Acute lung injury by gastric fluid instillation: activation of myofibroblast apoptosis during injury resolution

BACKGROUND

Gastric contents aspiration in humans has variable consequences depending on the volume of aspirate, ranging from subclinical pneumonitis to respiratory failure with up to 70% mortality. Several experimental approaches have been used to study this condition. In a model of single orotracheal instillation of gastric fluid we have shown that severe acute lung injury evolves from a pattern of diffuse alveolar damage to one of organizing pneumonia (OP), that later resolves leaving normal lung architecture. Little is known about mechanisms of injury resolution after a single aspiration that could be dysregulated with repetitive aspirations. We hypothesized that, in a similar way to cutaneous wound healing, apoptosis may participate in lung injury resolution by reducing the number of myofibroblasts and by affecting the balance between proteases and antiproteases. Our aim was to study activation of apoptosis as well as MMP-2/TIMP-2 balance in the sub-acute phase (4-14 days) of gastric fluid-induced lung injury.

METHODS

Anesthesized Sprague-Dawley rats received a single orotracheal instillation of gastric fluid and were euthanized 4, 7 and 14 days later (n = 6/group). In lung tissue we studied caspase-3 activation and its location by double immunofluorescence for cleaved caspase-3 or TUNEL and alpha-SMA. MMP-2/TIMP-2 balance was studied by zymography and Western blot. BALF levels of TGF-β₁ were measured by ELISA.

RESULTS

An OP pattern with Masson bodies and granulomas was seen at days 4 and 7 that was no longer present at day 14. Cleaved caspase-3 increased at day 7 and was detected by immunofluorescence in Masson body-alpha-SMA-positive and -negative cells. TUNEL-positive cells at days 4 and 7 were located mainly in Masson bodies. Distribution of cleaved caspase-3 and TUNEL-positive cells at day 14 was similar to that in controls. At the peak of apoptosis (day 7), an imbalance between MMP-2 activity and TIMP-2 expression was produced by reduction in TIMP-2 expression.

CONCLUSIONS

Apoptosis is activated in Masson body-alpha-SMA-positive and -negative cells during the sub-acute phase of gastric fluid-induced lung injury. This mechanism likely contributes to OP resolution, by reducing myofibroblast number and new collagen production. In addition, pre-formed collagen degradation is favored by an associated MMP-2/TIMP-2 imbalance.

Furanoid diterpene glucosides from Tinospora rumphii

The stems of Tinospora rumphii yielded clerodane type furanoid diterpene glucosides: the new rumphioside I, the known borapetosides C and F and three other compounds. Their structures were established on the basis of various spectroscopic techniques. The three compounds have physical and spectral data identical to those of the reported compounds borapetosides E, D and B, respectively. However, the positions of the lactone rings of the first two compounds and the configuration of the bond attaching the glucose moiety to C-6 of the third differ from the reported ones.

Light-emitting diodes as a light source for intraoperative photodynamic therapy

The development of more cost-effective light sources for photodynamic therapy of brain tumors would be of benefit for both research and clinical applications. In this study, the use of light-emitting diode arrays for photodynamic therapy of brain tumors with Photofrin porfimer sodium was investigated. An inflatable balloon device with a light-emitting diode (LED) tip was constructed. These LEDs are based on the new semiconductor aluminum gallium arsenide. They can emit broad-spectrum red light at high power levels with a peak wavelength of 677 nm and a bandwidth of 25 nm. The balloon was inflated with 0.1% intralipid, which served as a light-scattering medium. Measurements of light flux at several points showed a high degree of light dispersion. The spectral emission of this probe was then compared with the absorption spectrum of Photofrin. This analysis showed that the light absorbed by Photofrin with the use of the LED source was 27.5% of that absorbed with the use of the monochromatic 630-nm light. Thus, to achieve an energy light dose equivalent to that of a laser light source, the LED light output must be increased by a factor of 3.63. This need for additional energy is the difference between a 630- and 677-nm absorption of Photofrin. Using the LED probe and the laser balloon adapter, a comparison of brain stem toxicity in canines was conducted. LED and laser light showed the same signs of toxicity at equivalent light energy and Photofrin doses. The maximal tolerated dose of Photofrin was 1.6 mg/kg, using 100 J/cm2 of light energy administered by laser or LED. This study concludes that LEDs are a suitable light source for photodynamic therapy of brain tumors with Photofrin. In addition, LEDs have the potential to be highly efficient light sources for second-generation photosensitizers with absorption wavelengths closer to the LED peak emission.

Light-emitting diodes as a radiation source for plants

Development of a more effective radiation source for use in plant-growing facilities would be of significant benefit for both research and commercial crop production applications. An array of light-emitting diodes (LEDs) that produce red radiation, supplemented with a photosynthetic photon flux (PPF) of 30 micromoles s-1 m-2 in the 400- to 500-nm spectral range from blue fluorescent lamps, was used effectively as a radiation source for growing plants. Growth of lettuce (Lactuca sativa L. Grand Rapids') plants maintained under the LED irradiation system at a total PPF of 325 micromoles s-1 m-2 for 21 days was equivalent to that reported in the literature for plants grown for the same time under cool-white fluorescent and incandescent radiation sources. Characteristics of the plants, such as leaf shape, color, and texture, were not different from those found with plants grown under cool-white fluorescent lamps. Estimations of the electrical energy conversion efficiency of a LED system for plant irradiation suggest that it may be as much as twice that published for fluorescent systems.

Light-emitting diodes as a radiation source for plants

Development of a more effective radiation source for use in plant-growing facilities would be of significant benefit for both research and commercial crop production applications. An array of light-emitting diodes (LEDs) that produce red radiation, supplemented with a photosynthetic photon flux (PPF) of 30 micromoles s-1 m-2 in the 400- to 500-nm spectral range from blue fluorescent lamps, was used effectively as a radiation source for growing plants. Growth of lettuce (Lactuca sativa L. Grand Rapids') plants maintained under the LED irradiation system at a total PPF of 325 micromoles s-1 m-2 for 21 days was equivalent to that reported in the literature for plants grown for the same time under cool-white fluorescent and incandescent radiation sources. Characteristics of the plants, such as leaf shape, color, and texture, were not different from those found with plants grown under cool-white fluorescent lamps. Estimations of the electrical energy conversion efficiency of a LED system for plant irradiation suggest that it may be as much as twice that published for fluorescent systems.

Experience with 407 transvenous, finned pacing leads with a sintered porous-surfaced electrode

Experience with 407 transvenous ventricular finned pacing leads with a sintered porous-surfaced electrode is reported. A low complication rate was encountered: 97% of patients were free from lead-related complications. Four patients (1%) required re-operation: two for lead displacement, one for failure to sense spontaneous ventricular activity and one for exit block. A further patient developed exit block which resolved spontaneously. The vast majority of patients had low chronic stimulation thresholds; for example at six months after implantation, the mean threshold for a group of pacemakers with a pulse duration of 0.5 ms was 1.4 +/- 0.7 V and for another group with a pulse duration of 0.8 ms it was 1.9 +/- 0.7 mA. However, six patients developed a transient high stimulation threshold during the month after implantation, and a high threshold developed in another patient at five months and persisted. Mean acute stimulation and sensing thresholds were satisfactory: 0.7 +/- 0.2 V at 0.5 ms pulse duration and 7.6 +/- 2.4 mV, respectively.