Ultrasound Screening of Men with Coronary Artery Disease for Abdominal Aortic Aneurysms: A Prospective Dual Center Study.

BACKGROUND AND AIMS: According to the heterogeneous results of previous studies, the prevalence of abdominal aortic aneurysm seems high among men with coronary artery disease. The associating risk factors for abdominal aortic aneurysm in this population require clarification. Our objective was to assess the prevalence of non-diagnosed abdominal aortic aneurysms in men with angiographically verified coronary artery disease and to document the associated co-morbidities and risk factors. MATERIAL AND METHODS: Altogether, 407 men with coronary artery disease were screened after invasive coronary angiography in two series at independent centers. Risk factor data were recorded and analyzed. RESULTS AND CONCLUSION: The mean age of the study cohort was 70.0 years (standard deviation: 11.0). The prevalence of previously undiagnosed abdominal aortic aneurysms in the whole screened population of 407 men was 6.1% (n = 25/407). In a multivariate analysis of the whole study population, the only significant risk factors for abdominal aortic aneurysm were age (odds ratio: 1.04, 95% confidence interval: 1.00-1.09) and history of smoking (odds ratio: 3.13, 95% confidence interval: 1.26-7.80). Non-smokers with abdominal aortic aneurysm were significantly older than smokers (mean age: 80.7 (standard deviation: 8.0) vs 68.0 (standard deviation: 11.1), p = 0.003), and age was a significant risk factor only among non-smokers (p = 0.011; p = 0.018 for interaction). Among smokers, the prevalence of abdominal aortic aneurysm was 8.8%, and 72% (n = 18/25) of all diagnosed abdominal aortic aneurysm patients were smokers. Prevalence of undiagnosed abdominal aortic aneurysms among patients with coronary artery disease is high, and history of smoking is the most significant risk factor for abdominal aortic aneurysm. Effectiveness of selective screening of abdominal aortic aneurysm in male patients with coronary artery disease warrants further studies.

Loss of the ability to generate large burst-forming unit-like megakaryocytic colonies from thawed cord blood in semisolid cultures after short term suspension culture.

BACKGROUND AND OBJECTIVES: Total colony-forming cells from thawed cord blood units (CBUs) include megakaryocytic colony-forming units (CFU-Mks), which survive the freezing process. The aim of this study was to evaluate whether different megakaryocytic progenitors from unseparated CBUs survive the freezing process and a short-term liquid culture. MATERIALS AND METHODS: Thawed samples of CBUs were cultured in liquid medium. During the cultures, serial samples were drawn to assess the growth of different megakaryocytic progenitors in a semisolid collagen medium with identical cytokines as in the liquid medium. Megakaryocytic cells were detected using immunohistochemistry and flow cytometry. RESULTS: In suspension culture, the megakaryocytic progenitors almost completely lost the ability to generate large (burst-forming unit-like, BFU-like) megakaryocytic colonies in semisolid cultures (large colonies, median count per chamber d0: 7.25 vs. d7: 1.5; P < 0.0001), whereas the number of small colonies (median count per chamber d0: 7.25 vs. d7: 16.0; P = 0.0505) peaked at day seven. Further 7-day culture in suspension resulted in the decline of small colonies as well (d7: 16.0 vs. d14: 5.75; P = 0.0088). Total CFU-Mk count declined from 23.3 (range 12.5-34.0) at d0 to 7.25 (range 1.0-13.5) at d14 (P < 0.0001). CONCLUSION: Immediately post-thaw, CBUs possess an ability to generate large BFU-like megakaryocytic colonies, whereas the colonies were not detectable in most CBUs in semisolid culture after a short suspension culture. Small CFU-Mks were observed throughout the cultures. It may be that the BFU-Mk colonies matured and acquired CFU-Mk behaviour.

Association of CFU-Mk with total colony-forming units in thawed cord blood units.

