Protective effects of Celsior in lung transplantation

BACKGROUND

Celsior is a new preservation solution for heart transplants that recently has been shown also to improve protection of pulmonary grafts. As these data were obtained in isolated lung preparations, we sought to perform further tests with an in vivo model of allogeneic lung transplantation.

METHODS

The left lungs of 41 rats were either transplanted immediately after harvest (controls) or flushed with and cold stored in Celsior or the blood-based Wallwork solution for 5 or 12 hours. Lungs were then reperfused for 30 minutes, after which ligation of the contralateral pulmonary artery and bronchus made the recipient rat exclusively dependent on the transplanted lung. Assessment of preservation was made on functional (blood gases, pulmonary hemodynamics) and structural (dry-to-weight ratio, light microscopy, myeloperoxidase [MPO] content) end points.

RESULTS

The protective effects of Celsior were primarily manifest, once the contralateral lung had been functionally excluded, as a better preservation of oxygen tensions in the 5-hour storage experiments (416 +/- 52 mm Hg vs 406 +/- 59 mm Hg in controls [p = NS] and vs 239 +/- 34 mm Hg in Wallwork [p < 0.05 vs the 2 other groups]) and a smaller increase in pulmonary vascular resistance in the 12-hour storage experiments (10.2 +/- 4.1 mm Hg/mL/minute vs 3.2 +/- 1.1 mm Hg/mL/minute in controls [p = NS] and vs 23.1 +/- 4.3 mm Hg/mL/minute in Wallwork [p < 0.02 vs Celsior, p < 0.002 vs controls]). Survival was also longer in the 12-hour preserved Celsior group. Other end points were not significantly different between the two preservative solutions.

CONCLUSION

These data support the efficacy of Celsior as a flush-out and storage solution for pulmonary grafts. Given its previously documented ability to adequately preserve heart transplants, Celsior might provide a unified "solution" to thoracic organ preservation.

Cold-regulated gene expression and freezing tolerance in an Arabidopsis thaliana mutant

Low temperature is an important environmental factor influencing plant growth and development. In this study, we report the characterization of a genetic locus, HOS2, which is defined by three Arabidopsis thaliana mutants. The hos2-1, hos2-2 and hos2-3 mutations result in enhanced expression of RD29A and other stress genes under low temperature treatment. Gene expression in response to osmotic stress or ABA is not affected in the hos2 mutants. Genetic analysis indicates that the hos2 mutations are recessive and in a nuclear gene. Compared with the wild-type plants, the hos2-1 mutant plants are less capable of developing freezing tolerance when treated with low non-freezing temperatures. However, the hos2-1 mutation does not impair the vernalization response. These results indicate that HOS2 is a negative regulator of low temperature signal transduction important for plant cold acclimation.

Evaluation of gadopentetate dimeglumine magnetic resonance cisternography in an animal model: preliminary report

RATIONALE AND OBJECTIVES

To evaluate magnetic resonance (MR) imaging characteristics of the cisternal administration of gadopentetate dimeglumine (gadolinium) in a small experimental animal.

METHODS

Four female New Zealand White rabbits were used for this experiment. Each rabbit received a single dose of intrathecal gadolinium (doses ranged from 75-100 micromol) via a cisternal puncture. Immediate and delayed sagittal and axial T1-weighted images of the brain and cervical spinal cord were acquired on a 2 Tesla CSI magnet.

RESULTS

All the rabbits tolerated the experiment well, without significant alterations in behavior or seizure activity. During the early phase of imaging, subarachnoid space enhancement was observed over the surface of the brain parenchyma and spinal cord on T1-weighted images. Gradual diffusion of the gadolinium into the cranial parenchyma was seen on the delayed MR studies (45 minutes-6 hours), as revealed by progressive generalized enhancement of the brain. Sustained enhancement of gray matter of the spinal cord was observed.

CONCLUSION

This study illustrates that there is no barrier between the cerebrospinal fluid (CSF) and the brain-spinal cord with regard to gadolinium. Possible practical applications for gadolinium-enhanced MR myelography or cisternography include the assessment of communication or obstruction of CSF pathways, subarachnoid space CSF flow pattern analysis, spontaneous or acquired CSF fistula evaluation, evaluation of the intercommunication of central nervous system cystic structures bordering on CSF pathways, and the study of the dynamics of gadolinium diffusion in the central nervous system parenchyma.

