Effects of intranasal cocaine on sympathetic nerve discharge in humans

Cocaine-induced cardiovascular emergencies are mediated by excessive adrenergic stimulation. Animal studies suggest that cocaine not only blocks norepinephrine reuptake peripherally but also inhibits the baroreceptors, thereby reflexively increasing sympathetic nerve discharge. However, the effect of cocaine on sympathetic nerve discharge in humans is unknown. In 12 healthy volunteers, we recorded blood pressure and sympathetic nerve discharge to the skeletal muscle vasculature using intraneural microelectrodes (peroneal nerve) during intranasal cocaine (2 mg/kg, n = 8) or lidocaine (2%, n = 4), an internal local anesthetic control, or intravenous phenylephrine (0.5-2.0 microg/kg, n = 4), an internal sympathomimetic control. Experiments were repeated while minimizing the cocaine-induced rise in blood pressure with intravenous nitroprusside to negate sinoaortic baroreceptor stimulation. After lidocaine, blood pressure and sympathetic nerve discharge were unchanged. After cocaine, blood pressure increased abruptly and remained elevated for 60 min while sympathetic nerve discharge initially was unchanged and then decreased progressively over 60 min to a nadir that was only 2+/-1% of baseline (P < 0.05); however, plasma venous norepinephrine concentrations (n = 5) were unchanged up to 60 min after cocaine. Sympathetic nerve discharge fell more rapidly but to the same nadir when blood pressure was increased similarly with phenylephrine. When the cocaine-induced increase in blood pressure was minimized (nitroprusside), sympathetic nerve discharge did not decrease but rather increased by 2.9 times over baseline (P < 0.05). Baroreflex gain was comparable before and after cocaine. We conclude that in conscious humans the primary effect of intranasal cocaine is to increase sympathetic nerve discharge to the skeletal muscle bed. Furthermore, sinoaortic baroreflexes play a pivotal role in modulating the cocaine-induced sympathetic excitation. The interplay between these excitatory and inhibitory neural influences determines the net effect of cocaine on sympathetic discharge targeted to the human skeletal muscle circulation.

Clinically silent microemboli in patients with artificial prosthetic aortic valves are predominantly gaseous and not solid

BACKGROUND AND PURPOSE

Microembolic signals (MES) are frequently observed by transcranial Doppler ultrasound after prosthetic heart valve implantation. Whether these MES are due to solid or gaseous particles is uncertain. We hypothesized that MES are gaseous and that if they are due to cavitation effects, their occurrence should respond to changes of dissolved oxygen concentration in the blood.

METHODS

Transcranial monitoring of MES was performed in five patients with prosthetic aortic valves, who inspired 100% oxygen through a facial mask. In one patient 100% oxygen was administered under hyperbaric (2.5 kPa) conditions in a hyperbaric chamber.

RESULTS

Inspiration of 100% oxygen reduced the total number of MES from 96/30 min to 2/30 min. Increasing the concentration of dissolved oxygen in the hyperbaric chamber led to an increase from 0.3 MES per minute (1.0 kPa) to 0.9 MES per minute (2.5 kPa).

CONCLUSIONS

The dependence of occurrence of MES in patients with prosthetic cardiac valves on the oxygen partial pressure in blood provides strong evidence that these microemboli are gaseous.

Siroheme biosynthesis in Saccharomyces cerevisiae requires the products of both the MET1 and MET8 genes

Siroheme is a uroporphyrinogen III-derivative used by sulfite reductase as a prosthetic group. We investigated in Saccharomyces cerevisiae the possible involvement in siroheme biosynthesis of three genes, MET1, MET8 and MET20. The MET1 gene from S. cerevisiae was cloned and shown to be the same gene as MET20. Sequence similitudes as well as complementation studies indicate that Met1p and Met8p are both involved in siroheme biosynthesis. In addition, we show formally that S. cerevisiae does not need vitamin B12 for growth.

Epitope mapping and functional characterization of monoclonal antibodies specific for herpes simplex virus type I DNA polymerase

Three monoclonal antibodies (MAbs 1051a, 1051b and 1051c) were raised against a surface region (residues 597-686) of the herpes simplex virus type 1 (HSV-1) DNA polymerase (HSV pol), and their epitopes were mapped. The MAbs reacted serotype specifically with the native and denatured HSV pol, as shown by Western blot analysis, immunoprecipitation and immunofluorescence microscopy, indicating their usefulness for biochemical studies and clinical diagnosis of HSV-1 infections, MAb 1051c, displaying the least cross-reactivity with cellular proteins in the Western blot analysis, was successfully utilized not only for coimmunoprecipitation, but also for the analysis and three-dimensional modeling of the cellular sites of HSV pol interaction by confocal laser immunofluorescence microscopy.

