Identification of diverse astrocyte populations and their malignant analogs

Astrocytes are the most abundant cell type in the brain, where they perform a wide array of functions, yet the nature of their cellular heterogeneity and how it oversees these diverse roles remains shrouded in mystery. Using an intersectional fluorescence-activated cell sorting-based strategy, we identified five distinct astrocyte subpopulations present across three brain regions that show extensive molecular diversity. Application of this molecular insight toward function revealed that these populations differentially support synaptogenesis between neurons. We identified correlative populations in mouse and human glioma and found that the emergence of specific subpopulations during tumor progression corresponded with the onset of seizures and tumor invasion. In sum, we have identified subpopulations of astrocytes in the adult brain and their correlates in glioma that are endowed with diverse cellular, molecular and functional properties. These populations selectively contribute to synaptogenesis and tumor pathophysiology, providing a blueprint for understanding diverse astrocyte contributions to neurological disease.

Mutual antagonism between Sox10 and NFIA regulates diversification of glial lineages and glioma subtypes

Lineage progression and diversification is regulated by the coordinated action of unique sets of transcription factors. Oligodendrocytes (OL) and astrocytes (AS) comprise the glial sub-lineages in the CNS, and the manner in which their associated regulatory factors orchestrate lineage diversification during development and disease remains an open question. Sox10 and NFIA are key transcriptional regulators of gliogenesis associated with OL and AS. We found that NFIA inhibited Sox10 induction of OL differentiation through direct association and antagonism of its function. Conversely, we found that Sox10 antagonized NFIA function and suppressed AS differentiation in mouse and chick systems. Using this developmental paradigm as a model for glioma, we found that this relationship similarly regulated the generation of glioma subtypes. Our results describe the antagonistic relationship between Sox10 and NFIA that regulates the balance of OL and AS fate during development and demonstrate for the first time, to the best of our knowledge, that the transcriptional processes governing glial sub-lineage diversification oversee the generation of glioma subtypes.

Human papillomavirus and cervical neoplasia: a case-control study in Taiwan

As part of a large-scale, community-based cervical neoplasia screening project in rural Taiwan, a case-control study was undertaken to evaluate the etiologic role of human papillomavirus (HPV) infection in this mainly monogamous (2% reported having multiple sexual partners) female population. A total of 88 biopsy-confirmed cases and 261 cytologically normal controls were selected for the study. The case group included 40 cases of cervical intraepithelial neoplasia (CIN) 1, 9 of CIN 2, 36 of CIN 3 and 3 cases of invasive cancer. Cervical swabs collected at screening from study subjects were tested for HPV DNA by an LI consensus primer polymerase chain reaction (PCR)-based technique. HPV DNA was found in 92% of high-grade cases (CIN 2-3 and invasive cancer); 54% of low-grade cases (CIN 1); and 9% of controls. HPV was significantly associated with both high-grade and low-grade cervical neoplasia. As reported in Western countries, HPV 16 was the predominant type among HPV-positive high-grade cases. However, HPVs 52 and/or 58 combined were the most common types among HPV-positive low-grade cases and controls. Among women without any high-risk HPV infection (types 16, 18, 31 or 45), those with multiple-type HPV infection had a higher risk for high-grade cervical neoplasia than those with single-type infection. Overall, 91% of high-grade cases and 50% of low-grade cases could be attributed to HPV infection. Our results show that, even in this monogamous population, HPV is the major risk factor for high-grade cervical neoplasia.

