Expiratory muscle pressure and breathing mechanics in chronic obstructive pulmonary disease

Expiratory muscle recruitment is common in stable chronic obstructive pulmonary disease (COPD) patients. Due to airway obstruction, there is little reason to believe that active expiration in COPD would be mechanically effective in lowering operating lung volume. The physiological significance of expiratory muscle recruitment in COPD, therefore, remains unknown. The purpose of this study was to assess, in COPD patients breathing at rest, the effect of expiratory muscle contraction on force generating ability of the diaphragm. The force generating ability of the diaphragm was evaluated from its pressure swing (Pdi) for a given diaphragm electrical activity (Edi), where Edi was normalized as % of its maximal value (Pdi/Edi/Edi,max). Phasic expiratory muscle contraction was measured as the total expiratory rise in gastric pressure (Pga,exp.rise). Nineteen seated patients with moderate to severe COPD, participated in the study and 10 exhibited phasic rise in Pga during expiration with a mean Pga,exp.rise of 1.91+/-0.89 cmH2O. The patients were thus divided into passive expiration (PE) and active expiration (AE) groups. There was no significant difference in various lung function and breathing pattern parameters between the two groups. Pdi/Edi/Edi,max was 0.63+/-0.07 and 0.54+/-0.07 cmH2O/% in PE and AE groups, respectively, and was not significantly different between each other. Compared with PE group, AE group not only recruited expiratory muscles, but also preferentially recruited inspiratory rib cage muscles and derecruited the diaphragm. The results do not support a significant improvement of the force-generating ability of the diaphragm by phasic contraction of expiratory muscles at rest in chronic obstructive pulmonary disease patients.

Endotoxin in pooled pericardial blood contributes to the systemic inflammatory response during cardiac surgery

Although endotoxin has been implicated as an important contributor to the systemic inflammatory response (SIR) during cardiopulmonary bypass (CPB), its source remains unclear. While gut translocation has traditionally been perceived as the primary source of endotoxemia, accumulation of endotoxin in pooled pericardial blood may represent an additional source of endotoxin that is continually reinfused into the CPB circuit. Eighteen patients undergoing primary coronary revascularization procedures were prospectively evaluated. Shed blood pooled in the pericardial space was returned to the CPB circuit through cardiotomy suction catheters at 45 min after placement of the aortic cross-clamp. Simultaneous samples of pooled pericardial and peripheral arterial blood were obtained and analyzed by a limulus amebocyte lysate assay for the determination of endotoxin concentration, and an enzyme-linked immunosorbent assay for tumor necrosis factor (TNF-alpha) levels. Significant elevations in endotoxin were demonstrated in pooled pericardial blood samples compared with arterial blood (3.5 +/- 0.5 vs 0.8 +/- 0.2 pg/ml; p < 0.05). TNF-alpha levels were below the limits of detection in both samples. These data implicate pooled pericardial blood as an important primary source of endotoxin that, when continually reinfused throughout CPB, may contribute to the overall SIR. Because endotoxemia has been identified as an important predictor of adverse outcomes following cardiac surgery, removal of endotoxin antigen in shed pericardial blood, prior to its reinfusion into the CPB circuit, may provide a directed means to improve perioperative outcome without compromising established blood conservation techniques.

Examination of the human prion protein-like gene doppel for genetic susceptibility to sporadic and variant Creutzfeldt-Jakob disease

A novel human gene named Doppel (DPL) that has homology to the prion protein gene (PRNP) has recently been identified on chromosome 20p. By automated sequencing we have found a common (M174T, 48%) and an uncommon coding polymorphism. The polymorphic frequency of the M174T allele was examined in cases of variant and sporadic Creutzfeldt-Jakob Disease and compared with the frequency in the normal UK population. In sharp distinction to the M129V polymorphism of PRNP we have not found any evidence of disease association nor is there any association with age of onset, disease duration, or prion protein (PrP(Sc)) strain type.

