Analisi clinica ed ex-vivo dei punti isometrici durante tecnica tightrope nella ricostruzione del legamento crociato craniale del cane

La rottura del Legamento Crociato Craniale (LCCr) rappresenta una delle patologie ortopediche di maggiore riscontro clinico nella specie canina. In seguito a rottura del LCCr si presenta un continuo slittamento craniale della tibia il quale esita in un processo osteoartrosico. La risoluzione chirurgica rappresenta la migliore soluzione terapeutica. Le tecniche chirurgiche extra-articolari con sfruttamento dei punti isometrici del ginocchio si presentano come delle procedure molto diffuse e utilizzate. Questa tesi propone di validare l’uso di un nuovo sistema di navigazione computerizzato-assistito per la valutazione cinematica durante la ricostruzione del LCCr nel cane, ma soprattutto di studiare e confrontare il comportamento e l’efficacia dopo ricostruzione TightRope (TR) in due diverse coppie di punti isometrici. Abbiamo effettuato due analisi in parallelo. La prima eseguendo interventi chirurgici con tecnica TR su 18 casi clinici e sfruttando il punto isometrico del femore (F2) e due diversi punti isometrici della tibia (T2 o T3). L’analisi prevedeva dei controlli postoperatori a 1, 3 e 6 mesi. Ad ogni controllo veniva effettuata una visita ortopedica, esami radiografici, un questionario di valutazione clinico e di soddisfazione del proprietario. Mentre nella ricerca Ex-Vivo abbiamo eseguito dei test su 14 preparati anatomici con l’utilizzo di un sistema di navigazione computerizzato per la rilevazione dei dati. L’analisi prevedeva la valutazione dell’articolazione in diversi stadi: LCCr intatto; LCCr rotto; dopo ricostruzione con TR in F2-T2 e tensionato a 22N, 44N e 99N; dopo ricostruzione con TR in F2-T3 e tensionato a 22N, 44N e 99N. Ad ogni stadio si eseguivano cinque test di valutazione, tra cui: Test del Cassetto, Test di compressione tibiale (TCT), Rotazione Interna/Esterna, Flesso/Estensione e Varo/Valgo. Lo scopo di tale studio è quello di confrontare tra loro i punti isometrici del ginocchio e di analizzare l’efficacia della tecnica TR nelle due differenti condizioni di isometria (F2-T2 e F2-T3).

Komparative Analyse der humanen Chromosomenregion 11p15.3 um die Gene LMO1,TUB und der orthologen Region in der Maus

