Importance of valine at position 152 for the substrate transport and 2beta-carbomethoxy-3beta-(4-fluorophenyl)tropane binding of dopamine transporter

Human and bovine dopamine transporters (DAT) demonstrate discrete functional differences in dopamine (DA), 1-methyl-4-phenylpyridium (MPP(+)) transport, and cocaine analog binding. In a previous study, the functional analyses on the chimeras of human and bovine DAT have revealed that the region from residues 133 through 186 (encompassing the third transmembrane domain) is responsible for the substrate transport and cocaine analog binding. The present study has been carried out to determine the specific amino acid(s) conferring DAT functions by interchanging the amino acid residues in the corresponding region between human and bovine DAT. As described previously, the DA, MPP(+) transport, and 2beta-carbomethoxy-3beta-(4-fluorophenyl)tropane (CFT) binding almost disappeared in chimera hb3 in which the region from residues 133 through 186 of bovine DAT was substituted into human DAT. Replacement of isoleucine, residue 152 of chimera hb3 (bovine DAT sequence), with valine, the human DAT residue at the identical position, remarkably restored the substrate transport and CFT binding to 76% to 98% of the human DAT values. Similarly, substitution of isoleucine for valine at position 152 in the human DAT reduced the substrate transport and CFT binding by 57% to 97%. Among other amino acids tested at position 152 of the chimera hb3, only alanine resulted in small but significant increases in the DAT functions ranging from 16 to 34%. Thus, valine at position 152 plays a crucial role for molecular mechanisms underlying the interactions of DA, MPP(+), and CFT with human DAT.

Improved detection of individual nodal involvement in squamous cell carcinoma of the esophagus by FDG PET

Because both the number and location of metastatic lymph nodes and the N stage influence survival in esophageal cancer, accurate noninvasive evaluation of individual lymph node groups for the presence of metastasis is essential for therapeutic planning. Therefore, we investigated the accuracy of FDG PET for evaluating individual lymph groups in esophageal cancer patients and compared the results with those of CT and endoscopic sonography (ES).

METHODS

Sixty-one consecutive patients with histologically proven primary esophageal carcinoma were studied prospectively with FDG PET. Thirteen patients who were treated nonsurgically were excluded from data analysis. The remaining 48 patients underwent esophagectomy and lymph node dissection. All 48 patients underwent CT scanning, including the lower neck, thorax, and upper abdomen, with intravenous administration of contrast medium. ES was performed in 45 of the patients but was incomplete in 12 patients because of esophageal stenosis. The accuracies of FDG PET, CT, and ES were compared with histologic findings.

RESULTS

During surgery, a total of 382 lymph node groups were dissected in 48 patients, of which 100 node groups in 32 patients were malignant on histologic examination. For assessing metastasis to individual groups, FDG PET showed 57% sensitivity, 97% specificity, and 86% accuracy, whereas CT showed 18% sensitivity (P < 0.0001), 99% specificity (P = 0.033), and 78% accuracy (P = 0.003). For N staging, FDG PET was correct in 83% (40/48) of the patients, whereas CT and ES were correct in 60% (29/48; P = 0.006) and 58% (26/45; P = 0.003), respectively.

CONCLUSION

FDG PET is more accurate than is CT or ES for evaluating metastasis to individual lymph node groups and for N staging in esophageal cancer and thus may be helpful in determining the therapeutic plan.

Sustained formation of focal adhesions with paxillin in morphological differentiation of PC12 cells

Differentiation of PC12 cells triggered by nerve growth factor (NGF) is characterized by several well-defined events including induction of a set of neuron-specific genes, gain of membrane excitability, and morphological changes such as neurite outgrowth. Here we report that K252a, a protein kinase inhibitor, converts the proliferation signal of epidermal growth factor (EGF) into the morphological differentiation signal without inducing the sustained activation of ERK and the expression of neurofilament. Major effects of EGF/K252a, found also in the NGF-treated cells, are the sustained mobility shift of paxillin in SDS-PAGE and the promoted association of Crk-II with paxillin. These effects explain the prominent and robust development of peripheral focal adhesion assembly and stress fiber-like structures observed in the early stages of PC12 cell differentiation. These results suggest a model that cytoskeletal reorganization via focal adhesion assembly triggered by NGF provides a signal required for the morphological differentiation of PC12 cells.

