The effects of ACE inhibition on serum angiotensin II concentration following cardiac transplantation.

Aims: ANGII mediates vascular neointimal formation through smooth muscle cell stimulation and enhanced production of growth factors leading to increased arterial medial layer thickness, which is a characteristic of transplant arteriosclerosis. ACE inhibition is known to be of benefit to patients with cardiovascular risk factors. We aimed to determine the effect of ACE inhibitor therapy on ACE enzymatic activity and serum ANGII levels following cardiac transplantation.

Study of modifiable risk factors for asthma exacerbations: virus infection and allergen exposure increase the risk of asthma hospital admissions in children.

Background: Asthma exacerbation is the most common cause of hospital admission in children. A study was undertaken to investigate the importance of allergen exposure in sensitised individuals in combination with viral infections and other potentially modifiable risk factors precipitating asthma hospital admission in children.

Methods: Eighty four children aged 3-17 years admitted to hospital over a 1 year period with an acute asthma exacerbation (AA) were matched for age and sex with two control groups: stable asthmatics (SA) and children admitted to hospital with non-respiratory conditions (IC).

Tumor necrosis factor alpha influences the inflammatory response after coronary surgery.

Background: A systemic inflammatory response is not uncommonly observed after coronary revascularization. Tumor necrosis factor alpha is one of a number of modulators of this response. A functional polymorphism within the TNFalpha gene at position G-308A has been associated with increased TNFalpha levels.

The role of hyaluronic acid in wound healing: assessment of clinical evidence.

Hyaluronic acid (hyaluronan), a naturally occurring polymer within the skin, has been extensively studied since its discovery in 1934. It has been used in a wide range of medical fields as diverse as orthopedics and cosmetic surgery, but it is in tissue engineering that it has been primarily advanced for treatment. The breakdown products of this large macromolecule have a range of properties that lend it specifically to this setting and also to the field of wound healing.

Is the hypoxia-inducible factor pathway important in gastric cancer?

Tumour hypoxia is well recognised in oncology to be a key factor resulting in treatment resistance and poor prognosis. Hypoxia leads to the expression of a number of gene products that are involved in tumour progression, invasion and metastasis formation. The most important of these proteins is thought to be hypoxia-inducible factor-1alpha (HIF-1alpha), which appears to be a master regulator of the cellular response to hypoxia.

Physiotherapy management of cystic fibrosis.

For many years physiotherapy for cystic fibrosis (CF) was synonymous with a daily routine of postural drainage and percussion. Improved longevity and a desire for independence, together with a clearer understanding of the pathophysiology of the disease, has led to the development of many airway clearance techniques. The contribution of 'chest' physiotherapy remained unchallenged until recent times when lack of robust evidence and the presentation of asymptomic infants and adults led some physiotherapists to question this traditional approach.

Genetic dissection of inflammatory bowel disease: unravelling etiology and improving diagnostics.

Over the past 10 years, remarkable advances in the mapping and identification of genes involved in susceptibility to inflammatory bowel disease have been witnessed. Most notable among these advances has been the discovery of variants in the CARD15, DLG5, SLC22A4 and SLC22A5 genes, which are associated with increased risk of inflammatory bowel disease or specifically Crohn's disease. These discoveries have provided critical new insights into the molecular pathophysiology of inflammatory bowel disease and the pathways wherein genetic and environmental factors such as enteric bacterial flora may interact to trigger immune dysregulation and intestinal inflammation.

Natriuretic peptides in heart valve disease.

Synthesis and release of B-type natriuretic peptide (BNP) are increased in heart failure, and plasma concentrations provide important therapeutic and prognostic information. Recent studies have shown that BNP concentrations are also increased with disease of the mitral and aortic valves. The extent of the increase is broadly related to the severity of the valve abnormality and the degree of consequent cardiac remodelling.

Patterns, incidence and predictive factors for pain after interventional radiology.

Aim: To evaluate prospectively the pattern, severity and predictive factors of pain after interventional radiological procedures.

Materials And Methods: All patients undergoing non-arterial radiological interventional procedures were assessed using a visual-analogue scale (VAS) for pain before and at regular intervals for 24 h after their procedure.

Results: One hundred and fifty patients (87 men, mean age 62 years, range 18-92 years) were entered into the study.

Interleukin 6 G-174C polymorphism influences outcome following coronary revascularization surgery.

