Med Sci Monit Basic Res
· 2016 Dec · PMID 27980322
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BACKGROUND Aquaporin-2 (AQP2) plays a major role in water reabsorption in the renal collecting duct, and is involved in a variety of renal disease. Recent studies have indicate that sirtuin1 (SIRT1) exerts renoprotective...BACKGROUND Aquaporin-2 (AQP2) plays a major role in water reabsorption in the renal collecting duct, and is involved in a variety of renal disease. Recent studies have indicate that sirtuin1 (SIRT1) exerts renoprotective properties against kidney diseases. This study aimed to determine the potential role of SIRT1 in AQP2 expression induced by tumor necrosis factor-alpha (TNF-α) and to disclose the underlying mechanism in renal inner medullary collecting duct (IMCD) cells. MATERIAL AND METHODS Quantitative real-time PCR and Western blotting were respectively identified mRNA and protein expression. Immunofluorescence staining was used to detect the localization of AQP2. Small-interfering RNA (siRNA) was carried out for mechanism study. RESULTS Results showed that AQP2 was clearly increased in the plasma membrane and decreased in the cytoplasm of IMCD cells treated with AVP. TNF-α treatment in IMCD cells significantly reduced SIRT1 and AQP2 expression, and increased acetylated NF-κBp65 protein level in time- and concentration-dependent manners. Moreover, SIRT1 overexpression or the activator SRT1720 augmented AQP2 expression and reduced the acetylation of NF-κBp65, which was reversed by SIRT1 siRNA or the inhibitors Ex527 and sirtinol in TNF-α-induced IMCD cells. Knockdown of NF-κBp65 or NF-κBp65 inhibition by pyrrolidine dithiocarbamate (PDTC) enhanced AQP2 expression in IMCD cells exposed to TNF-α. Importantly, knockdown of NF-kBp65 augmented the up-regulation of SIRT1 on AQP2 expression in IMCD cells induced by TNF-α. CONCLUSIONS These findings indicate that SIRT1 increases AQP2 expression in TNF-α-induced IMCD cells via the NF-κB-dependent signalling pathway, which might provide novel insight to understanding the renoprotective effects of SIRT1 in kidney diseases.
Liu H, Zhang Y, Ai M
… +5 more, Wang J, Jin B, Teng Z, Wang Y, Li L
Med Sci Monit Basic Res
· 2016 Nov · PMID 27899789
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BACKGROUND This study sought to appraise the association between raised body mass index (BMI) and the risk of gallbladder cancer (GBC) by performing a meta-analysis of 14 cohort studies. MATERIAL AND METHODS Eligible coh...BACKGROUND This study sought to appraise the association between raised body mass index (BMI) and the risk of gallbladder cancer (GBC) by performing a meta-analysis of 14 cohort studies. MATERIAL AND METHODS Eligible cohort studies were selected by searching PubMed and EMBASE from their inception to May 26, 2016, and the reference lists of retrieved articles were also consulted. The information was screened by two authors separately. We used a fixed-effects model to calculate the overall pooled risk estimates. A random-effects model was used to identify heterogeneity. RESULTS The meta-analysis incorporated 14 cohort studies. Nine papers were deemed to be of high quality based on the Newcastle-Ottawa Scale (NOS). Compared with normal weight (BMI 18.5-24.9 kg/m²), the overall pooled relative risks (RR) of GBC was 1.45 (95% CI 1.30-1.61) for excess body weight individuals (BMI ≥25 kg/m²); 1.10 (95% CI 1.02-1.18) for overweight persons (BMI 25-29.9 kg/m²) and 1.69(95% CI 1.54-1.86) for obese folks (BMI ≥30 kg/m²). A higher risk of GBC was presented in obese women (women: RR 1.78, 95% CI 1.59-1.99; men: RR 1.50, 95% CI 1.25-1.79). And a positive relationship between overweight and GBC risk was also displayed in female (RR 1.25, 95% CI 1.11-1.40), but not in male (RR 1.01, 95% CI 0.93-1.11). The sensitivity analysis indicated stable results, and no publication bias was observed. CONCLUSIONS This meta-analysis of 14 cohort studies demonstrated that raised BMI has a dramatic association with risk of GBC, especially in women. But, no association between overweight and GBC in men was found.