Antitumor agents. Part 202: novel 2'-amino chalcones: design, synthesis and biological evaluation

New 4',5',2,3,4-substituted 2'-amino chalcones were synthesized and evaluated for cytotoxicity against a panel of human tumor cell lines. Several compounds displayed significant cytotoxicity. The most promising lead molecule (10) also had high activity toward multi-drug resistant KB-VIN, and ovarian 1A9 cell lines. 2'-Amino chalcones demonstrated significantly increased antitumor activity compared with the corresponding chalcones, while, the epoxide derivatives generally showed greatly reduced activity.

Distribution of heat shock protein 108 mRNA in the chicken central nervous system

The constitutive expression of heat shock protein 108 (HSP108) mRNA is mapped in a normal chicken central nervous system using in situ hybridization technique. HSP108 mRNAs were found to be mainly localized in the small neuroglial cells of various regions of the brain, although some neuronal cells also showed positive signals. This tendency is observed to be more marked in the cerebellum; HSP108 signals were not found in the Purkinje cells, but in Bergmann glial cells and oligodendrocytes. Although neuronal cells in the deep cerebellar nuclei and the molecular layer showed occasional HSP108 signals, the expression pattern of HSP108 mRNA is different from homologous HSP90 that is mostly expressed in neurons, but rather similar to that of TfBP immunoreactivity, a new member of the HSP108 family. The constitutive neuroglial localization of HSP108 could suggest that HSP108 may play an important role in the normal metabolism of neuroglial cells in the chicken brain.

Clinical assessment after varicocelectomy

The present study, conducted in Hong Kong, was designed to evaluate the clinical assessment and interobserver variation between doctors with different levels of training in the assessment of recurrent varicoceles, and to compare their findings with those made by ultrasound. Fifteen patients, previously operated for left varicocele testis, were evaluated clinically by four observers. The mean age was 12.9 years (range 8-15 years) at surgery. The testicular texture, size and flow with and without the Valsalva manoeuvre were determined by colour Doppler sonography. The follow-up time was 6-48 months after surgery. The echotexture of the testes was normal in all patients. The mean volumes of the left and right testes were equal after surgery (left 9.0 ml [range 2.4-15.2 ml and right 8.7 ml [range 3.4-15.6 ml]). There was large variation between observers in the predictability of both positive and negative clinical findings of varicocele testis when compared with ultrasound. Objective assessment in grading varicocele testis and testicular volume using ultrasound is required for both clinical management and scientific research.

Genomic analysis

Advances in genomic analysis include improved technology for DNA sequencing, routine use of DNA microarray technology for the analysis of gene expression profiles at the mRNA level and improved informatic tools to organize and analyze such data. At the same time, new developments in chip-based analysis of samples and the emergence of models of gene networks hold promise for the future of the 'Genomic Era'.

Enzyme-linked immunosorbent assay for detection of chitooligosaccharides

In order to detect chitooligosaccharides (COS), an enzyme-linked immunosorbent assay (ELISA) was developed. A chitooligosaccharide mixture (COSM) conjugated to bovine serum albumin was used to immunize rabbits to produce an anti-COS polyclonal antibody. By use of specific antibody and COSM-horseradish peroxidase conjugate, we established a competitive direct ELISA (cdELISA) the detection limit of which was about 0.1 microg/ml. In the cdELISA, the cross-reactivities of the specific antibody toward glucosamine, chitobiose, chitotriose, chitotetraose, chitopentaose, and chitohexaose were 0.27, 27, 75, 75, 144, and 100%, respectively, and those toward N-acetylchitobiose, N-acetylchitotriose, N-acetylchitotetraose, N-acetylchitopentaose, and N-acetylchitohexaose were 1.58, 0.005, 1.08, 0.05, and 0.40%, respectively.

