The effects of postmortem delay on mu, delta and kappa opioid receptor subtypes in rat brain and guinea pig cerebellum evaluated by radioligand receptor binding

Studies of human and animal central nervous system receptor degradation and measurement postmortem are important as human tissue can rarely be collected under ideal experimental conditions. Correlating the change in binding of opioid receptor subtypes over time will help define the conditions under which human studies may be valid. The present study was designed to investigate the rate at which opioid receptor subtypes degrade postmortem. Brains from rats or cerebelli from guinea pigs were kept at 22 degrees C or 4 degrees C at times from zero to 24 hours to simulate two common human collection techniques; room temperature and morgue refrigeration. Tissue homogenates from these brains were analysed for mu1, mu2, delta, kappa1 and kappa3 opioid receptor binding using standard radioligand binding techniques. At room temperature mu1, mu2 and delta opioid receptor binding was reduced between 6 and 12 hours, whereas kappa1 and kappa3 binding was reduced after 24 hours. At 4 degrees C mu1, mu2, delta, kappa1 and kappa3 binding remained constant over the 24 hour period.

Contact activation of plasmatic coagulation on polymeric membranes measured by the activity of kallikrein in heparinized plasma

Kallikrein is involved in the generation of bradykinin during extracorporal circulation, that is believed to play an important role in cases of anaphylactic shock during hemodialysis. Therefore, a method for the assessment of kallikrein generation was developed, based on the chromogenic substrate S-2302. Comparison of kallikrein-like activity on glass using citrate or heparinized plasma demonstrated enhanced activity in the presence of heparin. The applicability of the assay, and the time course of kallikrein generation was demonstrated with glass and cuprophan. Membranes based on pure polyacrylonitrile, or its copolymers differing in their content of acrylic acid, 2-hydroxyethyl acrylate, and allylsulphonate were investigated with respect to kallikrein-like activity, and physicochemical surface properties. It was found that high content in 2-hydroxyethyl acrylate, and acrylic acid caused a substantial activation of the contact system while low content in allylsulphonate (less than 2 mol%) did not result in enhanced kallikrein-like activity. The activating materials were characterized to be highly wettable, and had the most negative zeta potentials.

Paclitaxel/5-fluorouracil/leucovorin in metastatic breast cancer: a Vanderbilt Cancer Center phase II trial

Fifty-five women with metastatic breast cancer were treated with a regimen consisting of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) 175 mg/m2 administered intravenously over 3 hours on day 1 only plus leucovorin given intravenously over 30 to 60 minutes followed by 5-fluorouracil 350 mg/m2 via intravenous push on days 1 to 3 every 28 days for six cycles. Eight patients were chemotherapy naive. Of 47 previously treated women, 30 had received anthracyclines. Fifty-two patients were evaluable for response. Three (6%) experienced a complete response and 24 (46%) had a partial response, for an overall response rate of 52%. Patients previously exposed to doxorubicin had a response rate similar to those with no prior doxorubicin exposure (50% v 54%, respectively). The median duration of response was 8.6 months and median survival was 17.7 months. Toxicity was modest, with grade 3 or 4 neutropenia observed in only 5.5% (15 of 274) of cycles. Preliminary results indicate that paclitaxel/5-fluorouracillleucovorin is an active, well-tolerated regimen for treating metastatic breast cancer.

[Offering a hand to new parents: listening or informing?]

Nurses working in the perinatal field have a variety of objectives, one of which is helping new parents feel competent in their new role. Recognizing parents' potential and offering them the support they need to realize it is one of the strategies suggested by the Department of Health and Social Services (MSSS, 1991 and 1992a). In order to identify aspects of nursing interventions at the time of the post-natal visit that promote parental skills, the authors conducted research into the concept of empowerment. Following an in-depth survey of the literature on this concept, they came up with a definition of interventions promoting empowerment, and used this definition as the basis for their analysis of perinatal nurse-client relations. The study, subsidized by the Fondation de recherche en sciences infirmières du Québec (FRESIQ), was carried out between 1993 and 1995 in four CLSCs in the Eastern Townships region. Thirteen nurses agreed to record their conversations with first-time parents during 20 postnatal visits.

