Expansion of afferent vestibular signals after the section of one of the vestibular nerve branches

The anterior branch of N. VIII was sectioned in adult frogs. Two months later the brain was isolated to record in vitro responses in the vestibular nuclei and from the abducens nerves following electric stimulation of the anterior branch of N. VIII or of the posterior canal nerve. Extra- and intracellularly recorded responses from the intact and operated side were compared with responses from controls. Major changes were detected on the operated side: the amplitudes of posterior canal nerve evoked field potentials were enlarged, the number of vestibular neurons with a monosynaptic input from the posterior canal nerve had increased, and posterior canal nerve stimulation recruited stronger abducens nerve responses on the intact side than vice versa. Changes in the convergence pattern of vestibular nerve afferent inputs on the operated side strongly suggest the expansion of posterior canal-related afferent inputs onto part of those vestibular neurons that were deprived of their afferent vestibular input. As a mechanism we suggest reactive synaptogenesis between intact posterior canal afferent fibers and vestibularly deprived second-order vestibular neurons.

Second gas effect of N2O on oxygen uptake

PURPOSE

The concept of the second gas effect is well known, however, there have been no studies that showed the relationship between alveolar oxygen concentration and arterial oxygen tension (PaO2) after the inhalation of nitrous oxide (N2O) in humans. The purpose of this study was to examine the changes in both end-tidal oxygen fraction (F(ET)O2) and PaO2 after N2O inhalation in patients under general anesthesia.

METHODS

Fifteen patients scheduled for elective orthopedic surgery were enrolled in this study. Anesthesia was maintained with the continuous infusion of propofol and with nitrogen (N2) and oxygen (O2) (6 L x min(-1), F1O2, 0.33). In all patients, the lungs were ventilated with a Servo 900C ventilator equipped with a gas mixer for O2, N2O, and N2. After obtaining baseline data, N2 was replaced with N2O maintaining FIO2 constant at 0.33. The changes in fractional concentration of O2, N2O, and N2 were continuously measured using mass spectrometer in a breath-by-breath basis. PaO2 and hemodynamic data were obtained at 1, 5, 10, 30 and 60 min after the start of N2O inhalation.

RESULTS

Five minutes after N2O inhalation, F(ET)O2 increased from 0.27+/-0.01 to 0.31+/-0.02 (P<0.01) and PaO2 increased from 172.0+/-22.5 mm Hg to 201.0+/-10.3 mm Hg (P<0.01). These effects produced by N2O were observed for 30 min.

CONCLUSIONS

These results confirm the concept of second gas effect of N2O on oxygen uptake in humans and provide evidence that the PaO2 increase correlated with the increase in F(ET)O2 after N2O inhalation.

Intraoperative QRS-interval changes caused by hyperkalaemia in an infant with Arima syndrome

A one-year-and-ten-months-old male infant with Arima syndrome, a very rare genetic disorder, underwent urgent insertion of a catheter for continuous ambulatory peritoneal dialysis (CAPD) under general anaesthesia. During the procedure he showed QRS-interval changes caused by hyperkalaemia which was successfully treated with calcium gluconate. The management and intraoperative complications of this syndrome are reported and available literature reviewed.

Jugular venous bulb oxygen saturation in patients with preexisting diabetes mellitus or stroke during normothermic cardiopulmonary bypass

BACKGROUND

The authors hypothesized that patients with cerebrovascular abnormalities or metabolic disorders may experience abnormality in cerebral circulation more frequently than patients without these risks. The current study attempted to assess jugular venous bulb oxygen saturation (SjvO2) in patients with preexisting diabetes mellitus or stroke undergoing normothermic cardiopulmonary bypass.

METHODS

Thirty-nine patients undergoing elective coronary artery bypass graft surgery were studied, including 19 age-matched control patients, 10 diabetic patients, and 9 patients with preexisting stroke A 4.0-French fiberoptic oximetry oxygen saturation catheter was inserted into the right jugular bulb to continuously monitor internal SjvO2. Hemodynamic parameters and arterial and jugular venous blood gases were measured at seven time points: (1) after the induction of anesthesia and before the start of surgery, (2) just after the beginning of cardiopulmonary bypass, (3) 20 min after the beginning of bypass, (4) 40 min after the beginning of bypass, (5) 60 min after the beginning of bypass, (6) just after the cessation of bypass, and (7) at the end of the operation.