Med Sci Monit Basic Res
· 2016 Nov · PMID 27847384
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BACKGROUND We explored the effect of parathyroid hormone (PTH)-induced bone marrow stem cells (BMSCs) complexed with fibrin glue (FG) in the repair of articular cartilage injury in rabbits. MATERIAL AND METHODS Forty-eig...BACKGROUND We explored the effect of parathyroid hormone (PTH)-induced bone marrow stem cells (BMSCs) complexed with fibrin glue (FG) in the repair of articular cartilage injury in rabbits. MATERIAL AND METHODS Forty-eight rabbits randomized into four groups were subjected to articular surgery (cartilage loss). The PTH and non-PTH intervention groups included transplantation with PTH/BMSC/FG xenogeneic and BMSC/FG xenogeneic complexes, respectively, into the injured area. The injured group contained no transplant while the control group comprised rabbits without any articular injury. Samples were monitored for cartilage repair up to three months post-surgery. Immunohistochemistry as well as real-time fluorescent quantitative PCR and Western blot were used to analyze the expression of type II collagen and aggrecan in the repaired tissue. RESULTS At 12 weeks post-surgery, the loss of articular cartilage in the PTH group was fully repaired by hyaline tissue. Typical cartilage lacunae and intact subchondral bone were found. The boundary separating the surrounding normal cartilage tissue disappeared. The gross and International Cartilage Repair Society (ICRS) histological ranking of the repaired tissue was significantly higher in the PTH intervention group than in the non-PTH intervention and injury groups (p<0.05) without any significant difference compared to the control group (p>0.05). Type II collagen and aggrecan stained positive and the average optical density, relative mRNA expression and protein-integrated optical density in the PTH group were higher than in non-PTH and injured groups (p<0.05) but not significantly different from the control group (p>0.05). CONCLUSIONS PTH/BMSC/FG xenogeneic complexes effectively repaired the loss of cartilage in rabbit knee injury.
Kremer J, Farag M, Arif R
… +8 more, Brcic A, Sabashnikov A, Schmack B, Popov AF, Karck M, Dohmen PM, Ruhparwar A, Weymann A
Med Sci Monit Basic Res
· 2016 Nov · PMID 27803495
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BACKGROUND Total artificial heart (TAH) implantation in patients with aggressive tumor infiltration of the heart can be challenging. CASE REPORT We report on a patient with a rare primary undifferentiated high-grade spin...BACKGROUND Total artificial heart (TAH) implantation in patients with aggressive tumor infiltration of the heart can be challenging. CASE REPORT We report on a patient with a rare primary undifferentiated high-grade spindle cell sarcoma of the mitral valve and in the left atrium, first diagnosed in 2014. The referring center did a first resection in 2014. In the course of 17 months, computer tomography (CT) scan again showed massive invasion of the mitral valve and left atrium. Partial resection and mitral valve replacement was not an option. We did a subtotal heart excision with total artificial heart implantation. In this report we discuss complications, risk factors, and perioperative management of this patient. CONCLUSIONS Patients with aggressive tumors of the heart can be considered for TAH implantation.
Sousa LM, de Andrade AF, Belon AR
… +5 more, Soares MS, Amorim RL, Otochi JP, Teixeira MJ, Paiva WS
Med Sci Monit Basic Res
· 2016 Oct · PMID 27777397
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BACKGROUND Current clinical treatment methods for refractory intracranial hypertension include elevation of the decubitus, ventilation adjustment, and use of hypertonic solutions such as hypertonic saline and mannitol so...BACKGROUND Current clinical treatment methods for refractory intracranial hypertension include elevation of the decubitus, ventilation adjustment, and use of hypertonic solutions such as hypertonic saline and mannitol solutions. Previous studies have shown that hypertonic solutions are particularly effective. Although several concentrations of saline solution have been proposed, a 3% solution is the most widely used. The aim of this study was to evaluate the maintained efficacy of a 3% hypertonic saline solution in an experimental model of intracranial hypertension. MATERIAL AND METHODS A porcine model of reversible intracranial hypertension was created by inserting a balloon catheter into the brain parenchyma, which was inflated and deflated to simulate intracranial hypertension and its surgical correction. The experiment included 3 groups of animals (A, B, and C) with different balloon inflation volumes. In group B, balloons were inflated 2 times to simulate reexpansion. A 20 mL/kg bolus of 3% saline solution was infused using a pump 90 minutes after the start of balloon inflation, and the effects of intracranial pressure were evaluated 60 minutes after infusion. RESULTS No increases outside of the normal range were observed in mean serum sodium concentrations (p=0.09). In addition, we identified no differences within each group in serum sodium levels measured during hypertonic saline infusion (p=0.21). No significant reductions in intracranial pressure were observed in any of the 3 groups. CONCLUSIONS Bolus infusion of 3% hypertonic saline solution with the aid of a pump does not significantly reduce intracranial pressure in an animal model of intracranial hypertension.