Pathogenesis of lethal cardiac arrhythmias in Mecp2 mutant mice: implication for therapy in Rett syndrome

Rett syndrome is a neurodevelopmental disorder typically caused by mutations in methyl-CpG-binding protein 2 (MECP2) in which 26% of deaths are sudden and of unknown cause. To explore the hypothesis that these deaths may be due to cardiac dysfunction, we characterized the electrocardiograms in 379 people with Rett syndrome and found that 18.5% show prolongation of the corrected QT interval (QTc), an indication of a repolarization abnormality that can predispose to the development of an unstable fatal cardiac rhythm. Male mice lacking MeCP2 function, Mecp2(Null/Y), also have prolonged QTc and show increased susceptibility to induced ventricular tachycardia. Female heterozygous null mice, Mecp2(Null/+), show an age-dependent prolongation of QTc associated with ventricular tachycardia and cardiac-related death. Genetic deletion of MeCP2 function in only the nervous system was sufficient to cause long QTc and ventricular tachycardia, implicating neuronally mediated changes to cardiac electrical conduction as a potential cause of ventricular tachycardia in Rett syndrome. The standard therapy for prolonged QTc in Rett syndrome, β-adrenergic receptor blockers, did not prevent ventricular tachycardia in Mecp2(Null/Y) mice. To determine whether an alternative therapy would be more appropriate, we characterized cardiomyocytes from Mecp2(Null/Y) mice and found increased persistent sodium current, which was normalized when cells were treated with the sodium channel-blocking anti-seizure drug phenytoin. Treatment with phenytoin reduced both QTc and sustained ventricular tachycardia in Mecp2(Null/Y) mice. These results demonstrate that cardiac abnormalities in Rett syndrome are secondary to abnormal nervous system control, which leads to increased persistent sodium current. Our findings suggest that treatment in people with Rett syndrome would be more effective if it targeted the increased persistent sodium current to prevent lethal cardiac arrhythmias.

Treatment of painful heel syndrome with shock waves

In a prospective clinical study, the effectiveness of shock waves on painful heel syndrome in 80 patients (20 men and 60 women) with an average age of 48 years was investigated. Six patients had bilateral treatments. Each treatment consisted of 1,000 impulses of shock waves at 14 kV. A 100-point scoring system (70 points for pain and 30 points for function) was used for evaluation. The intensity of pain was measured with a visual analog scale from 0 to 10. The overall results were no complaints in 20.6%, significantly better in 52.9%, slightly better in 17.6%, and unchanged in 8.8% of 64 patients (68 heels) with 12 weeks followup; no complaints in 59.3%, significantly better in 27.7 %, slightly better in 13% of 52 patients (54 heels) with 6 months followup. None of patients' symptoms became worse. Seventeen patients (18 heels) who did not respond favorably to the first treatment had significantly better results after a second treatment. There were no device-related problems, and no systemic or local complications. Shock wave treatment is a new modality of therapy that is safe and effective in the treatment of patients with painful hell syndrome.

Indium-111 platelet imaging for detection of platelet deposition in abdominal aneurysms and prosthetic arterial grafts

Thirty-four platelet imaging studies were performed in 23 patients to determine whether platelet deposition could be detected in patients with vascular aneurysms (18 patients) or in patients in whom Dacron prosthetic grafts had been place (5 patients). In patients in whom abnormal platelet deposition was detected, the effect of administration of platelet-active drugs on platelet deposition was examined. Of the 18 patients with an aneurysm, 12 had positive studies on initial imaging and 2 had equivocally positive images. Of five patients with Dacron arterial grafts in place, four had diffuse platelet deposition in the grafts; the fifth patient had platelet deposition only in a pseudoaneurysm. Eight patients with an abdominal aneurysm and positive or equivocally positive baseline images were restudied during platelet-active drug therapy either with aspirin plus dipyridamole (seven patients) or with sulfinpyrazone (four patients). No patient studied during treatment with aspirin plus dipyridamole had detectably decreased platelet deposition compared with baseline determinations. In contrast, two of four patients studied while receiving sulfinpyrazone showed decreased platelet deposition. Thus, platelet imaging may be of value for studying platelet physiology in vivo and for assessing platelet-active drugs and the thrombogenicity of prosthetic graft materials in human beings.

