Direct evidence for in vivo nitroxide free radical production from a new antiarrhythmic drug by EPR spectroscopy

The new Class I anti-arrhythmic agent 2,2,5,5-tetramethyl-3-pyrroline-1-carboxamide derivative, is currently being evaluated in clinical trials in patients with a high risk for cardiac arrhythmias. In this study we show that this antiarrhythmic drug can be chemically converted to the nitroxide free radical analog. Further, using an in vivo Electron Paramagnetic Resonance (EPR) spectroscopy model by detecting free radicals in the distal portion of the tail of an anesthetized mouse, we demonstrate that the drug is oxidized to the corresponding nitroxide. In vitro studies using Chinese hamster V79 cells suggest that the oxidation products of the drug, namely, the hydroxylamine and the nitroxide protect against oxidative damage induced by hydrogen peroxide (H2O2). Taken together, our results suggest that, in addition to the antiarrhythmic effects of the parent drug, sufficient levels of nitroxides may accumulate from the parent drug in vivo to provide antioxidant defense to cardiac tissue that may be subject to ischemia and oxidation-driven injury.

MR imaging of articular cartilage in the ankle: comparison of available imaging sequences and methods of measurement in cadavers

OBJECTIVE

To assess hyaline cartilage of cadaveric ankles using different magnetic resonance (MR) imaging techniques and various methods of measurement.

DESIGN AND PATIENTS

Cartilage thicknesses of the talus and tibia were measured in ten cadaveric ankles by naked eye and by digitized image analysis from MR images of fat-suppressed T1-weighted gradient recalled (FS-SPGR), sequences and pulsed transfer saturation sequences with (FS-STS) and without fat-suppression (STS); these measurements were compared with those derived from direct inspection of cadaveric sections. The accuracy and precision errors were evaluated statistically for each imaging technique as well as measuring method. Contrast-to-noise ratios of cartilage versus joint fluid and marrow were compared for each of the imaging sequences.

RESULTS

Statistically, measurements from FS-SPGR images were associated with the smallest estimation error. Precision error of measurements derived from digitized image analysis was found to be smaller than that derived from naked eye measurements. Cartilage thickness measurements in images from STS and FS-STS sequences revealed larger errors in both accuracy and precision. Inter-observer variance was larger in naked eye assessment of the cartilage. Contrast-to-noise ratio of cartilage versus joint fluid and marrow was higher with FS-SPGR than with FS-STS or STS sequences.

CONCLUSION

Of the sequences and measurement techniques studied, the FS-SPGR sequence combined with the use of digitized image analysis provides the most accurate method for the assessment of ankle hyaline cartilage.

BDNF down-regulates neurotrophin responsiveness, TrkB protein and TrkB mRNA levels in cultured rat hippocampal neurons

Regulation of Trk receptors by their ligands, the neurotrophins, was investigated in dissociated cultures of embryonic day 18 rat hippocampal neurons. Cultures were exposed to brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3) or NT-4/5 for 24 h upon plating followed by factor washout. As determined by immunohistochemical staining and phosphotyrosine blotting, the functional responses to acute stimulation with BDNF, NT-3 and NT-4/5, including c-Fos induction and phosphorylation of Trk and extracellular signal-regulated kinase (ERK) proteins, were significantly decreased after 6 days in culture by prior exposure to BDNF. As determined by Western and Northern blot analysis respectively, there was a parallel down-regulation of TrkB protein as well as of trkB and trkC mRNA levels in BDNF-pretreated cultures. Exposure to NT-3 or NT-4/5 at the same concentrations as BDNF did not down-regulate any of the measured cellular responses or TrkB protein and/or trkB and trkC mRNA levels. Regulation of hippocampal neuronal Trkb protein does not appear to be just a development phenomenon, as infusion of BDNF into the hippocampus of adult rats for 6 days produced an 80% decrease in levels of full-length TrkB protein. We thus show that exposure of hippocampal neurons to BDNF, both in culture and in the adult brain, results in down-regulation of TrkB. At least in vitro, this leads to long-term functional desensitization to BDNF, NT-3 and NT-4/5, as well as down-regulation of trkB and trkC mRNA.