RESULTS

No significant differences were seen in mean arterial pressure, arterial carbon dioxide tension (PaCO2), or hemoglobin concentration among the three groups during the study. The SjvO2 value did not differ among the three groups after anesthesia induction and before surgery, just after the beginning of cardiopulmonary bypass, 60 min after the beginning of bypass, just after the end of bypass, or at the end of the operation. Significant differences between the control group and the diabetic and stroke groups were observed, however, at 20 min and 40 min after the beginning of bypass (at 20 min: control group 62.2 +/- 6.8%, diabetes group 48.4 +/- 5.1%, stroke group 45.9 +/- 6.3%; at 40 min: control group 62.6 +/- 5.2%, diabetes group 47.1 +/- 5.2%, stroke group 48.8 +/- 4.1% [values expressed as the mean +/- SD]; P < 0.05). Also, values in the diabetes and stroke groups were decreased at 20 min and 40 min after the beginning of bypass compared with before the start of surgery.

CONCLUSIONS

A reduced SjvO2 value was observed more frequently in patients with preexisting diabetes mellitus or stroke during normothermic cardiopulmonary bypass. It is possible that cerebral circulation during normothermic bypass is altered in patients with risk factors for cerebrovascular disorder.

Propofol potentiates ATP-activated currents of recombinant P2X(4) receptor channels expressed in human embryonic kidney 293 cells

We examined the effects of a general anesthetic 2, 6-diisopropylphenol (propofol) on ATP- and alpha,beta-methylene ATP (alphabetameATP)-activated currents in the human embryonic kidney 293 (HEK 293) cells expressing recombinant P2X receptor channels, using the whole-cell patch-clamp method. Propofol at clinical relevant concentrations ( approximately 56 microM) potentiated the current responses through the P2X(4) receptor in a dose-dependent manner, whereas propofol did not affect the responses through the P2X(2) receptor or through the heterologous complex of the P2X(2) and P2X(3) (P2X(2+3)) receptor. These results suggest that activation of P2X(4) subtype in the brain and the motor neurons of the spinal anterior horn might be involved in the excitatory effect by propofol such as convulsion and unexpected movements.

Cerebral oxygenation is better during mild hypothermic than normothermic cardiopulmonary bypass

PURPOSE

Normothermic cardiopulmonary bypass (CPB) has been recently used in cardiac surgery. However, there is a controversy whether there is a difference in incidence of neurological disorder after coronary artery bypass graft (CABG) surgery between normothermic CPB and mild hypothermic CPB. In this study, we assessed the effects of normothermia and mild hypothermia (32 degrees C) during CPB on jugular oxygen saturation (SjvO2).

METHODS

Twenty patients scheduled for elective CABG surgery were divided into two groups. Group 1 (n = 10) underwent normothermic (>35 degrees C) CPB, and Group 2 (n = 10) underwent mild hypothermic (32 degrees C) CPB. Alpha-stat blood gas regulation was applied. After inducing anesthesia, a 4.0 French fibre optic oximetry oxygen saturation catheter was inserted into the right jugular bulb to monitor SjvO2 continuously throughout anesthesia and surgery.

RESULTS

The SjvO2 in the normothermic group was decreased at 20 (41.5+/-2.4%) and 40 min (43.8+/-2.8%) after the onset of CPB compared with control (53.9+/-5.4%, P<0.05). However, there was no change in SjvO2 in the mild hypothermic group during the study. No changes in jugular venous-arterial differences of lactate or creatine phosphokinase isoenzyme BB were observed in two groups during the study.

CONCLUSIONS

Cerebral oxygenation, as assessed by SjvO2 was increased during mild hypothermic CPB than during normothermic CPB.

Accuracy of carboxyhemoglobin dilution method for the measurement of circulating blood volume

PURPOSE

The management of circulating blood volume (BVc) is crucial in intensive care unit (ICU) patients. The purpose of this study was to verify the accuracy and precision of the carbon monoxide-labeled hemoglobin (CO-Hb) dilution method (CO method) by comparing it with the 51Cr-labeled erythrocyte dilution method (51Cr method) for the measurement of BVc.

METHODS

A prospective study was performed in 18 patients who underwent coronary artery bypass grafting (CABG) under mild hypothermic cardiopulmonary bypass (CPB). The BVc was measured by both the CO method and the 51Cr method at 24 hr after ICU admission in order to verify the accuracy and precision of the CO method. Paired data were assessed in absolute terms, and percentage errors were calculated by the degree of agreement.

