Spin Probe Spin Labeled Studies of Heparins and Derivatives

The polyelectrolyte heparins have a multiplicity of activities in vivo and in vitro including interactions in the coagulation cascade. The stereochemical factors or functional groups specifically associated with these activities have not been clarified. In order to further study the structure-function relationships we used a probe technique, labeling the carboxyl groups of heparins, derivatives and chondroitins with ATEMPO. Electron spin resonance and biological activity studies of nitroxide labeled heparins, and derivatives reveal a small correlation time (Ic) indicating that the label has free rotation when complexed to the carboxyl group. The labeled compound retains 85% of its anticoagulant activity and the complex binds antithrombin III to the same extent as heparin. Nuclear magnetic resonance spectra of the derivatives indicate that the complexing agent, carbodiamide is differentially displaced by ATEMPO at some of the carboxyl groups. The technique permits study of the stereochemistry of the carboxyl groups present in the polysaccharide.

Disseminated Cryptococcus treated with transfer factor

Cardiac toxic reactions and pulmonary consolidation in the left lower lobe developed in a patient who was receiving amphotericin B therapy for cryptococcal meningitis. Following surgical resection of the lobe, multiple subcutaneous cryptococcal abscesses appeared. Flucytosine administered intravenously failed to eradicate the lesions. Transfer factor therapy and multiple drainage procedures elimniated the skin abscesses. Transfer factor therapy was administered for one year; the patient was asymptomatic 16 months after therapy was discontinued.

A high-humidity circle system for infants and children

A scaled-down version of a modified adult circle system capable of increasing normal humidity output 300% was constructed for pediatric use. The moisture content of the gases leaving the system was tested and found to be superior to that of any pediatric circle system commercially available that does not incorporate an electrically heated water vaporizer.

An infant circuit with a water vaporizer warmed by carbon dioxide neutralization

A pediatric anesthesia system was constructed by connecting the machine end of a modified Mapleson D system to a soda lime canister containing a water vaporizer heated through the reaction of neutralization of the lime by the CO2 emerging from the breathing tube. The vaporizer was placed in line with the fresh-gas delivery tube of the circuit. The humidity output of the system varied from 15 +/- 1 mg H2O/L with a CO2 output of 15 ml/L to 27 +/- 1.5 mg H2O/L with a CO2 output of 60 ml/min. Rebreathing of CO2 was within acceptable limits as long as fresh-gas inflow remained at 5 L/min. The system compares favorably in respect to its humidity output with all other circuits availabe on the market for pediatric anesthesia.

Cellular content of amniotic fluid as predictor of central nervous system malformations

Prospective observations on 442 consecutive samples have confirmed that pregnancies with CNS malformations are regularly associated with an abnormal cellular content of amniotic fluid. A crude semiquantitative test of the cell content can give valuable clinical information in relation to borderline amniotic fluid alpha-fetoprotein values, and help to detect false positive AFP's.

Comparative toxicity of polychlorinated biphenyl and polybrominated biphenyl in the rat liver: light and electron microscopic alterations after subacute dietary exposure

The comparative toxicity of polychlorinated biphenyl (PCB) and polybrominated biphenyl (PBB) in livers was studied in male Holtzman rats. Four-week-old animals were fed at dietary levels of 0, 5, 50, or 500 ppm for 5 weeks and then sacrificed. The mean liver-body weight ratios of the 50 and 500 ppm groups were increased. Histopathologic examination of the livers revealed fatty degenerative change associated with both compounds. This change was more marked at 500 than at 50 ppm. Various sized lamellar cytoplasmic inclusions were detected in livers of animals fed 500 ppm of either compound. However, the inclusions were more numerous in the PBB-treated rats. Several animals fed 50 ppm PBB had a few inclusions. In rats that received 500 ppm PBB, hypertrophic degenerative hepatocytes were present around the central veins. On the periphery of this change there were occasionally multinucleated hepatocytes. Electron microscopic examination at a dose level of 5 ppm in both the PCB and PBB groups showed a slight proliferation of smooth endoplasmic reticulum (SER), a moderate increase of lipid droplets and some liposomes, and a marked proliferation of Golgi condensing vesicles containing lipoprotein particles. A decreased number of mitochondria and lysosomes was also observed. At 50 ppm, similar but more marked ultrastructural alterations were seen. In addition, an increased number of branched and cup-shaped profiles of mitochondria and a decreased number of Golgi condensing vesicles containing lipoprotein particles were observed. Concentric membranous cytoplasmic whorls were encountered only in the 50 ppm PBB-treated rats. At 500 ppm the number of mitochondria decreased in both groups. There was also a marked increase in the number of SER and liposomes concomitant with a decreased number of Golgi condensing vesicles containing lipoprotein granules. Membranous whorls were also present in the 500 ppm groups.

