An epidemiological study of the role of chrysotile asbestos fibre dimensions in determining respiratory disease risk in exposed workers

BACKGROUND

Evidence from toxicological studies indicates that the risk of respiratory diseases varies with asbestos fibre length and width. However, there is a total lack of epidemiological evidence concerning this question.

METHODS

Data were obtained from a cohort mortality study of 3072 workers from an asbestos textile plant which was recently updated for vital status through 2001. A previously developed job exposure matrix based on phase contrast microscopy (PCM) was modified to provide fibre size-specific exposure estimates using data from a re-analysis of samples by transmission electron microscopy (TEM). Cox proportional hazards models were fit using alternative exposure metrics for single and multiple combinations of fibre length and diameter.

RESULTS

TEM-based cumulative exposure estimates were found to provide stronger predictions of asbestosis and lung cancer mortality than PCM-based estimates. Cumulative exposures based on individual fibre size-specific categories were all found to be highly statistically significant predictors of lung cancer and asbestosis. Both lung cancer and asbestosis were most strongly associated with exposure to thin fibres (<0.25 microm). Longer (>10 microm) fibres were found to be the strongest predictors of lung cancer, but an inconsistent pattern with fibre length was observed for asbestosis. Cumulative exposures were highly correlated across all fibre size categories in this cohort (0.28-0.99, p values <0.001), which complicates the interpretation of the study findings.

CONCLUSIONS

Asbestos fibre dimension appears to be an important determinant of respiratory disease risk. Current PCM-based methods may underestimate asbestos exposures to the thinnest fibres, which were the strongest predictor of lung cancer or asbestosis mortality in this study. Additional studies are needed of other asbestos cohorts to further elucidate the role of fibre dimension and type.

Emergence and early cognitive function in the elderly after xenon or desflurane anaesthesia: a double-blinded randomized controlled trial †

BACKGROUND

Postoperative cognitive impairment after general anaesthesia, especially in the elderly, is a well-recognized problem. Xenon, known to be an N-methyl-d-aspartate antagonist, may be advantageous. In this study, the early cognitive function in the elderly after general anaesthesia with xenon was compared with that after desflurane.

METHODS

After approval by the local ethical committee and after obtaining written informed consent, patients were enrolled in this randomized, double-blinded, controlled study. Thirty-eight patients (65-75 yr old, ASA status I-III) undergoing an elective surgery with a planned duration of 60-180 min were allocated to either the xenon (n = 18) or the desflurane (n = 20) anaesthesia group. The primary outcome was the cognitive Test for Attentional Performance (TAP) with its subtests Alertness, Divided Attention, and Working Memory. After baseline assessment 12-24 h before operation, patients were followed-up 6-12 and 66-72 h after operation. Secondary outcomes were emergence times from anaesthesia and the modified Aldrete score.

RESULTS

No difference was found between the groups in the TAP at 6-12 and 66-72 h after operation. In the xenon group, emergence time was significantly faster for the following parameters: time to open eyes (P = 0.001), to react on demand (P = 0.001), to extubation (P = 0.001), and for time and spatial orientation (P = 0.007). The modified Aldrete score was significantly higher after 30, 45 and 60 min in the xenon group.

CONCLUSIONS

There was no difference in the postoperative cognitive testing at 6-12 and 66-72 h. Xenon was associated in the elderly with a faster emergence from general anaesthesia than desflurane.

Autonomic cardiac control with xenon anaesthesia in patients at cardiovascular risk

BACKGROUND

The cardiovascular stability found with xenon anaesthesia may be caused by absence of circulatory depression. Xenon may also act directly on autonomic cardiovascular control.

METHODS

In a prospective, randomized design, 26 patients (ASA class III and IV) with increased cardiac risk were anaesthetized for elective non-cardiac surgery with either xenon (n = 13) or propofol (n = 13), each combined with remifentanil. From intraoperative Holter ECG, 5-min intervals of stable sinus rhythm were analysed at baseline anaesthesia with etomidate/remifentanil, and after 30 and 60 min of propofol or xenon anaesthesia. Target criteria were total power and ratio of low to high frequency power of the heart rate (HR) power spectrum between 0.003 and 0.4 Hz, indicating global activity and sympatho-vagal balance of autonomic modulation of HR.

