Vasopressin increases milk flow and milk fat concentration in the goat

AIM

The aim of this study was to investigate whether physiological doses of vasopressin affect milk flow and milk composition in goats.

METHODS

Six goats were given vasopressin intravenously at doses of 0.1 ng kg(-1) min(-1) (a low dose, VL), 0.3 ng kg(-1) min(-1) (a medium dose, VM) and 1.0 ng kg(-1) min(-1) (a high dose, VH), oxytocin at 10 ng kg(-1) min(-1) and 0.15 m NaCl during 90 min at random.

RESULTS

Milk flow increased from 1.3 +/- 0.2 to 3.5 +/- 1.0 g min(-1) (VL), from 1.8 +/- 0.4 to 4.3 +/- 0.6 g min(-1) (VM) and from 1.5 +/- 0.2 to 7.9 +/- 0.9 g min(-1) (VH) during the first 30-min infusions (all P < 0.001), respectively, and then declined. The response to oxytocin corresponded to that of VH. Milk fat concentration increased from 2.1 +/- 0.1 to 3.3 +/- 0.4% during VH and from 2.8 +/- 0.6 to 4.1 +/- 0.6% during oxytocin (both P < 0.001), and tended to increase during VM and VL. The mammary blood flow of four goats was studied with ultrasound during VH and oxytocin infusion. Milk flow increased from 1.8 +/- 0.4 to 4.7 +/- 1.0 g min(-1) during VH and from 1.9 +/- 0.3 to 12.4 +/- 2.4 g min(-1) during oxytocin (both P < 0.001). Mammary blood flow decreased from 262 +/- 37 to 53 +/- 7 mL min(-1) (P < 0.001) during VH, but did not change during oxytocin.

CONCLUSION

We conclude that vasopressin increases milk flow and milk fat concentration and suggest that vasopressin, like oxytocin, acts on the myoepithelial cells.

Wet belly in reindeer (Rangifer tarandus tarandus) in relation to body condition, body temperature and blood constituents

Wet belly, when the reindeer becomes wet over the lower parts of the thorax and abdomen, sometimes occurs in reindeer during feeding. In a feeding experiment, 11 out of 69 reindeer were affected by wet belly. The problem was first observed in 7 animals during a period of restricted feed intake. When the animals were then fed standard rations, 3 additional animals fed only silage, and 1 fed pellets and silage, became wet. Four animals died and 1 had to be euthanized. To investigate why reindeer developed wet belly, we compared data from healthy reindeer and reindeer affected by wet belly. Urea, plasma protein, glucose, insulin and cortisol were affected by restricted feed intake or by diet but did not generally differ between healthy reindeer and those with wet belly. The wet animals had low body temperature and the deaths occurred during a period of especially cold weather. Animals that died were emaciated and showed different signs of infections and stress. In a second experiment, with 20 reindeer, the feeding procedure of the most affected group in the first experiment was repeated, but none of the reindeer showed any signs of wet belly. The study shows that wet belly is not induced by any specific diet and may affect also lichen-fed reindeer. The fluid making the fur wet was proven to be of internal origin. Mortality was caused by emaciation, probably secondary to reduced energy intake caused by diseases and/or unsuitable feed.

Pulmonary function subsequent to expiratory muscle fatigue in healthy humans

One of the mechanisms proposed to explain the decrement in pulmonary function often seen after exercise is fatigue of the expiratory muscles. To test the hypothesis that expiratory muscle fatigue alters lung function, several indices of pulmonary function were measured before and after expiratory muscle fatigue was induced by expiratory loaded breathing. Eight subjects completed a fatigue trial (EF) in which expiratory threshold loaded breathing was performed at an initial resistance equal to 80 % of their maximal expiratory pressure (MEP), at a respiratory rate of 13 bpm, and a duty cycle (T(I)/T(Tot)) of 0.33. MEP was taken at predefined intervals throughout the loaded breathing protocol, and loaded breathing was discontinued when MEP was less than 80 % of each subject's pre EF trial MEP (T(Lim)). FVC, FEV(1.0), FEF(25 %), FEF(25-75 %), and maximal inspiratory and expiratory pressures (MIP and MEP) were taken prior to, immediately after, and at 5, 10, and 15 min post fatigue. On a separate day a control trial (CON) was performed that was identical to each subjects EF trial with the exception that no expiratory load was utilized. At T(Lim) MEP was significantly reduced (p < 0.001) by 23.5 % from the pre-expiratory loaded breathing value (183.1 +/- 39.56 to 140.13 +/- 30.45 mmHg), whereas it remained unchanged during the CON trial (191.06 +/- 44.18 to 188.06 +/- 43.50 mmHg). FVC measured prior to and immediately after T(Lim) remained unchanged following both the EF (5349.45 +/- 1130.8 to 5387.43 +/- 1139.92 mL) and CON trials (5287.75 +/- 1220.29 and 5352.78 +/- 1191.30 mL). These results suggest that any expiratory muscle fatigue developed during exercise by itself does not result in altered pulmonary function. However, any interactions between expiratory muscle fatigue and other consequences of exercise that may alter lung function cannot be ruled out.