Asthma severity, recommended changes of inhaled therapy and exhaled nitric oxide in children: a prospective, blinded trial

Orally exhaled nitric oxide (ENO) correlates with several variables of airway inflammation and might be useful to direct asthma therapy. If this is true, ENO should correlate with disease severity and the therapeutic decisions made. - In 74 children with allergic asthma (age 9.7 years, range 4-16) disease severity was determined by history, clinical symptoms, and lung function and inhaled therapy was adjusted according to the NIH criteria. ENO was also measured, but the patients, their parents and the physicians who made the therapeutic decision were left unaware of the results. 31 healthy children served as controls. ENO was higher in asthmatics than in controls, but did not differ with asthma severity. ENO was weakly correlated with the changes in asthma therapy recommended (r = 0.303, P = 0.009). ENO values above normal (> 13 ppb) had a sensitivity of 0.67 and a specificity of 0.65 to predict a step up in therapy. Due to the non-normal distribution of ENO there was a substantial overlap between the different groups. The lack of correlation with disease severity and the weak prediction of physician recommended inhaled therapy, suggest that ENO may be of some value to guide asthma therapy. Studies using ENO to direct therapy are necessary for a definite answer.

The effect of CVVHD and endotoxin on the oxidative burst, adhesion molecules and distribution in tissues of granulocytes

OBJECTIVE

Extracorporeal circulation, such as cardiopulmonary bypass and haemodialysis, has been associated with an activation of the immune system, especially the granulocytes. Continuous veno-venous haemodiafiltration (CVVHD) is used in critically ill septic patients. During CVVHD cytokines are excreted in the ultrafiltrate. But when the membranes used in CVVHD are cultured with granulocytes, the granulocytes are slightly activated. This effect is potentiated by endotoxin. We therefore, in vivo, compared the effect on granulocyte activation of CVVHD with an endotoxin group and a control group.

METHODS

Thirty-one pigs were anaesthetized and mechanically ventilated. In ten pigs CVVHD was performed. Eleven pigs received an infusion of Escherichia coli endotoxin 30 mu/kg(-1) and ten pigs served as a control group. The adhesion molecules CD18 and CD62L were measured using monoclonal antibodies. The oxidative burst activity was assayed as superoxide dismutase-inhibitory reduction of cytochrome c. The number of granulocytes in peripheral blood and in the lungs and liver were counted.

RESULTS

The infusion of endotoxin was followed by granulocytopenia, reduced oxidative burst activity, increased expression of CD18 and decreased expression of CD62L on granulocytes. Accumulation of granulocytes in liver and lung tissue was also noted in this group. CVVHD was only associated with a non-significant decrease in CD62L expression on granulocytes. It did not affect any of the other measured immunological parameters.

CONCLUSION

In contrast to endotoxin-induced sepsis, the granulocytes were not activated during CVVHD.

Leukocyte-endothelium interactions in pial venules during the early and late reperfusion period after global cerebral ischemia in gerbils

The contribution of leukocytes to secondary brain damage after cerebral ischemia is still under discussion. The purpose of the present study was to examine the pial microcirculation after global cerebral ischemia while focusing on leukocyte-endothelium interactions during the early and late reperfusion period of up to 4 days. A closed cranial window technique that leaves the dura mater intact was used. Global cerebral ischemia of 15 minutes' duration was induced in male Mongolian gerbils (n = 91). Pial microcirculation was observed by intravital fluorescence microscopy. Leukocyte-endothelium interactions (LEIs) in pial venules, vessel diameters, capillary density, and regional microvascular blood flow measured by laser Doppler flowmetry were quantified during 3 hours of reperfusion and in intervals up to 4 days after ischemia. Within 3 hours of reperfusion, the number of leukocytes (cells/100 microm x minute) rolling along or adhering to the venular endothelium increased from 0.1 +/- 0.2 to 28.4 +/- 17.4 (P < 0.01 vs. control) and from 0.2 +/- 0.2 to 4.0 +/- 3.8 (P < 0.05), respectively. There was no capillary plugging by leukocytes; capillary density remained unchanged. In the late reperfusion period, at 7 hours after ischemia, LEIs had returned to baseline values. Furthermore, from 12 hours to 4 days after ischemia, no LEIs were observed. Changes in regional microvascular blood flow did not correlate with LEIs. Global cerebral ischemia of 15 minutes' duration induces transient LEIs that reach a maximum within 3 hours of reperfusion and return to baseline at 7 hours after ischemia. LEIs are not related to changes in microvascular perfusion, which suggests mainly that the expression of adhesion receptors is necessary to induce LEIs rather than rheologic factors. It seems unlikely that this short-lasting activation of leukocytes can play a role in the development of secondary brain damage.

