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Marianna Zana,Anita Szécsényi,Agnes Czibula,Annamária Bjelik,Anna Juhász,Agnes Rimanóczy,Krisztina Szabó,Agnes Vetró,Péter Szucs,Agnes Várkonyi,Magdolna Pákáski,Krisztina Boda,István Raskó,Zoltán Janka,János Kálmán The aim of the present study was to investigate the oxidative status of lymphocytes from children (n=7) and adults (n=18) with Down's syndrome (DS). The basal oxidative condition, the vulnerability to in vitro hydrogen peroxide exposure, and the repair capacity were measured by means of the damage-... ( view more )specific alkaline comet assay. Significantly and age-independently elevated numbers of single strand breaks and oxidized bases (pyrimidines and purines) were found in the nuclear DNA of the lymphocytes in the DS group in the basal condition. These results may support the role of an increased level of endogenous oxidative stress in DS and are similar to those previously demonstrated in Alzheimer's disease. In the in vitro oxidative stress-induced state, a markedly higher extent of DNA damage was observed in DS children as compared with age- and gender-matched healthy controls, suggesting that young trisomic lymphocytes are more sensitive to oxidative stress than normal ones. However, the repair ability itself was not found to be deteriorated in either DS children or DS adults. ( view less ) Agnes Hajnal,Orsolya Nagy,Agnes Litvai,Julius Papp,James R Parratt,Agnes Végh We have shown previously that a single period of treadmill exercise in dogs protects the heart against the severe ventricular arrhythmias that arise when a major (anterior descending) branch of the left coronary artery is occluded following anaesthesia 24 h later. This protection is aminoguanidine ... ( view more )sensitive, suggesting a role for nitric oxide (NO) in this exercise-induced delayed antiarrhythmic effect. The present study has further examined the possible role of NO as a mediator and/or as a trigger using the selective induced (iNOS) inhibitor S-(2-aminoethyl)-methyl-isothiourea (AEST) and the specific but not selective nitric oxide synthase inhibitor N(omega)-nitro-L-arginine-methyl-ester (L-NAME). Exercise markedly reduced the severity of ischaemia and reperfusion-induced ventricular arrhythmias 24 h later. Thus, only one of the dogs (8%) so exercised fibrillated on occlusion (contrast 46% in the control, non-exercised dogs; P<0.05) and the marked changes in the inhomogeneity of electrical activation that occur in the ischaemic region following occlusion were much reduced (P<0.05 compared to controls). This delayed exercise-induced cardioprotection was significantly attenuated by the nitric oxide synthase (NOS) inhibitors L-NAME, given prior to the exercise protocol and by AEST given prior to the coronary artery occlusion. For example, survival from the ischaemia-reperfusion insult was 54% in the exercise dogs, 0% in the controls and 14% in those dogs given a NOS inhibitor. We conclude that nitric oxide (NO) is both the trigger and the mediator of this delayed protection against ischaemia and reperfusion-induced arrhythmias. ( view less ) Agnes ArnoldIn last month's BJPB, Agnes Arnold discussed the pathophysiology of deep vein thrombosis and suggested ways that the risk could be reduced, particularly with respect to DVTs resulting from endothelial damage in surgery. In this, the second of a two-part series, Agnes continues by looking at hyperco... ( view more )agulability of blood and venous stasis and the impact of these conditions on the risk of DVT. ( view less ) László Filák,Tibor András Rokob,Gyöngyvér Agnes Vaskó,Orsolya Egyed,Agnes Gömöry,Zsuzsanna Riedl,György Hajós2-Pyrazinyl (2) and 3-pyridazinylketone arylhydrazones (6) and their benzologues undergo a ring closure reaction to yield pyrazolo[3,4- b]pyrazines (4) and pyrazolo[4,3- c]pyridazines (7), respectively, in acceptable to good yields. The reaction was found to be accelerated by using acidic or basic ... ( view more )conditions. Quantum chemical calculations suggest the key step of the mechanism to be a direct cyclization; analysis of aromaticity based on computed magnetic properties revealed its medium-dependent pericyclic or pseudopericyclic character. The cyclization reaction has also been extended for the synthesis of related ring systems ( 9, 12, 14). ( view less ) Irina Guseva Canu,Agnès Rogel,Eric Samson,Simone Benhamou,Agnès Laplanche,Margot Tirmarche OBJECTIVE: To investigate all-cause and cancer mortality of biological research laboratories workers of the French Atomic Energy Commission (CEA) and the National Institute of Health and Medical Research (INSERM). METHODS: Two cohorts, bioCEA (N = 3,509) and bioINSERM (N = 4,966) were followed from... ( view more ) 1968 to 1994 and 1980 to 1993, respectively. The