Image quality and dose in computed tomography

Radiation exposure to the patient during CT is relatively high, and it is therefore important to optimize the dose so that it is as low as possible but still consistent with required diagnostic image quality. There is no established method for measuring diagnostic image quality; therefore, a set of image quality criteria which must be fulfilled for optimal image quality was defined for the retroperitoneal space and the mediastinum. The use of these criteria for assessment of image quality was tested based on 113 retroperitoneal and 68 mediastinal examinations performed in seven different CT units. All the criteria, except one, were found to be usable for measuring diagnostic image quality. The fulfillment of criteria was related to the radiation dose given in the different departments. By examination of the retroperitoneal space the effective dose varied between 5.1 and 20.0 mSv (milli Sievert), and there was a slight correlation between dose and high percent of "yes" score for the image quality criteria. For examination of the mediastinum the dose range was 4.4-26.5 mSv, and there was no significant increment of image quality at high doses. The great variation of dose at different CT units was due partly to differences regarding the examination procedure, especially the number of slices and the mAs (milli ampere second), but inherent dose variation between different scanners also played a part.

HLA-B27 heavy chains contribute to spontaneous inflammatory disease in B27/human beta2-microglobulin (beta2m) double transgenic mice with disrupted mouse beta2m

MHC class I allele, HLA-B27, is strongly associated with a group of human diseases called spondyloarthropathies. Some of these diseases have an onset after an enteric or genitourinary infection. In the present study, we describe spontaneous disease in HLA-B27 transgenic mice where endogenous beta2-microglobulin (beta2m) gene was replaced with transgenic human beta2m gene. These mice showed cell surface expression of HLA-B27 similar to that of human peripheral blood mononuclear cells. In addition, free heavy chains (HCs) of HLA-B27 were also expressed on thymic epithelium and on a subpopulation of B27-expressing PBLs. These mice developed spontaneous arthritis and nail changes in the rear paws. Arthritis occurred primarily in male animals and only when mice were transferred from the pathogen-free barrier facility to the conventional area. Transgenic mice expressing HLA-B27 with mouse beta2m have undetectable levels of free HCs on the cell surface and do not develop arthritis. In vivo treatment with anti-HC-specific antibody delayed the onset of disease. Our data demonstrate specific involvement of HLA-B27 'free' HCs in the disease process.

Inactivation of MET10 in brewer's yeast specifically increases SO2 formation during beer production

Sulfite is widely used as an antioxidant in food production. In beer brewing, sulfite has the additional role of stabilizing the flavor by forming adducts with aldehydes. Inadequate amounts of sulfite are sometimes produced by brewer's yeasts, so means of controlling the sulfite production are desired. In Saccharomyces yeasts, MET10 encodes a subunit of sulfite reductase. Partial or full elimination of MET10 gene activity in a brewer's yeast resulted in increased sulfite accumulation. Beer produced with such yeasts was quite satisfactory and showed increased flavor stability.

Relationship between protein structure and geometrical constraints

We evaluate to what extent the structure of proteins can be deduced from incomplete knowledge of disulfide bridges, surface assignments, secondary structure assignments, and additional distance constraints. A cost function taking such constraints into account was used to obtain protein structures using a simple minimization algorithm. For small proteins, the approximate structure could be obtained using one additional distance constraint for each amino acid in the protein. We also studied the effect of using predicted secondary structure and surface assignments. The constraints used in this approach typically may be obtained from low-resolution experimental data. When using a cost function based on distances, half of the resulting structures will be mirrored, because the resulting structure and its mirror image will have the same cost. The secondary structure assignments were therefore divided into chirality constraints and distance constraints. Here we report that the problem of mirrored structures, in some cases, can be solved by using a chirality term in the cost function.