Atoh1 governs the migration of postmitotic neurons that shape respiratory effectiveness at birth and chemoresponsiveness in adulthood

Hindbrain neuronal networks serving respiratory, proprioceptive, and arousal functions share a developmental requirement for the bHLH transcription factor Atoh1. Loss of Atoh1 in mice results in respiratory failure and neonatal lethality; however, the neuronal identity and mechanism by which Atoh1-dependent cells sustain newborn breathing remains unknown. We uncovered that selective loss of Atoh1 from the postmitotic retrotrapezoid nucleus (RTN) neurons results in severely impaired inspiratory rhythm and pronounced neonatal death. Mice that escape neonatal death develop abnormal chemoresponsiveness as adults. Interestingly, the expression of Atoh1 in the RTN neurons is not required for their specification or maintenance, but is important for their proper localization and to establish essential connections with the preBötzinger Complex (preBötC). These results provide insights into the genetic regulation of neonatal breathing and shed light on the labile sites that might contribute to sudden death in newborn infants and altered chemoresponsiveness in adults.

Role of clonazepam in the treatment of idiopathic downbeat nystagmus

OBJECTIVE/HYPOTHESIS

Downbeat nystagmus is defined as spontaneous nystagmus present with fixation in the primary position or lateral gaze. Those who have downbeat nystagmus but negative magnetic resonance imaging results are termed as idiopathic. Patients with idiopathic downbeat nystagmus, although unconcerned with their etiology, have visual symptoms such as oscillopsia, diplopia, or blurred vision. The purpose of this study is to evaluate the efficacy of clonazepam in treating idiopathic downbeat nystagmus.

METHODS

Patients with downbeat nystagmus were rechecked by electronystagmography (ENG); then 0.5 mg clonazepam was administered orally. One hour later, follow-up ENG was performed again to evaluate the evolution of the downbeat nystagmus. If the test was effective, then 1.0 mg clonazepam twice daily was administered to the patients.

RESULTS

Seven cases had downbeat nystagmus, including idiopathic in five, cerebellar degeneration in one, and cerebellopontine angle tumor in one. The efficacy rate for the clonazepam test was 100% in five cases of idiopathic downbeat nystagmus, whereas it was ineffective in the case of cerebellar degeneration. After long-term therapy with clonazepam, all patients with idiopathic downbeat nystagmus experienced elimination of oscillopsia, relief of diplopia, and improvement of visual acuity. Although temporary relief of downbeat nystagmus was observed 1 hour after the clonazepam test, downbeat nystagmus was not eliminated permanently.

CONCLUSION

We recommend long-term therapy by clonazepam with a dosage of 1.0 mg twice daily in cases of idiopathic downbeat nystagmus. Reducing the downbeat nystagmus as well as eliminating the oscillopsia can be anticipated.

Basal lamina heterogeneity in the glomerular capillary tufts of human kidneys

Two classes of glomerular basal laminas are identified with a newly developed guanidine technique. The electron-opaque epithelial basal lamina is the most prominent element of the glomerular basal lamina scaffold. It is a continuous layer within each glomerulus, folding into capillary tufts and loops, but never completely encircling the entire circumference of each capillary, similar to the serosa covering the intestinal loop and mesentery. The vascular space so defined is further partitioned into individual capillary lumen by an electron-lucent mesangial basal lamina, that forms a meshwork continuous with the vascular pole of the glomerulus and extends peripherally to surround capillary lumens. The latter, designated endothelial basal lamina, is extremely attenuated and appears as a vestigial structure in glomerular capillary loops. Changes in juxtamesangial epithelial basal lamina indicate that it may be the site of the bulk removal and renewal of the epithelial basal lamina. The unique epithelial origin of glomerular capillary basal lamina and its organization provide a structural basis for understanding the glomerular physiology gained by various tracer studies. The results also suggest that the guanidine technique may be a useful new approach to the analysis of basal lamina alterations in various glomerular diseases.

