Ageing of juvenile coral grouper (Plectropomus maculatus) reveals year-round spawning and recruitment: implications for seasonal closures

Temporal patterns in spawning and juvenile recruitment can have major effects on population size and the demographic structure of coral reef fishes. For harvested species, these patterns are crucial in determining stock size and optimizing management strategies such as seasonal closures. For the commercially important coral grouper (Plectropomus spp.) on the Great Barrier Reef, histological studies indicate peak spawning around the summer new moons. Here we examine the timing of spawning activity for P. maculatus in the southern Great Barrier Reef by deriving age in days for 761 juvenile fish collected between 2007 and 2022, and back-calculating settlement and spawning dates. Age-length relationships were used to estimate spawning and settlement times for a further 1002 juveniles collected over this period. Unexpectedly, our findings indicate year-round spawning activity generates distinct recruitment cohorts that span several weeks to months. Peak spawning varied between years with no clear association with environmental cues, and little to no alignment with existing seasonal fisheries closures around the new moon. Given the variability and uncertainty in peak spawning times, this fishery may benefit from additional and longer seasonal closures, or alternative fisheries management strategies, to maximize the recruitment contribution from periods of greatest reproductive success.

Efficacy of detergent-based cleaning and wiping against SARS-CoV-2 on high-touch surfaces

Efficacy of cleaning methods against SARS-CoV-2 suspended in either 5% soil load (SARS-soil) or simulated saliva (SARS-SS) was evaluated immediately (hydrated virus, T0) or 2 hours post-contamination (dried virus, T2). Hard water dampened wiping (DW) of surfaces, resulted in 1.77-3.91 log reduction (T0) or 0.93-2.41 log reduction (T2). Incorporating surface pre-wetting by spraying with a detergent solution (D + DW) or hard water (W + DW) just prior to dampened wiping did not unilaterally increase efficacy against infectious SARS-CoV-2, however, the effect was nuanced with respect to surface, viral matrix, and time. Cleaning efficacy on porous surfaces (seat fabric, SF) was low. W + DW on stainless steel (SS) was as effective as D + DW for all conditions except SARS-soil at T2 on SS. DW was the only method that consistently resulted in > 3-log reduction of hydrated (T0) SARS-CoV-2 on SS and ABS plastic. These results suggest that wiping with a hard water dampened wipe can reduce infectious virus on hard non-porous surfaces. Pre-wetting surfaces with surfactants did not significantly increase efficacy for the conditions tested. Surface material, presence or absence of pre-wetting, and time post-contamination affect efficacy of cleaning methods.

Residual Antimicrobial Coating Efficacy Against SARS-CoV-2

AIMS

This study evaluated the residual efficacy of commercially available antimicrobial coatings or films against SARS-CoV-2 on nonporous surfaces.

METHOD AND RESULTS

Products were applied to stainless steel or ABS plastic coupons and dried overnight. Coupons were inoculated with SARS-CoV-2 in the presence of 5% soil load. Recovered infectious SARS-CoV-2 was quantified by TCID50 assay. Tested product efficacies ranged from <1.0 to >3.0 log₁₀ reduction at a 2-hour contact time. The log₁₀ reduction in recovered infectious SARS-CoV-2 ranged from 0.44 to 3 log₁₀ reduction on stainless steel and 0.25 to >1.67 log₁₀ on ABS plastic. The most effective products tested contained varying concentrations (0.5 to 1.3%) of the same active ingredient: 3- (trihydroxysilyl) propyldimethyloctadecyl ammonium chloride. Products formulated with other quaternary ammonium compounds were less effective against SARS-CoV-2 in this test.

CONCLUSIONS

The residual antimicrobial products tested showed varied effectiveness against SARS-CoV-2 as a function of product tested. Several products were identified as efficacious against SARS-CoV-2 on both stainless steel and ABS plastic surfaces under the conditions evaluated. Differences in observed efficacy may be due to variation in active ingredient formulation; efficacy is, therefore, difficult to predict based upon listed active ingredient and its concentration.

SIGNIFICANCE AND IMPACT

This study highlights formulation-specific efficacy of several products against SARS-CoV-2 and may inform future development of residual antiviral products for use on nonporous surfaces. The identification of antimicrobial coatings or films showing promise to inactivate SARS-CoV-2 suggests that these products may be worth future testing and consideration.

Demography of the largest and most endangered Brazilian parrotfish, Scarus trispinosus, reveals overfishing

Many parrotfishes (Labridae: Scarinae) have life history traits, including late maturation and long lifespans, that make them vulnerable to overfishing. The greenbeak parrotfish Scarus trispinosus is the largest Brazilian endemic parrotfish and has been harvested in reef-associated fisheries along the coast. After a sharp population decline, S. trispinosus is now considered by the IUCN to be an Endangered species. We provide an assessment of age-based and reproductive biology for this species and discuss applications for fisheries management. We sampled 95 individuals from inshore and offshore reefs from Rio Grande do Norte state, northeast Brazil, both obtained from artisanal fishing landings and fishery-independent collections. All sampled specimens were females with fork lengths (FL) ranging from 8.1 to 55.9 cm and ages ranging from 0.3 to 7 yr, with estimated median maturity (L50) of 39.2 cm FL and median age (A50) of 4.2 yr. Size class distributions indicate that the inshore reefs are mostly inhabited by juveniles under L50, whereas the offshore reefs are inhabited by mature individuals, suggesting an ontogenetic habitat shift from inshore to offshore reefs around the timing of maturation. The fishing pressure on this species is concentrated in inshore reefs, therefore mostly on immature individuals, which may be severely affecting the reproductive capacity of this species. This information is useful to guide size-based fisheries management, such as regulating minimum capture size and fishing gears that capture individuals smaller than L50. Managing fisheries of endangered species with late maturity and complex reproductive cycles such as S. trispinosus is imperative to aid recovery.

Modelling the time to detection of urban tuberculosis in two big cities in Portugal: a spatial survival analysis

SETTING

Portuguese National Tuberculosis Control Programme.

OBJECTIVE

To examine delays in tuberculosis (TB) diagnosis using a spatial component in two high-incidence cities, Lisbon and Oporto, in Portugal, a low-incidence country.

DESIGN

A retrospective nationwide study was conducted based on official TB data between 2010 and 2013 to analyse diagnostic delays at the lowest administrative level (freguesias) using spatial survival analyses, taking into account individual level covariates.

RESULTS

Median diagnostic delays in Lisbon (n = 2706 cases) and Oporto (n = 1883) were respectively 62 (range 1-359, mean 81.01) and 60 days (range 1-3544, mean 79.5). In both cities, case detection rates initially rose until 50 days, then stabilised, but rose again at about 200 days. Diagnostic delay was significantly shorter among males and human immunodeficiency virus positive individuals in both cities, but was significantly longer among migrants in Lisbon. There is evidence of spatial correlation between freguesias; different spatial patterns were observed in diagnostic delays and in likelihood of case detection.

CONCLUSION

These results are concordant with existing literature. The two study areas present considerable spatial variations in diagnostic delay, highlighting the fact that large cities should not be treated as homogeneous entities. The potential of spatial survival methods in spatial epidemiology is highlighted.

Growth and maturation of the redlip parrotfish Scarus rubroviolaceus

This study presents age-based life-history information for the red lip parrotfish Scarus rubroviolaceus based on a 5 year sampling programme from the commercial fishery of American Samoa. Females reached sexual maturity at 31·9 cm fork length (L_F ) and 2·6 years and sex change occurred at 42·3 cm L_F , although not all females change sex through their ontogeny. The maximum observed age was 14 years and c. 65% of the fishery harvest was above the median L_F at sex change.

