Continuous intercostal analgesia with 0.5% bupivacaine after thoracotomy: a randomized study

This study was undertaken to evaluate the effectiveness of 0.5% bupivacaine (360 mg/day) as a continuous infusion through an indwelling intercostal catheter inserted intraoperatively in the management of pain after thoracotomy. Eighty-six patients were randomized into three groups: group 1 = intercostal bupivacaine, group 2 = intercostal saline solution, and group 3 = fixed-schedule intramuscular buprenorphine. Supplementary buprenorphine was given as required. Pain and pulmonary function were assessed throughout the first 5 days after operation. Pain score was lower in group 1 than in group 2 for the first 8 hours after operation (p < 0.02). During the first 3 postoperative days, mean postoperative pain scores of 5 or more were recorded in 9% of group 1 patients versus 40% of group 2 patients (p < 0.05) and 13% of group 3 patients (not significant). Total doses of buprenorphine were lower in groups 1 and 2 than in group 3 (p < 0.001). No between-group differences in pulmonary function were observed. Respiratory complications occurred in no patients in groups 1 and 3 versus 5 in group 2 (p < 0.05). Continuous intercostal bupivacaine provided similar early pain control as compared with fixed-schedule narcotics but induced better analgesia with fewer complications than on-demand narcotics alone (group 2).

Substrate binding induces depolymerization of the C-terminal peptide binding domain of murine GRP78/BiP

To investigate the role of each domain in BiP/GRP78 function, we have used a full-length recombinant BiP engineered to contain two enterokinase sites; one site is located after an N-terminal FLAG epitope, and a second site has been inserted at the junction between the N- and C-terminal domains (FLAG-BiP.ent). FLAG-BiP.ent oligomerizes into multiple species that interconvert with each other in a slow, concentration- and temperature-dependent equilibrium. Binding of ATP or AMP-PNP (adenosine 5'-(beta, gamma-imino)triphosphate), but not ADP, or of a peptidic substrate induces depolymerization of FLAG-BiP.ent and stabilization of monomeric species. Enterokinase cleavage of monomeric, nucleotide-free BiP.ent results in the physical dissociation of the 44-kDa N-terminal ATPase fragment (N44.ent) from the 30-kDa C-terminal substrate binding domain (C30.ent). Upon dissociation, the freed C-terminal substrate binding domain readily undergoes self-association while N44.ent remains monomeric. Enterokinase cleavage performed in the presence of a synthetic peptide prevents oligomerization of the freed C30.ent domain. Addition of ATP during enterokinase cleavage has no effect on C30.ent oligomerization. Our data clearly indicate that binding of a specific peptide onto the C-terminal domain, or ATP onto the N-terminal domain, induces internal conformational change(s) within the C30 domain that result(s) in BiP depolymerization.

Randomized controlled trial of adenine arabinoside 5'-monophosphate in chronic active hepatitis B: comparison of the efficacy in heterosexual and homosexual patients

Twenty-two heterosexuals and 21 homosexuals with chronic active hepatitis B and who had HBsAg, HBeAg and hepatitis B virus DNA in serum were randomized separately to receive adenine arabinoside monophosphate or placebo. In the 10 heterosexuals and nine homosexuals who received placebo, no change in hepatitis B virus DNA level and HBeAg was observed. Among the patients who received adenine arabinoside monophosphate, seven of the 12 heterosexuals and five of the 12 homosexuals lost hepatitis B virus DNA; five heterosexuals and three homosexuals also lost HBeAg; one homosexual lost HBsAg. There was no significant differences in response between heterosexual and homosexual patients. When results were pooled, there was a significant effect of adenine arabinoside monophosphate on hepatitis B virus replication. None of the 19 patients who received placebo but 50% of the 24 patients who received adenine arabinoside monophosphate were negative for serum hepatitis B virus DNA at 10 months after treatment (p less than 0.001) and none of the 19 patients who received placebo and 33% of the 24 patients who received adenine arabinoside monophosphate were negative for HBeAg in serum (p less than 0.005). Retrospective analysis showed that disappearance of hepatitis B virus DNA after administration of adenine arabinoside monophosphate was more common (i) in patients with a low pretreatment hepatitis B virus DNA level than in patients with a high pretreatment hepatitis B virus DNA level (8/11 vs. 4/13, p less than 0.05); (ii) in patients with a high pretreatment ALT level than in patients with a low pretreatment ALT level (10/14 vs. 2/10, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