Nuclear factor I-A regulates diverse reactive astrocyte responses after CNS injury

Reactive astrocytes are associated with every form of neurological injury. Despite their ubiquity, the molecular mechanisms controlling their production and diverse functions remain poorly defined. Because many features of astrocyte development are recapitulated in reactive astrocytes, we investigated the role of nuclear factor I-A (NFIA), a key transcriptional regulator of astrocyte development whose contributions to reactive astrocytes remain undefined. Here, we show that NFIA is highly expressed in reactive astrocytes in human neurological injury and identify unique roles across distinct injury states and regions of the CNS. In the spinal cord, after white matter injury (WMI), NFIA-deficient astrocytes exhibit defects in blood-brain barrier remodeling, which are correlated with the suppression of timely remyelination. In the cortex, after ischemic stroke, NFIA is required for the production of reactive astrocytes from the subventricular zone (SVZ). Mechanistically, NFIA directly regulates the expression of thrombospondin 4 (Thbs4) in the SVZ, revealing a key transcriptional node regulating reactive astrogenesis. Together, these studies uncover critical roles for NFIA in reactive astrocytes and illustrate how region- and injury-specific factors dictate the spectrum of reactive astrocyte responses.

The disordered N-terminal domain of DNMT3A recognizes H2AK119ub and is required for postnatal development

DNA methyltransferase 3a (DNMT3A) plays a crucial role during mammalian development. Two isoforms of DNMT3A are differentially expressed from stem cells to somatic tissues, but their individual functions remain largely uncharacterized. Here we report that the long isoform DNMT3A1, but not the short DNMT3A2, is essential for mouse postnatal development. DNMT3A1 binds to and regulates bivalent neurodevelopmental genes in the brain. Strikingly, Dnmt3a1 knockout perinatal lethality could be partially rescued by DNMT3A1 restoration in the nervous system. We further show that the intrinsically disordered N terminus of DNMT3A1 is required for normal development and DNA methylation at DNMT3A1-enriched regions. Mechanistically, a ubiquitin-interacting motif embedded in a putative α-helix within the N terminus binds to mono-ubiquitinated histone H2AK119, probably mediating recruitment of DNMT3A1 to Polycomb-regulated regions. These data demonstrate an isoform-specific role for DNMT3A1 in mouse postnatal development and reveal the N terminus as a necessary regulatory domain for DNMT3A1 chromatin occupancy and functions in the nervous system.

Podoendin. A new cell surface protein of the podocyte and endothelium

A new cell surface protein, podoendin, has been identified in Sprague-Dawley rats, and isolated using monoclonal antibody (mAb) G4. The distribution of podoendin is restricted to the surface of glomerular podocytes, urinary surface of the parietal epithelium of Bowman's capsule, and the luminal surface of endothelial cells. The antibody does not crossreact with podocytes or endothelia of human or mice. In newborn rats, the appearance of podoendin on glomerular epithelium is attendant on podocyte differentiation during glomerulogenesis of metanephrogenic vesicles. It disappears when podocytes retract and efface foot processes in tissue culture. Thus, podoendin appears to be a cell differentiation-dependent surface protein of podocytes. Podoendin is a protein of 62 kD mobility on 5% polyacrylamide gel electrophoresis. It stains intensely with Coomassie blue, but gives negative reactions to carbohydrate (periodic acid/Schiff reaction) and polyanions (alcian blue, colloidal iron, and carbocyanine). It is distinct from the major sialoglycoprotein of podocyte fuzzy coat, podocalyxin (11). Podoendin isolated and purified from endothelium of lungs appears to be identical with that from podocytes and endothelium of kidneys. Injection of mAb G4 into left ventricle of rats resulted in intense decoration of the endothelium and podocyte surface within 30 min. The decoration persisted throughout the 3-d period of observation. This was not accompanied by complement (C3) fixation. Preliminary results showed that the rats developed moderate proteinuria (100 mg/ml protein in urine), which was associated with the presence of hyaline droplets in renal tubules, on the third day. The proteinuria was not accompanied by effacement of podocyte pedicels. There were no morphologic alterations indicating glomerular or vascular injury in the kidneys.