RESULTS

Small mean differences and standard deviations between the CO method and the 51Cr method (-70.2 +/-184.8 mL) and small percentage errors (-0.49+/-1.29%) indicated the accuracy and precision of the CO method, and a close correlation was observed (r = 0.97).

CONCLUSION

The CO method can measure BVc with a similar degree of accuracy as the 51Cr method. It is simple, repeatable and safe without the risk of exposure to radioactivity in the ICU.

Long-term clomipramine treatment upregulates forebrain acetylcholine muscarinic receptors, and reduces behavioural sensitivity to scopolamine in mice

We have investigated the effects of long-term treatment with clomipramine, a tricyclic antidepressant, on central muscarinic acetylcholine receptors (mAChR) in mice. Repeated clomipramine administration resulted in an increase in the forebrain receptor density value (Bmax) for [3H]quinuclidinyl benzilate, a muscarinic ligand (P < 0.05), that was dependent on dose per administration (saline or 5, 10, or 20 mg kg(-1) once a day for 7 days) and number of days treated (20 mg kg(-1) for 1, 3, 5, or 7 days). No change in apparent affinity (defined as the reciprocal of the dissociation constant) (KD) occurred. Seven daily treatments with clomipramine (saline or 5, 10, or 20 mg kg(-1)) reduced hyperlocomotion induced by scopolamine (0.5 mg kg(-1), s.c.) dose-dependently, and the effect of 20 mg kg(-1) clomipramine was significant (P < 0.05). These results suggest that an upregulation of mAChR is produced by repeated clomipramine administration, and such a change is responsible for the decreased sensitivity to the muscarinic antagonist scopolamine.

Halothane facilitates the translocation of GRK-2 and phosphorylation of beta2-adrenergic receptor in rat synaptosomes

PURPOSE

To examine the effect of halothane on beta2-adrenergic receptor phosphorylation and on G-protein coupled receptor kinase (GRK), responsible for beta2-receptor downregulation.

METHODS

Rat forebrain synaptosomes were incubated for 30 min with halothane 1 or 2%. The cytosolic and membrane fractions were separated, and phosphorylation activity of recombinant beta2-adrenergic receptor was quantified autoradiographically using 32P labeled adenosine triphosphate. Phosphorylation activity of a specific GRK-2 substrate, was examined by measuring 32P binding. Subcellular localization of the enzyme was immunologically analyzed by Western blotting.

RESULTS

Halothane 2% decreased the phosphorylation activity of the recombinant receptor in the cytosol fraction, regardless of 10 microM isoproterenol (ISP) (P<0.01), which activity in the membrane fraction was increased (P<0.01). Phosphorylation activity of the synthetic peptide decreased in the cytosol obtained from synaptosomes exposed to halothane 2% (P<0.05). In contrast, activity in the membrane increased by exposure to halothane 2% (P<0.01). The concentration of GRK-2 decreased in the cytosol obtained from synaptosomes exposed to halothane 1% or 2% (decreases of 8.3+/-1.2% @ 1%, and 18.0+/-2.1% @ 2%, P<0.05). In the membrane, exposure to halothane 1% or 2% increased the GRK-2 amount dose dependently (22.5+/-3.1% @ 1%, and by 45.7+/-6.1% @ 2%, P<0.01).

CONCLUSION

Halothane could facilitate translocation of GRK-2 and possibly promote the downregulation of beta2-adrenergic receptors in the synaptic membrane. The anesthetic action and hemodynamic suppressive action of halothane may be related to this phenomenon.

Epidural block with mepivacaine before surgery reduces long-term post-thoracotomy pain

PURPOSE

To examine the effect of continuous epidural block initiated before thoracic surgery upon early and long-term postoperative pain.

METHODS

In a double-blind study, 70 patients scheduled for thoracic surgery under general anesthesia were assigned randomly to receive continuous epidural block with mepivacaine 1.5% initiated either 20 min before surgical incision (Pre group) or at completion of surgery (Post group). In both groups the initial dose was 4 ml, followed by a continuous infusion at 4 ml x hr(-1) until 72 hr after operation. Indomethacin suppositories, 50 mg, were administered on request as supplementary analgesics. Visual analogue scale at rest was assessed four hours after operation, and then every 24 hr after operation on postoperative days 1 through 7, and also days 14 and 30. At three and six months after operation, all patients were interviewed by telephone with respect to postoperative pain. The most severe pain was assessed using modified numerical rating scale.