Med Sci Monit Basic Res
· 2016 Oct · PMID 27739419
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BACKGROUND A whole-body vibration technique delivered in a horizontal position through a massage mattress was introduced in 2007. The present study analyzed the effects of different exposure periods to these vibrations o...BACKGROUND A whole-body vibration technique delivered in a horizontal position through a massage mattress was introduced in 2007. The present study analyzed the effects of different exposure periods to these vibrations on microcirculation of mice. MATERIAL AND METHODS Different periods of vibrations (30Hz) were locally delivered in a horizontal position on the external abdominal skin in 3 randomized groups of mice (N=42). The 3 groups receiving vibrations were compared to an untreated control group (N=14). The 3 experimental groups received 3, 6, and 10 min of vibrations. The in vivo measurement of the arterial and venous diameters was done before and after each vibration period. RESULTS Average venous diameters (µm) after 6 to 10 min of vibrations were significantly increased (7% and 12%, p values 0.026 and 0.013, respectively), but 3 min did not significantly change average venous diameters. Arterial diameters (µm) did not significantly vary after 3, 6, and 10 min. In the control group, variations of arterial and venous diameters during 10 min were not significant. CONCLUSIONS This study shows a vasodilatory effect of low-frequency vibrations. The hypothesis of local cutaneous blood flow increase is retained. A phenomenon of shear stress of the endothelium induced by skin massage generates this local venous vasodilation and blood flow increase.
Samak M, Fatullayev J, Sabashnikov A
… +7 more, Zeriouh M, Schmack B, Ruhparwar A, Karck M, Popov AF, Dohmen PM, Weymann A
Med Sci Monit Basic Res
· 2016 Oct · PMID 27698339
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Total arterial revascularization is the leading trend in coronary artery bypass grafting (CABG) for the treatment of coronary artery disease (CAD). Adding to its superiority to vein conduits, arteries allow for a high de...Total arterial revascularization is the leading trend in coronary artery bypass grafting (CABG) for the treatment of coronary artery disease (CAD). Adding to its superiority to vein conduits, arteries allow for a high degree of versatility and long-term patency, while minimizing the need for reintervention. This is especially important for patients with multi-vessel coronary artery disease, as well as young patients. However, arterial revascularization has come a long way before being widely appreciated, with some yet unresolved debates, and advances that never cease to impress. In this review, we discuss the evolution of this surgical technique and its clinical success, as well as its most conspicuous limitations in light of accumulated published date from decades of experience.