RESULTS

When compared with baseline, total power decreased with propofol from 8.6 (1.6) to 7.1 (0.5) and to 7.8 (1.1) ms(2) at 30 and 60 min, respectively, [mean (sd) of logarithmic transform] and was unchanged with xenon (P = 0.02; anova). The low/high frequency power ratio changed from 3.0 (3.5) to 4.3 (4.3) and 4.1 (6.2), respectively, with xenon and from 3.9 (3.6) to 1.8 (1.5) and 1.8 (0.8) with propofol (P = 0.04; generalized linear model test). Mean arterial pressure was significantly higher with xenon throughout (P < 0.001; anova).

CONCLUSIONS

Propofol caused a decrease in arterial pressure as well as autonomic HR modulation, but xenon did not. The higher arterial pressure with xenon anaesthesia may be explained by less suppression of sympatho-vagal balance.

Cervical occlusion in women with cervical insufficiency: protocol for a randomised, controlled trial with cerclage, with and without cervical occlusion*

OBJECTIVE

To evaluate the effect of double cerclage compared with a single cerclage.

DESIGN

Randomised, controlled multicentre trial.

SETTING

Ten different countries are participating with both secondary and tertiary centres. The countries participating are Denmark, Sweden, Germany, United Kingdom, Spain, South Africa, Australia and India. This gives both a broad spectrum of diversity global and local. We expect a total of 242 women enrolled per year.

POPULATION

Prophylactic study: 1. History of cervical incompetence/insufficiency. (Delivery 15 to <36 weeks.) 2. Congenital short cervix (secondary to maternal administration of diethyl stilbestrol) or traumatic/surgical damage rendering the vaginal approach difficult (e.g. conisation). 3. Cervical suture applied in previous pregnancy, successful outcome. 4. Previous failed cerclage. Therapeutic study: 5. Secondary cerclage: Short cervix, without the membranes being exposed to the vagina. 6. Tertiary cerclage: Short cervix, membranes exposed to the vagina. Observational study: Eligible women who refuse to be randomised will participate in an observational study. 7. Repeat/requested cervical occlusion.

METHODS

The women will be randomised between a single (vaginal or abdominal) and a double cerclage. The cervical cerclage (McDonald or Shirodkar) as well as the abdominal suture will be performed with the same material and technique normally used by the participating department. Those randomised to the double cerclage will have their external os closed with a continuous nylon 2-0/3-0 suture, in addition to the standard single cerclage. Local guidelines concerning antibiotics, Heparin, bed rest, tocolytics etc. are followed and recorded in the follow-up form.

MAIN OUTCOME MEASURES

Primary endpoint is take home baby rate. The secondary endpoints are gestational age at delivery, incidence of preterm birth (<34+0 days) and number of days in neonatal unit.

Could a cervical occlusion suture be effective at improving perinatal outcome?

Cervical weakness and infection have long been regarded as major causes of preterm birth. Cervical cerclage has been used extensively to reduce the risk of preterm birth arising as a result of cervical weakness, but increasing evidence suggests that the cervix plays more than just a mechanical role. Immunological function of the cervix and mucus plug is thought to be important in minimising the ingress of microbes, which can lead to chorioamnionitis and rupture of the amniotic membranes. In this review, we examine the background of traditional cervical cerclage and introduce the concept of the occlusion suture and its potential benefit in reducing the risk of recurrent preterm prelabour rupture of membranes.

Effects of xenon anaesthesia on the circulatory response to hypoventilation

BACKGROUND

Circulatory response to hypoventilation is aimed at eliminating carbon dioxide and maintaining oxygen delivery (DO(2)) by increasing cardiac output (CO). The hypothesis that this increase is more pronounced with xenon than with isoflurane anaesthesia was tested in pigs.

METHODS

Twenty pigs received anaesthesia with xenon 0.55 MAC/remifentanil 0.5 microg kg(-1) min(-1) (group X, n=10) or isoflurane 0.55 MAC/remifentanil 0.5 microg kg(-1)min(-1) (group I, n=10). CO, heart rate (HR), mean arterial pressure (MAP) and left ventricular fractional area change (FAC) were measured at baseline, after 5 and 15 min of hypoventilation and after 5, 15 and 30 min of restored ventilation.