Alzheimer's disease due to an intronic presenilin-1 (PSEN1 intron 4) mutation: A clinicopathological study

We describe 21 affected individuals from a kindred with early-onset autosomal dominant familial Alzheimer's disease caused by an intronic presenilin-1 mutation (in intron 4). Mean age at onset of symptoms was 37.4 years [95% confidence interval (CI): 36.6-38.2 years], mean age at death was 44.7 years (95% CI: 43.1-46.3 years) and mean duration of illness was 7.3 years (95% CI: 5.9-8.7 years). Myoclonus and seizures were prominent features of this pedigree. In the four cases for whom neuropsychometric data were available, verbal memory impairment preceded visual memory deficits; naming was relatively preserved until late in the disease. One of these four cases underwent serial volumetric MRI scans demonstrating in vivo brain tissue loss of 3.9% (38.9 ml, annualized rate of atrophy: 1. 7%) over 22 months of follow-up. The four individuals who had necropsies demonstrated the neuropathological hallmarks of Alzheimer's disease. Apolipoprotein E (APOE) status was assessed in five individuals: the case with the youngest age at onset at 33 years of age was found to be homozygous epsilon4/epsilon4, > 1 SD below the mean age of onset for those of known APOE genotype (36.4 +/- 2.3 years, mean +/- SD), and > 2 SDs below the mean age of onset for the pedigree as a whole (37.4 +/- 1.7 years, mean +/- SD). APOE genotype may therefore modulate age at onset in this pedigree.

Influence of IGF-I and cell density on MDR1 expression in the T-lymphoblastoid cell line CCRF-CEM

The debate about a direct or indirect effect of GH and IGF-I on the recurrence of malignancy, especially in the case of rhGH therapy in patients with leukemia, is still going on. Recent studies suggested that IGF-I plays a role in drug resistance during anticancer therapy. This resistance to diverse cytotoxic drugs, named multidrug-resistance (MDR), is mainly due to high levels of P-glycoprotein (P-gp). The gene encoding this membrane-associated transporter protein was named MDR1, and increased levels of P-gp are linked to enhanced MDR1 mRNA expression. Our aim was to investigate a possible effect of rhIGF-I on MDR1 gene expression in vitro. We cultured the T-lymphoblastoid cell line CCRF-CEM with different rhIGF-I concentrations (0, 5, 20 and 50 ng/ml) in serum-free medium for 3 days. CCRF-CEM cells are drug-sensitive and express MDR1 at low levels. MDR1 mRNA expression was measured by semiquantitative RT-PCR using a competitive assay with a heterologous DNA construct. In addition, GAPDH mRNA was amplified as an internal control for RNA integrity. P-gp activity was determined by a flow cytometric assay measuring rhodamine 123 accumulation. Furthermore, cell proliferation was monitored in all experiments. Our data do not support an effect of rhIGF-I on MDR1 mRNA expression, P-gp activity or cell proliferation in the CCRF-CEM cell line. MDR1 mRNA levels were inversely correlated to cell density with high significance (p < 0.0001). In conclusion, multidrug resistance linked to P-gp is not induced by IGF-I in CCRF-CEM cells. At high density, CCRF-CEM cells downregulate MDR1 gene expression. Our experimental model provides a very useful tool for monitoring the influence of growth factors on multidrug resistance in vitro.

Vaccination against hepatitis B: current challenges for Asian countries and future directions

AIMS

To review the current status of hepatitis B immunization programmes as well as future issues concerning hepatitis B immunization in Asian countries.

