Multi-Institutional Phase II Trial Using Dose Escalated Five Fraction Stereotactic Partial Breast Irradiation (S-PBI) with GammaPodTM for Early-Stage Breast Cancer

PURPOSE/OBJECTIVE(S)

We report on our early experience of a multi-institutional phase II study of dose escalated five fraction stereotactic partial breast irradiation (S-PBI) for early-stage breast cancer after partial mastectomy using the GammaPodTM stereotactic radiation system.

MATERIALS/METHODS

Patient eligibility included DCIS or invasive epithelial histologies, AJCC clinical stage 0, I, or II with tumor size < 3 cm, and negative margins. Prior safety of Phase I dose escalation has been reported. Dose was 40 Gy delivered in 5 fractions to the CTV, and minimum dose 30 Gy in 5 fractions to the PTV. CTV margin was 1 cm and PTV margin 3 mm. For PTV cavities larger than 100cc, dose was reduced to 35Gy in 5 fractions to the CTV and 30 Gy in 5 fractions to the PTV. Primary endpoint of the study is to determine the 3-year patient global cosmesis score (4-point scale excellent, good, fair, or poor) and adverse cosmesis using a dose escalated approach with smaller PTV margins than conventional methods. Both patients and physicians completed baseline and subsequent cosmesis outcome questionnaires. Treatment related toxicity was graded using the NCI version 4.0 and RTOG/EORTC late radiation scale.

RESULTS

From 3/2019-10/2021, 74 patients were treated respectively. Of these, 38 were treated to 40Gy and 36 were treated to 35 Gy. Median follow up (f/u) was 24 months (mo), range (r) 3-39mo. Median age was 63 years (r 43-77). Histology included 28 DCIS, and 46 invasive carcinomas. 45/46 invasive tumors were ER+. 60/74 (81%) patients received endocrine therapy, and 7/74 patient received chemotherapy. There were 221 acute grade 1 toxicities, and 28 Grade 2 toxicities. No grade 3 or higher acute toxicities were reported (< 90 days). The most common Grade 2 toxicities were radiation dermatitis (10), breast pain (8), blister (4), skin infection (2), nipple discharge (2), and fatigue (2). In the late period, there were 54 Grade 1 late toxicities, 4 Grade 2 late toxicities, and no Grade 3 or higher late toxicities. Grade 2 toxicities included fibrosis (2), and pain (2). Two patients developed grade 1 asymptomatic nonpalpable fat necrosis both diagnosed at 12 months after radiation treatments. The most common grade 1 late toxicities were breast pain (14), hyperpigmentation (8), fibrosis (10), and fatigue (5). Physicians scored cosmesis excellent or good 70/73 (95.8%), 58/60 (96.7%), 36/36 (100%),17/17(100%) respectively at baseline, 12 months, 24 months, and 36months post SBRT, while patients scored the same periods 62/71 (83.7%), 53/59 (89.8%), 33/36 (91.6%), 17/18 (94.4%). There have been no reports of disease recurrences.

CONCLUSION

Results at 24-month median follow-up, of our dose escalated stereotactic partial breast 5 fraction regimen, has low acute and late toxicity, while maintaining high proportion of excellent/good cosmetic outcomes. Continued analysis of all cohorts is in progress.

CLINICAL TRIALS

gov identifier is NCT03581136.

Financial Toxicity and Patient Experience Outcomes on a Multi-Institutional Phase I Single Fraction Stereotactic Partial Breast Irradiation Protocol for Early-Stage Breast Cancer

PURPOSE/OBJECTIVE(S)

Given the demonstrated financial toxicity (FT) of radiation treatment on breast cancer patients shown in both conventional and our recent 5 fraction stereotactic APBI (S-PBI) study, we assessed the FT, as well as patient-reported utility, quality-of-life and patient experience measures, on patients treated in our phase I single fraction S-PBI trial.

MATERIALS/METHODS

A phase I single fraction dose escalation trial of S-PBI for early-stage breast cancer was conducted. Women with in-situ or stage I-II (AJCC 6) invasive breast cancer following breast conserving surgery were treated with S-PBI in 1 fraction to a total dose of 22.5, 26.5 or 30 Gy (Clinical trials.gov ID NCT02685332). At one month follow-up, patients were asked to complete our novel "Patient Perspective Cost and Convenience of Care Questionnaire". Patients also completed the EQ-5D-5L, including the visual analogue scale of overall health (VAS), at enrollment, 6, 12-, 24-, 36-, and 48-month follow-up.

RESULTS

Of 29 patients enrolled and treated, questionnaire data was available for all patients. Our trial encompassed a wide range of annual household incomes, education, and employment status. Overall, 44.8% (n = 13/29) of patients reported that radiation treatment presented a financial burden. Interestingly, no demographic information, such as patient race, marital status, education, household income, or employment during treatment predicted perceived FT. Patients reporting FT trended towards younger age (median 64 vs 70.5) and having a cancer related co-pay similar to our 5 fraction S-PBI FT trial; however, due to the small size of this study, this did not reach significance (p = 0.24 and 0.10, respectively). VAS and utility scores were calculated per the EQ-5D-5L and remained unchanged from baseline through 4-year follow-up. Likewise, there was no difference in the utility or VAS between patients who reported FT and those who did not. Interestingly, while patient reported cosmesis was similar for all patients at enrollment, patients who reported FT noted significantly worse cosmesis scores (fair/poor vs good/excellent) at 6 month and 2-year follow-ups (p = 0.01 and 0.04, respectively). Finally, patients were surveyed on treatment related disruption to their daily activities and enjoyment of life. The median values were 0 (scale 0-10, with 0 being no disruption) regardless of perceived FT. Patients were also uniformly satisfied with treatment time with a median score of 10 (scale 0-10, 10 being most satisfied).

CONCLUSION

Here, we show that despite using SPBI in a single fraction, nearly half of the patients treated still reported FT of treatment. Importantly, single fraction S-PBI has no negative impact on patient VAS or utility scores, and all patients were uniformly satisfied with treatment time without significant disruption to their life.