RESULTS

CO increased by 10-20% with both anaesthetics, with an equivalent rise in HR, maintaining DO(2) in spite of a 20% reduction in arterial oxygen content. Decreased left ventricular (LV) afterload during hypoventilation increased FAC, and this was more marked with xenon (0.60-0.66, P<0.05 compared with baseline and isoflurane). This difference is attributed to negative inotropic effects of isoflurane. Increased pulmonary vascular resistance during hypoventilation was found with both anaesthetics.

CONCLUSION

The cardiovascular effects observed in this model of moderate hypoventilation were sufficient to maintain DO(2). Although the haemodynamic response appeared more pronounced with xenon, differences were not clinically relevant. An increase in FAC with xenon is attributed to its lack of negative inotropic effects.

Haemodynamic effects of haemorrhage during xenon anaesthesia in pigs

BACKGROUND

It was hypothesized that xenon would stabilize mean arterial pressure (MAP) in haemorrhagic shock, recovery, and volume resuscitation, because a higher MAP has been observed with xenon, when compared with isoflurane anaesthesia. The responses to haemorrhage and subsequent volume replacement were therefore compared between xenon and isoflurane anaesthesia, in pigs.

METHODS

Pigs were randomized to anaesthesia with xenon 0.55 MAC (group Xe, n=9) or isoflurane 0.55 MAC (group Iso, n=9), each with remifentanil 0.5 microg kg(-1) min(-1). MAP, heart rate, cardiac output (CO), and left ventricular fractional area change (FAC) were collected at control (1), after haemorrhage (20 ml kg(-1)) (2), after 10 min of recovery (3), after volume replacement (4), and 30 min later (5). Data were analysed by two-way repeated measures anova.

RESULTS

Blood loss decreased MAP (Xe: 103 [21] to 53 [24] mm Hg; Iso: 92 [18] to 55 [14] mm Hg) and CO (Xe: 4.1 [0.8] to 2.6 [0.5] litre min(-1); Iso: 5.1 [1.1] to 3.8 [1.2] litre min(-1)), in spite of significant tachycardia. MAP and CO recovered to about 75% of control, and subsequent volume replacement completely reversed symptoms in both groups, but increased FAC only with xenon.

CONCLUSION

Haemodynamic response to acute haemorrhage appeared faster with xenon/remifentanil than with isoflurane/remifentanil anaesthesia. In particular MAP decrease and short-term recovery were more marked with xenon (P<0.02). In the xenon group, volume replacement increased FAC compared with control and isoflurane (P<0.02).

Entanglement in spin chains and lattices with long-range Ising-type interactions

We consider N initially disentangled spins, embedded in a ring or d-dimensional lattice of arbitrary geometry, which interact via some long-range Ising-type interaction. We investigate relations between entanglement properties of the resulting states and the distance dependence of the interaction in the limit N-->infinity. We provide a sufficient condition when bipartite entanglement between blocks of L neighboring spins and the remaining system saturates and determine S(L) analytically for special configurations. We find an unbounded increase of S(L) as well as diverging correlation and entanglement length under certain circumstances. For arbitrarily large N, we can efficiently calculate all quantities associated with reduced density operators of up to ten particles.

A double-blinded, placebo-controlled trial of garlic as a mosquito repellant: a preliminary study

The hypothesis that the ingestion of garlic provides protection against bloodsucking pests such as mosquitoes was investigated using a randomized, double-blinded, placebo-controlled crossover study. Subjects were asked to consume either garlic (one visit) or a placebo (the other visit). They were then exposed to laboratory-reared Aedes aegypti (Linnaeus) (Diptera: Culicidae). The numbers of mosquitoes that did not feed on the subjects, the number of mosquito bites, the weights of the mosquitoes after feeding and the amounts of blood ingested were determined. The data did not provide evidence of significant systemic mosquito repellence. A limitation of the study is that more prolonged ingestion of garlic may be needed to accomplish repellence.