An ancient retrovirus-like element contains hot spots for SINE insertion

Vertebrate retrotransposons have been used extensively for phylogenetic analyses and studies of molecular evolution. Information can be obtained from specific inserts either by comparing sequence differences that have accumulated over time in orthologous copies of that insert or by determining the presence or absence of that specific element at a particular site. The presence of specific copies has been deemed to be an essentially homoplasy-free phylogenetic character because the probability of multiple independent insertions into any one site has been believed to be nil. Mys elements are a type of LTR-containing retrotransposon present in Sigmodontine rodents. In this study we have shown that one particular insert, mys-9, is an extremely old insert present in multiple species of the genus Peromyscus. We have found that different copies of this insert show a surprising range of sizes, due primarily to a continuing series of SINE (short interspersed element) insertions into this locus. We have identified two hot spots for SINE insertion within mys-9 and at each hot spot have found that two independent SINE insertions have occurred at identical sites. These results have major repercussions for phylogenetic analyses based on SINE insertions, indicating the need for caution when one concludes that the existence of a SINE at a specific locus in multiple individuals is indicative of common ancestry. Although independent insertions at the same locus may be rare, SINE insertions are not homoplasy-free phylogenetic markers.

Lentiviral-mediated gene transfer into haematopoietic stem cells

OBJECTIVES

Lentiviral vectors can transduce nondividing cells. As most haematopoietic stem cells (HSCs) are nondividing in vivo, lentiviral vectors are promising viral vectors to transfer genes into HSCs.

DESIGN AND SETTING

We have used HIV-1 based lentiviral vectors containing the green fluorescent protein (GFP) gene to transduce umbilical cord blood CD34+ and CD34+/CD38- cells prior to transplantation into NOD/SCID mice.

RESULTS

High level engraftment of human cells was obtained and transgene expression was seen in both myeloid and lymphoid lineages. Bone marrow from the primary transplant recipients mice was transplanted into secondary recipients. GFP expression was seen in both lymphoid and myeloid cells in the secondary recipients 6 weeks posttransplantation. Human haematopoietic progenitor colonies were grown from both primary and secondary recipients. Over 50% of the haematopoietic colonies in these recipients were positive for the GFP transgene by PCR. Following inverse PCR, amplified fragments were sequenced and integration of the vector into human genomic DNA was demonstrated. Several vectors containing different internal promoters were tested in NOD/SCID mice that had been transplanted with transduced CD34+ and CD34+/CD38- cells. The elongation factor-1alpha (EF-1alpha) promoter gave the highest level of expression, both in the myeloid and lymphoid progeny of the engrafting cells.

CONCLUSIONS

These data collectively indicate that candidate human HSCs can be efficiently transduced with lentiviral vectors and that the transgene is highly expressed in their progeny cells.

A serial study of heart function during pregnancy, lactation and the dry period in dairy goats using echocardiography

Echocardiography and Doppler measurements were performed to investigate changes in heart dimensions and function during pregnancy, lactation and the non-pregnant, non-lactating (dry) period in dairy goats. Eight Swedish domestic goats (Capra hircus) were studied with two-dimensional (2DE), M-mode and continuous wave Doppler measurements. Cardiac dimensions did not differ between periods. The mean cardiac outputs were 35 and 28% greater during pregnancy and lactation, respectively, vs. the dry period. Arterial blood pressure (measured by telemetry) did not differ between reproductive periods before echocardiographic measurements, but became elevated during the measurements, with the smallest rise during lactation. Heart rate was elevated during pregnancy and increased further during echocardiographic measurements, but was not elevated during the other periods. The cranial location of the heart influenced the selection of examination window and caused some difficulties in positioning the ultrasound transducer. This may have led to underestimation of the velocity trace integral and therefore to underestimation of cardiac output. However, our values were within the range of these obtained with dye- and thermodilution methods. The goats tolerated the investigations well during lactation and the dry period, but showed increased blood pressure and heart rate during pregnancy. Therefore, the non-invasive and safe echocardiographic-Doppler method appears to be a good alternative for studies of heart dimensions and function during lactation and the dry period in the dairy goat.