mortality of each cohort was compared with that of the French population by computation of the standardized mortality ratio (SMR) with their 90% confidence interval (90% CI). Trend and heterogeneity tests were computed in order to study SMRs variation by job characteristics. In the bioCEA cohort individual dosimetry data being available, a trend test was also computed according to ionizing radiation cumulative dose. RESULTS: The SMRs were significantly below one in both cohorts for all-cause mortality (bioCEA: SMR = 0.52 [0.46-0.59], bioINSERM: SMR = 0.56 [0.46-0.67]) and for all-cancer mortality (bioCEA: SMR = 0.66 [0.54-0.80], bioINSERM: SMR = 0.55 [0.39-0.75]). There were some specific cancer sites for which the SMR was higher than 1, but not significantly. In the bioCEA cohort a positive trend was observed between ionizing radiation cumulative doses and all-cause as well as all-cancer SMRs. CONCLUSION: This study on two French cohorts of biological research workers found a favorable mortality pattern. These findings are consistent with recent publications. The positive trend of cancer mortality according to ionizing radiation exposure among bioCEA cohort needs to be confirmed with more precise assessment of exposures and information on individual risk factors. ( view less ) Imre Gerlinger,László Török,Agnes Nagy,Agnes Patzkó,Hajna Losonczy,József Pytel INTRODUCTION: The most serious complication of tonsillectomy is haemorrhage. Primary post-tonsillectomy bleeding occurs during the first 24 hours following the procedure as a consequence of inadequate suturing/ligation of the feeding arteries. Secondary post-tonsillectomy bleeding occurs most frequ... ( view more )ently between the 5-8. postoperative days. The role of different risk factors has intensively been examined in the background of secondary post-tonsillectomy bleedings, however, their real role is rather confusing. AIM: The aim of the present study was to examine whether preoperative haematological screening in order to detect hidden coagulopathies in the background of post-tonsillectomy bleedings is reasonable or not. METHOD: Of the 115 patients who were admitted to the Department of Otorhinolaryngology, Head and Neck Surgery, Medical School, University of Pécs, between 2002 and 2004, 107 patients (59 female, 48 male, average age 29+/-10.9 years) were asked to undergo screening of the following factors: thrombocytes, bleeding time using the Ivy method, thrombin time, activated partial prothrombin time, prothrombin/INR ratio, fibrinogen level. RESULTS: Of the 58 patients who accepted the invitation 28 (49%) presented with abnormal screening results. Isolated factor determination was recommended to all of them, however, only 19 patients (68%) turned up for the second screening. In 2 cases--3.4% of the re-examined patients--unknown coagulopathy was diagnosed: isolated factor VII underproduction in 1 patient and combined factor VII and XII underproduction also in 1 patient. Three female patients presented with a surprising isolated factor IX overproduction which proned them to thrombosis: all 3 patients had been on oral anticoncipients. CONCLUSIONS: From this study several conclusions can be drown for the practising physician: 1. the universal preoperative haematological screening does not seem to be cost-effective; 2. in cases of children, especially if the family history and also both the preoperative history and detailed physical examination are suspicious (e.g. recurrent mild nasal bleedings!) hidden coagulopathy needs to be ruled out; 3. in our study activated partial thromboplastin time seemed to be the most sensitive screening parameter; 4. due to the fact that coagulopathies are inherited diseases, the diagnosis of a patient with a particular hidden coagulopathy can contribute to the exploration of further family members; 5. the vast majority of secondary post-tonsillectomy bleedings were observed after procedures which had been carried out with "hot" techniques: bipolar forceps or bipolar scissors; 6. Ivy's method is the recommended method of choice to examine the bleeding time. ( view less ) Julie Mollet,Agnès Delahodde,Valérie Serre,Dominique Chretien,Dimitri Schlemmer,Anne Lombes,Nathalie Boddaert,Isabelle Desguerre,Pascale de Lonlay,Hélène Ogier de Baulny,Arnold Munnich,Agnès Rötig Coenzyme Q(10) (CoQ(10)) plays a pivotal role in oxidative phosphorylation (OXPHOS) in that it distributes electrons between the various dehydrogenases and the cytochrome segments of the respiratory chain. Primary coenzyme Q(10) deficiency represents a clinically heterogeneous condition suggestive ... ( view more )of genetic heterogeneity, and several disease genes have been previously identified. The CABC1 gene, also called COQ8 or ADCK3, is the human homolog of the yeast ABC1/COQ8 gene, one of the numerous genes involved in the ubiquinone biosynthesis pathway. The exact function of the Abc1/Coq8 protein is as yet unknown, but this protein is classified as a putative protein kinase. We report here CABC1 gene mutations in four ubiquinone-deficient patients in three distinct families. These patients presented a similar progressive neurological disorder with cerebellar atrophy and seizures. In all cases, enzymological studies pointed to ubiquinone deficiency. CoQ(10) deficiency was confirmed by decreased content of ubiquinone in muscle. Various missense mutations (R213W, G272V, G272D, and E551K) modifying highly conserved amino acids of the protein and a 1 bp frameshift insertion c.