Pesticide use and practices in an Iowa farm family pesticide exposure study

Residents of Iowa were enrolled in a study investigating differences in pesticide contamination and exposure factors between 25 farm homes and 25 non-farm homes. The target pesticides investigated were atrazine, metolachlor, acetochlor, alachlor, 2,4-D, glyphosate, and chlorpyrifos; all were applied to either corn or soybean crops. A questionnaire was administered to all participants to determine residential pesticide use in and around the home. In addition, a questionnaire was administered to the farmers to determine the agricultural pesticides they used on the farm and their application practices. Non-agricultural pesticides were used more in and around farm homes than non-farm homes. Atrazine was the agricultural pesticide used most by farmers. Most farmers applied pesticides themselves but only 10 (59%) used tractors with enclosed cabs, and they typically wore little personal protective equipment (PPE). On almost every farm, more than one agricultural pesticide was applied. Corn was grown by 23 (92%) farmers and soybeans by 12 (48%) farmers. Of these, 10 (40%) grew both soybeans and corn, with only 2 (8%) growing only soybeans and 13 (52%) growing only corn. The majority of farmers changed from their work clothes and shoes in the home, and when they changed outside or in the garage, they usually brought their clothes and shoes inside. Applying pesticides using tractors with open cabs, not wearing PPE, and changing from work clothes in the home may increase pesticide exposure and contamination. Almost half of the 66 farm children less than 16 years of age were engaged in some form of farm chores, with 6 (9%) potentially directly exposed to pesticides, while only 2 (4%) of the 52 non-farm children less than 16 years of age had farm chores, and none were directly exposed to pesticides. Farm homes may be contaminated with pesticides in several ways, resulting in potentially more contamination than non-farm homes, and farm children may be directly exposed to pesticides through farm chores involving pesticides. In addition to providing a description of pesticide use, the data presented here will be useful in evaluating potential contributing factors to household pesticide contamination and family exposure.

An in vitro study of antibacterial properties of the cervical mucus plug in pregnancy

OBJECTIVE

To evaluate whether cervical mucus plugs are antibacterial in vitro.

STUDY DESIGN

Cervical mucus plugs from 56 healthy women in labor were studied by 2 different antimicrobial assays: (1) analysis of the inhibition by the cervical mucus plug of several gram-positive and gram-negative bacteria by overlaying the cervical mucus plug onto an agar plate with imbedded bacteria, and (2) determination of the antibacterial property of the cervical mucus plug material by radial diffusion assay with group B Streptococcus and Escherichia coli.

RESULTS

In the agar overlay assay, there was complete inhibition of clinical isolates of Staphylococcus saprophyticus, E coli, and Pseudomonas aeruginosa and patient-variable partial-to-complete inhibition of Enterococcus faecium, Staphylococcus aureus, Streptococcus pyogenes, and Streptococcus agalactiae. In the radial diffusion assay, cervical mucus plugs had activity toward group B Streptococcus equivalent to 0.075 microg/mL of gentamicin and toward E coli equivalent to 0.5 microg/mL of gentamicin.

CONCLUSION

A low-molecular substance with antibacterial activity in the cervical mucus plug may protect the fetus against ascending infections.

Antibacterial properties of human amnion and chorion in vitro

OBJECTIVE

The purpose of the present study was to explore the direct effects of amnion and chorion on bacterial growth in vitro including the antibacterial spectrum. Chorioamniotic membranes were obtained under sterile conditions from 13 healthy women undergoing elective cesarean section at term. Likewise, chorioamniotic membranes were obtained from 10 healthy women with spontaneous vaginal delivery at term. Five strains of Hemolytic streptococci group B (GBS) were tested and one clinical isolate of the following species or bacterial groups: Hemolytic streptococcus group A, Staphylococcus aureus, Staphylococcus saprophyticus, Enterococcus faecalis, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter calcoaceticus and Lactobacillus species. Bacteriological media included (1) blood-agar medium; (2) a transparent agar medium for submerged cultures; and (3) a nutrient broth medium.

RESULTS

An inhibitory effect of fetal membranes against a range of bacteria was found. Consistent results were obtained in experiments with cultures on agar and cultures suspended in agar (membranes from eight women in both studies). In experiments with liquid cultures (seven women) only chorion showed a marginal inhibitory effect. All strains were inhibited, but the most pronounced inhibition was obtained for streptococcus group A, S. aureus and S. saprophyticus by both chorion and amnion.

CONCLUSION

This study demonstrated an inhibitory effect of the fetal membranes on a diverse panel of bacteria

NMR spectra of fluorinated carbohydrates

Recent advances in structural and conformational analysis of fluorinated carbohydrates by NMR spectroscopy are reviewed. Characteristic 1H, 13C, and 19F NMR chemical shifts and coupling constants for selected examples are given and the spectral data of a series of fluorinated carbohydrates were collected in continuation of the review of Csuk and Glänzer [Adv. Carbohydr. Chem. Biochem., 46 (1988) 73-177].