The mode of presentation and route of administration are critical for the induction of immune responses to p53 and antitumor immunity

We have examined the immune response to full-length wild-type human p53 presented by a recombinant canarypox vector (ALVAC) and by plasmid DNA. For the ALVAC recombinant, intravenous, but not subcutaneous, intramuscular or intradermal administration, induced CD8+ CTLs that lysed tumor cells transfected with human mutant p53. Intrasplenic administration also induced CTLs. Biodistribution studies showed that intravenously injected ALVAC localized primarily in the lung, liver and spleen, whereas intramuscularly injected virus remained predominantly at the injection site. Intradermal and intramuscular immunization with naked plasmid DNA encoding human wild-type p53 also induced a specific CTL response. DNA immunization induced complete protection against challenge with a mouse embryo fibroblast transfected with human mutant p53 and partial, but significant, protection against a transfected mastocytoma. The ALVAC recombinant induced partial protection in both models. These results suggest that recombinant ALVAC and DNA might be interesting presentation platforms for p53 to be tested in clinical studies.

Isolation, expression, and characterization of fully functional nontoxic BiP/GRP78 mutants

Mammalian BiP/GRP78 and Escherichia coli DnaK belong to the highly conserved hsp70 family and function as molecular chaperones in the endoplasmic reticulum or the cytosol, respectively. Induction of murine BiP/GRP78 expression in E. coli leads to growth arrest and cell death, independent of the bacterial strain and vector used. Analysis of various BiP constructs and mutants shows that the dominant-lethal phenotype is induced specifically by the expression of the 13.7-kDa C-terminal domain and abolished by a single substitution in that region. Deletion of that region also results in nontoxic gene products that can be overexpressed and purified to homogeneity. The nontoxic mutants are highly expressed in E. coli, representing up to 20% of the soluble fraction. They are catalytically active, depolymerize upon binding ATP or synthetic peptide, and interact with the J-domain of the DnaJ-like accessory protein, MTJ1, with near wild-type affinity. Our data indicate that the cytotoxic effect encountered during overexpression of recombinant proteins can be caused by a single domain and can be alleviated by a specific mutation or deletion in that region without altering the catalytic properties of the enzyme.

Dehydroepiandrosterone (DHEA) inhibits voltage-gated T-type calcium channels

BACKGROUND AND PURPOSE

Dehydroepiandrosterone (DHEA) and its sulfated form, DHEAS, are the most abundant steroid hormones in the mammalian blood flow. DHEA may have beneficial effects in various pathophysiological conditions such as cardiovascular diseases or deterioration of the sense of well-being. However to date, the cellular mechanism underlying DHEA action remains elusive and may involve ion channel modulation. In this study, we have characterized the effect of DHEA on T-type voltage-activated calcium channels (T-channels), which are involved in several cardiovascular and neuronal diseases.

KEY RESULTS

Using the whole-cell patch-clamp technique, we demonstrate that DHEA inhibits the three recombinant T-channels (Ca(V)3.1, Ca(V)3.2 and Ca(V)3.3) expressed in NG108-15 cell line, as well as native T-channels in pulmonary artery smooth muscle cells. This effect of DHEA is both concentration (IC(50) between 2 and 7μM) and voltage-dependent and results in a significant shift of the steady-state inactivation curves toward hyperpolarized potentials. Consequently, DHEA reduces window T-current and inhibits membrane potential oscillations induced by Ca(V)3 channels. DHEA inhibition is not dependent on the activation of nuclear androgen or estrogen receptors and implicates a PTX-sensitive Gi protein pathway. Functionally, DHEA and the T-type inhibitor NNC 55-0396 inhibited KCl-induced contraction of pulmonary artery rings and their effect was not cumulative.