[1812_1813insG] were identified. The missense mutations were introduced into the yeast ABC1/COQ8 gene and expressed in a Saccharomyces cerevisiae strain in which the ABC1/COQ8 gene was deleted. All the missense mutations resulted in a respiratory phenotype with no or decreased growth on glycerol medium and a severe reduction in ubiquinone synthesis, demonstrating that these mutations alter the protein function. ( view less ) Christine Bellanné-Chantelot,Claire Carette,Jean-Pierre Riveline,René Valéro,Jean-François Gautier,Etienne Larger,Yves Reznik,Pierre-Henri Ducluzeau,Agnès Sola,Agnès Hartemann-Heurtier,Pierre Lecomte,Lucy Chaillous,Marie Laloi-Michelin,Jean-Marie Wilhem,Pierre Cuny,Françoise Duron,Bruno Guerci,Nathalie Jeandidier,Helen Mosnier-Pudar,Michel Assayag,Danièle Dubois-Laforgue,Gilberto Velho,José Timsit OBJECTIVE: The clinical expression of maturity-onset diabetes of the young (MODY)-3 is highly variable. This may be due to environmental and/or genetic factors, including molecular characteristics of the hepatocyte nuclear factor 1-alpha (HNF1A) gene mutation. RESEARCH DESIGN AND METHODS: We analyz... ( view more )ed the mutations identified in 356 unrelated MODY3 patients, including 118 novel mutations, and searched for correlations between the genotype and age at diagnosis of diabetes. RESULTS: Missense mutations prevailed in the dimerization and DNA-binding domains (74%), while truncating mutations were predominant in the transactivation domain (62%). The majority (83%) of the mutations were located in exons 1- 6, thus affecting the three HNF1A isoforms. Age at diagnosis of diabetes was lower in patients with truncating mutations than in those with missense mutations (18 vs. 22 years, P = 0.005). Missense mutations affecting the dimerization/DNA-binding domains were associated with a lower age at diagnosis than those affecting the transactivation domain (20 vs. 30 years, P = 10(-4)). Patients with missense mutations affecting the three isoforms were younger at diagnosis than those with missense mutations involving one or two isoforms (P = 0.03). CONCLUSIONS: These data show that part of the variability of the clinical expression in MODY3 patients may be explained by the type and the location of HNF1A mutations. These findings should be considered in studies for the search of additional modifier genetic factors. ( view less ) Sylvie Kieffer- Jaquinod,Agnès Chapel,Jérôme Garin,Agnøs Journet This chapter describes the process of production, purification, separation, and mass spectrometry identification of soluble lysosomal proteins. The rationale for purification of these proteins resides in their characteristic sugar, the mannose-6-phosphate (M6P), which allows an easy purification by... ( view more ) affinity chromatography on immobilized M6P receptor (MPR). The secretion of M6P proteins (essentially soluble lysosomal proteins) from cells in culture is induced by adding a weak base in the culture medium. Secreted proteins are ammonium sulfate precipitated, dialyzed, and loaded onto the immobilized MPR column. After specific elution and collection of the M6P proteins, these are resolved by either bidimensional or monodimensional gel electrophoresis (designated as 2-DE or 1-DE, respectively). Mass spectrometry analysis is performed on spots excised from the 2-DE gel, or on discrete bands covering altogether the whole length of the 1-DE gel lane: these spots or bands are in-gel digested with trypsin and protein identification is obtained, thanks to peptide mass fingerprints [provided by analysis of the digests by matrix-assisted laser desorption ionization-mass spectrometry (MALDI-MS)] or peptide amino acid sequences (provided by analysis of the digests by the coupling between liquid chromatography and tandem mass spectrometry, LC-MS/MS). ( view less ) Romaric Lacroix,Florence Sabatier,Agnès Mialhe,Agnès Basire,Ralph Pannell,Hélène Borghi,Stephane Robert,Edouard Lamy,Laurent Plawinski,Laurence Camoin-Jau,Victor Gurewich,Eduardo Angles-Cano,Françoise Dignat-George The regulation of plasmin generation on cell surfaces is