Liquid crystals based on fluorinated carbohydrates

Fluorine introduced in the hydrophilic or the hydrophobic region of amphiphiles influences the thermomesomorphy of amphiphilic and monophilic fluorosugars in a very specific manner. This paper is the first review about chiral mesogens based on fluorinated carbohydrates. It covers the literature published so far. Analytical objectives are given to: (i) Effects of fluorine atoms on the H-bonding network of the hydrophilic region of sugar amphiphiles; (ii) Effects of perfluoroalkyl chains compared to alkyl chains; (iii) Polymorphism, e.g., also formation of smectic S(C)* phases.

Noninvasive glucose measurement by monitoring of scattering coefficient during oral glucose tolerance tests. Non-Invasive Task Force

BACKGROUND

Continuous glucose monitoring by means of optical glucose sensors would allow patients with diabetes to check their metabolic control to their convenience. In an earlier study, we showed that noninvasive glucose monitoring is feasible for rapid changes in blood glucose by means of measuring the scattering coefficient of human skin. In this study, we investigated whether also slower changes in blood glucose, this time induced by an oral glucose load, can also be monitored by this approach.

METHODS

Five healthy subjects and 13 patients with type 2 diabetes have been given a 75-g oral glucose load. Portable noninvasive systems were used to measure the skin tissue scattering coefficient. For this purpose, two optical sensor heads were attached directly to the skin of each volunteer. Light was applied to the skin and the reflected light intensity was registered.

RESULTS

In 8 of 10 measurements, correlation of changes in scattering coefficient with changes in glycemia was acceptable. In 19 of 26 measurements (73%) of patients with type 2 diabetes the observed changes in the scattering coefficient also correlated in acceptable manner. The accordance between the simultaneous measurements of the two sensor heads was acceptable in 13 of 18 volunteers and patients studied. There were virtually no differences in the quality of the measurements between healthy volunteers and patients with diabetes.

CONCLUSIONS

This study shows that also slow changes in blood glucose induced by an oral glucose load can be monitored by registration of scattering coefficient changes. It remains to be elucidated why this has not been possible in all experiments.

Inhaled nitric oxide as a prophylactic treatment against reperfusion injury of the lung

BACKGROUND

Inhaled Nitric Oxide (NO) has been found to be effective in clinical treatment of reperfusion injury after lung transplantation. This study was designed to determine a possible prophylactic role to reduce severe reperfusion injury.

METHODS

In 12 minipigs the left lung was selectively perfused with cold Euro-Collins solution. After 90 minutes of warm ischemia the lungs were reperfused and the contralateral pulmonary artery and main bronchus clamped. Hemodynamic and respiratory parameters were monitored for 7 hours. 6 animals were used as controls. 6 pigs formed the NO group and were ventilated continuously with 40 ppm nitric oxide (NO) starting 30 minutes prior to reperfusion.

RESULTS

In the control group right heart failure developed within 1.9 +/- 0.8 hours of reperfusion. Lung compliance was significantly reduced. A significant increase of pulmonary vascular resistance (PVR) was found. All animals of the NO group survived the reperfusion period of 7 hours. PVR was decreased compared to controls (p = 0.03). AaDO2 was lower, but not significantly different. The dynamic compliance of the lung was significantly higher (p = 0.007) in the NO group.

CONCLUSIONS

The prophylactic institution of inhaled NO reduces reperfusion injury of the lung. Short-term use of inhaled NO should be adopted as a prophylactic agent after transplantation of lungs preserved in Euro-Collins solution.

Gene transfer into rat heart-derived endothelial cells

OBJECTIVE

Progressive graft arteriosclerosis is responsible for the majority of late deaths in cardiac transplant recipients. Despite many investigations, the pathogenesis of this disease remains undetermined and its control inadequate. A somatic gene transfer during the cold ischemic time and thus before transplantation might be a new therapeutic tool. This approach allows a long incubation time of the DNA and a safe transfer with liposomes and transferrin with less adverse effects for the organ recipient.