CONCLUSIONS

Altogether, the present data demonstrate that DHEA inhibits T-channels by a Gi protein dependent pathway. DHEA-induced alteration in T-channel activity could thus account for its therapeutic action and/or physiological effects.

Not every patient needs a triglyceride check, but all can get pancreatitis: a systematic review and clinical characterization of isotretinoin-associated pancreatitis

Monitoring of triglycerides for patients on isotretinoin is practised primarily to avoid hypertriglyceridaemia-associated pancreatitis. The aim of this study was to describe clinically the published cases of hypertriglyceride-associated pancreatitis. A comprehensive search strategy using MEDLINE, Embase and grey literature was conducted (1960 to January 2016) to identify all case reports of isotretinoin-associated pancreatitis and all relevant studies of isotretinoin and triglycerides for any indication (≥ 20 patients). Terms related to isotretinoin, triglycerides and pancreatitis were searched with all available synonyms. Any studies that used isotretinoin and mentioned triglycerides or pancreatitis were searched in full text, where available, for cases of pancreatitis. Studies from all countries and published in any language were included, but Korean and Turkish studies could not be analysed. Two authors independently reviewed the publications to determine eligibility, and for data extraction. In total, 125 papers fulfilled the inclusion criteria and were searched for cases of pancreatitis. Eleven papers with 25 cases of pancreatitis associated with isotretinoin were identified; four of these cases were likely due to hypertriglyceridaemia. Three patients had elevated baseline triglycerides, but no monitoring. Pancreatitis occurred 6 and 7 weeks, and 6 months after initiation of therapy. For the fourth patient who was treated for glioblastoma and died, no detailed clinical information was available. Idiosyncratic pancreatitis associated with isotretinoin is the most frequent pancreatitis on isotretinoin, and patients should be warned about it. Hypertriglyceride-associated pancreatitis is an exceedingly rare adverse event of isotretinoin therapy. Our data cannot give a frequency or risk for either adverse event. Based on the clinical information of the patients available, we conclude that for patients without elevated baseline triglycerides, or risk thereof, monitoring of triglycerides during therapy is of little value.

Chitinases of Trichoderma atroviride Induce Scab Resistance and Some Metabolic Changes in Two Cultivars of Apple

ABSTRACT This study reports the combination of a transgene-mediated defense mechanism with a conventionally bred resistance in order to improve apple scab resistance. Two cultivars of apple (Galaxy, scab-susceptible, and Ariane, carrying the Vf resistance gene) were transformed with endochitinase and exochitinase genes derived from the biocontrol fungus Trichoderma atroviride. The obtained transgenic lines were analyzed for the expression of both genes and resistance to two races of the pathogen Venturia inaequalis: the common race 1 and race 6 which overcomes the resistance conferred by the Vf gene. A negative correlation between growth of transgenic lines and endochitinase activity was observed. Reduced growth appeared to be associated with high lignin content and high peroxidase as well as glucanase activity, suggesting that endochitinase activity may disturb the metabolism of the plant. Scab inoculation with races 1 and 6 performed in a growth chamber on 14 lines of normal vigor identified 6 lines with significantly enhanced resistance. Ten lines with reduced vigor were tested in vitro with a bioassay on rooted shoots. All lines expressing high endochitinase activity exhibited a significant reduction of scab symptoms.