Interaction of osmotic stress, temperature, and abscisic acid in the regulation of gene expression in Arabidopsis

The impact of simultaneous environmental stresses on plants and how they respond to combined stresses compared with single stresses is largely unclear. By using a transgene (RD29A-LUC) consisting of the firefly luciferase coding sequence (LUC) driven by the stress-responsive RD29A promoter, we investigated the interactive effects of temperature, osmotic stress, and the phytohormone abscisic acid (ABA) in the regulation of gene expression in Arabidopsis seedlings. Results indicated that both positive and negative interactions exist among the studied stress factors in regulating gene expression. At a normal growth temperature (22 degrees C), osmotic stress and ABA act synergistically to induce the transgene expression. Low temperature inhibits the response to osmotic stress or to combined treatment of osmotic stress and ABA, whereas low temperature and ABA treatments are additive in inducing transgene expression. Although high temperature alone does not activate the transgene, it significantly amplifies the effects of ABA and osmotic stress. The effect of multiple stresses in the regulation of RD29A-LUC expression in signal transduction mutants was also studied. The results are discussed in the context of cold and osmotic stress signal transduction pathways.

A ketolide resistance mutation in domain II of 23S rRNA reveals the proximity of hairpin 35 to the peptidyl transferase centre

Ketolides represent a new generation of macrolide antibiotics. In order to identify the ketolide-binding site on the ribosome, a library of Escherichia coli clones, transformed with a plasmid carrying randomly mutagenized rRNA operon, was screened for mutants exhibiting resistance to the ketolide HMR3647. Sequencing of the plasmid isolated from one of the resistant clones and fragment exchange demonstrated that a single U754A mutation in hairpin 35 of domain II of the E. coli 23S rRNA was sufficient to confer resistance to low concentrations of the ketolide. The same mutation also conferred erythromycin resistance. Both the ketolide and erythromycin protected A2058 and A2059 in domain V of 23S rRNA from modification with dimethyl sulphate, whereas, in domain II, the ketolide protected, while erythromycin enhanced, modification of A752 in the loop of the hairpin 35. Thus, mutational and footprinting results strongly suggest that the hairpin 35 constitutes part of the macrolide binding site on the ribosome. Strong interaction of ketolides with the hairpin 35 in 23S rRNA may account for the high activity of ketolides against erythromycin-resistant strains containing rRNA methylated at A2058. The existence of macrolide resistance mutations in the central loop of domain V and in hairpin 35 in domain II together with antibiotic footprinting data suggest that these rRNA segments may be in close proximity in the ribosome and that hairpin 35 may be a constituent part of the ribosomal peptidyl transferase centre.

Central noradrenergic mediation of nitrous oxide-induced analgesia in rats

PURPOSE

Although several studies have demonstrated that both supra opiate receptors and spinal alpha 2 adrenoceptors play a mediating role in nitrous oxide(N2O) analgesia, controversy still exists. The present study was undertaken to evaluate further the involvement of noradrenergic (NA) neuronal activity in N2O analgesia by investigating tail-flick latency and supra- and spinal NA levels in rats.

METHODS

In an analgesia study, effect of N2O 75% and its modification were evaluated using the tail-flick test in male Wistar rats. Results were expressed as % maximum possible effect (MPE). Modification of N2O analgesia was examined in rats pretreated with either the alpha 2 receptor agonist, clonidine(CLO: 150 micrograms.kg-1, i.p.), alpha 2 receptor antagonist, idazoxone(IDZ: 100 micrograms.kg-1, i.v.) by lesioning the locus coeruleus (LC) seven days before exposure to N2O, or naloxone (5 mg.kg-1, i.v.). Also, in a NAergic neuronal transmission study, the changes in NA content at LC and spinal cord were determined using HPLC-ECD.

RESULTS

Nitrous oxide produced analgesia, % MPE increased to a maximum of 78% at 30 min, thereafter declining to 38% at 120 min. Clonidine potentiated the analgesic effect of N2O at 120 min (80%). The analgesic effect of N2O was attenuated by IDZ or by LC lesioning. However, naloxone, in a dose sufficient to block morphine-induced analgesia, had no effect. With N2O exposure, NA content was decreased by 52% in the LC and by 20% at spinal cord. With morphine, NA content did not differ from the control group.

