Oxidative status during late pregnancy and early lactation in dairy cows

In the last few years, the detection of free radical damage and the body's defences against it have become increasingly important in clinical medicine as a complementary tool in the evaluation of metabolic status. The aim of this study was to evaluate, under field conditions, the anti-oxidant status of healthy cows during late pregnancy and lactation onset using two parameters: (1) plasma levels of malondialdehyde (MDA), a degradation product of lipid peroxidation, and (2) total antioxidant status (TAS). Results were compared with those obtained in another group of cows with lesser metabolic demands. We also investigated possible relationships between antioxidant status markers and other relevant blood parameters. Our results confirmed the characteristic metabolic changes associated with late pregnancy and early lactation. MDA and TAS provided an accurate reflection of the internal physiological status of the animal. The data indicated increased lipid peroxidation around parturition, but with wide individual variations that may be attributable not only to the physiological stage but also to unknown factors that will have to be further considered in future studies.

Treatment of submassive pulmonary embolism with tenecteplase or placebo: cardiopulmonary outcomes at 3 months: multicenter double-blind, placebo-controlled randomized trial

BACKGROUND

Acute pulmonary embolism (PE) can worsen quality of life due to persistent dyspnea or exercise intolerance.

OBJECTIVE

Test if tenecteplase increases the probability of a favorable composite patient-oriented outcome after submassive PE.

METHODS

Normotensive patients with PE and right ventricular (RV) strain (by echocardiography or biomarkers) were enrolled from eight hospitals. All patients received low-molecular-weight heparin followed by random assignment to either a single weight-based bolus of tenecteplase or placebo, administered in a double-blinded fashion. The primary composite outcome included: (i) death, circulatory shock, intubation or major bleeding within 5 days or (ii) recurrent PE, poor functional capacity (RV dysfunction with either dyspnea at rest or exercise intolerance) or an SF36(®) Physical Component Summary (PCS) score < 30 at 90-day follow-up.

RESULTS

Eighty-three patients were randomized; 40 to tenecteplase and 43 to placebo. The trial was terminated prematurely. Within 5 days, adverse outcomes occurred in three placebo-treated patients (death in one and intubation in two) and one tenecteplase-treated patient (fatal intracranial hemorrhage). At 90 days, adverse outcomes occurred in 13 unique placebo-treated patients and five unique tenecteplase-treated patients Thus, 16 (37%) placebo-treated and six (15%) tenecteplase-treated patients had at least one adverse outcome (exact two-sided P = 0.017).

CONCLUSIONS

Treatment of patients with submassive pulmonary embolism with tenecteplase was associated with increased probability of a favorable composite outcome.

Dexterity enhancement with robotic surgery

BACKGROUND

The aim of this study was to quantify the extent of dexterity enhancement in robotic surgery as compared to laparoscopic surgery.

METHODS

Ten surgeons with varying laparoscopic suturing experience were asked to place three sutures on a suture pad. The sutures were placed laparoscopically, robotically with 2-D vision and robotically with 3-D vision. The da Vinci systems Application Programming Interface (API) was used for positional data. A validated motion analysis system was used for data retrieval for the laparoscopic task. Custom software was developed for data analysis.

RESULTS

Compared to laparoscopic suturing, when the task was undertaken robotically with 2-D vision there was a 20% reduction in the time taken but this was not significant (p = 0.07). There was a 55% reduction in the path traveled by the right hand (p = 0.01) and a 45% reduction in the path traveled by the left hand (p = 0.008). When the task was undertaken robotically with 3-D vision, there was a 40% reduction in the time taken (p = 0.01). There was a 70% reduction in the path traveled by right hand (p = 0.008) and a 55% reduction by the left hand (p = 0.08).

CONCLUSIONS

The presence of wristed instrumentation, tremor abolition, and motion scaling enhance dexterity by nearly 50% as compared to laparoscopic surgery. 3-D vision enhances dexterity by a further 10-15%. In addition, the presence of 3-D vision results in a 93% reduction in skills-based errors.