Lentiviral gene transfer into primary and secondary NOD/SCID repopulating cells

The ability of lentiviral vectors to transfer genes into human hematopoietic stem cells was studied, using a human immunodeficiency virus 1 (HIV-1)-derived vector expressing the green fluorescence protein (GFP) downstream of the phosphoglycerate kinase (PGK) promoter and pseudotyped with the G protein of vesicular stomatitis virus (VSV). High-efficiency transduction of human cord blood CD34(+) cells was achieved after overnight incubation with vector particles. Sixteen to 28 percent of individual colony-forming units granulocyte-macrophage (CFU-GM) colonies derived from cord blood CD34(+) cells were positive by polymerase chain reaction (PCR) for the GFP gene. The transduction efficiency of SCID-repopulating cells (SRC) within the cord blood CD34(+) population was assessed by serial transplantation into nonobese diabetic/severe combined immunodeficient (NOD/SCID) mice. When 400,000 cord blood CD34(+) cells were transplanted into primary recipients, all primary and secondary recipients contained and expressed the transgene. Over 50% of CFU-GM colonies derived from the bone marrow of these primary and secondary recipients contained the vector on average as determined by PCR. Transplantation of transduced cells in limiting dilution generated GFP(+) lymphoid and myeloid progeny cells that may have arisen from a single SRC. Inverse PCR analysis was used to amplify vector-chromosomal junctional fragments in colonies derived from SRC and confirmed that the vector was integrated. These results show that lentiviral vectors can efficiently transduce very primitive human hematopoietic progenitor and stem cells. (Blood. 2000;96:3725-3733)

Addition of the human interferon beta scaffold attachment region to retroviral vector backbones increases the level of in vivo transgene expression among progeny of engrafted human hematopoietic stem cells

Absence of durable high-level expression of transgenes from Moloney murine leukemia (Mo-MuLV) retroviral vectors has been a hurdle in bringing effective gene therapy to the clinic. In this study we have analyzed transgene expression among the progeny of mobilized hematopoietic stem cells (HSCs), comparing Mo-MuLV and mouse stem cell virus (MSCV) vectors, with or without addition of a scaffold attachment region (SAR) from the human interferon beta gene. Retroviral (RV) vector supernatant quality was assessed by comparing NGFR transgene expression by HEL cells, and transgene delivery and expression by CD34(+) cells 72 hr after transduction, using real-time PCR and FACS analysis. This is the first description of the effect of SAR within both Mo-MuLV and MSCV vector backbones on long-term RV transgene expression among in vivo HSC progeny in HSC repopulation assays (SCID-hu bone and NOD/SCID). After transduction of mobilized CD34(+) cells with MSCV-SAR vector, transgene expression was observed among a mean of 10% of donor HSC progeny in the SCID-hu bone (range, 0.6-43%). The predominant effect of SAR was to increase the mean fluorescence intensity (MFI) of transgene expression among HSC progeny in both in vivo bone repopulation models (three- to fourfold), and after long-term stromal cultures (twofold).

Health, body condition and blood metabolites in reindeer after submaintenance feed intake and subsequent feeding

