Screening for lupus anticoagulant: improving the performance of the lupus-sensitive PTT-LA.

INTRODUCTION: The aim of the present work was to verify whether calculating a ratio between clotting times obtained with the sensitive PTT-LA and a less sensitive activated partial thromboplastin time (aPTT)-reagent may represent a valuable aPTT-based screening strategy for lupus anticoagulants (LA). METHODS: For the pilot study, plasma samples from normal subjects (n = 15) and from patients with LA (n = 10), therapeutic anticoagulation with vitamin K-antagonists (VKA) (n = 15) or unfractionated heparin (n = 15), coagulation factors deficiency (n = 16), and inhibitory antibodies against factor VIII or IX (n = 11) were studied. For the evaluation study, 1553 consecutive plasma samples from nonanticoagulated patients investigated for LA between January 2005 and December 2007 at our institution were studied. Following screening strategies were employed: Pathromtin-SL (aPTT-SL), PTT-LA (aPTT-LA), ratio aPTT-LA/aPTT-SL (aPTT-ratio), and Russell's viper venom (RVV) based LA-Check. LA positive samples were identified by mixing studies and diluted RVV confirmation test (LA-Check/LA-Sure). RESULTS: Pilot study: All screening strategies had a 100% sensitivity, and the aPTT-ratio reached the highest specificity (82%; 95%CI: 74-90%). Within the evaluation study, following sensitivities for LA screening were observed: aPTT-SL 59.0% (95%CI: 57-61%), aPTT-LA 82.1% (95%CI: 80-84%), aPTT-ratio 92.3% (95%CI: 91-94), and LA-Check 83.3% (95%CI: 82-85%). CONCLUSION: Calculating a ratio between the LA-sensitive PTT-LA and the less sensitive Pathromtin-SL improves the performance of the PTT-LA itself and represents a simple and sensitive aPTT-based integrated strategy for LA screening.

Transplantation of human mesenchymal stem cells in a non-autogenous setting for bone regeneration in a rabbit critical-size defect model.

Human mesenchymal stem cells (hMSC) represent an attractive cell population for tissue engineering purposes. Furthermore, hMSC are described as immune privileged, and non-autogenous application seems possible. The current study examines the regeneration potential of hMSC after xenogenic transplantation compared with autogenous rabbit MSC in a critical-size bone defect. After isolation, hMSC and rabbit MSC were seeded on calcium-deficient hydroxyapatite (CDHA) and transplanted into a radial critical-size defect of New Zealand white rabbits. Defects were filled with a CDHA scaffold seeded with autogenous rabbit MSC, CDHA seeded with xenogenic hMSC or unseeded CDHA. An empty defect served as control group. Animals were sacrificed after 3 months. Evaluation was performed using radiography, micro-computed tomography (micro-CT) and histology. In addition, a non-destructive four-point-bending test was performed in order to evaluate biomechanical stiffness. While autogenous MSC seeded on CDHA led to increased healing of critical-size bone defects from radiological (micro-CT; p = 0.009) and histological (p = 0.048) perspectives compared with unloaded CDHA, it was not possible to demonstrate analogous effects for the xenogenic transplantation of hMSC. The xenogenic treatment group displayed inferior results in all parameters compared with the autogenous MSC treatment group (histology p = 0.041; micro-CT p = 0.006; biomechanical testing p = 0.017). Nevertheless, no local or systemic inflammatory response resulting from xenogenic transplantation was observed. While previous papers suggest the use of non-autogenous hMSC cells for tissue engineering purposes, the present results show inferior clinical results from transplantation of hMSC in a xenogenic setting compared with autogenous MSC.

Weak effect of metal type and ica genes on staphylococcal infection of titanium and stainless steel implants.

Currently, ica is considered to be the major operon responsible for staphylococcal biofilm. The effect of biofilm on susceptibility to staphylococcal infection of different implant materials in vivo is unclear. The interaction of ica-positive (wild-type (WT)) and ica-negative (ica(-)) Staphylococcus aureus and Staphylococcus epidermidis strains with titanium and both smooth and rough stainless steel surfaces was studied by scanning electron microscopy in vitro and in a mouse tissue cage model during 2 weeks following perioperative or postoperative inoculation in vivo. In vitro, WT S. epidermidis adhered equally and more strongly than did WT S. aureus to all materials. Both WT strains, but not ica(-) strains, showed multilayered biofilm. In vivo, 300 CFUs of WT and ica(-)S. aureus led, in all metal cages, to an infection with a high level of planktonic CFUs and only 0.89% adherent CFUs after 8 days. In contrast, 10(6) CFUs of the WT and ica(-) strains were required for postoperative infection with S. epidermidis. In all metal types, planktonic numbers of S. epidermidis dropped to <100 WT, and adherent CFUs were low in WT-infected cages and absent in ica(-)-infected cages after 14 days. Perioperative S. epidermidis inoculation resulted in slower clearance than postoperative inoculation, and in titanium cages adherent WT bacteria survived in higher numbers than ica(-) bacteria. In conclusion, the metal played a minor role in susceptibility to and persistence of staphylococcal infection; the presence of ica genes had a strong effect on biofilm in vitro and a weak effect in vivo; and S. epidermidis was more pathogenic when introduced during implantation than after implantation.

