A rapid in vitro test for chloroquine-resistant Plasmodium falciparum

We report a rapid (2-3 hr) in vitro test for chloroquine resistance in Plasmodium falciparum. The test is based on the inhibition of chloroquine efflux by verapamil; it is performed by diluting infected blood in culture medium and incubating the diluted blood for 60 min at 37 degrees C with 50 nM 3H-chloroquine, with and without 10 microM verapamil. The test can be performed with the ring stage parasites in the blood of infected patients and in the presence of white cells, platelets and anticoagulants (heparin, EDTA, or citrate). Although the test can be performed in triplicate with 20 microliters of blood and specimens may be kept in anticoagulants at 4 degrees C for up to 24 hr, parasitemias less than 0.1% limit the sensitivity of the assay. Inhibition of chloroquine efflux by verapamil may permit the rapid identification of chloroquine resistant P. falciparum in blood specimens from infected patients.

Refractory congestive heart failure after ribavirin in infants with heart disease and respiratory syncytial virus

Although treatment with ribavirin has been known to be associated with a decreased mortality in infants with congenital heart disease (CHD) who have respiratory syncytial virus (RSV), few data are available regarding morbidity. We reviewed records of 10 consecutively hospitalized infants with CHD during a recent RSV epidemic. Despite the presence of left-to-right shunt in each patient, symptoms of RSV were respiratory at presentation. After ribavirin, decreased respiratory symptoms were found in 8 infants but in 2 assisted ventilation were required 1 and 3 days after admission. Congestive heart failure worsened in 8 patients, 6 of whom had improved respiratory status after ribavirin. Of the 8 patients with worse CHF (pulmonary edema), 3 responded to medical management but 5 were refractory and 4 required surgical repair of CHD. One patient died of pulmonary hemorrhage. Medically refractory CHF may develop in infants with CHD who become infected with RSV and are treated with ribavirin. Further studies are needed to determine whether the pulmonary edema is caused by RSV, ribavirin, or combination of effects on pulmonary capillary function or some other unrecognized mechanism.

Postoperative isolated dysfunction of the long thoracic nerve: a rare entity of uncertain etiology

A "winged" scapula is a rare, poorly understood, and potentially disabling curiosity following anesthesia and surgery. It is produced by dysfunction of the long thoracic nerve and consequent paralysis of the serratus anterior muscle. A survey of senior anesthesiologists indicated a consistent lack of familiarity with the entity. This article presents six cases of postoperative long thoracic nerve palsy. In a literature review of 111 instances of long thoracic nerve palsy, 51 were trauma-related, 47 were either idiopathic or of debatable origin, and 13 appeared following a surgical or obstetrical procedure. Unprovable etiologic contentions were frequent. Considerations of the etiologies of postoperative long thoracic nerve palsies must include a coincidental infectious neuropathy ("neuralgic amyotrophy") as a valid alternative to the assertion that a preventable injury occurred during anesthesia.

Massive intraoperative atelectasis secondary to untreated mediastinal Hodgkin's disease: report of the hazard and review of the literature

Mediastinal adenopathy in Hodgkin's disease has been known to cause relative airway compromise, particularly in the more vulnerable left mainstem bronchus. This has been infrequently reported to occur during general anesthesia and to cause respiratory embarrassment, representing a significant hazard. The possibility of its occurrence should be recognized. Preoperative evaluation of the airway by chest films and tomography, followed by radiation therapy in those patients at risk, is recommended to minimize the chances of respiratory complications during general anesthesia.