The transition from experimentally induced poor nutritional conditions to feeding was studied with 69 eight-month-old female reindeer (Rangifer tarandus tarandus). During a pre-experimental period, all reindeer were fed a simulated winter diet with 80% lichens Cladina spp. and 20% Vaccinum myrtillus shrubs and Salix spp. leaves (lichen diet) ad lib. The reindeer were divided into five groups. A control group (group C) was fed the lichen diet ad lib. throughout the experiment. Four groups were fed half of that ration for eight days and were then totally deprived of feed for one day (restriction period). During the following 34 days (feeding period) the groups were re-fed the lichen diet (group L), fed pelleted reindeer feed combined with either lichen (group PL) or grass silage (group PS), or fed silage with a gradually increasing addition of pellets (group SP). Weekly measurements of blood samples and body weighr showed that the control group remained clinically healthy and had stable blood plasma concentrations of protein, urea, glucose and insulin throughout the experiment, but they lost weight. At slaughter, before and after the restriction period, all animals had lost rumen-free body weight, but the reindeer fed a restricted amount of feed lost more than the control group. Also the plasma metabolites were affected by the restricted feeding, with increased concentrations of urea and decreased concentrations of glucose. Group L responded immediately to the ad lib. feeding with blood metabolite levels rapidly approaching those of group C. The body weight developments were similar in groups L and C. Although the feed rations were increased gradually, diarrhoea occurred in some animals belonging to groups PL and PS within the first week of the feeding period. All reindeer recovered, after antibiotic treatment of the worst affected animals. The PL and PS groups, which had high contents of metabolisable energy and crude protein in their diets, showed increased con-centtations of plasma protein, urea and insulin. At the end of the feeding period, these groups had increased their body and carcass weights and gained fat, whereas reindeer fed the lichen diet had lost weight. Severe health problems (malnutrition and so-called wet belly) occurred in group SP during the first weeks of feeding and led to loss of animals, and consequently the SP group was excluded from the remainder of rhe experiment. The general conclusion is that the lichen diet did not cause any digestive problems, but resulted in a continuous decline in body weight and small or deficient fat reserves. After the initial diarrhoea, feeding with diets comprising pellets from the start resulted in improved condition, expressed as increased body weight, fat gain and higher concentrations of plasma protein, urea and insulin in relation to the control group. The diet initially based on grass in the form of silage of the given quality seemed insufficient as feed to reindeer calves in a poor nutritional state.

Impact of polychlorinated naphthalenes (PCNs) in juvenile Baltic salmon, Salmo salar: evaluation of estrogenic effects, development, and CYP1A induction

Juvenile Baltic salmon, Salmo salar, were fed commercial salmon food contaminated with different concentrations of polychlorinated naphthalenes (PCNs; 0.1, 1, 2, or 10 microg PCN/g food). Among other effects, possible estrogenic impact caused by PCNs were evaluated. Fish were therefore fed a diet contaminated with 17beta-estradiol (E2; 0.94 or 9.4 microg E2/g food), as a positive control. After 8, 13, 17, and 41 weeks, sampling took place. Growth, liver somatic index (LSI), EROD activity, and vitellogenin content in blood plasma were measured along with morphological studies of gonads and chemical analyses to determine the effects caused by PCNs. Exposure to PCNs did not seem to have any effects on body weight gain, since the group fed the high dose followed the growth in the control group during the entirely experimental period. After 41 weeks of exposure the groups fed 2 and 10 microg PCN/g food had significantly lower LSIs compared with the control, indicating liver toxic effects of PCNs. Furthermore, a dose-dependent induction of EROD activity was found. At week 41, the control group had an activity of 4.9 +/- 4.8 pmol/mg prot/min, whereas it was between 69 +/- 21 and 720 +/- 370 pmol/mg prot/min in the exposed groups, respectively. Examination of gonadal morphology showed that PCNs also had negative effects on ovaries in Baltic salmon, including delayed development. The distribution between females and males, gonadal morphology, and vitellogenin content in blood plasma did, however, indicate that PCNs are not capable of causing effects similar to E2 or xenoestrogens. Exposure to both of the concentrations of E2 resulted in decreased body weight gain, increased LSI, and feminization of the gonads. E2 did, however, not induce any EROD activity.

Real-time t(11;14) and t(14;18) PCR assays provide sensitive and quantitative assessments of minimal residual disease (MRD)