Immediate and short-term benefit of multilesion coronary angioplasty: influence of degree of revascularization

The safety and short-term therapeutic benefit of multilesion percutaneous transluminal coronary angioplasty was assessed in 135 patients, 66 of whom had a minimum of 6 months of follow-up study. Primary success, defined as successful dilation of the most critical lesion or all lesions attempted without major in-hospital complications was obtained in 117 (87%) of the 135 patients. Cardiac complications associated with the procedure were uncommon; prolonged angina occurred in 5% and myocardial infarction in 3%; emergency coronary bypass surgery was performed in 4% of the patients. There were no deaths. Complete revascularization was achieved in 46% of the 117 patients with a primary success. Of the 66 patients eligible for 6 month follow-up, 80% had an uncomplicated course and required no further procedures. Clinical improvement by at least one angina functional class was observed in 90% of the patients. Cardiac events such as the need for a second revascularization procedure were significantly more common in patients who had incomplete versus complete revascularization (35 versus 9%; p = 0.018). Repeat coronary angiography performed an average of 5 months after angioplasty revealed restenosis in 18 of 22 symptomatic patients and 3 of 9 asymptomatic patients. Restenosis occurred at the site of a single dilation in 12 patients, at two sites in 8 patients and at three sites in 1 patient. Thus, multilesion coronary angioplasty is an important therapeutic option for selected patients with multivessel disease and can be performed with relatively low risk. Improvement in angina status can be expected even in patients who have incomplete revascularization.(ABSTRACT TRUNCATED AT 250 WORDS)

Identification of a novel family of targets of PYK2 related to Drosophila retinal degeneration B (rdgB) protein

The protein tyrosine kinase PYK2 has been implicated in signaling pathways activated by G-protein-coupled receptors, intracellular calcium, and stress signals. Here we describe the molecular cloning and characterization of a novel family of PYK2-binding proteins designated Nirs (PYK2 N-terminal domain-interacting receptors). The three Nir proteins (Nir1, Nir2, and Nir3) bind to the amino-terminal domain of PYK2 via a conserved sequence motif located in the carboxy terminus. The primary structures of Nirs reveal six putative transmembrane domains, a region homologous to phosphatidylinositol (PI) transfer protein, and an acidic domain. The Nir proteins are the human homologues of the Drosophila retinal degeneration B protein (rdgB), a protein implicated in the visual transduction pathway in flies. We demonstrate that Nirs are calcium-binding proteins that exhibit PI transfer activity in vivo. Activation of PYK2 by agents that elevate intracellular calcium or by phorbol ester induce tyrosine phosphorylation of Nirs. Moreover, PYK2 and Nirs exhibit similar expression patterns in several regions of the brain and retina. In addition, PYK2-Nir complexes are detected in lysates prepared from cultured cells or from brain tissues. Finally, the Nir1-encoding gene is located at human chromosome 17p13.1, in proximity to a locus responsible for several human retinal diseases. We propose that the Nir and rdgB proteins represent a new family of evolutionarily conserved PYK2-binding proteins that play a role in the control of calcium and phosphoinositide metabolism downstream of G-protein-coupled receptors.

Effect of lameness on the calving-to-conception interval in dairy cows

OBJECTIVE

To examine the relationship between lameness and the duration of the interval from calving to subsequent conception in lactating dairy cows.

DESIGN

Cohort study.

ANIMALS

837 dairy cows.

PROCEDURE

Cows affected with lameness were classified into 1 of 4 groups on the basis of types of disease or lesions observed, including foot rot, papillomatous digital dermatitis, claw lesions, or multiple lesions. Cows not affected with lameness were classified as healthy. Time from calving to conception was compared between lame cows and healthy cows.

RESULTS

254 (30%) cows were affected with lameness during lactation. Most lame cows (59%) had claw lesions. Lame cows with claw lesions were 0.52 times as likely to conceive as healthy cows. Median time to conception was 40 days longer in lame cows with claw lesions, compared with healthy cows. Number of breedings per conception for lame cows with claw lesions was significantly higher than that for healthy cows.