Growth and reproduction of the highfin grouper Epinephelus maculatus

Highfin grouper Epinephelus maculatus sampled in Chuuk, Micronesia, exhibited a moderate growth rate and a relatively short life span compared to other epinephelids of a similar size. Combined gonad and otolith analysis provide preliminary evidence that the species conforms to a protogynous sexual pattern. Mean total length at maturity for females was 308 mm with first age at maturity 2·8 years for females and 4 years for males, which differs from other regional studies. Based on the gonado-somatic index and microscopic analysis of gonads, E. maculatus in Chuuk have a 4 month spawning season (January to April) that corresponds with seasonal lows in sea surface water temperature and overlaps with that of other aggregating epinephelids. The estimated von Bertalanffy growth factor (K) was 0·51 year(-1) , while total mortality was 0·34 year(-1) . Current management for E. maculatus in Chuuk includes a January to May catch, sale and export ban, which overlaps with its reproductive season. The effectiveness of these arrangements will require on-going monitoring to determine whether alternative management strategies are required to ensure population persistence.

Age-based demographic and reproductive assessment of orangespine Naso lituratus and bluespine Naso unicornis unicornfishes

Bluespine unicornfish Naso unicornis and orangespine unicornfish Naso lituratus were sampled in Pohnpei and Guam, Micronesia, over 13 months to identify reproductive and age-based demographic features necessary for informed management. Age and reproductive information were derived from analysis of sagittal otoliths and gonads. Both species had moderate life spans [maximum ages of 23 (N. unicornis) and 14 years (N. lituratus)] compared with published estimates of conspecifics from other locations (>30 years) and of other Naso species. Length at maturation for N. unicornis was similar between Pohnpei and Guam while females consistently matured at a larger size [c. 30 cm fork length (LF )] than males (c. 27 cm LF ). This sex-specific pattern was reversed in N. lituratus for which estimates of maturation length (females: 15 cm LF ; males: 18 cm LF ) were only obtained from Guam. Developmental patterns in female gonads of both species suggested that initiation of maturation occurs very early. Growth patterns of N. lituratus displayed rapid asymptotic growth compared with N. unicornis and other congeners as well as slight sex-specific patterns of length-at-age. Results highlight the considerable spatial variation that may occur in the population biology of these species across various scales. Additionally, proper management remains complicated without improved knowledge of fishery trends and reproductive behaviour in unicornfishes, species that are prime fishery targets in Micronesia and elsewhere.

Comparative demography of commercially important parrotfish species from Micronesia

Fishery-independent sampling was used to determine growth patterns, life span, mortality rates and timing of maturation and sex change in 12 common parrotfishes (Labridae: tribe Scarinae) from five genera (Calotomus, Cetoscarus, Chlorurus, Hipposcarus and Scarus) in Micronesia. Interspecific variation in life-history traits was explored using multivariate analysis. All species displayed strong sex-specific patterns of length-at-age among which males reached larger asymptotic lengths. There was a high level of correlation among life-history traits across species. Relationships between length-based and age-based variables were weakest, with a tenuous link between maximum body size and life span. Cluster analysis based on similarities among life-history traits demonstrated that species were significantly grouped at two major levels. The first grouping was driven by length-based variables (lengths at maturity and sex change and maximum length) and separated the small- and large-bodied species. Within these, species were grouped by age-based variables (age at maturity, mortality and life span). Groupings based on demographic and life-history features were independent of phylogenetic relationships at the given taxonomic level. The results reiterate that body size is an important characteristic differentiating species, but interspecific variation in age-based traits complicates its use as a life-history proxy. Detailed life-history metrics should facilitate future quantitative assessments of vulnerability to overexploitation in multispecies fisheries.

Reproductive biology of squaretail coralgrouper Plectropomus areolatus using age-based techniques

The squaretail coralgrouper Plectropomus areolatus was identified as a fast-growing, early maturing and relatively short-lived aggregation-spawning epinephelid. Examinations of sectioned otoliths found females and males first maturing at 2 and 3 years, respectively, suggesting protogynous hermaphroditism; however, no transitionals were observed in samples. Age distribution for the two sexes was similar and both were represented in the oldest age class; however, significant sex-specific differences in size-at-age were identified. Both sexes fully recruit into the fishery at age 4 years and reach 90% of asymptotic length by age 3 years. Underwater visual assessments, combined with the gonado-somatic indices, revealed a 5 month reproductive season, with interannual variability observed in the month of highest density within the spawning aggregation. Catch restrictions on adults during spawning times and at reproductive sites, combined with gear-based management and enhanced enforcement, are recommended to maintain spawning stocks. Based on the available evidence, the sexual pattern for this species is unresolved.

Investigations of the reaction mechanisms of 1,2-indanediones with amino acids

The reaction mechanisms of amino acids with a new class of fluorogenic reagents were investigated. The structures of colored and fluorescent species formed in these reactions were partially confirmed by experimental evidence. Reaction intermediates, C-N-C 1,3-dipoles derived from imines, were trapped with dipolarophiles in 3 + 2 cycloadditions to form spiropyrrolidines.

A competitive fluorescence assay to measure the reactivity of compounds

A sensitive competitive method was developed for assessing the reactivity of compounds toward glutathione and toward thiols in general. The method employs the reaction of the fluorogenic reagent fluorescein-5-maleimide (FM) with glutathione (GSH) to generate a large increase in fluorescence emission. When the reaction is measured in the presence of a compound that competes with FM toward GSH, the rate constant for fluorescent product formation increases while the total amount of product formed at the end of the reaction decreases. These changes in the presence of a series of competitor concentrations allow one to calculate the rate constant of the reaction of the competitor with GSH. At 23 degrees C, pH 7.40 in PBS buffer the second-order rate constant of the FM-GSH reaction is k2 = (1.67 +/- 0.32) x 10(4) M(-1) x s(-1). Two GSH-reactive compounds were evaluated: the second-order rate constant for the reaction of PNU-27707 with GSH under our experimental conditions is k(i) = 5660 +/- 266 M(-1) x s(-1), while that of PNU-37802 is k(i) = 21,200 +/- 1600 M(-1) x s(-1). The method is easily adaptable to a high-throughput screening format.

Subcutaneous heparin versus low-molecular-weight heparin as thromboprophylaxis in patients undergoing colorectal surgery: results of the canadian colorectal DVT prophylaxis trial: a randomized, double-blind trial

OBJECTIVE

To compare the effectiveness and safety of low-dose unfractionated heparin and a low-molecular-weight heparin as prophylaxis against venous thromboembolism after colorectal surgery.

METHODS

In a multicenter, double-blind trial, patients undergoing resection of part or all of the colon or rectum were randomized to receive, by subcutaneous injection, either calcium heparin 5,000 units every 8 hours or enoxaparin 40 mg once daily (plus two additional saline injections). Deep vein thrombosis was assessed by routine bilateral contrast venography performed between postoperative day 5 and 9, or earlier if clinically suspected.

RESULTS

Nine hundred thirty-six randomized patients completed the protocol and had an adequate outcome assessment. The venous thromboembolism rates were the same in both groups. There were no deaths from pulmonary embolism or bleeding complications. Although the proportion of all bleeding events in the enoxaparin group was significantly greater than in the low-dose heparin group, the rates of major bleeding and reoperation for bleeding were not significantly different.

CONCLUSIONS

Both heparin 5,000 units subcutaneously every 8 hours and enoxaparin 40 mg subcutaneously once daily provide highly effective and safe prophylaxis for patients undergoing colorectal surgery. However, given the current differences in cost, prophylaxis with low-dose heparin remains the preferred method at present.