Cleavage site analysis in picornaviral polyproteins: discovering cellular targets by neural networks

Picornaviral proteinases are responsible for maturation cleavages of the viral polyprotein, but also catalyze the degradation of cellular targets. Using graphical visualization techniques and neural network algorithms, we have investigated the sequence specificity of the two proteinases 2Apro and 3Cpro. The cleavage of VP0 (giving rise to VP2 and VP4), which is carried out by a so-far unknown proteinase, was also examined. In combination with a novel surface exposure prediction algorithm, our neural network approach successfully distinguishes known cleavage sites from noncleavage sites and yields a more consistent definition of features common to these sites. The method is able to predict experimentally determined cleavage sites in cellular proteins. We present a list of mammalian and other proteins that are predicted to be possible targets for the viral proteinases. Whether these proteins are indeed cleaved awaits experimental verification. Additionally, we report several errors detected in the protein databases. A computer server for prediction of cleavage sites by picornaviral proteinases is publicly available at the e-mail address NetPicoRNA@cbs.dtu.dk or via WWW at http:@www.cbs.dtu.dk/services/NetPicoRNA/.

Inactivation of MET2 in brewer's yeast increases the level of sulfite in beer

Brewer's yeasts sometimes produce inadequate or excessive amounts of sulfite, an antioxidant and flavour stabilizer, so means of controlling the sulfite production are desired. Understanding the physiology and regulation of the sulfur assimilation pathway of Saccharomyces yeasts is the key to change sulfite production. The MET2 gene of Saccharomyces yeasts encodes homoserine O-acetyl transferase, which catalyzes the conversion of homoserine to O-acetyl homoserine which in turn combines with hydrogen sulfide to form homocysteine, the immediate precursor of methionine. We expected that inactivation of MET2 would lead to accumulation of sulfide and derepression of the entire sulfur assimilation pathway and, therefore, possibly also to sulfite accumulation. Brewer's yeasts were constructed in which several of the four MET2 gene copies were inactivated. Sulfite production was increased in strains with one remaining MET2 gene and even more so when no active MET2 was present. In both cases, hydrogen sulfide production was also increased. To the extent that excess sulfide can be removed, this strategy may be applied to control sulfite accumulation by brewer's yeast in beer production.

Total effective radiation dose from spiral CT and conventional radiography of the pelvis with regard to fracture classification

PURPOSE

In most departments CT has replaced special radiographic projections with regard to classification of pelvic fractures. This change of procedure calls for analysis in terms of dosimetry.

METHODS

The total effective radiation doses given with spiral CT and conventional 5 projection radiography were determined according to ICRP 60 by measuring organ doses with an anthropomorphic Rando Alderson phantom packed with thermoluminescence dosimeters. For comparison, easily obtainable calculated effective doses were also determined, based on the CT dose index (CTDI), measured free-in-air and as entrance surface dose using organ conversion factors according to NRPB-R250 and NRPB-R262.

RESULTS

The total effective radiation dose was lower in spiral CT than in conventional 5 projection radiography, 4.4 and 5.0 mSv, respectively. In spiral CT the calculated effective dose was 11% lower and in conventional radiography 68% higher than the dose obtained by actual measurement using the Alderson phantom.

CONCLUSION

As CT gives important diagnostic information with regard to classification of pelvic fractures, and without a greater radiation risk than impacted by 5 projection conventional radiography, we recommend the performance of spiral CT instead of special projections.

Modification of biochemical pathways in industrial yeasts

Yeasts have many applications in industrial food and beverage production. While these uses are often of ancient origin, modern demands for control of the amounts of process-derived compounds and for cost-effective processing can make it desirable to modify metabolic pathways of production yeasts. While the genetics of standard laboratory strains of Saccharomyces cerevisiae are well described, industrial strains and species are less characterized, and many of them have a complicated genetic constitution. Nevertheless, their biochemical pathways can be modified, and the knowledge becoming available on the physiology of genetic reference strains of S. cerevisiae is a great help in directing the modifications of the industrial yeasts towards practical goals.

Differential sympathetic neural control of oxygenation in resting and exercising human skeletal muscle