One-step capillary isoelectric focusing for the separation of the recombinant human immunodeficiency virus envelope glycoprotein glycoforms

One-step capillary isoelectric focusing was investigated as a rapid method to resolve the glycoforms of the heterogeneous recombinant human immunodeficiency virus (HIV) envelope glycoprotein (rgp 160sMN/LAI). The separation was performed in a poly(vinyl alcohol) (PVA) coated capillary using a mixture of ampholyte of narrow and wide pH range. A combination of saccaharose and 3-(cyclohexylamino)-1-propanesulfonic acid was shown to be the most efficient additive to avoid protein precipitation which occurs at a pH close to its pI. Although the calibration curve [isoelectric point (pI) vs. migration times] showed a non-linear relationship, an adequate linearity could be yielded for short pI ranges permitting to exhibit the acidic character of the different glycoforms of the rgp 160s MN/LAI (pI from 4.00 to 4.95). Reproducibility evaluated by comparing the performance of a polyacrylamide and a PVA coated capillary showed that low RSD values were obtained for intra-day (0.5 to 1.9%) and inter-day (1.6 to 7.6%) measurements using the PVA capillary. Moreover, the long term stability of the PVA capillary was demonstrated by measuring the variation of migration times of the protein markers for a long period of use. Finally, this method was able to differentiate the glycoform pattern of two close glycoproteins such as the rgp 160 of two sub-populations of the virus HIV-1.

Evolution and testosterone content of the epididymis during the annual cycle of the lizard Lacerta vivipara

The lizard epididymis provides a model for studying the control, by testosterone, of a secretory activity related to the physiology of spermatozoa. To evaluate seasonal changes and to establish chronological correlations between the structure of the epididymis and its testosterone content, lizards (Lacerta vivipara) were killed between March (emergence) and October (retreat). The epididymal tissue was examined histologically and assayed for testosterone content. Ten stages of development were defined, mainly on the basis of the epithelial structure and the morphological features of secretory activity. Degeneration of the epithelium after the breeding period and its subsequent renewal also were considered. Increased epithelial height and secretory activity coincided with a progressive rise of the testosterone level, and a severe atrophy followed a sudden reduction of blood testosterone. Reorganization of the epithelium takes place when testosterone is at its lowest level, and the hormonal dependency of this stage is questionable. This study confirms in vivo, during a sexual cycle, experimental evidence previously obtained concerning testosterone's control of the secretory activity of the lizard epididymis.

Measurements of _{Λ}^{3}H and _{Λ}^{4}H Lifetimes and Yields in Au+Au Collisions in the High Baryon Density Region

We report precision measurements of hypernuclei _{Λ}^{3}H and _{Λ}^{4}H lifetimes obtained from Au+Au collisions at sqrt[s_{NN}]=3.0  GeV and 7.2 GeV collected by the STAR experiment at the Relativistic Heavy Ion Collider, and the first measurement of _{Λ}^{3}H and _{Λ}^{4}H midrapidity yields in Au+Au collisions at sqrt[s_{NN}]=3.0  GeV. _{Λ}^{3}H and _{Λ}^{4}H, being the two simplest bound states composed of hyperons and nucleons, are cornerstones in the field of hypernuclear physics. Their lifetimes are measured to be 221±15(stat)±19(syst)  ps for _{Λ}^{3}H and 218±6(stat)±13(syst)  ps for _{Λ}^{4}H. The p_{T}-integrated yields of _{Λ}^{3}H and _{Λ}^{4}H are presented in different centrality and rapidity intervals. It is observed that the shape of the rapidity distribution of _{Λ}^{4}H is different for 0%-10% and 10%-50% centrality collisions. Thermal model calculations, using the canonical ensemble for strangeness, describes the _{Λ}^{3}H yield well, while underestimating the _{Λ}^{4}H yield. Transport models, combining baryonic mean-field and coalescence (jam) or utilizing dynamical cluster formation via baryonic interactions (phqmd) for light nuclei and hypernuclei production, approximately describe the measured _{Λ}^{3}H and _{Λ}^{4}H yields. Our measurements provide means to precisely assess our understanding of the fundamental baryonic interactions with strange quarks, which can impact our understanding of more complicated systems involving hyperons, such as the interior of neutron stars or exotic hypernuclei.