A Preliminary Study on the Antigenic Proteins of Linguatula serrata Nymphal Stage in Sheep with Visceral Linguatulosis

Scant information is available on the immunological aspect of Linguatula serrata causing linguatulosis in humans and animals. The present study aimed to analyze the content of crude somatic extracts and excretory-secretory products of L. serrata nymphs to detect the immune response of sheep and immunogenic proteins of the parasite. After collecting the nymphs, somatic extracts were prepared by sonication. Excretory secretory products were prepared by the incubation of nymphs in RPMI medium at 37°C with 5% CO2. Somatic and excretory-secretory proteins were isolated using SDS-PAGE. The immunogenic properties of the resulting proteins were determined using immunoblotting and positive sera from sheep infected with visceral linguatulosis. The total content of somatic extracts and excretory-secretory products of L. serrata nymphs analyzed by SDS-PAGE (12% gel) revealed two protein patterns with more than 18 and 9 strong bands, respectively. Immunoblots using sera samples of sheep infected with the parasite, somatic extracts and excretory-secretory products demonstrated 12 and 3 antigenic proteins with molecular weights mostly in the range of 24-100 kDa and an antigen more than 180 kDa. Three common immunodominant antigenic proteins with molecular weights of 38 and 57, as well as an antigen of more than 180 kDa, were detected in the somatic extracts and excretory-secretory products of L. serrata nymphs in sheep with visceral linguatulosis. These antigens can be considetered prime candidates for future serodiagnosis and immunoprotective studies of the parasite.

POS0349 SEQUENCE COMPLEMENTARITY BETWEEN SARS-CoV-2 GENOME AND HUMAN NONCODING RNAS ASSOCIATED WITH IMMUNOLOGICAL DISORDERS: AN IN SILICO PIVOTAL STUDY

Background:

Recent evidence shows that human cells may produce several noncoding (nc)RNAs in response to viral infections. Among them, a central role has been attributed to long noncoding (lnc)RNAs, more than 200 nucleotides in length, which are also crucially involved in cancer and autoimmunity. LncRNAs epigenetically control the transcription of genes presiding over cell proliferation, differentiation, migration and apoptosis, by directly or indirectly binding cellular or foreign nucleic acids, including viral genomes.

Objectives:

The objectives of this study were to evaluate in silico the presence of a nucleotide sequence complementarity between the RNA genome of Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2) and human ncRNA genes and to analyze any associations between SARS-CoV-2 gene-matching ncRNAs and human diseases.

Methods:

The FASTA sequence of each of the 11 SARS-CoV-2 isolate Wuhan-Hu-1 genes (ORF1ab, ORF3a, ORF6, ORF7a, ORF7b, ORF8, ORF10, S, E, M, N) was retrieved from NCBI.nlm.nih.gov/gene (reference sequence NC_045512.2). The ensembl.org library for human ncRNA genes was interrogated for any base-pair match and detected human ncRNAs analyzed for their functional activity. Finally, the associations between ncRNAs and human diseases were searched on GWAS databases (https://www.ebi.ac.uk/gwas and https://www.genecards.org).

Results:

A total of 252 matches between SARS-CoV-2 genes and human ncRNAs were recorded (ORF1ab: 28; ORF3a: 9; ORF6: 50; ORF7a: 31; ORF7b: 16; ORF8: 23; ORF10: 5; S: 24; E: 17; M: 32; N: 17). With the exception of two small nuclear RNAs (RNVU1-4 and RNU4-74P corresponding to ORF6 and ORF10, respectively), all of them were lncRNAs, mostly expressed in testis and central nervous system under physiological conditions. Percentage of alignment ranged from 91.30% to 100%, with a mean nucleotide alignment length of 17.5±2.4. Polymorphic variants of these transcripts have mostly been reported in patients with neuropsychiatric disorders, cancer and dysmetabolism. Of note, we found 13 and 15 complementarities with lncRNAs associated with immune-mediated diseases Table 1. and immunological pathways (IL-2, IL-6, IL-12, IL-12R, IL-13, IL-17, M-CSF, CXCL-10, TRAIL-R2 and IgG glycosylation), respectively.

Conclusion:

This pivotal study shows that SARS-CoV-2 genes contain complementary sequences to human ncRNAs in turn associated with several diseases, including autoimmunity. The biological effects of this interaction remain to be elucidated.

Table 1.

SARS-CoV-2 complementary ncRNAs and associated immunological disorders

SARS-CoV-2 geneLncRNAGenomic locationNucleotide alignment lengthAlignment percentageAssociated immunological disorderSXACTX:113705866-11370588318100%Crohn’s diseaseNLINC013581:59082428-5908257417100%Acute Graft-versus-Host DiseaseECOX10-AS117:14029229-1402924517100%Systemic lupus erythematosusORF8AC093765.34:116752764-1167527842195.24%Ulcerative colitisORF6CDKN2B-AS19:22033529-2203354618100%Multiple sclerosisCHROMR2:178433948-1784339682195.24%Multiple sclerosisPsoriasisAtopic eczemaWAKMAR26:137857643-13785765715100%Atopic eczemaHay feverAllergic rhinitisMultiple sclerosisPsoriasisSystemic sclerosisSystemic lupus erythematosusRheumatoid arthritisAC008691.15:159362809-159362828(promoter flank)2095%SarcoidosisPsoriasisPsoriatic arthritisSclerosing cholangitisCeliac diseaseType I diabetes mellitusSystemic lupus erythematosusJuvenile idiopathic arthritisUlcerative colitisCrohn’s diseaseTakayasu arteritisMultiple sclerosisLMCD1-AS13:7953602-7953616(enhancer)15100%Systemic sclerosisMLINC019342:181403969-18140398416100%Multiple sclerosisAnkylosing spondylitisCeliac diseaseRheumatoid arthritisORF7bXACTX:113959816-11395983116100%Crohn’s diseaseLINC0262110:62289643-6230233515100%Rheumatoid arthritisLINC019913:187966255-18796626915100%IgA deficitAtopic asthmaAllergic rhinitis

Disclosure of Interests:

None declared

Efficacy of amiodarone and voriconazole combination therapy in cutaneous leishmaniasis in the mice experimentally infected with Leishmania major

INTRODUCTION

The aim of the present study was to evaluate in vitro and in vivo efficacy of combination therapy of amiodarone and voriconazole against Leishmania major and investigating immune and wound healing responses of cutaneous leishmaniasis to this combination therapy.

METHODS

For in vitro study, replication of L. major promastigotes and intracellular amastigotes were investigated in the presence and absence of amiodarone and voriconazole. Isobologram construction and calculation of the Fractional Inhibitory Concentration (FIC) were performed. After the appearance of ulcers on the base of tails of BALB/c mice, treatment was initiated by a combination of amiodarone at 40 mg/kg plus voriconazole at 30 mg/kg orally and glucantime at 60 mg/kg intraperitoneally for 28 consecutive days.