METHODS

Pertinent literature was identified via in-house and MEDLINE (1980-99) searches and references cited in published articles. Articles within the Proceedings of the IX Triennial International Symposium on Viral Hepatitis and Liver Disease provided valuable state-of-the-art resource data.

RESULTS

Chronic hepatitis B infection is responsible for 75-90% of primary hepatocellular carcinoma, one of the 10 most common cancers worldwide. Hepatitis B and its chronic sequelae can potentially be eradicated through vaccines that have been shown to be 95-99% efficacious in preventing development of the disease or the carrier state in immunized infants. Approximately 75% of the world's hepatitis B carriers live in Asian countries wherein wide variations in immunization strategies exist. Vaccination programmes in hyperendemic Asian countries have elicited decreases in the incidence of acute and chronic infections as well as a decrease in chronic carriers in the unvaccinated population. Decreases in the incidence of hepatocellular carcinoma have been recorded in Taiwan and Singapore after at least 10 years of universal hepatitis B immunization programmes.

CONCLUSIONS

In Asian countries currently without nationwide hepatitis B programmes, utilization of the existing vaccination infrastructure for administration of other World Health Organization Expanded Programme on Immunization vaccines will provide the most economical and efficient means of administration of the hepatitis B vaccine.

Characterization of lineage-specific chimaerism in patients with acute leukaemia and myelodysplastic syndrome after allogeneic stem cell transplantation before and after relapse

Recently, we have shown that patients with acute leukaemias and myelodysplastic syndromes (MDS), who showed increasing mixed chimaerism (MC) upon serial PCR analysis after transplant, have a significantly increased risk of relapse. To determine whether the increasing MC in these patients is caused by the reappearance of normal recipient haematopoiesis or by the reoccurrence of malignant cells, we purified different leucocyte subpopulations and analysed these subfractions with regard to their donor-recipient ratio by a PCR-based method for the analysis of minisatellite DNA regions. In 14 patients [eight acute lymphoblastic leukaemia (ALL), three acute myelogenous leukaemia (AML) and three MDS] subfractions were analysed when increasing MC was first noted upon serial analysis of the peripheral blood. In seven of these 14 patients (four ALL, two AML and one MDS), subfractions were characterized at the time of frank haematological relapse. In all 14 patients investigated with increasing MC, recipient cells were detected in different mononuclear cell subpopulations. In patients characterized during frank relapse, two distinct distribution patterns were found. Patients who relapsed before day +300 (one ALL, two AML and one MDS) showed recipient-derived (normal) cells in addition to blast populations in different mononuclear subsets as well as granulocytes. In patients with acute leukaemias who relapsed after day +300 (two ALL and one AML), only leukaemic cells were found that were of recipient origin, whereas all other haematopoietic cell lines were donor derived. These data show that persistent MC in the early post-transplant period is caused predominantly by normal recipient haematopoietic cells. This finding further supports the hypothesis that a state of mixed haematopoietic chimaerism may reduce the clinical graft-versus-leukaemia (GVL) effect of alloreactive donor-derived effector cells in patients with acute leukaemias and MDS, and thus facilitate the proliferation of residual malignant cells that may have survived the preparative regimen.

The role of mounts and intromissions in triggering ejaculation in rats

Eight male rats copulated with an estrus female with an open vagina (NF) and an estrus female with the vagina covered by adhesive tape (CF). Experimental sessions were composed of two phases. During Phase 1 the males copulated with NF or with CF females until 4 intromissions or 4 mount bouts were displayed respectively. In Phase 2 the males copulated alternately with NF or CF according to three schedules: (1) a sequence two mount bouts with a CF female followed by one intromission, (2) a sequence one intromission followed by two mount bouts with a CF female, and (3) a sequence one intromission followed by four mount bouts with a CF female. All of these sequences were repeated until ejaculation. Ejaculation occurred in 95.8% of cases within one minute after the last intromission during copulation with the CF female. The results of this study indicate that: (1) the number of intromissions displayed during Phase 2 does not depend on the character of the copulatory behaviour displayed during Phase 1, (2) at least two intromissions are displayed before ejaculation, and (3) the tactile stimulation of the glans of penis plays a crucial role in the ejaculatory seminal reflex.

