Phosphorylation and dephosphorylation events play critical roles in Sindbis virus maturation

We have examined the effects of various inhibitors of protein kinases and phosphatases on Sindbis virus maturation in BHK cells. 2-aminopurine, a nonspecific protein kinase inhibitor, N-(6-aminohexyl)-5-chloro-1-naphthalenesulfonamide hydrochloride (W-7), a specific inhibitor of calmodulin/Ca(2+)-dependent protein kinase, and okadaic acid (OKA), a protein phosphatase inhibitor, dose-dependently inhibited Sindbis virus maturation. Although virus production was inhibited, the membrane glycoprotein precursors PE2/E1 were exported from the endoplasmic reticulum and PE2 was converted to E2 at normal kinetic rates. The glycoproteins were delivered to the plasma membrane in conformations which rendered them competent for low pH-mediated cell-cell fusion from within. Electron microscopy showed that in the presence of W-7, virus nucleocapsids were free in the cell cytoplasm, while in the presence of OKA, the nucleocapsids were associated with cell membranes. Metabolic labeling of Sindbis virus-infected cells with [32P]orthophosphate in the presence of OKA resulted in the specific labeling of the PE2/E2 glycoprotein. We have previously shown that the carboxyl terminus of the PE2 glycoprotein is initially buried in cell membranes and is then exposed to the cytoplasm at some later stage in virus maturation. The data shown are consistent with the hypothesis that phosphorylation and dephosphorylation play a critical role in a late stage in Sindbis virus maturation, possibly in releasing of the E2 tail from cell membranes.

Comparison of cDNAs from bovine brain coding for two isoforms of calreticulin

Calreticulin is a major calcium-binding protein of the endoplasmic reticulum of non-muscle cells. In addition to a 1.9-kb calreticulin mRNA, some evidence has suggested the existence of another transcript of 3.75 kb, which is very similar to calreticulin. We report here the isolation and sequencing of cDNA clones from a bovine brain lambda gt11 cDNA library, two of which appear to code for calreticulin and a third for a novel isoform of calreticulin. The deduced amino-acid sequence of the novel clone shares high similarity with mouse calreticulin in the C-terminal 318 amino acids. However, its N-terminal sequence is completely divergent. Northern blot analysis of bovine cerebral cortex RNA indicates that the conserved region of the clone hybridizes to two messages of 1.9 kb and 3.75 kb. The divergent region of this clone hybridizes to the 3.75-kb message, but not to the 1.9-kb message. We believe that this novel clone corresponds to an alternate form of calreticulin which is identical to calreticulin toward the C-terminus, but completely different at the N-terminal region, and that this isoform is encoded by a much larger message.

Clonidine comparably decreases the thermoregulatory thresholds for vasoconstriction and shivering in humans

BACKGROUND

Clonidine stops postoperative shivering, but its underlying mechanism of action is unknown. Clonidine may impair central control of thermoregulation or act on peripheral receptors. Accordingly, the authors tested the hypothesis that clonidine reduces both the vasoconstriction and shivering thresholds, a pattern consistent with central thermoregulatory impairment.

METHODS

Seven healthy volunteers participated in the study. Thermoregulatory vasoconstriction was evaluated using forearm minus fingertip, skin-temperature gradients; values exceeding 4 degrees C were considered to be significant vasoconstriction. Systemic oxygen consumption (VO2) was measured with a canopy system. In addition, shivering was qualitatively evaluated using a simple scale, graduated from 0 (no shivering) to 2 (intense shivering). The tympanic membrane temperatures triggering significant vasoconstriction and grade 1 shivering were considered to be the thresholds for the two thermoregulatory responses. Measurements were performed after a 10-min steady state period and during cooling by central venous infusion of Ringer's lactate solution at 4 degrees C. Each subject was evaluated at two sessions, separated by at least 48 h. They were randomly and blindly assigned to received either an intravenous bolus of 75 micrograms clonidine or a placebo before cooling. When the shivering score equaled 2, 75 micrograms clonidine was injected intravenously, and repeated if necessary, to completely stop shivering.