Non-Hodgkin's lymphoma (NHL) arises as a clonal transformation of normal B and T cell differentiation and is often characterized by a higher incidence of specific chromosomal translocations. We have developed real-time TaqMan PCR assays directed toward two of these tumor-associated DNA markers, the t(14;18)(q32;q21.3) at the major breakpoint region of the bcl-2 gene and the t(11;14)(q13;q32) at the bcl-1 major translocation cluster. During analysis of serial dilutions of t(14;18)-positive DNA, the t(14;18) real-time PCR was at least as sensitive as nested PCR and demonstrated enhanced quantitative potential. Moreover, in a blinded comparison of the t(14;18) real-time PCR and a clinically validated nested PCR protocol using 134 cell line and patient DNA samples, the real-time PCR detected the translocation in 30.0% more cases than nested PCR. Both the t(14;18) and t(11;14) real-time PCR assays were used to quantitate minimal residual disease (MRD) in an NHL clinical trial assessing the safety and efficacy of a tumor-purging protocol in autologous stem cell transplantation. The assays were also used to evaluate disease depletion in an ex vivo tumor spiking model in which normal peripheral blood was spiked with tumor cell lines and processed according to the clinical purging method. PCR data from both the clinical trial and the ex vivo model demonstrated a 4 to 6 log reduction in tumor cells during CD34+ and CD34+ Thy-1+ enrichment. Because the t(14;18) and t(11;14) real-time PCR assays are very sensitive, quantitative, rapid, and require no post-PCR manipulation, they may serve as practical alternatives to nested PCR.

Changes in airway dead space in response to methacholine provocation in normal subjects

Measurements of bronchial hyper-responsiveness rely on sensitive techniques for measurement of bronchoconstriction, ideally based on tidal breathing. A potentially useful technique is measurement of airway dead space (VDaw), which reflects the volume of the conducting airways. The aim of this study was to evaluate measurements of VDaw with the single breath test for CO2 (SBT-CO2), compared to spirometric measurements, as a method of measuring bronchial response to methacholine challenge. Nineteen healthy adults were studied. Dosimetric methacholine challenge tests were performed on two study days. Forced expirations or the SBT-CO2 were used to assess the response. There were dose-dependent reductions in the spirometric measurements, with a 10 +/- 10% reduction from the baseline value of forced expiratory volume at the highest dose of methacholine. There was a dose-dependent reduction from the baseline value of VDaw by 19 +/- 9% at the highest dose. There was also a dose-dependent increase in the slope of the alveolar plateau of the SBT-CO2. This study provides support for measurement of VDaw as a means of evaluating bronchial responsiveness after methacholine challenge. In a group of healthy adults, this method shows a greater response but with similar dispersion as measurement of forced expiratory volume after methacholine challenge.

Lenticular opacities in individuals exposed to ionizing radiation in infancy

Development of lens opacities and the measures taken to avoid them have clinical relevance in the fields of oncology, radiotherapy and radiation protection. The aim of this study was to correlate the prevalence of lenticular opacities in individuals exposed to ionizing radiation in childhood with radiation dose and other possible risk factors. Between 1920 and 1959, about 16,500 children (age <18 months) with skin hemangiomas were referred to Radiumhemmet, Karolinska University Hospital, 89% of whom were treated with radiotherapy. A total of 484 exposed individuals and 89 nonexposed controls participated in an ophthalmological examination. Lens opacities were found in 357 (37%) of the 953 lenses examined in the exposed persons. In contrast, lens opacities were observed in only 35 (20%) of the 178 lenses examined in the nonexposed control individuals. It is concluded that the increased prevalence of cortical and posterior subcapsular opacities is related to previous radiotherapy. Age at examination was the strongest modifier of risk. Children exposed to a lenticular dose of 1 Gy had a 50% increased risk (odds ratio 1.50; 95% confidence interval 1.10-2.05) of developing a posterior subcapsular opacity and a 35% increased risk of a cortical opacity (odds ratio 1.35; 95% confidence interval 1. 07- 1.69).

Cardiovascular changes associated with dehydration and drinking in unrestrained, lactating goats

The aim of this study was to investigate if the alertness connected with seeing water increased arterial blood pressure and heart rate to the same extent as the act of drinking, and if ingestion of warm water caused a different effect compared with ingestion of cool water on these cardiovascular variables. Seven goats of the Swedish domestic breed (Capra hircus) were used in a cross-over design. The animals were dehydrated for 24 h. They were allowed to watch water being prepared for 11-16 min, after which they were given access to warm (35 degrees C) or cool (15 degrees C) water. The goats drank 6.86 +/- 0.36 l of the warm water and 4.54 +/- 0.35 l of the cool water (P < 0.05) within the first hour. The arterial blood pressure, heart rate and activity of the animals were registered by an implanted telemetric device. Dehydration did not affect the cardiovascular variables, except before feeding in the morning, when the heart rate accelerated faster in dehydrated goats. Heart rate increased abruptly when dehydrated goats saw water being prepared, remained at the increased level during drinking and then slowly declined. It increased again during the afternoon feeding, to a level similar to that on control days, but between 18.00 and 06.00 h the heart rate was higher than during control nights. Blood pressure did not change when the goats saw water, but increased when they drank. On the morning following rehydration, the rise in heart rate in response to feeding was delayed compared with that during control and dehydration periods. It is concluded that seeing water caused arousal in the goats, resulting in an accelerated heart rate. The additional rise in blood pressure during the act of drinking appears to be a combination of excitement and sensory inputs from the pharyngeal region, causing a temporary activation of the sympathetic nervous system.