Med Sci Monit Basic Res
· 2016 Sep · PMID 27667570
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Ossification is a tightly regulated process, performed by specialized cells called osteoblasts. Dysregulation of this process may cause inadequate or excessive mineralization of bones or ectopic calcification, all of whi...Ossification is a tightly regulated process, performed by specialized cells called osteoblasts. Dysregulation of this process may cause inadequate or excessive mineralization of bones or ectopic calcification, all of which have grave consequences for human health. Understanding osteoblast biology may help to treat diseases such as osteogenesis imperfecta, calcific heart valve disease, osteoporosis, and many others. Osteoblasts are bone-building cells of mesenchymal origin; they differentiate from mesenchymal progenitors, either directly or via an osteochondroprogenitor. The direct pathway is typical for intramembranous ossification of the skull and clavicles, while the latter is a hallmark of endochondral ossification of the axial skeleton and limbs. The pathways merge at the level of preosteoblasts, which progress through 3 stages: proliferation, matrix maturation, and mineralization. Osteoblasts can also differentiate into osteocytes, which are stellate cells populating narrow interconnecting passages within the bone matrix. The key molecular switch in the commitment of mesenchymal progenitors to osteoblast lineage is the transcription factor cbfa/runx2, which has multiple upstream regulators and a wide variety of targets. Upstream is the Wnt/Notch system, Sox9, Msx2, and hedgehog signaling. Cofactors of Runx2 include Osx, Atf4, and others. A few paracrine and endocrine factors serve as coactivators, in particular, bone morphogenetic proteins and parathyroid hormone. The process is further fine-tuned by vitamin D and histone deacetylases. Osteoblast differentiation is subject to regulation by physical stimuli to ensure the formation of bone adequate for structural and dynamic support of the body. Here, we provide a brief description of the various stimuli that influence osteogenesis: shear stress, compression, stretch, micro- and macrogravity, and ultrasound. A complex understanding of factors necessary for osteoblast differentiation paves a way to introduction of artificial bone matrices.
Gillespie JL, Anyah A, Taylor JM
… +2 more, Marlin JW, Taylor TA
Med Sci Monit Basic Res
· 2016 Sep · PMID 27616137
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BACKGROUND Obtaining high-quality images of cellular structures via immunofluorescence staining is critical for cellular localization studies. Often, these studies cannot be performed in parallel with certain oncology, v...BACKGROUND Obtaining high-quality images of cellular structures via immunofluorescence staining is critical for cellular localization studies. Often, these studies cannot be performed in parallel with certain oncology, virology, pharmacokinetic, and drug absorption studies due to model system technicalities requiring the cells to be cultured on porous membranes rather than glass or plastic. MATERIAL AND METHODS Here, we report a method of immunofluorescent staining of cells cultured on permeable membranes. RESULTS As proof of principle, HeLa cells grown on Transwell® membrane supports were stained with fluorescently labeled antibodies using this modified immunofluorescence staining method and visualized by fluorescent microscopy. CONCLUSIONS This protocol is a convenient alternative to staining cells on glass coverslips, thereby expanding the scope and applications of this important research tool.
Med Sci Monit Basic Res
· 2016 Aug · PMID 27554918
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BACKGROUND The aim of this study was to investigate the variety of plasma contents of membrane glycolipids in 65 gastrointestinal tumors and 31 transplant hepatomas in mice. MATERIAL AND METHODS The experimental model wa...BACKGROUND The aim of this study was to investigate the variety of plasma contents of membrane glycolipids in 65 gastrointestinal tumors and 31 transplant hepatomas in mice. MATERIAL AND METHODS The experimental model was a transplantable murine hepatoma. Experimental mice were divided into 3 groups. RESULTS The LSA and TSA content in the 2 groups were significantly difference (p<0.01), and were significantly lower in the therapeutic group than in the control group (p<0.01). CONCLUSIONS These results indicate that membrane glycolipids index LSA and TSA are sensitive markers in gastrointestinal tumors. In the transplanted hepatomas in mice, they may be considered as ancillary indicators for judging the therapeutic effect of hepatoma.
Med Sci Monit Basic Res
· 2016 Aug · PMID 27503745
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BACKGROUND The relationship between HLA-DRB1 alleles and asthma is controversial. The purpose of this study was to evaluate the relationship between HLA-DRB1 alleles and risk of asthma. MATERIAL AND METHODS We searched P...BACKGROUND The relationship between HLA-DRB1 alleles and asthma is controversial. The purpose of this study was to evaluate the relationship between HLA-DRB1 alleles and risk of asthma. MATERIAL AND METHODS We searched PubMed, Chinese National Knowledge Infrastructure (CNKI), Wan Fang (Chinese) database, and Chinese Biomedical Medical databases (CBM) to find studies on the relationship between HLA-DRB1 alleles and risk of asthma. We calculated the pooled odds ratio (OR) and 95% confidence interval (CI) using STATA 12.0. Finally, a total of 24 studies were included in this meta-analysis. RESULTS The results revealed that DRB1*03 was positively associated with risk of asthma (OR=1.51, 95%CI=1.27-1.80), and DRB1*15 was negatively associated with risk of asthma (OR=0.63, 95%CI=0.42-0.93), but no association was found in other HLA-DRB1 alleles. Subgroup analysis by age revealed that DRB1*03, DRB1*04, DRB1*09, and DRB1*15 were associated with asthma in children. Subgroup analysis by ethnicity showed that DRB1*03 and DRB1*15 were associated with asthma in whites, and DRB1*07 and DRB1*14 were associated with asthma in Asians. CONCLUSIONS This results of this meta-analysis suggest that HLA-DRB1 alleles are associated with asthma.