of critical importance in the control of vascular homeostasis. Cell-derived microparticles participate in the dissemination of biological activities. However, their capacity to promote plasmin generation has not been documented. In this study... ( view more ), we show that endothelial microparticles (EMPs) from tumor necrosis factor alpha (TNFalpha)-stimulated endothelial cells served as a surface for the generation of plasmin. The generation of plasmin involved expression of urokinase-type plasminogen activator (uPA) and its receptor (uPAR) at the surface of EMPs and was further increased by their ability to bind exogenous uPA on uPAR. Plasminogen was activated at the surface of EMPs in a dose-dependent, saturable, and specific manner as indicated by the inhibition of plasmin formation by epsilon-amino-caproic acid (epsilon-ACA) and carboxypeptidase B. EMP-induced plasmin generation affects tube formation mediated by endothelial progenitor cells. However, low amounts of EMPs increased tube formation, whereas higher concentrations inhibited it. Prevention of these effects by inhibitors of either uPA or plasmin underscore the key role of EMP-induced plasmin generation. In conclusion, we demonstrated that EMPs act as vectors supporting efficient plasmin generation and dissemination, a new pathway in the regulation of endothelial proteolytic activities with potential involvement in inflammation, angiogenesis, and atherosclerosis. ( view less ) Agnes Dencs,Agnes SebestyénHGV/GBV-C is a mainly parenterally transmitted Flavivirus that causes a persistent infection. So far no disease has been associated with HGV/GBV-C infection, but its beneficial role in co-infection with the human immunodeficiency virus has been shown in many recent studies. The aim of our study was... ( view more ) to determine the frequency of ongoing HGV/GBV-C infections among a sociologically unique group of the Hungarian population, who are at great risk for parenterally transmitted diseases. Viral RNA was detected in 75 serum samples by an RT-PCR method specific for the NS5 region. Nine (12%) samples were positive for HGV/GBV-C RNA. All nine PCR products were sequenced and a phylogenetic analysis was performed to identify the genotypes and subtypes of the detected viruses. All nine isolates proved to be genotype 2, eight of them were classified as subtype 2a, and one as subtype 2b. ( view less ) Anaïs G Jensen,Magali Chemali,Agnès Chapel,Sylvie Kieffer-Jaquinod,Michel Jadot,Jérôme Garin,Agnès Journet Most soluble lysosomal proteins carry Man6P (mannose 6-phosphate), a specific carbohydrate marker that enables their binding to cellular MPRs (Man6P receptors) and their subsequent targeting towards the lysosome. This characteristic was exploited to identify novel soluble lysosomal proteins by prot... ( view more )eomic analysis of Man6P proteins purified from a human cell line. Among the proteins identified during the course of the latter study [Journet, Chapel, Kieffer, Roux and Garin (2002) Proteomics, 2, 1026-1040], some had not been previously described as lysosomal proteins. We focused on a protein detected at 76 kDa by SDS/PAGE. We named this protein 'p76' and it appeared later in the NCBI protein database as the 'hypothetical protein LOC196463'. In the present paper, we describe the identification of p76 by MS and we analyse several of its biochemical characteristics. The presence of Man6P sugars was confirmed by an MPR overlay experiment, which showed the direct and Man6P-dependent interaction between p76 and the MPR. The presence of six N-glycosylation sites was validated by progressive peptide-N-glycosidase F deglycosylation. Experiments using N- and C-termini directed anti-p76 antibodies provided insights into p76 maturation. Most importantly, we were able to demonstrate the lysosomal localization of this protein, which was initially suggested by its Man6P tags, by both immunofluorescence and sub-cellular fractionation of mouse liver homogenates. ( view less ) Agnès Gartner,Yves Kameli,Pierre Traissac,Agnès Dhur,Francis Delpeuch,Bernard Maire OBJECTIVE: We evaluated the impact of the Community Nutrition Project (CNP) of Senegal, West Africa on the population. In poor urban districts, the CNP provided underweight 6- to 35-mo-old children with growth monitoring/promotion and food supplementation, and education for mothers for a period of ... ( view more )6 mo. METHODS: A before/after intervention and intervention zone (IZ)/control zone (CZ) design was used to assess whether CNP had an impact 18 mo after it began in Diourbel. Exhaustive samples included children 6-35 mo old in the CZ (n = 895 before and 917 after) and IZ (n = 912 and 759). The impact was assessed by the differential effect of the zone on changes in underweight, wasting, and stunting defined by