CONCLUSION

The data suggest that N2O-induced analgesia is principally mediated by activation of the descending inhibitory NAergic system and/or increased NA release at spinal cord which may lead to presynaptic inhibition of primary afferent neurotransmitter release and hyperpolarize the dorsal horn neurons by alpha 2 receptors.

Genetic analysis of salt tolerance in arabidopsis. Evidence for a critical role of potassium nutrition

A large genetic screen for sos (for salt overly sensitive) mutants was performed in an attempt to isolate mutations in any gene with an sos phenotype. Our search yielded 28 new alleles of sos1, nine mutant alleles of a newly identified locus, SOS2, and one allele of a third salt tolerance locus, SOS3. The sos2 mutations, which are recessive, were mapped to the lower arm of chromosome V, approximately 2.3 centimorgans away from the marker PHYC. Growth measurements demonstrated that sos2 mutants are specifically hypersensitive to inhibition by Na+ or Li+ and not hypersensitive to general osmotic stresses. Interestingly, the SOS2 locus is also necessary for K+ nutrition because sos2 mutants were unable to grow on a culture medium with a low level of K+. The expression of several salt-inducible genes was superinduced in sos2 plants. The salt tolerance of sos1, sos2, and sos3 mutants correlated with their K+ tissue content but not their Na+ tissue content. Double mutant analysis indicated that the SOS genes function in the same pathway. Based on these results, a genetic model for salt tolerance mechanisms in Arabidopsis is presented in which SOS1, SOS2, and SOS3 are postulated to encode regulatory components controlling plant K+ nutrition that in turn is essential for salt tolerance.

Genetic analysis of salt tolerance in arabidopsis. Evidence for a critical role of potassium nutrition

A large genetic screen for sos (for salt overly sensitive) mutants was performed in an attempt to isolate mutations in any gene with an sos phenotype. Our search yielded 28 new alleles of sos1, nine mutant alleles of a newly identified locus, SOS2, and one allele of a third salt tolerance locus, SOS3. The sos2 mutations, which are recessive, were mapped to the lower arm of chromosome V, approximately 2.3 centimorgans away from the marker PHYC. Growth measurements demonstrated that sos2 mutants are specifically hypersensitive to inhibition by Na+ or Li+ and not hypersensitive to general osmotic stresses. Interestingly, the SOS2 locus is also necessary for K+ nutrition because sos2 mutants were unable to grow on a culture medium with a low level of K+. The expression of several salt-inducible genes was superinduced in sos2 plants. The salt tolerance of sos1, sos2, and sos3 mutants correlated with their K+ tissue content but not their Na+ tissue content. Double mutant analysis indicated that the SOS genes function in the same pathway. Based on these results, a genetic model for salt tolerance mechanisms in Arabidopsis is presented in which SOS1, SOS2, and SOS3 are postulated to encode regulatory components controlling plant K+ nutrition that in turn is essential for salt tolerance.

Pulmonary blood flow measured by inspiratory inert gas concentration forcing oscillations

The aim of this study was to discover if the forced inspired inert gas sinewave technique could be used to measure pulmonary blood flow, using nitrous oxide as the indicator gas, following inotropic stimulation of the heart by dobutamine, in the presence of a constant alveolar ventilation. Cardiac output (range 1-4.5 L min(-1)) was measured in six dogs by thermodilution and by calculation from the sinusoidal expired partial pressures of argon and nitrous oxide using: (i) analytical equations and a conventional continuous ventilation three-compartment lung model, which did not include recirculation; and (ii) a digital simulation tidal ventilation lung model (Gavaghan and Hahn, 1996. Respir. Physiol. 106, 209-221) which was adapted to include nitrous oxide mixed-venous recirculation from a combined single viscera compartment. The continuous ventilation model calculations always underestimated thermodilution cardiac output, with the bias error increasing to almost -1 L min(-1) at the longest forcing periods, 4-5 min. In contrast, the tidal ventilation model calculations were in close agreement to thermodilution cardiac output, with biases of -0.04 and -0.26 L min(-1) at forcing periods of 2 and 3 min, respectively.

