47 EFFECT OF THE TYPE OF CYTOPLASTS, SOURCE OF KARYOPLASTS, AND ACTIVATION PROCESS ON IN VITRO DEVELOPMENT OF BOVINE CLONE EMBRYOS

As the recipient cytoplast plays a key role in nuclear reprogramming after somatic cell nuclear transfer (SCNT), the aim of this study was to compare the type of cytoplast/karyoplast [metaphase II (MII) oocyte, early zygote, somatic cells] and the chemical (CA) or sperm-mediated/spontaneous activation (SA) on in vitro development of bovine SCNT embryos produced by handmade cloning (HMC). After 17 h of in vitro maturation, a group of cumulus–oocyte complexes (COCs, n = 945) was manually bisected following zona removal and segregated as enucleated (MII hemi-Cyt) or non-enucleated (MII hemi-Kar). Another group of COCs was in vitro-fertilized, and, 4 h after the onset of IVF, zona-free zygotes with 2 polar bodies (n = 490) were manually bisected under fluorescent light to obtain IVF hemi-Cyt and IVF hemi-Kar. A somatic cell (SC) culture from an adult cow was used for HMC procedures (SC Kar). In 5 replications, experimental groups were composed of: zona-intact MII oocytes (parthenote control, PG); zona-intact zygotes (IVF control); MII Cyt + MII Cyt + SC Kar (SCNT control); IVF Cyt + MII Cyt + SC Kar (G1); MII Cyt + IVF Kar (G2); IVF Cyt + IVF Kar (G3); IVF Cyt + IVF Cyt + SC Kar (G4); and MII Cyt + MII Kar (G5). Following reconstruction and electrofusion, groups G1 to G5 were further divided into 2 sub-groups each, 1 being chemically activated (ionomycin/6-DMAP) along with the control groups PG and SCNT, whereas the others were cultured to verify sperm-mediated (G1 to G4) or spontaneous (G5) activation. Embryos were in vitro-cultured in the WOW system for 7 days. Cleavage (Day 2) and blastocyst (Day 7) rates were compared by the chi-square and Fisher tests, respectively. Cleavage rates in G1-SA, G2-SA, and G3-SA were lower than in their CA counterparts, which were similar to controls (Table 1). Such decrease in cleavage in G1-SA and G2-SA may be caused by the manipulation process rather than by sperm-mediation, since the observed rates were very similar to the G5-SA group. Cleavage in G3 and G4 were also similar to controls, most likely due to the fusion of 2 sperm-activated IVF hemi-Cyt. Blastocyst rates were generally higher in CA than in SA sub-groups except for G4, for which SA benefited from 2 sperm-activated cytoplasts. The lower blastocyst yield in SA sub-groups may reflect at least 2 possible mechanisms: an increased level of heteroplasmy (G1 and G2), potentially caused by an insufficient sperm-activated IVF hemi-Cyt or by a blocking effect imposed by the M-phase-derived hemi-Cyt, and/or a disruption in karyokinetic events caused by the manipulation in sperm-activated IVF hemi-Kar (G2 and G3). In G4, both mechanisms were probably attenuated by the use of 2 sperm-activated IVF hemi-Cyt and a SC-kar, analogous to conditions in the SCNT and G5 groups. Table 1.Effect of cytoplast type and activation process on in vitro development of bovine SCNT embryos This study was supported by a grant from CAPES/Brazil.

69 A HOMEMADE N2 SUPERCOOLING DEVICE (NITROCOOLER) ENHANCES VIABILITY AFTER VITRIFICATION OF BOVINE OOCYTES BUT NOT OF IN VITRO-PRODUCED EMBRYOS

Increasing the cooling rate is a common strategy to enhance vitrification efficiency of bovine oocytes and in vitro-produced (IVP) embryos. Under vacuum conditions, liquid N2 (LN2) temperature decreases, increasing the cooling rate during the vitrification procedure. However, commercially available brands of equipment to supercool nitrogen are expensive. The aim of this study was to verify the effectiveness of a low-cost homemade nitrogen supercooling apparatus (Nitrocooler) for vitrification of bovine oocytes and IVP embryos. The device consists of a vacuum pump coupled to a close-tight-lidded flask with a styrofoam cup filled with 300 mL of LN2. After 5 to 7 min of vacuum pumping, LN2 goes through the slushing phenomenon, turning solid. After the lid is opened, the N2 turns liquid again, but in a stable, supercooled physical state lasting for approximately 10 min, boiling off when objects are plunged into it. Nitrocooler was tested for vitrified oocytes (Experiment I), vitrified oocytes in different containers (Experiment II), and embryos in 2 different vitrification solutions (Experiment III). In Experiment I (Ciência Rural, 2006 36, 1501–1506), immature (IM, n = 172) or in vitro-matured (IVM, n = 174) oocytes were exposed to 10% ethylene glycol (EG) + 10% DMSO for 30 s, followed by 20% EG + 20% DMSO + 0.5 m sucrose for 20 s, loaded in open-pulled straws (OPS), and plunged into LN2 or Nitrocooler-pumped LN2. For both IM (8.8%) and IVM (10.6%) oocytes, Nitrocooler-pumped LN2 increased blastocyst rates (Bonferroni, P < 0.05). In Experiment II, 1454 oocytes were vitrified using Nitrocooler after loading in different containers: stainless steel straws (SSS), beveled-tip straws (BTS), open-OPS, and glass-pulled straws (GPS). Greater blastocyst rates were obtained in the SSS (10.2%) and the GPS (8.0%) treatments, both being greater than the BTS (6.1%) and OPS (6.1%) containers (Tukey, P < 0.05). In Experiment III (Acta Sci. Vet. 2006 34, 77–82), 195 IVP bovine blastocysts were vitrified with or without Nitrocooler under 2 different cryoprotectant solutions: 10% EG + 10% DMSO or 10% EG + 10% propylene glycol (PROP). Hatching rates using Nitrocooler for EG + DMSO (50.2%) or EG + PROP (54.0%) were similar (ANOVA, P > 0.05) to normal atmosphere rates using EG + DMSO (50.1%) or EG + PROP (56.0%). Under these experimental conditions, our results suggest that the greater cooling rates obtained favored an increase in oocyte viability after vitrification, whereas no such beneficial effects were detected for vitrified IVP embryos. In conclusion, Nitrocooler was proven effective as a low-cost device to supercool LN2, increasing viability after vitrification of bovine oocytes, but not of IVP embryos. Table 1.Effect of Nitrocooler apparatus on cryopreservation of bovine oocytes and embryos