Low frequency TENS is less effective than high frequency TENS at reducing inflammation-induced hyperalgesia in morphine-tolerant rats

Both transcutaneous electrical nerve stimulation (TENS) and morphine are commonly used for relief of pain. Extensive research has been done on the effectiveness of each of these two methods for pain relief when given independently. However, very little literature exists examining the effectiveness of their combined use. Systemically administered morphine activates mu opioid receptors and when administered for prolonged periods results in analgesic tolerance. Low (4 Hz) and high (100 Hz) frequency TENS activate mu- and delta-opioid receptors, respectively, It is thus possible that TENS would be less effective in morphine-tolerant subjects. The current study investigated the effectiveness of high- and low-frequency TENS in the reversal of hyperalgesia in inflamed rats that were morphine-tolerant. Morphine tolerance was induced by subcutaneous implantation of morphine pellets over 10 days. Knee joint inflammation was induced by injection of kaolin and carrageenan into the knee joint cavity. Secondary heat hyperalgesia was tested by measuring the paw withdrawal latency to radiant heat (1) before pellet implantation (either morphine or placebo), (2) after pellet implantation and before inflammation, (3) after inflammation and (4) after TENS. Both high (100 Hz) and low (4 Hz) frequency TENS caused nearly 100% inhibition of secondary hyperalgesia in animals receiving placebo pellets. In contrast, the hyperalgesia in morphine-tolerant animals with knee joint inflammation was unaffected by low frequency TENS but fully reversed by high frequency TENS. These results suggest that patients who are tolerant to morphine may respond better to high frequency TENS than to low frequency TENS.

Maturation of locomotor and Fos responses to the NMDA antagonists, PCP and MK-801

Antagonists at the N-methyl-D-aspartate (NMDA)-type glutamate receptor, such as phencyclidine (PCP) and dizocilpine (MK-801), are well-known to evoke increases in locomotor activity in adult rats and mice. However, little is known about the effects of NMDA antagonists on locomotor activity as a function of development. The present study examined locomotor responses to PCP or MK-801 in male rats of varying ages and found that prepubertal rats were more sensitive to the locomotor-elevating effects of PCP (1.5 mg/kg and 3. 0 mg/kg, s.c.) than were adults. Locomotor responses to MK-801 (0.1 and 0.2 mg/kg, s.c.) were not dependent on age. The age-dependent response to PCP may be related to developmental events in the motor cortex, since more Fos-immunoreactive neurons were observed in the motor cortex of prepubertal animals after PCP administration relative to adult animals. An opposite pattern of age-dependent Fos responses was observed in the posterior retrosplenial cortex. The results suggest that locomotor responses to NMDA antagonists can be influenced in an age- and drug-dependent manner and that maturational events in the motor cortex may modify responses to PCP.

Regulation of the epithelial cell-specific integrin, CD103, by human CD8+ cytolytic T lymphocytes

BACKGROUND

The destruction of the graft epithelium by CD8+ cytolytic T lymphocytes (CTL) is an important aspect of organ allograft rejection. Our recent finding in a mouse model that the epithelial cell-specific integrin, CD103, defines a subset of CD8+ CTL potentially sheds new light onto such interactions. The goal of the present study was to assess the relevance of these data to the human system.

METHODS

CD103 expression by human T-cell populations generated in mixed lymphocyte cultures or isolated from transplant nephrectomy specimens was quantitated using multiparameter FACS analyses.

RESULTS

CD103 defined a major subset (26-76%) of CD8+ CTL generated in human mixed lymphocyte cultures; cell sorting experiments confirmed that the CD103+ and CD103- subsets both possess allospecific lytic activity. Anti-transforming growth factor (TGF)-beta blocked the appearance of the CD103+ CTL subset, and persistent expression of CD103 by CD8+ CTL was dependent on bioactive TGF-beta. Isolated CD103+ and CD103- CD8 subsets maintained their phenotypic integrity during in vitro expansion, although optimal CD103 expression on the former was TGF-beta dependent. Although CD103+ cells were rare among activated CD8 cells in peripheral lymphoid compartments (< 10%), analyses of transplant nephrectomy specimens revealed that a major subset (21-61%) of CD8 memory/effector cells that infiltrate rejecting renal allografts express high levels of CD103.

CONCLUSIONS

We conclude that CD103 defines a discrete and stable subset of human CD8+ CTL and that CD103 expression by such cells is initiated and maintained by bioactive TGF-beta. These data point to the existence of a human effector subset that is uniquely specialized for the destruction of the graft epithelium.

Prevention of adhesion formation with use of sodium hyaluronate-based bioresorbable membrane in a rat model of ventral hernia repair with polypropylene mesh--a randomized, controlled study

BACKGROUND

There is a high incidence of adhesions after ventral hernia repair with polypropylene mesh. Hyaluronic acid (HA)-based membrane has been shown to reduce the incidence of adhesions in the absence of prosthetic mesh. The purpose of this study was to determine the effect of HA membrane on the quantity and grade of adhesions and its effect on strength of repair after abdominal wall repair with polypropylene mesh.

METHODS

In 61 rats a full-thickness abdominal wall defect (excluding skin) was created, and a section of small bowel was abraded. The animals were randomized, receiving either HA membrane to cover the viscera or no membrane. The fascial defect was repaired with polypropylene mesh. Equal numbers of animals from each group were killed at 4 weeks and 8 weeks after surgery. Adhesion severity and percentage of mesh surface covered with adhesions were estimated. Tensile strength between mesh and muscle from each animal was measured. Sections of the mesh-muscle interface were examined histologically and measured for thickness and graded for inflammation and fibrosis.

RESULTS

Fifty-five animals survived until the end point. Animals in the HA membrane group had a significant reduction in (1) grade of adhesions between small bowel and mesh at 4 weeks (P = .009) and 8 weeks (P = .000001), (2) grade of adhesions between colon and mesh at 8 weeks (P = .00003), and (3) percentage of mesh covered with adhesions at 4 weeks (P = .01) and 8 weeks (P = .0000002). There was no difference between the 2 groups in tensile strength of the repairs, tissue thickness, degree of inflammation, or degree of fibrosis.

CONCLUSIONS

HA membrane reduces the quantity and grade of adhesions of both small and large bowel, to polypropylene mesh in a rat model of ventral hernia repair, without compromising strength of the repair.

Local injection of bupivacaine after rubber band ligation of hemorrhoids: prospective, randomized study

PURPOSE

The aim of this study was to determine if local injection of bupivacaine after hemorrhoidal banding causes a decrease in pain and in the incidence of associated symptoms.

METHODS

After hemorrhoidal banding, patients were randomly assigned to receive a local injection of bupivacaine with 1:200,000 epinephrine, an injection of normal saline, or no injection, just superior to each band. Pain was graded by the patient and by the study nurse within 30 minutes, and any associated symptoms were recorded. At intervals 6, 24, and 48 hours postbanding, the patient recorded pain, limitation of activities, and analgesic requirements. Associated symptoms while at home were recorded.

RESULTS

Of 115 patients studied, 42 received bupivacaine injection, 42 received normal saline injection, and 31 received no injection. In patients receiving bupivacaine compared with no injection, within 30 minutes postbanding there was a significant reduction in pain graded by the patient (P = 0.000002) and by the nurse (P = 0.000005) and a significant reduction in incidence of nausea (P = 0.01) and shaking (P = 0.008). However, in the bupivacaine group compared with the other two groups, at the intervals of 6, 24, and 48 hours postbanding there was no sustained reduction in the severity of pain and no reduction in analgesic requirements or limitation of normal activities. In the week after banding, there was no difference between groups in symptoms of nausea, shaking, lightheadedness, urinary retention, or bleeding.

CONCLUSIONS

Bupivacaine injection may be useful for reducing pain and associated symptoms long enough to tolerate a trip home from the outpatient department but does not show a sustained effect.