HOS1, a genetic locus involved in cold-responsive gene expression in arabidopsis

Low-temperature stress induces the expression of a variety of genes in plants. However, the signal transduction pathway(s) that activates gene expression under cold stress is poorly understood. Mutants defective in cold signaling should facilitate molecular analysis of plant responses to low temperature and eventually lead to the identification and cloning of a cold stress receptor(s) and intracellular signaling components. In this study, we characterize a plant mutant affected in its response to low temperatures. The Arabidopsis hos1-1 mutation identified by luciferase imaging causes superinduction of cold-responsive genes, such as RD29A, COR47, COR15A, KIN1, and ADH. Although these genes are also induced by abscisic acid, high salt, or polyethylene glycol in addition to cold, the hos1-1 mutation only enhances their expression under cold stress. Genetic analysis revealed that hos1-1 is a single recessive mutation in a nuclear gene. Our studies using the firefly luciferase reporter gene under the control of the cold-responsive RD29A promoter have indicated that cold-responsive genes can be induced by temperatures as high as 19 degrees C in hos1-1 plants. In contrast, wild-type plants do not express the luciferase reporter at 10 degrees C or higher. Compared with the wild type, hos1-1 plants are l ess cold hardy. Nonetheless, after 2 days of cold acclimation, hos1-1 plants acquired the same degree of freezing tolerance as did the wild type. The hos1-1 plants flowered earlier than did the wild-type plants and appeared constitutively vernalized. Taken together, our findings show that the HOS1 locus is an important negative regulator of cold signal transduction in plant cells and that it plays critical roles in controlling gene expression under cold stress, freezing tolerance, and flowering time.

23S rRNA positions essential for tRNA binding in ribosomal functional sites

rRNA plays an important role in function of peptidyl transferase, the catalytic center of the ribosome responsible for the peptide bond formation. Proper placement of the peptidyl transferase substrates, peptidyl-tRNA and aminoacyl-tRNA, is essential for catalysis of the transpeptidation reaction and protein synthesis. In this report, we define a small set of rRNA nucleotides that are most likely directly involved in binding of tRNA in the functional sites of the large ribosomal subunit. By binding biotinylated tRNA substrates to randomly modified large ribosomal subunits from Escherichia coli and capturing resulting complexes on the avidin resin, we identified four nucleotides in the large ribosomal subunit rRNA (positions G2252, A2451, U2506, and U2585) whose modifications prevent binding of a peptidyl-tRNA analog in the P site and one residue (U2555) whose modification interferes with transfer of peptidyl moiety to puromycin. These nucleotides represent a subset of positions protected by tRNA analogs from chemical modification and significantly narrow the number of 23S rRNA nucleotides that may be directly involved in tRNA binding in the ribosomal functional sites.

MR of parenchymal spinal cord signal change as a sign of active advancement in clinically progressive posttraumatic syringomyelia

Extensive MR signal change in the craniad spinal cord parenchyma was found to be an ancillary sign of disease advancement in three patients with clinically progressive posttraumatic syringomyelia. This craniad margin of parenchymal spinal cord T2 hyperintensity resolved after cystoperitoneal shunt placement. There was a concomittant reduction or disappearance of the cyst in each instance, a halt in the progression of neurologic deficit, and some reversal of signs and symptoms.

Genetic analysis of osmotic and cold stress signal transduction in Arabidopsis: interactions and convergence of abscisic acid-dependent and abscisic acid-independent pathways

To dissect genetically the complex network of osmotic and cold stress signaling, we constructed lines of Arabidopsis plants displaying bioluminescence in response to low temperature, drought, salinity, and the phytohormone abscisic acid (ABA). This was achieved by introducing into Arabidopsis plants a chimeric gene construct consisting of the firefly luciferase coding sequence (LUC) under the control of the stress-responsive RD29A promoter. LUC activity in the transgenic plants, as assessed by using in vivo luminescence imaging, faithfully reports the expression of the endogenous RD29A gene. A large number of cos (for constitutive expression of osmotically responsive genes), los (for low expression of osmotically responsive genes), and hos (for high expression of osmotically responsive genes) mutants were identified by using a high-throughput luminescence imaging system. The los and hos mutants were grouped into 14 classes according to defects in their responses to one or a combination of stress and ABA signals. Based on the classes of mutants recovered, we propose a model for stress signaling in higher plants. Contrary to the current belief that ABA-dependent and ABA-independent stress signaling pathways act in a parallel manner, our data reveal that these pathways cross-talk and converge to activate stress gene expression.