Differential effect of NMDA and AMPA receptor blockade on protein synthesis in the rat infarct borderzone

We investigated whether the known neuroprotective effects of two selective glutamate receptor antagonists, the NMDA antagonist MK-801 and the AMPA antagonist NBQX, are reflected in the regional cerebral protein synthesis rates (CPSR) in rats with middle cerebral artery occlusion (MCAO). Rats treated with either saline, MK-801 (5 mg/kg i.p.) or NBQX (30 mg/kg i.p. x 3) were subjected to permanent MCAO. Regional CPSR and volumes of gray matter structures displaying normal CPSR were measured in coronal cryosections of the brain by quantitative autoradiography following an i.v. bolus injection of 35S-labelled L-methionine 2 h after occlusion. MCAO completely inhibited protein synthesis in the lateral part of striatum and part of the adjacent frontoparietal cortex corresponding to the ischemic focus. Surrounding this, a metabolic penumbra with approximately 50% reductions in CPSR was present. Treatment with MK-801 significantly increased the volume of tissue with normal CPSR in the ischemic hemisphere compared to controls, whereas this was not seen with NBQX treatment. The results suggest that MK-801 and NBQX have different effects on peri-infarct protein synthesis after MCAO. Since both compounds reduce infarct size, it is questionable that acute inhibition of protein synthesis in focal ischemia is of significant importance to the final outcome of a stroke lesion.

[Diagnosis of magnesium deficiency in intensive care patients]

AIM

Magnesium deficiency was investigated in critically ill patients, comparing measurements of plasma concentrations with the results obtained by the magnesium tolerance test.

DESIGN AND METHODS

20 critically ill patients (5 females, 15 males) between the ages of 27 and 86 were investigated. Magnesium plasma concentrations were determined before the magnesium tolerance test according to Ryzen was performed. For this purpose, magnesium sulfate (0.1 mmol/kg) was infused intravenously over four hours. Renal magnesium excretion was measured in the 24 h urine beginning at the start of the infusion. Magnesium concentrations in plasma and urine were determined using atomic absorption spectrophotometry.

MAIN RESULTS

In 12 patients magnesium plasma concentrations were decreased to 0.58-0.79 mmol/l. 6 patients showed values within the normal range of 0.80 to 1.0 mmol/l. In 2 patients the plasma concentration was increased to 1.07 and 1.27 mmol/l. Parenteral magnesium tolerance testing revealed a considerable magnesium deficiency by retention of 65-100% of the loading dose in 14 of the 20 patients. The remaining 6 patients retained 23-48% of the loading dose, thus demonstrating a moderate magnesium deficiency.

CONCLUSION

Determination of magnesium plasma concentration appears suitable as an informative preliminary survey, since low values are reliable indicating a magnesium deficiency. However, this study confirms that normal magnesium plasma concentrations do not exclude a considerable magnesium deficiency, which is more sensitively determined by the magnesium tolerance test.

Possible mechanism for late gestational development of the antioxidant enzymes in the fetal rat lung

We hypothesized that a possible mechanism to explain the significant increases that occur in the pulmonary antioxidant enzyme (AOE) system late in gestation might be an endogenous increase in the normal reactive O2 substrates for these enzymes. We found that lung O2 free radical formation increased approximately 175% between fetal day 18 and birth (p < 0.01). We also found that late fetal rat lung mitochondrial and microsomal rates of AOE substrate (H2O2) generation increased markedly, and there was also significantly increased lung lipid peroxidation products with increasing gestational age. These definite elevations in reactive O2 species production in parallel with the time course of maturational elevations in the pulmonary AOE system, suggest that increasing enzyme substrate concentrations could be a primary controlling mechanism for increasing lung AOE gene expression in preparation for birth of the newborn.

Typhoid fever in the park: epidemiology of an outbreak at a cultural interface

The number of reported outbreaks of typhoid fever in the United States has recently increased. Only six were reported from 1980-1989, but seven outbreaks were reported in 1990. In August 1990, health officials in Montgomery County, Maryland, were notified of two cases of typhoid fever among persons who had attended both a family picnic attended by 60 persons and a Latin Food Festival attended by 100,000 people. We obtained interviews, blood and stool cultures, and Vi serologies from attendees at and food handlers for the picnic. We defined cases as culture-confirmed or probable. Of the 60 picnic attendees, 24 (40%) had cases, of which 16 were culture confirmed. Those who ate potato salad were at increased risk of disease (17/32 vs. 6/28, relative risk [RR] = 2.5, 95% confidence interval [CI] 1.1-5.4). Picnic attendees who also attended the Latin Food Festival were not at significantly greater risk of disease than those who did not, (11/22 vs. 13/38, RR = 1.5, CI = 0.8-2.7) and we found no evidence of disease among other festival attendees. The potato salad was prepared with intensive handling and without adequate temperature control by a recent immigrant from El Salvador who was asymptomatic, did not attend the picnic, had Salmonella typhi (S. typhi) in her stool, and had elevated Vi antibodies, strongly suggestive of the carrier state. Outbreaks of typhoid fever are a threat for cosmopolitan communities. While currently available control measures are unlikely to prevent all outbreaks, thorough investigation can identify previously unrecognized carriers.