The effects of kainic acid lesions on locomotor responses to haloperidol and clozapine

Spontaneous and amphetamine-elicited locomotor activity in rats is reduced by most clinically effective antipsychotic drugs. We have recently demonstrated that intracerebroventricular infusion of kainic acid (KA), which produces cell loss in the hippocampus and other limbic-cortical brain regions, increases spontaneous and amphetamine-elicited locomotion. The present study determined if KA lesions alter the suppressive effects of the antipsychotic drugs, haloperidol and clozapine, on spontaneous and amphetamine-elicited locomotor behavior. Young adult male rats (70 days of age) received intracerebroventricular infusions of vehicle or KA, which produced hippocampal pyramidal cell loss in each rat and more variable cell loss or gliosis in the amygdala, piriform cortex, and laterodorsal thalamus. Thirty days post-surgery, lesioned and control rats were tested once a week for locomotor responses to drug treatments. As observed previously, spontaneous locomotor activity and hyperactivity elicited by amphetamine (1.50 mg/kg s.c.) were greater in lesioned animals than controls. In addition, the level of spontaneous activity and/or amphetamine-elicited hyperlocomotion observed in lesioned rats after haloperidol treatment (0.13, 0.35, or 1.50 mg/kg s.c.) was greater than that found in controls. Locomotor responses to low (6.30 mg/kg) and moderate doses of clozapine (20 mg/kg) were similar in lesioned and control rats, although lesioned rats were more active than controls following the administration of a high dose of clozapine (30 mg/kg). These data indicate that the hyperactivity associated with limbic-cortical lesions may be insensitive to reversal by haloperidol, yet uniquely sensitive to suppression by clozapine.

Roles of adhesion molecules ICAM-1 and alpha4 integrin in antigen-induced changes in microvascular permeability associated with lung inflammation in sensitized brown Norway rats

Increased microvascular permeability and mucosal edema are pathological features of airway inflammation in asthma. In this study, we investigated the characteristics of the edema response occurring in a model of antigen-induced lung inflammation in sensitized brown Norway rats and examined the effects of monoclonal antibodies (mAbs) to adhesion molecules on this response. Ovalbumin (OA) challenge-induced increases in lung permeability were determined by the leakage of 125I-labeled bovine serum albumin (BSA) into the extravascular tissues of the lungs 24 h after challenge in animals intravenously injected (prechallenge) with this tracer. Inflammatory cell infiltration into the alveolar space was determined by bronchoalveolar lavage (BAL). Mean extravascular plasma volume in the lung increased 233% as compared with control (P < 0.005) at 24 h and increased to 517% by 72 h. The 24-h edema response was completely inhibited by two oral doses (0.1 mg/kg) of dexamethasone 1 h before, and 7 h after, challenge. Intraperitoneal administration of the anti-rat ICAM-1 mAb 1A29, or anti-rat alpha4 integrin mAb TA-2 (2 mg/kg at 12 and 1 h before, and 7 h after, antigen challenge), significantly suppressed eosinophil infiltration into the alveolar space without inhibiting the enhanced microvascular leakage and lung edema. Determination of plasma antibody concentrations by ELISA of mouse IgG1 indicated that sufficient concentrations of the appropriate mAb were present to block alpha4- or ICAM-1-dependent adhesion. The results suggest that increases in microvascular permeability and plasma leakage occurred independently of eosinophil accumulation.

Analysis of job-share as a process of change

This paper describes the introduction of a district nursing job-share in a primary health care team. Exploring change theory and different strategies for organizational change, the implications for members of the team are considered. In addition, changes in the balance of power which resulted in conflict within the district nursing team are discussed.

Recurrent superior mesenteric artery (Wilkie's) syndrome: a case report

Superior mesenteric artery syndrome (SMAS) is a rare condition. The diagnosis is usually made by exclusion. A previously healthy 20-year-old woman who had recurrent SMAS is described. Diagnosis of the condition was difficult. Initially, small-bowel enteroclysis, upper gastrointestinal series and endoscopy, biopsy of gastric and duodenal mucosa, abdominal computed tomography (CT) and ultrasonography were used to make the diagnosis. Abdominal CT suggested pancreatitis causing compressive obstruction of the superior mesenteric artery. Conservative management was helpful at first, but cramping and projectile emesis recurred. Upper gastrointestinal series suggested duodenal distension and a filling defect in the region of the superior mesenteric artery. Repeat endoscopy showed a lateral pulsatile compression in the region of the distal duodenum and SMAS was diagnosed. Medical therapy was not helpful so duodenojejunostomy was carried out. The operation was successful and the patient was symptom-free for 1 year, when the syndrome recurred, with symptoms of periumbilical pain, intermittent episodes of vomiting and loose stools. At reoperation the duodenojejunal anastomosis was found to be displaced to the left of the superior mesenteric artery pedicle causing recurrent obstruction. The duodenojejunostomy was converted to a Roux-en-Y duodenojejunostomy. The patient has since remained well. A MEDLINE search of the literature for the period 1961 to October 1994 revealed that there were no reported cases of a recurrence of SMAS in an otherwise healthy adult patient. In spite of the difficulty in diagnosing this condition, heightened awareness can lead to early diagnosis and avoid unnecessary suffering for the patient.

Phenotypic analysis of airway eosinophils and lymphocytes in a Th-2-driven murine model of pulmonary inflammation

In order to investigate whether the pulmonary response to helminth antigens mimics that seen in allergic inflammation of the airways, we have examined the phenotypic characteristics of lymphocytes and eosinophils recruited to the airways following Nippostrongylus brasiliensis (N.b.) infection. Specifically, the cellular response was divided into an early and a late phase. During the early response there was a small but significant increase in neutrophil numbers recovered by bronchoalveolar lavage (BAL). Phenotypic analysis of BAL leukocytes revealed an early rise in the percentage of BAL lymphocytes expressing the naive T cell markers CD45RB and L-selectin, and the activation marker IL-2R. In addition, during the early response, there was an increased percentage of lymphocytes expressing the gamma delta TCR, but not the alpha beta TCR. In contrast, the late response was marked by a much larger accumulation, in the lungs and BAL, of memory CD4+ T lymphocytes and an influx of small, hypodense eosinophils which produced LTB4 and LTC4 on stimulation with calcium ionophore. At this time there was a substantial increase in the number of T lymphocytes and eosinophils expressing ICAM-1 and the integrins VLA-4 and LFA-1, implicating these adhesion molecules in inflammatory cell recruitment to the airways. We conclude that the pattern and phenotypic characteristics of the cellular recruitment seen following N.b. infection resemble those seen in early- and late-phase allergic inflammation of the airways in asthma, and therefore N.b. may be used to model these aspects of the disease.

Changes in membrane properties during energy depletion-induced cell injury studied with fluorescence microscopy

The changes in membrane structural properties occurring during the process of ATP depletion-induced cell injury in adherent human astrocytoma cells (UC-11 MG) were studied with two epifluorescence techniques: 1) steady-state fluorescence anisotropy (r) to examine microstructural changes in the membrane phospholipids and 2) fluorescence redistribution after photobleaching (FRAP) to examine membrane fluidity changes. A new method for r measurement was established that provides the unique advantage of simultaneously monitoring both vertical and horizontal polarized fluorescence emissions needed for the calculation of r. In this study, r in the astrocytoma cells labeled with 1-(4-trimethylammonium phenyl)-6-phenyl-1,3,5-hexatriene p-toluenesulfonate was shown to remain stable for up to 90 min. However, when the cells were treated with 75 microM iodoacetic acid (IAA), a metabolic inhibitor that induces rapid depletion of cellular ATP, r continually decreased, indicating a decrease in membrane lipid order and perturbation of the bilayer structure. This decrease in r could be prevented by the pretreatment of cells with lipophilic antioxidants such as tirilazad or gossypol. Tirilazad itself caused a significant increase in r, suggesting that tirilazad intercalates into the membrane bilayer and profoundly increases the lipid order in uninjured cells. Gossypol, however, did not exhibit this property. Further investigations into these phenomena with FRAP confirmed the r results and indicated that membrane fluidity increased while its structure became less rigid during the process of ATP-induced cell injury. In addition, lipophilic antioxidants prevented the membrane structural aberrations induced by IAA. Experimental results suggest that different mechanisms of cytoprotective action may exist for tirilazad and the antioxidant gossypol. Gossypol appears to prevent or delay the observed cell injury entirely because of its antioxidant action, whereas tirilazad's protection is mediated not only via its antioxidant activity, but also by its ability to increase cell membrane lipid order.