Regionally Distinct Astrocytes Display Unique Transcription Factor Profiles in the Adult Brain

Astrocytes are the most abundant type of glial cell in the central nervous system and perform a myriad of vital functions, however, the nature of their diversity remains a longstanding question in neuroscience. Using transcription factor motif discovery analysis on region-specific gene signatures from astrocytes we uncovered universal and region-specific transcription factor expression profiles. This analysis revealed that motifs for Nuclear Factor-I (NFI) are present in genes enriched in astrocytes from all regions, with NFIB and NFIX exhibiting pan-astrocyte expression in the olfactory bulb, hippocampus, cortex, and brainstem. Further analysis into region-specific motif patterns, identified Nkx3-1, Stat4, Pgr, and Nkx6-1 as prospective region-specific transcription factors. Validation studies revealed that Nkx6-1 is exclusively expressed in astrocytes in the brainstem and associates with the promoters of several brainstem specific target genes. These studies illustrate the presence of multiple transcriptional layers in astrocytes across diverse brain regions and provide a new entry point for examining how astrocyte diversity is specified and maintained.

Basal lamina of alveolar epithelium and capillaries: quantitative changes with aging and in diabetes mellitus

Epithelial and capillary basal laminae (BL) of alveoli are significantly thicker in diabetics than they are in age-matched control subjects. The degree of thickening does not correlate significantly with patient age or with known duration of diabetes. The thickness of both types of BL in the lungs correlates significantly with thickness of BL in renal tubules and muscle capillaries. However, in muscle capillaries and in renal tubules, the BL deposits are 5 to 10 times greater than they are in the lungs. The effects of BL changes on pulmonary function remain to be explored.

Brilliant petawatt gamma-ray pulse generation in quantum electrodynamic laser-plasma interaction

We show a new resonance acceleration scheme for generating ultradense relativistic electron bunches in helical motions and hence emitting brilliant vortical γ-ray pulses in the quantum electrodynamic (QED) regime of circularly-polarized (CP) laser-plasma interactions. Here the combined effects of the radiation reaction recoil force and the self-generated magnetic fields result in not only trapping of a great amount of electrons in laser-produced plasma channel, but also significant broadening of the resonance bandwidth between laser frequency and that of electron betatron oscillation in the channel, which eventually leads to formation of the ultradense electron bunch under resonant helical motion in CP laser fields. Three-dimensional PIC simulations show that a brilliant γ-ray pulse with unprecedented power of 6.7 PW and peak brightness of 10²⁵ photons/s/mm²/mrad²/0.1% BW (at 15 MeV) is emitted at laser intensity of 1.9 × 10²³ W/cm².

Obstructive leiomyoma of the female urethra: report of a case

We report a case of leiomyoma of the female urethra and review the literature. A mass protruding from the urethral meatus during voiding caused dysuria. Urodynamic study showed an obstructive pattern with low maximum urine flow and high detrusor pressure in initiating voiding. Cystourethroscopy revealed a mass extending from the proximal segment of the left lateral urethral wall into the bladder. At transurethral resection of the tumor 12.2 gm. of tissue were excised. Histopathological studies confirmed urethral leiomyoma. Surgery completely resolved the original symptoms of dysuria.

Olfactory bulb astrocytes mediate sensory circuit processing through Sox9 in the mouse brain

The role of transcription factors during astrocyte development and their subsequent effects on neuronal development has been well studied. Less is known about astrocytes contributions towards circuits and behavior in the adult brain. Astrocytes play important roles in synaptic development and modulation, however their contributions towards neuronal sensory function and maintenance of neuronal circuit architecture remain unclear. Here, we show that loss of the transcription factor Sox9 results in both anatomical and functional changes in adult mouse olfactory bulb (OB) astrocytes, affecting sensory processing. Indeed, astrocyte-specific deletion of Sox9 in the OB results in decreased odor detection thresholds and discrimination and it is associated with aberrant neuronal sensory response maps. At functional level, loss of astrocytic Sox9 impairs the electrophysiological properties of mitral and tufted neurons. RNA-sequencing analysis reveals widespread changes in the gene expression profiles of OB astrocytes. In particular, we observe reduced GLT-1 expression and consequential alterations in glutamate transport. Our findings reveal that astrocytes are required for physiological sensory processing and we identify astrocytic Sox9 as an essential transcriptional regulator of mature astrocyte function in the mouse OB.

