The human genome and gene expression profiling

The mapping and sequencing of the human genome has generated a large resource for answering questions about human disease. This achievement is akin in scientific importance to developing the periodic table of elements. Plastic surgery has always been at the frontier medical research. This resource will help us to improve our understanding on the many unknown physiological and pathogical conditions we deal with daily, such as wound heating keloid scar formation, Dupuytren's disease, rheumatoid arthritis, vascular malformation and carcinogenesis. We are primed in obtaining both disease and normal tissues to use this resource and applying it to clinical use. This review is about the human genome, the basis of gene expression profiling and how it will affect our clinical and research practices in the future and for those embarking on the use of this new technology as a research tool, we provide a brief insight on its limitations and pitfalls. (C) 2006 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved.

Influence of arterial compliance on presence and extent of ischaemia during stress echocardiography

Objective: To seek an association between total arterial compliance (TAC) and the extent of ischaemia at stress echocardiography. Design: Cohort study. Setting: Regional cardiac centre. Methods: 255 consecutive patients (147 men; mean (SD) age 58 (8)) presenting for stress echocardiography for clinical indications were studied. Wall motion score index (WMSI) was calculated and ischaemia was defined by an inducible or worsening wall motion abnormality. Peak WMSI was used to reflect the extent of dysfunction (ischaemia or scar), and Delta WMSI was indicative of extent of ischaemia. TAC was assessed at rest by simultaneous radial applanation tonometry and pulsed wave Doppler in all patients. Results: Ischaemia was identified by stress echocardiography in 65 patients (25%). TAC was similar in the groups with negative and positive echocardiograms (1.08 (0.41) v 1.17 (0.51) ml/ mm Hg, not significant). However, the extent of dysfunction was associated with TAC independently of age, blood pressure, risk factors, and use of a beta blocker. Moreover, the extent of ischaemia was determined by TAC, risk factors, and use of a b blocker. Conclusion: While traditional cardiovascular risk factors are strong predictors of ischaemia on stress echocardiography, TAC is an independent predictor of the extent of ischaemia.

Prognostic value of intraventricular dyssynchrony according to clinical stage of left ventricular impairment

Intraventricular dyssynchrony has prognostic implications in patients who have severe functional limitation and decreased ejection fraction. Patients with less advanced cardiac disease often exhibit intraventricular dyssynchrony, but there is little available information about its prognostic relevance in such patients. We investigated the prognostic effect of intraventricular dyssynchrony on outcome in 318 patients with known or suspected coronary artery disease who were classified according to the presence or absence of left ventricular dysfunction and heart failure symptoms. Mortality was considered the primary end point over a median follow-up of 56 months, and a Cox proportional hazards model was used for survival analysis. Despite a low prevalence (8%) of left bundle branch block, there was a high prevalence of intraventricular dyssynchrony even in patients without symptomatic heart failure. The magnitude of intraventricular dyssynchrony correlated poorly with QRS duration (r = 0.25),end-systolic volume index (r = 0.27), and number of scar segments (r = 0.25). There,were 58 deaths during follow-up. Ventricular volume, ischemic burden, and magnitude of intraventricular dyssynchrony predicted outcome, but magnitude of intraventricular dyssynchrony was an independent predictor of survival only in patients with asymptomatic left ventricular dysfunction. In conclusion, patients with known or suspected coronary artery disease have a high prevalence of intraventricular dyssynchrony. Although ventricular volume, ischemic burden, and intraventricular dyssynchrony are potentially important prognostic markers, the relative importance of intraventricular dyssynchrony changes with the clinical setting and, may be greatest-in patients with preclinical disease. (c) 2006 Elsevier Inc. All rights reserved.