The mechanism of cytoprotective action of lazaroids I: Inhibition of reactive oxygen species formation and lethal cell injury during periods of energy depletion

Tirilazad mesylate and related compounds, known as lazaroids, are recognized as inhibitors of membrane lipid peroxidation that also act as free radical scavengers. These compounds have demonstrated protective activity in animal models of traumatic head injury and cerebral ischemia. In this study we used an in vitro cell model to investigate the mechanism by which tirilazed mesylate and related antioxidants delay or prevent the lethal cell injury provoked by chemically induced energy depletion. When the cultured human astrocytoma cell line UC-11MG was treated with the metabolic inhibitor sodium iodoacetate for 4 hr, the cells exhibited signs of irreversible cell injury, including alterations in plasma membrane morphology, the breakdown of membrane phospholipids (release of arachidonic acid into the extracellular medium) and the loss of viability as indicated by the leakage of cytoplasmic components. A large quantity of reactive oxygen species (ROS) was detected in the injured cells by a dichlorofluorescin assay. Increases in early lipid peroxidation products were detected as elevated hydroxyeicosatetraenoic acids in the membrane phospholipds, which indicated that the membrane lipids were oxidatively damaged. The addition of tirilazad mesylate, a troloxamine derivative or the common phenolic antioxidant nordihydroguaiaretic acid effectively prevented the increases in ROS, attenuated the elevation of hydroxyeicosatetraenoic acids, and delayed irreversible cell injury. We propose that the destruction of crucial cell constituents in the lipophilic compartments by ROS is one of the major causes of lethal cell injury. The cyytoprotective action of the lazaroids in related, as least in part, to their ability to block the formation of ROS and to arrest the secondary cell injury.

Alterations in reactive oxygen, pH, and calcium in astrocytoma cells during lethal injury

Exposure of cultured human astrocytoma cells to iodoacetic acid results in rapid depletion of cellular ATP and cell death. Pathophysiological changes in the injured cells, including formation of reactive oxygen species (ROS), cell viability, glutathione, pH, and cytosolic calcium, were characterized at the cellular level via fluorescence microscopy. After iodoacetic acid treatment, cellular ATP and intracellular glutathione fell sharply to undetectable levels within 2 h. ROS, as detected by the oxidation of dichlorofluorescein, appeared in 20 min and reached a maximum before the loss of membrane integrity. Cells became acidotic within 10 min. Cytosolic free calcium concentration exhibited a slow increase and then a sharp influx shortly before the rupture of the cell membrane. The addition of lipophilic antioxidants, nordihydroguaiaretic acid or the troloxamine U-78517F, eliminated the accumulation of ROS and delayed the onset of cell death without affecting other parameters observed in the early phase of the injury. We conclude that ROS is formed and may play important roles during lethal cell injury caused by energy depletion.

Gender-power relations and safer sex negotiation

This paper examines the gender-power relations in heterosexual relationships and discusses the implications for women in attempting to negotiate safer sex. Whilst acknowledging the need for examining both male and female perceptions of sexuality, the paucity of research on men's heterosexual experiences has restricted this paper to the consideration of the woman's standpoint. Reviewing the literature, the complexities of sexual relationships are explored in terms of the power imbalance which arises from the ideologies of femininity and masculinity. The implications for safer sex promotion by practice nurses working in primary health care teams are then discussed within the context of gender divisions of labour and gender role conflict.

Lack of effect of postinjury treatment with methylprednisolone or tirilazad mesylate on the increase in eicosanoid levels in the acutely injured cat spinal cord

Methylprednisolone (MP) improves motor recovery in spinal cord-injured patients when administered in a 24 h intensive high dose regimen beginning within 8 h after spinal cord injury (SCI). The rationale for this regimen has been based upon the need for high doses (i.e., 30 mg/kg initial IV dose) to inhibit posttraumatic lipid peroxidation (LP) in the injured spinal segment. However, injury also triggers the immediate calcium-mediated activation of phospholipase A2 (PLA2), the release of arachidonic acid, and the enzymatic formation of potentially deleterious prostaglandins (PGE2 alpha, PGE2), thromboxane A2 (TXA2), and leukotrienes (LTs). Thus, in view of the glucocorticoid receptor-mediated inhibition of PLA2 that underlies much of MP's antiinflammatory actions, an additional neuroprotective mechanism may relate to an inhibition of eicosanoid formation. Using the cat spinal cord compression model (180g x 5 min at L3; Na pentobarbitol anesthesia), we examined whether 30 min postinjury dosing with MP (30 mg/kg IV) could attenuate spinal tissue eicosanoid levels measured by enzyme immunoassay at 1 h (Experiment 1). Pial blood flow was measured over the dorsal columns at the injury site using laser doppler flowmetry to monitor posttraumatic hyperperfusion as an index of the microvascular pathophysiology of acute SCI. In vehicle treated animals at 1 h postinjury, there was a significant increase in the tissue levels of PGF2 alpha (+290%), PGE2 (+260%), TXB2 (stable analog of TXA2, +126%), and LTB4 (+73%) in comparison to sham, uninjured animals. However, 6-keto-PGF1 alpha (stable analog of prostacyclin or PGI2) and LTC4 did not increase. Methylprednisolone did not reduce the increase in eicosanoid production. In the case of LTB4 and LTC4, MP actually increased the levels further. In addition, we examined the effects of a double dose MP regimen (30 mg/kg IV at 30 min plus 15 mg/kg IV at 2.5 h postinjury) on spinal cord eicosanoid levels at 4 h postinjury (Experiment 2). At 4 h postinjury, significant increases in PGF2 alpha, PGE2, TXB2, and 6-keto-PGF1 alpha were observed, and with the exception of PGE2, no MP attenuation of the increased eicosanoids was seen. These results fail to provide evidence that postinjury administration of high dose MP exerts a significant anti-PLA2 action. On the other hand, MP effectively inhibited secondary spinal cord pial hyperperfusion, which is believed to be largely mediated by free radical-lipid peroxidative mechanisms. Thus, it seems likely that the protective action of MP on the acute microvascular pathophysiology of SCI is mediated by its well-documented effects on posttraumatic LP.(ABSTRACT TRUNCATED AT 400 WORDS)

Effects of the lipid peroxidation inhibitor tirilazad mesylate (U-74006F) on gerbil brain eicosanoid levels following ischemia and reperfusion

The present study measured the production of eicosanoids in the gerbil brain during early reperfusion after either a 3-h unilateral carotid occlusion (UCO, model of focal ischemia) or a 10-min bilateral carotid occlusion (BCO, model of global ischemia). Arachidonic acid (AA) metabolites were examined to determine if pretreatment with the 21-aminosteroid lipid peroxidation inhibitor U-74006F (tirilazad mesylate) could influence postreperfusion synthesis of brain eicosanoids. In the 3-h UCO focal ischemia model, there was an early (5-min) postreperfusion elevation in brain levels of PGF2 alpha, TXB2 and LTC4 (P < 0.05 vs. sham for all three eicosanoids). LTB4 also rose but not significantly. On the other hand, PGE2 and 6-keto-PGF1 alpha tended to decrease during ischemia and at 5-min postreperfusion (P < 0.05 vs. sham for PGE2). Pretreatment with known neuroprotective doses of U-74006F in this model (10 mg/kg i.p. 10 min before and again immediately upon reperfusion) did not affect the increase in PGF2 alpha or TXB2 but significantly blunted the elevations in LTC4 and LTB4. The postreperfusion decrease in PGE2 was also attenuated. In the 10-min BCO global ischemia model, there was also an increase in each of the measured eicosanoids, except LTB4, at 5 min after reperfusion. Pretreatment with U-74006F (10 mg/kg i.p. 10 min before ischemia) selectively decreased the rise in LTC4 but did not significantly affect the other eicosanoids. In contrast, the antioxidant actually caused a significant enhancement of the postreperfusion increase in PGE2 vs. vehicle-treated animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Metabolism of leukotriene B4 by guinea pig eosinophils