Ziel der vorliegenden Arbeit war die vergleichende Sequenzierung und nachfolgende Analyse des syntänen chromosomalen Abschnitts auf dem kurzen Arm des humanen Chromosoms 11 in der Region 11p15.3 mit den Genen LMO1, TUB und dem orthologen Genomabschnitt der Maus auf Chromosom 7 F2. Die im Rahmen dieser Arbeit durchgeführte Kartierung dieser beiden chromosomalen Bereiche ermöglichte die Komplettierung einer genomischen Karte auf insgesamt über eine Megabase, die im Kooperationssequenzierprojekt der Universitäts-Kinderklinik und dem Institut für Molekulargenetik in Mainz erstellt wurde. Mit Hilfe von 28 PAC- und Cosmid-Klonen konnten in dieser Arbeit 383 kb an genomischer DNA des Menschen und mit sechs BAC- und PAC-Klonen 412 kb an genomischer DNA der Maus dargestellt werden. Dies ermöglichte erstmals die exakte Festlegung der Reihenfolge der in diesem chromosomalen Abschnitt enthaltenen Gene und die genaue Kartierung von acht STS-Markern des Menschen, bzw. vier STS-Sonden der Maus. Es zeigte sich dabei, dass die chromosomale Orientierung telomer-/centromerwärts des orthologen Bereichs in der Maus im Vergleich zum Menschen in invertierter Ausrichtung vorliegt. Die Sequenzierung von drei humanen Klonen ermöglichte die Bestimmung von 319.119 bp an zusammenhängender genomischer DNA. Dadurch konnte die genaue Lokalisation und Strukturaufklärung der Gene LMO1, ein putatives Tumorsuppressorgen, das mit der Entstehung von Leukämien assoziiert ist, und TUB, ein Transkriptionsmodulator, der in die Fettstoffwechselregulation involviert ist, vorgenommen werden. Für das murine Genom wurden 412.827 bp an neuer DNA-Sequenz durch Sequenzierung von ebenfalls drei Klonen generiert. Der im Vergleich zum Menschen ca. 100 kb größere Genombereich beinhaltete zudem die neuen Gene Stk33 und Eif3. Es handelte sich dabei um zwei Gene, die erst im Rahmen dieser Arbeit entdeckt und charakterisiert wurden. Die parallele Bearbeitung beider Genombereiche ermöglichte eine umfassende komparative Analyse nach kodierenden, funktionellen und strukturgebenden Sequenzabschnitten in beiden Spezies. Es konnten dabei für beide Organismen die Exon-Intron-Strukturen der Gene LMO1/Lmo1 und TUB/Tub geklärt. Zudem konnten vier neue Exons und zwei neue speziesspezifischer Spleißvarianten für TUB/Tub beschrieben werden. Die Identifizierung dieser neuen Spleißvarianten offenbart neue Möglichkeiten für alternative Regulation und Funktion, oder für eine veränderte Proteinstruktur, die weitere Erklärungsansätze für die Entstehung der mit diesen Genen assoziierten Erkrankungen zulässt. In der sequenzierten, größeren Genomsequenz der Maus konnte in den flankierenden, nicht mit der sequenzierten Humansequenz überlappenden Bereich das neue Gen Eif3 in seiner Exon-Intron-Struktur und die beiden letzten Exons 11 und 12 des Gens Stk33 kartiert und charakterisiert werden. Die umfangreiche Sequenzanalyse beider sequenzierter Genombereiche ergab für den Abschnitt des Menschen insgesamt 229 potentielle Exonsequenzen und für den Bereich der Maus 527 mögliche Exonbereiche. Davon konnten beim Menschen explizit 21 Exons und bei der Maus 31 Exons als exprimierte Bereiche identifiziert und experimentell mittels RT-PCR, bzw. durch cDNA-Sequenzierung verifiziert werden. Diese Abschnitte beschrieben nicht nur die Exonbereiche der oben genannten vier Gene, sondern konnten auch neuen nicht weiter definierten EST-Sequenzen zugeordnet werden. Mittels des Interspeziesvergleiches war darüber hinaus auch die Analyse der nichtkodierenden Intergen-Bereiche möglich. So konnten beispielsweise im ersten Intron des LMO1/Lmo1 sieben Sequenzbereiche mit Konservierungen von ca. 90% bestimmt werden. Auch die Charakterisierung von Promotor- und putativ regulatorischen Sequenzabschnitten konnte mit Hilfe unterschiedlicher bioinformatischer Analyse-Tools durchgeführt werden. Die konservierten Sequenzbereiche der DNA zeigen im Durchschnitt eine Homologie von mehr als 65% auf. Auch die Betrachtung der Genomorganisation zeigte Gemeinsamkeiten, die sich meist nur in ihrer graduellen Ausprägung unterschieden. So weist ein knapp 80 kb großer Bereich proximal zum humanen TUB-Gen einen deutlich erhöhten AT-Gehalt auf, der ebenso im murinen Genom nur in verkürzter Version und schwächer ausgeprägt in Erscheinung tritt. Die zusätzliche Vergleichsanalyse mit einer weiteren Spezies, den orthologen Genomabschnitten von Fugu, zeigte, dass es sich bei den untersuchten Genen LMO1 und TUB um sehr konservierte und evolutiv alte Gene handelt, deren genomisches Organisationsmuster sich auch bei den paralogen Genfamilienmitglieder innerhalb derselben Spezies wiederfindet. Insgesamt konnte durch die Kartierung, Sequenzierung und Analyse eine umfassende Datenbasis für die betrachtete Genomregion und die beschriebenen Gene generiert werden, die für zukünftige Untersuchungen und Fragestellungen wertvolle Informationen bereithält.