Transgenic mice transcribing the human H1 zero histone gene exhibit a normal phenotype

The linker histone H1degree accumulates in terminally differentiating cells and replaces other members of the H1 histone family, even in the absence of cell division. To study the role of H1degree in vivo, we have created two lines of transgenic mice with either the human H1degree promoter (HH minigene) or the mouse metallothionein T promoter (MH minigene) upstream of the human H1degree gene. Mice bearing the minigenes HH or MH overexpress human H1degree mRNA at 10-20-fold higher levels than in normal mice in a constitutive or metal-inducible manner. In contrast to this increase in mRNA content, which was studied in liver, kidney and brain, no significant changes in the relative proportions of the H1 protein subtypes, including H1degree were observed. Transgenic mice exhibited normal anatomic phenotypes, growth rates and reproduction rates. Thus, our results suggest a posttranscriptional and/or translational mechanism that compensates the unbalanced linker-histone expression in different tissues.

Paclitaxel, 5-fluorouracil, and folinic acid in metastatic breast cancer: BRE-26, a phase II trial

5-Fluorouracil plus folinic acid and paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) are effective salvage therapies for metastatic breast cancer patients. Paclitaxel and 5-fluorouracil have additive cytotoxicity in MCF-7 cell lines. We performed a phase II trial of paclitaxel 175 mg/m2 over 3 hours on day I followed by folinic acid 300 mg over 1 hour before 5-fluorouracil 350 mg/m2 on days 1 to 3 every 28 days (TFL) in women with metastatic breast cancer. Analysis is reported on 37 patients with a minimum of 6 months follow-up who received a total of 192 cycles of TFL: nine cycles (5%) were associated with grade 3/4 neutropenia requiring hospitalization; seven (4%) cycles in two patients required granulocyte colony-stimulating factor due to neutropenia; no patient required platelet transfusions. Grade 3/4 nonhematologic toxicities were uncommon. Among the 34 patients evaluable for response, there were three complete responses (9%) and 18 partial responses (53%) for an overall response rate of 62%. Of the 19 evaluable patients with prior doxorubicin exposure, 11 (58%) responded compared with nine of 15 (60%) without prior doxorubicin. Plasma paclitaxel concentrations were measured at the completion of paclitaxel infusion and at 24 hours in 19 patients. TFL is an active, well-tolerated regimen in metastatic breast cancer.

Digging in sand crabs (Decapoda, Anomura, Hippoidea): interleg coordination

Sand crabs (Decapoda, Anomura, Hippoidea) are highly specialised for digging into sand using their thoracic legs. Using video-recording and electromyography, we examined the digging leg movements of three species of sand crabs belonging to two families: Blepharipoda occidentalis (Albuneidae), Lepidopa californica (Albuneidae) and Emerita analoga (Hippidae). The digging patterns of all three species are similar. The ipsilateral legs 2 and 3 are tightly coupled and shovel sand forward from underneath the animal, whereas the movements of leg 4 are more variable, apparently stirring up sand and providing the purchase for rearward descent into the sand. The digging patterns of B. occidentalis and L. californica resemble each other more than either resembles that of E. analoga. In the albuneids, leg 4 cycles at the same frequency as legs 2 and 3, and both albuneid species switch gait from bilateral alternation to synchrony midway through digging. In E. analoga, right and left legs 2 and 3 always alternate. Legs 4 can cycle at about twice the frequency of legs 2 and 3, and they tend to move in bilateral synchrony during high-frequency leg movements (e.g. at the start of digging); their bilateral coupling becomes variable during low-frequency movements. Sand crab digging may have originated as a modified form of walking, but this behavioural innovation subsequently diverged in the sand crab superfamily.

Phase I clinical trial of melphalan and 41.8 degrees C whole-body hyperthermia in cancer patients

PURPOSE

To evaluate the biologic interactions and toxicities of melphalan (L-PAM) combined with 41.8 degrees C whole-body hyperthermia (WBH) for 60 minutes.

PATIENTS AND METHODS

Sixteen patients with refractory cancer were treated (May 1992 to May 1995) with WBH alone during week 1) thereafter patients were randomized to receive either L-PAM alone on week 2 and L-PAM plus WBH on week 5, or the reverse sequence. Patients who demonstrated clinical improvement received WBH plus L-PAM monthly. Dose levels of L-PAM were 10 mg/m2 (n = 3), 15 mg/m2 (n = 3), 17.5 mg/m2 (n = 6), and 20 mg/m2 (n = 4). L-PAM was administered at target temperature; WBH was administered with an Aquatherm radiant-heat device (patent pending; Cancer Research Institute, New York, NY).