METHODS

The target cells (microvascular endothelial cells (MVECs)) for this gene transfer were isolated from rat hearts by perfusion with collagenase via an aortic cannulae. The cells were purified by changing the medium 30 min after subcultivation in order to remove fibroblasts and smooth muscle cells. The endothelial cells (ECs) were identified by typical morphology and the uptake of Dil-Ac-LDL. The gene transfer was carried out with a beta-galactosidase reporter plasmid (pCMVbeta), cationic liposomes (Lipofectin), and transferrin. Different transfection solutions were prepared with or without serum, and with different plasmid-liposome ratios and transferrin concentrations. The transfer rate was monitored with a semiquantitative orthonitrophenyl-beta/-D-galactoside (ONPG) assay and histologically by X-Gal staining. The cytotoxicity of this procedure was determined with a colorimetric ELISA with Alamar blue. The cardioplegic property of the transfection solution was tested in a Langendorff perfusion system monitoring the coronary blood flow over time after a cold ischemic time of 4 h.

RESULTS

The maximal gene expression could be detected after transfection with 4 microl Lipofectin, 2 microg pCMVbeta, and 16 microg transferrin/200 microl transfection solution. Under these conditions 60% of the cells showed a blue staining with X-Gal. Only 20% of the cells died during transfection. The lowest cytotoxicity during cold ischemic time for ECs was assessed with normal cell culture medium and the Buckberg solution. The best coronary flow rates after 4 h cold ischemia of the heart were measured for cardioplegia with St. Thomas and Buckberg solutions. In summary, the best transfection solution with a good cardioplegic property was the Buckberg solution.

CONCLUSIONS

Finally, the results of this study show that an effective DNA delivery with a low toxicity into ECs is possible with a combination of liposomes and transferrin. This method might be useful for a safe and effective gene transfer into solid organs during the cold ischemic time and thus a therapeutic tool for chronic rejection.

[Comparison of roentgenological, macroscopic and histological degree of degeneration in varus gonarthrosis]

In 20 cases of varus gonarthrosis the degree of severity of osteoarthrosis was assessed preoperatively, intraoperatively and postoperatively for the medial and lateral compartments, respectively. The preoperative assessment was carried out on the basis of x-ray taken in an anterior-posterior and lateral view, whereas the intraoperative assessment was based on the recognizable macroscopic alteration of the femur and tibia. Following implantation of a total knee prosthesis, the resected osteocartilogical samples were assessed from a histological point of view. In the case of varus gonarthrosis there is a distinct difference in the degree of degeneration in the medial and lateral compartments. This difference becomes less noticeable if the assessment is carried out intraoperatively. The histological analysis shows that there are certainly differences between the compartments from a quantitative point of view but a late stage of osteoarthrosis was discernible both medially and laterally. From a histological point of view the radiological concept of the so-called "unicompartmental varus gonarthrosis" cannot be supported. In both compartments the osteoarthrotic process is more uniform than is to be expected.

Peripheral noradrenergic turnover in streptozotocin-induced diabetic rats

Our goal was to determine whether basal sympathetic tone to the kidney and various peripheral tissues is altered in conscious diabetic rats. Norepinephrine (NE) turnover was determined by measuring the decline in tissue NE concentration ([NE]) at 4 and 8 h after administering alpha-methyl-p-tyrosine to animals from each of three groups, diabetic (STZ injected 4 weeks prior to experimentation), diabetic + insulin (STZ injected; insulin injected; 2 U/day per rat for 4 weeks) and control (n = 18-20 per group). Various peripheral tissues (duodenum, left ventricle of the heart, kidney, skeletal muscle, left adrenal gland and liver) were examined. [NE] was significantly increased in the kidney and liver, but decreased in the duodenum of the diabetic compared to the control rats. In contrast to the changes in [NE], the rate constant, which provides an index of sympathetic tone, increased in the duodenum and liver, and a decreased in the adrenal gland. The turnover of NE, which is a composite of [NE] and rate constant, increased in the kidney and liver, and decreased in the adrenal gland of diabetic rats. Chronic treatment of diabetic rats with insulin normalized NE turnover in the liver, but not in the adrenal gland. Diabetic rats treated with insulin exhibited a reduced turnover of NE in the kidneys. These data demonstrate that there are differential changes in the [NE], rate constant, and turnover of NE in diabetic rats. Overall, these data indicate that there is increased noradrenergic activity to the kidney, possibly related to sodium retention, and a differential change in noradrenergic activation to various peripheral tissues in diabetic rats.