Entwicklung und Optimierung eines Mikroarray zur Erfassung der genetischen Prädisposition von Atherosklerose

Die Entstehung der Atherosklerose ist ein komplexer Vorgang, der sich durch Ablagerung von Lipiden an der Gefäßwand sowie durch immunologische und inflammatorische Prozesse auszeichnet. Neben konventionellen Risikofaktoren wie Alter, Geschlecht, Rauchen, HDL-Cholesterin, Diabetes mellitus und einer positiven Familienanamnese werden zur Bestimmung des atherosklerotischen Risikos neue Biomarker der inflammatorischen Reaktion untersucht. Ziel dieser Arbeit war die Entwicklung einer Methode zur Diagnostik des Atheroskleroserisikos. Es wurde eine neuartige Chip-Technologie eingesetzt, um das Risiko für eine potentiell drohende atherosklerotische Erkrankung abzuschätzen. Dabei wurde ausgenutzt, dass molekulare Veränderungen in Genen bestimmte Krankheitsbilder auslösen können. rnEs wurde ein molekularbiologischer Test entwickelt, welcher die Untersuchung von genetischen Variationen aus genomischer DNA ermöglicht. Dafür fand die Entwicklung einer Multiplex-PCR statt, deren Produkt mit der Chip-Technologie untersucht werden kann. Dazu wurden auf einem Mikroarray Sonden immobilisiert, mit deren Hilfe genspezifische Mutationen nachgewiesen werden können. So wurden mehrere Gene mit einem geringen Aufwand gleichzeitig getestet. rnDie Auswahl der entsprechenden Marker erfolgte anhand einer Literaturrecherche von randomisierten und kontrollierten klinischen Studien. Der Mikroarray konnte für zwölf Variationen in den acht Genen Prostaglandinsynthase-1 (PTGS1), Endotheliale NO-Synthase (eNOS), Faktor V (F5), 5,10-Methylentetrahydrofolsäure-Reduktase (MTHFR), Cholesterinester-Transferprotein (CETP), Apolipoprotein E (ApoE), Prothrombin (F2) und Lipoproteinlipase (LPL) erfolgreich etabliert werden. Die Präzision des Biochips wurde anhand der Echtzeit-PCR und der Sequenzierung nachgewiesen. rnDer innovative Mikroarray ermöglicht eine einfache, schnelle und kosteneffektive Genotypisierung von wichtigen Allelen. Viele klinisch relevante Variationen für Atherosklerose können nun in nur einem Test überprüft werden. Zukünftige Studien müssen zeigen, ob die Methode eine Vorhersage über den Ausbruch der Erkrankung und eine gezielte Therapie ermöglicht. Dies wäre ein erster Schritt in Richtung präventive und personalisierter Medizin für Atherosklerose.rn

Accuracy of liver stiffness measurement using fibroscan ® to predict the response to antiviral therapy in patients with chronic hepatitis c viral infection

Introduction: Antiviral therapy can prevent disease progression in patients with chronic hepatitis C . Transient Elastografy (TE; Fibroscan) is an accurate surrogate marker to liver fibrosis, by measuring liver stiffness (LS). LS decrease has been associated with sustained virologic response (SVR). Aim: to assess the changes of LS measurments in CHC patients during and one year after Interferon (IFN)-based antiviral therapy (IFN/ribavirin) or (telaprevir+IFN/ribavirin). Methods: consecutive 69 CHC patients (53.6% females, mean age 57.9 ± 11.4) who underwent antiviral therapy for at least 20 weeks were enrolled. LS was measured using FibroScan at baseline, after three months, at the end of treatment and one year after treatment discontinuation. Fibrosis was graded using METAVIR score. Results: twenty patients treated with triple therapy and 49 with IFN/ribavirin. Fifty patients had SVR and 19 were non-responders. SVR patients: F0-F1, F2 and F3 patients (39.1%, 7.2% and 17.4%; respectively) showed no significant LS decrease (P= 0.186, 0.068 and 0.075; respectively). Conversely, in F4 patients (36.2%) LS was significantly decreased (P=0.015) after one year of treatment completion. In all patients with no SVR, no significant decrease in LS was observed. Interestingly, all Patients with F4 fibrosis (even non-responders) showed an initial significant decrease in LS (P=0.024) at 3 months after the start of treatment. However, this decrease was not predictive of SVR; area under the ROC curve 0.369 (CI %: 0.145-0.592) P= 0.265. Conclusion: Our study showed that initial decrease in LSM, especially in patients with higher baseline fibrosis score is unlikely to predict an SVR. In addition no significant association was found between clinical or virological parameters and fibrosis improvement. Further studies are needed to delineate the most appropriate clinical scenarios for the LSM by Fibroscan in chronic hepatitis C and its role in monitoring the response to antiviral treatment.

