Use of automated external defibrillators in a Brazilian airline. A 1-year experience

After the incorporation of automated external defibrillators by other airlines and the support of the Brazilian Society of Cardiology, Varig Airlines began the onboard defibrillation program with the initial purpose of equipping wide-body aircrafts frequently used in international flights and that airplanes use in the Rio - São Paulo route. With all flight attendants trained, the automated external defibrillation devices were incorporated to 34 airplanes of a total fleet of 80 aircrafts. The devices were installed in the baggage compartments secured with velcro straps and 2 pairs of electrodes, one or which pre-connected to the device to minimize application time. Later, a portable monitor was address to the resuscitation kit in the long flights. The expansion of the knowledge of the basic life support fundamentors and the corrected implantation of the survival chain and of the automated external defibrillators will increase the extense of recovery of cardiorespiratory arrest victims in aircrafts.

NMR studies on energy metabolism of immobilized primary neurons and astrocytes during hypoxia, ischemia and hypoglycemia

Changes in high-energy phosphate metabolites (ATP and phosphocreatine) were monitored, in real time, by 31P-nuclear magnetic resonance in primary cell cultures of neurons and astrocytes during periods of hypoxia, ischemia and hypoglycemia, and also during the recovery periods following the re-establishment of standard conditions. Cells were immobilized in basement membrane gel threads and perfused with oxygen-depleted medium (oxygen concentration below 30 microM), to create hypoxic conditions, or with aerobic medium (oxygen concentration approximately 460 microM) containing different concentrations of glucose (hypoglycemia). Ischemic conditions were imposed by stopping perfusion for different periods of time (15 min to 2 h). The experimental set-up enabled the acquisition of 31P-spectra with high signal-to-noise ratio within 10-20 min for both cell types. The effect of hypoxia on glucose metabolism was assessed by 13C-NMR using [1-13C]glucose as substrate. The levels of ATP and PCr in astrocytes were unaffected during hypoxia (up to 2 h), but decreased notably under ischemia. In neurons, hypoxic periods caused a sharp drop of the ATP and PCr levels, and considerable damage to the capacity of neurons to replenish the ATP and PCr pools upon returning to normoxic conditions. However, neurons were remarkably less sensitive to ischemic conditions, the ATP and PCr pools being restored quickly, even after 2 h under challenging conditions. The data show that neurons were more resistant to ischemia than astrocytes, and suggest that the capacity to sustain the pools of ATP and PCr was part of the neuronal protective strategy.

Metabolism of 3-(13)C-malate in primary cultures of mouse astrocytes

Malate, specifically labeled with carbon 13 on C(3), was synthesized by chemical means and used to study malate metabolism by primary cultures of mouse cortical astrocytes. 3-(13)C-Malate in combination with glucose as well as 3-(13)C-malate alone were used as substrates; the effect of 3-nitropropionic acid, an inhibitor of succinate dehydrogenase and fumarase was also examined. The consumption of malate was only 0.26 micromol/mg of protein, approx. 25-fold lower than the consumption of glucose. Besides lactate, glutamine and fumarate were the two major metabolites released to the medium. Very low and similar levels of isotopic enrichment were detected on C(2) and C(3) of lactate; glutamine was labeled on C(2) and C(3) to a similar extent as well and labeling on C(4) was only detected when glucose was not added. These labeling studies suggest that cytosolic malic enzyme is not active in primary astrocytes and support the occurrence of pyruvate recycling in astrocytes.

Metabolic shifts do not influence the glycosylation patterns of a recombinant fusion protein expressed in BHK cells

BHK-21 cells expressing a human IgG-IL2 fusion protein, with potential application in tumor-targeted therapy, were grown under different nutrient conditions in a continuous system for a time period of 80 days. At very low-glucose (< 0.5 mM) or glutamine (< 0. 2 mM) concentrations, a shift toward an energetically more efficient metabolism was observed. Cell-specific productivity was maintained under metabolically shifted growth conditions and at the same time an almost identical intracellular ATP content, obtained by in vivo (31)P NMR experiments, was observed. No significant differences in the oligosaccharide structures were detected from the IgG-IL2 fusion protein preparations obtained by growing cells under the different metabolic states. By using oligosaccharide mapping and MALDI/TOF-MS, only neutral diantennary oligosaccharides with or without core alpha1-6-linked fucose were detected that carried no, one or two beta1-4-linked galactose. Although the O-linked oligosaccharide structures that are present in the IL2 moiety of the protein were studied with less detail, the data obtained from the hydrazinolysis procedure point to the presence of the classical NeuAcalpha2-3Galbeta1-3GalNAc structure. Here, it is shown that under different defined cellular metabolic states, the quality of a recombinant product in terms of O- and N-linked oligosaccharides is stable, even after a prolonged cultivation period. Moreover, unaffected intracellular ATP levels under the different metabolic states were observed.