Samak M, Fatullayev J, Sabashnikov A
… +8 more, Zeriouh M, Schmack B, Farag M, Popov AF, Dohmen PM, Choi YH, Wahlers T, Weymann A
Med Sci Monit Basic Res
· 2016 Jul · PMID 27450399
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Ventricular hypertrophy is an ominous escalation of hemodynamically stressful conditions such as hypertension and valve disease. The pathophysiology of hypertrophy is complex and multifactorial, as it touches on several...Ventricular hypertrophy is an ominous escalation of hemodynamically stressful conditions such as hypertension and valve disease. The pathophysiology of hypertrophy is complex and multifactorial, as it touches on several cellular and molecular systems. Understanding the molecular background of cardiac hypertrophy is essential in order to protect the myocardium from pathological remodeling, or slow down the destined progression to heart failure and cardiomyopathy. In this review we highlight the most important molecular aspects of cardiac hypertrophic growth in light of the currently available published research data.
Sabashnikov A, Zeriouh M, Mohite PN
… +9 more, Patil NP, García-Sáez D, Schmack B, Soresi S, Dohmen PM, Popov AF, Weymann A, Simon AR, De Robertis F
Med Sci Monit Basic Res
· 2016 Jul · PMID 27425199
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BACKGROUND Lung transplantation remains the gold standard treatment for patients with end-stage lung disease. Lobar lung transplantation allows for transplantation of size-mismatch donor lungs in small recipients; howeve...BACKGROUND Lung transplantation remains the gold standard treatment for patients with end-stage lung disease. Lobar lung transplantation allows for transplantation of size-mismatch donor lungs in small recipients; however, donor lung volume reduction represents a challenging surgical technique. In this paper we present our initial experience with bilateral lobectomy in donor lungs before lobar lung transplantation using normothermic perfusion on the Organ Care System (OCS) Lung. MATERIAL AND METHODS Specifics of the surgical technique for donor lung instrumentation on the OCS, lobar dissection on the OCS, and right and left donor lobectomies are presented in detail. RESULTS Potential advantages of the use of the OCS for lobectomy for lobar lung transplantation are described in this section. Donor lung volume reduction utilizing OCS appeared to be easier and safer compared to the conventional cold storage technique, due to continuous perfusion of the lungs with blood and well-distended vessels that offer the feel of live lobectomy. Moreover, the OCS represents a platform for donor organ assessment and optimization of its function before transplantation. CONCLUSIONS Donor lung volume reduction was safe and feasible utilizing the OCS, which could be a useful tool for volume reduction in cases of size mismatch. Further research is needed to evaluate early and long-term results after lobar lung transplantation using the OCS in clinical studies.
Med Sci Monit Basic Res
· 2016 Jun · PMID 27357920
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BACKGROUND We present the case of a 69-year-old female patient with giant aortic aneurysm who underwent previously multiple cardiac surgeries or interventions. CASE REPORT Ross procedure was performed in 2006 due to aort...BACKGROUND We present the case of a 69-year-old female patient with giant aortic aneurysm who underwent previously multiple cardiac surgeries or interventions. CASE REPORT Ross procedure was performed in 2006 due to aortic valve regurgitation and aneurysm of the ascending aorta. In 2010 the patient was re-admitted for pulmonary valve insufficiency and a transcatheter pulmonary valve was implanted. Recently, the patient presented with an aortic arch aneurysm, maximum diameter 78 mm, which was treated by a hybrid approach, implanting a frozen elephant trunk and a covered stent graft. CONCLUSIONS The current case report demonstrates a suitable hybrid option for an extremely demanding procedure by multiple previous cardiac procedures.