Extraction and simultaneous elution and derivatization of 11-nor-9-carboxy-delta 9-tetrahydrocannabinol using Toxi-Lab SPEC prior to GC/MS analysis of urine

A new sample preparation procedure is described for the extraction and simultaneous elution and derivation of urine for analysis of 11-nor-9-carboxy-delta 9-tetrahydrocannabinol (THC-COOH) by gas chromatography/ion trap mass spectrometry (GC/MS). Urine samples are extracted for THC-COOH and d6-THC-COOH internal standard onto a hydrophobic membrane. Extracts are simultaneously eluted and derivatized with MSTFA while on the membrane to produce the corresponding trimethylsilane derivative. Using results of blank urine, the limits of detection and quantitation were 1.1 and 2.5 ng/mL, respectively. The linearity of the assay was 250 ng/mL. The within-run and day-to-day precision ranged 3-5%. Compared with a solid-phase column extraction procedure, the overall time for sample preparation was decreased from 3 h down to 1. The SPEC extraction procedure with trimethyl derivatization produces a cleaner total ion chromatogram than the solid-phase column extraction system (minicolumn) and does not require the use of any organic solvents.

Immunohistochemical evidence for different pathways immunoreactive to substance P and calcitonin gene-related peptide (CGRP) in the guinea-pig stellate ganglion

The colocalization of immunoreactivities to substance P and calcitonin gene-related peptide (CGRP) in nervous structures and their correlation with other peptidergic structures were studied in the stellate ganglion of the guinea pig by the application of double-labelling immunofluorescence. Three types of fibre were distinguished. (1) Substance P+/CGRP+ fibres, which sometimes displayed additional immunoreactivity for enkephalin, constituted a small fibre population of sensory origin, as deduced from retrograde labelling of substance P+/CGRP+ dorsal root ganglion cells. (2) Substance P+/CGRP- fibres were more frequent; some formed baskets around non-catecholaminergic perikarya that were immunoreactive to vasoactive intestinal polypeptide (VIP). (3) CGRP+/substance P- fibres were most frequent and were mainly distributed among tyrosine hydroxylase (TH)-immunoreactive cell bodies. The peptide content of fibre populations (2) and (3) did not correspond to that of sensory ganglion cells retrogradely labelled by tracer injection into the stellate ganglion. Therefore, these fibres are thought to arise from retrogradely labelled preganglionic sympathetic neurons of the spinal cord, in which transmitter levels may have been too low for immunohistochemical detection of substance P or CGRP. CGRP-immunoreactivity but no substance P-immunolabelling was observed in VIP-immunoreactive postganglionic neurons. Such cell bodies were TH-negative and were spared by substance P-immunolabelled fibre baskets. Retrograde tracing with Fast Blue indicated that the sweat glands in the glabrous skin of the forepaw were the targets of these neurons. The streptavidin-biotin-peroxidase method at the electron-microscope level demonstrated that immunoreactivity to substance P and CGRP was present in dense-cored vesicles of 50-130 nm diameter in varicosities of non-myelinated nerve fibres in the stellate ganglion. No statistically significant difference in size was observed between vesicles immunolabelled for substance P and CGRP. Immunoreactive varicosities formed axodendritic and axosomatic synaptic contacts, and unspecialized appositions to non-reactive neuronal dendrites, somata, and axon terminals. Many varicosities were partly exposed to the interstitial space. The findings provide evidence for different pathways utilizing substance P and/or CGRP in the guinea-pig stellate ganglion.