Metabolic products of skeletal muscle contraction activate metaboreceptor muscle afferents that reflexively increase sympathetic nerve activity (SNA) targeted to both resting and exercising skeletal muscle. To determine effects of the increased sympathetic vasoconstrictor drive on muscle oxygenation, we measured changes in tissue oxygen stores and mitochondrial cytochrome a,a3 redox state in rhythmically contracting human forearm muscles with near infrared spectroscopy while simultaneously measuring muscle SNA with microelectrodes. The major new finding is that the ability of reflex-sympathetic activation to decrease muscle oxygenation is abolished when the muscle is exercised at an intensity > 10% of maximal voluntary contraction (MVC). During high intensity handgrip, (45% MVC), contraction-induced decreases in muscle oxygenation remained stable despite progressive metaboreceptor-mediated reflex increases in SNA. During mild to moderate handgrips (20-33% MVC) that do not evoke reflex-sympathetic activation, experimentally induced increases in muscle SNA had no effect on oxygenation in exercising muscles but produced robust decreases in oxygenation in resting muscles. The latter decreases were evident even during maximal metabolic vasodilation accompanying reactive hyperemia. We conclude that in humans sympathetic neural control of skeletal muscle oxygenation is sensitive to modulation by metabolic events in the contracting muscles. These events are different from those involved in either metaboreceptor muscle afferent activation or reactive hyperemia.

[Occupational exposure to formaldehyde and risk of cancer]

Formaldehyde is a widespread animal carcinogen with limited evidence of carcinogenesis in humans. We investigated the occupational risk of cancer (1970-84) among men and women in Denmark. Relative risks (RR) were estimated from standardized proportionate incidence ratios among patients whose longest employment had been held since 1964, at least 10 years before diagnosis, in 265 companies in which exposure to formaldehyde was identified. The only biologically plausible increased risk was for nasal cancer, for which relative risks of 2.3 (95% confidence interval = 1.3-4.0) and 2.4 (0.6-6.0) appeared for men and women, respectively. In the subgroup of blue-collar men with no probable exposure to wood-dust, the major confounder, the relative risk for this cancer was 3.0 (1.4-5.7). It is concluded that occupational exposure to formaldehyde may increase the risk of nasal cancer, but formaldehyde does probably not affect other cancers.

Radiation dose by spiral CT and conventional tomography of the sternoclavicular joints and the manubrium sterni

OBJECTIVE DESIGN AND PATIENTS: Conventional frontal tomography of the sternum has to some extent been replaced by spiral computed tomography (CT). The objective of this study was to analyse this change of procedure in terms of dosimetry by measurement of the radiation dose to individual organs using an anthropomorphic Rando Alderson phantom.

RESULTS

The total effective radiation dose in examination of the sternoclavicular joints and the manubrium sterni was found to be lower using spiral CT than conventional tomography, the values being 0.6 and 0.8 mSv, respectively.

CONCLUSION

As spiral CT is diagnostically comparable and in some respects superior to tomography, its use is recommended for studies of the sternum.

Management of accidentally found pathological lymph nodes on routine screening mammography

Normal lymph nodes in the anterior part of the axilla are readily seen on routine mammography. It is important, however, to recognize pathological lymph nodes, characterized by increased attenuation, high density, a round or irregular shape and lack of fat in the hilus, as they often indicate significant diseases. We examined the final diagnosis in 22 patients referred for clinical examination from a mammographic screening programme because of pathological lymph nodes without concomitant breast malignancy. Ten of them were found to have a malignant lesion, and one had sarcoidosis. None of the malignancies had been diagnosed before screening. Among women with abnormal but impalpable nodes, only one malignancy was found (in a woman with previous breast cancer), whereas nine of 13 women with palpable nodes had malignancies. Seven malignant lymphomas were discovered, but among all 60 women of the age group in question with newly diagnosed lymphomas in the region, only 13 had pathological axillary nodes. Mammography cannot therefore be used as a screening method for lymphoma. We conclude that mammographically pathological lymph nodes in the axilla should be examined clinically and propose a simple programme for patient management.

Occurrence of cancer in women with Turner syndrome

A study of cancer incidence in a cohort of 597 women with Turner syndrome (TS) and a virtually complete follow-up is presented. The cohort was established from the Danish Cytogenetic Register. Information on cancer incidence was obtained from the Danish Cancer Registry and compared with the expected number calculated from the age-, period- and site-specific cancer rates for Danish women. A total of 21 neoplasms was observed, of which 13 occurred more than 1 year after diagnosis of TS, corresponding to a relative risk of cancer of 1.1. Wilms' tumour was the only identified childhood cancer. No case of gonadoblastoma or dysgerminoma was identified in the 29 women with a Y chromosome or in the women in whom no Y chromosome material was detected by standard cytogenetic methods, suggesting that the risk of ovarian germ cell tumours may be lower than previously estimated. Colon cancer was observed in five patients (relative risk 6.9, 95% confidence interval 2.2-16.2). Further studies are needed to assess whether colon cancer in TS is related to Turner-associated genes on the sex chromosome(s).