Effects of ammonia and lactate on growth, metabolism, and productivity of BHK cells

The aim of the present work was to study the effect of ammonia and lactate on growth, metabolism, and productivity of BHK cells producing a recombinant fusion protein. Results show that cell growth was reduced with the increase in ammonia or lactate: k(1/2) of 1.1 mM and 3.5 mM for stirred and stationary cultures, respectively, for ammonia and of 28 mM for both stationary and stirred cultures for lactate, were obtained. The cell-specific consumption rates of both glucose (q(Glc)) and glutamine (q(Gln)) increased, whereas that of oxygen (q(O2)) decreased, with the increase in ammonia or lactate concentrations. The cell-specific production rates of lactate (q(Lac)) increased with an increase in ammonia concentration; similarly for the cell-specific production rates of ammonia (q(Amm)), which also increased with an increase in lactate concentration; on the other hand, both q(Lac) and q(Amm) markedly decreased when lactate or ammonia concentrations were increased, respectively; lactate was consumed at lactate concentrations above 30 mM and ammonia was consumed at ammonia concentrations above 5 mM. In vivo (31)P NMR experiments showed that ammonia and lactate affect the intracellular pH, leading to intracellular acidification, and decrease the content in phosphomonoesters, whereas the cell energy state was maintained. The effect of lactate on cell growth and q(Gln) is partially due to osmolarity, on q(Glc) and q(Amm) is entirely due to osmolarity, but on q(Lac) is mainly due to lactate effect per se. An increase in ammonia from 0 to 20 mM induced a 50% reduction in specific productivity, whereas an increase in lactate from 0 to 60 mM induced a 40% decrease.

Proteolytic activity in infected and noninfected insect cells: degradation of HIV-1 Pr55gag particles

In this work the proteolytic activity in the supernatant and inside insect cells in culture was evaluated for different multiplicities of infection (MOI) and times of infection (TOI). Several methods to detect proteolytic activity in insect cells were tested and that using fluorescein thiocyanite-casein as a substrate was chosen. It was observed that infection caused not only a reduction in the concentration of proteases by decreasing their synthesis but also an inhibition of the intracellular proteolytic activity by increasing the intracellular ATP level (measured by in vivo nuclear magnetic resonance, NMR). The maximum proteolytic activity in the supernatant was observed at 72 hpi except when the cells were infected in the late exponential growth phase or with very low MOI, yielding a nonsynchronous infection. The proteolytic degradation of Pr55gag particles was studied during culture and after harvest. In this particular case it was concluded that the supernatant should be stored at low temperature or quickly purified, since the degradation after 24 h is only 3% at 4 degrees C while at 27 degrees C this value rises to 23%. There is a complex relationship between MOI, TOI, proteolytic activity, and product titer and quality. Thus, the optimal conditions for each case will be a compromise between the final product titer, the desired product quality, and operational issues like process time and capacity, requiring proper integration between bioreaction and downstream processing.

Immobilization of primary astrocytes and neurons for online monitoring of biochemical processes by NMR

Immobilization of primary astrocytes and cerebellar granule neurons in basement membrane gel threads and on porous microcarriers, respectively, is described. Five different porous microcarriers were examined for their capabilities to support maturation of neurons, as evaluated by determinations of protein content and glucose uptake. These systems proved suitable for perfusion in the NMR tube for long periods of time. The energetic status of the cells was monitored by 31P-NMR, and a very good temporal resolution (less than 30 min) was achieved with superfused astrocytes; thus, this provides a valuable method for real time NMR investigation of biochemical processes in primary astrocytes. Significantly longer acquisition times (approximately 8 h) were required in order to obtain a spectrum of neurons with a reasonably good signal to noise ratio, even so, the results presented here and obtained with this difficult system are very encouraging.

