Experimental studies and early phase clinical trials suggest that transplantation of blood-derived or bone marrow-derived stem cells may improve cardiac regeneration and neovascularization after ...acute myocardial infarction. Granulocyte colony-stimulating factor (G-CSF) induces mobilization of bone marrow stem cells.
To assess the value of stem cell mobilization by G-CSF therapy in patients with acute myocardial infarction.
Randomized, double-blind, placebo-controlled trial of patients diagnosed with ST-segment elevation acute myocardial infarction who had successful reperfusion by percutaneous coronary intervention within 12 hours after onset of symptoms in Germany between February 24, 2004, and February 2, 2005.
Patients were randomly assigned to receive subcutaneously either a daily dose of 10 microg/kg of G-CSF or placebo for 5 days.
The primary end point was reduction of left ventricular infarct size according to technetium Tc 99m sestamibi scintigraphy performed at baseline and at 4 to 6 months after randomization. Secondary end points included improvement of left ventricular ejection fraction measured by magnetic resonance imaging and the incidence of angiographic restenosis.
Of the 114 patients, 56 were assigned to receive treatment with G-CSF and 58 were assigned to receive placebo. Treatment with G-CSF produced a significant mobilization of stem cells. Between baseline and follow-up, left ventricular infarct size according to scintigraphy was reduced by a mean (SD) of 6.2% (9.1%) in the G-CSF group and 4.9% (8.9%) in the placebo group (P = .56) and left ventricular ejection fraction was improved by 0.5% (3.8%) in the G-CSF group and 2.0% (4.9%) in the placebo group (P = .14). Angiographic restenosis occurred in 19 (35.2%) of 54 patients in the G-CSF group and in 17 (30.9%) of 55 patients in the placebo group (P = .79). The most common adverse event among patients assigned to G-CSF was mild to moderate bone pain and muscle discomfort.
Stem cell mobilization by G-CSF therapy in patients with acute myocardial infarction and successful mechanical reperfusion has no influence on infarct size, left ventricular function, or coronary restenosis.
ClinicalTrials.gov Identifier: NCT00126100.
Crystal orientation fabric (COF) analysis provides information about the c-axis orientation of ice grains and the associated anisotropy and microstructural information about deformation and ...recrystallisation processes within the glacier. This information can be used to introduce modules that fully describe the microstructural anisotropy or at least direction-dependent enhancement factors for glacier modelling. The COF was studied at an ice core that was obtained from the temperate Rhonegletscher, located in the central Swiss Alps. Seven samples, extracted at depths between 2 and 79 m, were analysed with an automatic fabric analyser. The COF analysis revealed conspicuous four-maxima patterns of the c-axis orientations at all depths. Additional data, such as microstructural images, produced during the ice sample preparation process, were considered to interpret these patterns. Furthermore, repeated high-precision global navigation satellite system (GNSS) surveying allowed the local glacier flow direction to be determined. The relative movements of the individual surveying points indicated longitudinal compressive stresses parallel to the glacier flow. Finally, numerical modelling of the ice flow permitted estimation of the local stress distribution. An integrated analysis of all the data sets provided indications and suggestions for the development of the four-maxima patterns. The centroid of the four-maxima patterns of the individual core samples and the coinciding maximum eigenvector approximately align with the compressive stress directions obtained from numerical modelling with an exception for the deepest sample. The clustering of the c axes in four maxima surrounding the predominant compressive stress direction is most likely the result of a fast migration recrystallisation. This interpretation is supported by air bubble analysis of large-area scanning macroscope (LASM) images. Our results indicate that COF studies, which have so far predominantly been performed on cold ice samples from the polar regions, can also provide valuable insights into the stress and strain rate distribution within temperate glaciers.
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