[Clinical spectrum of tako-tsubo cardiomyopathy in Germany: results of the tako-tsubo registry of the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK)]. / Klinische Versorgung von Patienten mit Tako-Tsubo-Kardiomyopathie: Ergebnisse des Tako-Tsubo-Registers der ALKK.

BACKGROUND: Tako-tsubo cardiomyopathy (TTC) was first described in 1990 in Japan. A TTC registry was initiated by the Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte (ALKK) in order to evaluate the clinical spectrum and the management of patients with this syndrome in Germany. METHODS: Patients from 37 hospitals were included in the registry if they fulfilled the following criteria: 1. acute chest symptoms or syncope, 2. new ischemic ECG changes with ST-segment elevation ± T-wave inversion, 3. reversible left ventricular regional wall motion abnormality not corresponding to a single coronary artery territory, 4. absence of significant coronary artery stenoses. RESULTS: 296 of the 324 patients (age 68 ± 12) were women (91 %) and 28 men (9 %). Leading symptoms were angina pectoris (72 %), dyspnoea (16 %), syncope (3 %) or resuscitation/cardiogenic shock (2 %). An antecedent trigger was found in 77  %. Time from symptom onset to hospital admission was 7,6 ± 6,9 hours. An acute coronary syndrome (ACS) was clinically suspected in 87 %. The ECG showed ST-segment elevation in 85 %. Cardiac troponin was elevated in more than 90 % of patients. Left ventricular ejection fraction by angiography was reduced to 49 ± 14 %. Initial medical treatment corresponded to the working diagnosis of an ACS. Catecholamines or an intraaortic balloon pump were necessary in 5 % and 1 %, respectively. Seven patients (2.2 %) died in hospital. CONCLUSION: TTC afflicts mainly women and presents clinically as an ACS in 87 %. Hospital mortality is low with symptomatic therapy.

The expression of the testis-specific Dyrk4 kinase is highly restricted to step 8 spermatids but is not required for male fertility in mice.

Members of the dual specificity tyrosine phosphorylated and regulated kinase family (Dyrk) were shown to have a highly testis-abundant or testis-restricted expression pattern. Furthermore, for some members of the family an involvement in gene expression regulation by phosphorylating transcription factors has been shown. Since little is known about the complex regulation of germ cell differentiation in spermatogenesis, we analysed the possible involvement of Dyrk kinases in this process. ISH experiments showed specific distribution of Dyrk kinases mainly in postmeiotic germ cell. We identified Dyrk4 as a testis-specific kinase with a very restricted expression to stage VIII postmeiotic spermatids. In vitro and in vivo experiments proved the enzymatic activity and suggested the cytoplasmatic localisation of Dyrk4. Finally, analysis of a Dyrk4 deficient mouse line showed that Dyrk4 is dispensable for male fertility, hence suggesting a functional redundancy of some Dyrk isoforms during spermiogenesis.

[A pilot project with clowns in psychiatric clinics]. / Clowns in der Psychiatrie? Ein Pilotprojekt.

BACKGROUND: This project examines whether visits of specially trained clinic clowns, as established in pediatrics, would also be useful in psychiatry. METHODS: We describe the effects of a 6-week phase with one clown visit per week in a ward for acutely ill geriatric patients. The patients and medical team were also questioned about their attitudes towards the clowns. RESULTS: We found more positive attitudes in patients after this phase. CONCLUSIONS: We interpret this result as an indication of positive effects and sufficient reason to initiate similar projects in the future.

Preparatory study for detection of nickel in industrial flue gas by excimer laser-induced fragmentation fluorescence spectroscopy.

The purpose of this work is to survey possibilities for detecting molecular nickel species in industrial flue gas using excimer laser-induced fragmentation fluorescence (ELIF), in particular to establish suitable detection schemes and to obtain a sensitivity estimate for Ni detection. Investigations were conducted in a heated laboratory cell under defined conditions of temperature and pressure, using NiCl2 as the precursor molecule. An ArF excimer laser (193 nm) was used for excitation and Ni atomic emission spectra were recorded in the range 300 to 550 nm. The dependence of ELIF signal on laser fluence was quadratic in the range of laser intensities investigated, as expected for a two-photon excitation process. The temporal behavior of the ELIF signals gave lifetimes significantly longer than the known natural lifetimes. This result and the energetics of the system suggest a Ni* production mechanism involving the formation of Ni+ and subsequent ion-electron recombination. The temperature dependence of the ELIF signal, determined in the range 773 to 1223 K, was found to follow the vapor-pressure curve (Antoine equation) known from the literature. Finally, quenching effects were investigated by measuring ELIF signals and lifetimes in nitrogen or air up to 1 atm. On the basis of the results so far, detection limits for Ni in practical combustion applications in the range of tens of ppb should be achievable, which will be sufficient for regulatory measurements in incinerators and power plants.