RESULTS

According to the concave isobologram and fractional inhibitory concentration <1, combination of amiodarone plus voriconazole had synergistic effects against L. major promastigotes and intracellular amastigotes. There were less inflammatory cells, more fibroblasts and more collagen deposition in tissue sections in the mice treated with combined drugs compared to the vehicle and untreated mice. Increased glutathione peroxidase activity and decreased malondialdehyde, Interleukin-6, and Tumor necrosis factor-α levels were detected in the combination therapy group in comparison to the vehicle and untreated groups.

CONCLUSIONS

It seems a combination of amiodarone plus voriconazole can be a rational and promising therapeutic approach in the treatment of cutaneous leishmaniasis.

Effectiveness of amiodarone in treatment of cutaneous leishmaniasis caused by Leishmania major

Development of new chemotherapeutic agents is an essential issue in the treatment and control of a disease. This study aimed to evaluate the anti-leishmanial activity of amiodarone, an antiarrhythmic class III drug, against Leishmania major, the most prevalent etiological agent of cutaneous leishmaniasis in the old world. The proliferation of promastigotes and intracellular amastigotes in the absence or presence of amiodarone was estimated, in an in vitro study. For in vivo study, five weeks after infection of BALB/c mice with L. major, when the lesions appeared at the injection site, the mice were divided into four groups (n = 6 each); treatment was conducted for 28 consecutive days with vehicle, amiodarone at 40 mg/kg orally and glucantime at 60 mg/kg intraperitoneally. Therapy with amiodarone reduced the size of lesions compared to the untreated group after 12 days. Amiodarone decreased the parasite load and inflammatory responses, particularly the macrophages containing amastigotes, and enhanced granulation tissue formation in the dermis and subcutaneous area. The Tumor necrosis factor-α and Interleukin-6 levels were significantly lower in the cell culture supernatants of the inguinal lymph node in the amiodarone treated group compared to the vehicle and untreated groups. Amiodarone significantly increased the activity of glutathione peroxidase in comparison to the vehicle and untreated groups but did not affect the plasma levels of superoxide dismutase, malondialdehyde, adiponectin, and ferric reducing ability of plasma. Therefore, the anti- L. major activity and immunomodulatory effects of amiodarone reduced the parasitic load and enhanced wound healing in cutaneous leishmaniasis in BALB/c mice. Amiodarone reduced the lesion surface area, but it did not cure it completely.

Emerging role of amiodarone and dronedarone, as antiarrhythmic drugs, in treatment of leishmaniasis

Leishmaniasis is a group of human and animal diseases causing 20,000-40,000 annual deaths and its etiological agents belong to the Leishmania genus. The most current treatment against leishmaniasis is chemotherapy. Pentavalent antimonials such as glucantime and pentostam have been administrated as the first-line drugs in treatment of various forms of leishmaniasis. The second-line drugs such as amphotericin B, liposomal amphotericin B, miltefosine, pentamidine, azole drugs and paromomycin are used in resistant cases to pentavalent antimonials. Because of drawbacks of the first-line and second-line drugs including adverse side effects on different organs, increasing resistance, high cost, need to hospitalization and long-term treatment, it is necessary to find an alternative drug for leishmaniasis treatment. Several investigations have reported the effectiveness of amiodarone, the most commonly used antiarrhythmic drug, against fungi, Trypanosomes and Leishmania spp. in vitro, in vivo and clinical conditions. Moreover, the beneficial effects of dronedarone, amiodarone analogues, against Trypanosoma cruzi and Leishmania mexicana have recently been demonstrated and such treatment regimens resulted in lower side effects. The anti- leishmanial and anti- trypanosomal effectiveness of amiodarone and dronedarone has been attributed to destabilization of intracellular Ca²⁺ homeostasis, inhibition of sterol biosynthesis and collapse of mitochondrial membrane potential. Because of relative low cost, excellent pharmacokinetic properties, easy accessibility and beneficial effects of amiodarone and dronedarone on leishmaniasis, they are proper candidates to replace the current drugs used in leishmaniasis treatment.

A Serological Survey of Neospora caninum Infection in Urban and Rural Dogs in Ahvaz District, Southwest of Iran

Dogs are important in the epidemiology of Neospora caninum because they act as definitive hosts, shedding oocysts in the environment. The aim of the present survey was to evaluate the serological prevalence of Neospora caninum infection in urban and rural dogs in Ahvaz district, southwest of Iran. In this study, blood samples were taken from 100 rural dogs and 50 urban dogs. The dogs were categorized into two age groups (i.e., &amp;le; 3 and &amp;gt; 3 years). Neospora agglutination test (NAT) was performed for the detection of infection. Among 150 samples, 30 (20%) showed infection in 1:50 to 1:800 dilutions by NAT (confidence interval 95%: 13.60-26.40). The antibody titers were as follows: 1:50 (n=1), 1:100 (n=14), 1:200 (n=3), 1:400 (n=10) and 1:800 (n=2). The highest serum dilution was 1:100 in 46.67% of the infected dogs and the lowest serum dilution was 1:50 in 3.33% of them. The obtained results showed a significant difference in seroprevalence between urban (10%) and rural (25%) dogs (P=0.03). Although the seroprevalence was higher in dogs above three years of age (23.33%) than below three years (17.78%), there was not a significant difference among different age groups in this regard (P&amp;gt;0.05). The possibility of infection in dogs above the age of three years was 1.3 more than those below three years of age (confidence interval 95%: 0.58-2.9). It can be concluded that a relatively considerable percentage of dogs in Ahvaz district are infected with N. caninum. These infected dogs can play an important role in the transmission of neosporosis to other animals.