74 EFFECT OF BETA-MERCAPTOETHANOL ON THE VITRIFICATION CRYOTOLERANCE OF BOVINE IN VITRO-PRODUCED EMBRYOS

The control of oxidative processes in in vitro production (IVP) systems by the use of additives may be an alternative approach to improve embryo cryotolerance. The aim of this study was to verify the effect of β-mercaptoethanol (βME) on the cryotolerance of bovine IVP embryos. In 7 replications, and following IVM-IVF, presumptive zygotes (n = 3735) were in vitro-cultured in SOF medium supplemented or not with 100 μm βME (IVC treatment), at 38.5°C and high humidity. The initial 24 h of IVC was performed in 5% CO2 in air, with the remaining 6 days of IVC carried out in 5% CO2, 5% O2, and 90% N2. On Day 7, resulting blastocysts and expanded blastocysts were vitrified in glass micropipettes in a solution with 20% ethylene glycol + 20% propylene glycol. After warming, embryos were randomly allocated to 1 of 2 sub-groups for an additional 72 h of IVC to the hatching blastocyst (HBL) stage, in fresh SOF medium supplemented or not with 100 μm βME (PVC treatment), at 38.5°C, high humidity and 5% CO2. Experimental groups were as follows: G1 (βME-free medium during IVC and PVC); G2 (βME only during PVC); G3 (βME only during IVC); and G4 (βME during IVC and PVC). Cleavage (Day 2) and blastocyst (Day 7) rates in the IVC treatment and hatching rates (Days 7 to 9) for the PVC treatment were analyzed by the chi-square test, for P < 0.05. Total cell number (TCN) estimated by fluorescence staining in HBL derived from vitrified and nonvitrified embryos was analyzed by ANOVA. The use of βME during IVC did not affect cleavage rates (βME-free, 1491/1858, 80.2% v. βME, 1522/1877, 81.1%), but negatively affected development to the blastocyst stage (βME-free, 813/1858, 43.8% v. βME, 525/1877, 28.0%). Following vitrification, however, βME supplementation during PVC improved hatching rates (G2, 58.1% and G4, 63.8%) compared with groups without the additive (G1, 36.6% and G3, 42.0%). In addition, the presence of βME either during IVC or PVC, or during both culture periods, increased TCN in HBL from vitrified embryos (Table 1). The use of βME during IVC, irrespective of the presence of βME during the PCV period, caused an increase in TCN in HBL in G3 + G4, with no effects on hatching rates (Table 1b), whereas the addition of βME during PVC, irrespective of the presence of βME during the IVC period, resulted in greater hatching rates and TCN in HBL in G2 + G4 than in G1 + G3 (Table 1). In conclusion, the addition of βME during the IVC period did not affect cleavage, but reduced blastocyst yield. Despite that, βME supplementation during the IVC period appeared to have increased the cryotolerance of the resulting blastocysts, expressed by greater TCN in HBL, whereas βME supplementation during the PVC period also improved embryo survival to the vitrification process, manifested by greater hatching rates and TCN in HBL. Table 1.Effect of βME on the cryotolerance of bovine IVP embryos This study was supported by a grant from CNPq/Brazil.

MR imaging findings in 56 patients with Wernicke encephalopathy: nonalcoholics may differ from alcoholics

BACKGROUND AND PURPOSE

Wernicke encephalopathy (WE) is a severe neurologic disorder resulting from dietary vitamin B(1) deficiency. This study was undertaken to analyze and compare MR imaging findings and neurologic manifestations at clinical presentations of patients with WE with and without a history of alcohol abuse.

MATERIALS AND METHODS

WE patients were identified using diagnostic neurologic data bases. Fifty-six patients (29 females, 27 males) diagnosed between 1999 and 2008 with WE who improved within 1 month from the onset of thiamine administration were included in the analysis. Patients' records were reviewed for clinical manifestations and imaging studies' findings. MR imaging was performed in the acute phase of the disease at a field strength of 1T (16 patients) and 1.5T (40 patients). All MR images were of acceptable to good quality and were retrospectively reviewed. We compared imaging findings and clinical presentation in the alcoholic (AL) group versus the non-alcoholic (NA) group using the 2-tailed Fisher exact test and the Phi coefficient as appropriate.

RESULTS

Forty-three percent of the patients were in the AL group, whereas 57% were in the NA group. Eighty-nine percent showed changes in consciousness, 75% had ocular manifestations, and 54% had ataxia. On MR imaging, 80% of the patients had evidence of symmetric lesions in the medial thalami and in the periventricular region of the third ventricle; 59%, in the periaqueductal area; 45%, in the mamillary bodies; 36%, in the tectal plate; and 7%, in the periventricular gray matter located anteriorly to the fourth ventricle. Signal-intensity alterations in areas considered atypical for the disease were noted only in the NA group and always in association with the typical findings. Contrast enhancement of the thalamus and mamillary bodies was significantly associated with alcohol abuse.

CONCLUSIONS

Contrast enhancement in the mamillary bodies and thalamus is a typical finding of the disease in AL patients. Atypical MR imaging findings characterize NA patients.

50 EFFECT OF AGGREGATION OR FUSION ON DEVELOPMENT AND CELL NUMBER OF BOVINE EMBRYOS PRODUCED BY HANDMADE CLONING AND PARTHENOGENESIS

Cloning by somatic cell nuclear transfer has been associated with developmental abnormalities, with the level of heteroplasmy imposed by cell fusion being one of many potential determining factors. As the cytoplast exerts a key role in nuclear reprogramming, embryo aggregation is an alternative to minimize such negative effects during cloning. The aim of this study was to determine the effect of fusion of hemi-cytoplasts or aggregation of hemi-embryos on in vitro development and cell number of clone and parthenote embryos. Bovine cumulus–oocyte complexes (COCs) from slaughterhouse ovaries, after 17 h of IVM, were used for the production of parthenotes by chemical activation, and clone embryos by handmade cloning (HMC) (Vajta et al. 2003 Biol. Reprod. 68, 571–578). Following cumulus and zona removal, oocytes were manually bisected, followed by segregation of nucleated and enucleated hemi-cytoplasts by fluorescence using Hoechst stain. One or two enucleated hemi-cytoplasts were paired with an adult skin somatic cell from primary cultures (>90% confluence) and fused using a 25V AC pre-pulse, followed by a single 1.2 kV cm–1 DC pulse for 10 μs. Reconstructed clone structures and groups of zona-intact oocytes and nucleated hemi-cytoplasts were chemically activated in ionomycin and 6-DMAP. Clone and parthenote structures were in vitro-cultured in the WOW system (Vajta et al. 2000 Mol. Reprod. Dev. 55, 256–264) for 7 days, as follows: (G1) clone embryos reconstructed by aggregation of two hemi-embryos per WOW; or (G2) one embryo (two hemi-cytoplasts + cell) perWOW; and parthenote embryos composed of (G3) zona-intact oocytes cultured in wells; or aggregation of one (G4), two (G5), three (G6), or four (G7) nucleated hemi-cytoplasts per WOW. Fusion, cleavage (Day 2), and blastocyst (Day 7) rates, evaluated on a per WOW basis, were compared by the chi-square test (8 replications). Total cell number estimated by fluorescence (Hoechst stain) in blastocysts was analyzed by the Student t-test. Fusion rates of one hemi-cytoplast + cell (G1; 275/592, 46.5%) were lower than for two hemi-cytoplasts + cell (G2; 264/337, 78.3%). Cleavage rates were lower in G1 and G4 and higher in G6 and G7 than G2 and G3. A significant linear increase in blastocyst rates was observed in G5, G6, and G7. Total cell numbers were lower in parthenotes than in clones, except in G6 and G7. The lower fusion and cleavage rates after the aggregation of two clone hemi-embryos (G1) caused nearly a 50% reduction in the overall cloning efficiency. In addition, the aggregation of parthenogenetic hemi-embryos increased cleavage and blastocyst rates and cell number. However, aggregation of hemi structures did not improve blastocyst yield or cell number on a hemi-cytoplast basis. Table 1. In vitro development of parthenote or clone bovine embryos This work was supported by funding from CAPES/Brazil.

