Progress on development of the Nimbus-University of Pittsburgh axial flow left ventricular assist system

Nimbus Inc. (Rancho Cordova, CA) and the University of Pittsburgh have completed the second year of development of a totally implanted axial flow blood pump under the National Institutes of Health Innovative Ventricular Assist System Program. The focus this year has been on completing pump hydraulic development and addressing the development of the other key system components. Having demonstrated satisfactory pump hydraulic and biocompatibility performance, pump development has focused on design features that improve pump manufacturability. A controller featuring full redundancy has been designed and is in the breadboard test phase. Initial printed circuit layout of this circuit has shown it to be appropriately sized at 5 x 6 cm to be compatible with implantation. A completely implantable system requires the use of a transcutaneous energy transformer system (TETS) and a diagnostic telemetry system. The TETS power circuitry has been redesigned incorporating an improved, more reliable operating topography. A telemetry circuit is undergoing characterization testing. Closed loop speed control algorithms are being tested in vitro and in vivo with good success. Eleven in vivo tests were conducted with durations from 1 to 195 days. Endurance pumps have passed the 6 month interval with minimal bearing wear. All aspects of the program continue to function under formal quality assurance.     

Use of photo-anchoring of DNA probes for fluorescent in situ hybridization

A possibility was investigated to use photo-crosslinking DNA probes for fluorescent in situ hybridization (FISH). DNA probes were modified by incorporating photonucleotides in these, containing a photoreactive group (tetrafluorobenzazid) and capable of making covalent bonds with the examined DNA, when irradiated in 300-330 nm region. The photonucleotide was incorporated into the probe either by nick-translation, or upon elongation of the hybridized probe by the Kljonow fragment. It has been shown that the DNA probe, cross-linking to a chromosome as a result of covalent bonds, is not removed from the place of hybridization under consequent denaturating washing, which makes it possible to carry out the following DNA hybridization with selective conservation of signals obtained due to previous hybridization. This peculiarity of photo-linking DNA probes makes it possible to use them for the two-step DNA hybridization. To demonstrate this, preparations of human chromosomes were investigated. On the first step, chromosomal DNA was hybridized by means of DNA probe having nucleotide sequences of centromeric regions of chromosomes 13 and 21, the probe being linked to chromosomal DNA by the photonucleotide. Following the denaturation treatment of the preparation, and after the second chromosomal DNA hybridization with cosmid DNA, containing chromosome 13 DNA nucleotide sequence, the signal in chromosome 13 centromeric region was retained to serve a marker of this chromosome, thus fascilitating its easier identification following the hybridization of its DNA with cosmic DNA. The denaturation stability of photo-crosslinking probes opens some new possibilities in technology of DNA in situ hybridization.     

Urinary mutagenicity as a biomarker in workers exposed to benzidine: correlation with urinary metabolites and urothelial DNA adducts

Urinary mutagenicity has been used in occupational and epidemiological studies for over two decades as a cost-effective, general biomarker of exposure to genotoxic agents. However, few studies have compared urinary mutagenicity to additional biomarkers determined among low- and high-exposed groups. To address this issue, we evaluated the relationship between urinary mutagenicity and other types of biomarkers in a cross-sectional study involving 15 workers exposed to the urinary bladder carcinogen benzidine (BZ, high exposure), 15 workers exposed to BZ-dyes (low exposure), and 13 unexposed controls in Ahmedabad, India. Urinary organics were extracted by C18/methanol and evaluated for mutagenicity in the presence of S9 in the Salmonella strain YG1024, which is a frameshift strain that overproduces acetyltransferase. The results were compared to biomarker data reported recently from the same urine samples (Rothman et al., Proc. Natl Acad. Sci. USA, 93, 5084-5089, 1996) that included a metabolite biomarker (the sum of the urinary levels of BZ + N-acetylbenzidine + N,N'-diacetylbenzidine) and a DNA adduct biomarker [a presumptive N-(3'-phosphodeoxyguanosin-8-yl)-N'-acetylbenzidine (C8dG-ABZ) DNA adduct in exfoliated urothelial cells]. The mean +/- SE urinary mutagenicity (revertants/micromol of creatinine) of the low-exposure (BZ-dye) workers was 8.2 +/- 2.4, which was significantly different from the mean of the controls (2.8 +/- 0.7, P = 0.04) as was that of the mean of the high-exposure (BZ) workers (123.2 +/- 26.1, P < 0.0001). Urinary mutagenicity showed strong, positive correlations with urinary metabolites (r = 0.88, P < 0.0001) and the level of the presumptive C8dG-ABZ urothelial DNA adduct (r = 0.59, P = 0.0006). A strong association was found between tobacco use (bidi smoking) and urinary mutagenicity among the controls (r = 0.68, P = 0.01) but not among the exposed workers (r = 0.18, P = 0.11). This study confirms the ability of a biomarker such as urinary mutagenicity to detect low-dose exposures, identify additional genotoxic exposures among the controls, and correlate strongly with urinary metabolites and DNA adducts in the target tissue (urinary bladder epithelia) in humans.     