Aspiration subsequent to a pure medullary infarction: lesion sites, clinical variables, and outcome

BACKGROUND

Aspiration as a symptom of dysphagia and its apparent sequela, aspiration pneumonia, are common consequences of a stroke in the medulla. Previous reports that focused on dysphagia due to a medullary lesion were studies of single cases or a relatively small number of patients with multiple lesion loci. Moreover, the interval between the onset of stroke and the evaluation time of swallowing was not controlled and varied largely among patients. Thus, prediction of the swallowing status of patients with a medullary lesion has not been tenable.

OBJECTIVES

To investigate the relation between the loci of pure medullary lesions and aspiration, to examine swallowing function over time, and to explore clinical variables that can predict aspiration.

METHODS

We investigated 23 patients with pure medullary infarctions using the videofluoroscopic swallowing study and compared the airway status findings with the lesion location as determined with magnetic resonance imaging. The patients were classified by 6 medullary lesion-level categories (lower, lower-middle, middle, lower-middle-upper, middle-upper, and upper) and by 5 intralevel lesion loci (inferior-dorsal, large inferior-dorsolateral, para-median, midlateral, and dorsolateral). From the results of the videofluoroscopic swallowing studies, 2 patient groups were formed: one with aspiration and the other without aspiration. The clinical variables related to aspiration and outcome measures were also explored.

RESULTS

Ten (44%) of the 23 patients manifested aspiration on swallowing: 9 (69%) of 13 with only middle-level lesions or lesions in multilevels, including the middle level; 1 (33%) of 3 with only upper-level lesions; and 0 (0%) of 7 with only lower-level medullary lesions. A lesion running the length of the middle and the lower medullary levels always resulted in aspiration. When an upper-level lesion was additionally involved, the incidence of aspiration depended on the horizontal extension of the lesion. We were able to discriminate the 2 patient groups with 95.7% accuracy using such variables as dysphonia, soft palate dysfunction, and facial hypesthesia. Most of the patients with aspiration symptoms due to a pure medullary infarction recovered rather quickly.

CONCLUSIONS

Medullary infarctions often cause aspiration, but the occurrence may depend on the levels along the neuraxis and intralevel lesion loci. When different lesion levels and loci and their related clinical findings are considered as possible variables, aspiration becomes predictable. The outcome data prove that systematic control of evaluation time of swallowing was critical as we engaged in this study, since many aspirators with pure medullary infarctions resolve their swallowing difficulties rather quickly.

Proteomic analysis

The field of proteomics is becoming increasingly important as genome sequences are being completed and annotated. Recent advances in proteomics include experimental and mathematical proofs of the need to complement microarray analysis with protein analysis, improved sensitivity for mass spectrometric analysis of separated proteins, better informatic tools for gel analysis and protein spot annotation, first steps towards automated experimental procedures, and new technology for quantitation of protein changes.

Design and synthesis of novel antimicrobial pseudopeptides with selective membrane-perturbation activity

By incorporating carbamate bond(s) into a cytolytic peptide, novel pseudopeptides with potent antibacterial activity and low hemolytic activity were synthesized. Circular dichroism spectra suggested that the incorporation of carbamate bond(s) decrease the alpha helical conformation of the peptide in lipid membrane circumstances, which must be regarded as a major factor for the separation of antibacterial activity from cytotoxic activity for mammalian cell. Experiments in which dye was released from vesicles indicated that the potent antibacterial activity and low hemolytic activity of the pseudopeptides must be due to their great lipid membrane selectivity. The present result suggest that backbone modifications can be a great tool for developing pseudopeptides with improved biological activity and bioavailability from cytolytic peptides.