Unchanged balance between levels of mRNA encoding AMPA glutamate receptor subtypes following global cerebral ischemia in the rat

Transient global ischemia leads to glutamate mediated delayed neuronal death in the CA1 but not in the CA3 region of the rat hippocampus, and changes in AMPA receptor subunit composition has been proposed to cause a difference in excitatory input to the CA1 and CA3 regions. In situ hybridization with riboprobes for AMPA receptor subtype GluR1-4 mRNA was performed on sections from the brain of sham operated and ischemic rats in two models (neck cuff and 4-vessel occlusion combined with hypotension) with identical results: the content of the GluR1-3 mRNA species was down regulated in the hippocampal regions CA1 and CA3 but only weak changes were observed in the dentate gyrus. The down regulation observed in CA1 was non-selective among GluR1-3, i.e. all GluR mRNA species showed approximately the same degree of down regulation. A change in calcium permeability of the AMPA channels mediated by a shift in channel sub-unit composition and corroborating an increased calcium influx is thus not supported by these findings.

Premature rats treated with propylthiouracil show enhanced pulmonary antioxidant enzyme gene expression and improved survival during prolonged exposure to hyperoxia

In full-term newborn rats, propylthiouracil (PTU) treatment has been previously shown to decrease susceptibility to O2-induced lung damage and improve survival during hyperoxic exposure. However, no differences were found in lung antioxidant enzyme (AOE) activity responses to hyperoxia compared with O2-exposed untreated (control) term rats. To further explore possible pulmonary protective effects of PTU treatment in prematurely delivered animals, we administered PTU (0.015%) in drinking water to timed-pregnant rats for the final 10 d of gestation prior to delivery 1 d before term, and during lactation; control pregnant/nursing rats received untreated water. Both groups of 21-d premature rat pups were randomized to either > 95% O2 or room air exposure after birth for up to 14 d. The left lungs of 7-d exposure pups were used to quantitate the concentrations of AOE mRNA by solution hybridization; the right lungs of the same pups were assayed for AOE activities. PTU treatment resulted in survival rates of O2-exposed preterm rat pups that were consistently higher at all time periods in hyperoxia including 7 d [PTU, 67 of 82 (82%) versus control pups, 58 of 113 (51%); p < 0.001] and 14 d [PTU, 31 of 39 (79%) versus control, 15 of 66 (23%); p < 0.001]. Further evidence of increased tolerance to > 95% O2 in PTU pups included a significant decrease in the incidence of microscopic intraalveolar edema and a significant increase in lung tissue surfactant-related phospholipids compared with O2-exposed control pups.(ABSTRACT TRUNCATED AT 250 WORDS)

Positive regulation of pulmonary antioxidant enzyme gene expression by prenatal thyrotropin releasing hormone plus dexamethasone treatment in premature rats exposed to hyperoxia

Prenatal administration of thyrotropin releasing hormone (TRH) plus dexamethasone (DEX) to pregnant rats produces significantly depressed fetal lung antioxidant enzyme (AOE) activities and AOE mRNA levels in late gestation. Because of this negative regulation of AOE gene expression in the late fetal lung, we hypothesized that hormonally pretreated prematurely delivered rats might demonstrate inferior tolerance to prolonged hyperoxia. Litters of prenatal TRH+DEX-treated and sham-treated prematurely delivered rat pups (gestational d 21 of 22) were randomized to either > 95% O2 or room air for up to 14 d. The right lungs of 2- and 7-d exposure pups were assayed for AOE activities; the left lungs of the same pups were used to quantitate the concentrations of AOE mRNA by solution hybridization. The prenatal TRH+DEX-treated pups were able to induce adaptive lung AOE mRNA and activity responses to hyperoxia by 2 d of exposure; and by 7 d in O2 they showed greater increases in AOE mRNA concentrations and AOE activities in response to hyperoxic challenge compared with the sham-treated controls. Lung lipid surfactant measurements after hyperoxia were not affected by prenatal TRH+DEX treatment. In addition, TRH+DEX-pretreated premature rats did not show the hypothesized increased susceptibility to O2-induced lung damage and lethality, but, in fact, had slightly improved hyperoxic survival (d 3-7 of O2 exposure) compared with sham-treated controls. Exposure to hyperoxia significantly reduced serum triiodothyronine and thyroxine levels in the sham-control pups.(ABSTRACT TRUNCATED AT 250 WORDS)