RESULTS

By a visual analogue scale, postoperative pain was less in the Pre group than in the Post group at four hours, two and three days after operation (P < 0.05). By a numerical rating scale six months after operation, pain was less in the Pre group than in the Post group (P = 0.015). The percentage of pain-free patients was higher in the Pre group than in the Post group at three (P = 0.035) and six (P = 0.0086) months after operation.

CONCLUSION

Continuous epidural block initiated prior to surgery may reduce long-term post-thoracotomy pain.

Comparison of the hemodynamic effects of amrinone in patients who required low-to-moderate-dose and high-dose catecholamines after cardiac valve replacement

OBJECTIVES

To determine hemodynamic response to amrinone in patients after cardiac surgery, in relation to the postoperative cardiac function, which was indicated by the required doses of catecholamines.

DESIGN

Prospective clinical study.

SETTING

Surgical intensive care unit in a university hospital.

PATIENTS

Fourteen patients who required a low-to-moderate dose of dopamine and dobutamine (group L) and 14 patients who required a high dose of dopamine and dobutamine (group H) after cardiac valve replacement.

INTERVENTIONS

A loading dose of amrinone (0.75 mg/kg) was administered during a 15-min period and the continuous infusion was followed incrementally by doses of 5, 10, and 20 microg/kg/min every 60 mins on the first postoperative day.

MEASUREMENTS AND MAIN RESULTS

Hemodynamic variables were determined by the radial and pulmonary artery catheters at a dose of 0, 5, 10, and 20 microg/kg/min. Two-way repeated-measures analysis of variance showed significant interaction in the two groups in cardiac index and mean systemic arterial pressure. Cardiac index increased in a dose-dependent manner in group L but was unchanged in group H. Systemic vascular resistance index decreased in a dose-dependent manner in both groups. The mean systemic arterial pressure decreased in group L at a dose of 5 microg/kg/min and returned to the baseline level at doses of 10 and 20 microg/kg/min. On the other hand, the mean systemic arterial pressure significantly decreased in group H at a dose of 20 microg/kg/min.

CONCLUSIONS

The inotropic effects of amrinone after cardiac valve replacement may be associated with the postoperative myocardial reserve, which was indicated by the required doses of catecholamines, although a similar vasodilative effect was observed in both groups.

Intrathecal co-administration of NMDA antagonist and NK-1 antagonist reduces MAC of isoflurane in rats

BACKGROUND

Intravenous administration of N-methyl-D-aspartate (NMDA) receptor antagonists and alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor antagonists reportedly reduce the minimum alveolar anaesthetic concentration (MAC) for inhalation anaesthetics. If pain perception can be prevented by the intrathecal administration of antinociceptive receptor antagonists, these agents may reduce the requirements for inhalation anaesthetics. We studied the effect of intrathecal administration of an AMPA/kainate receptor antagonist, a metabotropic glutamate (mGlu) receptor antagonist and co-administration of NMDA and a neurokinin-1(NK-1) receptor antagonist drugs at low doses on the MAC.

METHODS

After Wistar rats (n=36) were fitted with indwelling intrathecal catheters, the MAC of isoflurane was determined following intrathecal administration of a non-NMDA receptor antagonist (CNQX) at 10 microg, a mGlu receptor antagonist (AP3) at 10 microg, or a combination of NMDA receptor antagonist (APV) at 0.01 microg to 1 microg with NK-1 receptor antagonist (CP96345, CP) at 0.1 microg to 10 microg. Subsequently, a reversal dose of intrathecal NMDA with substance P (SP) was administered, and the MAC of isoflurane was redetermined. Conscious rats (n=15) were also examined for the presence of locomotor dysfunction following the intrathecal co-administration of APV and CP.

RESULTS

Neither CNQX nor AP3 reduced the MAC of isoflurane. APV at 0.01 microg plus CP at 1 microg, as well as APV at 0.1 microg plus CP at 10 microg, reduced the MAC of isoflurane, with respective reductions of 7.6% and 14%; (P<0.05). Co-administration of NMDA plus SP reversed the decrease in the MAC of isoflurane. Locomotive activity was not changed.

CONCLUSIONS

The NMDA receptor and the NK-1 receptor are important determinants of the MAC of isoflurane, exerting this influence by inhibition of pain transmission in the spinal cord, while mGlu and AMPA receptors have no effect on the MAC of isoflurane.