Partial reversal of the effects of extradural clonidine by oral yohimbine in postoperative patients

Extradural clonidine produces analgesia, with sedation, hypotension and bradycardia, in postoperative patients. This study assessed if oral yohimbine would reverse these side effects. We studied 30 ASA I-II patients undergoing orthopaedic surgery. After operation they were allocated randomly to three groups to receive placebo, extradural clonidine 450 micrograms or extradural clonidine 450 micrograms plus oral yohimbine 16 mg. Pain score was measured on a visual analogue scale (VAS); sedation was assessed on a simple scale graded from 0 (awake and alert) to 3 (deeply sedated, awakening after tactile stimulations) and heart rate and arterial pressure were monitored for 5 h. Yohimbine reversed the sedation induced by extradural clonidine, but also shortened the duration of analgesia (31 (SD 15) min, 186 (72) min and 126 (52) min in the placebo, extradural clonidine and extradural clonidine+yohimbine groups, respectively) (P < 0.05), and did not reduce the hypotension and bradycardia related to clonidine administration. These results suggest that alpha 2 adrenoceptors are mediators of the sedation induced by clonidine and that the haemodynamic effects are not related to stimulation of supraspinal alpha 2 receptors.

Epidural clonidine decreases postoperative requirements for epidural fentanyl

OBJECTIVE

This study assesses the possibility that clonidine may decrease analgesic opioid demand in postoperative patients.

METHODS

Twenty-five patients were allocated randomly after abdominal surgery to receive either an epidural bolus dose of fentanyl (1.0 mcg.kg-1) followed by a 1.0 mcg.kg-1h-1 continuous epidural infusion, or an epidural bolus dose of fentanyl (1.0 mcg.kg-1) followed by a continuous epidural infusion combining fentanyl 0.5 mcg.kg-1 x h-1 and clonidine 0.3 mcg.kg-1 x h-1. Pain was assessed at definite intervals on a visual analog scale (VAS) over 3 postoperative days. Epidural infusion was halved when VAS score was lower than 2. Patients were monitored with a pulse oximeter over 12 hours during the first postoperative night. Plasma fentanyl was measured by radioimmunoassay when patients left the recovery room and at 8 a.m. on the first and the second postoperative days.

RESULTS

VAS scores were comparable in the two groups of patients. The amount of fentanyl delivered was significantly lower in the fentanyl + clonidine group, as were the plasma fentanyl concentrations. The duration of SaO2 < 90% episodes was significantly less prolonged in the fentanyl + clonidine group (3.5 +/- 4.8 minutes versus 14.4 +/- 14.6 minutes).

CONCLUSIONS

The combination of clonidine to epidural fentanyl allows a decrease in opioid requirements without impairing analgesia. Reduction of opioids administration may have beneficial effects on respiratory function in postoperative patients.

Radiosensitive Chinese hamster irs2 cells show enhanced chromosomal sensitivity to ionizing radiation and restriction endonuclease induced blunt-ended double-strand breaks

The Chinese hamster irs2 cell line shows cellular hypersensitivity to ionizing radiation although the induction and repair of double-strand breaks (dsb) in bulk DNA is normal. Here we report that irs2 shows chromosomal hypersensitivity to ionizing radiation and the restriction endonuclease PvuII. The ratio of induced chromosomal aberrations in irs2 versus V79 was similar to that for survival (factor of between 2 and 4). PvuII was administered during cell poration with the bacterial toxin streptolysin O. We also report that when streptolysin O porated irs2 and V79 cells were treated with PvuII, and dsb assayed by neutral filter elution, equivalent numbers of dsb were induced in the two lines as a function of time following treatment. Our data show that irs2 has a DNA damage processing defect that leads to enhanced conversion of blunt-ended dsb into visible chromosomal damage.

Prolonged placement of spinal catheters does not prevent postdural puncture headache

OBJECTIVE

To determine whether leaving an intrathecal catheter in place in the postoperative period prevents postdural puncture headache (PDPH).

METHODS

Lumbar puncture was performed with an 18-gauge Tuohy needle. 0.5% bupivacaine spinal anesthesia was given through a 20-gauge catheter in 87 patients having orthopedic surgery. Postoperatively, patients were allocated randomly to have the catheter immediately withdrawn (group 1, N = 47) or kept in place for 12 to 24 hours (group 2, N = 40). Patients were questioned by a blinded observer, about PDPH twice a day on postoperative days 1, 2, 3, and 8.