A small 2'-OH- and base-dependent recognition element downstream of the initiation site in the RNA encapsidation signal is essential for hepatitis B virus replication initiation

Hepatitis B viruses replicate through reverse transcription of an RNA intermediate. In contrast to retroviral reverse transcriptases, their replication enzyme, P protein, does not use a nucleic acid primer but initiates DNA synthesis de novo from within an RNA stem-loop structure called epsilon. A short DNA oligonucleotide is copied from epsilon and covalently attached to P protein, and then synthesis is arrested. The information for initiation site selection and synthesis arrest must be contained in the structure of the P protein/epsilon complex. Because P protein activity depends on cellular chaperones this complex can as yet only be generated by in vitro translation of duck hepatitis B virus P protein in rabbit reticulocyte lysate; functional interaction with its cognate RNA element Depsilon can be monitored by the covalent labeling of P protein during primer synthesis. Combining this in vitro priming reaction and a set of chimeric RNA-DNA Depsilon analogues, we found that only five ribose residues in the 57-nucleotide stem-loop were sufficient to provide a functional template; these are a single residue in the template region and the two base pairs at the tip of the lower stem. The base identities in the very same region are essential as well. The presence of this 2'-OH- and base-dependent determinant shortly downstream of the initiation site suggests a mechanism that can account for both initiation site selection and programmed primer synthesis arrest.

Phase I study of subcutaneously administered recombinant human interleukin 12 in patients with advanced renal cell cancer

A phase I study was conducted to characterize the maximum tolerated dose (MTD), dose-limiting toxicity (DLT), and pharmacokinetics of a single dose followed by three times weekly s.c. injections of recombinant human interleukin 12 (rHuIL-12). The study encompassed 28 patients with advanced renal cell carcinoma. rHuIL-12 was administered on day 1, followed by an observation period of 7 days. Starting on day 8, repeated s.c. injections were administered 3 times a week for 2 weeks. The MTD of the initial injection was evaluated at dose levels of 0.1, 0.5, and 1.0 microg/kg. DLT was observed at 1.0 microg/kg and consisted of fever, perivasculitis of the skin, and leukopenia. The MTD of the subsequent repeated injections after 1 week of rest was studied at dose levels 0.5, 1.0, and 1.25 microg/kg. DLT at 1.25 microg/kg comprised deterioration of performance status, fever, vomiting, mental depression, and leukopenia. Other notable toxicities were oral mucositis and elevation of hepatic enzymes. Fever, leukopenia, and elevation of hepatic enzymes were more severe after the initial injection than after repeated injections at the same dose level. At dose level 0.5 microg/kg, the mean area under the plasma concentration-time curve decreased from 7.4 ng/h/ml after the first injection to 3.3 ng x h/ml (P = 0.034) after repeated administrations, and at dose level 1.0 microg/kg, it ranged from 31.8 ng/h/ml to 6.0 ng x h/ml (P = 0.041). One patient had a partial response and seven had stable disease. The MTD of a single s.c. injection of rHuIL-12 was 0.5 microg/kg, and the MTD of three subsequent administrations per week was 1.0 microg/kg. In comparison with a single administration, the three times weekly administrations at the same dose level was accompanied with a milder pattern of side effects and a reduction of the area under the plasma concentration-time curve.

Surfactant lipid uptake and metabolism by neonatal and adult type II pneumocytes

Animal experiments suggest developmental changes in surfactant homeostasis. The uptake and metabolism of [(3)H]dipalmitoylphosphatidylcholine-labeled liposomes with a surfactant-like composition were evaluated in type II cells isolated from rats of different postnatal ages. The early part of the uptake process (0-60 min) was more rapid and reached higher levels in cells from 2-day-old rats than in those from 7-day-old, 14-day-old, or adult rats. Temperature independence of this initial phase, differences in response to trypsin-EDTA or neuraminidase treatment, and the dependency of increased neonatal uptake on the presence of phosphatidylglycerol in liposomes suggested binding as a major mechanism of cell-lipid interaction. Although a two to three times larger amount of lipid was associated with neonatal cells, the metabolism of phosphatidylcholine, indicated by a decrease in label in phosphatidylcholine and an accompanying increase in sphingomyelin, was significantly smaller in 2-day-old than in adult cells. These studies support the hypothesis that neonatal and adult cells may have differences in the interaction with alveolar phospholipids and in the metabolism of phosphatidylcholine.