CONCLUSION AND CLINICAL RELEVANCE

Claw lesions were the most important cause of lameness, impairing reproductive performance in dairy cows, as indicated by a higher incidence of affected cows and a greater time from calving to conception and a higher number of breedings required per conception, compared with healthy cows.

6q deletion in Waldenström macroglobulinemia is associated with features of adverse prognosis

Fluorescence in situ hybridisation (FISH) is an effective technique for the cytogenetic analysis of Waldenström macroglobulinemia (WM), but the potential impact of molecular cytogenetics on disease evolution and as a prognostic marker is still unknown. Deletion of the long arm of chromosome 6 (6q-) is the most frequent cytogenetic abnormality in WM. This study analysed the prevalence of this aberration in 102 WM patients, and correlated it with disease characteristics. The incidence of 6q21 deletion was 7% by conventional cytogenetics and 34% when analysed by FISH (54% when cytoplasmic immunoglobulin M-FISH was used). Patients with deletion of 6q displayed features of adverse prognosis, such as higher levels of beta2-microglobulin and monoclonal paraprotein and a greater tendency to display anaemia and hypoalbuminemia. Interestingly, there was a correlation between the presence of 6q deletion and the International Staging System prognostic index (incidence of 6q- among patients stratified in stages 1, 2 and 3 was 24%, 42% and 67% respectively). Those patients diagnosed with smouldering WM who displayed the abnormality showed a trend to an earlier requirement of treatment. Finally, the survival analysis did not show differences between the two groups of patients, probably due to the short follow up of our series.

High-sensitive immunophenotyping and DNA ploidy studies for the investigation of minimal residual disease in multiple myeloma

Sensitive techniques for monitoring minimal residual disease (MRD) in multiple myeloma (MM) are needed to evaluate the effectiveness of new intensive treatment strategies. The aim of the present study was to explore the applicability and sensitivity of flow cytometry immunophenotyping and DNA ploidy studies for the investigation of residual myelomatous plasma cells (PC) in MM patients. Bone marrow (BM) samples from 61 untreated MM patients were immunophenotypically analysed with a panel of 21 monoclonal antibodies, using a high-sensitive method based on a two-step acquisition procedure through a SSC/CD38 -CD138+ 'live-gate'. Overall, in 87% of MM cases, PC displayed an aberrant phenotype at diagnosis. The most important aberrant criteria were: antigen over-expression of CD56 (62%), CD28 (16%) and CD33 (6%) and asynchronous expression of CD117 (28%), sIg (21%) and CD20 (10%). DNA aneuploidy was found in 62% of cases. The simultaneous use of these two techniques allowed the detection of aberrant/aneuploid PC in 95% of the cases. Based on dilutional experiments, the detection limit of both techniques ranged from 10(-4) to 10(-5). In 29 stem cells harvests and 19 BM samples obtained 3 months after autologous transplantation, we have investigated the presence of residual myelomatous PC; they were detected in 44% of the stem cell collections and in 61% of the BM samples obtained after transplant. The percentage of pathological PC did not significantly change during the days of harvest. In summary, the present study shows that the combined use of immunophenotyping and DNA ploidy studies is a suitable approach for MRD investigation in MM patients based on their applicability (95% of cases) and sensitivity (up to 10(-5)).

Lack of Borrelia burgdorferi DNA in synovial samples from patients with antibiotic treatment-resistant Lyme arthritis

OBJECTIVE

To determine whether Borrelia burgdorferi DNA may be detected in synovial tissue from patients with Lyme arthritis who have persistent synovial inflammation after antibiotic treatment.

METHODS

Synovial specimens obtained at synovectomy from 26 patients with antibiotic treatment-resistant Lyme arthritis and from 10 control subjects were tested for B burgdorferi DNA using 3 primer-probe sets that target genes encoding outer surface proteins A or B or a flagellar protein (P41) of the spirochete.