Background: Levels of the proinflammatory cytokine interleukin 6 (IL-6) increase after surgery. The functional polymorphism in the IL-6 promoter region, G-174C, is associated with an increased risk of coronary heart disease. We investigated the genetic predisposition in IL-6 response to coronary revascularization and studied the association between the G-174C polymorphism, IL-6 levels, and clinical outcomes of surgery.

Extra-adrenal pheochromocytoma: an unusual cause of deep vein thrombosis.

We report a case of extra-adrenal pheochromocytoma within the organ of Zuckerkandl that presented initially with a left iliofemoral deep venous thrombosis (DVT). At the time of presentation, the DVT was thought to be idiopathic as no underlying cause was detected. Subsequently, because of a series of medical events, the patient was further investigated.

Measurement of citrate in urine using liquid chromatography tandem mass spectrometry: comparison with an enzymatic method.

Background: Measurement of urine citrate is used to assess the risk of further urinary stone formation and to assess the benefit of treatment in affected individuals. We wanted to develop a simple and rapid liquid chromatography tandem mass spectrometry (LC-MS/MS) method for the analysis of urinary citrate and to compare it with our current enzymatic assay.

Methods: For the LC-MS/MS assay, samples were prepared in a deep-well block by adding 10 microL of urine and 20 microL of internal standard to 400 microL of water.

Giant cell tumour of tendon sheath in a child: a case report.

Giant cell tumour of the tendon sheath is uncommon in children. We describe this tumour arising from the right ring finger in an eight-year-old girl. Plane radiographs showed a soft tissue mass with erosion of the distal phalanx.

Effect of superficial venous surgery on venous function in chronic venous insufficiency.

Patients with chronic venous insufficiency often have combined superficial and deep venous incompetence. The aims of this study were to determine the effects of superficial venous surgery (SVS) on deep venous haemodynamics and on ambulatory venous pressure (AVP) and to determine if the AVP tourniquet test can predict the effect of SVS. Of 119 legs, 42 legs (32 subjects) with chronic venous insufficiency, healed ulceration, or active ulceration and with combined superficial and deep incompetence underwent preoperative duplex imaging and AVP measurement followed by appropriate SVS.

Sacral nerve stimulation reduces corticoanal excitability in patients with faecal incontinence.

Background: Sacral nerve stimulation (SNS) can produce symptomatic relief in patients with faecal incontinence. Moreover, peripheral nerve stimulation has been shown to affect brain function. The aim of this study was to determine whether SNS might produce important changes in cortical activity linked to improved continence.

Donor CCR5 Delta32 polymorphism and outcome following cardiac transplantation.

Background: Chemokines regulate the recruitment and trafficking of leukocytes during an immune response. Animal models have shown correlations between chemokine production and leukocyte infiltration during allograft rejection. Also, antagonism of chemokine receptors in transplant models has produced prolonged graft survival.

Extra help required by litigants after simple fractures--a questionnaire based study.

A questionnaire based interview of 100 patients under fracture clinic review was undertaken to assess the help required with the activities of daily living (ADL) in the first 2 weeks following fractures of the hand, wrist, neck of humerus, foot or ankle. The amount of help patients required was correlated with whether or not the patients were claiming compensation for their injuries. Twenty-five percent were litigating and this was shown to influence the amount of help a patient reported having received with dressing, shopping, cooking, housework, personal hygiene and travelling (p<0.

Donor heart selection: Wythenshawe experience.

Background: The decline in the number of suitable donor hearts has led to an increasing interest in the use of previously unacceptable donors. This study aimed to evaluate the outcome of recipients of donor hearts considered medically unsuitable for transplantation at this center that were used in other centers in the United Kingdom.

Methods: Forty donor hearts (group 1) were declined by Wythenshawe Hospital and used in other units in the United Kingdom in the period extending from April 1998 to March 2003.

Angiotensin converting enzyme insertion/deletion polymorphism does not influence postcardiac transplantation hypertension onset or progression.

Background: The angiotensin converting enzyme insertion deletion polymorphism (ACE I/D) has been associated with much cardiovascular pathology, including posttransplantation hypertension. Hypertension is a significant cause of morbidity and mortality after cardiac transplantation. We investigated the influence of the ACE I/D polymorphism on posttransplantation hypertension.

Is there an effect of dysphonic teachers' voices on children's processing of spoken language?

There is a vast body of literature on the causes, prevalence, implications, and issues of vocal dysfunction in teachers. However, the educational effect of teacher vocal impairment is largely unknown. The purpose of this study was to investigate the effect of impaired voice quality on children's processing of spoken language.