The metabolism of leukotriene B4 (5(S),12(R)-dihydroxy-6-cis-8,10-trans-14-cis-eicosatetraenoic acid) by isolated guinea pig eosinophils was investigated. Incubation of guinea pig eosinophils with [3H]-leukotriene B4 resulted in the rapid conversion of leukotriene B4 to several more polar metabolites. Two of these metabolites were identified by ultraviolet spectroscopy and gas chromatography-mass spectrometry as the omega oxidation products 5(S),12(R),20-trihydroxy-6,8,10,14-eicosatetraenoic acid (20-hydroxy-leukotriene B4) and 5(S),12(R),19-trihydroxy-6,8,10,14- eicosatetraenoic acid (19-hydroxy-leukotriene B4). Two novel metabolites, 5(S),12(R),18,19-tetrahydroxy-6,8,10,14 eicosatetraenoic acid (18,19-dihydroxy-leukotriene B4) and 5(S),12(R)-dihydroxy-1,18-dicarboxylic-6,8,10,14,16-octadecapentaenoi c acid (delta 16,17-18-carboxy-19,20-dinor-leukotriene B4) were tentatively identified. The identification of these compounds indicates that guinea pig eosinophils are capable of metabolizing leukotriene B4 by both omega and beta oxidation. This catabolic activity may play a role in modulating inflammatory reactions by removing the chemoattractant leukotriene B4 from inflammatory sites.

Degradation of membrane phospholipids in the cultured human astroglial cell line UC-11MG during ATP depletion

The exposure of brain cells to adverse conditions, such as ATP depletion, induces the degradation of membrane phospholipids and the accumulation of free fatty acids. We have investigated the mechanism of membrane breakdown in an in vitro cell injury model. Confluent cells from the human astroglial cell line UC-11MG were treated with sodium iodoacetate to deplete their intracellular ATP. Large amounts of saturated (palmitic acid) and unsaturated (oleic, linoleic and arachidonic acid) free fatty acids as well as diacylglycerols containing prelabeled fatty acids were released from the cells prior to the loss of plasma membrane integrity. The capacity of the cells to reincorporate free fatty acid into membrane phospholipids decreased in parallel with the loss of intracellular ATP, indicating the failure of the acyltransferase pathway. The addition of the phospholipase A2 inhibitors manoalide, mepacrine, or U-26384, or the phospholipase C inhibitor U-73122, reduced the severity of cell injury, but did not maintain cell viability. The addition of a battery of protease inhibitors with or without the phospholipase inhibitors had no protective effect. These results suggest that the activation of phospholipases A2 and C coupled with the loss of the reacylation process lead to the breakdown of membrane components during lethal cell injury.

Deep pelvic abscesses: transrectal drainage with radiologic guidance

Transrectal catheter drainage was performed under radiologic guidance in eight patients with deep pelvic abscesses during a 7-month period. One patient underwent two procedures. In five patients, the abscess could not be palpated at rectal examination. Seven procedures were performed with fluoroscopic guidance. Transrectal ultrasound was performed in conjunction with fluoroscopy for two procedures. Medium to large (8-14-F) locking catheters were used in seven procedures, and small (5-F) nonlocking pigtail catheters were used in two. The catheter was left in place for 3 days or less in all but one patient, in whom the catheter was left in place for 20 days. Five abscesses were drained through the anterior or anterolateral rectal wall and four, including one repeat drainage, through the posterior rectal wall. No complications occurred as a direct result of transrectal drainage. Successful initial drainage was established with clinical improvement in all cases. Two patients eventually required surgery, one for continued bleeding into an infected hematoma and one for abscess recurrence after tube dislodgment. Transrectal drainage performed with radiologic guidance is a safe, feasible procedure; is well tolerated by patients; and is relatively easy to perform with the techniques described.

Functional properties of guinea pig eosinophil leukotriene B4 receptor

It is currently thought that pulmonary eosinophils play a proinflammatory role in bronchial asthma. Leukotriene B4 (LTB4) is being considered as an important mediator in regulating eosinophil function because of its potent activities in inducing leukocyte chemotaxis, chemokinesis, degranulation, and aggregation. Because the LTB4 receptor has not been characterized in eosinophils, we report in this study the presence of a functional high affinity receptor for LTB4 on guinea pig (GP) eosinophils. Scatchard analysis of saturation binding studies yielded a Kd of 1.4 +/- 0.2 nM (mean +/- SEM, n = 3) and a Bmax of 1.6 +/- 0.4 pmol/mg of protein for LTB4 in GP eosinophil membranes. A linear Scatchard plot was obtained, suggesting that GP eosinophil membranes expressed only a single high affinity LTB4 receptor population. Saturation binding studies in whole cells also yielded a linear Scatchard plot, with a Kd of 2.8 +/- 0.96 nM (mean +/- SEM, n = 4) and a Bmax of 4 x 10(4) +/- 6 x 10(3) receptors/cell. Competitive binding studies using several compounds with structures similar to that of LTB4 showed that these agents bound to the receptor in the following descending order of affinity (Ki, nM): LTB4 (0.96) less than TB3 (1.0) greater than 20-hydroxy-LTB4 (3.5) greater than 12(R)-hydroxy-5,8,14-cis,10-trans-eicosatetraenoic acid (20) greater than 12(S)-hydroxy-5,8,14-cis,10-trans-eicosatetraenoic acid (231) greater than 20-carboxy-LTB4 (350) greater than 5(S),12(S)-dihydroxy-6,10-trans,8,14-cis-eicosatetraenoic acid (541). This rank order of potency in binding affinity correlates closely with the ability of these compounds to induce both chemotaxis and superoxide anion generation. Analysis of the structure-activity relationship suggests that the 12R-hydroxyl group and a cis double bond at the C-6 position are important for optimal agonist binding to the LTB4 receptor present in GP eosinophil membranes. The results suggest that LTB4 may be an important chemoattractant for eosinophils in GP and may induce the release of reactive oxygen species from this cell.

Functional properties of guinea pig eosinophil leukotriene B4 receptor

It is currently thought that pulmonary eosinophils play a proinflammatory role in bronchial asthma. Leukotriene B4 (LTB4) is being considered as an important mediator in regulating eosinophil function because of its potent activities in inducing leukocyte chemotaxis, chemokinesis, degranulation, and aggregation. Because the LTB4 receptor has not been characterized in eosinophils, we report in this study the presence of a functional high affinity receptor for LTB4 on guinea pig (GP) eosinophils. Scatchard analysis of saturation binding studies yielded a Kd of 1.4 +/- 0.2 nM (mean +/- SEM, n = 3) and a Bmax of 1.6 +/- 0.4 pmol/mg of protein for LTB4 in GP eosinophil membranes. A linear Scatchard plot was obtained, suggesting that GP eosinophil membranes expressed only a single high affinity LTB4 receptor population. Saturation binding studies in whole cells also yielded a linear Scatchard plot, with a Kd of 2.8 +/- 0.96 nM (mean +/- SEM, n = 4) and a Bmax of 4 x 10(4) +/- 6 x 10(3) receptors/cell. Competitive binding studies using several compounds with structures similar to that of LTB4 showed that these agents bound to the receptor in the following descending order of affinity (Ki, nM): LTB4 (0.96) less than TB3 (1.0) greater than 20-hydroxy-LTB4 (3.5) greater than 12(R)-hydroxy-5,8,14-cis,10-trans-eicosatetraenoic acid (20) greater than 12(S)-hydroxy-5,8,14-cis,10-trans-eicosatetraenoic acid (231) greater than 20-carboxy-LTB4 (350) greater than 5(S),12(S)-dihydroxy-6,10-trans,8,14-cis-eicosatetraenoic acid (541). This rank order of potency in binding affinity correlates closely with the ability of these compounds to induce both chemotaxis and superoxide anion generation. Analysis of the structure-activity relationship suggests that the 12R-hydroxyl group and a cis double bond at the C-6 position are important for optimal agonist binding to the LTB4 receptor present in GP eosinophil membranes. The results suggest that LTB4 may be an important chemoattractant for eosinophils in GP and may induce the release of reactive oxygen species from this cell.