Genotoxicity of drinking water from three Korean cities

Organic content of drinking tap water from Seoul, Taejon, and Suwon was extracted with an XAD-2 resin column and organic solvents. Four doses of the extract equivalent to 4, 2, 1, and 0.5 l water were tested for mutagenicity in Salmonella typhimurium strains TA98 and TA100 in the presence and absence of S9 mix. The organic extracts of the water from all three cities were mutagenic in TA 98 without S9 mix and in TA 100 with and without S9 mix. The highest number of revertants per plate was found in the absence of S9 mix. Three doses of the extract (equivalent to 22, 11, and 3.7 l water) were also tested in the bone marrow micronucleus test using BDF1 mice. At the highest dose, a significant increase of the micronucleus frequency was observed. The time required to be on the effect, however, varied with the source of the water. Our results indicate that the drinking tap waters from the three cities were genotoxic clearly in the bacterial test and also in the in vivo assay with mice. As we found no genotoxicity of the source water as seen in a previous study, it is likely that the chlorination process leads to the genotoxicity of the tap water.

Dimer to monomer phase transition in alkali-metal fullerides: magnetic susceptibility changes

Ab initio calculations have been employed to investigate the peculiar change in magnetic property (from diamagnetic to paramagnetic) of the dianionic C60-dimer phase in a rapidly cooled AC60 samples ( A: alkali metal). We first note that the triplet state of (C60)-22 which was never considered previously is nearly degenerate with the singlet state, and the transition barrier between the two states is reasonably small. This explains the susceptibility increase with an increase in temperature and the magnetic phase transition in the process of the dimer to monomer phase transition.

A comparison of three commercially available isoelectric focusing units for proteome analysis: the multiphor, the IPGphor and the protean IEF cell

We tested and compared three different commercially available instruments for isoelectric focusing for proteome analysis by two-dimensional protein electrophoresis. These instruments, the Multiphor, the IPGphor, and the Protean IEF cell, were used with 18 cm immobilized pH gradient strips and run under various conditions. The total number of spots and features was obtained by Melanie software (Bio-Rad Laboratories) and separately by visual inspection. The Multiphor consistently resulted in the highest number of spots detected per gel independent of sample type, immobilized pH gradient (IPG) and method to calculate the number of spots. The Protean IEF cell had the next highest number of spots detected per gel. In the experiments performed, the IPGphor afforded good reproducibility in the total number of Melanie-detected spots from gel to gel while the Protean IEF cell offered better reproducibility in the total number of manually detected spots from gel to gel. Among gels run with the different instruments, differences in the quality of the ammoniacal silver stain were also observed. A measure of quantitative reproducibility suggests that the Protean IEF cell, which was the easiest instrument to use, performs better than the other instruments, although all three instruments had demonstrated good quantitative reproducibility in the experiments performed.

Unique biochemical, cytotoxic, and antitumor activity of camptothecin and 4beta-amino-4'-O-demethylepipodophyllotoxin conjugates

Two compounds having a camptothecin (CPT) analog conjugated to the 4beta-amino-4'-O-demethylepipodophyllotoxin analog were evaluated for their biochemical and biological activities. W1[camptothecin-(para)-4beta-amino-4'-O-demethylepipodophyllotoxin] had no activity against topoisomerase II (TOP II), but inhibited topoisomerase I (TOP I) with an IC(50) value 2-fold higher than CPT. W2 [camptothecin-(ortho)-4beta-amino-4'-O-demethylepipodophyllotoxin] had inhibitory activity against TOP I and TOP II with IC(50) values 1.5-fold higher than either CPT or etoposide (VP-16). Both conjugates had similar cytotoxicity against the KB cell line, although the protein-linked DNA breaks (PLDBs) generated by W2 in KB cells were about 4-fold more than those of W1. No cross-resistance with the two conjugates was seen in a VP-16-resistant KB subline, which showed down-regulation of TOP II and overexpression of the multiple drug resistance-associated protein, or in a vincristine-resistant KB subline with overexpression of gp-170/mdr-1. The CPT-resistant KB variant (KB CPT 100), which has a reduction in TOP I content and another mechanism that occurs post-PLDB formation, was partially resistant to both compounds. W1 was not affected by this post-PLDB resistance mechanism. Cell cycle analysis demonstrated that W1 and W1 had similar cell cycle effects on KB and KB CPT 100 cells, which accumulated in S-phase upon drug treatment. These results suggested that W1 and W2 exerted their cytotoxicity through TOP I. In CPT-resistant cells, however, an unidentified target also may be involved in the cytotoxic action of W1 and TOP II may still be a target for W1. In vivo, W1 was more effective against the growth of human prostate cancer cells in nude mice than VP-16, CPT, or W2. Given its antitumor activity and unique biochemical mechanism of action, W1 warrants exploration as an antitumor compound.