RESULTS

The incidence of PDPH was 9.2%, and this was comparable in the two groups (5 patients in group 1 and 3 patients in group 2).

CONCLUSION

Leaving the intrathecal catheter in place in the postoperative period for 12 to 24 hours does not prevent PDPH.

Cell-type specific interaction of Neu differentiation factor (NDF/heregulin) with Neu/HER-2 suggests complex ligand-receptor relationships

The Neu/HER-2 receptor tyrosine kinase is overexpressed in some types of human adenocarcinomas, including tumors of the breast and the ovary. A 44 kDa glycoprotein that elevates tyrosine phosphorylation of Neu has been isolated and named Neu differentiation factor (NDF), or heregulin. Here we show that NDF affects tyrosine phosphorylation of Neu in human tumor cells of breast, colon and neuronal origin, but not in ovarian cells that overexpress the receptor. By using monoclonal antibodies (mAbs) to Neu, we found that the ovarian receptor is immunologically and biochemically similar to the mammary p185neu. Nevertheless, unlike breast-derived Neu, the ovarian protein did not display covalent cross-linking to radiolabeled NDF, and was devoid of ligand-induced association with phosphatidylinositol 3'-kinase. Direct binding analysis showed that NDF binds with high affinity (Kd approximately 10(-9) M) to mammary cells, but its weak association with ovarian cells is probably mediated by heparin-like molecules. Similar to the endogenous receptor, the ectopically overexpressed Neu of mammary cells, but not of ovarian and fibroblastic cells, exhibited elevated levels of NDF-induced phosphorylation and covalent cross-linking of the radiolabeled factor. Taken together, our results imply that NDF binding to cells requires both Neu and an additional cellular component, whose identity is still unknown, but its tissue distribution is more restricted than the expression of the neu gene.

Transient translocation of the cytoplasmic (endo) domain of a type I membrane glycoprotein into cellular membranes

The E2 glycoprotein of the alphavirus Sindbis is a typical type I membrane protein with a single membrane spanning domain and a cytoplasmic tail (endo domain) containing 33 amino acids. The carboxyl terminal domain of the tail has been implicated as (a) attachment site for nucleocapsid protein, and (b) signal sequence for integration of the other alpha-virus membrane proteins 6K and E1. These two functions require that the carboxyl terminus be exposed in the cell cytoplasm (a) and exposed in the lumen of the endoplasmic reticulum (b). We have investigated the orientation of this glycoprotein domain with respect to cell membranes by substituting a tyrosine for the normally occurring serine, four amino acids upstream of the carboxyl terminus. Using radioiodination of this tyrosine as an indication of the exposure of the glycoprotein tail, we have provided evidence that this domain is initially translocated into a membrane and is returned to the cytoplasm after export from the ER. This is the first demonstration of such a transient translocation of a single domain of an integral membrane protein and this rearrangement explains some important aspects of alphavirus assembly.

Can portable chest x-ray examination accurately diagnose lung consolidation after major abdominal surgery? A comparison with computed tomography scan

PURPOSE

To prospectively quantify the degree of accuracy of portable chest x-ray film examination in the detection of postoperative lung consolidations.

STUDY

Nineteen patients had a chest x-ray film and computed tomography (CT) scan the day before and 48 h following elective abdominal aortic replacement.

RESULTS

The diagnosis of lung consolidations by x-ray film examination showed sensitivity of between 0.33 and 1.00, depending on the lung zone considered (lower at the lung bases). Specificity always was greater than 0.79. Radiologic lung volume decreased 16 percent postoperatively (p < 0.01) on average and noninflated parenchyma increased by a factor of 3 (p < 0.0001). Postoperatively, PaO2 correlated with the amount of condensed lung by CT scan (p < 0.002).

CONCLUSION

In postoperative conditions, x-ray film examination is a method which presents good specificity but poor sensitivity in the diagnosis of lung consolidations.