Evaluation of Local tissue oxidative stress and its possible involvement in the pathogenesis of toxoplasmosis in rats experimentally infected with Toxoplasma gondii

Toxoplasmosis caused by the protozoan parasite Toxoplasma gondii, is a zoonotic parasitic disease. Oxidative stress plays a dominant role in the host's defense against protozoan infection. In the present study the possible involvement of local oxidative stress in the pathogenesis of T. gondii were investigated. Twenty five female Wistar rats were infected with RH strain of Toxoplasma tachyzoites and twenty female rats were used as control group that only received sterile PBS. Tissue samples from liver, heart and brain on 0, 3, 5, 8 and 45 days post infection were collected. As biochemical markers of oxidative stress, endogenous concentrations of GSH, GPX and SOD activity, MDA level, protein carbonyl content and total antioxidant capacity were determined from the mentioned tissues of control and infected rats. Based on the results, on day 3, 5 and 8 post infection the level of hepatic glutathione were significantly decreased in infected rats when compared to control. There was a significant rise in hepatic glutathione peroxidase activity and malondialdehyde level on the third day post infection in comparison to uninfected rats. Significant elevation of superoxide dismutase activity and malondialdehyde level on 5 day post infection and protein carbonyls and total antioxidant capacity on 8 day post infection in infected livers were obtained. Significant changes of glutathione level, total antioxidant capacity and protein carbonyls contents were observed in cardiac homogenate on days 3, 5 and 45, respectively. Measured parameters were constant throughout all stages of experiment in brain of infected rats. Indeed increased production of reactive oxygen species accompanies Toxoplasma infection in liver and heart tissues of experimentally infected rats. Based on this study, antioxidant defense system can probably play a role in parasitic stage interconversion and shifting the toxoplasmosis into the chronic phase.

Smart micro/nanoparticles in stimulus-responsive drug/gene delivery systems

New achievements in the realm of nanoscience and innovative techniques of nanomedicine have moved micro/nanoparticles (MNPs) to the point of becoming actually useful for practical applications in the near future. Various differences between the extracellular and intracellular environments of cancerous and normal cells and the particular characteristics of tumors such as physicochemical properties, neovasculature, elasticity, surface electrical charge, and pH have motivated the design and fabrication of inventive "smart" MNPs for stimulus-responsive controlled drug release. These novel MNPs can be tailored to be responsive to pH variations, redox potential, enzymatic activation, thermal gradients, magnetic fields, light, and ultrasound (US), or can even be responsive to dual or multi-combinations of different stimuli. This unparalleled capability has increased their importance as site-specific controlled drug delivery systems (DDSs) and has encouraged their rapid development in recent years. An in-depth understanding of the underlying mechanisms of these DDS approaches is expected to further contribute to this groundbreaking field of nanomedicine. Smart nanocarriers in the form of MNPs that can be triggered by internal or external stimulus are summarized and discussed in the present review, including pH-sensitive peptides and polymers, redox-responsive micelles and nanogels, thermo- or magnetic-responsive nanoparticles (NPs), mechanical- or electrical-responsive MNPs, light or ultrasound-sensitive particles, and multi-responsive MNPs including dual stimuli-sensitive nanosheets of graphene. This review highlights the recent advances of smart MNPs categorized according to their activation stimulus (physical, chemical, or biological) and looks forward to future pharmaceutical applications.

Study on research anxiety among faculty members of isfahan university of medical sciences

Introduction:

One of the most common anxieties in higher education is research anxiety. The purpose of this study was to determine the research anxiety level among the faculty members of Isfahan University of Medical Sciences (IUMS).

Methods:

this was survey- analytical study. The stratified random sampling method was used and a sample of 212 people was selected. For data collection was used a questionnaire. Data were analyzed with descriptive and analytical (T Test, ANOVA and LSD) statistics.

Findings:

The average anxiety research in IUMS was about 3.27 ±0.536. Among factors, highest scores in descending order are related to lack of timely payment of fees (3.97±0.961), the long approval process of proposals and research project reporting (3.86.±0.99) and lack of research efficiency on the part of faculty (3.70±1.00). The lowest scores were related to having insufficient funds to conduct research (2.67±1.08), another’s understanding of inability for researching (2.84±1.192), and unfriendly behavior from journals and research center staffs (2.89±0.802).

Conclusion:

The mean level of research anxiety among faculty members of IUMS was found higher than average. So it’s essential that authorities pay greater attention to the factors that cause research anxiety.

The effective factors on library anxiety of students in Isfahan University of Medical Sciences and Shiraz University of Medical Sciences

INTRODUCTION

The efficient use of libraries can be an important factor in determining the educational quality of Universities. Therefore, investigation and identification of factors affecting library anxiety becomes increasingly necessary. The purpose of this research is to determine the factors effecting library anxiety of students in Isfahan University of Medical Sciences and Shiraz University of Medical Sciences.

MATERIALS AND METHODS

This was an applied survey research using Bostick's Library Anxiety questionnaire as data gathering tool. The statistical population consisted of all students of Isfahan University of Medical Sciences and Shiraz University of Medical Sciences (15011 students) with the sample size of 375 using stratified random sampling. The validity of data gathering tool was confirmed by experts in the library and information science and its reliability was determined by Cronbach's alpha (r = 0.92). Descriptive statistics (frequency, percentage, mean and standard deviation) and inferential statistics (t-test and ANOVA) were used for data analysis using SPSS 18 software.

RESULTS

Findings showed that the mean of library anxiety score was 2.68 and 2.66 for students of Isfahan University of Medical Sciences and Shiraz University of Medical Sciences respectively which is above average (2.5). Furthermore, age and gender had no meaningful effect on the library anxiety of students of Isfahan University of Medical Sciences, but gender had a meaningful effect on library anxiety of students of Shiraz University of Medical Sciences while age had no such effect.

CONCLUSION

The results showed that the mean of factors effecting library anxiety in students of Isfahan University of Medical Sciences and students of Shiraz University of Medical Sciences is higher than average and therefore not satisfactory and only factors relating to feeling comfortable in the library is lower than average and somewhat satisfactory.

Systemic inhibition and liver-specific over-expression of PAI-1 failed to improve survival in all-inclusive populations or homogenous cohorts of CLP mice

BACKGROUND

The role of plasminogen activator inhibitor type-1 (PAI-1) in abdominal sepsis remains elusive.

OBJECTIVES

To study the influence of inhibition and over-expression of PAI-1 upon survival in cecal ligation and puncture (CLP) sepsis.

METHODS

(i) Mice underwent moderate CLP and received 10 mg kg(-1) of either monoclonal anti-PAI-1 (MA-MP6H6) or control (MA-Control) antibody intravenously at 0, 18 or 30 h post-CLP. The 30-h treatment group was additionally stratified into mice predicted to survive (P-SUR) or die (P-DIE) based on IL 6 measured at 24 h post-CLP. (ii) PAI-1 expression was induced with pLIVE.PAI-1 plasmid administered 72 h pre-CLP. Blood was sampled for 5 days and survival was monitored for 28 days.