Lactate metabolism in mouse brain astrocytes studied by [13C]NMR spectroscopy

Astrocytes possess at least two pathways for pyruvate and thus lactate formation involving precursors derived from mitochondria. The present results suggest that malic enzyme is the preferred route for this process. Although overall lactate release appeared to be independent of extracellular lactate concentration, the incorporation of mitochondrial precursors was decreased by starvation, which is known to deplete astrocyte glycogen stores. Using 1-[13C]glucose in the presence of 10 mM lactate led to label incorporation into extracellular lactate which increased from 3.4 +/- 0.4 to 6.5 +/- 0.5% during 4 and 6 h incubation periods, respectively. Lactate production from glycolysis proceeded virtually unaffected by the extracellular lactate concentration. The total amount of lactate in the medium decreased, however, demonstrating that lactate was used as a substrate.

Studies of baby hamster kidney natural cell aggregation in suspended batch cultures

Microcarrier cultures of animal cells of industrial relevance are known to shed aggregates into the suspension phase. For a BHK cell line, which is known to be prone to aggregate naturally, microcarrier and aggregate forms of culture are compared in spinner culture. In microcarrier cultures, it is shown that increasing initial microcarrier concentration yields decreasing concentration of smaller aggregates in suspension; roughly equivalent concentrations of total cells and single cells in suspension are obtained. In the absence of Cytodex 3, aggregate final size is hydrodynamically controlled in batch and semicontinuous suspension culture. Rate of agitation is the main variable controlling aggregate size in batch cultures. The range of agitation rates studied (20 to 70 rpm in 250 mL spinner flasks) produced aggregates with maximum sizes of 200 microns. Necrotic centers were not observed; this was confirmed by Trypan blue viability measurements after mechanical dissociation of aggregates and also by the constant productivity obtained from different aggregate sizes. Comparing aggregate and microcarrier culture conditions, it is shown that at 100 rpm maximum total cell concentration is larger in the absence of microcarriers; dead cell concentrations, most of which exist in suspension, are slightly larger in microcarrier culture. Total viable cell concentrations in aggregate, hydrodynamically controlled culture, are almost one order of magnitude higher than in microcarrier cultures. These results suggest that there might be advantages in using aggregate cultures under hydrodynamic control of aggregate size in lieu of microcarrier cultures for naturally aggregating cell lines.

Changes in animal cell natural aggregates in suspended batch cultures

Some anchorage-dependent animal cells can form natural aggregates in stirred tanks. Baby hamster kidney (BHK) natural aggregates are described and characterized. Total cell concentration and viability could be obtained after aggregate mechanical dissociation, with negligible cell lysis and no change in cell membrane permeability. During a normal batch run, aggregates were formed immediately after inoculation, a few spherical aggregates increasing in size during the initial growth phase. At the end of the growth phase, an increase in aggregate concentration was observed, without a considerable increase in aggregate diameter. At the end of the batch run, 160 h after inoculation, aggregates disintegrated into smaller, non-spherical units, following a sharp viability decrease. Cell concentrations of 1.2 x 10(6) cells/ml were obtained, with 60% of the total cells being in aggregates; the cell concentration in aggregates achieved 5 x 10(8) cells/ml, with a porosity of 55%. Viability was consistently in the range 85-90%, both for aggregate and suspended cells.

Expression of recombinant antibody and secreted alkaline phosphatase in mammalian cells. Influence of cell line and culture system upon production kinetics

The growth and productivity of an Sp2/0 cell line, F3b10, expressing a recombinant antibody (rAb) and BHK21 cells expressing either the same rAb from the same plasmids (BHK.IgG) or secreted alkaline phosphatase (SEAP) (BHK.SEAP) were investigated. The F3b10 line was grown as a single cell suspension. The BHK lines were grown either as suspended natural aggregates or on Cytodex 3 microcarriers. The data for F3b10 showed that the cell-specific rAb production rate (QsrAb) increased in parallel with increases in the specific growth rate (mu). A similar result was obtained for suspended aggregate cultures of both recombinant BHK cell lines. In contrast, for microcarrier cultures of both BHK cell lines, Qsproduct increased as mu decreased. This report shows that the relationship between cell growth and Qsproduct for the cell lines and products studied is dependent upon the culture process. In systems where recombinant cells are growing as a single cell suspension or within a natural suspension aggregrate, Qsproduct increased with increases in mu. In such systems, the cells have a rounded morphology. When cells were grown on microcarriers. Qsproduct decreased as mu increased. Cells growing attached to a surface are flat and elongated. The observed differences in the relationship of Qsproduct to mu are correlated with changes in cell morphology. The relationship between Qsproduct and mu is also affected by the choice of cell line.