Valutazione delle funzioni cardio-respiratorie ed epatiche in pazienti con cuore univentricolare trattati con intervento di connessione cavo-polmonare totale

L'intervento di connessione cavo-polmonare totale (TCPC) nei pazienti portatori di cuore univentricolare, a causa della particolare condizione emodinamica, determina un risentimento a carico di numerosi parenchimi. Scopo della ricerca è di valutare l'entità di questo danno ad un follow-up medio-lungo. Sono stati arruolati 115 pazienti, sottoposti ad intervento presso i centri di Cardiochirurgia Pediatrica di Bologna (52 pz) e Torino (63 pz). Il follow-up medio è stato di 125±2 mesi. I pazienti sono stati sottoposti ad indagine emodinamica (88 pz), test cardiopolmonare (75 pz) e Fibroscan ed ecografia epatica (47 pz). La pressione polmonare media è stata di 11.5±2.6mmHg, ed in 12 pazienti i valori di pressione polmonare erano superiori a 15mmHg. La pressione atriale media era di 6.7±2.3mmHg ed il calcolo delle resistenze vascolari polmonari indicizzate (RVP) era in media di 2±0.99 UW/m2. In 29 pazienti le RVP erano superiori a 2 UW/m2. La VO2 max in media era pari a 28±31 ml/Kg/min, 58±15 % del valore teorico. La frequenza cardiaca massima all'apice dello sforzo era di 151±22 bpm, pari al 74±17% del valore teorico. Il Fibroscan ha fornito un valore medio di 17.01 kPa (8-34.3kPa). Cinque pazienti erano in classe F2, 9 pazienti in classe F3 e 33 pazienti risultavano in classe F4. Nei pazienti con follow-up maggiore di 10 anni il valore di stiffness epatica (19.6±5.2kPa) è risultato significativamente maggiore a quello dei pazienti con follow-up minore di 10 anni (15.1±5.8kPa, p<0.01). La frequenza cardiaca massima raggiunta durante lo sforzo del test cardiopolmonare è risultata significativamente correlata alla morfologia del ventricolo unico, risultando del 67.8±14.4% del valore teorico nei pazienti portatori di ventricolo destro contro il 79.6±8.7% dei portatori di ventricolo sinistro (p=0.006). L'intervento di TCPC determina un risentimento a carico di numerosi parenchimi proporzionale alla lunghezza del follow-up, e necessita pertanto un costante monitoraggio clinico-strumentale multidisciplinare.

Bonding of restorative materials to dentin with various luting agents

The aim was to compare eight types of luting agents when used to bond six indirect, laboratory restorative materials to dentin. Cylinders of the six restorative materials (Esteticor Avenir [gold alloy], Tritan [titanium], NobelRondo [feldspathic porcelain], Finesse All-Ceramic [leucite-glass ceramic], Lava [zirconia], and Sinfony [resin composite]) were ground and air-abraded. Cylinders of feldspathic porcelain and glass ceramic were additionally etched with hydrofluoric acid and were silane-treated. The cylinders were luted to ground human dentin with eight luting agents (DeTrey Zinc [zinc phosphate cement], Fuji I [conventional glass ionomer cement], Fuji Plus [resin-modified glass ionomer cement], Variolink II [conventional etch-and-rinse resin cement], Panavia F2.0 and Multilink [self-etch resin cements], and RelyX Unicem Aplicap and Maxcem [self-adhesive resin cements]). After water storage at 37°C for one week, the shear bond strength of the specimens (n=8/group) was measured, and the fracture mode was stereomicroscopically examined. Bond strength data were analyzed with two-factorial analysis of variance (ANOVA) followed by Newman-Keuls' Multiple Range Test (?=0.05). Both the restorative material and the luting agent had a significant effect on bond strength, and significant interaction was noted between the two variables. Zinc phosphate cement and glass ionomer cements produced the lowest bond strengths, whereas the highest bond strengths were found with the two self-etch and one of the self-adhesive resin cements. Generally, the fracture mode varied markedly with the restorative material. The luting agents had a bigger influence on bond strength between restorative materials and dentin than was seen with the restorative material.