RESULTS

MA-MP6H6 effectively neutralized active PAI-1 and fully restored fibrinolysis while PAI-1 over-expression was liver-specific and correlated with PAI-1 increase in the blood. Without stratification, MA-MP6H6 co-/post-treatment conferred no survival benefit. Prospective stratification (IL-6 cut-off: 14 ng mL(-1) ) suggested increased mortality by MA-MP6H6 treatment in P-SUR that reached 30% difference (vs. MA-Control; P < 0.05) after a retrospective cut-off readjustment to 3.3 ng mL(-1) for better P-SUR homogeneity. Subsequent prospective anti-PAI-1 treatment in P-SUR mice with 3.3 ng mL(-1) cut-off demonstrated a negative but statistically insignificant effect: mortality was higher by 17% after MA-MP6H6 vs. MA-Control. Over-expression of PAI 1 did not alter post-CLP survival. Neither PAI-1 inhibition nor over-expression meaningfully modified inflammatory response and/or organ function.

CONCLUSIONS

Restoration of fibrinolysis in early abdominal sepsis was not beneficial and it may prove detrimental in subjects with the lowest risk of death, while preemptive PAI-1 up-regulation at the current magnitude was not protective.

Diagnosis of subclinical equine theileriosis in center of Iran using parasitological and molecular methods

A total of 105 blood samples from healthy horses from different stables in Yazd province, center of Iran, were examined for the presence of Theileria equi infection using parasitological and molecular methods. Out of the 105 samples, the parasitological method detected T. equi infection in 5 (4.76%) cases while the PCR method gave 24 (22.86%) positive results. Age, gender and breed were not determined as risk factors for T. equi infection in this study. Since blood samples were taken from healthy animals, this implies that 22.86% of horses had subclinical theileriosis in the current study. In conclusion, this study demonstrated that T. equi is present in horses in the center of Iran. Despite the healthy appearance of horses, these carrier animals can transmit the parasites to ticks and are a potential continuous source for maintaining and disseminating the organisms to the horse population. We concluded that it is important to make further studies on definitive host and vectors in the respective areas.

Klossiella equi in a donkey--a first case report from Iran

Klossiella equi is the only known and rarely reported coccidian parasite of the renal paranchyma of equids. An aged male donkey (Equus asinus asinus) was submitted to necropsy department of veterinary hospital. In histopathological study of renal sections different developmental stages of parasite were observed. These stages were as follow: Trophozoites, microgametes, macrogametes, sporont, budding sporont, sporoblasts, free sporoblasts, mature sporoblast and sporocyst. Parasitic infection with K. equi was encountered in the donkey. According to literature review this is the first report of donkey klossiellosis in Iran.

Relationship between information literacy and creativity: a study of students at the isfahan university of medical sciences

INTRODUCTION

In an era of huge volume of publications and information products, information literacy has become a very important survival tool. Information literacy is an instrument for individual empowerment that leads one to search for the truth and the desired information for decision making with independence. While creativity is the foundation of sciences and innovation, one of the main functions of universities is expanding the frontiers of knowledge and productions of scientific information. Therefore creativity is more vital and necessary for these kinds of institutions than other organizations. In this regard, this paper investigates the relationship between information literacy and creativity of students at the Isfahan University of Medical Sciences.

METHOD

This is a correlation-descriptive study. Statistical population was third year students of Isfahan University of Medical Sciences (1054 individuals) in 2011. Sample size was 250 individuals selected by stratified random Sampling. The instruments for data collection were two questionnaires, an investigator made questionnaire for information literacy and a creativity questionnaire. For questionnaires validity used content validity and for their reliability used Cronbach Alpha Coefficient (r1= 0.95, r2=0.85). SPSS 18 statistical software and descriptive and inferential statistics tests (Frequency distribution tab, Pearson Correlation, T test, Tukey test and ANOVA) were used to analyze data.

RESULTS

The results indicate that mean of information literacy was higher than average and mean of creativity was lower than average. There is a significant multiple correlation between 5 dimensions of information literacy (Ability to determine extent and nature of information, effective and efficient access, critical assessment, ability of purposeful application, ability of understanding legal and economic issues) and creativity in level of (p≤ 0.05). Also mean difference of ability of purposeful application based on gender was significant in level of (p≤ 0.05). It means the ability of purposeful application in male students was more than female students.

CONCLUSION

We are living in the information age and one of the variables that are associated with creativity is information literacy. The results indicated that the students who are more creative are more information literate and can reach higher goals. Therefore we can contemplate that increasing information literacy in the universities and other scientific education centers plays an important role in teaching and training a creative workforce.

The relationship between organizational trust and nurse administrators' productivity in hospitals

CONTEXT

Management of health care organizations based on employee's mutual trust will increase the improvement in functions and tasks.

AIMS

The present study was performed to investigate the relationship between organizational trust and the nurse administrators' productivity in educational health centers of in Health-Education Centers of Isfahan University of Medical Sciences.

SETTINGS AND DESIGN

This research was a descriptive and correlational study.

MATERIALS AND METHODS

The population included all nurse administrators. In this research, 165 nurses were selected through random sampling method. Data collection instruments were organizational trust questionnaire based on Robbins's model and productivity questionnaire based on Hersy and Blanchard's model. Validity of these questionnaires was determined through content validity and their reliability was calculated through Cranach's alpha. Statistical analysis was used: The data analysis was done using the SPSS (18) statistical software.

RESULTS

The indicators of organizational trust such as loyalty, competence, honesty, and stability were more than average level but explicitness indicator was at average level. The components of productivity such as ability, job knowledge, environmental compatibility, performance feedback, and validity were more than average level but motivation factor was at average level and organizational support was less than average level. There were a significant multiple correlations between organizational trust and productivity. Beta coefficients among organizational trust and productivity were significant and no autocorrelation existed and regression model was significant.

CONCLUSIONS

Committed employees, timely performing the tasks and developing the sense of responsibility among employees can enhance production and productivity in the health care organizations.

In vitro cultivation of axenic amastigotes and the comparison of antioxidant enzymes at different stages of Leishmania tropica

The present study aimed to establish a simple method to yield large amounts of Leishmania tropica amastigote-like forms in axenic cultures and to compare the superoxide dismutase (SOD) and glutathione peroxidase (GPX) enzymes at different stages of L. tropica. Different culture conditions were tested to find the optimum condition of axenic amastigotes generation. Superoxide dismutase (SOD) and glutathione peroxidase (GPX) activities were determined at logarithmic and stationary phases and axenic amastigote stage of the parasite. A high proportion (88%) of amastigote-like forms of L. tropica was observed in BHI medium supplemented with 20% FCS, pH 4.5, and incubated at 37ºC with 5% CO(2). The results showed that SOD activity was at the lowest level in the logarithmic phase of promastigotes and increased towards the stationary phase of promastigotes and amastigote stage. The results showed that the optimum condition for differentiation of L. tropica promastigotes to axenic amastigotes was BHI medium containing 20% FCS at pH 4.5, incubated at 37ºC in the presence of 5% CO(2). It seems that SOD, but not GPX is a major determinant of intracellular survival of the parasite.