Wernicke encephalopathy: MR findings at clinical presentation in twenty-six alcoholic and nonalcoholic patients

BACKGROUND AND PURPOSE

Wernicke encephalopathy is a severe neurologic disorder that results from a dietary vitamin B1 deficiency. It is characterized by changes in consciousness, ocular abnormalities, and ataxia. This study was undertaken to analyze and compare findings on MR imaging and neurologic symptoms at clinical presentations of patients with Wernicke encephalopathy with and without a history of alcohol abuse.

MATERIALS AND METHODS

A multicenter study group retrospectively reviewed MR brain imaging findings, clinical histories, and presentations of 26 patients (14 female, 12 male) diagnosed between 1999 and 2006 with Wernicke encephalopathy. The age range was 6-81 years (mean age, 46 .6+/-19 years).

RESULTS

Fifty percent of the patients had a history of alcohol abuse, and 50% had no history of alcohol abuse. Eighty percent showed changes in consciousness, 77% had ocular symptoms, and 54% had ataxia. Only 38% of the patients showed the classic triad of the disease at clinical presentation. At MR examination, 85% of the patients showed symmetric lesions in the medial thalami and the periventricular region of the third ventricle, 65% in the periaqueductal area, 58% in the mamillary bodies, 38% in the tectal plate, and 8% in the dorsal medulla. Contrast enhancement of the mamillary bodies was statistically positively correlated with the alcohol abuse group.

CONCLUSIONS

Our study confirms the usefulness of MR in reaching a prompt diagnosis of Wernicke encephalopathy to avoid irreversible damage to brain tissue. Contrast enhancement in the mamillary bodies is a typical finding of the disease in the alcoholic population.

23 NEONATAL PHYSIOLOGICAL STATUS OF CLONED AND CONTROL CALVES

Health problems and mortality rates of cloned calves are major limitations of cloning technology and represent substantial economic losses as well as justifiable animal health and welfare concerns. The objectives of this study were to compare neonatal viability and physiological status of cloned and control calves. Cloned (Holstein, n = 5; Hereford, n = 3) and control (embryo transfer: Holstein, n = 3; Hereford, n = 3) calves were carried in the same group of Hereford × Angus crossbred recipient dams and were delivered by Cesarean section at term (Days 273–280) following induced labor. Additional calves (Holstein, n = 3; Hereford, n = 2) resulting from AI and delivered vaginally by their natural dams (Days 269–279) following spontaneous initiation of parturition were included as normal controls to evaluate the effects of the induction procedure. Physical evaluations and measurements of blood biochemistry (19 parameters), gases and electrolytes (9 parameters), and complete blood counts (18 parameters) were performed within 10 min of birth and at 1, 6, 12, 18, 24, 36, and 48 h after birth. Cloned calves were observed with increased occurrence of flexural limb deformities (4/8 clones, 0/9 controls; P < 0.05) and developmental delays of physical adjustment parameters such as time to suckle and stand (5/8 clones requiring >3 h; P < 0.05). Cloned calves were more variable than, but not different from, controls for most blood parameters measured. Compared with controls, at birth clones exhibited reduced red blood cell counts (6.8 and 8.6 × 109 cells/mL, clones and controls, respectively; P < 0.01), plasma bicarbonate (23.1 vs. 26.2 mmol/L; P < 0.05), and plasma glucose (39.4 vs. 73.6 mg/dL; P < 0.05). Blood urea nitrogen concentrations in clones tended to be elevated beginning 24 h after birth and were significantly greater than those in controls by 48 h (13.4 vs. 7.4 mg/dL; P < 0.01). Echocardiographic measurements at 24 h of age varied between groups (Table 1) and were indicative of circulatory abnormalities likely originating in utero for clones. The results of this study identified the physiological differences between clones and controls at birth and may be useful in the development of clinical-care protocols to maximize the health and survival of cloned calves. Table 1. Echocardiographic characteristics of cloned and control calves

120 EMBRYO SURVIVAL FOLLOWING LIPID-BASED TRANSFECTION OF 1-CELL STAGE BOVINE EMBRYOS WITH SMALL INTERFERING RNA (siRNA) FRAGMENTS AND/OR DNA

The RNA interference (RNAi) technology is a powerful tool for studies in functional genomics. The aim of this study was to evaluate the effects of a cationic lipid-based small interfering RNA (siRNA) and/or DNA delivery to 1-cell-stage bovine embryos on survival to the blastocyst stage. In vitro-produced (IVP) embryos were generated according to Bertolini et al. 2002 (Theriogenology 58, 973), and cloned embryos were produced by the handmade cloning technique (Vajta et al. 2003 Biol. Reprod. 68, 571) using green fluorescent protein (GFP)-expressing fibroblast cells as nuclear donors. Lipofections were performed on zona-free 1-cell-stage IVP embryos at 24–28 h post-fertilization by exposure to 1% (v/v) Lipofectamine 2000 (Invitrogen Co., CA, USA), 0.002% (w/v) GFP plasmid (pEFGP-N1, Clontech Laboratories, CA, USA) and/or various doses of siRNA GFP-specific siRNA oligonucleotide (Invitrogen) or DNA methyltransferase 1 (Dnmt1)-specific siRNA fragments for 60 min at 39°C, according to 5 treatment groups: (1) zona-intact IVP embryos (controls), (2) zona-free control embryos (controls for embryo development after zona removal), (3) embryos treated with GFP + GFP-siRNA at 0, 50, 100, 200, 400, or 800 nm, (4) embryos treated with Dnmt1-siRNA at 0, 50, 100, 250, or 500 nm, and (5) cloned embryos (positive controls for GFP expression). After treatment, embryos were in vitro-cultured in a WOW culture system (Vajta et al. 2000 Mol. Reprod. Dev. 55, 256) for 7 days. Cleavage and developmental rates to at least 8-cell and to blastocyst stages were assessed at 48, 96, and 168 h post-fertilization (hpf), respectively. Data were analyzed by the chi-square test. Cleavage rates in embryos treated with higher doses of siRNA were lower than in all other groups (Table 1). Embryo survival to at least 8-cell stage at 48 h, based on cleavage, was similar among all treatments (data not shown), but survival to blastocyst stage was affected by higher doses of GFP- or Dnmt1-siRNA (Table 1). After a qualitative assessment by fluorescence microscopy at 168 hpf, 40 to 63% of GFP-transfected blastocysts showed various levels of fluorescence, irrespective of the siRNA treatments. Fragments of siRNA are known to be short-lived in cultured cells, although we are still uncertain of their behavior and effects in early bovine embryos. We are currently analyzing the effectiveness of the siRNA transfection in the early IVP and clone embryo. In conclusion, liposome transfection of 1-cell-stage embryos did not affect survival and development to the blastocyst stage. However, survival followed an siRNA dose-response effect, with doses higher than 400 nm appearing to be detrimental to embryo development, with a developmental arrest at or close to the embryonic genome activation period. Table 1. Developmental rate of bovine embryos following lipid-based transfection at the 1-cell-stage