Induction of astrocytic Slc22a3 regulates sensory processing through histone serotonylation

Neuronal activity drives alterations in gene expression within neurons, yet how it directs transcriptional and epigenomic changes in neighboring astrocytes in functioning circuits is unknown. We found that neuronal activity induces widespread transcriptional up-regulation and down-regulation in astrocytes, highlighted by the identification of Slc22a3 as an activity-inducible astrocyte gene that encodes neuromodulator transporter Slc22a3 and regulates sensory processing in the mouse olfactory bulb. Loss of astrocytic Slc22a3 reduced serotonin levels in astrocytes, leading to alterations in histone serotonylation. Inhibition of histone serotonylation in astrocytes reduced the expression of γ-aminobutyric acid (GABA) biosynthetic genes and GABA release, culminating in olfactory deficits. Our study reveals that neuronal activity orchestrates transcriptional and epigenomic responses in astrocytes while illustrating new mechanisms for how astrocytes process neuromodulatory input to gate neurotransmitter release for sensory processing.

Fluid leaks from extra-alveolar vessels in living dog lungs

Edema transudation from extra-alveolar vessels was investigated in anesthetized, open-chested dogs. Fluid accumulation at different alveolar and extra-alveolar vascular pressures was assessed by continuous lung weighing and microscopy. The left (experimental) lung was distended with 6% CO2 and air while normal arterial blood gases were maintained by separately ventilating the right lung. Extra-alveolar vessels were isolated by compressing alveolar vessels with alveolar pressures high enough to stop blood flow. Weight increased steadily (edemogenesis) when pulmonary arterial and/or pulmonary venous pressure was 1 cmH2O below this pressure. Because some alveolar vessels at the lung base could have remained open and leaked, extra-alveolar vessels were also separated from alveolar vessels by glass bead embolization sufficient to stop perfusion. Lung weight gains followed selective pulmonary arterial or venous pressure elevations. Electron microscopy demonstrated edema in experimental lobes which was not present in control lobes with undistended extra-alveolar vessels at the same alveolar pressure. Thus pulmonary edema can be caused by fluid leaking from extra-alveolar vessels.

Reoperative carotid surgery

Fourteen patients underwent carotid reoperation for symptomatic recurrent carotid stenosis after previous ipsilateral carotid endarterectomy. Eight of these patients presented with focal transient ischemic attacks, two with strokes, and four with vertebrobasilar insufficiency. Recurrent symptoms in eight patients were similar to those prompting the initial carotid endarterectomy. Symptoms recurred early after previous carotid endarterectomy in 2 patients and late in 12 patients. Eleven patients underwent repeat endarterectomy and carotid patch angioplasty, two patients underwent patch angioplasty alone, and one patient underwent carotid artery replacement with a vein graft. Persistent or recurrent focal symptoms referable to the reoperated carotid artery were not present during follow-up (mean 27.4 months, range 4 to 79 months). Vertebrobasilar symptoms were relieved by carotid reoperation in each patient. Although the natural history of asymptomatic postoperative carotid restenosis is unknown, reluctance to reoperate on symptomatic patients is unwarranted, since carotid reoperation can be performed safely with the expectation that recurrent focal and nonfocal vertebrobasilar symptoms will be relieved.

