Protective effects of Gingko biloba extract EGb 761 on myocardium of experimentally diabetic rats. I: ultrastructural and biochemical investigation on cardiomyocytes

Chronic diabetes in man and animal models develops cardiomyopathic alterations which cannot be absolutely avoided by insuline therapy. Since diabetic damage is partly attributed to oxidative stress antioxidative treatment could be able to reduce the alterations. Aim of this study was to investigate the cardioprotective effects of EGb 761, known as a radical scavenger, against diabetic alterations in rats. The diabetes was induced by i.p. injection of 60 mg/kg body weight streptozotocin. Duration of diabetes was 4 months, the protected group received 100 mg/kg body weight EGb 761 with the drinking water over 3 months. Electron and light microscopic morphometry of left-ventricular samples revealed typical diabetic alterations consisting in decrease of volume fraction of myofibrils, SR and t-tubules and diminishing of cardiomyocyte diameter, increase of interstitial volume, mitochondrial size and volume fraction, and of vacuoles and of lipid drops. EGb treatment could gradually prevent the loss of myofibrils and reduction of myocyte diameter but has only little influence on interstitial and mitochondria volume. The diabetic-induced increase of lipid and vacuoles and the decrease of SR and t-tubules were not influenced. Biochemical parameters of oxidative stress: malondialdehyde (MDA) was only insignificantly altered by diabetes and EGb. The superoxide dismutase (SOD) activity was increased by diabetes and more increased by EGb treatment. Creatine kinase (CK) activity was diminished by diabetes but slightly increased by EGb. The polymerase chain reaction (PCR) of i-NOS was not different between the diabetic and protected diabetic groups.

A deficit in the short-term retention of lexical-semantic information: forgetting words but remembering a story

This article examines the long-term memory of a patient, AB, who had previously been reported to have problems in the short-term retention of word meanings. The authors found that AB had a problem not only in the short-term but also in the long-term retention of lexical-semantic information. AB, however, had no problem in the long-term retention of other kinds of information (pictures, shapes, propositional information). This pattern of results was interpreted as evidence that lexical-semantic representations have their own specific memory resources that are involved in the retention of the corresponding representations across different time intervals (e.g., they are involved in short-term as well as long-term retention). Implications for models of memory are discussed.

The residential needs and preferences of persons with serious mental illness: a comparison of consumers and family members

This study reports on a systematic statewide effort to determine the residential needs and preferences of two important groups: primary consumers of mental health services and family members of consumers. Two comparable surveys regarding the residential needs of consumers were conducted. In all, 314 consumers and 459 family members participated in the survey. A comparison of the preferences of family members and consumers suggests that family members more often prefer congregate living situations and more staff support than do consumers. Consumers more often express a desire to reside by themselves without staff and without other persons who are mentally ill. While the direct comparison of preferences from these two constituencies has limitations, these data do suggest significant variability in needs and preferences voiced by consumers and their family members; discrepancies that need to be addressed by mental health policymakers and planners.

[Age related changes in cellular signal transduction of glucocorticoid hormones in rat brain]

Chronic or repeated stress can induce a damage of neurons, especially in hippocampus, by which the degree of damage differs in various species. Sapolski has reported that there is a correlation between hippocampal degeneration, disturbed feedback reaction, and hypersecretion of glucocorticoids. The aim of this study was to investigate if the signal transmission via glucocorticoid receptors (GR) in the brain of male wistar rats of two age groups (5-6 and 17-24 months, respectively) is changed in aging and which cytoplasmic factors/modulators participate in this process. The binding of 3H-dexamethasone to cytosolic GR, the transformation, translocation, and nuclear binding of GR complexes (GRC) were studied before and after physiological stress. The influence of cytoplasmic modulators ASTP1) and HSP 70(1)), isolated from brain cytosol and purified, and of exogenous PK C1) was also tested in parallel incubation systems. Whereas old control animals showed a higher cytosolic concentration of unoccupied GR than young ones, this was significantly reduced only in old stressed rats 60 min after stress compared to old controls. The part of transformed GRC, bound to isolated nuclei, was somewhat lower in old than in young rats before and after stress. The nuclear GRC binding could be slightly elevated by addition of ASTP and HSP 70, resp., at the heat transformation of GRC; however, by simultaneous addition of PK C it was significantly increased in both age groups. The GRC binding also rose significantly in stressed animals compared to controls, after simultaneous addition of PK C to more than double of initial assays in young animals. Purified ASTP, isolated from brain cytosol of young animals, showed a higher 32P-incorporation after phosphorylation in vitro than that from old animals. The reduced phosphorylation of ASTP could be one possible cause of the retarded transformation/translocation and the reduced nuclear binding of GRC together with the restricted expression of HSP 70 and decreased PK C activity in the old rat brain.