Development of a tracheal implant xenograft model to expose human bronchial epithelial cells to toxic gases

A tracheal implant model was developed which enabled exposure of differentiated normal human bronchial epithelial cells (NHBE) to a single exposure of a model toxic gas (formaldehyde). NHBE cells were grown in vitro in explant culture under defined serum-free conditions from previously frozen bronchial segments, harvested, and used to repopulate de-epithelialized rabbit tracheas. Rabbit tracheal segments repopulated with NHBE cells were implanted into the subcutis of congenitally athymic nude mice. Following graft vascularization, the xenografted NHBE cells differentiated and formed a mucociliary epithelial surface which lined approximately 50% of the surface of the implant lumen. Eight weeks post-implantation both ends of the implanted grafts were cannulated, and formaldehyde (HCHO) vapor (0, 6, or 15 ppm) in humidified air was passed through the tracheal lumens. Representative epithelial surfaces were examined by light and scanning electronmicroscopy, and autoradiography prior to, immediately after, and 48 hr following a 1-hr exposure to the test vapors. Light microscopic examination of implant sections immediately following exposure to 6 and 15 ppm HCHO detected cessation of ciliary activity, which recovered by 48 hr post-exposure. Scanning electron microscopic examination of the epithelial surface demonstrated mild morphologic changes, restricted to those implants exposed to 15 ppm. Findings immediately following HCHO exposure included swelling and exfoliation of individual cells, deciliation, and mucus release. Changes present after 48 hr included presence of flattened cells with few short microvilli and focal increase in the number of S-phase nuclei in the basal epithelium. These results demonstrate the utility of tracheal implants for single short-term exposure of differentiated human bronchial epithelial cells to gaseous agents.(ABSTRACT TRUNCATED AT 250 WORDS)

Alpha-melanocyte-stimulating hormone infusions during pregnancy in the rat: effects on offspring weight, pain reactivity and sexual behavior

Pregnant rats treated during the last third of pregnancy with a continuous infusion of alpha-melanocyte-stimulating hormone (alpha-MSH) produced offspring that weighed less at birth and in adulthood. These offspring of the alpha-MSH treated mothers were less sensitive to pain and as adults showed a reduced analgesic response to morphine. Male offspring of alpha-MSH treated mothers and of control animals responded similarly in sexual performance tests, except that the treated animals significantly shifted their pattern of responding when they encountered a new testing arena or experienced defeat. The offspring of alpha-MSH treated mothers were influenced more by changes in their environment than were control offspring. These effects are similar to those reported following perinatal treatment with opiate drugs or peptides.

Low-level, magnetic-field-induced growth modification of Bacillus subtilis

Experimental studies showed an increase in the growth of Bacillus subtilis mutant strain FJ7 above controls by exposing the bacterial culture to 800-Hz or 1-KHz magnetic fields with a 2-s-on/2-s-off period. The magnetic field strength was between 0.8 and 2.5 mT. Light microscopy and scanning electron microscopy demonstrated the morphology of controls to grow in a macrofiber of right-handed helix formation. In contrast, the field-exposed group showed little to no cohesion; the cells appeared to be homogeneously distributed throughout the sample. These results suggest that growth patterns of Bacillus subtilis can be altered as a result of magnetic-field-induced effects.

Neonatal exposure of female ferrets to testosterone alters sociosexual preferences in adulthood

Sociosexual preferences in adult female ferrets, as measured in a choice arena, were altered by neonatal exposure to exogenous testosterone. Adult female ferrets showed a preference for males which did not depend on the presence of gonadal steroids, because gonadectomized and gonadectomized estrogen-treated females showed identical preferences for males. Adult castrated males showed no preference for females unless these males were treated with testosterone. A similar no-preference pattern was found in adult females that had received testosterone neonatally. Females exposed neonatally to dihydrotestosterone or estradiol exhibited the normal females' male-oriented preference. These results indicate that testosterone secreted by the testes in the developing male may interrupt the phenotypic female development pattern and hence prevent the emergence of a homosexual preference in adulthood in the male ferret.