The relationship between students' study habits, happiness and depression

BACKGROUND

One of the important requirements for cultural, social and even economic development is having a book-loving nation. In order to achieve this, there is a need for purposeful and continuous programming. The purpose of this research was to determine the relationship between students' study habits, happiness and depression in Isfahan University of Medical Science.

METHODS

This research was a kind of descriptive and correlation survey. Statistical population included all MSc and PhD students in the second semester of the Isfahan University of Medical Science (263 students). In this research, stratified and random sampling was used in which a sample of 100 students was selected. Data collection instruments were Beck Depression Inventory (BDI), Oxford Happiness Inventory and a researcher-made questionnaire to determine the amount of students' study. Validity of this questionnaires was determined by structure and content related validity and its reliability was calculated by Cronbach's alpha coefficient for the first (r = 0.94), second (r = 0.91) and third (r = 0.85) questionnaire. Analysis of research findings was done through descriptive and inferential statistics.

RESULTS

Findings showed that 68.8 percent of students study less than 5 hours and only 2.5 percent of students study more than 10 hours. 65 percent of students had high amount of happiness and 35 percent had medium amount of happiness. In 60 percent of students there was no symptom of depression and 7.5 had depression symptoms. Also, there was no significant relationship between happiness and studying but there was a significant and negative relationship between studying and depression and happiness and depression.

CONCLUSIONS

The amount of study and tendency for reading are among the most important indices of human growth in terms of potential abilities for achieving a perfect human life and to prevent one-dimensional thinking. Thus, finding ways to encourage students to study is considered essential to achieve a healthy and developed society.

Prevalence of Cryptosporidium infection in camels (Camelus dromedarius) in a slaughterhouse in Iran

Cryptosporidiosis is a zoonotic protozoan disease of worldwide distribution, affecting a wide range of vertebrate hosts. Most data on the biology, distribution pattern, pathology and prevalence of cryptosporidial infection in farm animals is restricted to cattle, sheep and goats. Limited data is available in other domestic herbivores including camel. Numerous camels (Camelus dromedarius) are raised in the semi-arid regions of Iran. Although camel is acknowledged as a potential source of contamination, little is known with regards to the prevalence of Cryptosporidium in this population except a case report on the occurrence of this infection in a bactrian camel (Camelus bactrianus) in China. This investigation was undertaken to determine the prevalence of Cryptosporidium infection in camels (C. dromedarius) from Najaf-Abad slaughterhouse, Isfahan Province, central part of Iran. Out of 103 faecal samples from 63 adult males and 40 adult females, 2-14 years old, 39 (37.9%) were found positive for oocysts. No significant differences were observed between males and females, and among different age groups. There was also no significant difference among infection intensity in different age groups. This is the first report of Cryptosporidium infection in camels from this country.

Occurrence and biology of goat warble fly infestation by Przhevalskiana silenus (Diptera, Oestridae) in Iran

Goat warble fly infestation (GWFI) by the larvae of Przhevalskiana silenus is endemic in goats of semi-hilly and mountainous regions of Iran. This myiasis has severe economic impact on tanning industries, and it is responsible for impaired milk and meat production, growth retardation and carcass depreciation. To estimate the prevalence of GWFI in the southern areas of Iran, from October 2006 to December 2008, the carcasses of 8000 goats at a Shiraz slaughterhouse and 1000 each at Marvdasht and Darab cities were examined weekly for the presence of P. silenus larvae. In addition, appropriate sections from the skin and subcutaneous tissues were processed for histopathological investigation. The prevalence rate of infestation in different cities varied from 7.0% to 18.9% and the minimum and maximum infestation rate was 3 and 78, with an average rate of infestation of 26.2 warbles per animal. Significant differences were observed in the prevalence among different age groups with no significant difference between male and female animals. First instar larvae (L(1)) were found on infected animals from early August to end of September, second larval stage (L(2)) from early October to end of November and third-stage larvae (L(3)) from early December to mid-March. No larvae were found on skin or subcutaneous tissues from end of March to late July. Live L(1) initiated mild lymphocyte, macrophage and eosinophil infiltration while dead L(1) initiated granulomatous or pyogranulomatous reactions. Live L(2) induced severe inflammatory reaction and massive tissue necrosis, which continued for L(3) and until the end of infestation phase. The subcutaneous tissues, dermis and epidermis became necrotic and fragmented, and L(3) penetrated the necrotic area to start its aerobic life cycle.

Prevalence and pathology of camel filariasis in Iran

A total of 1,070 camels of different ages and of both sexes slaughtered at Mashhad slaughterhouse were inspected for infection with Dipetalonema evansi. Microfilariae were found in peripheral blood smears of 221 (20.7%) camels (14% females and 23% males). In a second study, the testicles, epididymises, spermatic cords, and lungs of 197 male camels were examined, and 165 (83.7%) were infected with adult forms of D. evansi. Tissue sections from 30 infected and ten uninfected camels were collected and processed routinely for further histopathological studies. The arteries infected with D. evansi in the region of nodules in testis showed chronic reaction characterized by proliferative and hyperplastic changes of the endothelial and fibrous connective tissue layers, narrowing the lumen or occluding it. The testicles were either hypertrophic or atrophic and showed chronic orchitis with infiltration of lymphocytes, eosinophils, macrophages and fibroblasts, parenchymal degeneration, and necrosis and, in some cases, with hematoma and hydrocele formation. Necrosis of the alveolar walls, atelectasis, pulmonary edema, and fibrosis of the pulmonary parenchyma with chronic interstitial pneumonia and rarely mineralization of the wall of the blood vessels were also seen in some of the infected animals. D. evansi is highly endemic and constitutes an important health problem to camels in this area, resulting in high morbidity, impaired working capacity, and lowered productivity.

Is Third-Time Heart Retransplantation Justifiable?