Molecular characterization of five porcine candidate genes for drip loss in pork

Drip loss is the loss of fluid from a piece of meat without mechanical force and represents an important meat quality trait. Previous work revealed a quantitative trait locus (QTL) for drip loss in pork in an experimental Duroc x Pietrain (DUPI) F2 family on SSC 5. Based on functional data indicating their possible involvement in water holding capacity and their expression in skeletal muscle, we selected five positional candidates (ACO2, ADSL, CBY1, KCNJ4, PLA2AG6) out of 130 predicted genes in the QTL interval for further analysis. We performed a mutation analysis of all coding exons and discovered 204 polymorphisms. We genotyped 39 single nucleotide polymorphisms (SNPs) in 192 Pietrain pigs with extreme drip loss phenotypes and detected a possible association with drip loss for one non-coding SNP in the ADSL gene (ss107793818, p(raw) = 0.021). Correspondingly, ADSL diplotypes were associated with drip loss and pH1 of M. longissimus dorsi. However, after correction for multiple testing, none of the tested SNPs were significantly associated with drip loss. One possible explanation for these results is that one of the QTL-alleles from the experimental DUPI family may be fixed or nearly fixed in the tested Pietrain population.

The mutation causing the black-and-tan pigmentation phenotype of Mangalitza pigs maps to the porcine ASIP locus but does not affect its coding sequence

The gene for agouti signaling protein (ASIP) is centrally involved in the expression of coat color traits in animals. The Mangalitza pig breed is characterized by a black-and-tan phenotype with black dorsal pigmentation and yellow or white ventral pigmentation. We investigated a Mangalitza x Piétrain cross and observed a coat color segregation pattern in the F2 generation that can be explained by virtue of two alleles at the MC1R locus and two alleles at the ASIP locus. Complete linkage of the black-and-tan phenotype to microsatellite alleles at the ASIP locus on SSC 17q21 was observed. Corroborated by the knowledge of similar mouse coat color mutants, it seems therefore conceivable that the black-and-tan pigmentation of Mangalitza pigs is caused by an ASIP allele a(t), which is recessive to the wild-type allele A. Toward positional cloning of the a(t) mutation, a 200-kb genomic BAC/PAC contig of this chromosomal region has been constructed and subsequently sequenced. Full-length ASIP cDNAs obtained by RACE differed in their 5' untranslated regions, whereas they shared a common open reading frame. Comparative sequencing of all ASIP exons and ASIP cDNAs between Mangalitza and Piétrain pigs did not reveal any differences associated with the coat color phenotype. Relative qRT-PCR analyses showed different dorsoventral skin expression intensities of the five ASIP transcripts in black-and-tan Mangalitza. The a(t) mutation is therefore probably a regulatory ASIP mutation that alters its dorsoventral expression pattern.

Single linkage group per chromosome genetic linkage map for the horse, based on two three-generation, full-sibling, crossbred horse reference families

A genetic linkage map of the horse consisting of 742 markers, which comprises a single linkage group for each of the autosomes and the X chromosome, is presented. The map has been generated from two three-generation full-sibling reference families, sired by the same stallion, in which there are 61 individuals in the F2 generation. Each linkage group has been assigned to a chromosome and oriented with reference to markers mapped by fluorescence in situ hybridization. The average interval between markers is 3.7 cM and the linkage groups collectively span 2772 cM. The 742 markers comprise 734 microsatellite and 8 gene-based markers. The utility of the microsatellite markers for comparative mapping has been significantly enhanced by comparing their flanking sequences with the human genome sequence; this enabled conserved segments between human and horse to be identified. The new map provides a valuable resource for genetically mapping traits of interest in the horse.