The impact of intraoperative brachytherapy on surgery of Ewing's sarcoma

Surgery of Ewing's sarcoma sometimes results in an inadequate surgical margin. The influence of intraoperative brachytherapy on local control of the tumor, operation time, blood loss, and surgical complications was evaluated, comparing the results of 20 patients who received brachytherapy to a series of 42 patients receiving surgery without brachytherapy. The dose of intraoperative brachytherapy ranged between 9 Gy and 21 Gy. The average operation time was longer in 20 cases with brachytherapy (7.9 h) than in 42 cases without brachytherapy (4.3 h) (P < 0.0001). The average blood loss in the groups with (3531 ml) and without brachytherapy (3515 ml) was comparable (P = 0.3840). The surgical complication rate in patients receiving brachytherapy was also similar to that of untreated patients (30% versus 31%, P = 0.7690). Local relapse developed in 1 of 20 patients who received brachytherapy and 1 of 42 patients without brachytherapy. On the basis of this analysis, it can be concluded that this procedure is safe and does not increase of the acute complication rate. The latest results of local controls are awaited.

Vascular smooth muscle cell phenotype influences glycosaminoglycan composition and growth effects of extracellular matrix

Rat neonatal and neointimal vascular smooth muscle cells differ dramatically from adult medical vascular smooth muscle cells in their growth properties, with the neonatal and neointimal cells exhibiting growth in the absence of exogenously added growth factors. Since it has been hypothesized that extra-cellular matrix proteoglycans may influence the growth and differentiation of vascular smooth muscle cells, we examined the ability of matrix derived from these cells to influence vascular smooth muscle cell proliferation. To produce test matrices, cells were grown to confluence and removed by brief alkali treatment. Test cells were seeded onto these matrices and the rates of growth in a growth-factor-deficient medium determined. Compared to plastic wells, matrix from neonatal or neointimal cells stimulated the growth of vascular smooth muscle cells. Interestingly, matrix from adult cells was less efficient at promoting growth. Enzymatic digestion of extracellular matrix heparan sulfate, but not of other glycosaminoglycans, further increased the growth-stimulatory effect of extracellular matrix, suggesting that matrix heparan sulfate acts as a growth inhibitor. Consistent with this, biochemical analysis showed that the adult matrix contained a higher percentage of heparan sulfate compared with neonatal or neointimal matrix. These results suggest that autocrine production of heparan sulfate proteoglycans may play an important role in growth regulation of vascular smooth muscle cells during normal vascular development and differentiation as well as in pathological response to injury.

Generation and assembly of secretory antibodies in plants

Four transgenic Nicotiana tabacum plants were generated that expressed a murine monoclonal antibody kappa chain, a hybrid immunoglobulin A-G heavy chain, a murine joining chain, and a rabbit secretory component, respectively. Successive sexual crosses between these plants and filial recombinants resulted in plants that expressed all four protein chains simultaneously. These chains were assembled into a functional, high molecular weight secretory immunoglobulin that recognized the native streptococcal antigen I/II cell surface adhesion molecule. In plants, single cells are able to assemble secretory antibodies, whereas two different cell types are required in mammals. Transgenic plants may be suitable for large-scale production of recombinant secretory immunoglobulin A for passive mucosal immunotherapy. Plant cells also possess the requisite mechanisms for assembly and expression of other complex recombinant protein molecules.

Possible imbalance of the immuno-hormonal axis in multiple myeloma

A comparative study of some immunologic aspects and hormonal balance was performed on 49 multiple myeloma (MM) patients and 29 healthy persons. Functional immunoregulatory imbalances were evident in the majority of patients with MM, as demonstrated by a significant reduction in the mitogenic response of peripheral blood lymphocytes (PBL) to phytohemagglutinin, increased mean stimulation indices of PBL to pisum sativatum agglutinin, wheat germ agglutinin (WGA) and dextran sulphate. Our results appear to provide important evidence in support of the existence of hormonal imbalance in MM: increased cortisol levels, augmented concentrations of follicle stimulating hormone, luteinizing hormone and 17 beta-estradiol and an increased estrogen to androgen ratio in male patients; decreased estrogen values and estrogen to androgen ratios were evident in female patients. Triiodothyronine and thyroxine mean concentrations were also found to be markedly diminished in MM patients. Our studies suggest some potentially important interactions between the immune and endocrine systems in multiple myeloma.