Heat resistance of Bacillus cereus spores: effects of milk constituents and stabilizing additives

Heat resistance of Bacillus cereus spores (ATCC 7004, 4342, and 9818) heated in different types of milk (skim, whole, and concentrated skim milk), skim milk containing stabilizing additives (sodium citrate, monopotassium phosphate, or disodium phosphate, 0.1%), and cream was investigated. Thermal resistance experiments were performed at temperatures within the range of 92 to 115 degrees C under continuous monitoring of pH. For strain 4342 no significant differences (P < 0.05) in D values were detected in any case. For strains 7004 and 9818 higher D values of about 20% were obtained in whole and concentrated skim milk than those calculated in skim milk. From all stabilizing additives tested, only sodium citrate and sodium phosphate increased the heat resistance for strain 9818. However, when the menstruum pH was measured at the treatment temperature, different pH values were found between the heating media. The differences in heat resistance observed could be due to a pH effect rather than to the difference in the substrates in which spores were heated. In contrast, when cream (fat content 20%) was used, lower D values were obtained, especially for strains 7004 and 9818. z values were not significantly modified by the milk composition, with an average z value of 7.95+/-0.20 degrees C for strain 7004, 7.88+/-0.10 degrees C for strain 4342, and 9.13+/-0.16 degrees C for strain 9818.

Exploring immunological specificity using synthetic peptide combinatorial libraries

The definition of epitopes for human B and T cells is fundamental for the understanding of the immune response mechanism and its role in the prevention and cause of human disease. This understanding can be applied to the design of diagnostics and synthetic vaccines. In recent years, the understanding of the specificity of B and T cells has been advanced significantly by the development and use of combinatorial libraries made up of thousands to millions of synthetic peptides. The use of this approach has had four major effects: first, the definition of high affinity ligands both for T cells and antibodies; second, the application of alternative means for identifying immunologically relevant peptides for use as potential preventive and therapeutic vaccines; third, a new appreciation of the requirements for TCR interactions with peptide-MHC complexes in immunogenicity; fourth, the establishment of new principles regarding the level of cross-reactivity in immunological recognition.

Anesthesia for in vitro fertilization: the addition of fentanyl to 1.5% lidocaine

Ultrasonically guided transvaginal oocyte retrieval is relatively short procedure that is performed on an out-patient basis. The optimal anesthetic technique should allow good surgical anesthesia with minimal side effects, a short recovery time, and, if possible, a high rate of successful pregnancy. Spinal anesthesia is often used in this institution, as well as many others, for this procedure. The addition of fentanyl may be effective for both intraoperative and postoperative pain relief. We assessed the effect of adding fentanyl to 1.5% lidocaine in women undergoing ultrasonically guided oocyte retrieval. Seventy-eight women were randomized to receive 45 mg of hyperbaric 1.5% lidocaine with or without 10 microg of fentanyl. Visual analog scale (VAS) pain scores were lower in the operating room (OR) (P < 0.05) and postanesthesia care unit (PACU) (P < 0.0005) for the group that received fentanyl. In addition, the amount of narcotic required in the PACU was less in the fentanyl group (P < 0.005). There was no difference in VAS scores the evening of or 24 h after the procedure. The amount of analgesics and narcotics required after discharge was the same for both groups. Timed variables, such as time to urination, ambulation, and discharge, were the same for both groups of women. The addition of fentanyl to lidocaine for transvaginal oocyte retrieval results in a more comfortable patient in the OR and PACU.