Instant stem cell therapy: characterization and concentration of human mesenchymal stem cells in vitro.

In regenerative medicine, there is an approach to avoid expansion of the mesenchymal stem cell (MSC) before implantation. The aim of this study was to compare methods for instant MSC therapy by use of a portable, automatic and closed system centrifuge that allows for the concentration of MSCs. The main outcome measures were the amount of MSCs per millilitre of bone marrow (BM), clusters of differentiation (CD), proliferation and differentiation capacities of the MSC. A volume reduction protocol was compared to the traditional laboratory methods of isolation using a Ficoll gradient and native BM. Fifty millilitres of BM were obtained from haematologically healthy male Caucasians (n=10, age 8 to 49 years). The number of colony forming units-fibroblast (CFU-F)/ml BM was highest in the centrifuge volume reduction protocol, followed by the native BM (not significant), the centrifuge Ficoll (p=0.042) and the manual Ficoll procedure (p=0.001). The MSC of all groups could differentiate into the mesenchymal lineages without significant differences between the groups. The CD pattern was identical for all groups: CD13+; CD 44+; CD73 +; CD90+; CD105+; HLA-A,B,C+; CD14-; CD34-; CD45-; CD271-; HLA-DR-. In a further clinical pilot study (n=5) with 297 ml BM (SD 18.6), the volume reduction protocol concentrated the MSC by a factor of 14: there were 1.08 x 10(2) MSC/ml BM (standard deviation (SD) 1.02 x 10(2)) before concentration, 14.8 x 10(2) MSC/ ml BM (SD 12.4 x 10(2)) after concentration, and on average 296 x 10(2) MSC (SD 248.9 x 10(2), range 86.4-691.5 x 10(2)) were available for MSC therapy. The volume reduction protocol of the closed centrifuge allows for the highest concentration of the MSC, and therefore, is a promising candidate for instant stem cell therapy.

Violations of pesticide use and worker safety regulations in North Carolina.

In North Carolina, responsibility for providing training and enforcing various regulations related to pesticide use and agricultural worker safety rests with three state agencies. This article summarizes an 11-year history of enforcement procedures concerning agricultural pesticide use, the Worker Protection Standard, the Hazard Communication Standard, the Migrant Housing Act of North Carolina, and field sanitation standards. The difficulty of linking specific types of violations with worker safety is discussed.

[Induction of bone tissue on different matrices: an in vitro and a in vivo pilot study in the SCID mouse]. / Induktion von Knochengewebe auf unterschiedlichen Matrizes: Eine In-vitro- und In-vivo-Pilotstudie in der SCID Maus.

AIM: Three resorbable biomaterials were evaluated regarding proliferation and osteogenic differentiation of human bone marrow stromal cells (BMSC) in vitro. In a second step, the new biomaterial, calcium-deficient hydroxyapatite (CDHA), was tested in a pilot in vivo study by subcutaneous implantation in the severe combined immunodeficiency (SCID) mouse. METHODS: CDHA, beta-tricalcium phosphate (beta-TCP), and demineralized bone matrix (DBM) were seeded with human BMSC and cultured in osteogenic supplements for 3 weeks. In the pilot in vivo study, CDHA was seeded with BMSC and kept in osteogenic media for 2 weeks (group A) before subcutaneous implantation in 8 SCID mice for 3 and 8 weeks. In addition, CDHA seeded with BMSC without prior osteogenic induction (group B) and empty ceramics were implanted in each mouse. RESULTS: Total protein content and the values for specific alkaline phosphatase (ALP) increased significantly in vitro on all matrices, but no significant difference between the groups was noted. In the pilot in vivo study all ceramics were well penetrated by cells. After 8 weeks 2 of 4 samples in group B and 1 of 4 samples in group A revealed cells resembling hypertrophic chondrocytes. Specific ALP was higher in the group B (p = 0.012, Z = - 2.5) compared to empty ceramics. There were no significant differences between groups A and B. Differences between group A and the empty control did not become significant (p = 0.069, Z = - 1.8). CONCLUSION: All three matrices promoted BMSC proliferation and differentiation to osteogenic cells in vitro. Human BMSC on CDHA showed signs of osteogenic differentiation after subcutaneous implantation into SCID mice.