29 COMPARISON OF TERM PLACENTAS IN CLONED AND CONTROL PREGNANCIES IN CATTLE

Somatic cell nuclear transfer is associated with high incidence of fetal loss, late-term pregnancy complications, perinatal mortality, and abnormal placental development. Several groups have described abnormalities of early and mid-gestation cloned placentas (Hill et al. 2000 Biol. Reprod. 63, 1787–1794; Lee et al. 2004 Biol. Reprod. 70, 1–11). The objective of our study was to characterize differences in the placentas of clones and control calves at term delivery. Clones were produced from ovarian cell lines from two donors (Holstein, n = 5; Hereford, n = 2). Breed-matched controls included AI (Holstein, n = 3) and embryo transfer (Holstein, n = 3; Hereford n = 3) calves. All calves were delivered alive with no visible birth defects between Days 273 and 280 of gestation, and placentas were recovered for measurement and morphological analysis. When possible, pregnancies were delivered via caesarian section, and the entire uterus was recovered for classification of anatomical shape of placentomes. Each placentome was measured, weighed, and classified by type as (A) engulfing mushroom-like; (B) sub-engulfing mushroom-like; (C) flattened, non-engulfing; and (D) convex (adapted from Penninga and Longo 1998 Placenta 19, 187–193, for sheep). Mean number of placentomes per placenta was significantly greater in controls than clones, while total mass of placentomes in the pregnant horn was significantly greater in clones than in controls (Table 1). Total surface area of placentomes in the pregnant horn tended to be larger and more variable in clones (range: 2710–7450 cm2) than in controls (range: 3120–5030 cm2; P < 0.10). A two-fold increase was observed in cloned placentas, as compared with control placentas, in mean surface area per placentome and mass per placentome. Anatomically, cloned placentas differed from controls in the percentage of placentomes classified Type A (controls > clones) and Type C (clones > controls). Other abnormalities noted in cloned placentas included moderate to severe edema, teratomas, enlarged vessels, and large areas devoid of placentation. All clones and 2/9 controls displayed enlarged umbilical vessels. Significant placental abnormalities were observed in all cloned pregnancies. Table 1. Placental characteristics of term cloned and control pregnancies

Evidence of increased substrate availability to in vitro-derived bovine foetuses and association with accelerated conceptus growth

Changes in placental development have been associated with foetal abnormalities afterin vitroembryo manipulations. This study was designed to investigate bovine conceptus development and substrate levels in plasma and fluids inin vivo- andin vitro-produced (IVP) concepti and neonates.In vivo-produced and IVP embryos were derived by established embryo production procedures. Pregnant animals from both groups were slaughtered on days 90 or 180 of gestation, or allowed to go to term. Conceptus and neonatal physical traits were recorded; foetal, maternal and neonatal blood, and foetal fluids were collected for the determination of blood and fluid chemistry, and glucose, fructose and lactate concentrations. Placental transcripts for specific glucose transporters were determined by quantitative RT-PCR. No significant differences in uterine and conceptus traits were observed between groups on day 90. On day 180, larger uterine, placental and foetal weights, and an increase in placental gross surface area (SA) in IVP pregnancies were associated with increased glucose and fructose accumulation in foetal plasma and associated fluids, with no differences in the expression of components of the glucose transporter system. Therefore, the enlarged placental SA in IVP pregnancies suggests an increase in substrate uptake and transport capacity. Newborn IVP calves displayed higher birth weights and plasma fructose concentrations soon after birth, findings which appeared to be associated with clinical and metabolic distress. Our results indicated larger concepti and increased placental fructogenic capacity in mid- to late IVP pregnancies, features which appeared to be associated with an enhanced substrate supply, potentially glucose, to the conceptus.

164BOVINE PLACENTAL LACTOGEN (BPL) AND BOVINE PREGNANCY-SPECIFIC PROTEIN B (BPSPB) AS INDIRECT MEASURES OF PLACENTAL FUNCTION IN IN VITRO-DERIVED BOVINE PREGNANCIES

Associations between abnormal placental and fetal development after in vitro embryo manipulations have been suggested to play a key role in the occurrence of high birth weights. This study was designed to investigate bovine conceptus development in in vivo- (controls) and in vitro-produced (IVP) concepti and newborn calves, and its association with specific placental proteins usually present in maternal, fetal and neonatal plasma and fetal (amniotic and allantoic) fluids. Females were superovulated to obtain control embryos, whereas IVP embryos were derived from established in vitro embryo production procedures (Bertolini et al., 2002 Theriogenology 58,973). Pregnant animals from each group were slaughtered on Days 90 and 180 of gestation (n=4 control, n=5 IVP pregnancies/day), or allowed to develop to term (n=6/group). Conceptus and neonatal physical traits were recorded after slaughter or delivery (Bertolini et al., 2001 Theriogenology 55,347; 2002 57,361; 2002 58,973). Maternal and fetal plasma and fluids were sampled after slaughter; maternal blood was sampled weekly from Day 30 of pregnancy to term. Neonatal blood samples were collected at 10min, and at 1, 6, 12 and 24h after birth. Bovine placental lactogen (bPL) and pregnancy-specific protein B (bPSPB) concentrations were determined in plasma and fluid samples, according to Wallace (1993 Dom. Anim. Endocrinol. 10, 67) for bPL, and by a commercial service for bPSPB (BioTracking, Moscow, ID, USA.). Data were compared by Proc GLM of SAS and Pearson’s correlation test (SAS Institute, Cary, NC, USA.). No major physical differences in conceptus traits were observed between groups on Day 90, but concentrations of bPL and bPSPB were higher in fetal plasma (8.1±0.5 v. 10.7±0.5ngmL−1 for bPL, and 4.4±8.2 v. 32.5±5.8ngmL−1 for bPSPB) and allantoic fluid (bPL only; 3.6±1.1 v. 7.8±1.0ngmL−1) of IVP concepti (P&lt;0.05). Day-180 IVP pregnancies displayed larger uterine and conceptus traits (P&lt;0.05), and bPSPB concentrations were 2.9-fold lower (84.3±22.4 v. 20.5±22.4ngmL−1) in the allantoic fluid (P&lt;0.05) of IVP pregnancies, for a 2- to 3-fold larger allantoic fluid volume than controls (P&lt;0.07). Concentrations of bPL in fetal plasma and fluids were higher than in maternal plasma, but no differences in bPSPB concentrations were observed across fluid types. Newborn IVP calves and fetal membranes were larger, displaying 3- to 4-fold higher concentrations of plasma bPL (P&lt;0.05) and bPSPB (P&lt;0.08) than controls (10 and 60min after birth) and maternal plasma (at delivery). Maternal concentrations of bPL in IVP pregnancies were lower than controls during the last 8 weeks of gestation (P&lt;0.05), to become similar as parturition approached. Generally, concentrations of bPL and bPSPB in plasma were correlated with physical traits (0.750&gt;r&gt;0.958, P&lt;0.001) and with one another in plasma and fluids (0.715&gt;r&gt;0.938, P&lt;0.001). Our results indicated that differential patterns of secretion of bPL and bPSPB into the maternal and fetal systems occurred at distinct stages of gestation, which were associated with altered conceptus development after in vitro embryo manipulations, indirectly demonstrating deviations in placental function in IVP pregnancies.