IMPLICATIONS

This study demonstrates that when fentanyl is added to a local anesthetic, lidocaine, with spinal anesthesia for egg retrieval procedures, patients are more comfortable during the procedure compared with those who receive lidocaine alone. In addition, the narcotic requirements of patients are less in the postanesthesia care unit.

Crystal structures of MMP-1 and -13 reveal the structural basis for selectivity of collagenase inhibitors

The X-ray crystal structures of the catalytic domain of human collagenase-3 (MMP-13) and collagenase-1 (MMP-1) with bound inhibitors provides a basis for understanding the selectivity profile of a novel series of matrix metalloprotease (MMP) inhibitors. Differences in the relative size and shape of the MMP S1' pockets suggest that this pocket is a critical determinant of MMP inhibitor selectivity. The collagenase-3 S1' pocket is long and open, easily accommodating large P1' groups, such as diphenylether. In contrast, the collagenase-1 S1' pocket must undergo a conformational change to accommodate comparable P1' groups. The selectivity of the diphenylether series of inhibitors for collagenase-3 is largely determined by their affinity for the preformed S1' pocket of collagenase-3, as compared to the induced fit in collagenase-1.

Use of high-intensity focused ultrasound to control bleeding

OBJECTIVE

High-intensity focused ultrasound (HIFU) has been shown to be effective in controlling hemorrhage from punctures in blood vessels. The objective of the current study was to investigate the capability of HIFU to stop bleeding after a more severe type of vascular injury, namely longitudinal incisions of arteries and veins.

METHODS

The superficial femoral arteries, common femoral arteries, carotid arteries, and jugular veins of four anesthetized pigs were exposed surgically. A longitudinal incision, 2 to 8 mm in length, was produced in the vessel. HIFU treatment was applied within 5 seconds of the onset of the bleeding. The HIFU probe consisted of a high-power, 3.5-MHz, piezoelectric transducer with an ellipsoidal focal spot that was 1 mm in cross section and 9 mm in axial dimension. The entire incision area was scanned with the HIFU beam at a rate of 15 to 25 times/second and a linear displacement of 5 to 10 mm. A total of 76 incisions and HIFU treatments were performed.

RESULTS

Control of bleeding (major hemosatsis) was achieved in all 76 treatments, with complete hemostasis achieved in 69 treatments (91%). The average treatment times of major and complete hemostasis were 17 and 25 seconds, respectively. After the treatment, 74% of the vessels in which complete hemostasis was achieved were patent with distal blood flow and 26% were occluded. The HIFU-treated vessels showed a consistent coagulation of the adventitia surrounding the vessels, with a remarkably localized injury to the vessel wall. Extensive fibrin deposition at the treatment site was observed.

CONCLUSION

HIFU may provide a useful method of achieving hemostasis for arteries and veins in a variety of clinical applications.

A deficit in the short-term retention of lexical-semantic information: forgetting words but remembering a story

This article examines the long-term memory of a patient, AB, who had previously been reported to have problems in the short-term retention of word meanings. The authors found that AB had a problem not only in the short-term but also in the long-term retention of lexical-semantic information. AB, however, had no problem in the long-term retention of other kinds of information (pictures, shapes, propositional information). This pattern of results was interpreted as evidence that lexical-semantic representations have their own specific memory resources that are involved in the retention of the corresponding representations across different time intervals (e.g., they are involved in short-term as well as long-term retention). Implications for models of memory are discussed.

Serial TCR engagement and down-modulation by peptide:MHC molecule ligands: relationship to the quality of individual TCR signaling events