Since repeat heart transplantation traditionally carries higher risk than primary engraftment, we tested the hypothesis that third-time cardiac allograft transplantation is associated with prohibitive mortality and morbidity. The cohort of all third-time cardiac retransplants performed at our institution (n=3) and reported to UNOS from 1987 to 2002 (n=10) was reviewed. The primary endpoints were early and late mortality. Extending the study frame through 2003 captures a total of 5 and 15 third-time heart transplant recipients in UCLA and UNOS databases, respectively. Of the 15 patients undergoing third-time retransplants, preoperatively one was ventricular assist device-dependent, four were on intravenous inotropes, and two had creatinine levels greater than 2.5. Additionally, four were male recipients of female donor hearts and the mean donor ischemic time was 2.6 hours. One patient was diagnosed with acute allograft rejection, 13 with coronary artery vasculopathy/chronic rejection, and one with primary graft failure. At our institution, five patients underwent a third heart transplant. There was no early or hospital mortality. One patient died late from transplant coronary artery disease and another following a fourth allograft. The mortality rate for third-time heart allograft recipients is acceptable. These results are influenced by small sample size, younger age, case selection, and operations at select, high-volume institutions with significant experience.

Plasma D-lactate as a potential early marker for colon ischaemia after open aortic reconstruction

BACKGROUND AND AIM

The breakdown of mucosal barrier function due to intestinal hypo-perfusion is the earliest dysfunction of ischaemic colitis. Severe colon ischaemia after aortic reconstruction is associated with mortality rates up to 90%. Therefore, early detection and treatment of patients with extensive ischaemic colitis is of crucial importance. In experimental studies, both D-lactate and bacterial endotoxin have been reported as markers of intestinal mucosal barrier impairment. However, evidence of their value in clinical practice is lacking. The aim of this pilot prospective cohort study was to assess the association between ischaemia of the colon (assessed histologically) and plasma levels of D-lactate and endotoxin in patients undergoing open aortic reconstruction.

PATIENTS AND METHODS

Twelve consecutive patients underwent surgery between February and April 2003. Six patients underwent emergency surgery and six patients elective aortic surgery. D-Lactate and endotoxin levels were measured in blood samples collected according to a standardised protocol. For histological examination biopsies were obtained by sigmoidoscopy on days 4-6 after surgery, or earlier if indicated clinically.

RESULTS

As early as 2 h postoperatively, elevated plasma levels of d-lactate were measured in patients with histologically proven ischaemic colitis. The peak of D-lactate elevation was on postoperative days 1 and 2. Concentration of plasma endotoxin was not significantly different in patients with or without ischaemic colitis.

CONCLUSION

Our data suggest that plasma D-lactate levels are a useful marker for early detection of ischaemic colitis secondary to aortic surgery.

Circulating S100B is increased after bilateral femur fracture without brain injury in the rat

BACKGROUND

S100B is an acknowledged marker of brain damage. However, trauma without brain damage also causes an increase in S100B. S100B concentrations are highest in multiple trauma patients with long bone fractures. Clinically, extensive long bone fractures are associated with haemorrhagic shock and haemorrhagic shock per se is associated with increased S100B. The aim of our experimental study was to verify the S100B increase in long bone fracture without haemorrhagic shock.

METHODS

and results. Bilateral femur fracture was carried out in 10 anaesthetized rats. Blood samples were drawn for immuno-luminometrical S100B measurement 5, 15, 30, 120, and 240 min after fracture. Mean arterial pressure (MAP), heart rate, and body temperature were monitored continuously. S100B increased after bilateral femur fracture and reached a peak 30-120 min after fracture (P<0.001). MAP remained at a level which is not associated with shock in rats. Heart rate and body temperature remained unchanged. Autopsy verified open bilateral femur fracture surrounded only by small zones of clotted blood.

CONCLUSIONS

S100B is increased in bilateral femur fracture without haemorrhagic shock in rats. This finding suggests that bone marrow is a potential extracerebral source of S100B.

Nitric oxide synthase-independent pathway(s) of nitric oxide formation after intestinal ischaemia–reperfusion

Background

Recent evidence suggests that nitric oxide produced in the gastrointestinal tract, in concert with other vasoactive mediators, plays an essential role in the regulation of splanchnic circulation.

Methods

To determine the sites and pathways of nitric oxide formation, electron paramagnetic resonance spectroscopy and the nitric oxide trap diethyldithiocarbamate-Fe were used to detect directly nitric oxide formed in intestine, liver and lungs of rats subjected to local intestinal ischaemia–reperfusion (I/R), in the presence or absence of nitric oxide donors or inhibitors. In addition, the role of nitric oxide in control of the gastrointestinal circulation was determined by means of a coloured microsphere technique employing N-(G)-Monomethyl-L-arginine (L-NMMA) in rats subjected to haemorrhagic shock followed by resuscitation.

Results

In contrast to remote organs lung and liver (no change), intestinal I/R resulted in an increase in nitric oxide formation in intestinal tissues. Administration of the non-specific nitric oxide inhibitor L-NMMA caused a decrease in I/R-independent basal nitric oxide levels in lung and liver but did not influence the I/R-induced increase in nitric oxide formation in intestinal tissues. In support of this, reverse transcriptase–polymerase chain reaction analyses showed inducible nitric oxide synthase (NOS) expression in the lung but not in intestinal tissues. In the microsphere experiment, a moderate and therapeutic dose of L-NMMA administered after the completion of resuscitation, which improved haemodynamic conditions and outcome, did not alter the intestinal circulation.

Conclusion

The data suggest that the early-phase I/R-induced nitric oxide formation in ischaemic intestinal tissue is probably NOS independent, while nitric oxide formation in normoxic remote tissues is partially NOS dependent. In addition, the authors' nitric oxide-related therapeutic approaches reveal that only the regulation of nitric oxide (e.g. nitric oxide supplementation during resuscitation or reperfusion and/or nitric oxide inhibition or modulation after resuscitation) may protect against hypovolaemic insults.