[Coronary risk factors in high-rank athletes]

PURPOSE

To report the prevalence of coronary risk factors in elite athletes.

METHODS

The prevalence of coronary risk factors was determined in 88 athletes (62 men and 26 women) who participate representing Brazil, in the Olympic Games at Seul in 1988, in the Project SEUL/COB/AMIL. The risk factors analyzed were: family history of coronary heart disease, hypercholesterolemia (total-cholesterol and subfractions), hypertension, glucose intolerance, smoking and left ventricle hypertrophy (LVH). We compared the mean values of total-cholesterol/HDL-cholesterol between men and women with unpaired Student's t Test. The distribution of risk factors prevalence by sex was analysed with the chi-square test.

RESULTS

Family history of coronary heart disease was detected in 11 (12.5%) athletes. Smoking was found in 12 (13.6%) athletes. There was no one with hypertension or glucose intolerance. LVH was diagnosed with the echocardiogram, in 36 athletes (40.9%). Total-cholesterol mean was 172 +/- 36 mg/dl in men and 187 +/- 34 mg/dl in women. HDL-cholesterol mean was 46 +/- 10 mg/dl in men and 60 +/- 13 mg/dl in women. Total-cholesterol/HDL-cholesterol mean was 4.02 +/- 1.39 mg/dl in men and 3.21 +/- 0.74 mg/dl in women. The difference between total-cholesterol in mean and women was not statistically significant (p less than 0.05). HDL-cholesterol and total-cholesterol/HDL-cholesterol means were statistically different (p less than 0.05). Prevalence distribution of the number of risk factors by sex were not statistically different (p less than 0.05).

CONCLUSION

The results shows how important is to look for coronary risk factors in elite athletes.

[Cholesterol and other cardiovascular risk factors among employees of the Universidade Federal do Rio de Janeiro. Prevalence and influence of social variables]

PURPOSE

To investigate the presence of cardiovascular risk factors in employees of the "Universidade Federal do Rio de Janeiro".

PATIENTS AND METHODS

A survey of 250 men age ranging from 35 to 64 years, randomly selected among 4651 employees of URFJ, was done. They were invited by letter to a consultation at which previously trained personnel applied a questionnaire to investigate about their education level, income, occupation, smoking habit, and use of anti-hypertensive drugs. They also had their blood pressure, height and weight measured and underwent a blood sample collection for serum cholesterol and HDL-cholesterol analysis. This procedure followed a standardized protocol.

RESULTS

Two hundred and nine subjects (83.6%) were examined. The characteristics of age, education, and occupation were similar for responders and non-responders. The mean (+/- standard deviation) for total cholesterol, HDL-cholesterol, systolic and diastolic blood pressure were respectively: 210 +/- 21.9 mg/dl; 41.1 +/- 12.4 mg/dl; 129.7 +/- 24.0 and 80.4 +/- 17.7. The prevalence of hypertension, hypercholesterolemia and smoking were: 30%, 22% and 38%. The prevalence of these risk factors together was 4%. Only SBP and DBP were statistically different when analyzed by income or education strata. There was a strong positive correlation between body mass index and serum cholesterol and blood pressure levels.

CONCLUSION

In spite of the high education level and income of this sample for brazilian standards, the prevalence of risk factors for cardiovascular diseases is very high, especially for the overweight and the socially less favoured. More precise indicators of dietary habits and socio-economic and cultural status are necessary to develop adequate interventional strategies. The control of obesity seems to be a desirable goal in achieving the concurrent control of associated risk factors.

Common arterial trunk arising exclusively from the right ventricle with hypoplastic left ventricle and intact ventricular septum

A common arterial trunk is a rare congenital anomaly usually accompanied by other intracardiac malformations. The association with hearts with a univentricular atrioventricular connexion is particularly uncommon. We report a case of a common arterial trunk occurring in a heart with absent left atrioventricular connexion. The trunk arose exclusively from the right ventricle, the left ventricle was incomplete and the ventricular septum was intact. Other associated malformations were an interrupted aortic arch and an atrial septal defect.