In the present study, we examined the relationships among quantitative aspects of TCR engagement as measured by receptor down-modulation, functional responses, and biochemical signaling events using both mouse and human T cell clones. For T cells from both species, ligands that are more potent in inducing functional responses promote TCR down-modulation more efficiently than weaker ligands. At low ligand density, the number of down-modulated TCR exceeds the number of available ligands by as much as 80-100:1 in the optimal human case, confirming the previous description of serial ligand engagement of TCR (Valitutti, et al. 1995. Nature 375:148-151). A previously unappreciated relationship involving TCR down-modulation, the pattern of proximal TCR signaling, and the extent of serial engagement was revealed by analyzing different ligands for the same TCR. Functionally, more potent ligands induce a higher proportion of fully tyrosine phosphorylated zeta-chains and a greater amount of phosphorylated ZAP-70 than less potent ligands, and the number of TCR down-modulated per available ligand is higher with ligands showing this full agonist-like pattern. The large number of receptors showing partial zeta phosphorylation following exposure to weak ligands indicates that the true extent of TCR engagement and signaling, and thus the amount of sequential engagement, is underestimated by measurement of TCR down-modulation alone, which depends on full receptor activation. These data provide new insight into T cell activation by revealing a clear relationship among intrinsic ligand quality, signal amplification by serial engagement, functional T cell responses, and observable TCR clearance from the cell surface.

Temporal lobe developmental malformations and hippocampal sclerosis: epilepsy surgical outcome

BACKGROUND

Temporal lobe developmental malformations coexist with mesial temporal sclerosis in the form of dual pathology with a high frequency of bilateral amygdala or hippocampal abnormalities.

OBJECTIVE

The aim of this study was to correlate and compare the MRI findings and the surgical outcome in patients with temporal lobe developmental malformations (n = 20) and isolated mesial temporal sclerosis (n = 36).

METHODS

MRI-based normalized volumetry of the amygdala and hippocampal formation in patients with unilateral temporal lobe developmental malformations and isolated mesial temporal sclerosis who underwent temporal lobe resections was performed. Seizure outcome was compared between groups at follow-up.

RESULTS

The frequency of bilateral hippocampal or amygdala atrophy (p < 0.04) and combined hippocampal-amygdala atrophy (p < 0.02) was higher in patients with temporal lobe developmental malformations. Although no significant difference in postsurgical seizure-free status was found between the temporal lobe developmental malformations and isolated mesial temporal sclerosis groups (70% versus 91%), patients with temporal lobe developmental malformations and bilateral amygdala or hippocampal-amygdala atrophy had a significantly worse outcome (p < 0.02).

CONCLUSION

Bilateral hippocampal atrophy is frequent in patients with temporal lobe developmental malformations. However, it is the presence of bilateral amygdala or amygdalo-hippocampal atrophy that is associated with a higher risk of seizure recurrence.

Chemokines in chronic progressive neurological diseases: HTLV-1 associated myelopathy and multiple sclerosis

It is hypothesized that in MS and HTLV-1, chemokine and chemokine receptor expression are important mechanisms by which T cells migrate to sites of inflammation. Preliminary evidence supports the roles of several chemokines, including MIP 1beta, in mediating the enhanced migration capacity of MS derived PBLs. In addition, the ligand CCR-5 seems to be up regulated on PBLs from some MS patients. Analysis of T cell clones does not reveal a definite correlation between cytokine phenotype and chemokine receptor profile. The chemokines and chemokine receptor family are likely to be important molecules in chronic progressive neurological diseases, in which immune cells invade the central nervous system.

Cognitive effects of topiramate, gabapentin, and lamotrigine in healthy young adults

OBJECTIVE

To study the acute and steady-state cognitive effects of three new antiepileptic drugs (AEDs): gabapentin, lamotrigine, and topiramate.

BACKGROUND

Several newer antiepileptic medications approved recently by the Food and Drug Administration are gaining attention as efficacious alternatives to established AEDs. Greater tolerability with fewer side effects are reported in some. However, the potential cognitive effects of these newer AEDs have received limited attention.

METHODS

Healthy young adults randomized to either of the three drugs were administered tests of attention, psychomotor speed, language, memory, and mood at baseline (predrug), acute single-dose period, and after 2 and 4 weeks on the drug.

RESULTS

Compared with baseline, the topiramate group had selective, statistically significant declines on measures of attention and word fluency at acute doses, whereas the other two AED groups had no performance changes. At the 2- and 4-week test periods, only the topiramate subjects continued to display neurocognitive effects from drug administration.