Farmers' perceptions and concerns: the risks of driving farm vehicles on rural roadways in North Carolina.

This study focuses on farmers' perceptions of roadway safety and reviews specific and pertinent North Carolina rural road crash data to evaluate their perceptions and concerns. A survey was mailed to 1,357 prospective participants throughout North Carolina. Of these, 656 (48.3%) North Carolina farmers completed and returned the survey. The study revealed that while the majority of respondents took a number of specific safety measures to ensure their safety while driving their tractor on rural roads, most believed that driving their tractor on rural roads was more dangerous than it was five years ago. Few respondents believed that laws governing tractors on rural roads are well known by urban residents. While a majority of the respondents would support a law to mandate the use of a slow-moving vehicle (SMV) emblem on the back of slow-moving farm equipment, a majority also believed that a more effective way to mitigate potential crashes would be to ensure that all farm vehicles had blinking or flashing lights, that diamond-shaped caution signs depicting a tractor were posted on roadways with frequent tractor traffic, and that roadway shoulders were created or widened on roads with heavy farm traffic so that tractors could move off the roadway. Only 22% of respondents felt safe driving their tractor on rural roadways in North Carolina. Most respondents felt that the biggest problem with roadway safety was the lack of respect and increased speed of other drivers. Recent data indicate that in crashes involving farm vehicles, citations were issued to 34% of the non-farm vehicle operators and 24% to farm vehicle operators. For those driving non-farm vehicle who were deemed at fault, 66% were cited for failure to reduce speed. For those driving farm vehicles, the most frequent citation involved the lack of safe movement.

Comparison of human bone marrow stromal cells seeded on calcium-deficient hydroxyapatite, beta-tricalcium phosphate and demineralized bone matrix.

The aim of this study was to compare three resorbable biomaterials regarding seeding efficacy with human bone marrow stromal cells (BMSCs), cell penetration into the matrix, cell proliferation and osteogenic differentiation. Calcium-deficient hydroxyapatite (CDHA), beta-tricalcium phosphate (beta-TCP), and demineralized bone matrix (DBM) were seeded with human BMSCs and kept in human serum and osteogenic supplements for 3 weeks. Morphologic and biochemical evaluations were performed on day 1, 7, 14 and 21. The allograft DBM and CDHA exhibited both an excellent seeding efficacy while the performance of beta-TCP was lower when compared. The total protein content and the values for specific alkaline phosphatase (ALP) increased on all matrices and no significant difference was found for these two markers. BMSCs in monolayer had a significant increase of protein, but not of ALP. Osteocalcin (OC) values increased significantly higher for BMSC in cultures on DBM when compared to CDHA and beta-TCP. The OC levels decreased significantly in the BMSC monolayer culture. BMSCs were found inconsistently within the synthetic materials, whereas in DBM they were found more homogeneously distributed throughout the matrix. All three matrices promoted BMSC proliferation and differentiation to osteogenic cells. DBM allografts seem to be more favorable with respect to cell ingrowth tested by histology, and osteogenic differentiation ascertained by an increase of OC. CDHA with its high specific surface area showed more favorable properties than beta-TCP regarding reproducibility of the seeding efficacy.

Understanding the public health impacts of farm vehicle public road crashes in North Carolina.

Discussions with groups of North Carolina farmers identified farm vehicle public road safety as their primary occupational health and safety concern. Findings of a mail survey of North Carolina growers participating in a North Carolina Department of Labor migrant housing inspection program indicated that over 97% of them felt less safe on North Carolina public roads now (1999) than five years prior (1995), and over 79% currently (1999) felt unsafe transporting farm vehicles on North Carolina public roads. Using both primary and secondary data, we explore the context of farm vehicle public road crashes, identify contributing individual and environmental risk factors, and estimate the public health cost. Recommendations and suggestions for future farm vehicle public road safety research and interventions are proposed.

Plasma polymerized N-isopropylacrylamide: synthesis and characterization of a smart thermally responsive coating.

A lower critical solution temperature (LCST) in an aqueous environment has been observed with poly(N-isopropylacrylamide) (pNIPAM) deposited onto solid surfaces from a plasma glow discharge of NIPAM vapor. The synthesis and spectroscopic data (ESCA, FTIR) for the plasma polymerized NIPAM (ppNIPAM) shows a remarkable retention of the monomer structure. The phase transition at 29 degrees C was measured by a novel AFM method. The phase transition was surprising because of the expectation that the plasma environment would destroy the specific NIPAM structure associated with the thermal responsiveness. The phase change of ppNIPAM is also responsible for the changes in the level of the meniscus when coated capillaries are placed in warm and cold water. Plasma polymerization of NIPAM represents a one-step method to fabricate thermally responsive coatings on real-world biomaterials without the need for specially prepared substrates and functionalized polymers.