The interaction of phosphatidylcholine with alveolar type II pneumocytes is dependent on its physical state

Dipalmitoylphosphatidylcholine, the principal phospholipid component of surfactant, inhibits agonist stimulated surfactant secretion whereas dioleoylphosphatidylcholine does not. As knowledge of the type of interaction of phosphatidylcholines is important for the detailed analysis of surfactant homeostasis, this was examined in isolated rat type II pneumocytes in primary culture. Solid state [3H]-dipalmitoylphosphatidylcholine liposomes associated with the cells rapidly. No effect of blockade of endocytosis on the cellular association was observed, whereas that of the fluid phase marker [14C]-sucrose was reduced. No evidence for the fusion of the dipalmitoylphosphatidylcholine liposomes or for phospholipid exchange with the cells was detected, suggesting that the cells primarily bound the dipalmitoylphosphatidylcholine liposomes. Although a "specific" site with a saturable binding capacity (20 nmol dipalmitoylphosphatidylcholine/mg protein, KD 25 microM) was demonstrated, the interaction did not exhibit all the characteristics of a typical pharmacological receptor. The preincubation with nonlabeled dipalmitoylphosphatidylcholine almost completely inhibited binding to the cells. In accordance with their effects on stimulated surfactant secretion, various other phosphatidylcholine liposomes inhibited binding that was very much dependent on their physical state, as only those in a solid state were inhibitory by more than 50%. These results support the view that the binding of dipalmitoylphosphatidylcholine may be involved in the feedback regulation of surfactant secretion in type II pneumocytes and that these processes are dependent on the physical state of the interacting liposomes.

Nursing assessment of patient readiness for ambulation after cardiac catheterization

Although nurses routinely perform activities that prevent or detect vascular complications following a cardiac catheterization, determining patient readiness for ambulation has received minimal research attention. Educating nurses to determine patient readiness for ambulation is a safe and effective way to promote patient comfort.

Inherited prion disease with an alanine to valine mutation at codon 117 in the prion protein gene

A large English family with autosomal dominant segregation of presenile dementia, ataxia and other neuropsychiatric features is described. Diagnoses of demyelinating disease, Alzheimer's disease, Creutzfeldt-Jakob disease (CJD) and Gerstmann-Sträussler-Scheinker syndrome have been attributed to particular individuals at different times. An Irish family, likely to be part of the same kindred, is also described, in which diagnoses of multiple sclerosis, dementia, corticobasal degeneration and new variant CJD have been considered in affected individuals. Molecular genetic studies have enabled the classification of this disease at the molecular level as one of the group of inherited prion diseases, with the substitution of valine for alanine at codon 117 of the prion protein gene (PRNP). Only three other kindreds have been described world-wide with this mutation and only limited phenotypic information has been reported. Here we describe the phenotypic spectrum of inherited prion disease (PrPA117V). The diversity of phenotypic expression seen in this kindred emphasizes the logic of molecular classification of the inherited prion diseases rather than classification by specific clinicopathological syndrome. Indeed, inherited prion disease should be excluded by PRNP analysis in any individual presenting with atypical presenile dementia or neuropsychiatric features and ataxia, including suspected cases of new variant CJD.