Sesquiterpene alkaloids from Tripterygium hypoglaucum and Tripterygium wilfordii: a new class of potent anti-HIV agents

Five new sesquiterpene pyridine alkaloids [triptonines A (1) and B (2), and wilfordinines A (3), B (4), and C (5)] and two known compounds (peritassine A and hypoglaunine C) were isolated from Tripterygium hypoglaucum and a clinically used extract of Tripterygium wilfordii. The structures of 1-5 were elucidated by spectroscopic methods. The anti-HIV activity of 1, 2, and several related compounds was evaluated. Triptonine B (2) demonstrated potent anti-HIV activity with an EC(50) value of <0.10 microg/mL and an in vitro therapeutic index value of >1000.

Cofilin: a missing link between T cell co-stimulation and rearrangement of the actin cytoskeleton

The actin cytoskeletal network plays a regulatory role in receptor-mediated signal-transducing events. Recently, we have shown that the small actin-depolymerizing protein cofilin represents a component of a co-stimulatory signaling pathway in human T cells. Cofilin is dephosphorylated on phosphoserine residues following co-stimulation via accessory receptors such as CD2, CD4, CD8 or CD28, but not in response to TCR engagement alone. Here we demonstrate that accessory receptor triggering induces the transient association of cofilin with the actin cytoskeleton. Only the dephosphorylated form of cofilin binds to cytoskeletal actin in vivo. The phosphatidylinositol 3-kinase inhibitors wortmannin and LY294002 block dephosphorylation of cofilin and its association with the actin cytoskeleton. These results suggest that cofilin provides an as yet missing link between functionally crucial T cell surface receptors and rearrangements of the actin cytoskeleton.

The use of laparoscopy in the management of adnexal pathologies in children

BACKGROUND

The authors' experience of using laparoscopy in the management of 23 girls (mean age: 8.9 years; range: 3 months-15 years) with various adnexal pathologies over a 3-year period is reviewed.

METHODS

Of the 23 patients, seven were evaluated for congenital gonadal pathologies, 15 presented with abdominal pain and one patient had an antenatally diagnosed adnexal mass. Detailed laparoscopic examination of the pelvic cavity and laparoscopic gonadectomy were successfully performed in all seven patients with congenital gonadal pathologies: mosaic Turner's syndrome (n = 2), gonadal dysgenesis (n = 3) and testicular feminization syndrome (n = 2). Of 15 patients presenting with abdominal pain, 11 had an adnexal mass, two had acute appendicitis and two had pelvic inflammatory disease.

RESULTS

Laparoscopic excision of the adnexal masses were successfully performed in 10 of 11 patients. Conversion to open surgery was required in one patient with a huge teratoma. Laparoscopic appendicectomy was successfully performed in both patients with acute appendicitis while diagnostic laparoscopy was the only procedure required in the two patients with pelvic inflammatory disease. Laparoscopy in the infant with an antenatally diagnosed adnexal mass confirmed this to be an omental cyst, which was successfully excised. All patients recovered without complications and good cosmetic result was universally achieved.

CONCLUSION

Laparoscopy is safe and effective in both diagnosis and treatment of adnexal pathologies in children.

Nodular hepatocellular carcinoma: variation of tumor conspicuity on single-level dynamic scan and optimization of fixed delay times for two-phase helical CT

PURPOSE

The purpose of this work was to determine the optimal delay times in two-phase helical CT for nodular hepatocellular carcinoma (HCC).

METHOD

Twenty-four patients with nodular HCC (size 2.1-6.7 cm, mean 4.2 cm) were divided into three groups to undergo single-level dynamic CT with 150 ml of contrast material (iodine load of 45 g) at a rate of 3 ml/s. CT acquisition started 10, 30, or 60 s after the injection for each group, respectively, and lasted for 110 or 120 s. The optimal 20 s windows that allowed a tumor-to-liver contrast of >10 HU were determined in the pooled tumor-to-liver contrast curve.