[Genetic divergence of Cordyceps sinensis as estimated by random amplified polymorphic DNA analysis]

Random amplified polymorphic DNA(RAPD) has been used in analyzing 13 winter worm, summer grasses (Cordyceps sinensis [Berk.], Sacc.) from 5 areas in Qingzang plateau. For 19 arbitrary primers, each individual showed about 65 RAPD markers. The genetic distances among those 13 winter worm, summer grasses were correlated to their geographic distances. Molecular phylogenetic tree constructed by UPGMA and NJ suggested that 13 winter worm, summer grasses could be divided into 3 clusters: east cluster, north cluster and middle cluster, in consistence with their origins and genetic divergence among different clusters. Furthermore, our results implied that the RAPD markers of winter worm, summer grasses showed a geographic specificity and could be a better genetic marker in studying genetic diversity and phylogeny of winter worm, summer grasses.

Erythromycin resistance peptides selected from random peptide libraries

Translation of a 5-codon mini-gene encoded in Escherichia coli 23 S rRNA was previously shown to render cells resistant to erythromycin (Tenson, T., DeBlasio, A., and Mankin, A. S. (1996) Proc. Natl. Acad. Sci. U. S. A. 93, 5641-5646). Erythromycin resistance was mediated by a specific interaction of the 23 S rRNA-encoded pentapeptide with the ribosome. In the present study, peptides conferring erythromycin resistance were selected from in vivo expressed random peptide libraries to study structural features important for peptide activity. Screening of a 21-codon mini-gene library (the general structure ATG (NNN)20 TAA) demonstrated that only short peptides (3-6 amino acids long) conferred erythromycin resistance. Sequence comparison of erythromycin resistance peptides isolated from the 5-codon library (ATG (NNN)4 TAA) revealed a strong preference for leucine or isoleucine as a third amino acid and a hydrophobic amino acid at the C terminus of the peptide. When tested against other antibiotics, erythromycin resistance peptides rendered cells resistant to other macrolides, oleandomycin and spiramycin, but not to chloramphenicol or clindamycin. Defining the consensus amino acid sequence of erythromycin resistance peptides provided insights into a possible mode of peptide action and the nature of the peptide binding site on the ribosome.

MR of disc protrusion engendered by infectious spondylitis

PURPOSE

The purpose of this study was to determine if infection-related disc protrusion formed a component of the perispinous/epidural mass in patients with intervertebral disc infection.

METHOD

A retrospective review was undertaken of 16 consecutive patients with intervertebral disc space infection who were referred for gadolinium-enhanced MRI. Possible correlation was sought between disc infection and the presence of associated posterior disc protrusion as determined by MRI.

RESULTS

Of the 16 infected discs, 10 cases were in the lumbosacral spine, 3 in the thoracic spine, and 3 in the cervical spine. Four cases had isolated posteriorly directed disc protrusion, and 12 showed both posterior and anterior disc protrusions. The infection in patients with disc protrusion was related to Staphylococcus aureus in 14 patients, Salmonella enteritidis in 1, and Streptococcus pneumoniae in 1.

CONCLUSION

This study showed that disc protrusion occurred in combination with disc space infections. Local factors such as the secretion by hyaluronidase from Staphylococcus aureus may play an important role in causing focal disc protrusion. The clinical importance of this finding is in the recognition that a significant part of the compromise of the spinal canal in cases of disc infection can be related to disc fragments engendered by the infectious process.

MR of optic papilla protrusion in patients with high intracranial pressure

PURPOSE

To evaluate the signal characteristics of the optic papilla (optic nerve head) on routine cranial MR images in patients with clinical evidence of optic papilla elevation caused by high intracranial pressure, and to compare these findings with findings in healthy adult volunteers.

METHODS

We reviewed retropectively the MR imaging examinations of 15 patients who were referred with objectively decreased visual acuity and funduscopic findings of optic papilla elevation. T1-weighted and T2-weighted axial MR images were obtained by using conventional spinecho acquisitions on 1.5-T MR imagers. In addition, the MR imaging studies in 10 healthy adult volunteers without visual impairment were reviewed as controls.