1DEVELOPMENT OF BOVINE NUCLEAR TRANSFER EMBRYOS CLONED FROM FOLLICULAR DONOR CELLS IN SEQUENTIAL STAGES OF DIFFERENTIATION

Efficient production of cloned embryos and live offspring is dependent on the ability of the nuclear-donor cell to be reprogrammed to direct normal conceptus development. Results of comparative studies indicate that embryonic and fetal cells are more successful candidates for nuclear transfer (NT) than terminally differentiated cells. Comparison of donor-cell efficiency is difficult to interpret across laboratories and from donor animals of varying genetic backgrounds and tissues of origin. This study was undertaken to determine the effect of the stage of differentiation of adult somatic donor cells derived from one-cell lineage of an individual donor animal. The follicular cell lineage including preantral follicle (PAFC), cumulus (CC), granulosa (GC), and luteal cells (LC) was chosen as several cell types in the lineage have previously proven successful for NT. Donor cell cultures were established from a 3-year-old Holstein cow. Embryos were reconstructed using confluent, early passage cultures. For each replicate, embryos were produced from two donor cell types in randomized block design (14 trials). Viable embryos were transferred to recipient females after 7 days of in vitro culture. Pregnancy and fetal viability were monitored weekly by ultrasonography from Days 30–100 of gestation and by rectal palpation thereafter. Embryos reconstructed from PAFC were less likely to develop to the blastocyst stage on Day 7 than embryos derived from CC or LC (Table 1, P&lt;0.05). Pregnancy rates at Day 30 were similar across donor cell types. A greater proportion of PAFC embryos were viable at Day 60 of gestation than embryos derived from CC and GC (P&lt;0.05). To date, normal cloned calves have been delivered at term from CC and GC, and two pregnancies (n=3 fetuses) are ongoing from PAFC. The fetus cloned from LC, the terminally differentiated cell type in the lineage, was spontaneously aborted at day 211 with congenital abnormalities. Results from comparative studies of development of mouse embryos cloned from embryonic stem (ES) cells v. somatic donor cells indicate that ES-derived clones are less efficient in blastocyst formation, but survival to term is greater (Humpherys D et al., 2002 PNAS 99, 12889–12894). Likewise, our results in cattle suggest that PAFC, the least differentiated cells in the lineage, result in fewer cloned blastocysts, but blastocysts that do develop are more likely to progress through implantation and into later stages of pregnancy. Table 1. Development of NT embryos reconstructed from follicular donor cells at sequential stages of differentiation

42ANGIOGENESIS IN CLONED AND IVF-DERIVED BOVINE PREGNANCIES AT DAY 30 OF GESTATION

New and expanded microvascular networks in maternal and embryonic tissue are vital to development of a functional placenta. Typically a large proportion of bovine pregnancies derived from somatic cell nuclear transfer (NT) are lost between Days 25 and 45 of gestation. Several laboratories have noted aberrant placental development of NT embryos and fetuses; one factor that may contribute to these defects is faulty maternal or embryonic angiogenesis during placentation. The aim of this study was to determine if angiogenesis in maternal caruncular tissues differs in bovine NT- and IVF-derived pregnancies at the time of placentation. Cloned embryos were produced using cultured ear skin fibroblasts from a 15-year-old Hereford cow; in other experiments, these donor cells resulted in a term live calf and 67% of viable Day-30 embryos dying by Day 51 of gestation. For IVF-derived embryos, IVM oocytes were fertilized with semen from Hereford or Angus bulls. All embryos were cultured in vivo in ligated sheep oviducts, and at Day 8 blastocysts were transferred to synchronized recipient heifers. Whenever possible, one embryo was transferred to each uterine horn. A total of 41 NT and 41 IVF grade 1, 2 and 3 embryos were transferred to 48 recipients. Viable NT (n=9; 22.0% of transferred) and IVF (n=9; 22.0%) embryos were recovered at Day 30, and caruncular tissue adjacent to each embryo was sampled. Expression of genes implicated in angiogenesis was measured by real-time quantitative RT-PCR and normalized to histone 2A expression. In addition, paraformaldehyde-fixed sections were stained by the Periodic Acid-Schiffs method to identify blood vessels. Microvascular density was determined as percentage of total tissue area composed of blood vessels in the luminal caruncular stroma as measured by two observers. Data were analyzed by ANOVA using the GLM procedure of SAS (SAS Institute, Cary, NC, USA). Quantification of gene expression revealed no differences between NT and IVF pregnancies for angiogenesis-promoting growth factors and their receptors: vascular endothelial growth factor-A (VEGF-A), VEGF-C, placental growth factor, VEGF receptor-1 (VEGFR-1/flt-1), VEGFR-2 (flk-1/KDR), VEGFR-3 (flt-4), angiopoietin-1 (Ang-1), and Ang receptor-1 (tie-1). Likewise, NT and IVF pregnancies demonstrated similar mean microvascular densities in the caruncles; however, density differed between individual pregnancies across both groups (P&lt;0.05). For these experiments, the timing of NT and IVF, embryo transfer, and tissue collection on Day 30 was as consistent as possible. Despite these efforts, embryo morphology and developmental stage were highly variable even within the IVF group. It follows that the progress of placentation, and hence the signaling between each embryo and the maternal tissues, may have differed as well, accounting for the variation observed. Our results suggest that failure of maternal tissue to increase angiogenesis during placentation is not a primary cause of aberrant placental development in cloned cattle.

Screening for Cushing's syndrome in obese women with and without polycystic ovary syndrome

Obesity and insulin resistance, menstrual abnormalities and clinical and biochemical signs of hyperandrogenism are common features in women with polycystic ovary syndrome (PCOS) and Cushing's syndrome (CS). Further, an overdrive of the pituitary-adrenal axis has been documented in PCOS and this condition is often present in women with CS. For this reason, screening for hypercortisolism is often needed in obese women with polycystic ovaries. The aim of this study was to compare the diagnostic value of different screening tests for CS in a population of obese premenopausal women with PCOS and without PCOS (OB) and in a group of patients with CS. We reviewed retrospectively the case records of 117 obese women of reproductive age (60 PCOS and 57 OB, BMI 25.1-70.1, 13-45 yr) who were screened for CS at our Institution in the years 1995-2001 and turned out to be free of the disease. Data were compared with those of 58 premenopausal obese women with active CS (BMI 25.1-50.2 kg/m2, 18-45 yr). Screening for CS was performed by urinary free cortisol (UFC) (three consecutive 24-h urine collections), cortisol circadian rhythm (blood samples taken at 08:00-17:00-24:00 h), and 1 mg overnight dexamethasone suppression test (DST). A 24:00 h plasma cortisol (MNC) of 207 nmol/l, a UFC of 221 nmol/day and plasma cortisol after DST of 50 nmol/l and 138 nmol/l were taken as cut-off values for the diagnosis of CS. As expected, patients with CS showed elevated basal and post-dexamethasone plasma cortisol and UFC levels (p < 0.001 vs OB and PCOS). PCOS had higher UFC (p < 0.005) but not MNC and post-DST plasma cortisol levels compared to OB. DST showed the greatest specificity and diagnostic accuracy in differentiating CS from PCOS and OB (both p < 0.05 vs MNC and UFC, according to the 138 nmol/l criterion) while MNC and UFC displayed a similar discriminatory value. However, by using a lower threshold (50 nmol/l) as response criterion, there were no diagnostic differences between DST and the other tests. Specificity and diagnostic accuracy of UFC measurement was lower in PCOS than in OB (both p < 0.05) whilst there were no differences between groups for DST and MNC. Similarly, the area under the ROC curve relative to DST, giving an estimate of the inherent diagnostic accuracy of the test, was slightly greater than those of MNC and UFC (z = 0.694 and z = 0.833 for DST vs MNC and UFC, respectively, both p = NS). These results indicate that the 1-mg DST and MNC are unaffected by the presence of PCOS and can be safely used to screen for CS premenopausal obese women with PCOS, while caution should be exercised in interpreting mildly elevated UFC levels in these patients.

