 was retained by 38% upon reexposure to altitude at POST7 (P = 0.004 vs. ALT1), whereas no retention was observed for the MCAv responses (P > 0.05). We found good agreement between steady-state and modified rebreathing estimates of MCAv and V(E) responses to CO2 across all three time points (P < 0.001, pooled data). Regardless of the method of assessment, altitude acclimatization elevates both the cerebrovascular and ventilatory responsiveness to CO2. Our data further demonstrate that this enhanced ventilatory CO2 response is partly retained after 7 days at low altitude.

The early IL-4 response to Leishmania major responsible for progressive disease in BALB/c mice is subject to the control of autocrine IL-2 production and regulatory CD4+C25+ T cells

Résumé : La majorité des souches de souris de laboratoire sont résistantes à l'infection par le parasite Leishmania major (L. major). A l'opposé, les souris de la souche BALB développent une maladie évolutive. La résistance et la sensibilité sont corrélées avec l'apparition de lymphocytes T CD4+ spécifiques du parasite, Th1 (de l'anglais T helper) ou Th2 respectivement. La réponse aberrante Th2 chez les souris de la souche BALB/c dépend, au moins en partie, de façon critique de la production rapide d'IL-4 suite à l'infection. Ce pic précoce d'IL-4 est produit par une population de lymphocytes T CD4+ restreinte aux molécules du MHC de classe II, exprimant les chaînes du récepteur des cellules T Vß4-Va8. Ces lymphocytes sont spécifiques d'un épitope de l'homologue Leishmania de la molécule RACK1 des mammifères, appelée LACK. Il a été clairement démontré que l'IL-4 rapidement produite par ces cellules T CD4+ Vß4-Va8 induit la maturation Th2 responsable de la sensibilité vis-à-vis de L. major. Des expériences ont été entreprises pour étudier la régulation de cette réponse précoce d'IL-4. Dans ce travail, nous avons documenté, dans les cellules provenant des ganglions de souris sensibles infectées par L. major, une augmentation de la transcription de l'ARNm de l'IL-2 qui précède la réponse précoce d'IL-4. La neutralisation de l'IL-2 durant les premiers jours d'infection induit la maturation des cellules Thl et la résistance vis-à-vis de L. major. Ces effets de l'anticorps anti-IL-2 neutralisant sont liés à sa capacité d'interférer avec la transcription rapide d'IL-4 des cellules CD4+ réactives à l'antigène LACK. Une augmentation similaire d'IL-2 survient chez les souris résistantes C57BL/6 qui sont incapables de générer la réponse précoce d'IL-4. Cependant, la protéiné LACK induit une transcription précoce d'IL-2 uniquement chez les souris sensibles. Des expériences de reconstitution utilisant des souris C.B.-17 SCID et des cellules T CD4+ réactives à LACK provenant de souris BALB/c IL-2-~démontrent un mode d'action autocrine de l'IL-2 sur la régulation de la réponse précoce d'IL4. Par conséquent, chez les souris C57BL/6, l'absence du pic précoce d'ARNm de l'IL-4 important pour la progression de la maladie paraît liée à l'incapacité des cellules T CD4+ réactives à LACK de produire de l'IL-2. Un rôle dans le contrôle de la production précoce d'IL-4 par les cellules T régulatrices CD4+CD25+ a été investigué en déplétant in vivo cette population de cellules. La déplétion induit une élévation du pic précoce de l'ARNm de l'IL-4 dans les ganglions drainant de souris BALB/c, ainsi qu'une exacerbation du cours de la maladie avec des taux augmentés d'IL-4 dans les ganglions. La réponse rapide d'IL-2 vis-à-vis de L. major est aussi significativement augmentée chez les souris BALB/c déplétées en cellules CD4+CD25+. De plus, nous avons démontré que le transfert de 10puissance(7) cellules provenant de la rate de souris BALB/c déplétées en cellules T régulatrices CD4+CD25+ rend les souris SCID sensibles à l'infection et permet la différentiation Th2. Au contraire, les souris SCID reconstituées avec 10' cellules de la rate de souris BALB/c contrôle sont résistantes à infection par L. major et développent une réponse Thl. Chez les souris SCID reconstituées avec des cellules de rate déplétées en cellules exprimant le marqueur CD25, le traitement avec un anticorps neutralisant l'IL-4 au moment de l'infection par L. major prévient le développement de la réponse Th2 et rend ces souris résistantes à l'infection. Ces résultats démontrent que les cellules T régulatrices CD4+CD25+ jouent un rôle dans la régulation du pic précoce d'IL-4 responsable du développement cellulaire Th2 dans ce modèle d'infection. Summary Mice from most strains are resistant to infection with Leishmania major (L. major). In contrast, BALB mice develop progressive disease. Resistance and susceptibility result from parasite-specific CD4+ Thl or Th2 cells, respectively. The aberrant Th2 response in BALB/c mice depends, at least in part, upon the production of IL-4 early after infection. The CD4+ T cells responsible for this early IL-4 response to L. major express a restricted TCR repertoire (Vß4-Va8) and respond to an I-Ad-restricted epitope of the Leishmania homologue of mammalian RACK1, designated LACK. The role of these cells and the IL-4 they produce for subsequent Th2 cell development and disease progression in BALB/c mice was demonstrated. Experiments have been undertaken to study the regulation of the rapid IL-4 production to L. major. In this report, we document an IL-2 mRNA burst, preceding the reported early IL-4 response, in draining lymph nodes of susceptible mice infected with L. major. Neutralization of IL-2 during the first days of infection redirected Thl cell maturation and resistance to L. major, through interference with the rapid IL-4 transcription in LACKreactive CD4+ cells. A burst of IL-2 transcripts also occurred in infected C57BL/6 mice that do not mount an early IL-4 response. However, although the LACK protein induced IL-2 transcripts in susceptible mice, it failed to trigger this response in resistant C57BL/6 mice. Reconstitution experiments using C.B.-17 SCID mice and LACK-reactive CD4+ T cells from IL-2-/- BALB/c mice showed that triggering of the early IL-4 response required autocrine IL2. Thus, in C57BL/6 mice, the inability of LACK-reactive CD4+ T cells to express early IL-4 mRNA transcription, important for disease progression, appears due to an incapacity of these cells to produce IL-2. A role for CD4+CD25+ regulatory T cells in the control of this early IL-4 production was investigated by depleting in vivo this regulatory T cell population. Depletion induced an increase in the early burst of IL-4 mRNA in the draining lymph nodes of BALB/c mice, and exacerbated the course of disease with higher levels of IL-4 mRNA and protein in their lymph nodes. The rapid IL-2 response to L. major is also significantly enhanced in BALB/c mice depleted of CD4+CD25+ cells. We further showed that transfer of 10~ BALB/c spleen cells that were depleted of CD4+CD25+ regulatory T cells rendered SCID mice susceptible to infection and allowed Th2 differentiation while SCID mice reconstituted with 10 control BALB/c spleen cells were resistant to infection with L. major and developed a Thl response. Treatment with a mAb against IL-4 upon infection with L. major in SCID mice reconstituted with CD25-depleted spleen cells prevented the development of Th2 polarization and rendered them resistant to infection. These results demonstrate that CD4+CD25+ regulatory T cells play a role in regulating the early IL-4 mRNA and the subsequent development of a Th2 response in this model of infection.