RESULTS

In 10 (67%) of the 15 patients, visual elevation of the optic papilla was shown by MR imaging. In all 15 patients, the MR signal intensity of the optic papilla was hypointense relative to the vitreous of the globe on T2-weighted images. In the healthy volunteer group, the optic papillae were all similarly hypointense relative to the vitreous of the globe on T2-weighted images; however, these optic papillae were flat.

CONCLUSION

Clinical examination and MR imaging may show elevation of the optic papilla in patients with high intracranial pressure. When chronic, optic papilla elevation has been shown to correlate well with severe loss of vision. Actual edema of the optic papilla seems to play little role in the physical elevation observed clinically in the chronic stages of this pathologic process.

Propranolol therapy in experimental heart failure in rabbits improves cardiac response to catecholamines without beta-adrenoceptor up-regulation

Beta-blockade has been shown to improve cardiac response to catecholamines in heart failure but cellular mechanisms of the improvement are unknown. The effect on left ventricular function of a 14 day propranolol treatment was studied in seven treated and eight non-treated rabbits with experimental heart failure. All animals were subjected to a volume (aortic insufficiency) plus pressure (aortic constriction) overload and were instrumented with a left ventricular catheter and ultrasonic crystals measuring anteroposterior left ventricular diameter. Beta-adrenoceptors were measured using 125I-Cyanopindolol in crude membranes. With isoproterenol, the heart rate was slower in treated rabbits than in non-treated rabbits (p < 0.005) and isoproterenol increased more systolic diameter shortening in treated than in non-treated rabbits (p < 0.05). With norepinephrine, for matched pressures, % delta D increased in the treated group but it did not change in the non-treated group. This improvement of ventricular function was due, in a large part, to an increased diastolic response to norepinephrine: end-diastolic diameter increased in the treated group but not in the non-treated group. In contrast with the improved ventricular response to catecholamines, beta-adrenergic receptor density in the treated group was identical to that of the non-treated group (27.8 fmoles/mg/proteins) and was significantly lower than that of normal rabbits (58.2 fmoles/mg, p < 0.01). The improvement of ventricular response to catecholamines appears to be due to a myocardial protection by propranolol against the toxic effect of catecholamines in heart failure and not, at least in this model, to an up-regulation of beta-adrenoceptors.

Lumbosacral spine: early and delayed MR imaging after administration of an expanded dose of gadopentetate dimeglumine in healthy, asymptomatic subjects

PURPOSE

To determine normal magnetic resonance (MR) imaging enhancement characteristics of the lumbosacral spine after intravenous administration of an expanded dose of gadopentetate dimeglumine.

MATERIALS AND METHODS

T1-weighted MR images of the lumbosacral spine were acquired before and after injection of 0.3 mmol/kg gadopentetate dimeglumine in 12 healthy subjects (eight men, four women; age range, 22-57 years).

RESULTS

In 10 (91%) of the 11 subjects who completed the investigation, multifocal linear enhancement within the thecal sac that generally extended from the conus to the nerve-root sheaths was demonstrated. In all cases, enhancement was seen in the facet joints and the intervertebral disks parallel to the vertebral end-plates.

CONCLUSION

After an expanded dose of intravenous gadopentetate dimeglumine, multiple intrathecal and extrathecal structures were enhanced. Recognition of normal enhancement patterns after an expanded gadopentetate dimeglumine dose is important because such enhancement after routine injection of 0.1 mmol/kg gadopentetate dimeglumine is often thought to indicate disease.

The midline pineal "eye": MR and CT characteristics of the pineal gland with and without benign cyst formation

The purpose of this study was to evaluate the magnetic resonance imaging characteristics of pineal cysts and pineal calcifications and to determine the incidence of benign pineal cysts. Two-hundred-fifty magnetic resonance examinations were retrospectively examined for the incidence of pineal cysts. In addition, 60 collected cases of pineal cysts were evaluated with regard to cross sectional diameter and magnetic resonance signal characteristics. Finally, the magnetic resonance signal characteristics of pineal tissue in 50 patients were compared to companion computed tomographic scans that were scrutinized for the presence or absence of calcification. The incidence of pineal cysts as revealed by magnetic resonance imaging in this study was 10.8%. The minimal and maximal measurements ranged from a low of 2 x 2 x 2 mm to a high of 10 x 12 x 10 mm. The magnetic resonance signal intensities of pineal cyst as compared to cerebrospinal fluid were iso- or hyperintense on all magnetic resonance sequences in the majority of cases. Calcifications of the pineal gland as revealed by computed tomography tended to be isointense to gray matter if the calcifications were small and hypointense to gray matter if large on all magnetic resonance acquisitions. A careful analysis of the magnetic resonance signal characteristics enables the recognition of moderate- to large-sized pineal calcifications and their differentiation from large pineal cysts. However, small cysts of the pineal gland can be difficult or impossible to distinguish on magnetic resonance imaging from calcifications without comparison with computed tomography.