Development of a clinical and echocardiographic score for assigning risk of major events after exercise and dobutamine echocardiograms

The prognostic value of exercise (EXE) and dobutamine echocardiograms (DbE) has been well defined in large studies. However, while risk is determined by both clinical and echo features, no simple means of combining these data has been defined. We sought to combine these data into risk scores. Methods. At 3 expert centers, 7650 pts underwent standard EXE (n=5211) and DbE (w2439) for evaluation of known or suspected CAD and were followed for up to 10 years (mean 5-2) for major events (death or myocardial infarction). A subgroup of 2953 EXE and 1025 DbE pts was randomly selected to develop separate multivariate models for prediction of events. After simplication of each model for clinical use, models were validated in the remaining EXE and DbE pts. ResuI1s. The total number of events was 200 in the EXE and 225 in the DbE pts, of which 58 and 99 events occurred in the respective testing groups. The following regression equations gave equivalent results I” the testing and validation groups for both EXE and DbE; DbE = (Age’O.02) + (DM’l .O) + (Low RPP’0.6) + ([CHF+lschemia+Scar]‘O.7) EXE = ([DM+CHF]‘O.S) + O.S(lschemla #) + l.B(Scar#) - (METS0.19) (where each categorical variable scored 1 when present and 0 when absent, Ischemia# = 1 for l-2 VD. 6 for 3 VD; Scar# = 1 for 1-2 VD, 1.7 for 3 VD). The table summarizes the scores and equivalent outcomes for EXE and DbE. Conclusions. Risk scores based on clinical and EXE or DbE results may be used to quantify the risk of events during follow-up.

Comparison between myocardial integrated backscatter and strain rate imaging in the quantitative assessment of subepicardial function post-myocardial infarction

Transmural extent of infarction (TME) may be an important determinant of functional recovery and remodeling. Recent animal data suggest that strain rate imaging (SRI) maybe able to identify subendocardial ischemia.We compared SRI and cyclic variation of integrated backscatter (CVIB) for predicting TME in the quantitative assessment of regional subepicardial function. Forty-nine (n = 49) postmyocardial infarct patients (61±10 years, EF 41±10%) underwent tissue Doppler echocardiography (TDE) and contrast enhanced magnetic resonance imaging (CMR). A15 mm×2mm sampling volume (tracked to wall motion) was placed over the long axis subepicardial region of each segment during TDE offline analysis to measure peak longitudinal systolic strain rate (SR), peak longitudinal systolic strain (PS), and CVIB. Findingswere compared with TME classified into two categories of scar thickness by CMR: Non-transmural (TME≤50%), and transmural (TME > 50%). Of 213 segments identified with resting wall motion abnormalities, 145 segments showed delayed hyperenhancement on CMR. SR, PS and CVIB were similar with no significant differences between transmural and non-transmural infarcts regardless of the echo modality.

Coronary revascularization can improve regional left ventricular volumes in non-transmural scars without contractile reserve

Revascularization (RVS) of scar segts does not lead to recovery of left ventricular (LV) function, but its effect on post-infarct remodeling is unclear. We examined the impact of RVS on regional remodeling in different transmural extents of scar (TME). Dobutamine echo (DbE) and contrast enhanced magnetic resonance imaging (ce- MRI) were performed in 72 pts post MI (age 63±10, EF 49±12%). Pts were selected for RVS (n = 31) or medical treatment (n = 41). Segts were classified as scar if there were no contractile reserve during lowdose DbE.TMEwas measured by ce-MRI; a cutoff of 75% was used to differentiate transmural (TM) from non-transmural (NT) scars. Regional end systolic (ESV) and end diastolic volumes (EDV) were measured at baseline and 12 months follow up.Of 218 segts identified as scar on DbE, 164wereNTand 54 were TM on ce-MRI. Revascularization was performed to 62 NT and 11 TM segts. In the RVS group, there was reverse remodeling with significant reduction in LV volumes in NT (ESV, 6.8±3.2 ml versus 5.8±3.7 ml, p = 0.002; EDV, 10.9±4.9 ml versus 9.8±5.6 ml, p = 0.02), but no significant change in volumes in TM (ESV, 6.9±3.7 ml versus 5.4±2.1 ml, p = 0.09; EDV, 10.2±4.4 ml versus 9.4±4.3 ml, p = 0.5). In the medically treated group, there were no changes in LV volumes in both NT (ESV, 12.0±11.9 ml versus 12.7±13.8 ml, p = 0.3; EDV, 12.5±7.8 ml versus 12.6±9.7 ml, p = 0.8) and TM (ESV, 8.0±3.8 ml versus 7.9±4.6 ml, p = 0.8; EDV, 10.3±4.8 ml versus 10.4±5.4 ml, p = 0.9). Despite absence of contractile reserve on DbE, NT benefit from coronary revascularization with regional reverse LV remodeling.