Implications of a non-lamellar lipid phase for the tight junction stability. Part II: Reversible modulation of transepithelial resistance in high and low resistance MDCK-cells by basic amino acids, Ca2+, protamine and protons

The transepithelial resistance of confluent epithelial cell monolayers was monitored to investigate the influence of basic amino acids, Ca2+, protamine and protons on tight junction electrical resistance. In an accompanying paper we investigated the effect of these substances on the lamellar/hexagonal II phase transition in reconstituted phospholipid membranes containing phosphatidylserine and phosphatidylethanolamine. We conclude that the permeability of tight junctions may be described by a lipid phase equilibrium where the lamellar phase corresponds to an open state and the hexagonal lipid phase to the closed state of the cell contact. This dynamic lipid model is well suited to describe the morphological as well as functional properties of the tight junctions.

Implications of a non-lamellar lipid phase for the tight junction stability. Part I: Influence of basic amino acids, pH and protamine on the bilayer-hexagonal II phase behaviour of PS-containing PE membranes

Inverted lipid micelles have been proposed, among other biological functions, to constitute the structural basis of the so-called tight junctions, a special cell cell contact found in epithelia and endothelial, which act as a barrier for the paracellular solute passage. As a model system for the opening and closing of this gate, we investigated the formation of the inverted hexagonal phase (HII phase) in lipid bilayer systems consisting of egg phosphatidylethanolamine (egg PE) and mixed egg PE/bovine brain phosphatidylserine (BBPS) membranes. The formation of the HII phase was modulated by Ca2+ ions, pH, basic amino acids and protamine. The lamellar-HII phase transition temperature TH of pure egg PE membranes at pH 7.0 was lowered with increasing Ca2+ concentration. This effect was attenuated by the presence of 50 mM lysine methyl ester. In the mixed lipid system, this effect was also observed, but even more pronounced. However this effect could be compensated for by raising the Ca2+ concentration from 2 to 10 mM. This was not observed in the pure PE system. In the absence of Ca2+, lysine methyl ester and protamine lowered TH in both monocomponent and mixed lipid systems, whereas lysine caused the opposite effect. The pH-dependence of mixed lipid systems, which were investigated up to a BBPS content of 20 mol%, clearly shows that increasing PS content stabilizes the lamellar phase even at low pH. The results obtained with model membranes are discussed with respect to biological implications of the lamellar-HII phase transition for the modulation of tight junction stability.

Abscisic Acid metabolism by source and sink tissues of sugar beet

The fate of exogenously applied, labeled abscisic acid (+/-)-(ABA) was followed in source leaves and taproot sink tissues of sugar beet (Beta vulgaris cv AH-11). The objective was to determine if differential pathways for ABA metabolism exist in source and sink tissues. Tissue discs were incubated for up to 13 hours in a medium containing 1 micromolar labeled ABA. At various time intervals, samples were taken for metabolite determination by reverse-phase high performance liquid chromatography. The labeled metabolites were identified by retention times using an online scintillation counter.Dihydrophaseic acid (DPA) aldopyranoside, DPA, phaseic acid (PA), ABA glucose ester (ABA-GE), and two unidentified compounds were recovered from both tissues. An additional unidentified metabolite was also present in root tissue. Leaf tissue discs exhibited a higher capacity for ABA conjugation, and root discs showed a greater preference for ABA catabolism to PA and DPA. After 4 to 5 hours, ABA incorporation into the various metabolites was proportional to the external ABA concentration in both tissues. But the internal ABA pool size was independent of external concentrations below 10(-6) molar. These results suggested that rates of ABA metabolism was proportional to the rates of uptake in both tissues.

[Inability to work in gastrointestinal diseases]

11.7% of all cases with inability to work, 11.3% of all days with inability to work, and 13.6% of all dismissals from hospital of working people concern diseases of the digestive system. Gastroenterological diseases occupy an anterior place in inability to work. The inability to work is essentially determined by 7 diagnoses--gastritis and duodenitis, cholelithiasis, gastroenteritis and colitis, cholecystitis and cholangitis, ulcus ventriculi and duodeni, acute appendicitis. They comprise 78% of the days of inability to work. The endoscopic diagnostics is further to be developed with the further improvement of the organisation of treatment, particularly the cooperation between outpatient department and hospital and the interdisciplinary work.