Evaluation of histopathologic changes in an animal model of mechanical corpus callosum impingement as seen in hydrocephalus

RATIONALE AND OBJECTIVES

We evaluated histologic changes associated with chronic impingement of the corpus callosum. Similar callosal impingement has been postulated to be responsible for some of the symptoms in people who have hydrocephalus.

METHODS

Eight rats with callosal impingement produced by surgical implantation of a blunt blade in the interhemispheric fissure and four control animals with no callosal impingement were evaluated by magnetic resonance (MR) imaging and by direct histologic evaluation after autopsy. The histologic evaluations occurred 1 month after surgery in half the animals and 6 months after surgery in the other half.

RESULTS

MR imaging results showed that the implanted blade was in a good position in all animals. Histologically, the corpus callosum appeared normal 1 month after implantation of the impingement blade. Six months after surgery, the experimental group demonstrated decreased callosal thickness and a loss of axonal fibers in the corpus callosum both near and remote to the blade.

CONCLUSION

Chronic impingement of the corpus callosum was associated with callosal thinning and by loss of callosal axons. Further research will be required to investigate the possible relation of these histologic findings to the clinical findings in normal-pressure hydrocephalus.

Methaemoglobin production in normal adults inhaling low concentrations of nitric oxide

OBJECTIVE

The study was performed to determine the changes in blood methaemoglobin level during the inhalation of nitric oxide.

DESIGN

The study was an unblinded dose-response study.

PARTICIPANTS

5 healthy adult volunteers aged 30-36 (4 male and 1 female) were studied on 4 occasions separated by at least one week.

INTERVENTION

Nitric oxide was inhaled at inspired concentrations of 32, 64, 128, and 512 volumes per million (vpm) in air. Venous blood samples were taken every 10 min for methaemoglobin determination. Inhalation continued for 3 h (32, 64 and 128 vpm) or until the methaemoglobin exceeded 5% of the total haemoglobin (512 vpm). The methaemoglobin levels were also recorded for 3 h after 512 vpm nitric oxide had been stopped.

MEASUREMENTS AND RESULTS

Both the increase in methaemoglobin fraction during nitric oxide inhalation and the decay after ceasing inhalation fitted well with a first order model describing methaemoglobin elimination. The calculated time constants were between 39-91 min. The predicted mean maximum methaemoglobin levels that would be achieved during inhalation of 32, 64, 128, and 512 vpm nitric oxide were 1.04% (0.92-1.16), 1.75% (1.80-1.90%), 3.75% (3.58-4.05), 6.93% (5.70-8.16) respectively (95% confidence interval of estimate in brackets).

CONCLUSIONS

In normal individuals inhalation of up to 128 vpm of nitric oxide, greater than any dose used clinically to date, does not result in clinically significant methaemoglobinaemia. Maximum methaemoglobin levels are likely to be reached in 3-5 h after inhalation begins. However, these figures may not apply to critically ill adults and infants. Nitric oxide may have other toxic effects not examined in this study.

Effect of methylene blue on the vasodilator action of inhaled nitric oxide in hypoxic sheep

We have examined the effect of methylene blue 4mg kg-1 on the pulmonary vasodilator action of inhaled nitric oxide (8, 32, 128 and 512 volumes per million) in nine sheep with pulmonary hypertension induced by hypoxia (FlO2 = 0.12). The dose-response to nitric oxide was unchanged by methylene blue, but increased cardiac output was noted (P < 0.01). These results indicate that methylene blue may not inhibit the action of nitric oxide on guanylate cyclase, as suggested previously, and that treatment of methaemoglobinaemia occurring during therapeutic inhalation of nitric oxide with methylene blue may not block the vasodilator effect of nitric oxide on the pulmonary vasculature.