Balloon pump-induced pulsatile perfusion during cardiopulmonary bypass does not improve brain oxygenation

BACKGROUND

Whether pulsatile flow offers substantial advantages for brain protection during cardiopulmonary bypass is controversial. The purpose of this study is to determine whether differences exist between pulsatile and nonpulsatile bypass concerning the effects on internal jugular venous saturation and on the state of regional cerebral oxygenation during normothermia.

METHODS

Twenty-two patients undergoing elective coronary artery bypass grafting were randomly divided into 2 groups: group 1 (n = 11) received nonpulsatile perfusion during cardiopulmonary bypass and group 2 (n = 11) received pulsatile perfusion during bypass. We used an intra-aortic balloon pump to generate pulsatility. A spectrophotometric probe (INVOS 3100R, Somanetics, Troy, Mich) was used to assess the state of regional cerebral oxygenation. A 4F fiberoptic oximetry oxygen saturation catheter was inserted into the right jugular bulb to monitor jugular venous oxygen saturation. Hemodynamic variables, arterial and jugular venous blood gases, and regional cerebral oxygenation were measured at 7 times points.

RESULTS

In both groups, jugular venous oxygen saturation decreased at the early stage of the cardiopulmonary bypass (P =.03). Five patients in group 1 and 6 in group 2 had a jugular venous oxygen saturation of less than 50%. In both groups, the regional cerebral oxygenation value decreased during cardiopulmonary bypass (P =.04).

CONCLUSIONS

The present results showed that pulsatility generated through the use of intra-aortic balloon pumping did not produce any beneficial effects on jugular venous oxygen saturation and regional cerebral oxygenation at normothermia.

Cecal ligation and puncture peritonitis model shows decreased nicotinic acetylcholine receptor numbers in rat muscle: immunopathologic mechanisms?

BACKGROUND

Although systemic inflammation is believed to cause upregulation of nicotinic acetylcholine receptors (nAchRs) in muscle, chronic infections such as Chagas' disease occasionally are complicated by myasthenia gravis. The authors investigated how a nonlethal cecal ligation and puncture (CLP) peritonitis model in rats could affect muscle nAchR.

METHODS

On day 1, 4, 7, 14, or 21 after CLP or sham operation, nAchR binding was assayed in the anterior tibial muscle and diaphragm using [125I]alpha-bungarotoxin. The presence or absence of weakness, in vivo dose-response relationships for d-tubocurarine, and serum anti-nAchR antibody titers were assayed in separate experiments.

RESULTS

Systemic inflammation was most severe during the first 4 to 5 days. Numbers of nAchRs were decreased in anterior tibial muscle on days 7, 14, and 21 after CLP, and in the diaphragm on days 7 and 14 (P < 0.01). Both 50% and 90% blocking doses of d-tubocurarine) were lower in CLP rats than in sham-operated rats on days 7, 14, and 21 (P < .05). Weakness was overt in approximately half of CLP rats at these times. Serum anti-nAchR antibody (0.7-1.4 nM) was detectable beginning on day 4 and continuing throughout the 21-day observation period in 58-67% of CLP rats.

CONCLUSIONS

During the recovery phase of injury, nonlethal CLP peritonitis resulted in downregulation of nAchR. However, further study is needed to determine the role of anti-nAchR antibodies in the development of decreased receptor numbers and impaired neuromuscular function.

Effects of hypothermic and normothermic cardiopulmonary bypass on brain oxygenation

BACKGROUND

In this study, we assessed the effects of normothermia and hypothermia during cardiopulmonary bypass (CPB) both on internal jugular venous oxygen saturation (SjvO2) and the regional cerebral oxygenation state (rSO2) estimated by near infrared spectroscopy (NIRS).

METHODS

Thirty patients scheduled for elective coronary artery bypass graft surgery (CABG) were randomly divided into two groups. Group 1 (n = 15) underwent surgery for normothermic (> 35 degrees C) CPB, and group 2 (n = 15) underwent surgery for hypothermic (30 degrees C) CPB, and alpha-stat regulation was applied. A 4.0-French fiberoptic oximetry oxygen saturation catheter was inserted into the right jugular bulb to continuously monitor the SjvO2 value. To estimate the rSO2 state, a spectrophotometer probe was attached to the mid-forehead. SjvO2 and rSO2 values were then collected simultaneously using a computer.