Sequential Quantitative Trait Locus Mapping in Experimental Crosses

The etiology of complex diseases is heterogeneous. The presence of risk alleles in one or more genetic loci affects the function of a variety of intermediate biological pathways, resulting in the overt expression of disease. Hence, there is an increasing focus on identifying the genetic basis of disease by sytematically studying phenotypic traits pertaining to the underlying biological functions. In this paper we focus on identifying genetic loci linked to quantitative phenotypic traits in experimental crosses. Such genetic mapping methods often use a one stage design by genotyping all the markers of interest on the available subjects. A genome scan based on single locus or multi-locus models is used to identify the putative loci. Since the number of quantitative trait loci (QTLs) is very likely to be small relative to the number of markers genotyped, a one-stage selective genotyping approach is commonly used to reduce the genotyping burden, whereby markers are genotyped solely on individuals with extreme trait values. This approach is powerful in the presence of a single quantitative trait locus (QTL) but may result in substantial loss of information in the presence of multiple QTLs. Here we investigate the efficiency of sequential two stage designs to identify QTLs in experimental populations. Our investigations for backcross and F2 crosses suggest that genotyping all the markers on 60% of the subjects in Stage 1 and genotyping the chromosomes significant at 20% level using additional subjects in Stage 2 and testing using all the subjects provides an efficient approach to identify the QTLs and utilizes only 70% of the genotyping burden relative to a one stage design, regardless of the heritability and genotyping density. Complex traits are a consequence of multiple QTLs conferring main effects as well as epistatic interactions. We propose a two-stage analytic approach where a single-locus genome scan is conducted in Stage 1 to identify promising chromosomes, and interactions are examined using the loci on these chromosomes in Stage 2. We examine settings under which the two-stage analytic approach provides sufficient power to detect the putative QTLs.

Concentration- and time-dependent effects of the synthetic estrogen, 17alpha-ethinylestradiol, on reproductive capabilities of the zebrafish, Danio rerio

Partial or full life-cycle tests are needed to assess the potential of endocrine-disrupting compounds (EDCs) to adversely affect development and reproduction of fish. Small fish species such as zebrafish, Danio rerio, are under consideration as model organisms for appropriate test protocols. The present study examines how reproductive effects resulting from exposure of zebrafish to the synthetic estrogen 17alpha-ethinylestradiol (EE2) vary with concentration (0.05 to 10 ng EE2 L(-1), nominal), and with timing/duration of exposure (partial life-cycle, full life-cycle, and two-generation exposure). Partial life-cycle exposure of the parental (F1) generation until completion of gonad differentiation (0-75 d postfertilization, dpf) impaired juvenile growth, time to sexual maturity, adult fecundity (egg production/female/day), and adult fertilization success at 1.1 ng EE2 L(-1) and higher. Lifelong exposure of the F1 generation until 177 dpf resulted in lowest observed effect concentrations (LOECs) for time to sexual maturity, fecundity, and fertilization success identical to those of the developmental test (0-75 dpf), but the slope of the concentration-response curve was steeper. Reproduction of zebrafish was completely inhibited at 9.3 ng EE2 L(-1), and this was essentially irreversible as a 3-mo depuration restored fertilization success to only a very low rate. Accordingly, elevated endogenous vitellogenin (VTG) synthesis and degenerative changes in gonad morphology persisted in depurated zebrafish. Full life-cycle exposure of the filial (F2) generation until 162 dpf impaired growth, delayed onset of spawning and reduced fecundity and fertilization success at 2.0 ng EE2 L(-1). In conclusion, results show that the impact of estrogenic agents on zebrafish sexual development and reproductive functions as well as the reversibility of effects, varies with exposure concentration (reversibility at < or = 1.1 ng EE2 L(-1) and irreversibility at 9.3 ng EE2 L(-1)), and between partial and full life-cycle exposure (exposure to 10 ng EE2 L(-1) during critical period exerted no permanent effect on sexual differentiation, but life-cycle exposure did).

Comparative acute effects of the calcium channel blockers tiapamil, nisoldipine, and nifedipine on blood pressure and some regulatory factors in normal and hypertensive subjects

To clarify the pharmacological profile of the two new calcium channel blockers tiapamil and nisoldipine in humans, their acute effects as compared with those of the reference agent nifedipine were assessed in 10 normal subjects and 10 patients with essential hypertension. Blood pressure (BP), heart rate (HR), plasma and urinary catecholamine, sodium and potassium, plasma renin and aldosterone levels, and urinary prostaglandin E2 and F2 excretion rates were determined before and up to 4 or 5 h (urine values) after intravenous injection of placebo (20 ml 0.9% NaCl), tiapamil 1 mg/kg body weight, nisoldipine 6 micrograms/kg, or nifedipine 15 micrograms/kg. The four studies were performed at weekly intervals according to Latin square design. All three calcium channel blockers significantly (p less than 0.05 or lower) lowered BP and distinctly increased sodium excretion in hypertensive patients, but had only little influence on these parameters in normal subjects. HR was increased in both groups. Changes in BP and HR were maximal at 5 min and largely dissipated 3 h after drug injection. Effects on BP and HR, as well as concomitant mild increases in plasma norepinephrine and renin levels that occurred in both groups, tended to be more pronounced (about double) following nisoldipine than following tiapamil or nifedipine at the dosages given. Plasma aldosterone, epinephrine levels, and prostaglandin excretion rates were not consistently modified. These findings demonstrate that tiapamil and nisoldipine possess distinct antihypertensive properties in humans. Different chronotropic and renin-activating effects of different calcium channel blockers may be determined, at least in part, by a different influence on sympathetic activity.(ABSTRACT TRUNCATED AT 250 WORDS)