Effect of preoperative normovolemic hemodilution on left ventricular segmental wall motion during abdominal aortic surgery

Preoperative normovolemic hemodilution (PNH) has been proposed for patients scheduled to undergo aortic surgery. Coronary artery disease is frequent in these patients. The aim of the study was to assess the effect of PNH on hemodynamics and segmental wall motion (SWM) evaluated by transesophageal echocardiography in such patients. Twenty patients with coronary artery disease were allocated randomly to either PNH or no PNH; PNH was performed after anesthetic induction using dextran 60,000. Patients were operated on under general anesthesia and monitored intraoperatively with electrocardiographic lead CM5, radial and pulmonary artery catheters, and transesophageal echocardiography positioned to obtain a short-axis view. Hemodynamic and transesophageal echocardiographic data were collected after anesthetic induction and after PNH, before and 5 min after aortic clamping, after unclamping, and at the end of surgery. Aortic clamping induced a significant increase in systemic vascular resistance and arteriovenous difference in oxygen and a decrease in cardiac index (P < 0.05), but the effect of aortic clamping was inversely related to hemodilution. The SWM score (graded from 1 = normal to 5 = dyskinesia) was significantly increased after aortic clamping, mainly in the anterior segment (P < 0.05). Four patients in the control (no PNH) group and one in the PNH group developed new SWM abnormalities indicative of myocardial ischemia during surgery (P = NS). This study suggests that PNH may improve hemodynamic tolerance to aortic clamping in patients with coronary artery disease. The observed changes in SWM indicate that PNH may not worsen myocardial ischemia in patients scheduled to undergo aortic surgery.

Functional implication of disulfide bond, Cys250 -Cys283, in bovine chymosin

The reduction, carboxymethylation and mercuration of disulfide bond, Cys250-Cys283, located on the surface of bovine chymosin molecule resulted in the loss of about 25% of enzyme activity, suggesting that Cys250-Cys283 is not intimately involved in catalytic mechanism. Cys250 and Cys283 were substituted with Asp. and Ser. by site- directed mutagenesis of the structural gene coding for bovine prochymosin B. All three mutants (C250D/C283S, C250D, C283S) failed to be activated to chymosin in acid, indicating that Cys250-Cys283 might have some contribution to the correct refolding of the unfolded prochymosin.

Single- versus triple-lumen central catheter-related sepsis: a prospective randomized study in a critically ill population

PURPOSE

A prospective randomized study was conducted over a 23-month period in an adult medical-surgical intensive care unit to determine whether triple-lumen catheters reduce the need for peripheral vascular access and whether they are associated with a higher rate of infection than single-lumen catheters.

PATIENTS AND METHODS

After the insertion route, internal jugular or subclavian, was selected by the physician, patients were randomized either to single-lumen or triple-lumen catheter groups. Complementary peripheral vascular access was allowed in both groups. Catheters were removed according to preestablished defined reasons: suspicion of catheter-related sepsis, uselessness of central venous access, duration of catheterization of more than 21 days, discharge from the intensive care unit, or death.

RESULTS

Data on 129 central venous catheters were collected from 91 consecutive patients. Twenty-five of 68 patients from the single-lumen group and 1 of 61 patients from the triple-lumen group needed peripheral vascular access (p less than 0.001). Catheter-related sepsis rates, defined either by clinical signs and positive qualitative tip cultures (8.9% versus 11.5%) or by quantitative tip cultures (16.2% versus 11.5%), were identical in the single-lumen and triple-lumen groups (type II error: 8%).

CONCLUSION

In intensive care units, the use of triple-lumen catheters is associated with a dramatic decrease in the need for peripheral vascular access. The incidence of central venous catheter-related sepsis appears identical for single- and triple-lumen catheters.