Failure of premature rabbits to increase lung antioxidant enzyme activities after hyperoxic exposure: antioxidant enzyme gene expression and pharmacologic intervention with endotoxin and dexamethasone

Premature rabbits, unlike full-term rabbits, are unable to mount a protective increase in pulmonary antioxidant enzyme (AOE) activities in response to 48 h of hyperoxic exposure and demonstrate increased pulmonary O2 toxicity compared with full-term rabbits. To examine AOE gene expression of CuZn superoxide dismutase (SOD), Mn SOD, catalase, and glutathione peroxidase in preterm versus term rabbits in response to hyperoxia, 29.5 d preterm rabbits (delivered by hysterotomy) and term rabbits (spontaneously vaginally delivered) were exposed to 48 h of > 90% O2 or room air. Preterm rabbits had a significant increase in CuZn SOD mRNA without corresponding AOE activity increases, suggesting translational/posttranslational inhibition. In full-term rabbits, the magnitude of lung AOE mRNA changes was associated with concordant magnitude changes in activities of CuZn SOD, Mn SOD, and catalase, suggesting pretranslational regulation of AOE gene expression; glutathione peroxidase, however, appears to be regulated translationally/posttranslationally. To investigate potential pharmacologic means of overcoming the susceptibility of the preterm rabbit to O2 toxicity, 29.5 d preterm rabbits received 20-40 micrograms/kg of Salmonella typhimurium endotoxin or diluent S.C. (after birth and at 24 h); in separate experiments, pregnant rabbits received intramuscular injections of dexamethasone (0.01-0.05 mg/kg) or saline on gestational d 27.5 and 28.5 and underwent hysterotomy at 29.5 d.(ABSTRACT TRUNCATED AT 250 WORDS)

Structural studies of metal binding by inositol monophosphatase: evidence for two-metal ion catalysis

The structure of inositol monophosphatase has been determined to 2.60 A resolution in complexes with Mn2+ and with Mn2+ and phosphate. In the Mn2+ complex, three metal cations and one Cl were bound in the active site on each of the two subunits of the enzyme. Ligands to the three metals include the side chains of Glu 70, Asp 90, Asp 93, and Asp 220, t he carbonyl group of Ile 92, several solvent molecules and the chloride, which is a ligand to each of the cations. When phosphate is soaked into these Mn2+ cocrystals, one of the three Mn2+ ions is expelled from the active site, leaving metal ions with octahedral and tetrahedral coordination geometry. In addition, the structure of apoinositol monophosphatase was determined to 2.5 A resolution. Residues 70-75, a two-turn helical segment which is involved in metal coordination, moves away from the metal binding site by 2-3 A in the absence of cations. Residues 30-40, which wrap around the metal binding site and interact with the metal indirectly through solvent molecules and protein ligands to the metal, become disordered in the absence of metal. In various metal complexes, segmental mobility is also observed in the residues which form the metal binding sites. The results of these studies of the interaction of inositol monophosphatase with cations suggest that the enzyme accomplishes phosphate ester hydrolysis using two metal ions, one with octahedral and one with tetrahedral coordination geometry. Broad metal-binding specificity appears to result from extensive flexibility in several of the protein segments which contribute metal ligands, from the presence of alternate metal ligands and from metal coordination spheres which include water molecules.

Structural analysis of inositol monophosphatase complexes with substrates

The structures of ternary complexes of human inositol monophosphatase with inhibitory Gd3+ and either D- or L-myo-inositol 1-phosphate have been determined to 2.2-2.3 A resolution using X-ray crystallography. Substrate and metal are bound identically in each active site of the phosphatase dimer. The substrate is present at full occupancy, while the metal is present at only 35% occupancy, suggesting that Li+ from the crystallization solvent partially replaces Gd3+ upon substrate binding. The phosphate groups of both substrates interact with the phosphatase in the same manner with one phosphate oxygen bound to the octahedrally coordinated active site metal and another oxygen forming hydrogen bonds with the amide groups of residues 94 and 95. The active site orientations of the inositol rings of D- and L-myo-inositol 1-phosphate differ by rotation of nearly 60 degrees about the phosphate ester bond. Each substrate utilizes the same key residues (Asp 93, Ala 196, Glu 213, and Asp 220) to form the same number of hydrogen bonds with the enzyme. Mutagenesis experiments confirm the interaction of Glu 213 with the inositol ring and suggest that interactions with Ser 165 may develop during the transition state. The structural data suggest that the active site nucleophile is a metal-bound water that is activated by interaction with Glu 70 and Thr 95. Expulsion of the ester oxygen appears to be promoted by three aspartate residues acting together (90, 93, and 220), either to donate a proton to the leaving group or to form another metal binding site from which a second Mg2+ coordinates the leaving group during the transition state.