the threshold of -2 or -3 z scores. RESULTS: The decrease in wasting was higher in the CZ (from 13.7% to 8.6% versus 11.3% to 10.8%, P = 0.042). Changes in stunting did not differ between zones (18.8% to 14.5% versus 15.1% to 14.7%, P = 0.21). However, in the IZ, severe wasting, stunting, and underweight disappeared in children 6-11 mo of age. In the CZ, the socioeconomic data and some outcomes in children reflected a favorable context independent of the CNP. CONCLUSION: Despite a globally satisfactory decrease in malnutrition in the IZ, no impact was demonstrated because the same or an even larger decrease was observed in the CZ, highlighting the importance of relying on a quasi-experimental design. This may be explained in part by weaknesses in the process, which probably interfered with a potential impact, and by the high degree of population mobility, which could have interfered with efficiency assessed on a geographic scale. ( view less ) Julie Mollet,Irina Giurgea,Dimitri Schlemmer,Gustav Dallner,Dominique Chretien,Agnès Delahodde,Delphine Bacq,Pascale de Lonlay,Arnold Munnich,Agnès Rötig Coenzyme Q10 (CoQ10) plays a pivotal role in oxidative phosphorylation (OXPHOS), as it distributes electrons among the various dehydrogenases and the cytochrome segments of the respiratory chain. We have identified 2 novel inborn errors of CoQ10 biosynthesis in 2 distinct families. In both cases, e... ( view more )nzymologic studies showed that quinone-dependent OXPHOS activities were in the range of the lowest control values, while OXPHOS enzyme activities were normal. CoQ10 deficiency was confirmed by restoration of normal OXPHOS activities after addition of quinone. A genome-wide search for homozygosity in family 1 identified a region of chromosome 10 encompassing the gene prenyldiphosphate synthase, subunit 1 (PDSS1), which encodes the human ortholog of the yeast COQ1 gene, a key enzyme of CoQ10 synthesis. Sequencing of PDSS1 identified a homozygous nucleotide substitution modifying a conserved amino acid of the protein (D308E). In the second family, direct sequencing of OH-benzoate polyprenyltransferase (COQ2), the human ortholog of the yeast COQ2 gene, identified a single base pair frameshift deletion resulting in a premature stop codon (c.1198delT, N401fsX415). Transformation of yeast Deltacoq1 and Deltacoq2 strains by mutant yeast COQ1 and mutant human COQ2 genes, respectively, resulted in defective growth on respiratory medium, indicating that these mutations are indeed the cause of OXPHOS deficiency. ( view less ) Agnes Toth-Petroczy,Agnes Szilagyi,Zsolt Ronai,Maria Sasvari-Szekely,András GuttmanTwo to four-basepair-short tandem repeats (i.e. microsatellites) are broadly utilized as genetic markers for mapping disease loci in whole genome search analyses. Based on their close vicinity on chromosome 11, the D11S1984 microsatellite was anticipated as a tentative marker for the dopamine D4 re... ( view more )ceptor gene. A capillary gel electrophoresis based genotype analysis method and an in-house made computational tool was developed for the analysis of the D11S1984 microsatellite marker to examine a healthy Hungarian population of n=106. The data obtained did not suggest significant linkage between the D11S1984 marker and the DRD4 gene. ( view less ) Béla Márkus,Agnes Bajner,András Csejtei,Borbála Firisz,Agnes Hegedus,Eszter Kocsis,Beáta Kovács,Gábor Pintér,Csaba Tóth In addition to discussing effectiveness of breast cancer screening initiated within the National Public Health Programme, the problem of how to treat non-palpable, early invasive and in situ breast cancer (DCIS) is considered. The theoretical issue of the sentinel lymph node and its impact on biops... ( view more )y practice have also been dealt with. In the authors' region, screening was introduced in 1999 and after a short break has been continued since 2002. Patient data of three periods, each of two years, each with ten years' interval (1982-1983, 1992-1993, 2002-2003) have been analysed. Changes in the number of surgical operations and tumour size, incidence of in situ cancer, lymph node involvement and distribution of types of surgery have been studied. Biopsy of the sentinel lymph node has been applied since May, 2003 (with 45 biopsies performed until 31 December, 2004). The number of persons participating in the screening programme has gradually increased, the number of surgical operations because of breast cancer increased from period to period. Size of the detected tumours has decreased, the percentage of non-palpable cases has been significant (445 surgical interventions during the years 2002-2004: surgery: 19%). The proportion of DCIS has increased to nearly four times as compared to data of years immediately preceding the era of screening (1993-1998: 11 