[The effect of 211At labelled monoclonal antibody against gastric cancer on DNA, RNA and protein synthesis in gastric cancer cell]

By means of nuclide precursor incorporation, the effects of 211At labelled monoclonal antibody against gastric cancer (211At-3H11McAb) on DNA, RNA and protein synthesis in gastric cancer cell were studied. The results show that 211At-3H11McAb and Na211At-3 inhibit 3H-TdR, 3H-UR and 3H-Leu incorporation, especially 3H-UR incorporation, into gastric cancer cell at 3.7 x 10(4)Bq and 1.85 x 10(5)Bq; the inhibiting rates depend on concentration. The DNA biosynthesis in gastric cancer cell gradually recover after the drug is removed, suggesting that the drug should exert an inhibiting action on DNA biosynthesis in tumor cell through interference of DNA metabolism.

A dose-range study of intrathecal meperidine combined with bupivacaine

Twenty-one patients were included in a randomized study to receive either 10 mg of 0.5% hyperbaric bupivacaine alone or combined with 0.05, 0.1, 0.2, 0.3, 0.4 or 0.5 mg.kg-1 meperidine for spinal anaesthesia. Sensory blockade was assessed by pin prick, motor blockade by the Bromage scale, and postoperative analgesia by VAS scores and by the time before the first demand for analgesia. Spinal meperidine did not change the duration of sensory blockade, but induced a dose-related increase in postoperative efficient analgesia. Spinal meperidine might be considered as a means to obtain postoperative analgesia in the hours immediately following surgery.

Test of 20 similar intensive care ventilators in daily use conditions--evaluation of accuracy and performances

Infrequent control, aging of components, may compromise the accuracy of ICU ventilators. In order to assess the reliability of ventilators during their clinical use, we bench tested a group of 20 CPU1 ventilators (Ohmeda) sampled at random in several ICU units. We found major leaks in 5 ventilators, attributable to the disposable tubings used in these systems. Mean error in expired tidal volume and corresponding standard deviation (precision) were greater than 100 ml in two. Positive end expiratory pressure measurement comprised a mean error higher than 2 cm H2O in 40% of the ventilators tested. The valve opening pressure threshold was correlated to the inspiratory flow (r = 0.81) contrary to the valve opening delay (average 138 +/- 40 ms). These two parameters did not correlate with the age of the ventilator. Our study addresses the need for periodic control of ventilator performance in order to minimize the risks of errors and malfunctions.

[A study of 11 ventilators for anesthesia: laboratory testing]

Eleven anaesthesia ventilators were instrumentally tested under various conditions. They included: Excel and Modulus II Plus (Ohmeda); 710 and Servo anaesthesia circle 985 (Siemens); Jollytronic (Soxil) and Elsa (Engström); SA2 and Cicero (Dräger); ABT 4,300 (Kontron); Monnal A and the prototype Alys (Taema). The test circuit comprised a two compartment model lung, a pneumotachograph, a pressure gauge in the "airway". The volume was calculated as the integral of flow rate. Each machine was calibrated by the firms' technicians. Before each test, the pneumotachograph was calibrated using a 11 air syringe and the pressure gauge with a 5 cm water column. Each machine ventilated the model lung for 30 min before starting the tests. There were five tests: 1) reliability of the machine's spirometer, 2) reliability of the ventilation rate, 3) reliability of pressure measurements, 4) effect of increasing fresh gas flow on spirometry, 5) effect of increasing downstream resistances. In usual simulated ventilatory conditions, all the machines accurately delivered the setted ventilation and spirometric measurements were with minimal error only. Several ventilators (SA2, Excel, 710, Elsa, ABT 4,300) did not succeed in maintaining their performances when compliance was strongly decreased or resistance of the test lung notably increased. Resistance in the circuit during simulated spontaneous ventilation was < 3.6 cmH2O.l-1.s-1. Increasing fresh gas flow raised the minute volume delivered in six ventilators. It is concluded that, during extreme ventilatory conditions, the inspired volume must be adjusted so as to maintain the inspired tidal volume. However, ventilators which increase inspiratory time in response to an increased mechanical load cannot be adjusted by this way.