RESULTS

Neither the cerebral desaturation time (duration during SjvO2 value below 50%), nor the ratio of the cerebral desaturation time to the total CPB time significantly differed (normothermic group: 18+/-6 min, 15+/-6%; hypothermic group: 17+/-6 min, 13+/-6%, respectively). The rSO2 value in the normothermic group decreased during the CPB period compared with the pre-CPB period. The rSO2 value in the hypothermic group did not change throughout the perioperative period.

CONCLUSIONS

These findings suggest that near infrared spectroscopy might be sensitive enough to detect subtle changes in regional cerebral oxygenation.

Identification and characterization of a novel UDP-GalNAc:GlcAbeta-R alpha1,4-N-acetylgalactosaminyltransferase from a human sarcoma cell line

We recently discovered a novel alpha-N-acetylgalactosaminyltransferase in fetal bovine serum (Kitagawa et al., J. Biol. Chem., 270, 22190-22195, 1995) and also in mouse mast cytoma cells (Lidholt et al., Glycoconjugate J., 14, 737-742, 1997), which catalyzed the transfer of an alpha-GalNAc residue to the linkage tetrasaccharide-serine, GlcAbeta1-3Galbeta1-3Galbeta1-4Xylbeta1-O-Ser, derived from proteoglycans. In this study, we characterized this enzyme using a preparation obtained from the serum-free culture medium of a human sarcoma (malignant fibrous histiocytoma) cell line by phenyl-Sepharose chromatography. Structural characterization by1H NMR spectroscopy of the reaction product using the linkage tetrasaccharide-serine, GlcAbeta1-3Galbeta1-3Galbeta1-4Xylbeta1-O-Ser, as a substrate demonstrated that the enzyme was a UDP-GalNAc:GlcAbeta1-R alpha1,4-N -acetylgalactosaminyltransferase. This is the first identification of an alpha1,4-N-acetylgalactosaminyltransferase. Using N -acetylchondrosine GlcAbeta1-3GalNAc as an alternative substrate, the enzyme required divalent cations for the transferase reaction, with maximal activity at 20 mM Mn2+and exhibited a dual optimum at pH 6.5 and pH 7.4 depending upon the buffers used, with the highest activity in a 50 mM 2-( N -morpholino)ethanesulfonic acid buffer at pH 6.5. The apparent Km values obtained for N -acetylchondrosine, the linkage tetrasaccharide-serine, and UDP-GalNAc were 1060 microM, 188 microM, and 27 microM, respectively. This suggested that the linkage tetrasaccharide-serine was a good acceptor substrate for the enzyme. In addition, the enzyme utilized glucuronylneolactotetraosylceramide GlcAbeta1-3Galbeta1-4GlcNAcbeta1-3Galbeta1-4G lcbeta1-1Cer but not sulfoglucuronylneolactotetraosylceramide GlcA(3-O -sulfate)beta1-3Galbeta1-4GlcNAcbeta1-3Galbeta1-4Gl cbeta1-1Cer as acceptor substrates. The possibility of involvement of this enzyme in the biosynthesis of glycosaminoglycan as well as other GlcA-containing glycoconjugates is discussed.

Involvement of the core protein in the first beta-N-acetylgalactosamine transfer to the glycosaminoglycan-protein linkage-region tetrasaccharide and in the subsequent polymerization: the critical determining step for chondroitin sulphate biosynthesis

alpha-Thrombomodulin (alpha-TM) with a truncated glycosaminoglycan-protein linkage tetrasaccharide, GlcAbeta1-3Galbeta1-3Galbeta1-4Xyl, was tested as an acceptor together with a sugar donor, UDP-N-[3H]acetylgalactosamine, using a cell-free enzyme system prepared from the serum-free culture medium of a human melanoma cell line. The truncated tetrasaccharide on alpha-TM served as an acceptor, whereas the linkage tetrasaccharide-serine did not. Our characterization of the radioactively labelled product by enzymic digestion revealed that the N-[3H]acetylgalactosamine residue was transferred to alpha-TM through a beta1,4-linkage. The substrate competition experiments with the chondro-hexasaccharide and alpha-TM reinforced our speculation that a common N-acetylgalactosaminyltransferase catalysed the transfer of N-acetylgalactosamine to both the linkage tetrasaccharide and the longer chondroitin oligosaccharides. Moreover, chondroitin polymerization was demonstrated on the tetrasaccharide of alpha-TM using both UDP-glucuronic acid and UDP-N-acetylgalactosamine as sugar donors. Much longer chains were synthesized on alpha-TM than on the linkage penta- and hexa-saccharide-serines. Together, these results indicated that the core protein is required for the transfer of the first N-acetylgalactosamine residue through a beta1,4-linkage and also for subsequent efficient chain polymerization reactions, and that the critical determining step for chondroitin sulphate biosynthesis is the transfer of the first N-acetylgalactosamine residue.