Telles S, Gupta RK, Singh N
… +1 more, Balkrishna A
Med Sci Monit Basic Res
· 2016 Jun · PMID 27351626
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BACKGROUND High-frequency yoga breathing (breath rate of 2.0 Hz) has been associated with changes in oxy-hemoglobin in the prefrontal region of the brain. The present study assessed the effects of high-frequency yoga bre...BACKGROUND High-frequency yoga breathing (breath rate of 2.0 Hz) has been associated with changes in oxy-hemoglobin in the prefrontal region of the brain. The present study assessed the effects of high-frequency yoga breathing (HFYB) at 1.0 Hz on frontal oxy-hemoglobin (oxy-Hb) and deoxy-hemoglobin (deoxy-Hb). MATERIAL AND METHODS Forty healthy male participants were recruited for the study. The experimental group consisted of 20 participants 23-40 years old (group mean ±S.D., 26.4±4.7 years) with at least 3 months of experience performing HFYB (group mean ±S.D., 16.3±9.8 months). The control group consisted of 20 participants ages 23-38 years (group mean age ± S.D., 27.4±4.1 years), who were seated quietly for the same duration and their average experience of yoga practice was (±S.D.) 4.3±2.7 months. Each participant in the experimental group was assessed at 2 sessions (HFYB and breath awareness [BAW]) on alternate days. Hemodynamic changes were assessed using a functional near-infrared spectroscopy sensor placed over the forehead. Data were analyzed using repeated-measures analyses of variance followed by post hoc Bonferroni adjustment. RESULTS A significant reduction was observed in oxy-Hb during and after HFYB on the left and right sides compared to values before. We also found a significant reduction in deoxy-Hb during and after the quiet sitting control session compared to pre-session values on left and right sides. CONCLUSIONS The decrease in oxy-Hb during and after HFYB suggests that there was no frontal activation during HFYB when practiced at the rate of 1.0 Hz.
Schmack B, Weymann A, Popov AF
… +8 more, Patil NP, Sabashnikov A, Kremer J, Farag M, Brcic A, Lichtenstern C, Karck M, Ruhparwar A
Med Sci Monit Basic Res
· 2016 May · PMID 27145697
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Right ventricular failure (RVF) is an unfortunate complication that continues to limit outcomes following durable left ventricular assist device (LVAD) implantation. Despite several 'RVF risk scores' having been proposed...Right ventricular failure (RVF) is an unfortunate complication that continues to limit outcomes following durable left ventricular assist device (LVAD) implantation. Despite several 'RVF risk scores' having been proposed, preoperative prediction of post-LVAD RVF remains a guesstimate at best. Current strategies for institution of temporary RVAD support are invasive, necessitate additional re-thoracotomy, restrict postoperative mobilization, and/or entail prolonged retention of prosthetic material in-situ. The authors propose a novel surgical strategy comprising simultaneous implantation of a permanent LVAD and percutaneous TandemHeart® plus ProtekDuo® to provide temporary RVAD support and preempt RVF in patients with impaired RV function.
Med Sci Monit Basic Res
· 2016 Apr · PMID 27122237
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BACKGROUND: Comparative DNA microarray analyses typically yield very large gene expression data sets that reflect complex patterns of change. Despite the wealth of information that is obtained, the identification of stab...BACKGROUND: Comparative DNA microarray analyses typically yield very large gene expression data sets that reflect complex patterns of change. Despite the wealth of information that is obtained, the identification of stable reference genes is required for normalization of disease- or drug-induced changes across tested groups. This is a prerequisite in quantitative real-time reverse transcription-PCR (qRT-PCR) and relative RT-PCR but rare in gene microarray analysis. The goal of the present study was to outline a simple method for identification of reliable reference genes derived from DNA microarray data sets by comparative statistical analysis of software-generated and manually calculated candidate genes. MATERIAL AND METHODS: DNA microarray data sets derived from whole-blood samples obtained from 14 Zucker diabetic fatty (ZDF) rats (7 lean and 7 diabetic obese) were used for the method development. This involved the use of software-generated filtering parameters to accomplish the desired signal-to-noise ratios, 75th percentile signal manual normalizations, and the selection of reference genes as endogenous controls for target gene expression normalization. RESULTS: The combination of software-generated and manual normalization methods yielded a group of 5 stably expressed, suitable endogenous control genes which can be used in further target gene expression determinations in whole blood of ZDF rats. CONCLUSIONS: This method can be used to correct for potentially false results and aid in the selection of suitable endogenous control genes. It is especially useful when aimed to aid the software in cases of borderline results, where the expression and/or the fold change values are just beyond the pre-established set of acceptable parameters.