RESULTS

The 26 patients with Lyme arthritis, who had received antibiotic therapy for a mean total duration of 8 weeks prior to synovectomy, and the 10 control subjects each had negative polymerase chain reaction (PCR) results in synovial samples. When the samples were spiked with approximately 1-10 B burgdorferi, all but 1 had positive PCR results, suggesting that spirochetal DNA could have been detected in most of the unspiked samples if it had been present.

CONCLUSION

These results indicate that synovial inflammation may persist in some patients with Lyme arthritis after the apparent eradication of the spirochete from the joint with antibiotic therapy.

The sequence alteration associated with a mutational hotspot in p53 protects cells from lysis by cytotoxic T lymphocytes specific for a flanking peptide epitope

A high proportion of tumors arise due to mutation of the p53 tumor suppressor protein. A p53 hotspot mutation at amino acid position 273 from R to H, flanking a peptide epitope that spans residues 264-272, renders cells resistant to killing by human histocompatibility leukocyte antigen (HLA)-A*0201-restricted cytotoxic T lymphocytes (CTLs) specific for this epitope. Acquisition of the R to H mutation at residue 273 of the human p53 protein promotes tumor growth in vivo by selective escape from recognition by p53.264-272 peptide-specific CTLs. Synthetic 27-mer p53 polypeptides covering the antigenic nonamer region 264-272 of p53 were used as proteasome substrates to investigate whether the R to H mutation at the P1' position of the COOH terminus of the epitope affects proteasome-mediated processing of the protein. Analysis of the generated products by tandem mass spectrometry and the kinetics of polypeptide processing in conjunction with CTL assays demonstrate that the R to H mutation alters proteasomal processing of the p53 protein by inhibiting proteolytic cleavage between residues 272 and 273. This prevents the release of the natural CTL epitope that spans flanking residues 264-272 as well as a putative precursor peptide. These results demonstrate that mutation of p53 not only leads to malignant transformation but may also, in some instances, affect immune surveillance and should be considered in the design of cancer vaccines.

Adaptor function for the Syk kinases-interacting protein 3BP2 in IL-2 gene activation

Syk-family tyrosine kinases are essential for lymphocyte development and activation. Using a yeast two-hybrid screen to identify Syk kinases-interacting proteins (SKIPs), we isolated 3BP2, an Abl SH3-interacting protein of unknown function. 3BP2 was selectively expressed in hematopoietic/lymphoid tissues and bound via its SH2 domain activated Syk-family kinases in mammalian cells, including in antigen receptor-stimulated T cells. In addition to Zap-70, the 3BP2 SH2 domain associated in vitro with LAT, Grb2, PLCgamma1, and Cbl from activated T cell lysates. Transient 3BP2 overexpression induced transcriptional activation of the IL-2 promoter and its NFAT or AP-1 elements. This activity was dependent on the SH2 and pleckstrin-homology domains of 3BP2, and required functional Syk kinases, Ras, and calcineurin. Thus, 3BP2 is an important adaptor that may couple activated Zap-70/Syk to a LAT-containing signaling complex involved in TCR-mediated gene transcription.

Race-start characteristics and risk of catastrophic musculoskeletal injury in Thoroughbred racehorses

OBJECTIVE

To identify race-start characteristics associated with catastrophic musculoskeletal (MS) injury in Thoroughbred racehorses at 2 racetracks in Florida during 1995 through 1998.

DESIGN

Matched case-control study.

ANIMALS

97 Thoroughbreds (case horses) that incurred a catastrophic MS injury during racing and 388 Thoroughbreds (control horses) randomly selected from noninjured participants and matched on the basis of racetrack and year.

PROCEDURE

Incidence of MS injury was calculated for all race meets at 2 racetracks in Florida from 1995 through 1998. Race-start characteristics were compared among case and control horses, using conditional logistic regression.

RESULTS

Overall incidence of MS injury was 1.2/1,000 race starts (97/79,416 starts). Incidence of injury was significantly higher for turf races (2.3/1,000 starts) than for dirt races (0.9/1,000 starts). Sex, number of days since last race, and racing surface were associated with risk of injury; geldings, > or = 33 days since the last race, and turf racing surface were associated with a higher risk of injury.