Substrate specificity studies of Flavobacterium chondroitinase C and heparitinases towards the glycosaminoglycan--protein linkage region. Use of a sensitive analytical method developed by chromophore-labeling of linkage glycoserines using dimethylaminoazobenzenesulfonyl chloride

Bacterial chondroitinases and heparitinases are potentially useful tools for structural studies of chondroitin sulfate and heparin/heparan sulfate. Substrate specificities of Flavobacterium chondroitinase C, as well as heparitinases I and II, towards the glycosaminoglycan-protein linkage region -HexA-HexNAc-GlcA-Gal-Gal-Xyl-Ser (where HexA represents glucuronic acid or iduronic acid and HexNAc represents N-acetylgalactosamine or N-acetylglucosamine) were investigated using various structurally defined oligosaccharides or oligosaccharide-serines derived from the linkage region. In the case of oligosaccharide-serines, they were labeled with a chromophore dimethylaminoazobenzenesulfonyl chloride (DABS-Cl), which stably reacted with the amino group of the serine residue and rendered high absorbance for microanalysis. Chondroitinase C cleaved the GalNAc bond of the pentasaccharides or hexasaccharides derived from the linkage region of chondroitin sulfate chains and tolerated sulfation of the C-4 or C-6 of the GalNAc residue and C-6 of the Gal residues, as well as 2-O-phosphorylation of the Xyl residue. In contrast, it did not act on the GalNAc-GlcA linkage when attached to a 4-O-sulfated Gal residue. Heparitinase I cleaved the innermost glucosaminidic bond of the linkage region oligosaccharide-serines of heparin/heparan sulfate irrespective of substitution by uronic acid, whereas heparitinase II acted only on the glucosaminidic linkages of the repeating disaccharide region, but not on the innermost glucosaminidic linkage. These defined specificities of chondroitinase C, as well as heparitinases I and II, will be useful for preparation and structural analysis of the linkage oligosaccharides.

[The effect of propofol as an anticonvulsant]

We observed that propofol was very effective for the refractory general convulsion after surgical operation of cerebral aneurysmal clipping in two patients. The first patient had suffered from asthma. Standard regimens except for thiopental were ineffective for the refractory general convulsion after the operation. So, we administered propofol to the patient, at the dosage of 1 mg.kg-1 intravenously and then, 1 mg.kg-1.hr-1 continuously i.v. Propofol suppressed the general convulsions completely. On the EEG, there were no convulsive spikes. Furthermore, patient's consciousness became clearer during the administration of propofol. The convulsion in the second patient not suffering from asthma, was intractable, too and diazepam, phenytoin, and phenobalbital were not effective. Then, we tried propofol in the same way, and good effect was obtained. Propofol may be an effective medicine for the refractory general convulsion.

The effect of intrathecal magnesium sulphate on nociception in rat acute pain models

We examined the antinociceptive effect of intrathecally administered magnesium sulphate (MgSO4) in rats, using acute pain models including mechanical pressure, heat and subcutaneous formalin injection. According to the locomotion test 10 microliters of 6.2% MgSO4 did not produce motor paralysis. At the same dose, responses to pressure and heat were intact, compared with controls given saline. MgSO4 produced depression of pain responses only after the first 10 min in the formalin test. Our studies indicated that MgSO4 did not show remarkable antinociceptive effects in acute pain models.

Iron fortification of rice seed by the soybean ferritin gene

To improve the iron content of rice, we have transferred the entire coding sequence of the soybean ferritin gene into Oryza sativa (L. cv. Kita-ake) by Agrobacterium-mediated transformation. The rice seed-storage protein glutelin promoter, GluB-1, was used to drive expression of the soybean gene specifically in developing, self-pollinated seeds (T1 seeds) of transgenic plants, as confirmed by reverse transcription PCR analysis. Stable accumulation of the ferritin subunit in the rice seed was demonstrated by western blot analysis, and its specific accumulation in the endosperm by immunologic tissue printing. The iron content of T1 seeds was as much as threefold greater than that of their untransformed counterparts.