Comparative study of dose values and image quality in mammography in the area of Madrid

Dose values and image quality in mammography resulting from a study carried out in the area of Madrid during 1990-1991 are presented in a two-part sequence. In this paper are reported the values of air kerma and mean glandular dose per film estimated at 14 centres by means of the Leeds TOR(MAX) mammographic phantom and from patient samples. The results obtained from patient measurements allow us to deduce that the TOR(MAX) phantom assembly used (4.5 cm thick) is equivalent to an average 5 cm thick compressed breast from the population in the area of Madrid. Approximately 75% of the air kerma values resulting from phantom estimations are below 6.6 and 12.2 mGy for X-ray units with and without grid, respectively. The mean glandular doses per film for 75% of the units with and without grid are below 1.5 and 1.7 mGy, respectively. The results showed that the higher values of both air kerma and mean glandular dose obtained for the units without grid result from the use of slow speed recording systems. On the other hand, the quality control programme carried out shows important faults in the performance of the X-ray units which have an important impact on both dose and image quality. Finally, the third quartile values of the air kerma and mean glandular dose per film (10.4 and 1.7 mGy, respectively), deduced by considering all the units (with and without grid), are proposed to be the reference values of the mammographic examinations during the aforementioned period. In a second paper, the image quality is analysed by using the same Leeds TOR(MAX) phantom. Results for each test object included in the phantom are discussed as a function of the X-ray unit characteristics. Subsequently, the phantom images obtained with each X-ray system are scored and the resulting values are compared with the corresponding dose values, so that the dose-image quality relationship for each unit is obtained.

In vitro androgenic induction of a major protein in epithelial cell subcultures from mouse vas deferens

Pure epithelial cell cultures, obtained from primary culture of vas deferens tissue collected from 20- to 30-day-old mice, were amplified by subculturing the cells over 3T3 feeder layer in a serum-free defined medium. Adhesion and proliferation of epithelial cells did not require androgens, but a minimal concentration of 5.10(-7) M hydrocortisone. In that system, epithelial cells expressed cytokeratin but failed to produce the tissue specific mouse vas deferens protein (MVDP) in response to androgens. Various culture procedures and medium compositions were assayed for induction of MVDP expression. Culture onto microporous membrane inserts, which allow polarization of cells, is absolutely required for androgenic induction of MVDP. Androgen action did not require the presence of hydrocortisone, insulin, triiodothyronine, pituitary extracts, epidermal growth factor and acetylcholine. A minimal supplemented medium was then defined in which the expression of MVDP by epithelial cells in response to androgens was dose dependent. It has also been shown that this response at each concentration of dihydrotestosterone was heterogeneous at individual cell level. Highly reproducible results were obtained from epithelial cell cultures between 8th to 16th passages, showing that subcultured cells have maintained their ability to differentiate and express specialized functions.

A survey of patient dose and clinical factors in a full-field digital mammography system

In this work, we analyse the dose to 5034 patients (20 137 images) who underwent mammographic examinations with a full-field digital mammography (FFDM) system over a 2-y period. The information relevant to this study has been extracted from the image Digital Imaging and Communications in Medicine (DICOM) headers. Entrance surface air-kerma (ESAK) without backscatter and average glandular dose (AGD) were estimated following the methodology proposed in the European Protocol on Dosimetry in Mammography. Mean values for patient age and compressed breast thickness were 56 +/- 11 y and 52 +/- 13 mm, respectively. The mean ESAK value was 8.1 mGy and the mean AGD was 1.9 mGy. In addition, the dose values from both FFDM and screening-film mammographic (SFM) examinations were compared. The third quartile (TQ) of the ESAK values delivered by the FFDM system was 33% lower and 32% higher than the TQ for SFM with slow and fast screen/film receptors. Differences between dose values for cranio-caudal (CC) and medio-lateral oblique (MLO) images (about 27% for SFM) decreased to 11% for FFDM.