RESULTS

The determined temporal windows were 36-56 and 130-150 s, respectively. However, each window was not appropriate in seven (33%) and five (36%) patients because of the individual variations of the contrast curve.

CONCLUSION

There is no optimal fixed delay time that is appropriate in all individual patients. The best delay times are 36 and at least 130 s with our injection protocol.

Pilomatricoma in the head and neck: CT findings in three patients

We report three cases of pilomatricoma, one in the infrahyoid neck and the others in the preauricular area. In all cases, CT showed well marginated soft tissue masses that were located mainly in the subcutaneous fat, partly attaching to the overlying skin. There was no evidence of infiltration to deeper structures. Substantial amounts of calcification were found in one tumor. Pilomatricoma should be included in diagnostic consideration when CT shows a well marginated subcutaneous soft tissue mass adherent to the skin with or without visible calcification in the head and neck region.

Coumarins and bicoumarin from Ferula sumbul: anti-HIV activity and inhibition of cytokine release

The methanol extract of the dried roots of Ferula sumbul afforded two furanocoumarin esters, fesumtuorin A, B, one bicoumarin, fesumtuorin C, five spirobicoumarins, fesumtuorin D, E, F, G and H, along with nineteen known coumarins. Their structures were established on the basis of spectroscopic studies. Some of the isolated compounds showed anti-HIV activity and very weak inhibition of cytokine release.

Purinoceptor-mediated calcium mobilization and cellular proliferation in cultured bovine corneal endothelial cells

In the present study, we investigated the effect of adenosine triphosphate (ATP) on cytosolic free calcium mobilization and mitogenic activity in cultured bovine corneal endothelial cells (BCEC). The [Ca2+]i was determined using a Ca2+ sensitive indicator, Fura-2/AM, and cell proliferation was evaluated by counting the cell number. ATP, its metabolites and analogs caused transient increase in [Ca2+]i in a concentration-dependent manner (10(-7) M-10(-3) M) and the potency of agonists was ordered as follows: 2-methylthio-ATP > uridine triphosphate > ATP > adenosine diphosphate. Adenosine monophosphate and adenosine did not affect [Ca2+]i. ATP (10(-4) M) also promoted the accumulation of inositol trisphosphate (IP3). The ATP-induced transient [Ca2+]i increase and IP3 accumulation were attenuated by pretreatment with a phospholipase C inhibitor, U-73122 (5 microM), for 30 min. ATP (10(-5) M) significantly enhanced the proliferation of BCEC. ATP-induced [Ca2+]i increase and cell proliferation were inhibited by a purinoceptor antagonist, suramin (10(-4) M). Thus, the present study indicates that BCEC contain P2 purinoceptors that regulate their proliferation.

Age estimation by occlusal tooth wear

The purpose of the present investigation was to test the accuracy of a new scoring system in recording tooth wear for age estimation. The material consisted of dental stone casts of 383 volunteers who had sound premolars and molars with normal occlusion. The degree of occlusal wear for all premolar and molar teeth was scored with the new system. The high intra- and inter-examiner concordances showed that the new score system was very reliable. The degree of tooth wear showed a significant positive correlation with age in each and every examined tooth of both males and females. Tooth wear scores of males were higher than those of females. Calculating tables for age estimation were designed and the accuracy of age estimation was obtained with the General Linear Models procedures. Our system could provide estimation of an individual's age within +/-3 years in 42.4% of males and 49.4% of females, within +/-5 years in 61.8% of males and 63.3% of females. When the subjects were divided into two age groups and data were re-treated, the accuracy of age estimation was increased. Collectively, it was shown that our new system for scoring tooth wear is a reliable and accurate method for age estimation.