Comparison of the determination of magnesium by methylthymol blue spectrophotometry and atomic absorption spectrophotometry

Plasma samples (n = 155) of 30 patients on an intensive ward were analysed for magnesium simultaneously by atomic absorption spectrophotometry (AAS) and methylthymol blue spectrophotometry. Methylthymol blue spectrophotometry was performed at the bedside, using two different multianalysers, Easy ST 1 and Easy ST 2, Merck, D-Darmstadt. Precision was 12.2% (Easy ST 1) and 17.1% (Easy ST 2), and the average value was 0.89 mmol/l, which was above the expected range (0.72-0.88 mmol/l). Accuracy was 16.25% (Easy ST 1) and 8.75% (Easy ST 2). Analyser 2 was more accurate (8.75% versus 6.25%) but less precise (17.1% versus 12.2%) than analyser 1. Precision of AAS was between the expected values of 0.69 and 0.84 mmol/l. Easy ST and AAS gave significantly different values (p < 0.0001) for 155 measurements. Comparison of AAS and methylthymol blue spectrophotometery showed that methylthymol blue spectrophotometry produced higher values than AAS (mean difference 0.186 mmol/l). Furthermore, analyses of 40 samples of a standardized plasma concentration with methylthymol blue spectrophotometry showed a very low precision (15.3%). Easy ST cannot be assigned for urinary measurements of magnesium. Experimentally measured samples gave unaccountable results.

Propylthiouracil treatment decreases the susceptibility to oxygen radical-induced lung damage in newborn rats exposed to prolonged hyperoxia

In newborn rats, antenatal thyroid stimulation with thyroid-releasing hormone is associated with developmental decreases in pulmonary antioxidant enzyme activities and decreased survival rates during prolonged hyperoxic exposure, with pathologic evidence of increased O2-induced lung damage. Propylthiouracil (PTU), in addition to its antithyroid effects, reportedly has antioxidant properties. To explore possible pulmonary protective effects from both the antithyroid and antioxidant properties of PTU, we administered PTU (0.015%) in drinking water to timed-pregnant rats for the final 10 d of gestation and during lactation; control rats received untreated water. The survival rate of the PTU-treated pups when placed in more than 95% O2 at birth was consistently higher at all time periods in hyperoxia from 6 d [PTU, 81 of 81 (100%); control pups, 70 of 84 (83%); p < 0.01] to 14 d [PTU, 41 of 53 (77%); control pups = 14 of 56 (25%); p < 0.01]. Further evidence of increased tolerance to more than 95% O2 in PTU pups included a significant decrease in the incidence of microscopic intraalveolar edema, decreased lipid peroxidation (malondialdehyde), and a significant increase in lung tissue surfactant-related phospholipids compared with O2-exposed control pups. No differences were present in lung structural maturation, antioxidant enzyme activity response to hyperoxia, or lung tissue O2 radical formation in more than 95% O2. We conclude that PTU treatment has important postnatal effects that protect newborn rats against oxidant-induced lung injury and lethality during hyperoxia, which may be related to PTU inhibition of thyroid hormone production, effect on O2 metabolism, or its direct antioxidant properties.

Development of gas-exchange surface area in rat lung. The effect of alveolar shape

During development, the surface area of the gas-exchange region of the lung can increase by: (1) expansion, (2) subdivision (septation), (3) replication, or (4) change of shape of the basic gas-exchange units (saccules or alveoli). We evaluated the shape of these units in rat lung from birth to adulthood. A shape factor (phi g) was defined in terms of the surface area (Sg) and the volume (Va) of the average unit, using the expression phi g = SgVa-2/3. We studied the lungs of untreated animals and of animals exposed to or treated with hyperoxia (> 95% O2) and/or dexamethasone, each of which is known to inhibit septation in early postnatal life, and with deferoxamine, which protects the lung against the inhibitory effect of hyperoxia. The values found for the shape factor showed no significant difference with regard to age or treatment. This finding suggests that: (1) saccules and alveoli are formed with a certain predetermined shape (close to a hemisphere), (2) any enlargement with time is isotropic, (3) alveolar shape is insensitive to the drastic treatments used, and (4) change of shape is not a mechanism used to increase the gas-exchange surface area of the developing rat lung.