CONCLUSIONS AND CLINICAL RELEVANCE

Incidence of injury among Thoroughbreds in Florida was associated with sex, number of days since last race, and racing surface. Days since last race may have been an indicator of previous health and lameness problems. Racing surface may have been a risk factor for MS injury because turf races tended to be more competitive than dirt races. Horses running in turf races were more likely to participate in races with a large field, handicap races, long races, and races with high purses.

Antibacterial and free-radical scavenging activities of Sonoran propolis

AIMS

To evaluate the antibacterial and free-radical scavenging (FRS) activities of propolis collected from three different areas of Sonoran Desert in northwestern Mexico [Pueblo de Alamos (PAP), Ures (UP) and Caborca (CP)].

METHODS AND RESULTS

The antibacterial and FRS activities of Sonoran propolis were determined by the broth microdilution method and the DPPH (1,1-diphenyl-2-picrylhydracyl) assay, respectively. Propolis samples had antibacterial activity against only Gram-positive bacteria. The UP sample showed the highest antibacterial activity against Staphylococcus aureus [minimal inhibitory concentration (MIC) 100 microg ml(-1)] in a concentration-dependent manner (UP > CP > PAP). Caffeic acid phenethyl ester (CAPE), a UP propolis constituent, had very high growth-inhibitory activity towards Gram-positive bacteria, particularly against S. aureus (MIC 0.1 mmol l(-1)). To our knowledge, this is the first study showing a strong antibacterial activity of CAPE against S. aureus. Additionally, propolis CP exhibited high FRS activity (86% +/- 0.3 at 100 microg ml(-1)) comparable with those of the reference antioxidants vitamin C (87.4% +/- 1.7 at 70 micromol l(-1)) and BHT (66.07% +/- 0.76 at 140 micromol l(-1)). The propolis compounds CAPE and rutin showed high FRS activity (90.4% +/- 0.2 and 88.5% +/- 0.8 at 70 micromol l(-1), respectively).

CONCLUSIONS

Sonoran propolis UP and CAPE had strong antibacterial activity against S. aureus. In addition, propolis CP showed potent FRS activity comparable with those of vitamin C and BHT.

SIGNIFICANCE AND IMPACT OF THE STUDY

The strong antibacterial and antioxidant properties of Sonoran propolis and some of its constituents support further studies on the clinical applications of this natural bee product against S. aureus and several oxidative damage-related diseases.

Human cytomegalovirus elevates levels of the cellular protein p53 in infected fibroblasts

Human cytomegalovirus (HCMV), like other DNA tumor viruses, induces morphological transformation of cells in vitro and stimulates host cell macromolecular synthesis in infected cells. Since other DNA tumor viruses, such as simian virus 40 and adenovirus, have previously been shown to interact with cellular protein p53, we investigated whether infection of cells by HCMV would modulate cellular p53 levels. Our results indicate that HCMV elevates cellular p53 levels on the order of 10- to 20-fold in infected fibroblasts. The induction of elevated p53 levels was dependent upon the presence of active virus and was prevented by neutralizing antibody. The induction of elevated p53 levels was determined not to be due to virus-receptor interactions or HCMV late events. The induction of elevated p53 levels commenced at immediate-early times of the HCMV multiplication cycle (6 h postinfection) and reached maximal levels by 24 h postinfection, before most of the HCMV DNA synthesis was initiated. HCMV immediate-early proteins were clearly shown to be responsible for elevating p53 levels in infected fibroblasts; expression of HCMV immediate-early region 1 and 2 proteins resulted in elevation of p53 levels in transfected human fibroblasts. This is the first report of increased p53 levels caused by HCMV in infected fibroblasts.