Interleukin-1 genotypes and the association between periodontitis and cardiovascular disease

An epidemiological association between periodontitis and cardiovascular disease has been reported in multiple studies. Various mechanisms have been proposed as potential explanations for this association, including a common factor that predisposes certain individuals to a hyper-responsive inflammatory response. Variations in the genes that regulate the interleukin-1 (IL-1) response have been associated with both periodontal disease and cardiovascular disease. New data indicate that one pattern of IL-1 genetic polymorphisms, characterized by the IL-1A (+4845) and IL-1B (+3954) markers, is associated with periodontitis but not certain measures of atherosclerosis. Another IL-1 genetic pattern, characterized by the IL-1B (-511) and IL-1RN (+2018) markers, is associated with atherosclerotic plaque formation, as measured by angiography and arterial wall thickness, but not periodontitis. These two patterns also have different functional implications relative to IL-1 biological activity. Studies of IL-1 gene polymorphisms, atherosclerotic plaque instability and cardiovascular clinical events are in progress. Hypothetical models are presented to explain how IL-1 genetic factors may be involved in cardiovascular disease.

Texture segregation in chromatic element-arrangement patterns

An element-arrangement pattern is composed of two types of elements arranged differently in different regions of a pattern. Rapid texture segregation depends on spontaneously discriminating the difference in the arrangement of the elements. Five experiments investigated the perceived segregation of patterns composed of two types of squares arranged in vertical stripes in the top and bottom regions and in a checkerboard arrangement in the middle region. The squares were either equal in luminance and different in hue or equal in hue and different in luminance. The rated similarities of the two hues in a pattern failed to predict perceived segregation. For a given background luminance, the perceived segregation was predicted by the square-root of the sum of the squares of the differences in the outputs of the L - M + S and L + M - S opponent channels, where L, M, and S were the cone contrasts of the long-, medium-, and short-wavelength receptors. The perceived similarity of the two hues in a pattern was not affected by the background luminance but was a function of cone excitations instead. For patterns differing in hue and equal in luminance, perceived segregation was an inverse function of the background luminance. A white background decreased the perceived segregation, but a black background did not. The effect of background luminance was not on the discrimination of the individual hues. The two hues making up a texture pattern were clearly distinguishable on a white background. A white background interfered with the discrimination of the vertical and diagonal columns of squares that distinguished the texture regions. For patterns differing in luminance and equal in hue, black and white backgrounds decreased the perceived segregation. The results indicate that adapting to an achromatic luminance distant from the luminance of the squares increased the Weber threshold for discriminating luminance differences, but did not increase the Weber threshold for discriminating hue differences. The experiments also revealed that luminance was the primary factor affecting perceived segregation and that perceived brightness is secondary. The results are consistent with the hypothesis that perceived segregation in element-arrangement patterns is primarily a function of the differences in the outputs of relatively early filtering mechanisms that encode pattern differences prior to the specification of the element shapes and their properties.

Characteristics of flow dependency of nitric oxide in exhaled air in children with cystic fibrosis and asthma

Nitric oxide (NO) is a free radical produced by the lungs which can easily be measured in exhaled air. NO may serve as a non-invasive marker for airway inflammation in chronic inflammatory diseases like asthma. However in patients with cystic fibrosis (CF) and severe airway involvemen normal or low levels of NO have been reported. To investigate this further we measured NO levels in exhaled air at 5 different flow rates in 14 asthmatics, 15 CF-patients and 13 healthy children. A dependency of exhaled NO on expiratory flow was demonstrated in all three groups. At slow flows lower NO levels in CF-patients and significantly higher levels in asthmatics compared to healthy individuals were found. When the data were fitted to a one compartment model of the lung described by NO(MOUTH) = NO(LUNG) - NO(LUNG) x e(-T/Vex) (T = transfer factor; Vex = expiratory flow), NO(LUNG) was increased in asthmatics (191.9 +/- 53.8 ppb) and low in CF (26.7 +/- 5.7 ppb) compared to healthy individuals (76.9 +/- 50.9 ppb; p(anova) = 0.0213). NO produced in the central compartment of the lung behaved similarly and was distinguished from a peripheral compartment with the two compartment model NO(MOUTH) = NO(central) - (NO(central) - NO(peripher) ) x e(-T/Vex). We conclude that NO in exhaled air is flow dependent and at slow expiratory flows elevated in asthmatics and reduced in CF-patients compared to healthy children. Concentrations extrapolated for the whole lung and for the central airways changed proportionally.