The sampling of pathological specimens for the diagnosis of infections in different clinical units

The probes sampled from patients, in hospital environment, sterility control departments, air microflora, medical personnel, were tested for the global number of germs and for the positivity registered. Between 1983 and 1994, 12,785 samples for microbiological examination were sampled, aiming to give emphasis to the nosocomial from units like: internal medicine and cardiology; surgery and intensive care; neonatology and pediatrics; obstetrics and gynecology. 7,430 samples were microbiologically positive, proving the potential circulation of facultatively aerobic and aerobic-anaerobic bacterial populations. Our investigations aimed to know more about the microbial structure inside the chosen medical units. The positivity of the samples differed widely from one unit to another, and was partially influenced by the number of the accomplished investigations. The selection of the different medical services was governed by the idea of knowing that the hospitalised patients have a much higher risk of exposure to nosocomial infections, than the patients from other medical services with beds.     

Human T-lymphotropic virus type II infection in Vietnamese thalassemic patients

Anti-human T-lymphotropic virus type I/II (HTLV-I/II) antibodies were screened by particle agglutination test in a total of 66 patients with thalassemia major who received multiple transfusion from paid donors at the Blood Transfusion Hematology Center of Ho Chi Minh City in South Vietnam. HTLV-II infection was confirmed in 6 patients (9.1%) by Western blot analysis and/or polymerase chain reaction. Phylogenetic analysis revealed that long terminal repeat sequences of HTLV-II proviruses from 5 thalassemic patients in Vietnam belonged to the same phylogenetic subgroup of HTLV-IIb as those from intravenous drug abusers in North America and Europe. These data shed light on the route of introducing HTLV-II into Vietnam.     

The evaluation of the organization of vocational rehabilitation for convalescents in the health workshop of an industrial enterprise

A patient with myasthenia gravis and a thymoma did not respond to thymectomy. He was submitted to radiotherapy concurrent with steroid therapy followed by an alkylating based chemotherapy. Four years later, he developed an otherwise typical Philadelphia chromosome/BCR-ABL positive chronic myelogenous leukemia (CML) that quickly evolved to a blast crisis. We discuss the possible cause-effect mechanism between the previous treatment and CML, and suggest that a distinct mechanism, albeit unknown, could be involved in the development and progression of secondary CML.     

Calcitonin and calcium content of the blood of patients with thyroid pathology

The blood calcitonin and calcium content was studied in 38 patients with thyrotoxicosis, 20 subjects with endemic euthyroid goiter and 7 persons with primary hypothyrosis. The blood calcium and calcitorim levels were not changed in males and females with endemic euthyroid goiter in comparison with those of 19 healthy controls. Calcitonin content was markedly decreased in patients with hypothyrosis. Calcium level was significantly increased in males, remaining practically unchanged in females. Calcium and calcitonin levels were dependent on thyrotoxicosis severity. Calcitonin content remained unchanged in moderate thyrotoxicosis and lowered in the severe stage of the disease. The blood calcium level remained unchanged both in males and females suffering from severe thyrotoxicosis and in males with the moderate form of the disease. Calcium content diminished in the blood serum of females with moderate thyrotoxicosis.