BACKGROUND AND OBJECTIVES: Cord blood unit (CBU) total colony-forming unit (CFU) count both pre-cryo and post-thaw has been shown to be associated with platelet (PLT) engraftment. Pre-cryo CBUs show good growth of megakaryocytic CFUs (CFU-Mk); however, CFU-Mk have rarely been studied in post-thaw CBUs. MATERIALS AND METHODS: Nucleated cells (NCs) from post-thaw CB were cultured in a collagen-based assay designed to support growth of CFU-Mk. To ensure accurate counting two independent investigators evaluated four culture chambers per sample for CFU-Mk growth. Post-thaw CFU and other cellular characteristics of the CBUs were enumerated independently and compared to CFU-Mk. RESULTS: The post-thaw CBU total CFU count varied from 0·47 to 4·20×10(6) colonies (median, 0·99×10(6)) and total CFU-Mk count from 0·11 to 0·70×10(6) colonies (median, 0·21×10(6)). Total CFU-Mk count was closely associated with total CFU count (Spearman's Rho=0·86, P=0·0072), haemoglobinized CFU (Rho=0·86, P=0·0072) and CFU-granulocyte/macrophage (CFU-GM; Rho=0·81; P=0·0154). Total CFU-Mk count also correlated with the post-thaw total CD34+ cell count (median, 2·55×10(6); range, 1·40-12·5×10(6); Rho=0·83; P=0·0154). CONCLUSION: CFU-Mk growth was associated with total CFU, haemoglobinized CFU, CFU-GM and CD34+ cells in thawed CBUs. This study confirms the preservation of CFU-Mk potential after CB cryopreservation.

Association of cord blood platelet count and volume with hemoglobin in healthy term infants.

OBJECTIVE: The aim of this study was to investigate relationships of cord blood cells in healthy term infants both from vaginal and Cesarean sections. STUDY DESIGN: The study sample comprised 167 consecutive cord blood collections accepted for processing in an accredited cord blood bank. The effect of varying anticoagulant-to-blood ratio was excluded by standardizing the cell concentrations to reflect the values in native blood. Statistical analysis included descriptive statistics, simple linear regression analysis, Mann-Whitney U-test, cumulative frequency plots and Smirnov two-sample test. RESULT: As expected, hemoglobin correlated with red blood cell concentration. Interestingly, mean platelet volume was associated with hemoglobin, red blood cell concentration and hematocrit. The platelet count was inversely associated with the parameters. CONCLUSION: The observed associations of cord blood hemoglobin with mean platelet volume and platelet count reflect the physiology of fetal hematopoiesis at term.

Cadmium intake of moose hunters in Finland from consumption of moose meat, liver and kidney.

Although the average cadmium intake in Finland is about 10 microg day(-1), some risk groups can be identified. This study assessed cadmium intake from the consumption of moose meat, liver and kidneys by moose hunters. Consumption data from a postal questionnaire were combined with a representative database on moose cadmium concentrations. Cadmium intakes were calculated as point estimates for all respondents (n = 711), for those consuming moose meat, liver and/or kidneys, and for the highest decile of those. Probabilistic modelling using the Monte Carlo technique was used to simulate the distribution of dietary cadmium exposure. Of the respondents, 69% consumed moose liver and only 23% moose kidneys. The consumption of moose liver or kidneys significantly increased cadmium intake, whereas moose meat (median consumption 17 kg year(-1) person(-1)) contributed only slightly (0.16 microg day(-1) person(-1)) to the daily total cadmium intake. In the simulation, 10% of the moose hunters had an intake of > 8.76 microg day(-1) (14.6% of PTWI for a 60-kg person) from moose. Point estimates provided only a partial understanding of the potential exposure. Simulated distributions of intake were more useful in characterizing exposure. The study revealed that heavy users of moose organs have a relatively narrow safety margin from the levels of cadmium probably causing adverse health effects.

Coronary artery dissection, combined aortic valve replacement and coronary bypass grafting in osteogenesis imperfecta.

Osteogenesis imperfecta is an inherited connective tissue disorder. Aortic root dilation, aortic insufficiency and mitral valve prolapse are uncommon cardiovascular manifestations of osteogenesis imperfecta. Cardiac surgery in patients with osteogenesis imperfecta involves a high risk of complication rate. We report a case of coronary artery dissection induced by coronary angiogram in a patient with osteogenesis imperfecta and severe aortic regurgitation. In this case, the dissection of a coronary artery was not completely sealed by coronary stenting, and followed by successful combined aortic valve replacement and coronary artery bypass grafting on an emergency basis.