Frequency domain models of the EEG

The structure of the normal resting EEG crosspectrum SVV(omega) is analyzed using complex multivariate statistics. Exploratory data analysis with Principal Component Analysis (PCA) is followed by hypothesis testing and computer simulations related to possible neural generators. The SVV(omega) of 211 normal individuals (ages 5 to 97) may be decomposed into two types of processes: the xi process with spatial isotropicity reflecting diffuse, correlated cortical generators with radial symmetry, and processes that seem to be generated by more spatially concentrated, correlated sources. The latter are reflected as spectral peaks such as the process. The eigenvectors of the xi process are the Spherical Harmonic Functions which explains the recurring pattern of maps characteristic of the spatial PCA of qEEG data. A new method for estimating sources in the frequency domain which fits dipoles to the whole crosspectrum is applied to explain the characteristics of the localized sources.

Clonal plasma cells from monoclonal gammopathy of undetermined significance, multiple myeloma and plasma cell leukemia show different expression profiles of molecules involved in the interaction with the immunological bone marrow microenvironment

The immunological bone marrow (BM) microenvironment plays a major role in controlling growth and survival of clonal plasma cells (PC); this might translate into different patterns of expression of molecules involved in immune responses on PC from different types of monoclonal gammopathies (MG). We have studied the expression of a group of nine such molecules on both BMPC and the plasma of 61 newly diagnosed MG patients (30 MG of undetermined significance (MGUS), 27 multiple myeloma (MM) and four plasma cell leukemia (PCL)) and five normal individuals. Clonal PC from all MG displayed significantly increased levels of CD56, CD86 and CD126, and decreased amounts of CD38 (P<0.001). Additionally, HLA-I and beta2-microglobulin were abnormally highly expressed in MGUS, while CD40 expression was decreased in MM and PCL (P<0.05). Interestingly, a progressive increase in the soluble levels of beta2-microglobulin was found from MGUS to MM and PCL patients (P=0.03). In contrast, all groups showed similar surface and soluble amounts of CD126, CD130 and CD95, except for increased soluble levels of CD95 observed in PCL. Overall, those phenotypic differences are consistent with increased antigen presentation and costimulatory capacities in MGUS, which progressively deteriorate in malignant MG (MM and PCL).

Sarco/endoplasmic reticulum calcium ATPase-2 expression is regulated by ATF6 during the endoplasmic reticulum stress response: intracellular signaling of calcium stress in a cardiac myocyte model system

The recently described transcription factor, ATF6, mediates the expression of proteins that compensate for potentially stressful changes in the endoplasmic reticulum (ER), such as reduced ER calcium. In cardiac myocytes the maintenance of optimal calcium levels in the sarcoplasmic reticulum (SR), a specialized form of the ER, is required for proper contractility. The present study investigated the hypothesis that ATF6 serves as a regulator of the expression of sarco/endoplasmic reticulum calcium ATPase-2 (SERCA2), a protein that transports calcium into the SR from the cytoplasm. Depletion of SR calcium in cultured cardiac myocytes fostered the translocation of ATF6 from the ER to the nucleus, activated the promoter for rat SERCA2, and led to increased levels of SERCA2 protein. SERCA2 promoter induction by calcium depletion was partially blocked by dominant-negative ATF6, whereas constitutively activated ATF6 led to SERCA2 promoter activation. Mutation analyses identified a promoter-proximal ER stress-response element in the rat SERCA2 gene that was required for maximal induction by ATF6 and calcium depletion. Although this element was shown to be responsible for all of the effects of ATF6 on SERCA2 promoter activation, it was responsible for only a portion of the effects of calcium depletion. Thus, SERCA2 induction in response to calcium depletion appears to be a potentially physiologically important compensatory response to this stress that involves intracellular signaling pathways that are both dependent and independent of ATF6.

Consanguineous matings in an Israeli-Arab community

OBJECTIVE

To determine the frequency of consanguineous marriages and the inbreeding coefficient in Israeli Arabs.

DESIGN

Cohort survey.

SETTING

General community in 70 settlements in Israel.

PARTICIPANTS

Nine thousand three hundred Israeli-Arab students in the second grade were sent questionnaires to be filled out by their fathers, with 8521 completed questionnaires returned.

INTERVENTIONS

None.