Transplantation of mesenchymal stem cells promotes an alternative pathway of macrophage activation and functional recovery after spinal cord injury

Abstract Mesenchymal stem cells (MSC) derived from bone marrow can potentially reduce the acute inflammatory response in spinal cord injury (SCI) and thus promote functional recovery. However, the precise mechanisms through which transplanted MSC attenuate inflammation after SCI are still unclear. The present study was designed to investigate the effects of MSC transplantation with a special focus on their effect on macrophage activation after SCI. Rats were subjected to T9-T10 SCI by contusion, then treated 3 days later with transplantation of 1.0×10(6) PKH26-labeled MSC into the contusion epicenter. The transplanted MSC migrated within the injured spinal cord without differentiating into glial or neuronal elements. MSC transplantation was associated with marked changes in the SCI environment, with significant increases in IL-4 and IL-13 levels, and reductions in TNF-a and IL-6 levels. This was associated simultaneously with increased numbers of alternatively activated macrophages (M2 phenotype: arginase-1- or CD206-positive), and decreased numbers of classically activated macrophages (M1 phenotype: iNOS- or CD16/32-positive). These changes were associated with functional locomotion recovery in the MSC-transplanted group, which correlated with preserved axons, less scar tissue formation, and increased myelin sparing. Our results suggested that acute transplantation of MSC after SCI modified the inflammatory environment by shifting the macrophage phenotype from M1 to M2, and that this may reduce the effects of the inhibitory scar tissue in the subacute/chronic phase after injury to provide a permissive environment for axonal extension and functional recovery.

Photodynamic therapy with verteporfin for juxtafoveal choroidal neovascularisation secondary to pathological myopia

The treatment of choroidal neovascularisation (CNV) secondary to pathological myopia has presented a number of problems to ophthalmologists over the years, but the advent of photodynamic therapy (PDT) with verteporfin has changed how we manage these patients. Until PDT became available, the use of laser photocoagulation for extra and juxtafoveal lesions had been shown to be effective in the short term in preventing loss of vision, although the risk of regrowth of CNV and undertreatment were well recognised. However, even in apparent successful cases of photocoagulation, laser scar enlargement and creepage into the fovea in the mid-to-long term often occurred with resulting loss of central vision.1 Other options for treatment were very limited with little evidence that other modalities such as transpupillary thermotherapy or submacular surgery and macular transplantation surgery would be successful in highly myopic eyes. The evidence for the role of PDT and verteporfin CNV secondary to pathological myopia comes from the verteporfin in photodynamic therapy (VIP) study that has shown how effective this treatment is in eyes with subfoveal CNV.2, 3 Now in this publication, Lam et al4 from Hong Kong have shown that PDT is also effective in juxtafoveal CNV, with high myopia. They performed a small prospective study of 11 patients of mean age 44.8 years, with 12 months of follow-up. They found that there was a mean improvement of 1.8 lines of LogMAR best-corrected visual acuity (BCVA) at 12 months, with a mean number of 2.3 PDT treatments. The most rapid improvement occurred within the first 3 months of treatment and by 12 months none of the patients had suffered a deterioration in BCVA from baseline. There were no cases of adverse effects from the infusion or laser treatment. For ophthalmologists dealing with patients with CNV secondary to causes other than AMD, this is further evidence of the effectiveness of PDT with verteporfin in maintaining vision. These patients are likely to be younger than those with AMD and are likely to be in active employment and supporting families, and clearly the preservation of best vision possible is imperative in this group. It is therefore encouraging for ophthalmologists in the United Kingdom that the verteporfin in PDT Cohort Study (VPDT Study) includes the ability to treat patients with subfoveal CNV secondary to high myopia if they fulfill National Institute of Clinical Excellence guidelines, and will allow representations to be made on an individual basis for treatment of juxtafoveal lesions.5 For those ophthalmologists used to juggling increased patient expectations with scarce NHS resources, this is promising news and will allow us to offer a better standard of care to our patients.