A STUDY OF THE IMPACTS OF FREEZE-THAW ON CLIFF RECESSION AT THE CALVERT CLIFFS IN CALVERT COUNTY, MARYLAND

The Calvert Cliffs, which form much of the western coastline of the Chesapeake Bay in Calvert County, Maryland, are actively eroding and destabilizing, resulting in a critical situation for many homes in close proximity to the slope's crest. Past studies have identified that where waves directly interact with the toe of the slope, wave action controls cliff recession; however, where waves do not regularly interact with the slope toe, the past work identified that freeze-thaw controls recession. This study investigated the validity of this second claim by analyzing the recession rate and freeze-thaw behavior of six study sites along the Calvert Cliffs that are not directly affected by waves. While waves do remove failed material from the toe, in these regions freeze-thaw is believed to be the dominant factor driving recession at the Calvert Cliffs. Past recession rates were calculated using historical aerial photographs and were analyzed together with a number of other variables selected to represent the freeze-thaw behavior of the Calvert Cliffs. The investigation studied sixteen independent variables and found that over 65% of recession at these study sites can be represented by the following five variables: (1) cliff face direction, (2 and 3) the percent of total cliff height composed of soil with freeze-thaw susceptibility F4 and F2, (4) the number of freeze-thaw cycles, and (5) the weighted shear strength. Future mitigation techniques at these sites should focus on addressing these variables and might include vegetation or addressing the presence of water along the face of the slope. Unmitigated, the Calvert Cliffs will continue to recede until a stable slope angle is reached and maintained.

Genotype 3 is associated with accelerated fibrosis progression in chronic hepatitis C

BACKGROUND/AIMS: While several risk factors for the histological progression of chronic hepatitis C have been identified, the contribution of HCV genotypes to liver fibrosis evolution remains controversial. The aim of this study was to assess independent predictors for fibrosis progression. METHODS: We identified 1189 patients from the Swiss Hepatitis C Cohort database with at least one biopsy prior to antiviral treatment and assessable date of infection. Stage-constant fibrosis progression rate was assessed using the ratio of fibrosis Metavir score to duration of infection. Stage-specific fibrosis progression rates were obtained using a Markov model. Risk factors were assessed by univariate and multivariate regression models. RESULTS: Independent risk factors for accelerated stage-constant fibrosis progression (>0.083 fibrosis units/year) included male sex (OR=1.60, [95% CI 1.21-2.12], P<0.001), age at infection (OR=1.08, [1.06-1.09], P<0.001), histological activity (OR=2.03, [1.54-2.68], P<0.001) and genotype 3 (OR=1.89, [1.37-2.61], P<0.001). Slower progression rates were observed in patients infected by blood transfusion (P=0.02) and invasive procedures or needle stick (P=0.03), compared to those infected by intravenous drug use. Maximum likelihood estimates (95% CI) of stage-specific progression rates (fibrosis units/year) for genotype 3 versus the other genotypes were: F0-->F1: 0.126 (0.106-0.145) versus 0.091 (0.083-0.100), F1-->F2: 0.099 (0.080-0.117) versus 0.065 (0.058-0.073), F2-->F3: 0.077 (0.058-0.096) versus 0.068 (0.057-0.080) and F3-->F4: 0.171 (0.106-0.236) versus 0.112 (0.083-0.142, overall P<0.001). CONCLUSIONS: This study shows a significant association of genotype 3 with accelerated fibrosis using both stage-constant and stage-specific estimates of fibrosis progression rates. This observation may have important consequences for the management of patients infected with this genotype.