MEASUREMENTS/MAIN RESULTS

Of the 8521 completed questionnaires, 1156 (14%) were from urban areas, 2267 (27%) were from suburban areas, and 5098 (60%) were from rural areas. The prevalence of consanguineous matings in the studied group was 44.3%, with a mean inbreeding coefficient of .0192. This prevalence is high and was highest in the rural areas. Marriages between first cousins occurred more often than marriages between other relatives in all locations.

CONCLUSION

The frequency of consanguineous marriages is quite high among Israeli Arabs, approaching 50%.

References ranges and sources of variation for indices of pulsed Doppler flow velocity waveforms from the uteroplacental and fetal circulation

Variation in indices used to characterize the maximum frequency outline of waveforms obtained from the uteroplacental and fetal circulations by duplex Doppler ultrasound was studied between observers, over a 24-h period and before and after a meal. No significant differences were found. Reference ranges were derived for three indices, the A/B ratio, the resistance index and the pulsatility index, for waveforms from the fetal descending aorta, umbilical artery, and the placental and maternal sides of the uteroplacental circulation. Indices from waveforms from the uteroplacental circulation demonstrated a fall from 16 to 24 weeks gestation with no change thereafter. The umbilical artery indices demonstrated a continuing fall with increasing gestation but the A/B ratio and resistance index from the fetal descending aorta did not change with gestation. The pulsatility index from the aorta demonstrated a gentle rise.

Hypertrophy of skeletal muscle in diabetic rats in response to chronic resistance exercise

This study had the following objectives: 1) to determine whether diabetic rats could increase muscle mass due to a physiological manipulation (chronic resistance exercise), 2) to determine whether exercise training status modifies the effect of the last bout of exercise on elevations in rates of protein synthesis, and 3) to determine whether chronic resistance exercise alters basal glycemia. Groups consisted of diabetic or nondiabetic rats that performed progressive resistance exercise for 8 wk, performed acute resistance exercise, or remained sedentary. Arterial plasma insulin in diabetic groups was reduced by about one-half (P < 0.05) compared with nondiabetic groups. Soleus and gastrocnemius-plantaris complex muscle wet weights were lower because of diabetes, but in response to chronic exercise these muscles hypertrophied in diabetic (0.028 +/- 0.003 vs. 0.032 +/- 0.0015 g/cm for sedentary vs. exercised soleus and 0.42 +/- 0.068 vs. 0.53 +/- 0.041 g/cm for sedentary vs. exercised gastrocnemius-plantaris, both P < 0.05) but not in nondiabetic (0.041 +/- 0.0026 vs. 0.042 +/- 0.003 g/cm for sedentary vs. exercised soleus and 0.72 +/- 0.015 vs. 0.69 +/- 0.013 g/cm for sedentary vs. exercised gastrocnemius-plantaris) rats when muscle weight was expressed relative to tibial length or body weight (data not shown). Another group of diabetic rats that lifted heavier weights showed muscle hypertrophy. Rates of protein synthesis were higher in red gastrocnemius in chronically exercised than in sedentary rats: 155 +/- 11 and 170 +/- 7 nmol phenylalanine incorporated x g muscle(-1) x h(-1) in exercised diabetic and nondiabetic rats vs. 110 +/- 14 and 143 +/- 7 nmol phenylalanine incorporated x g muscle(-1) x h(-1) in sedentary diabetic and nondiabetic rats. These elevations, however, were lower than in acutely exercised (but untrained) rats: 176 +/- 15 and 193 +/- 8 nmol phenylalanine incorporated x g muscle(-1) x h(-1) in diabetic and nondiabetic rats. Finally, chronic exercise training in diabetic rats was associated with reductions in basal glycemia, and such reductions did not occur in sedentary diabetic groups. These data demonstrate that, despite lower circulating insulin concentrations, diabetic rats can increase muscle mass in response to a physiological stimulus.