Effect of small doses of dexamethasone on plasma leptin levels in normal and obese subjects: a dose-response study

To further elucidate the role of glucocorticoids in the regulation of leptin secretion, we studied the effects of overnight small doses of dexamethasone on plasma leptin levels in normal weight controls and in obese patients and correlated the results with indexes of insulin sensitivity and body fat distribution. In 114 subjects (81 obese patients, 49 women and 32 men, BMI 37.4 +/- 0.77 kg/m2 and 33 normal-weight subjects, 17 women and 16 men, BMI 22.1 +/- 0.41 kg/m2) plasma F and leptin levels were measured at 08:00 h basally and after the administration of different doses of dexamethasone (a fixed dose of 1-mg and 0.0035, 0.007, 0.015-mg/kg bw, given po at 23:00 h the night before). Tests were performed one week apart with bw remaining stable over the study period. Basal leptin levels were significantly higher in obese than in normal subjects (31.9 +/- 2.41 vs 7.7 +/- 0.93 ng/ml, p<0.0001). In obese patients, leptin levels increased significantly by 1-mg (from 31.9 +/- 2.41 to 35.0 +/- 2.59 ng/ml, p<0.005) and the 0.015-mg/kg bw dose (from 31.5 +/- 2.34 to 33.7 +/- 2.44 ng/ml, p<0.05), while they were unaffected by each dose of dexamethasone in normal subjects. However, after splitting subjects by gender, mean leptin levels rose from 39.3 +/- 2.97 to 43.3 +/- 3.12 ng/ml after the 1-mg dose, p<0.005, from 39.1 +/- 2.87 to 43.6 +/- 2.91 ng/ml after the 0.015-mg/kg bw dose, p<0.005, from 39.3 +/- 2.90 to 42.2 +/- 2.90 ng/ml after the 0.007-mg/kg bw dose, p<0.05 and from 38.8 +/- 2.66 to 41.1 +/- 2.87 ng/ml after the 0.0035-mg/kg bw dose, p=0.055, only in obese women. Conversely, no leptin changes were seen in the other groups and no differences were observed in the leptin response between groups. After the 1-mg dose, in the whole group, the absolute leptin variation was weakly but significantly related to BMI values (r=0.231, p<0.02) while in all sessions the percent leptin changes over baseline were not significantly correlated with age, BMI, waist, WHR, insulin, HOMA index, a marker of insulin sensitivity, plasma dexamethasone concentrations and to the percent cortisol variation following dexamethasone. In conclusion, in obese women but not in obese men and in normal weight subjects, small overnight increases in plasma glucocorticoid concentrations induced gender-related plasma leptin elevations that were unrelated to body fat distribution and insulin sensitivity. A greater sensitivity of female adipose tissue to glucocorticoids probably underlies this sexually dimorphic pattern of leptin response. These findings provide an additional piece of information on the regulation of leptin secretion exerted by glucocorticoids.

Weight gain in women with breast cancer treated with adjuvant cyclophosphomide, methotrexate and 5-fluorouracil. Analysis of resting energy expenditure and body composition

BACKGROUND

Weight gain is a common side effect observed in women undergoing adjuvant chemotherapy for breast cancer. Among possible causes a direct effect of chemotherapy on metabolism has been proposed. Body composition variations after adjuvant chemotherapy suggest the occurrence of sarcopenic obesity, possibly due to ovarian failure. We investigated acute and chronic effects of adjuvant chemotherapy on body weight, resting energy expenditure (REE) and plasma catecholamines in a group of menopausal women.

PATIENTS AND METHODS

Thirty menopausal women with stage I-II breast cancer were recruited for the study. We measured REE and respiratory quotient (RQ) and body composition at the beginning and after 3 and 6 months of adjuvant cyclophosphomide, methotrexate, and 5-fluorouracil (CMF). REE, RQ, and plasma catecholamines were assessed before and after each chemotherapy session. At each session food intake was also assessed in all patients, by a food diary. Seven patients out of the group of 30 were also evaluated after a placebo infusion (saline).

RESULTS

A significant weight gain was observed in all women (70.5 +/- 3 v.s. 67.7 +/- 3 kg, p < 0.001), with increase in both fat-free mass (FFM) (45.2 +/- 1.5 v.s. 43.6 +/- 1.3 kg, p < 0.001) and fat-mass (FM) (25.3 +/- 1.7 v.s. 24.1 +/- 1.8 kg, p < 0.005). A decrease in REE and RQ was observed both during CMF and placebo infusion (p < 0.05). During acute CMF and placebo infusion a reduction of plasma levels of noradrenaline was observed at the first and last session. REE increased progressively during the study period.

CONCLUSIONS

CMF therapy apparently has no effect on REE either acutely or during a 6-month-period; the increased REE observed in the long-term is likely due to the concomitant increase in FFM. The lack of evidence of sarcopenic obesity, at variance with previous literature, is likely due to different patient selection.

Light and electric field control of ferromagnetism in magnetic quantum structures

A strong influence of illumination and electric bias on the Curie temperature and saturation value of the magnetization is demonstrated for semiconductor structures containing a modulation-doped p-type Cd(0.96)Mn(0.04)Te quantum well placed in various built-in electric fields. It is shown that both light beam and bias voltage generate an isothermal and reversible crossover between the paramagnetic and ferromagnetic phases, in the way that is predetermined by the structure design. The observed behavior is in quantitative agreement with the expectations for systems, in which ferromagnetic interactions are mediated by the weakly disordered two-dimensional hole liquid.

The placenta as a contributor to production of large calves

Unusually high birth weights frequently occur in calves born from cultured bovine embryos. The mechanism(s) through which in vitro manipulations during early cleavage are translated to enhanced fetal growth is (are) incompletely understood. Accelerated growth is primarily prenatal, and the placenta of an in vitro-derived conceptus could account for abnormal fetal growth. Results from a systematic comparison of placental morphology and function in bovine concepti produced in vitro versus in vivo are discussed.