Phosphorus Availability and Salinity Control Productivity and Demography of the Seagrass Thalassia testudinum in Florida Bay

Biomass, net primary productivity (NPP), foliar elemental content, and demography of Thalassia testudinum were monitored in populations from five sites across Florida Bay beginning in January 2001. Sites were selected to take advantage of the spatial variability in phosphorus (P) availability and salinity climates across the bay. Aboveground biomass and NPP of T. testudinum were determined five to six times annually. Short-shoot demography, belowground biomass, and belowground NPP were assessed from a single destructive harvest at each site and short-shoot cohorts were estimated from leaf scar counts multiplied by site-specific leaf production rates. Biomass, relative growth rate (RGR), and overall NPP were positively correlated with P availability. Additionally, a positive correlation between P availability and the ratio of photosynthetic to non-photosynthetic biomass suggests that T. testudinum increases allocation to aboveground biomass as P availability increases. Population turnover increased with P availability, evident in positive correlations of recruitment and mortality rates with P availability. Departures from seasonally modeled estimates of RGR were found to be influenced by salinity, which depressed RGR when below 20 psu or above 40 psu. Freshwater management in the headwaters of Florida Bay will alter salinity and nutrient climates. It is becoming clear that such changes will affect T. testudinum, with likely feedbacks on ecosystem structure, function, and habitat quality.

A Musicology for Literary Language

This study analyzed the reader's relationship to the sounds embedded in a written text for the purpose of identifying those sounds' contribution to the reader's interpretation of that text. To achieve this objective, this study negotiated Heideggerian phenomenology, Freudian and Lacanian psychoanalysis, linguistics, and musicology into a reader response theory, which was then applied to Edgar Allen Poe's "The Raven." This study argues that the orchestration of sounds in "The Raven" forces its reader into a regression, which the reader then represses, only to carry the resulting sound-image // away from the poem as a psychic scar.

Desenvolvimento e avaliação tribológica de emulsão O/A a partir de óleo vegetal epoxidado para aplicação em fluídos de corte

The cutting fluids are lubricants used in machining processes, because they present many benefits for different processes. They have many functions, such as lubrication, cooling, improvement in surface finishing, besides they decreases the tool wear and protect it against corrosion. Therefore due to new environment laws and demand to green products, new cutting fluids must be development. These shall be biodegradable, non-toxic, safety for environment and operator healthy. Thus, vegetable oils are a good option to solve this problem, replacing the mineral oils. In this context, this work aimed to develop an emulsion cutting fluid from epoxidized vegetable oil, promoting better lubrication and cooling in machining processes, besides being environment friendly. The methodology was divided in five steps: first one was the biolubricant synthesis by epoxidation reaction. Following this, the biolubricant was characterized in terms of density, acidity, iodo index, oxirane index, viscosity, thermal stability and chemical composition. The third step was to develop an emulsion O/A with different oil concentration (10, 20 and 25%) and surfactant concentration (1, 2.5 and 5%). Also, emulsion stability was studied. The emulsion tribological performance were carried out in HFRR (High Frequency Reciprocating Rig), it consists in ball-disc contact. Results showed that the vegetable based lubricant may be synthesized by epoxidationreaction, the spectra showed that there was 100% conversion of the epoxy rings unsaturations. In regard the tribological assessment is observed that the percentage of oil present in the emulsion directly influenced the film formation and coefficient of friction for higher concentrations the film formation process is slow and unstable, and the coefficient of friction. The high concentrations of surfactants have not improved the emulsions tribological performance. The best performance in friction reduction was observed to emulsion with 10% of oil and 5% of surfactant, its average wear scar was 202 μm.

Sea organisms as a source of collagen-derived polymers for skin tissue engineering applications

Advanced therapies combating acute and chronic skin wounds are likely to be brought about using our knowledge of regenerative medicine coupled with appropriately tissue engineered skin substitutes. At the present time, there are no models of an artificial skin that completely replicate normal uninjured skin and they are usually accompanied by fibrotic reactions that result in the production of a scar. Natural biopolymers such as collagen have been a lot investigated as potential source of biomaterial for skin replacement in Tissue Engineering. Collagens are the most abundant high molecular weight proteins in both invertebrate and vertebrate organisms, including mammals, and possess mainly a structural role in connective tissues. From this, they have been elected as one of the key biological materials in tissue regeneration approaches, as skin tissue engineering. In addition, industry is constantly searching for new natural sources of collagen and upgraded methodologies for their production. The most common sources are skin and bone from bovine and porcine origin. However, these last carry high risk of bovine spongiform encephalopathy or transmissible spongiform encephalopathy and immunogenic responses. On the other hand, the increase of jellyfish has led us to consider this marine organism as potential collagen source for tissue engineering applications. In the present study, novel form of acid and pepsin soluble collagen were extracted from dried Rhopilema hispidum jellyfish species in an effort to obtain an alternative and safer collagen. We studied different methods of collagen purification (tissues and experimental procedures). The best collagen yield was obtained using pepsin extraction method (34.16 mg collagen/g of tissue). The isolated collagen was characterized by SDS-polyacrylamide gel electrophoresis and circular dichroism spectroscopy.