Trichothecenes, ochratoxin A and zearalenone contamination and fusarium infection in Finnish cereal samples in 1998.

The occurrences and concentrations of trichothecenes, ochratoxin A and zearalenone in Finnish cereal samples are presented in this study. Furthermore, injections by moulds, especially Fusarium contamination of grains in the same samples, are reported. In total 68 cereal samples, including 43 rye, 4 wheat, 15 barley and 6 oats samples, were collected after a cool and very rainy growing season in 1998. A gas chromatograph combined with a mass spectrometric detector was used for determination of seven different trichothecenes. A high performance liquid chromatograph with a fluorescence detector was used for ochratoxin A and zearalenone determination. For the identification of moulds, the grain samples were incubated and the moulds were isolated and identified by microscopy. The analytical methods were validated for mycotoxin analysis and they were found to be adequately reliable and sensitive. Heavy rainfalls in the summer and autumn of 1998 caused abundant Fusarium mould infection in Finnish cereals, particularly in rye. Fusarium avenaceum was the most common Fusarium species found in cereals. However, the mycotoxin concentrations were very low and only deoxynivalenol, nivalenol and HT-2 toxin were detected. Deoxynivalenol was detected in 54 samples in the concentration range 5-111 microg/kg. Nivalenol and HT-2 toxin were detected in three and two samples, respectively, in the concentration range 10-20 microg/kg.

Sources of variation in the analysis of trichothecenes in cereals by gas chromatography-mass spectrometry.

The sources of variation In the analysis of trichothecenes in cereals by gas chromatography mass spectrometry (GC-MS) were studied and Identified. Ways to decrease some of the variations identified are presented and discussed. The method Is validated for deoxynivalenol, nivalenol, 3-acetyldeoxynivalenol, fusarenon-X, diacetoxyscirpenol, HT-2 toxin and T-2 toxin. The general variability in the performance of the GC-MS apparatus itself, as well as derivatisation, matrix effect, injection and quantification were identified to be the sources of variation. The use of internal standards was studied in order to decrease the variation due to problems with derivatisation and the overall sample preparation. Two derivatisation reagents were compared, one of which was found to be more effective for decreasing this variation. The calibrants prepared in the cereal extract reduced the variation due to the matrix effect and thus improved the quantification. "Constant Standards" were introduced in order to detect and decrease the variation caused by injection and the apparatus itself. The validation study proved that this analytical method for trichothecenes was adequately reliable and sensitive. The relative standard deviation varied between 3-9% and the recovery between 46-90% for the different trichothecenes determined. The limit of detection for a range of trichothecenes varied from 5 µg/kg to 15 µg/kg.

A study of the suitability of gas chromatography-electron capture detection for the analysis of deoxynivalenol in cereals.

A gas chromatographic-electron capture detection (GC-ECD) method for the analysis of deoxynivalenol (DON) in cereals was investigated. The sample was extracted with a mixture of acetonitrile-water and purified with a MycoSep #225 column. The silylation was performed with Tri-Sil-TBT reagent, followed by dilution with hexane and a washing step with buffer. By using Tri-Sil-TBT reagent no double peaks were observed for DON in the gas chromatograms, in comparison with two other silylation reagents TMSI and Tri-Sil-Z. The use of trichothecolone (TRI) as an internal standard for DON was studied in order to indicate possible problems in the derivatisation reaction. TRI proved to be a relatively good internal standard for DON in cereal samples, as well as 1,1-bis-(4-chlorophenyl)-2,2-dichloroethylene (DDE), which was used as a GC standard for ensuring the function of GC-ECD. During the study, a matrix effect was clearly observed between the cereal matrix-assisted calibration curve and the calibration curve prepared without cereal matrix. The results of spiked and reference material samples, quantified with the calibration curve prepared without and with matrix, demonstrated that the matrix affects the results. However, after recovery correction the results were comparable. The validation results demonstrated that the GC-ECD method for DON analysis in cereals is sufficiently reliable.