Comprehensive surface analysis of hydrophobically functionalized SFM tips

Tip-sample interactions have been of interest since the early development of the scanning force microscope. Investigations of interfacial interactions at the molecular level are of importance for fundamental studies of bi-molecular interactions and for possible applications in biomedical research and industrial settings. By engineering the surface chemical properties of the SFM probes, specific force interactions may be measured. However, as these modification schemes become more widely applied, detailed chemical analysis of the modified cantilever surfaces becomes crucial. In this paper, we describe two approaches to coat SFM cantilevers with hydrophobic coatings: a silanization protocol and ratio frequency plasma enhanced chemical vapor deposition.

Quantitative interrogation of micropatterned biomolecules by surface force microscopy.

Synthetic biomaterials are widely used in medical implants with success in improving and extending quality of life. However, these materials were not originally designed to interact with cells through specific signaling pathways. As a result, the interaction with the body is mediated through passive adsorption of a disorganized protein monolayer. Next generation biomaterials have been proposed to be active in modifying the biological response of the host through the incorporation of specific biorecognition moieties. An important tool in the development of these novel active biomaterials is the scanning force microscope (SFM). The SFM allows for interrogation of bioactive biomaterials in mapping or spectroscopic modes. In this work, micropatterned protein surfaces were prepared using biomolecules implicated in wound healing. The surfaces were imaged via SFM and the specific binding forces between surface associated biomolecules and antibody functionalized tips were quantified.

Immunosensing with photo-immobilized immunoreagents on planar optical wave guides.

Immunocomplexation at wave guiding TiO2/SiO2 surfaces was investigated using an integrated optical grating coupler. For extended application of this label-free monitoring system, F(ab')2 fragments of monoclonal antibodies were photo-immobilized by photolinker polymer-mediated procedures that do not require functionalization of either the immunoreagent or the TiO2/SiO2 surface. Covalent, light-dependent binding of photolinker polymer and F(ab')2 fragments was achieved using a single-step photo-reaction. Bovine serum albumin derivatized with aryldiazirines (T-BSA) served as a photolinker polymer. T-BSA suppressed the non-specific adsorption of analytes to wave guide surfaces. Immunoreagent binding and immunological activity were analyzed and modified surfaces were investigated by scanning force microscopy. Apparent immunoreagent surface densities were 16.7 fmol F(ab')2 per mm2 sensor surface. Optical analyses revealed linear, dose-dependent antigen binding with label free analytes. Immunocompetent surfaces were regenerable by treatment at pH 2.3, rendering the immunosensing system applicable for repetitive use.

Serologic detection of adenovirus infections in specific-pathogen-free chickens.

A specific-pathogen-free flock of White Leghorns, which were housed conventionally and were previously serologically negative for all common poultry pathogens including avian adenoviruses, incurred an outbreak of adenovirus that was detected at about 39 weeks of age. The infection was detected serologically through the agar-gel precipitin test (AGPT) and also by a microneutralization test (MNT) adapted for 11 serotypes of avian adenovirus. The MNT detected specific antibodies to serotype-3 avian adenovirus (IBHV-Tipton) but no other serotype. While AGPT-positive sera drawn from the flock gradually declined from 54% to 17%, neutralizing-antibody levels rose sharply at 46 weeks of age to a peak that was maintained over the remaining 18 weeks of the flock's production.

Oncogenesis by Marek's disease herpesvirus in chickens lacking expression of endogenous (gs, chick helper factor, Rous-associated virus-O) and exogenous avian RNA tumor viruses.

Chickens free of exogenous avian leukosis virus (ALV) infection, replicating endogenous ALV (Rous-associated virus-O), gs antigen, and chick helper factor were fully susceptible to induction of Marek's disease (MD) by ALV-free MD viruses. Dual infection with Rous-associated virus-2 and MD virus did not significantly alter the character of the MD lesions. Thus exogenous ALV infection was not requisite for MD virus-induced oncogenesis. Although participation of endogenous RNA tumor virus genes in MD lesion induction could not be excluded, expression of such genes in MD tumors as gs antigen was not established.

Neutralization studies with Marek's disease virus and turkey herpesvirus.

Use of Marek's disease virus (MDV) in a neutralization test presents several problems, which are described, making this potentially useful test difficult. To obviate these difficulties, a plaque reduction test has been designed based on cross-neutralization of turkey herpesvirus (HVT) by serum-neutralizing MDV. The technique for such a neutralization test is outlined. Kinetics of development of neutralizing antibodies in chickens inoculated with HVT and MDV are described. The neutralization test can be used to evaluate viability of HVT vaccines and the possible role of neutralizing antibodies in the protection afforded by vaccination against MDV-induced tumors.