cases, 2%; 1999-2004: 62 cases, 7.5%). Specificity of sentinel lymph node biopsy was 90%, with a sensitivity of 65%. The proportion of breast saving surgery has increased above 50%. The authors regard screening as successful, in their opinion, its benefits cannot be questioned, in spite of some controversial issues. As to the treatment of non-palpable, early invasive cancer, they underline the importance of preoperative evaluation--cytology, core biopsy--and establishing dignity. The issues of localisation--wire hook marking--and histological processing--large blocks--have also been dealt with. In spite of the fact that the risk for potential malignancy of DCIS lesions has not yet been fully clarified, adequate treatment is indicated; the authors take stand on the issues of indication for surgery, postoperative radiotherapy and use of Tamoxifen. Indications and contraindications of sentinel lymph node biopsy have been summed up. ( view less ) Judit Majnik,Attila Patocs,Katalin Balogh,Miklos Toth,Peter Gergics,Agnes Szappanos,Agnes Mondok,Gabor Borgulya,Pal Panczel,Zoltan Prohaszka,Karoly Racz CONTEXT: Some variants of the glucocorticoid receptor (GR) gene have been found to alter glucocorticoid sensitivity and have been associated with altered metabolic profiles. OBJECTIVE: The objective of the study was to examine whether N363S and ER22/23K variants of the GR gene may be associated wit... ( view more )h the development of adrenal incidentalomas and whether these variants may contribute to metabolic abnormalities frequently present in these patients. DESIGN, SETTING, AND PATIENTS: The study included 99 patients with unilateral and 44 patients with bilateral adrenal incidentalomas, 102 population-matched control subjects, and 100 patients with type 2 diabetes mellitus. MAIN OUTCOME MEASURES: Metabolic and hormonal parameters and GR gene variants were determined. RESULTS: When compared with control subjects, the carrier frequency for the N363S variant was markedly and significantly higher in patients with bilateral (7.8 vs. 20.5%, P < 0.05) but not in those with unilateral incidentalomas (7.1%) or in patients with type 2 diabetes (13.0%). Type 2 diabetes occurred more frequently in patients with bilateral, compared with those with unilateral incidentalomas (40.9 vs. 22.2%, P < 0.05). In patients with bilateral incidentalomas, a significant association of the N363S variant with impaired glucose homeostasis but not with body mass index, hypertension, hyperlipidemia, or history of coronary artery disease was found. The carrier frequency of the ER22/23EK variant was similar in all groups, and this variant failed to show any association with metabolic abnormalities. CONCLUSION: These results suggest that the N363S variant of the GR gene may play a role in the pathogenesis of bilateral adrenal incidentalomas, although the mechanism still remains to be investigated. ( view less ) Marta Novak,Miklos Zs Molnar,Csaba Ambrus,Agnes Zs Kovacs,Agnes Koczy,Adam Remport,Lilla Szeifert,Andras Szentkiralyi,Colin M Shapiro,Maria S Kopp,Istvan Mucsi BACKGROUND: Recent studies confirmed that sleep disorders have a significant impact on various aspects of health in patients at different stages of chronic kidney disease. At the same time, there is an almost complete lack of information on the prevalence and correlates of insomnia in kidney transp... ( view more )lant recipients. METHODS: In a cross-sectional study, the Athens Insomnia Scale was used to assess the prevalence of insomnia in a large sample of kidney transplant recipients compared with wait-listed dialysis patients and also a matched group obtained from a nationally representative sample of the Hungarian population. RESULTS: The prevalence of insomnia was 15% in wait-listed patients, whereas it was only 8% in transplant recipients (P < 0.001), which, in turn, was not different from the prevalence of this sleep problem in the sample of the general population (8%). Prevalences of insomnia in the transplant group were 5%, 7%, and 14% for the groups with glomerular filtration rates (GFRs) greater than 60 mL/min (> 1.00 mL/s), 30 to 60 mL/min (0.50 to 1.00 mL/s), and less than 30 mL/min (< 0.5 mL/s), respectively (P < 0.01). However, estimated GFR was no longer associated significantly with insomnia in the transplant population after statistical adjustment for several covariates. In a multivariate model, insomnia was significantly and independently associated with treatment modality (transplantation versus wait listing), as well as the presence of depression, restless legs syndrome, and high risk for obstructive sleep apnea syndrome, and with self-reported comorbidity. CONCLUSION: The prevalence of insomnia was substantially less in the transplant group than in wait-listed dialysis patients and similar