RESULTS

Comparisons of mean WBC count and platelet nadirs for L-PAM alone and L-PAM plus WBH demonstrated that the addition of WBH resulted in nadir counts that were, on average, 25% lower. There were no instances of febrile neutropenia or bleeding. Toxicities allowed for escalation of L-PAM to 20 mg/m2; all four patients at this level experienced grade 4 myelosuppression. No significant myelosuppression was observed at 10 and 15 mg/m2. Grade 3 myelosuppression was observed in two of six patients at 17.5 mg/m2. Responses included complete remission (CR) of pancreatic cancer (10 mg/m2), partial remission (PR) of malignant melanoma in two patients (20 mg/m2), and transient clinical and/or serologic improvement in five patients. The pharmacokinetics of L-PAM were not altered by WBH. Observed cytokine induction by WBH is also discussed in detail.

CONCLUSION

We conclude that L-PAM with 41.8 degrees C WBH is well tolerated. Clinical results are consistent with preclinical predictions and provide a foundation for second-generation trials now in progress.

Morphological evidence for a different fibronectin receptor organization and function during fibroblast adhesion on hydrophilic and hydrophobic glass substrata

A polyclonal antibody against the beta 1 subunit of the fibronectin (FN) receptor was used to mimic the early events of integrin receptor functioning to study the initial cellular processes during the organization of FN matrix on biomaterials. Hydrophilic glass and hydrophobic octadecylsilane (ODS) surfaces have been applied as models for different biocompatible materials. By immunofluorescence we could demonstrate that FN receptors organize on the dorsal cell surface of adhering fibroblasts in a specific linear pattern along with actin filaments, but only if the cells were attached to hydrophilic glass. In contrast, FN receptors were not reorganized on hydrophobic octadecylsilane (ODS). In parallel experiments, FN matrix formation after 72 h of incubation on the same substrata has been analyzed microscopically, and quantified by cell ELISA, in order to be further correlated with the integrin receptor functioning in contact with the biomaterials. It was found that FN structuring and the amount of FN matrix have been significantly diminished on ODS that was related to the observed changes in integrin receptor functioning. To learn more about the mechanism of this phenomenon, desorption of 125I-FN from these substrata was studied and found to be significantly decreased on hydrophobic ODS. As a consequence, FN receptor (function) might be arrested on the ventral cell surface, thus the important role of beta 1 integrins in the positional organization of the FN matrix may be disturbed. In light of these facts, antibody-induced clustering of FN receptor can be considered as a useful model for studying the early steps of FN matrix formation on biomaterials.

Analgesic effects of Tyr-W-MIF-1: a mixed mu2-opioid receptor agonist/mu1-opioid receptor antagonist

Tyr-W-MIF-1 (Tyr-Pro-Trp-Gly-NH2) is a naturally occurring neuropeptide that displays high selectivity for mu-opioid receptors. Recently, intrathecal (i.t.) Tyr-W-MIF-1 was shown to induce potent analgesia mediated through spinal mu2-opioid receptors in mice. In the current study, we investigated the supraspinal analgesic effects of Tyr-W-MIF-1 using intracerebroventricular (i.c.v.) administration in mice. I.c.v. Tyr-W-MIF-1 induced a dose-dependent analgesic response with an ED50 of 31.4 micrograms that was antagonized by i.c.v. naloxone (ED50 = 4.46 nmol) and the mu-opioid receptor antagonist beta-funaltrexamine but not by the mu1-opioid receptor-selective antagonist naloxonazine. I.t. naloxone (ED50 = 0.12 nmol), however, was nearly 40-fold more potent than i.c.v. naloxone at antagonizing i.c.v. Tyr-W-MIF-1-induced analgesia. Tyr-W-MIF-1 also possesses antagonist activity at mu1-opioid receptors in brain. Coadministration of i.c.v. Tyr-W-MIF-1 with i.c.v. morphine or i.c.v. [D-Ala2, MePhe4, Gly(ol)5]enkephalin (DAMGO) significantly decreased the analgesic response to either drug administered alone. Thus, Tyr-W-MIF-1 functions as a mixed mu2-opioid receptor agonist/mu1-opioid receptor antagonist after i.c.v. administration in mice.

[Becoming parents. Factors related to the feeling of competence]

In recent years, priority measures have been established within the health field in Québec for raising parents' self-esteem in regard to their role, and ensuring that their parenting skills improve. The study Perceptions de la relation conjugale, du fonctionnement familial et du sentiment de compétence parentale chez des pères et des mères d'un premier enfant âgé d'un an was conducted in keeping with these measures. Nathalie Léonard conducted the research as part of her studies toward a master's degree in nursing science; her thesis advisor was Denise Paul. One goal of her correlative descriptive study was to describe perceptions of the feeling of parental competence among couples with a first child one year of age. A survey of the literature enabled listing of the factors that influence the feeling of parental competence in three categories, according to whether it is linked to the parents, to the child or to their surroundings. Awareness of these factors enables nurses in hospital and community settings to provide more effective support to parents of a first child in their process of adapting to parenthood.