Rebreathing characteristics of the Bain anesthesia circuit

The humidity output and CO2 elimination of the Bain circuit were tested on a simulated adult patient. The moisture content of inspired gases was found to be adequate when the circuit was used with a minute volume of 8.4 L/min and a fresh gas inflow of 4.9 L/min (65 percent relative humidity at room temperature at the onset of experimentation, rising to 100 percent after 80 minutes). However, the mean inspired CO2 concentration increased from 0.8 percent to 5.5 percent when the fresh gas inflow was decreased from 8 L/min to 3.5 L/min. It is recommended, therefore, that the circuit should not be used for long periods of time without measuring arterial CO2 tension or in situations where intentional hypocarbia is desired.

Coronary risk factor reduction through biofeedback-aided relaxation and meditation

The effects of behaviour modification through education and biofeedback-aided relaxation and meditation on the levels of blood pressure, pulse rate, smoking habits as well as serum cholesterol, triglycerides, and free fatty acids were studied in 18 normotensive, 18 smoking, and 22 hypertensive patients with 18 normotensive controls.The results showed significant reduction in blood pressure, in all the treated groups; highly significant reduction in the number of cigarettes smoked by smokers; and reduction in some of the lipids in all the treated groups, but particularly in the hypertensive group. The therapy appears to be feasible and suitable for wider application. This approach is economical, acceptable to patients, and should be explored further.

Reduction of serum cholesterol and blood pressure in hypertensive patients by behaviour modification

In a pilot study, 14 pharmacologically treated hypertensive patients were given training in psychophysical relaxation exercises, reinforced by biofeedback instruments, for six weeks. The patients were asked to practise twice a day and also incorporate the exercises into everyday activities. In spite of their unchanged drug schedule, their mean blood pressure (B.P.) was reduced from 170.6/102.5 to 147.9/89.14 (P = < .001) while their mean (+/- S.D.) serum cholesterol level was reduced from 241.6 +/- 39.19 to 217.1 +/- 38.12 mg/100 ml (P = < .001). I believe the possibility of one therapy which can reduce two risk factors at the same time should be explored further in a controlled study.

Relaxation and biofeedback techniques in the management of hypertension

In a controlled trial, 27 patients with systemic hypertension were given training in relaxation and meditation using biofeedback procedures. As a result there was a significant reduction in both systolic and diastolic pressure in 77% of the patients. In 50% of the patients it was also possible to reduce antihypertensive drugs, ranging from 33 to 100%. Six-month follow up results show that the benefit can be maintained for a long term provided the patients practice relaxation regularly. The response is unlikely to be a "placebo effect" in the usual meaning. Its genuine therapeutic value should be exploited and reevaluated on a larger scale.

Altered immunologic responsiveness in mastocytoma-bearing mice

Immune responses to sheep erythrocytes were enhanced in mice bearing small mastocytomas soon after injection of a few tumor cells. In contrast, mice with larger tumors after transfer of a greater number of mastocytoma cells and those in the later stages of tumor development after transfer of small numbers of tumor cells showed moderately suppressed immune responses. Transfer of spleen cells from mastocytoma-bearing mice to irradiated recipients resulted in more antibody-forming cells as compared to transfer of splenocytes from normal donor mice. The addition of graded numbers of mastocytoma cells to a constant amount of normal spleen cells transferred to irradiated mice also resulted in enhanced responses and increased spleen weights in the recipients. This increase, in direct proportion to the number of mastocytoma cells transferred, also occurred when Escherichia coli lipopolysaccharide (a T-cell independent antigen) was used to immunize animals given spleen cells from normal mice and mastocytoma cells. Mastocytoma cell-free homogenates or X-irradiated tumor cells also heightened immune responses in recipient mice, which indicated that viable cells were not needed for the effect. Such homogenates, as well as the tumor cells per se, stimulated increased lactate dehydrogenase (LDH) activity in the sera of recipient mice. However, tumor cells passaged in tissue culture for several months, those derived from mice bearing a mastocytoma cell line with a low LDH-stimulatory activity, or UV-irradiated mastocytoma cells with a high LDH-stimulatory activity did not induce enhanced plaque-forming cell responses.