Biological activity of leukotriene B4 analogs: inhibition of guinea pig eosinophil migration in vitro by the 2,6-disubstituted pyridine analogs U-75,302 and U-75,485

A "late phase" antigen-induced bronchoalveolar eosinophilia has been demonstrated in ovalbumin sensitized guinea pigs (1,2). This in vivo response to antigen inhalation can be inhibited by a 2,6-disubstituted pyridine analog of LTB4, U-75,302(2) (3). In the present study, the mechanism of the drug action was studied by assessing the activity of U-75,302 and a second analog, U-75,485 to displace [3H]-leukotriene B4 binding at the guinea pig eosinophil membrane, as well as their action as chemoattractants or inhibitors of the directional migration of guinea pig eosinophils in vitro. Radioligand competition experiments demonstrated that both analogs interacted strongly with the high affinity LTB4 binding sites on guinea pig eosinophil membrane. Both analogs are powerful chemoattractants for guinea pig eosinophils since they induced directional migration of guinea pig eosinophils when administered alone. In addition, when the cells were treated with either analog and their chemotaxis response was measured in response to a natural chemoattractant, both U-75,302 and U-75,485 at concentrations of 0.1 to 100 microM dose dependently inhibited the LTB4 induced chemotaxis response. The EC50s obtained for U-75,302 and U-75,485 as inhibitors of LTB4 induced guinea pig eosinophil chemotaxis were estimated to be 11.5 +/- 5.5 microM and 5.4 +/- 2.5 microM respectively. Under the same conditions, they had no significant effect upon eosinophil migration induced by zymosan activated plasma at concentrations below 100 microM. We suggest that the inhibition of antigen-induced eosinophil infiltration in guinea pig airway in vivo by U-75,302 or U-75,485 may be a result of partial antagonism or desensitization at the LTB4 receptor level of guinea pig eosinophils.

Biochemical and functional differences between eosinophils from animal species and man

Eosinophils were isolated from peritoneal lavages of repeated horse serum-injected guinea pigs or rhesus monkeys and from peripheral blood of normal human donors. Eicosanoid metabolism and chemotaxis by these cells were studied by in vitro techniques. Upon calcium ionophore stimulation guinea pig eosinophils released thromboxane B2 (TXB2) and leukotriene B4 (LTB4) while monkey and human cells produced LTC4, LTB4, and 5-HETE. Guinea pig cells do not synthesize sulfidopeptide LTs, because they lack the specific LTA4 glutathione S-transferase. Guinea pig eosinophils exhibit maximal chemotactic responses to LTB4, zymosan activated plasma, and human recombinant C5a, while producing only a negligible response to platelet activating factor (PAF). Monkey and human cells responded maximally to PAF, but exhibit only a weak response to LTB4. These results suggest that the guinea pig eosinophils differ from monkey and human eosinophils in both the synthetic capacity and functional chemotaxis responses to lipid mediators.

Contribution of leukotriene B4 to airway inflammation and the effect of antagonists

Inhalation of aerosols of ovalbumin in sensitized guinea pigs produced a marked, bronchoalveolar eosinophilia 24 hr after challenge. The lung eosinophilia was not prevented by the cyclooxygenase inhibitors, indomethacin or PAF antagonists (WEB-2086 and L-652731) but was inhibited by methylprednisolone, the 5-LO inhibitor, U-66858 and a series of structural analogs of LTB4, U-75302, U-77692, U-75485 and U-78489. The effectiveness of LTB4 antagonists but not PAF antagonists in vivo was consistent with in vitro studies in which LTB4 was shown to be far more chemotactic than PAF for guinea pig eosinophils. LTB4 elicited maximal directional migration of guinea pig eosinophils at concentrations from 10(-7) M to 10(-9) M while PAF showed no effect over the same concentration range. The structural analogs of LTB4 were shown to inhibit LTB4 induced chemotaxis of guinea pig eosinophils and produced a dose-related inhibition of binding of LTB4 to guinea pig eosinophil membranes. To add further proof to the hypothesis that LTB4 contributed to the antigen-induced lung eosinophilia we attempted to measure LTB4 release into BAL fluid immediately after and at various time points up to 24 hr after antigen inhalation. However, using a sensitive radioimmunoassay (detection limit 10 pg/ml) very low levels of LTB4 (24.9-67.9 pg/ml) or its metabolite, 20-OH LTB4 (24.9-98.2 pg/ml) were detected in BAL fluid and these levels did not increase significantly following antigen provocation. Inhalation of LTB4 aerosols in unsensitized Brown-Norway rats or inhalation of aerosols of ovalbumin in sensitized Brown-Norway rats also produced a marked "late-phase" eosinophil-rich influx of inflammatory cells into the lungs. The lung eosinophilia in the rat was prevented by two structurally unrelated leukotriene B4 (LTB4) antagonists, U-75302 and Ly255283. These data implicate LTB4 as a mediator of allergen-induced bronchopulmonary eosinophilia. Leukotriene B4 antagonists may provide leads for the development of compounds which inhibit the chronic airway inflammation associated with asthma in man.

Arachidonic acid metabolism in guinea pig eosinophils: synthesis of thromboxane B2 and leukotriene B4 in response to soluble or particulate activators

The arachidonic acid metabolism of guinea pig eosinophils isolated from either peritoneal cavity or bronchoalveolar lavages was studied by reverse-phase high-performance liquid chromatography. The purified eosinophils (95-100%) from either source released thromboxane B2 (TxB2), luekotriene B4 (LTB4) and 5-hydroxy eicosatetraenoic acid (5-HETE) following calcium ionophore A23187 stimulation. Quantification by radioimmunoassay indicated that maximal mediator output from the stimulated peritoneal cells was reached at 3 min after stimulation. The increase in production of TxB2 and LTB4 was correlated to increasing calcium ionophore A23187 concentration up to 1.0 micrograms/ml. In addition to calcium ionophore, the guinea pig peritoneal cells were also activated by f-met-leu-phe, phorbol 12-myristate, 13-acetate (PMA), and to lesser extent platelet-activating factor (PAF) to produce TxB2. LTB4 synthesis was stimulated by calcium ionophore, by f-met-leu-phe, as well as by unopsonized glucan, a particulate phagocytotic stimulus. The guinea pig eosinophils do not synthesize sulfidopeptide leukotrienes because of the absence of the specific LTA4 glutathione S-transferase. These results suggest that the guinea pig eosinophils differ from the human circulating eosinophils in the synthetic capacity of lipid mediators derived from arachidonic acid metabolism. This difference may be important in the understanding of the role of the eosinophils in inflammatory reactions such as that which occurs in the bronchial tissues of asthmatics.

Epidural anesthesia for acute pseudo-obstruction of the colon (Ogilvie's syndrome)

With the theory that Ogilvie's syndrome is caused by sympathetic inhibition of contractility in the colon as a basis, 18 patients with acute colonic pseudo-obstruction were enrolled in a treatment program assessing the safety and efficacy of sympathetic blockade, by epidural anesthesia, in those who failed conservative management. In some cases colonoscopy had been performed initially and, if unsuccessful, these patients were referred for treatment with epidural anesthesia. Seven patients recovered with conservative treatment alone. One patient refused further treatment and died of her underlying disease. Five of eight patients treated by epidural anesthesia responded. There were no recurrences following successful epidural anesthesia. Five of eight patients treated by colonoscopic decompression responded. No patients required surgical intervention. One patient suffered a subendocardial infarction during colonoscopy. There were no significant complications from epidural anesthesia. Epidural anesthesia is safe, effective, simple, and well tolerated in the management of Ogilvie's syndrome.