Binding of Tyr-W-MIF-1 (Tyr-Pro-Trp-Gly-NH2) and related peptides to mu 1 and mu 2 opiate receptors

Two endogenous brain peptides (Tyr-W-MIF-1 (Tyr-Pro-Trp-Gly-NH2) and Tyr-MIF-1 (Tyr-Pro-Leu-Gly-NH2)), a cyclized analog and two fragments of Tyr-W-MIF-1, and hemorphin (Tyr-Pro-Trp-Thr) were tested for binding to mu 1 and mu 2 opiate receptor. All these peptides bound to both mu 1 and mu 2 sites in assays optimized to discriminate these subtypes of the mu opiate receptor in membranes from bovine thalamus. The cyclized analog of Tyr-W-MIF-1, previously shown to have potency near that of Tyr-D-Ala-Gly-N-MePhe-Gly-ol (DAMGO) and morphine in producing analgesia after intracerebroventricular (i.c.v.) injection, bound to mu 1 and mu 2 sites with affinities similar to those of DAMGO. Tyr-W-MIF-1, previously shown to induce analgesia after i.c.v. injection but with much higher potency after intrathecal (i.t.) injection, also bound to both mu 1 and mu 2 sites with an affinity between that of morphiceptin and hemorphin. Although the highest ratios of Ki's for mu 2/mu 1 were shown by hemorphin, Tyr-W-MIF-1, and Tyr-W-MIF-1, none of the compounds were significantly different in selectivity. The results indicate that the relatively lower potency of Tyr-W-MIF-1 after i.c.v., compared with i.t. injection, is not due to a lack of binding to mu 1 sites. They suggest that it has relatively high efficacy at mu 2, but low efficacy at mu 1 sites, a possibility that might explain some of the novel properties of these peptides.

The use of T-bars in laparoscopic ventral hernia repair

During the past 2 years 15 laparoscopic ventral hernias have been performed at our Community Hospital. Marlex mesh has been the material used. We have noticed some difficulty with the grasping and initial anchoring of the mesh. Percutaneously placed prolene sutures allow the mesh to be drawn upward with some effort. By using laparoscopic T-bars for the initial anchoring of the mesh to the anterior abdominal wall then stapling, the operative time was greatly reduced. This modification in technique allows for quicker placement of the mesh during the repair.

Intrathecal Tyr-W-MIF-1 produces potent, naloxone-reversible analgesia modulated by alpha 2-adrenoceptors

Spinal administration of morphine or [D-Ala2,MePhe4,Gly(ol)5)]enkephalin (DAMGO) produces potent, naloxone-reversible analgesia that is modulated by alpha 2-adrenoceptors. Tyr-W-MIF-1 (Tyr-Pro-Trp-Gly-NH2) is a naturally occurring, amidated tetrapeptide that is structurally related to the melanocyte-stimulating hormone release inhibiting factor-1 (MIF-1) family of endogenous peptides. Tyr-W-MIF-1 displays high selectivity for the mu-opioid receptor. We investigated the effect of spinal administration of Tyr-W-MIF-1 on analgesia using the mouse tail-flick assay. Intrathecal (i.t.) administration of Tyr-W-MIF-1 produced a dose-dependent analgesic response, with an ED50 of 0.41 microgram, that was reversed by naloxone. Pretreatment with the mu-opioid receptor-selective antagonist beta-funaltrexamine blocked the effect of i.t. Tyr-W-MIF-1. However, pretreatment with the mu1-opioid receptor-selective antagonist naloxonazine did not antagonize the analgesia, indicating the effect was mediated through spinal mu2-opioid receptors. Pretreatment with desipramine, an inhibitor of norepinephrine reuptake, potentiated the analgesic effect of i.t. Tyr-W-MIF-1, producing a 3.1-fold leftward shift in the dose-response curve. Spinal administration of yohimbine, an alpha 2-adrenoceptor-selective antagonist, significantly attenuated the analgesic effect of Tyr-W-MIF-1. Thus, the potent analgesic effect of i.t. Tyr-W-MIF-1 is mediated through spinal mu2-receptors, and is modulated by norepinephrine and alpha 2-adrenoceptors.