PI-3-kinase and MAPK regulate mesangial cell proliferation and migration in response to PDGF

Proliferation and migration are important biological responses of mesangial cells to injury. Platelet-derived growth factor (PDGF) is a prime candidate to mediate these responses in glomerular disease. PDGF and its receptor (PDGFR) are upregulated in the mesangium during glomerular injury. We have recently shown that PDGF activates phosphatidylinositol 3-kinase (PI-3-kinase) in cultured mesangial cells. The role of this enzyme and other more distal signaling pathways in regulating migration and proliferation of mesangial cells has not yet been addressed. In this study, we used two inhibitors of PI-3-kinase, wortmannin (WMN) and LY-294002, to investigate the role of this enzyme in these processes. Pretreatment of mesangial cells with WMN and LY-294002 dose-dependently inhibited PDGF-induced PI-3-kinase activity assayed in antiphosphotyrosine immunoprecipitates. WMN pretreatment also inhibited the PI-3-kinase activity associated with anti-PDGFR beta immunoprecipitates prepared from mesangial cells treated with PDGF. Pretreatment of the cells with different concentrations of WMN resulted in a dose-dependent inhibition of PDGF-induced DNA synthesis. Both WMN and LY-294002 inhibited PDGF-stimulated migration of mesangial cells in a dose-dependent manner. It has recently been shown that PI-3-kinase physically interacts with Ras protein. Because Ras is an upstream regulator of the kinase cascade leading to the activation of mitogen-activated protein kinase (MAPK), we determined whether activation of PI-3-kinase is necessary for activation of MAPK. Pretreatment of mesangial cells with WMN and LY-294002 significantly inhibited PDGF-induced MAPK activity as measured by immune complex kinase assay of MAPK immunoprecipitates. Furthermore, PD-098059, an inhibitor of MAPK-activating kinase inhibited PDGF-induced MAPK activity and resulted in significant reduction of mesangial cell migration in response to PDGF. These data indicate that MAPK is a downstream target of PI-3-kinase and that both these enzymes are involved in regulating proliferation and migration of mesangial cells.

Quality of spinal extradural anaesthesia: the influence of spinal nerve root diameter

Profiles on the progress of spinal extradural anaesthesia were made in 246 patients using various concentrations of lignocaine, bupivacaine and etidocaine. The advance of analgesia through the different dermatomes showed a consistent and orderly spread on the upper lumbar and thoracic segments. This spread was irregular through the lower lumbar and upper sacral segments. The first sacral segment was especially difficult to block with an overall failure rate of 17.53% with presently available concentrations of various local anaesthetics. This failure was abolished with the use of etidocaine 1.5%. The presence of a delay or failure at the level of L5-S2 is probably related to the larger diameter of these nerve roots as ascertained from measurements in 11 cadavers.

Peach allergy pattern: experience in 70 patients

We report the clinical characteristics of peach allergy encountered in a population of peach-allergic patients. We evaluated 165 patients. The 70 peach-allergic patients were diagnosed through clinical history, the skin prick-prick test, and open oral challenge and rub tests to peach. As a pollinic control group, 95 pollen-allergic patients were also evaluated. Some 49% of the patients were male and 51% female. The mean age was 20 +/- 8 years. Oral allergy syndrome (86%) was the most common symptom, followed by contact urticaria (61%) and systemic symptoms (26%). Some 67% of the patients were allergic to peach pulp and 36% reported symptoms related to canned peach. Canned peach and pulp symptoms were statistically associated (P < 0.01), and symptoms to canned peach were more frequently reported by patients with systemic symptoms (P < 0.05). On evaluation of the peach-allergic patients' characteristics, three risk factors--allergy to peach pulp, allergy to canned peach, and peach allergy in non-pollen-allergic patients--were found, indicating development of systemic symptoms on eating peach. Most of the peach-allergic patients (81%) also had pollen allergy, which was linked to a higher prevalence of asthma (73%) than in the pollen-allergic patients of the control group (48%); this difference was statistically significant (P < 0.01). Finally, two groups were clearly defined by the seriousness of the peach allergy--the non-pollen-allergic patients were more predisposed to the occurrence of systemic symptoms (> 50%), and the pollen-allergic patients to asthma (> 70%).