Mitochondria recycle nitrite back to the bioregulator nitric monoxide

Nitric monoxide (NO) exerts a great variety of physiological functions. L-Arginine supplies amino groups which are transformed to NO in various NO-synthase-active isoenzyme complexes. NO-synthesis is stimulated under various conditions increasing the tissue of stable NO-metabolites. The major oxidation product found is nitrite. Elevated nitrite levels were reported to exist in a variety of diseases including HIV, reperfusion injury and hypovolemic shock. Denitrifying bacteria such as Paracoccus denitrificans have a membrane bound set of cytochromes (cyt cd1, cyt bc) which were shown to be involved in nitrite reduction activities. Mammalian mitochondria have similar cytochromes which form part of the respiratory chain. Like in bacteria quinols are used as reductants of these types of cytochromes. The observation of one-e- divergence from this redox-couple to external dioxygen made us to study whether this site of the respiratory chain may also recycle nitrite back to its bioactive form NO. Thus, the aim of the present study was therefore to confirm the existence of a reductive pathway which reestablishes the existence of the bioregulator NO from its main metabolite NO2-. Our results show that respiring mitochondria readily reduce added nitrite to NO which was made visible by nitrosylation of deoxyhemoglobin. The adduct gives characteristic triplet-ESR-signals. Using inhibitors of the respiratory chain for chemical sequestration of respiratory segments we were able to identify the site where nitrite is reduced. The results confirm the ubiquinone/cyt be1 couple as the reductant site where nitrite is recycled. The high affinity of NO to the heme-iron of cytochrome oxidase will result in an impairment of mitochondrial energy-production. "Nitrite tolerance" of angina pectoris patients using NO-donors may be explained in that way.

Cytokine synthesis in the liver of endotoxin-tolerant and normal rats during hemorrhagic shock

In the present study the effects of endotoxin tolerance on hemorrhagic shock were investigated with particular focus on hepatic alterations. The following questions were addressed: (i) does hemorrhagic shock induce cytokine formation and heat shock response in the liver; and (ii) does endotoxin tolerance alter these reactions. Endotoxin tolerance was induced by repetitive daily injections of LPS for 5 days. Hemorrhagic shock was induced by hypovolemia (MAP 35 +/- 5 mmHg). After 3 h, the animals were resuscitated by re-infusion of homologous blood. m-RNA was isolated from liver biopsies and the mRNA levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), interleukin-10 (IL-10) and heat shock protein 70 (HSP-70) were determined by RT-PCR. TNF-alpha was measured by ELISA in serum samples and in the supernatants of whole blood cultures. It was found that endotoxin tolerance reduced mortality caused by hemorrhagic shock from 80% to 20%. In parallel, TNF-alpha production in response to LPS in vivo and in vitro was significantly decreased. During hemorrhage and after resuscitation. increased mRNA levels were detected in hepatic biopsies for TNF-alpha, IL-6, IL-10 and HSP-70, with highest levels immediately after re-infusion. Endotoxin-tolerant rats produced significantly lower levels of TNF-alpha, while no differences were found for IL-10 and HSP-70. Within 30 min after reperfusion, significantly higher levels of IL-6 mRNA were found in hepatic biopsies from tolerant rats; these differences disappeared 2 h after reperfusion.

A unique murine monoclonal antibody recognizing HLA-B53, B37, B51, B52, +/-B44

Monoclonal antibodies have played an important role in studying the biochemistry of the HLA-Class I molecules. Some murine anti-HLA mAbs can identify configurations of HLA epitopes that have never been reported in human allosera. One of these configurations is identified by an IgM mAb designated as: BHA-1441. This antibody was produced using a lymphoblastoid cell line typed as: A*02, A*25; B*38, B*4402/4405; C*0501, C*07, BW4, as the immunogen. A lymphocytotoxicity test of this mAb over a panel of 109 frozen, 452 fresh and, later, 44 DNA typed T cells revealed its specificity as B53, 37, 51, 52, +/- 44. All of the antigens recognized by this mAb share the Bw4 motif at positions 81-83, except for the HLA-B37, which shares only 82L and 83R. Furthermore, while B37 and B44 cross-react due to the aspartic acid (D) substitution at position 156, the reactivity with B53, B5 (51,52), B37 and 60% of B44 cells, makes it unlikely that the target epitope could be due only to the primary amino-acid sequence. The antibody-binding site might involve changes in tertiary structure and peptides bound by the MHC. BHA-1441 is an interesting tool to study and type the HLA-B53 antigen and its cross-reactive epitopes.

Experimental evidence suggesting that nitric oxide diffuses from tissue into blood but not from blood into tissue

The aim of this study was to evaluate in vivo whether nitric oxide (NO) is able to diffuse from blood into tissues and vice versa from tissues into blood. We used an in vivo model of intestinal ischemia (superior mesenteric artery occlusion) selectively increasing NO levels in intestinal tissue and an infusion of L-arginine selectively increasing NO levels in blood. In this model we followed formation of nitrosyl complexes of hemoglobin (Hb-NO) in blood and nitrosyl-diethyldithiocarbamate-iron complexes (DETC--Fe--NO) in ischemic intestine and normoxic tissues by means of electron paramagnetic resonance spectroscopy. NO trapping by DETC--Fe in the tissues resulted in a reduction of Hb--NO levels in blood accompanied by the formation of water-insoluble DETC--Fe-NO complexes in ischemic intestine and normoxic tissues both during ischemia and during reperfusion. Administration of L-arginine increased NO levels in blood but neither in ischemic intestine nor in normoxic tissue. Our data suggest that NO released in blood from endothelial cells does not diffuse into tissue. In contrast, NO formed in tissue diffuses into blood. The latter indicates that NO formed in tissues may exert its biological activities systematically.

Organ specific formation of nitrosyl complexes under intestinal ischemia/reperfusion in rats involves NOS-independent mechanism(s)

Intestinal ischemia/reperfusion may lead to local and distant organ damage involving nitric oxide (NO). NO rapidly reacts with heme/non-heme-iron-yielding nitrosyl complexes, which can be determined directly by electron paramagnetic resonance spectroscopy. The aim of the present study was to characterize nitrosylation reactions induced by transient intestinal ischemia in blood and tissues. We used electron paramagnetic resonance spectroscopy and reverse transcription polymerase chain reaction analyses to estimate nitrosyl complex levels and inducible NO synthase mRNA expression in rats subjected to superior mesenteric artery occlusion for 60 min followed by the reperfusion. Nitrosyl hemoglobin concentrations in circulating blood were significantly increased during ischemia and reperfusion. Nitrosyl hemoglobin complexes were detected in ischemic intestine, but not in normoxic lung and liver or reperfused intestine. Administration of N-G-monomethyl-L-arginine, a non-specific NO synthase inhibitor, did not affect the formation of circulating nitrosyl complexes. Moreover, inducible NO synthase mRNA was not found in intestinal tissues at 30 min of reperfusion. Our data suggest an organ-specific NO formation indicated by the increased nitrosylation reaction in ischemic intestinal tissue, but not in the distant normoxic organs, in spite of high circulating nitrosyl hemoglobin levels. NO involved in nitrosylation under intestinal ischemia/reperfusion is probably formed by NO synthase-independent mechanism(s).