to that observed in the general population. Because this condition potentially is treatable, attention should be directed to the appropriate diagnosis and management of insomnia in the kidney transplant recipient population. ( view less ) Agnès Basire,Florence Sabatier,Sophie Ravet,Edouard Lamy,Agnès Mialhe,Gwladys Zabouo,Pascale Paul,Victor Gurewich,José Sampol,Françoise Dignat-George Endothelial progenitor cells (EPC) display a unique ability to repair vascular injury and promote neovascularization although the underlying molecular mechanisms remain poorly understood. Urokinase-type plasminogen activator (uPA) and its receptor (uPAR) play a critical role in cell migration and a... ( view more )ngiogenesis by facilitating proteolysis of extracellular matrix. The aim of the present study was to characterize the uPA/uPAR-dependent proteolytic potential of EPC outgrown from human umbilical cord blood and to analyze its contribution to their angiogenic properties in vitro. Cells derived from EPC (EPDC), presenting typical features of late outgrowth endothelial cells, were compared to mature endothelial cells, represented by human umbilical vein endothelial cells (HUVEC). Using quantitative flow cytometry, enzyme-linked immunosorbent assays and zymography, we demonstrated that EPDC displayed higher levels of uPA and uPAR. In conditioned culture media, uPA-dependent proteolytic activity was also found to be significantly increased in EPDC. This activity was paralleled by a higher secretion of pro-metalloproteinase-2 (pro-MMP-2). Inhibition of EPDC-associated uPA by monoclonal antibodies that block either uPA activity or receptor binding, significantly reduced proliferation, migration and capillary like tube formation. Moreover, tumor necrosis factor-alpha and vascular endothelial growth factor, known to be locally secreted in ischemic areas, further increased the proteolytic potential of EPDC by up-regulating uPA and uPAR expression respectively. The EPDC response to these factors was found to be more pronounced than that of HUVEC. In conclusion, these findings indicated that EPDC are characterized by high intrinsic uPA/uPAR-dependent proteolytic potential that could contribute to their invasive and angiogenic behaviour. ( view less ) Chantal Loirat,Anne-Laure Sellier-Leclerc,Véronique Frémeaux-Bacchi,Agnès Dragon-Durey,Jean-Pierre Girma,Agnès VeyradierDuring the last decade, major progresses have been performed in the understanding and classification of hereditary haemolytic uremic syndromes and thrombotic thrombocytopenic purpura. The identification of patients with congenital thrombotic thrombocytopenic purpura due to hereditary deficiency of ... ( view more )von Willebrand factor protease (Adamts 13) is of primordial importance, as fresh frozen plasma infusions prevent relapses and the risk of visceral (mainly cerebral and renal) involvement. The identification of patients with haemolytic uremic syndromes due to mutations in the genes that encode complement alternative pathway regulatory proteins (factor H, factor I, MCP) opens the way to new physiopathologic and therapeutic advances. ( view less ) Claudio Hetz,Pierre-Alain Vitte,Agnes Bombrun,Tatiana K Rostovtseva,Sylvie Montessuit,Agnes Hiver,Matthias K Schwarz,Dennis J Church,Stanley J Korsmeyer,Jean-Claude Martinou,Bruno Antonsson Ischemic injuries are associated with several pathological conditions, including stroke and myocardial infarction. Several studies have indicated extensive apoptotic cell death in the infarcted area as well as in the penumbra region of the infarcted tissue. Studies with transgenic animals suggest t... ( view more )hat the mitochondrion-mediated apoptosis pathway is involved in ischemia-related cell death. This pathway is triggered by activation of pro-apoptotic Bcl-2 family members such as Bax. Here, we have identified and synthesized two low molecular weight compounds that block Bax channel activity. The Bax channel inhibitors prevented cytochrome c release from mitochondria, inhibited the decrease in the mitochondrial membrane potential, and protected cells against apoptosis. The Bax channel inhibitors did not affect the conformational activation of Bax or its translocation and insertion into the mitochondrial membrane in cells undergoing apoptosis. Furthermore, the compounds protected neurons in an animal model of global brain ischemia. The protective effect in the animal model correlated with decreased cytochrome c release in the infarcted area. This is the first demonstration that Bax channel activity is required in apoptosis. ( view less ) Agnès VigneryThe fusion of cells is a fundamental biological event that plays a central role in a variety of developmental and homeostatic processes. Macrophages are present in all tissues and can initiate