Stable-isotope ratios and accumulation rates of four firn cores from the Dronning Maud Land, Antarctica

Four firn cores were retrieved in 2007 at two ridges in the area of the Ekström Ice Shelf, Dronning Maud Land, coastal East Antarctica, in order to investigate the recent regional climate variability and the potential for future extraction of an intermediate-depth core. Stable water-isotope analysis, tritium content and electrical conductivity were used to date the cores. For the period 1981-2006 a strong and significant correlation between the stable-isotope composition of firn cores in the hinterland and mean monthly air temperatures at Neumayer station was (r=0.54-0.71). No atmospheric warming or cooling trend is inferred from our stable-isotope data for the period 1962-2006. The stable-isotope record of the ice/firn cores could expand well beyond the meteorological record of the region. No significant temporal variation of accumulation rates was detected. However, decreasing accumulation rates were found from coast to hinterland, as well as from east (Halvfarryggen) to west (Søråsen). The deuterium excess (d) exhibits similar differences (higher d at Søråsen, lower d at Halvfarryggen), with a weak negative temporal trend on Halvfarryggen (0.04 per mil/a), probably implying increasing oceanic input. We conclude that Halvfarryggen acts as a natural barrier for moisture-carrying air masses circulating in the region from east to west.

A escrita da escrita em (d)enunciação no espaço sócio-escolar: um espaço (em vão) para a (cri)atividade escrita

This thesis is a writing of (d)enunciation because it reveals the language experiencies of those individuals who take, in social school space, the social role of the teacher and of the student, for some reason, they feel restrained by a demand which prevents them of teaching and learning how to write – and, even, their own writing. On this basis, we consider some questions concerning Benveniste‘s theory of enunciation and the teaching and learning process in Portuguese from the triad among teacher – teaching of writing/ knowledge – student, making this theoretical area closer to the pedagogical one. We support in the working hypothesis that is based on the position of the loosening of this triad has its effects in the process of intervention-interference to the point where it does not leave a scar which can remain working on productive effects on the student‘s writing. As a consequence, we show two findings which allow us to think the teaching of writing in Portuguese is a space for writing creativity in such a way it reveals itself as a sine qua non condition for the institutionalized and subjective writing. The first finding is that taking genre as a model has some implications in the teaching and learning process of writing according to the instructions of the official documents. The second finding, as a result of the first one, is the assumption that genre is at the same time a model and a transgression and taking it as a (ex)sample opens space for writing creativity which ―is a transposition of the interior language‖ (BENVENISTE, 2014 [1968-1969], p. 132) in a way this creativity makes it intelligible and highlights what is a model (interactiveness) and a transgression (inventiveness). From such findings, we organize our heterogeneous corpus according to these procedures: recording the classes in audio; recording the interviews we made with teachers and students in audio; and constituting an archive with the students‘ writing production. From this corpus, we analyzed the (d)enunciative mo(ve)ments in the teacher – teaching of writing/ knowledge – student triad and the history of (d)enunciations, of language experiences. Besides, we analyzed the teacher‘s discourse in relation to the way he plans his classes based on the knowledge that must be taught and his own way of managing this knowledge in order to understand his interference in his students‘ writings. Our analyses (re)affirm that when the loosening of the triad happens, the students become lost, what makes them unable of working upon their own writing epilinguisticaly. Because of it, schools have lost their specificity as a place for teaching students how to read and write as they open space for training, only. On this basis, we consider that the effect of such a loosening generates complaints and denunciations. Therefore, based on such (d)enunciations, we present the Primary sketches of a proposition for intervention-interference in teaching how to write and we aim at introducing much knowledge to teachers and students in order to allow them to think about possible ways out.