The effect of intratracheal pulmonary ventilation on the decrease of dead space in rabbits with acute respiratory failure

OBJECTIVE

A technique that improves the efficiency of alveolar ventilation should decrease the pressure required and reduce the potential for lung injury during mechanical ventilation. High partial pressure of carbon dioxide (PaCO2) can be tolerated if associated with a lower airway pressure as in permissive hypercapnia (PH). Intratracheal pulmonary ventilation (ITPV) was developed to allow a decrease in physiological dead space during mechanical ventilation. We compared the effect of hybrid ventilation (HV) as a modification of ITPV with PH on the decrease of tidal volume and airway pressures in rabbits with acute respiratory failure.

METHODOLOGY

Tracheostomy was performed in seven rabbits ventilated under volume-controlled mode in the supine position. Arterial blood gas analysis, airway pressures, and dead space ventilation were measured at respiratory rates of 20/min as control values. Oleic acid (OA) of 0.06 mL/kg was injected to induce acute respiratory failure. Tidal volume (V(T)) was elevated to maintain PaCO2 in the normal range. These same parameters were measured as OA values. Then V(T) was reduced to the control level to allow PH. Hybrid ventilation was initiated by inserting a reverse thrust catheter (RTC) into the endotracheal tube. Hybrid ventilation consists of a pressure-controlled mode of mechanical ventilation and ITPV while flushing fresh gas continuously via the RTC. Respiratory parameters were compared under control, OA, PH and HV conditions.

RESULTS

Oleic acid injection decreased partial pressure of oxygen (PaCO2) from 401+/-35 mmHg to 129+/-39 mmHg, increased V(T) from 42+/-5 mL to 52+/-10 mL, and increased dead space (V(D))/V(T) ratio from 0.65+/-0.07 to 0.71+/-0.07. During PH, the increase in PaCO2 was accompanied by an increase in V(D)/V(T) ratio from 0.71+/-0.07 to 0.79+/-0.03 and by a decrease of peak inspiratory pressure (PIP) from 19.4+/-4.0 cmH2O to 16.8+/-3.1 cmH2O. PaCO2 was lowered from 50+/-5 mmHg in PH to 39+/-5 mmHg in HV with a lower V(T). V(D)/V(T) ratio in HV which was as low as that in control.

CONCLUSIONS

Hybrid ventilation is an effective and easy-to-use ventilatory modality to reduce PaCO2 and airway pressures by the reduction in V(D)/V(T) ratio in acute respiratory failure model.

The relationship between the angiographic findings and the clinical features of carotid artery plaque

The purpose of this study was to investigate the histological characteristics of atheromatous carotid plaque, and to analyze the relationship between the angiographic findings and the clinical features. We retrospectively reviewed 55 cases of carotid endarterectomy for extracranial internal carotid artery stenosis, who were treated at our institute from January 1995 to December 1997. The histological examination included hematoxylin-eosin staining, Masson-trichrome staining, and immunostaining for antismooth muscle antibody and anti-CD68 antibody. The main compositions of the carotid plaque included synthetic type vascular smooth muscle cells and extracellular matrix. The histological findings showed ulceration in 49 (89.1%) cases, calcium deposits in 42 (76.4%) cases, and an inflammatory reaction in 44 (80.0%) cases. Neurological abnormalities were strongly associated with plaque ulceration (P = 0.045) and an inflammatory reaction (P = 0.013), whereas no correlation existed regarding calcium deposits (P = 0.173). The angiographic findings showed ulceration in 46 (83.6%) cases. Plaque ulceration in the angiography findings showed no statistically significant correlation with the histologic findings (P = 0.410) and preoperative neurologic abnormalities (P = 0.059). All of the atherosclerotic risk factors such as hypertension, smoking, diabetes mellitus, hyperlipidemia, and myocardial infarction had no statistically significant correlation with the histological features of the carotid plaque. In conclusion, the main compositions of carotid plaque were synthetic-type vascular smooth muscle cells and extracellular matrix. The histological ulceration and inflammatory reaction of the plaque showed a statistically significant correlation with the preoperative neurologic symptoms, whereas no correlation was seen in the calcium deposits. Angiographic ulceration showed no correlation with the histological findings or preoperative neurologic abnormalities. In addition, the histological findings showed no correlation with the atherosclerotic risk factors.