interaction and fusion. The putative macrophage-fusion machinery is still poorly understood, but some of i... ( view more )ts components have been identified. Macrophages recognize each other as << self >> in order to fuse but some essential questions remain: do macrophages fuse with somatic cells to repair tissues and organs? Do macrophages fuse with tumor cells to trigger metastasis? Agnès Vignery discusses these novel and challenging ideas in this review. ( view less ) Agnes Ssali,Lisa M Butler,Donna Kabatesi,Rachel King,Agnes Namugenyi,Moses R Kamya,Jeffrey Mandel,Sanny Y Chen,Willi McFarland In the face of ongoing epidemics of HIV/AIDS and STI, high demand for family planning, and limited resources, traditional healers may be under-utilized providers of reproductive health education in rural sub-Saharan Africa. We implemented a training program in HIV prevention and family planning met... ( view more )hods for healers in the Kiboga district of Uganda and evaluated the program's impact on healers' clinical practice and the diffusion of information to their female clients. Of 46 healers recruited, 30 (65%) completed a pre- and post-training interview. Following training, traditional healers increased discussions of family planning with their clients. Of 84 female clients recruited, 44 (52%) completed the interview before and after the training for healers. Female clients corroborated that they increased discussions of family planning with their healers, as well as discussions about HIV/AIDS. Both healers and their female clients were more likely to make a connection between family planning, condom use, and HIV prevention after the training compared to before the training. Findings provide evidence that traditional healers in a rural area of Uganda can successfully adapt HIV prevention messages and family planning information into their clinical practices. ( view less ) David J Hughes,Sophie M Ginolhac,Isabelle Coupier,Laure Barjhoux,Valérie Gaborieau,Brigitte Bressac-de-Paillerets,Agnès Chompret,Yves-Jean Bignon,Nancy Uhrhammer,Christine Lasset,Sophie Giraud,Hagay Sobol,Agnès Hardouin,Pascaline Berthet,Jean-Philippe Peyrat,Joelle Fournier,Catherine Nogues,Rosette Lidereau,Danièle Muller,Jean-Pierre Fricker,Michel Longy,Christine Toulas,Rosine Guimbaud,Drakoulis Yannoukakos,Sylvie Mazoyer,Henry T Lynch,Gilbert M Lenoir,David E Goldgar,Dominique Stoppa-Lyonnet,Olga M Sinilnikova Marked variation in phenotypic expression among BRCA1 and BRCA2 mutation carriers may be partly explained by modifier genes that influence mutation penetrance. Variation in CAG/CAA repeat lengths coding for stretches of glutamines in the C-terminus of the AIB1 protein (amplified in breast cancer 1,... ( view more ) a steroid receptor coactivator) has been proposed to modify the breast cancer risk in women carrying germline BRCA1 mutations. We genotyped the AIB1 repeat length polymorphism from the genomic DNA of a group of 851 BRCA1 and 324 BRCA2 female germline mutation carriers to estimate an association with breast cancer risk modification. Hazard ratios (HR) were calculated using a Cox proportional hazards model. For BRCA1 and BRCA2 mutation carriers, analyzed separately and together, we found that women who carried alleles with 28 or more polyglutamine repeats had no increased risk of breast cancer compared to those who carried alleles with fewer repeats (HR for BRCA1/2 carriers = 0.88, 95% CI [confidence interval] = 0.75-1.04). Analyzing average repeat lengths as a continuous variable showed no excess risk of breast cancer (BC) in BRCA1 or BRCA2 mutation carriers (HR for average repeat length in BRCA1/2 carriers = 1.01, 95% CI = 0.92-1.11). These results strongly suggest that contrary to previous studies, there is no significant effect of AIB1 genetic variation on BC risk in BRCA1 mutation carriers and provide an indication that there is also no strong risk modification in BRCA2 carriers. ( view less ) Constantia E Kritsch,Agnes Berger,Christa Heinrich-Cseh,Agnes Bugajska-Schretter,Wolfgang ZaunerTwo reversed-phase HPLC methods were developed for the quantitative determination of the two components of the novel vaccine adjuvant IC31. The adjuvant consists of a mixture of a synthetic oligodeoxynucleotide (ODN) and an 11-mer cationic peptide. The negatively charged oligodeoxynucleotide and th... ( view more )e positively charged peptide form a complex that has to be quantitatively dissociated for analysis. Dissociation of the complex was achieved with a basic heparin solution (1000 IU/ml) when analyzing the ODN, whereas 30% acetic acid was used for the determination of the peptide. Both methods are suitable for identification and quantification but also for stability indicating investigations. ( view less )
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