Effects of the 21-aminosteroid, U74389F, on bleomycin-induced pulmonary fibrosis in rats

OBJECTIVE

To determine if a new class of agents, the 21-aminosteroids, which are reportedly potent inhibitors of iron-dependent lipid peroxidation, could protect rats from bleomycin-induced pulmonary fibrosis.

SUBJECTS

Fifty-five adult male Sprague-Dawley rats.

DESIGN

Prospective, randomized, blinded, controlled trial.

INTERVENTIONS

The rats were subjected to intratracheal bleomycin (or saline vehicle), and were then treated with the 21-aminosteroid, U74389F (20 mg/kg/day), or vehicle, for the next 7 days.

MEASUREMENTS AND MAIN RESULTS

At 21 days after bleomycin administration, pulmonary fibrosis was assessed histologically as percent of lung fields with evidence of fibrosis. Pulmonary fibrosis was assessed biochemically by measuring pulmonary elastin and hydroxyproline content. To determine if a protective effect of U74389F was linked to the 21-aminosteroid's ability to suppress lipid peroxidation, two products of lipid peroxidation were assayed in the lungs at 7 and 14 days after bleomycin exposure. By histologic assessment, the 21-aminosteroid-treated, bleomycin-exposed animals were found to have significantly decreased the extent of pulmonary fibrosis when compared with the bleomycin control group (mean 48.6 +/- 20.0 [SD] % [n = 9] vs. 68.4 +/- 19.6% [n = 11]; p < .05). In addition, lung elastin was decreased by approximately 75% (p < .05) and hydroxyproline was decreased by approximately 50% (NS) in the 21-aminosteroid-treated group when compared with the bleomycin control group. At 7 and 14 days after bleomycin exposure, all bleomycin-exposed animals had evidence of increased lipid peroxidation (conjugated dienes and thiobarbituric acid-reactive substances), but the 21-aminosteroid-treated, bleomycin-exposed animals had significantly decreased evidence of lipid peroxidation when compared with bleomycin controls.

CONCLUSIONS

The 21-aminosteroid can substantially protect animals from bleomycin-induced pulmonary fibrosis and may prove useful in other lung diseases where iron-dependent, free-radical reactions and/or lipid peroxidation are presumed mechanisms of toxicity.

Comparative responses of premature versus full-term newborn rats to prolonged hyperoxia

Because fetal rat lungs have lower baseline levels of both surfactant and antioxidant enzymes than full-term newborn rats, we questioned whether prematurely delivered rats might be more susceptible to O2 toxicity than those born at term. In the present studies, prematurely delivered rats (gestational d 21 of 22) and full-term rat pups were simultaneously put in > 95% O2 after birth. Surprisingly, we found that the preterm rats were not more susceptible to O2-induced lung damage and lethality than full-term newborns, but, in fact, the composite percentage of survival was even greater in the preterm pups from 7 to 9 d in hyperoxia and were similar thereafter up to 14 d in high O2. In addition, the preterm rats showed significantly decreased lung wet/dry weight ratios and consistently less severe pathologic evidence of pulmonary edema compared with term rats at 6 and 8 d of O2 exposure. The premature pups demonstrated the capability of inducing pulmonary antioxidant enzyme responses to hyperoxia by 3 d, and had significantly elevated copper-zinc superoxide dismutase, catalase, and glutathione peroxidase activities (and lung surfactant contents) at 6 d of O2 exposure compared with the term rats in O2. The rates of lung total O2 consumption and cyanide-resistant O2 consumption at d 6 in hyperoxia were not different for preterm versus term pups.(ABSTRACT TRUNCATED AT 250 WORDS)

Dramatic changes in care: the experience of one psychiatric hospital

Recent and dramatic changes in this country's mental healthcare service are widely documented. To assess the extent and timing of those changes at one private psychiatric hospital, the authors examined length of stay, number of admissions, and patient age for general trends between 1980 and 1990 and more closely examined trends between July 1990 and December 1991. We related our findings to data for other private psychiatric hospitals and compared them with data from psychiatric units in general hospitals. The results are discussed in terms of changes in insurance coverage, changing utilization by different age groups, and a national shift from inpatient to outpatient care.