Immunosuppression induced in vitro by cell-free extracts of Friend leukemia virusinfected splenocytes

The immunologic responsiveness by normal BALB/c spleen lymphocytes immunized in vitro with sheep erythrocytes was markedly suppressed by calrified cell-free homogenates of Friend leukemia virus (FLV)-infected mouse spleens. Suppression was achieved with a 3,000Xg supernatant of FLV-containing homogenates freed of cellular debris but not with crude unclarified homogenates or pelleted material after centrifugation. The immunosuppressive effects of the virus were dose dependent, whether the virus was added directly to the target spleen cells or separated from them by a 0.4mu Nuclepore filter. Suppression was prevented by heating of the virus at 100 degrees C for 10 minutes or by neutralization with antiserum to FLV. Addition of the virus as late as 48 hours after in vitro immunization of splenocytes affected the immune response. However, suppression was maximum when the clarified virus was added to the splenocytes 1 or 2 days before immunization. The agent in the FLV-infected spleen homogenates responsible for immunosuppression appeared to be the virus per se; however, virus-associated soluble factor(s) might have been involved.

Restoration of in vitro immune responsiveness of mastocytoma-suppressed splenocytes by activated T cells

Spleen cells from normal DBA/2 mice pretreated with a soluble factor from mastocytoma cells or from ascitic fluid of mastocytoma-bearing mice were markedly impaired in terms of antibody formation to SRBC in vitro. Such immunosuppression by mastocytoma homogenates or ascitic fluid was reversed when syngeneic T cells activated to SRBC were added to the cultures, but not when peritoneal exudate cells or anti-theta-treated normal splenocytes were used. Activated T cells, as well as normal B lymphocytes prepared from spleens of lethally irradiated mice reconstituted with bone marrow cells, were less sensitive to the immunosuppressive factor than non-activated T cells. The ability of educated T cells to restore immunocompetence of suppressed spleen cells in vitro suggests that the target of the immunosuppressive factor from mastocytoma cells may be non-activated T cells, especially those involved in T cell helper function.

Randomised controlled trial of yoga and bio-feedback in management of hypertension

34 hypertensive patients were assigned at random either to six weeks' treatment by yoga relaxation methods with bio-feedback or to placebo therapy (general relaxation). Both groups showed a reduction in blood-pressure (from 168/100 to 141/84 mm. Hg in the treated group and from 169/101 to 160/96 mm Hg in the control group). The difference was highly significant. The control group was then trained in yoga relaxation, and their blood-pressure fell to that of the other group (now used as controls).

Immunosuppression induced in vitro by mastocytoma tumor cells and cell-free extracts

Suppressed anti-sheep RBC responses occurred when spleen cells from mastocytoma-bearing mice were incubated in vitro and immunized with red blood cells. Marked immunosuppression also occurred when mastocytoma cells were added to spleen cell cultures from normal mice immunized in vitro with the sheep RBC. Suppressed immune responses also occurred when the mastocytoma cells were separated from the normal cells by 0.4-mu nucleopore membranes, but not by dialysis membranes in double chambered culture vessels. Cell-free homogenates prepared from mastocytoma cells, as well as ascitic fluid from tumor-bearing mice, also impaired the responsiveness of normal splenocytes to the SRBC. The suppressive activity of the cell-free homogenates was abolished by heating at 56 degrees C for 30 min. The immunosuppressive activity, however, was retained in supernatant ultracentrifugates of the cell-free homogenate after 100,000 times G for 90 min. Immunosuppression was most evident when mastocytoma extracts were added to cultures of normal splenocytes at the time of in vitro immunization and culture initiation. Suppression was not reversed by washing of the cultured cells and addition of fresh medium. Immunosuppression also occurred when mastocytoma extracts were incubated with spleen cells from allogeneic tumor resistant C57BL/6 mice. Additional physicochemical analyses should provide information as to the nature and specificty of the inhibitory factor(s) and its role as an immunoregulatory substance important in the host-tumor relationship.

Yoga and biofeedback in the management of 'stress' in hypertensive patients

1. Psychophysical relaxation exercises based on yogic principles and reinforced by biofeedback instruments were used for behaviour modification in sixteen hypertensive subjects. 2. Preliminary studies indicated that their pressor response to emotional and physical stimuli became less exaggerated and less protracted compared with controls.

12-month follow-up of yoga and bio-feedback in the management of hypertension

Twenty hypertensive patients treated by psychophysical relaxation exercises were followed up monthly for 12 months. Age and sex matched hypertensive controls were similarly followed up for 9 months. Statistically significant reductions in blood-pressure (BP) and antihypertensive drug requirements were satisfactorily maintained in the treatment group. Mere repetition of B.P. measurements and increased medical attention did not in themselves reduce B.P. significantly in control patients.