X-Ray spectra and electronic correlations of FeSe(1-x)Te(x)

Critical issues concerning emerging Fe-based superconductors include the degree of electron correlation and the origin of the superconductivity. X-Ray absorption spectra (XAS) and resonant inelastic X-ray scattering spectra (RIXS) of FeSe(1-x)Te(x) (x = 0-1) single crystals were obtained to study their electronic properties that relate to electron correlation and superconductivity. The linewidth of Fe L(2,3)-edges XAS of FeSe(1-x)Te(x) is narrower than that of Fe-pnictides, revealing the difference between their hybridization effects and localization character and those of other Fe-pnictides. While no significant differences exist between the Fe L-edge XAS and RIXS of FeSe(1-x)Te(x) and those of Fe-pnictides, Se K-edge and Te K-edge XAS exhibit substantial edge shift, suggesting that the superconductivity in an Fe-Se superconductor is strongly associated with the ligand states. A comparison of the Se K-edge and Te K-edge spectra reveals that the charge transfer may occur between Se and Te. Given the Coulomb interaction and the bandwidth, the spectral results indicate that FeSe(1-x)Te(x) is unlikely to be a weakly correlated system unlike the Fe-pnictides of the "1111" and "122" families. The spectral results further demonstrate that superconductivity in this class of Fe-based compounds is strongly associated with the ligand 4p hole state.

Mayer-Rokitansky-Kuster-Hauser syndrome with immature teratoma of the ovary at age 4 years

We describe a rare combination of Mayer-Rokitansky-Kuster-Hauser syndrome and immature teratoma of the ovary in a 4-year-old girl. The patient was admitted due to increased abdominal size. Sonagraphy and C-T scan revealed a heterogeneous mass with cystic, calcified, and solid parts. A right salpingo-oophorectomy was performed under the FIGO (International Federation of Gynecology and Obstetrics) staging of stage Ia. The diagnosis of immature teratoma, grade II, was confirmed by histopathologic examination. Agenesis of the upper third of the vagina and the uterus was also confirmed by the surgery.

The effects of prophylactic expiratory positive airway pressure on the resolution of oleic acid-induced lung injury in dogs

It is not known whether positive end-expiratory airway pressure (PEEP) merely improves gas exchange in patients with the adult respiratory distress syndrome (ARDS) or if it also affects the resolution of their lung injury. The present investigation was performed to determine whether expiratory positive airway pressure (EPAP), a form of PEEP, is prophylactic in preventing the lung injury induced by oleic acid in dogs or in enhancing its resolution. Arterial and mixed venous blood gases and functional residual capacity (FRC) were measured in 14 pairs of mongrel dogs with indwelling catheters and permanent tracheostomies. One member of each pair was treated with 10 cm H2O EPAP through a valve attached to the tracheostomy tube. Both dogs received 0.06 ml/kg oleic acid intravenously at hour 0. Measurements were made at three, 12, and 24 hours, when EPAP was discontinued, and over the next six days. Five dog pairs were sacrificed at 72 hours; the other surviving animals were sacrificed at 168 hours. FRC was higher at three, 12, and 24 hours in dogs receiving EPAP than in the untreated dogs. The arterial oxygen tension (PaO2) was higher and the venous admixture (Qva/Qt) was lower at three and 12 hours in the dogs receiving EPAP than in the untreated dogs. However, after 24 hours, no differences were noted between the two groups in FRC, PaO2, Qav/Qt, mortality, final lung compliance to initial lung compliance differences, lung water to dry lung weight ratios, or histology. It is concluded that EPAP improves gas exchange during its administration, but has no demonstrable prophylactic effect on the resolution of lung injury in the oleic acid model of human ARDS.

Experimental Escherichia coli epididymitis in rabbits

We describe an experimental model of bacterial epididymitis in New Zealand white rabbits. Inoculation of 10(7) colony-forming units of Escherichia coli in a retrograde fashion into the vas deferens reliably produced clinical, bacteriologic, and pathologic epididymitis. Inflammation was maximum at two weeks and subsided by one month without treatment. E. coli could be reisolated from the epididymides for up to two weeks post inoculation. We detected loss of spermatogenesis in both the ipsilateral and contralateral testes and the appearance of antisperm antibodies subsequent to the infection in some animals. There were 2 cases (11%) of histologic bilateral epididymitis after unilateral inoculation; one of these had bilateral clinical epididymitis with E. coli recovered from both epididymides at two weeks.