Influence of insulin-like growth factor-I and its interaction with gonadotropins, estradiol, and fetal calf serum on in vitro maturation and parthenogenic development in equine oocytes

The effects of insulin-like growth factor-I (IGF-I) and its interaction with gonadotropins, estradiol, and fetal calf serum (FCS) on in vitro maturation (IVM) of equine oocytes were investigated in this study. We also examined the role of IGF-I in the presence or absence of gonadotropins, estradiol, and FCS in parthenogenic cleavage after oocyte activation with calcium ionophore combined with 6-dimethylaminopurine (6-DMAP), using cleavage rate as a measure of cytoplasmic maturation. Only equine cumulus-oocyte complexes with compact cumulus and homogenous ooplasm (n = 817) were used. In experiment 1, oocytes were cultured in TCM-199 supplemented with BSA, antibiotics, and IGF-I at 0 (control), 50, 100, 200 ng/ml, at 39 degrees C in air with 5% CO(2), 95% humidity for 36 or 48 h. In experiment 2, oocytes were cultured with FSH, LH, estradiol, and FCS with IGF-I at the concentration that promoted the highest nuclear maturation rate in experiment 1. In experiment 3, oocytes from the three experimental groups (IGF-I; hormones; and IGF-I + hormones) were chemically activated by exposure to calcium ionophore followed by culture in 6-DMAP. In experiment 1, IGF-I stimulated equine oocyte maturation in a dose-dependent manner with the highest nuclear maturation rate at a concentration of 200 ng/ml. No significant effect of IGF-I on nuclear maturation was observed in experiment 2. In experiment 3, a significant difference in cleavage rate was observed between the hormone + IGF-I group (15 of 33; 45.4%) compared with IGF-I (10 of 36; 27.8%) and hormone (4 of 31; 12.9%) alone (P < 0.05). These results demonstrated that IGF-I has a positive effect on nuclear maturation rate of equine oocytes in vitro. The addition of IGF-I to an IVM medium containing hormones and FCS did not increase nuclear maturation, but resulted in a positive effect on cytoplasmic maturation of equine oocytes measured by parthenogenic cleavage.

Metabolic effects of fluoxetine in obese menopausal women

Our objective was to assess thermogenic action of fluoxetine (FL) in obese menopausal women, evaluating the effect of FL administration on resting energy expenditure (REE) and on glucose-induced thermogenesis both after acute administration (40 mg in single dose the evening before measurements) and after a 12- week period of diet treatment plus FL (60 mg per day) or placebo. It was a double-blind, placebo-controlled design both in acute and in chronic study. The subjects were 32 obese, otherwise healthy, menopausal women. The patients were assigned randomly to three groups, one performing an acute study protocol, in which resting and glucose-induced thermogenesis was measured after FL and placebo administration, performed in randomised order. The other two groups underwent dietary plus pharmacological treatment (FL or placebo, PL). Resting and glucose-induced thermogenesis was measured at baseline and after 12 weeks of treatment. The results showed that acute FL administration caused an increase in resting energy expenditure (PL: 5.35+/-0.18 vs FL: 5.53+/-0.24 KJ/min, p<0.05). A significant decrease of REE was observed in the PL group after 12 weeks (p<0.03), while a slight, but not significant, decrease was observed in the FL group (p=NS). FL did not affect thermic response to oral glucose neither after acute nor chronic administration (p=NS for all groups studied). The conclusion was that our data give support to thermogenic actions of FL after acute administration, suggesting also that chronic FL treatment may restrain to some degree the metabolic adaptation expected during weight loss in obese subjects. At variance with what observed with other drugs, such as dexfenfluramine, an increased thermic effect of oral glucose does not seem to be involved in the thermogenetic action of FL.

Regulation of ob gene expression: evidence for epinephrine-induced suppression in human obesity

Leptin acts as satiety factor and increases energy expenditure. Studies conducted on animals and in vitro on adipocytes culture have shown that infusion of catecholamines leads to a significant reduction of ob gene expression; it appears of interest to evaluate the in vivo effects of adrenergic activation on the expression of the ob gene in humans. We studied ob gene expression in adipose tissue samples from 13 obese subjects before and after epinephrine (25 ng/min x kg ideal body weight for 3 h) and 6 obese patients during saline infusion. Hormonal infusion led to a significant increase in epinephrine plasma levels (from 27 +/- 4 to 339 +/- 75 pg/mL; P < 0.001), plasma free fatty acids (from 0.73 +/- 0.05 to 0.98 +/- 0.07; P < 0.05), heart rate (13.5 +/- 3.1 beats/min; F = 2.9; P < 0.03), and systolic blood pressure (F = 2.7; P < 0.05), whereas diastolic blood pressure did not show significant variation. Plasma leptin levels decreased by the end of the infusion (from 63 +/- 13 to 49 +/- 11 ng/mL; P < 0.05), and ob messenger ribonucleic acid levels were significantly reduced (decrease amounting to 47 +/- 5% of basal values). Our study shows that adrenergic activation contributes to regulate ob messenger ribonucleic acid levels in humans. The interaction between epinephrine and leptin may operate during metabolic and psychological stress to regulate energy expenditure and food intake.

[Ciaglia's percutaneous dilatative tracheostomy in intensive care. Perioperative complications and long-term results]

BACKGROUND AND AIM

The introduction of percutaneous tracheostomic techniques using dilatation (PDT) has led to the gradual disuse of conventional methods of surgery. The aim of this study was to evaluate ventilatory function in critical patients during the execution of PDT using Ciaglia's method as well as, in the postoperative phase, the long-term results, namely endotracheal lesions and cosmetic deformities of the stoma.

EXPERIMENTAL DESIGN

A prospective study was carried out on a consecutive series of adult patients.

SETTING

The intensive care ward of a 600-bed teaching hospital.

PATIENTS

A group of 50 critical patients undergoing PDT from 1993 to 1996. Valuations of ventilatory function: expiratory volume (EV), PaO2 and PaCO2, were calculated in 40 patients undergoing PDT. Endoscopic controls of the trachea were performed in 21 surviving patients 60 days after the removal of the tracheostomic tube and a cosmetic evaluation of the tube insertion site was also made in the same patients.

RESULTS

During PDT a mean reduction of EV was observed of 1.41/min and PaO2 values also diminished 15% accompanied by a 14.2% increase in PaCO2. The endoscopic control performed after 60 days in 21 out of 50 patients revealed a subglottal stenosis in 1 patient, the presence of nonstenosing cicatricial granuloma in 2 patients, edema in 2 patients and dysepithelisation of the tracheal mucosa in a further 2 patients. The remaining 66% showed flattening of the mucosa and complete restitutium ad integrum. No usurpations and cicatricial tractions of the tube insertion site were observed.

CONCLUSIONS

This prospective study of intraoperative ventilatory function and the final outcome of PDT according to Ciaglia confirms that this is a reliable technique for the ventilatory management of critical patients with a low percentage of long-term complications.