CONCLUSIONS

Results demonstrate potential acute and steady-state adverse cognitive effects for topiramate, whereas minimal effects were displayed for either gabapentin or lamotrigine in young healthy adults.

Neurofilament phosphorylation and axon diameter in the squid giant fibre system

Electron energy loss spectroscopic analysis of squid giant axons in a phosphorus energy window yielded bright signals, which were shown to originate from highly phosphorylated neurofilaments. The frequency and distribution of these signals were analysed at defined intervals in cross-sections of the giant axon, starting from its origin in the stellate ganglion and extending distally along the stellar nerve. The analysis revealed a proximodistal gradient of increasing neurofilament phosphorylation. Within the stellate ganglion and for some distance beyond, the increase in frequency of signals correlated with the widening of the neurofilament meshwork and the radial growth of the axon. This agrees with the hypothesis that neurofilament phosphorylation regulates axon calibre by affecting interfilament spacing. In distal axon domains where the axon diameter diminished, contrary to expectations, the spacing of signals increased and the signals were significantly larger. Hyperphosphorylation apparently compensated for a diminishing supply of neurofilament protein. Contrary to predictions, the presynaptic terminal of the giant synapse contained a distinct and highly phosphorylated neurofilament meshwork. We conclude that the growth of the axon diameter is a function of neurofilament phosphorylation, interfilament spacing and neurofilament density. A mature and highly phosphorylated neurofilament cytoskeleton completely filled the presynaptic terminal of the giant synapse.

A longitudinal ethics curriculum for medical students and generalist residents at the Medical College of Georgia

Medical ethics is an important instructional area for both the undergraduate student pursuing a generalist education and generalist residents. With the support of a Generalist Physician Initiative (GPI) award from The Robert Wood Johnson Foundation, the Medical College of Georgia has implemented a longitudinal experience in clinical ethics spanning the four undergraduate years to make this area more meaningful and clinically relevant. This report outlines the structure and content of this four-year curriculum, which has been developed and implemented in a stepwise fashion since 1996. Course themes and students' activities during the four years are described. Since 1997, a shared curriculum in ethics--developed for residents in internal medicine, family medicine, and pediatric generalist programs--has been provided in combined interdepartmental conferences as part of a broader interdepartmental generalist curriculum. Early evaluation findings and plans for future evaluation programs are also described.

Chemoenzymatic synthesis of iminocyclitol derivatives: a useful library strategy for the development of selective fucosyltransfer enzymes inhibitors

A chemoenzymatic strategy has been developed for the synthesis of libraries of iminocyclitol derivatives for the discovery of new and selective fucosidase inhibitors.

Human sperm chromosome complements in chemotherapy patients and infertile men

Our studies of human sperm karyotypes and interphase sperm analyzed by fluorescence in situ hybridization (FISH) have both yielded estimates of disomy frequencies of approximately 0.1% per chromosome with an overall aneuploidy frequency in human sperm of approximately 5%-6%. However, the distribution of aneuploidy in sperm is not even, as our data from sperm karyotypes and multicolour FISH analyses both demonstrate a significant increase in the frequency of aneuploidy for chromosome 21 and the sex chromosomes. We have studied men at increased risk of sperm chromosomal abnormalities including cancer patients and infertility patients. Testicular cancer patients were studied before and 2-13 years after chemotherapy (CT) with BEP (bleomycin, etoposide, cisplatin). Sperm karyotype analysis on 788 sperm demonstrated no significant difference in the frequency of numerical or structural chromosomal abnormalities post-CT vs pre-CT. Similarly, multicolour FISH analysis for chromosomes 1, 12, XX, YY and XY in 161,097 sperm did not detect any significant differences in the frequencies of disomy before and after treatment. However, recent evidence has suggested a significant increase in the frequency of disomy and diploidy during CT. We have found that infertile men, who would be candidates for intracytoplasmic sperm injection, have an increased frequency of chromosomally abnormal sperm karyotypes. Also, FISH analysis for chromosomes 1, 12, 13, 21, XX, YY and XY in 255,613 sperm demonstrated a significant increase in chromosomes 1, 13, 21, and XY disomy in infertile men compared with control donors.