Effect of antibiotic and fluid resuscitation upon survival time in experimental intestinal ischemia

Acute massive intestinal ischemia is an abdominal catastrophe. Prompt diagnosis and restoration of blood flow is essential; otherwise, massive intestinal resection occurs, leading to death or, in the survivors, intestinal cripples. In this study, the time of warm reversible ischemia in the canine intestine was explored. After this time was established, fluids and antibiotics were administered to note change in survival times. Massive intestinal ischemia (superior mesenteric artery was clamped) was tolerated without death for five hours (20 dogs in each group). With six hours of ischemia, a 10 per cent mortality rate occurred; with seven hours of ischemia, a 90 per cent mortality rate occurred. These dogs had a maintenance of 75 milliliters of fluid administered per hour. Using this group of dogs as the control (that is, the group with seven hour clamping time of the superior mesenteric artery with maintenance intravenously administered replacement), fluids were given to dogs in the experimental group to keep the pulmonary artery wedge pressure at a normal value (average of 300 milliliters per hour). This group of dogs had an increased survival rate of 40 per cent (ten dogs). Antibiotics were given to the dogs in the experimental group both before and after clamping, increasing the over-all survival rate to more than 80 per cent (46 dogs). Aggressive fluid replacement and antibiotic coverage may lengthen the so-called golden period in which intestinal ischemia may be reversed by revascularization.

Disappearance and metabolism of leukotriene B4 during carrageenan-induced pleurisy

Leukotriene B4 (LTB4) has been implicated as a mediator in the inflammatory process by virtue of its potent chemotactic activity. At present, very little is known of the stability of this compound in vivo; therefore, the present study was designed to determine the half-life and metabolic fate of radiolabeled LTB4 during a 2-hr intrapleural incubation in rats with acute carrageenan pleurisy. After injection of 0.2 ml of 1% sodium carrageenan (Viscarin), inflammation was allowed to develop for 4 hr. A small polyethylene cannula was then inserted into the chest, and 0.1 microCi of [14C]LTB4 was injected into the chest. Samples for radioactivity determination were taken at 0, 1, 2, 3, 4, 5, 7, 10, 15, 20, 30, 45, 60, 90 and 120 min via the cannula, and at 120 min the entire content of the chest was collected. The half-life for the disappearance of radioactivity from the chest was 45.8 +/- 3.5 min. The 120-min samples were treated with acetone to precipitate protein and extracted with Sep-Paks. The extracts were analyzed by reversed phase high performance liquid chromatography using an ultraviolet detector set at 269 nm and a radioactivity detector. An additional experiment was run using multi-[3H]LTB4, and the only major metabolites detected were omega-hydroxylated compounds. It can be concluded from these results that LTB4 is relatively stable in vivo and could be present for long enough at the inflammatory site to have an influence upon inflammatory cell migration.

Tone of canine ileocolonic junction: topography and response to phasic contractions

We wished to define the physiology of the canine ileocolonic sphincter (ICS) and to examine function in relation to the region's anatomy. Prolonged recordings of tone at the ICS were made from seven dogs with isolated ileocolonic loops, and the effects of ileal and colonic distension on sphincteric tone were assessed. In acute experiments, pull-through pressures were measured at the ICS, and the location of the high-pressure zone was related to the region's anatomy. Basal tone at the ICS of approximately 30 cmH2O was confirmed; tone was augmented by colonic and ileal distension. The high-pressure zone was always centered on the anatomic ICS, but it extended into the adjacent ileum and colon for a total length of 2.0 cm (range 1.5-3.0 cm). Phasic contractions contributed to the maintenance of tone at the ICS, and a coordinated pattern of phasic contractions appears to contribute to the sphincteric properties of the region.

Epoxidation of prostacyclin in the rabbit kidney

In the isolated Tyrode's perfused rabbit kidney, metabolism of [9-3H]prostacyclin was examined. In addition to 7,9-dihydroxy-4,13-diketo-dinor-prostanoic acid, dinor-6-keto-prostaglandin F1 alpha, and pentanorprostaglandin (PG)F1 alpha gamma-lactone, a new, previously unreported, metabolite was isolated and identified by radio-gas chromatography and gas chromatography-mass spectrometry as 5-hydroxy-6-keto-PGF1 alpha. The structure of this metabolite was further confirmed by comparison of the mass spectra to that of the synthetic standard. The formation of 5-hydroxy-6-keto-PGF1 alpha in the kidney suggested epoxidation of prostacyclin via the renal epoxygenase pathway.

Alternatives to ileostomy after colectomy for inflammatory bowel disease

Proctocolectomy and Brooke ileostomy have long been the standard surgical procedure for patients with refractory ulcerative colitis or colonic Crohn's disease. Ileorectal anastomosis, ileoanal anastomosis, the continent ileostomy, and the continent ostomy valve are now being used in selected patients as options to the Brooke ileostomy. The indications for and advantages of these procedures and their potential disadvantages and contraindications are discussed in this chapter.

Gastric influences on canine small intestinal myoelectric activity

The aim was to determine whether the canine stomach modulates interdigestive and digestive small intestinal myoelectric activity. In four conscious dogs with electrodes implanted chronically on the duodenum and jejunum, enteric myoelectric activity was recorded during fasting and after feeding a 200-g liver meal. The dogs then underwent total gastrectomy and esophagoduodenostomy, after which they were restudied. Gastrectomy did not alter the pattern of the enteric interdigestive myoelectric complexes; the occurrence, period, duration of phase III, and consistency of distal propagation of enteric IMCs remained unchanged. Gastrectomy also preserved both the postcibal inhibition of the enteric IMCs and the postcibal induction of the fed myoelectric pattern in the small bowel. However, the onset of the fed pattern occurred more promptly after gastrectomy than before gastrectomy. We concluded that the pattern of canine duodenal and jejunal interdigestive myoelectric activity was largely independent of the stomach. The more rapid onset of the fed pattern with feeding postgastrectomy may relate to more rapid entry of chyme into the small intestine.

The endorectal ileal pouch-anal anastomosis. Current clinical results

One hundred thirteen patients with either chronic ulcerative colitis (108 patients) or familial polyposis coli (five patients) received an ileal J pouch-anal anastomosis after sphincter-saving proctocolectomy. There were no postoperative deaths. Leaks (radiologic and/or clinical) from the pouch or ileoanal anastomosis occurred in 14 per cent of patients. Small-bowel obstruction, requiring operative correction, occurred in 7 per cent and 3 per cent, respectively, of patients after either proctocolectomy or closure of the loop ileostomy. All 66 patients whose diverting ileostomy had been closed for at least three months could defecate spontaneously and their mean (+/- SE) stool frequency per 24 hours was 9.0 +/- 1 at one month and 5.9 +/- at 12 months. Major fecal incontinence was observed in 3 per cent of patients, and two patients eventually required a permanent ileostomy. The ileal J pouch-anal anastomosis has become our procedure of choice in selected patients who require proctocolectomy.

Longitudinal and radial variations of pressure in the human anal sphincter

The pressure profile of the human anal canal integrates the effects of several separate muscles including internal and external and sphincters and the puborectalis. To define the topography of pressure along the anal canal, we developed a new probe that features four perfused side-hole channels spaced at 90 degrees circumferentially. In 18 healthy volunteers (10 women, 8 men), simultaneous four-quadrant pressures were measured at orad, mid-, and distal stations in the anal canal, at rest and during a maximum voluntary "squeeze." Anterior quadrant pressures were reduced significantly (p less than 0.001) at the orad station at rest and during maximum voluntary effort. In the midcanal, radial pressures were equal in all quadrants. Distally, pressures in the posterior quadrant were significantly lower than those in the other three quadrants. Men had longer sphincters than women, but men had higher pressures at the orad station only. Orad pressures were reduced in women who had had vaginal deliveries. We conclude that the human anal canal has marked, but consistent, radial and longitudinal variations of pressure. Based on these results, a structural and physiological explanation for their genesis is suggested. The findings may also be relevant to the development of cystoceles, rectoceles, and chronic anal fissures.