3-[123I]Iodo-alpha-methyl-L-tyrosine uptake in cerebral gliomas: relationship to histological grading and prognosis.

3-[123I]Iodo-alpha-methyl-L-tyrosine (IMT) is employed clinically as a tracer of amino acid transport in brain tumours using single-photon emission tomography (SPET). This study investigates the role of IMT SPET in the non-invasive histological grading and prognostic evaluation of cerebral gliomas. The files of patients investigated by IMT SPET in our clinic between 1988 and 1996 were evaluated retrospectively. Complete follow-up was available for 58 patients with cerebral gliomas investigated by IMT SPET shortly after tumour diagnosis. Seventeen patients had low-grade gliomas (WHO grade II), 14 had anaplastic gliomas (WHO grade III) and 27 had glioblastomas (WHO grade IV). Thirty-six cases were primary tumours and 22 cases, recurrences. Maximal and mean tumour-to-brain (T/B) ratios of IMT uptake at the first IMT SPET investigation were related to histological grading and survival time. Patients with low-grade gliomas showed significantly longer survival than patients with high-grade (grade III or IV) tumours. Gliomas without contrast enhancement on computed tomography or magnetic resonance imaging scans were associated with longer patient survival than tumours with contrast enhancement. The T/B ratios of IMT SPET showed no differences in relation to histological grading [WHO grade II: 1.73+/-0.59; WHO grade III: 1.74+/-0.38; WHO grade IV: 1.59+/-0.35, (mean+/-SD, T/B ratios of mean tumour uptake)]. The median survival time of patients with a high T/B ratio on IMT SPET was not significantly different from that of patients with a low T/B ratio (T/B ratio <1.6, 14.8 months; T/B ratio > or =1.6, 13.0 months). Thus, no evidence could be found for a relationship between IMT uptake in cerebral gliomas and either histological grading or survival time. Nevertheless, IMT SPET constitutes a useful method for the detection of primary and recurrent gliomas, determination of tumour extent and individual follow-up.

The influence of fuel additives on the behaviour of gaseous alkali-metal compounds during pulverised coal combustion.

The alkali-metal vapour release during pulverised hard (bituminous) coal combustion was investigated in a semi-technical drop flow reactor in the temperature range 1100-1400 degrees C. Absolute concentrations of total gas-phase sodium and potassium species were determined using the in situ/on-line excimer laser induced fragmentation fluorescence technique (ELIF). Alkali-metal concentrations measured for the untreated coals were found to be in the range 0.1 to 4.7 ppm, depending on the temperature. As well as observing the temperature dependence, the effect of co-feeding defined amounts of silica and clay minerals was studied. In addition, to assist interpretation of ELIF measurements, ash samples were taken and analysed by scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDX). The additives lead to a pronounced binding of the alkali-metal species and suppression of the sharp temperature dependence observed without co-feeding. Therefore, the use of such getter materials can be confirmed as an effective way to remove corrosive alkali-metal species from the flue gas in pulverised coal combustion.

Identification of a cyclase-associated protein (CAP) homologue in Dictyostelium discoideum and characterization of its interaction with actin.

In search for novel actin binding proteins in Dictyostelium discoideum we have isolated a cDNA clone coding for a protein of approximately 50 kDa that is highly homologous to the class of adenylyl cyclase-associated proteins (CAP). In Saccharomyces cerevisiae the amino-terminal part of CAP is involved in the regulation of the adenylyl cyclase whereas the loss of the carboxyl-terminal domain results in morphological and nutritional defects. To study the interaction of Dictyostelium CAP with actin, the complete protein and its amino-terminal and carboxyl-terminal domains were expressed in Escherichia coli and used in actin binding assays. CAP sequestered actin in a Ca2+ independent way. This activity was localized to the carboxyl-terminal domain. CAP and its carboxyl-terminal domain led to a fluorescence enhancement of pyrene-labeled G-actin up to 50% indicating a direct interaction, whereas the amino-terminal domain did not enhance. In polymerization as well as in viscometric assays the ability of the carboxyl-terminal domain to sequester actin and to prevent F-actin formation was approximately two times higher than that of intact CAP. The sequestering activity of full length CAP could be inhibited by phosphatidylinositol 4,5-bisphosphate (PIP2), whereas the activity of the carboxyl-terminal domain alone was not influenced, suggesting that the amino-terminal half of the protein is required for the PIP2 modulation of the CAP function. In profilin-minus cells the CAP concentration is increased by approximately 73%, indicating that CAP may compensate some profilin functions in vivo. In migrating D. discoideum cells CAP was enriched at anterior and posterior plasma membrane regions. Only a weak staining of the cytoplasm was observed. In chemotactically stimulated cells the protein was very prominent in leading fronts. The data suggest an involvement of D. discoideum CAP in microfilament reorganization near the plasma membrane in a PIP2-regulated manner.