Variations on a segmental theme: muscle receptor organs and extensor neuromusculature in the squat lobster Munida quadrispina (Anomura, Galatheidae)

Extensor neuromusculature and the muscle receptor organs (MROs) associated with them have been conserved during the evolution of malacostracan crustaceans, despite species-specific differences between homologous segments in divergent taxa. Investigations of these differences could provide insight into how sensory and neuromuscular elements are modified to accommodate changing behavioural patterns. The most obvious differences between squat lobsters (galatheid anomurans) and macruran decapods, such as crayfish, are the greater dorso-ventral flattening of the galatheid abdomen and its flexed resting posture. To investigate whether the evolution of this altered posture affected extensor neuromusculature and MRO morphology and physiology, we used Methylene Blue staining, cobalt backfilling and extracellular recording techniques to describe these elements in the caudal thoracic and six abdominal segments of the squat lobster Munida quadrispina and compared our results with published descriptions of homologous elements in macrurans. In M. quadrispina, there is segmental variation both in the orientation of the MROs along the abdomen and in their physiological responses to stretch: apparent sensitivity is higher in caudal than rostral MROs. Homologues of three of the four accessory neurones found in crayfish occur, but AN#1 has a major dendrite not present in crayfish. Intersegmental differences in size and morphology of extensor motoneurones occur in M. quadrispina, as have been reported in crayfish, but are dissimilar in the two: abdominal ganglion 5 extensor motoneurones are the largest in M. quadrispina and the smallest in crayfish; this difference correlates with the difference in relative size of axial muscles along the abdomen reported previously for these species. M. quadrispina also differs from macrurans in having a single tonic, and no phasic, MRO on each side of the last abdominal segment. Together, these observations suggest that galatheids have evolved modified or additional neurobehavioural control(s) for the abdomen and tailfan.

Cytokine induction by 41.8 degrees C whole body hyperthermia

The potential for 41.8 degrees C whole body hyperthermia (WBH) to enhance ionizing irradiation and cytotoxic chemotherapy without a commensurate increase in normal tissue toxicity is currently receiving renewed clinical interest. Additionally, WBH may have other biological sequela which may be clinically exploited. In this paper, data are summarized revealing the ability of WBH to induce elevated plasma levels of granulocyte-colony stimulating factor (G-CSF), interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), and tumor necrosis factor-alpha (TNF-alpha) within hours of WBH. Data regarding TNF-alpha shows induction in only a proportion of patients. No induction of C-reactive protein (CRP) or the following cytokines was observed: granulocyte macrophage-colony stimulating factor (GM-CSF), interferon-gamma (IFN-gamma), interleukin-1 alpha (IL-1 alpha), interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-7 (IL-7), interleukin-11 (IL-11), interleukin-12 (IL-12), macrophage-colony stimulating factor (M-CSF), and macrophage inflammatory protein-1 alpha (MIP-1 alpha). Data regarding interleukin-3 (IL-3) and transforming growth factor-beta 1 (TGF-beta 1) were variable and inconclusive. The implications of these results to past and future clinical trials are discussed.

[The life of the couple and feelings of parental competence]

With the birth of their first child a couple must learn to adapt to their new role as parents. During this learning process, their degree of comfort with their new identities as mother and father is linked to how they develop as competent parents. According to the ecological approach to human development, several variables influence parental competency. The marital relationship and the family dynamics are of special interest to the nurse who often has to evaluate the family system and intervene during the transition period to parenthood. This descriptive-correlative study is in direct response to provincial priorities aimed at promoting parenthood and providing better support to parents. Surveys were mailed to 133 couples with a one-year-old child to determine the nature of the link between the marital relationship, the family dynamics and the feeling of parental competency. The results confirm the importance of the nurses involved in evaluating these variables so that effective interventions can be developed to support and assist the couple--thus reinforcing their feelings of parental competency.

Salivary megalith with a sialo-cutaneous and a sialo-oral fistula: a case report

A rare case of a salivary megalith with a sialo-cutaneous and a sialo-oral fistula in an elderly man is presented. A brief review of the literature is made.

Health impacts of AT&T's Total Life Concept (TLC) program after five years

For study group participants who returned for measurement in 1988, the health promotion program appeared to have a limited effect on health risk indicators and a positive effect on health-related attitudes. The data suggest that decreases in smoking and alcohol consumption may be attributed to the program. The combined evidence after 5 years of improved health behaviors, better health attitudes, and self-reports of lifestyle improvements suggests that the program has a positive impact on habit and attitude changes.