Plasma nitric oxide in posttrauma critical illness: a function of "sepsis" and the physiologic state severity classification quantifying the probability of death

The time course of nitric oxide (NO) production in posttrauma critical illness was monitored, and its relationship to posttrauma "sepsis/SIRS" and physiologic patterns was described. Eighty multiple trauma patients were studied (514 samples) during their course in the intensive care unit (Injury Severity Score 27.6; 36% deaths). Plasma NO was estimated from NO3 + NO2 by the Griess test and compared with that of 10 healthy controls (HC). At each sample period, the patient was categorized as having bacteremic sepsis (BAC), sepsis syndrome (SS), or systemic inflammatory response syndrome (SIRS), and classified by Physiologic State Severity Classification (PSSC) into normal stress response (A-State), metabolic insufficiency (B-State), or respiratory insufficiency (C2-State), each quantified by their physiologic "distance" from reference state of recovering trauma patients (R-State). A severity index (L2PDEATH), based on a logistic model of state distances from R-State, quantified probability of death. Deaths showed increased NO (p < .05) over survivors or HC by day 3 posttrauma. A fall in vascular tone in deaths was related to the increased NO (p < .0001). The level of NO was higher as sepsis worsened: BAC > SS > SIRS > HC (all simultaneous, p < .05). PSSC and L2PDEATH correlated with incidence > HC and level of NO. In conclusion, the severity of posttrauma critical illness was classified by PSSC and quantified by the L2PDEATH index. These reflect progressively increased NO levels and suggest worsening sepsis status. The reduced total peripheral resistance (TPR)-to-flow relationship (vascular tone) in deaths characteristic of the more severe septic PSSC states appeared related to the increased plasma NO.

Physiologic state severity classification as an indicator of posttrauma cytokine response

A Physiologic State Severity Classification (PSSC) derived from clustering of 17 cardiorespiratory variables was used to predict cytokine response in critically ill posttrauma patients. The PSSC defined physiologic states: A-State (A), normal stress response; B-State (B), metabolic insufficiency; C2-State (C), respiratory insufficiency. Bayesian analysis of these states defined a probability of death (Pdeath). 416 studies from 60 newly studied multiple trauma patients (70% males, Injury Severity Score = 27.5) were analyzed; 45 (75%) had sepsis (s), 28 (47%) had sepsis-adult respiratory distress syndrome (s-ARDS). Of 35 survivors (66% s, 37% s-ARDS, mean Pdeath = .42) 23% were predominantly A, 66% B, and 11% C. Of 25 deaths (88% s, 60% s-ARDS, mean Pdeath = .64) 0% were A, 44% B, and 56% C. PSSC States were correlated with incidence and mean plasma levels (pl) in picograms/mL of cytokines. 23 samples from recovering nonseptic trauma patients were used as controls.

Plasma lipoproteins and cholesterol metabolism in Yoshida rats: an animal model of spontaneous hyperlipemia

The purpose of this study was to characterize the lipoprotein profile and cholesterol metabolism in Yoshida rats, a strain of inbred genetically hyperlipemic animals. For comparison, Brown Norway rats were used as control animals. Plasma cholesterol and triglycerides were higher in Yoshida as compared to Brown Norway, the elevation of cholesterol being due to a rise in HDL fraction. Triglyceride distribution among lipoproteins showed an increase in VLDL fraction. Hyperlipemia was not related to diabetes, hypothyroidism or nephropathy. Plasma triglycerides production was increased in Yoshida rats, while lipoprotein and hepatic lipases were similar in the two groups. Hypercholesterolemia was associated with a defect of lipoprotein receptor activity and with elevated HMG-CoA reductase and cholesterol 7 alpha - hydroxylase; conversely ACAT activity was lower in Yoshida as compared to Brown Norway rats. Sterol fecal excretion was comparable in the two groups and hypercholesterolemia in Yoshida rats was not associated to an increase of cholesterol saturation of the bile. We suggest that lipoprotein overproduction is the main cause for hyperlipidemia in this strain of rats.

[Lipolysis and ketosis during swimming in thermal water]

Plasma free fatty acids, blood glucose, beta-hydroxybutyrate and acetoacetate variations were studied in rats during swimming. Rats were forced to swim for 30 min in thermal water (source of Abano Terme) at 35 degrees and in normal water at 25 degrees. During swimming in thermal water plasma free fatty acids were increased, the glycemia remained unaffected, the beta-hydroxybutyrate and acetoacetate decreased. The swim in normal water induced a sharp increase of plasma free fatty acids, a decrease of blood glucose, an increase of blood beta-hydroxybutyrate and a marked decrease of acetoacetate. From these data, some indications of clinical interest are presented and discussed.

[Beneficial effect of swimming in thermal waters on muscle glycogen depletion]

The effect of swimming in the termal water on muscle glycogen stores was studied. After 30 min the muscle glycogen results in a diminution, but it is not depleted. On the contrary, 30 min of swimming in normal water results in a depletion of muscle glycogene stores. The glycemic homeostasis is well maintained in thermal water, and hypoglicemia occurs only after swimming in normal water.

[Nimesulide in the treatment of postoperative pain in minor orthopedic surgery]

The study assesses the effect of Nimesulide in the treatment of post-operative pain in minor orthopedic surgery. Twenty-five patients who had received regional peridural or subarachnoid anesthesia were included in the study. After a variable interval of 60 to 90 minutes, the average level of pain, evaluated using a "pain score", was considerably reduced. This effect lasted for an average of 360 +/- 120 minutes. There were minimum side-effects.

[Hyperbaric oxygen therapy in acute carbon monoxide poisoning. Illustration of a treatment protocol]

After a brief digression on the etiopathogenesis of carbon monoxide poisoning, the paper underlines the importance of the timely use of hyperbaric oxygen treatment not only to impede the immediate effects of CO, but also to reduce the incidence of neurological complications. The paper illustrates the paroxysm protocol and hyperbaric oxygen treatment protocol used by the Authors.

Psychopharmacological perspectives in childhood psychoses

1. Neuroleptic drugs are still widely employed in childhood psychoses, but new experiences on a large number of cases in this field, have shown the usefullness of antidepressive drugs, either alone or associated with neuroleptics, also when depressive symptoms are not clearly evident. 2. This peculiar aspect, still noticed in pathological situations of less gravity, calls again attention to childhood depression and to the difficulty of identifying it. 3. The problem is developed and discussed as follows: a. The psychopathological features regarded from the psychodynamic point of view; b. The neurofunctional background in various ages; c. The pharmacodynamic characteristics of the drugs; d. The good results with lithium treatment in several cases allow the authors to outline some clinical pictures as well as biochemical markers as to recognize endogenous depression in childhood.

Cognitive processes and cognitive progresses as didactic tools in psychiatry

The authors expose the characteristics of two methods about the teaching and the learning of Psychiatry. Hermeneutic method is based on the model: "this want to say that". It gives rise to rapid and diffused learning which are rarely personalized and it attributes activity to the teacher and passivity to the pupil. "Conjectural" method is based on the model: "this is one of the aspects of a polymer of significances that we may point out as probable conjecture and not as truth". It produces learning less rapid, less diffused but more personal. It attributes activity and passivity as to the teacher as to the pupil. The first method tends to provoke pathological dependence as proselitism and/or contest so the pupil difficulty may assume the heritage of the teacher by having idealized or killed him. The second method tends to form self-governing pupils able to break away from the teacher after having learned from him new knowledges which they use in a personal way.