Surface topography and distribution of cell types in the rat nasal respiratory epithelium: scanning electron microscopic observations

Several cell types were identified in the rat nasal respiratory epithelium using scanning electron microscopy. In addition to the previously described ciliated, nonciliated, and goblet cells, the nasal brush cell was identified based on its surface characteristics and its location between nonciliated epithelial cells. Scanning electron microscopy clearly showed the differences in distribution of cell types in the nasal mucosa. The ciliated cells increase in number from the anterior to the posterior areas of the respiratory epithelium with a corresponding decrease in nonciliated cells. However, even at a single cross-sectional area of the nasal cavity, the various surfaces have different proportions of ciliated versus nonciliated cells, e.g., the medial surface of the nasal concha has more ciliated cells than other surfaces. Brush cells are distributed between nonciliated cells of the respiratory epithelium on most surfaces of the nasal cavity including the conchae and the lateral wall. Based on the available information, scanning electron microscopy will be useful in future studies to determine the effects that inhaled toxicants have on cells and on the location of lesions.

Differentiated features of a transformed epithelial cell line (TRKE-1) derived from dimethylnitrosamine-treated rat kidney

TRKE-1 is a pure line of epithelium-like neoplastic cells derived from the kidney of a rat treated 48 hr previously with a carcinogenic dose of dimethylnitrosamine. Using light microscopy, the line was characterized by cohesive growth behavior typical for epithelium and the formation of hemicysts (domes) at postconfluence. Enhancement of dome formation by dibutyryl cyclic adenosine 3':5'-monophosphate and dimethyl sulfoxide and inhibition by ouabain established these structures as a manifestation of differentiated cellular function, namely, transepithelial fluid transport. Structurally, TRKE-1 cells in monolayer culture were characterized by apical distribution of microvilli, cilia, and endocytic vesicles, ordered sequence of junctional components at the apical lateral border including tight junction and desmosomes, basolateral cellular interdigitations below the junctional complex, basal location of microfilament bundles, and a conspicuous content of mitochondria. Each of these features typifies mammalian renal tubule epithelium in vivo. The occasional profusion of microvilli; the prominent, apically distributed endocytic vesicles; and the well-developed basal microfilament tracts suggest, in particular, that the proximal segment of the nephron may represent the site of origin of this transformed cell line. The various morphological aspects of renal epithelial differentiation were also expressed in multicellular tumor spheroids grown in suspension, with an accentuation of junctional complexes, endocytic vesicles, and intracytoplasmic lumina. In addition, this three-dimensional culture mode supported cellular organization into acinar profiles suggestive of primitive tubule formation. In confirming the epithelial nature of TRKE-1 and a possible identity with the proximal tubule, this study provides an in vitro animal model representative of chemically transformed renal epithelium which may be analogous to human renal cell carcinoma.

Succinylcholine-induced increases in plasma catecholamine levels in humans

Given the hypothesis that interaction of succinylcholine with nicotinic receptors releases endogenous catecholamines, plasma levels of epinephrine and norepinephrine were determined in anesthetized and manually ventilated patients immediately before and 2 min after intravenous administration of succinylcholine. Anesthesia was induced with intravenous thiopental (3-4 mg/kg) followed by the administration of nitrous oxide and oxygen (1:1) and 0.5-1.0% halothane. Stimulation of the patients was avoided. Succinylcholine (1 mg/kg) or metocurine (0.3 mg/kg) was injected intravenously and ventilation was controlled without intubation. Plasma norepinephrine levels increased from 301 pg/ml to 491 pg/ml (SEM = +/- 19 pg/ml, P less than 0.01, N = 5) 2 min after the injection of succinylcholine; the increase in plasma epinephrine was not statistically significant. The time course of catecholamine elevation was studied in three additional patients. The increase of norepinephrine occurred immediately after the injection of succinylcholine, peaked (647 +/- 67 pg/ml) around the third minute, and disappeared by the 10th min. The increase in epinephrine was less marked. Plasma levels of catecholamines did not change after the injection of metocurine (N = 2). The possibility that succinylcholine stimulates nicotinic receptors on the postganglionic sympathetic terminals is discussed. We propose that the elevation of plasma norepinephrine might contribute to the development of early adverse cardiovascular reactions to succinylcholine.