Telemetric registration of heart rate and blood pressure in the same unrestrained goats during pregnancy, lactation and the non-pregnant, non-lactating period

The purpose of this study was to investigate how changes in heart rate and arterial blood pressure relate to the time of day, reproductive period and feeding routines in dairy goats (Capra hircus). Registrations were made by radiotelemetry in the same four goats during pregnancy, lactation and the non-pregnant, non-lactating (dry) period. Heart rate rose around the morning and afternoon feedings, whereas blood pressure did not show any diurnal rhythm. Comparison between reproductive periods revealed that heart rate was higher during the fifth month of pregnancy than during lactation and the dry period, whereas for blood pressure no such differences between periods were found. Withholding three meals from lactating goats resulted in a continuous slowdown of the heart rate, whereas blood pressure fluctuated. Re-feeding temporarily increased the heart rate but had no effect on blood pressure which continued to fluctuate. After another 2 days, blood pressure (but not heart rate) had stabilized. Food-restriction, aimed at terminating milk production resulted in a consistently depressed heart rate and reduced the mean and systolic blood pressures at night. The results show that with this implantable telemetry device it is possible to measure both heart rate and blood pressure day and night in the same unrestrained animals over a length of time long enough to include all reproductive periods. Our results emphasize that when planning experiments it is important that the exact stage in each reproductive period, the act of feeding and the amount of food given be taken into account.

Hormonal changes during parturition in heifers and goats are related to the phases and severity of labour

Parturition is a natural event that involves stress and pain for the mother. We thus hypothesized that levels of stress hormones measured during parturition could reflect levels reached in response to severe discomfort and pain of other kinds as well. The aim of this study was therefore to determine whether plasma concentrations of cortisol, adrenaline, noradrenaline, beta-endorphin, met-enkephalin, vasopressin and oxytocin vary depending on the phase and severity of labour in dairy heifers (ten) and dairy goats (six), and how these hormones interact with each other. Blood samples were taken once a day for 3 days before labour and for 3 days afterwards and at predetermined phases during labour. All heifers delivered one calf and five of them needed obstetrical assistance. Two of the goats delivered one kid, and four had twins; all kidded without help. The cortisol concentration peaked when the calf and the first kid were born. In the heifers, plasma adrenaline increased after delivery, while the noradrenaline concentration did not change significantly in heifers that needed assistance, but increased during expulsion in heifers calving without help. In the goats, adrenaline and noradrenaline concentrations increased in association with expulsion of the first kid. The beta-endorphin concentration increased during labour in goats. In heifers that needed assistance, beta-endorphin concentration increased 1 h after labour but there was no change in heifers that did not need assistance. The met-enkephalin concentration was elevated during expulsion in heifers and fluctuated in the goats. Both oxytocin and vasopressin increased during expulsion in both groups of heifers, but vasopressin increased four times more in heifers needing assistance. In the goats, oxytocin reached its highest levels just as the feet of the first kid became visible, and vasopressin peaked as the head emerged. Parturition took longer in heifers that needed assistance than in those that did not. It is concluded that, even though the pattern of change differed between hormones during labour, the changes were related to the phases of labour. A longer labour therefore meant that the hormone concentrations stayed elevated for longer. Vasopressin reached high levels in goats and was the only hormone for which plasma concentrations were higher in heifers that needed assistance than in those that did not, indicating that this hormone is released in order to deal with the pain-related stress associated with labour.