Patelis N, Moris D, Karaolanis G
… +1 more, Georgopoulos S
Med Sci Monit Basic Res
· 2016 Apr · PMID 27090791
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BACKGROUND: Patients presenting with ruptured abdominal aortic aneurysms are most often treated with open repair despite the fact that endovascular aneurysm repair is a less invasive and widely accepted method with clear...BACKGROUND: Patients presenting with ruptured abdominal aortic aneurysms are most often treated with open repair despite the fact that endovascular aneurysm repair is a less invasive and widely accepted method with clear benefits for elective aortic aneurysm patients. A debate exists regarding the definitive benefit in endovascular repair for patients with a ruptured abdominal aortic aneurysm. The aim of this literature review was to determine if any trends exist in favor of either open or endovascular repair. MATERIAL AND METHODS: A literature search was performed using PUBMED, OVID, and Google Scholar databases. The search yielded 64 publications. RESULTS: Out of 64 publications, 25 were retrospective studies, 12 were population-based, 21 were prospective, 5 were the results of RCTs, and 1 was a case-series. Sixty-one studies reported on early mortality and provided data comparing endovascular repair (rEVAR) and open repair (rOR) for ruptured abdominal aneurysm groups. Twenty-nine of these studies reported that rEVAR has a lower early mortality rate. Late mortality after rEVAR compared to that of rOR was reported in 21 studies for a period of 3 to 60 months. Results of 61.9% of the studies found no difference in late mortality rates between these 2 groups. Thirty-nine publications reported on the incidence of complications. Approximately half of these publications support that the rEVAR group has a lower complication rate and the other half found no difference between the groups. Length of hospital stay has been reported to be shorter for rEVAR in most studies. Blood loss and need for transfusion of either red cells or fresh frozen plasma was consistently lower in the rEVAR group. CONCLUSIONS: Differences between the included publications affect the outcomes. Randomized control trials have not been able to provide clear conclusions. rEVAR can now be considered a safe method of treating rAAA, and is at least equal to the well-established rOR method.
Li S, Han D, Zhang Y
… +7 more, Xie X, Ke R, Zhu Y, Liu L, Song Y, Yang L, Li M
Med Sci Monit Basic Res
· 2016 Mar · PMID 26978596
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BACKGROUND: The current study was performed to investigate the effect of adenosine monophosphate (AMP) - activated protein kinase (AMPK) activation on the extracellular matrix (ECM) remodeling of pulmonary arteries in pu...BACKGROUND: The current study was performed to investigate the effect of adenosine monophosphate (AMP) - activated protein kinase (AMPK) activation on the extracellular matrix (ECM) remodeling of pulmonary arteries in pulmonary arterial hypertension (PAH) and to address its potential mechanisms. MATERIAL AND METHODS: PAH was induced by a single intraperitoneal injection of monocrotaline (MCT) into Sprague-Dawley rats. Metformin (MET) was administered to activate AMPK. Immunoblotting was used to determine the phosphorylation and expression of AMPK and expression of tissue inhibitor of metalloproteinase-1 (TIMP-1). Gelatin zymography was performed to determine the activity of matrix metalloproteinase-2 (MMP-2) and MMP-9. RESULTS: Activation of AMPK by MET significantly reduced the right ventricle systolic pressure and the right ventricular hypertrophy in MCT-induced rat PAH model, and partially inhibited the ECM remodeling of pulmonary arteries. These effects were coupled with the decrease of MMP-2/9 activity and TIMP-1 expression. CONCLUSIONS: This study suggests that activation of AMPK benefits PAH by inhibiting ECM remodeling of pulmonary arteries. Enhancing AMPK activity might have potential value in clinical treatment of PAH.