Hyperventilation after tourniquet deflation prevents an increase in cerebral blood flow velocity

PURPOSE

In this study we examined whether normocapnia maintained by hyperventilation after lower limb tourniquet deflation prevents an increase in cerebral blood flow velocity.

METHODS

Thirteen patients, undergoing elective orthopedic surgery, requiring a pneumatic tourniquet around the lower extremity, were divided into two groups. In group 1, ventilation was controlled at tidal volume of 10 mL x kg(-1) and respiratory rate of eight per minute after tourniquet release. In group 2, ventilation was controlled to maintain P(ET)CO2 between 30 and 35 mmHg after tourniquet release. Arterial blood pressure, heart rate, peak and mean middle cerebral artery (MCA) flow velocity, and arterial blood gas were measured every minute for ten minutes after tourniquet release. The MCA blood flow velocity was measured using Transcranial Doppler ultrasonography (TCD).

RESULTS

In group 1, the maximum peak MCA flow velocity was 53+/-6 cm x sec(-1) (50%+/-6% increase compared with pre- release value), and achieved 3+/-0.4 min after tourniquet release. In group 2, there was no increase either in mean or peak MCA velocity after tourniquet release.

CONCLUSIONS

Normocapnia maintained by hyperventilation after tourniquet deflation prevents an increase in cerebral blood flow velocity.

High predictive value of red cell volume measurement using carboxy-haemoglobin in a rabbit model of haemorrhage

We have studied the accuracy of blood volume measurements using carbon monoxide (CO)-labelled haemoglobin (COHb) injection and dilution (CO method) by comparing changes in red cell volume (RCV) measured using the CO method and 51Cr-labelled erythrocyte dilution (51Cr method) in a haemorrhage and infusion model in rabbits. RCV was measured repeatedly using the CO method at four different blood volume stages (stages I-IV). At stages I and IV, RCV was measured simultaneously using the 51Cr method. In comparing the sum of the circulating RCV and extracted RCV (SUM RCV) using the CO method, the values were almost equal and there were no significant differences between the values at the four stages. In comparing circulating RCV measured using the CO method and the 51Cr method, mean difference between the two methods was 0.80 (SD 0.76) ml kg-1 or 4.7 (4.6)%, and a positive correlation was observed (r = 0.91). We conclude that the CO method can be used to measure blood volume during perioperative periods in infants because it avoids use of a radioactive tracer, is simple and repeated measurements are possible.

Measurement of blood concentration of indocyanine green by pulse dye densitometry--comparison with the conventional spectrophotometric method

OBJECTIVE

Pulse dye densitometry (PDD) uses two wavelengths (805 and 890 nm) in association with pulse oximetry to compute the arterial blood concentration ratio of indocyanine green (ICG) to hemoglobin (Hb). When Hb is measured in the usual way, this permits the PDD to compute cardiac output, plasma or blood volume, and liver blood flow following an intravenous injection of ICG. In this study, we evaluate the accuracy of the PDD calculation of dye concentration by comparing it with measurement of the dye concentration in blood (Cb) measured by the spectrophotometric cuvette method during dye clearance in patients.

METHODS

In 25 patients receiving major abdominal surgery, ICG (10, 20, or 40 mg) was injected into a central vein and arterial ICG concentration was continuously and simultaneously monitored at nose and finger by PDD; concurrently, ICG concentrations were measured by a spectrophotometer at 805 nm in 4 radial arterial blood samples. Repeated measures or one-way ANOVA were used for comparison of ICG concentrations and percent errors by PDD at the nose, finger, and Cb.

RESULTS

The percent error (bias) of calculated dye concentration and its standard deviation (precision) was -3.9 +/- 16.8% (p < 0.01) with the probe on a nostril and 3.4 +/- 12.6% using the finger probe. These errors were found to be greatest when the mean transit time of the dye was rapid (-20.7 +/- 6.8% at nose p < 0.01 and -8.5 +/- 2.5% at finger p < 0.05) due to factors other than the time delay of blood sampling.

CONCLUSION

These errors are of similar size to those associated with thermal cardiac output measurement, suggesting that PDD should be valuable clinically as a noninvasive tool especially since it provides values for blood volume and liver blood flow.