Improved quantitation of minimal residual disease in multiple myeloma using real-time polymerase chain reaction and plasmid-DNA complementarity determining region III standards

The complementarity determining region III of the rearranged immunoglobulin heavy chain gene has been the target for tumor-specific PCR assays for the detection and follow-up of B-cell malignancies. Previously, these assays have relied on gel-based end point data collection methods (i.e., band densitometry) and, thus, have provided at best a semiquantitative assessment of tumor levels. We show the development of a novel, real-time TaqMan PCR assay to quantitate residual multiple myeloma cells in clinical samples after high-dose chemotherapy and autologous stem cell transplantation. We provide evidence that real-time PCR is reproducible, sensitive, and quantitative. In a 40-replicate PCR experiment targeting the beta-actin gene, the coefficient of variation for threshold cycle data was 1.6%, whereas it increased to 13.6% and 31%, respectively, for end point fluorescence and gel densitometry. Moreover, in an experiment directly comparing standard curves obtained from band densitometry and threshold cycle data, the standard curve constructed from threshold cycle data had a multiple R2 value of 1.00 and demonstrated a dynamic range >4 logs, compared with the 2-log linear range of gel densitometry. Finally, we show that when a complementarity determining region III-specific PCR primer is used in conjunction with a consensus primer for the immunoglobulin heavy chain joining gene, plasmid DNA can be used as a readily available and effective substitute for clonal plasma-cell genomic DNA when preparing standards. By applying real-time PCR to the analysis of clinical samples, we are able to quantitate levels of tumor involvement with unparalleled reproducibility and statistical confidence. Real-time PCR technology may well provide the accuracy and reliability necessary for minimal residual disease detection to have real prognostic significance.

Diagnosis of pulmonary embolism by measurement of alveolar dead space

OBJECTIVE

Pulmonary embolism (PE) gives rise to alveolar dead space, which can be measured with a single breath test for CO2 (SBT-CO2). The characteristics of the SBT-CO2 are different in PE and other common conditions giving rise to alveolar dead space, notably airways disease. An analysis of alveolar dead space focusing on the late part of the breath (fDlate) has been suggested as a method for diagnosis of PE. Our aim was to evaluate this technique by comparison with lung scintigraphy.

METHODS

We randomly selected patients with clinical suspicion of PE. SBT-CO2 and lung scintigraphy were performed on the same day. The scintigraphies were reviewed and classified as high, intermediate and low probability of PE.

RESULTS

Out of 223 patients able to be evaluated, there were 20 of the high, 29 of the intermediate and 174 of the low probability category. There were large differences between the means of fDlate in the high and the intermediate and in the high and the low categories. We obtained a sensitivity of 85% and a specificity of 93% for diagnosis of PE, based on high and low probability categories. If a patient with previous PE, but no scintigraphic evidence of current PE, is excluded the sensitivity increases to 90%.

CONCLUSIONS

This study provides further support for the measurement of fDlate by the SBT-CO2 as a diagnostic test in patients with suspicion of PE. The test should be especially useful in small hospitals without access to pulmonary scintigraphy or pulmonary angiography.

Psychophysiologic sensitization to headlight glare among professional drivers with and without cardiovascular disease

Previous studies have shown that young, healthy professional drivers show heightened central nervous system arousal and cardiovascular hyperreactivity to simulated headlight glare. Electroencephalographic and cardiovascular response and recovery to simulated headlight glare (the glare pressor test) were examined in 4 groups of male professional drivers (age 25-52 years)--12 with ischemic heart disease (IHD), 12 with hypertension (HTN), 10 with borderline hypertension (BHTN), and 34 who were healthy--and in 23 non-professional driver controls--with the aim of assessing sensitization to this night driving stressor in relation to degree of cardiovascular disease severity. After glare exposure the IHD drivers showed the most pronounced alpha blockade, a rise in diastolic blood pressure (DBP; p < .05), and, unlike the other groups, a persistent fall in finger pulse volume (p < .02). The BHTN group reacted initially with DBP rise and finger pulse drop (ps < .05 and .02, respectively), mainly without central nervous system arousal. The DBP remained constant in normotensive professional drivers older than 40. The drivers' cardiovascular responses to glare were inversely related to reported stressors and subjective experience. Anxiety trait and long work hours were associated with heightened central arousal to glare in professional drivers. The results suggest that there may be progressive degrees of sensitization to glare exposure in these samples, with the least among normotensive professional drivers older than 40, moderate levels in borderline hypertensives, and the most severe in drivers with IHD.