Evidence for the participation of proteinases released by Candida albicans in the early killing of peritoneal macrophages in vitro. 1. We have investigated the possibility that proteinases released by Candida albicans participate in the early killing of three types of mice peritoneal macrophage (resident, thioglycollate-elicited, or Con A-activated) in vitro. 2. Phagocytic assays were performed by incubation of macrophages and C. albicans together at a 1:10 ratio for 30 min at 37 degrees C in RPMI medium buffered to pH 7.0 with 12 mM Hepes without serum. With no albumin added to the medium, the macrophages were 85% to 100% damaged and unviable, to a greater extent than expected from the proportion of phagocytic cells containing germ tubes. When 10 mg/ml of albumin was added to the medium, however, 90% of the macrophages remained viable for the 2 hours of the phagocytic assay, suggesting that albumin may have acted as a substrate for or inhibitor of proteinases released by C. albicans, thereby protecting the macrophage from the proteolytic action of the proteinases. 3. The phagocytosis of IgG-coated erythrocytes was reduced to 43% when IgG was preincubated with the supernatant from C. albicans cultures, but the addition of 10 mg/ml albumin or of 5 micrograms/ml pepstatin (an inhibitor of C. albicans acid proteinases) to the same supernatants prevented the effect on phagocytosis of IgG-coated erythrocytes. 4. These results suggest that proteinases released from C. albicans are involved in the early killing of macrophages.


Undernutrition during suckling has no effect on the rat locomotor activity response to caffeine. It is known that early malnutrition causes hyposensitivity to serotonergic, gabaergic, catecholaminergic and opioid stimulation. In the present study, we determined whether adult rats undernourished during suckling presented an altered response to caffeine administration in a locomotor activity test. Rats were undernourished during suckling by feeding their dams a 7% casein diet. During the same period, well-nourished dams were fed a 28% casein diet. Animals (90-100 days of age) were habituated to the apparatus. Thereafter, a dose-response curve for caffeine (2.5, 10.0, 20.0, 40.0 and 120.0 mumol/kg, ip) was determined. During handling sessions, undernourished rats presented lower activity scores than well-nourished animals (average values: 44.2 +/- 16.4 vs 57.9 +/- 15.4). Well-nourished and undernourished rats responded in a similar way to caffeine administration by increasing the locomotor activity in a dose-dependent manner. Although undernourished animals present an altered sensitivity to various neuropharmacological compounds, the present results indicate that their sensitivity to the locomotor-activating effect of caffeine is the same as that of rats well-nourished during suckling.


Effect of the neonatal steroid hormone treatment of rats on adult hormone levels and the reactivity of seminal vesicles to parasympathomimetic drugs. 1. Seminal vesicle reactivity to cholinergic agents, plasma testosterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH) concentrations and seminal vesicle testosterone concentrations were determined in adult male rats treated during the first 6 h of life with 1.0 ml peanut oil (oil-treated), 1.0 mg testosterone propionate (TP-treated) or 1.2 mg 19-nor-testosterone homofarnesate (19-NT-treated). 2. At 90-100 days of age, the neonatally treated animals presented atrophied accessory genital organs and increased (TP-treated, N = 10) or unchanged (19-NT-treated, N = 11) pD2 values for acetylcholine (vehicle: 5.18 +/- 0.06, N = 10; TP-treated: 5.26 +/- 0.06, N = 10; 19-NT-treated: 5.14 +/- 0.09, N = 11), and acetyl-beta-methylcholine (vehicle: 5.19 +/- 0.07; TP-treated: 5.43 +/- 0.06; 19-NT-treated: 5.25 +/- 0.07). The relative intrinsic activity, alpha, of acetyl-beta-methylcholine increased after both hormonal treatments (vehicle: 0.85 +/- 0.03; TP-treated: 0.95 +/- 0.02; 19-NT-treated: 0.92 +/- 0.03). 3. No variation in mean adult plasma testosterone concentration was observed after neonatal treatment with either TP or 19-NT (vehicle: 752.93 +/- 273.66, N = 8; TP-treated: 459.05 +/- 88.32, N = 8; 19-NT-treated: 836.86 +/- 113.08, N = 7). However, testosterone content of seminal vesicles of adult rats was decreased in the animals treated with TP (N = 5) and 19-NT (N = 6) compared to controls. 4. These results indicate a specific effect of neonatal hormone treatment on androgen metabolism which is demonstrable in the adult.


Effect of prepuberal chronic morphine administration on the onset of puberty in pituitary-grafted female rats. The effect of morphine on the onset of puberty was studied in female Wistar rats bearing pituitary grafts implanted at 21 days of age, or sham operated (SO). Morphine was given sc, daily, from day 22 until the occurrence of vaginal opening (VO), taken as an index of puberty. Two doses of morphine (2 or 8 mg kg-1 day-1) were used and control animals received saline of the same volume. Morphine (both doses) induced delayed puberty in SO rats, as indicated by age at VO: mean +/- SEM, 36.90 +/- 0.75 and 36.33 +/- 1.08 days vs 33.06 +/- 0.69 days for 2 and 8 mg vs control group. Pituitary graft induced precocious puberty and this effect was reversed by the highest dose of morphine (29.47 +/- 0.84 vs 32.80 +/- 0.59 days for saline vs 8 mg morphine, grafted rats). These data show that chronic administration of morphine during the prepuberal period delayed the onset of puberty and reversed the precocious puberty induced by pituitary graft in the female rat.


The effect of fasting and refeeding on oxygen consumption by rats. Oxygen consumption is usually measured on fasted animals to avoid the thermal effect of feeding. However, fasting itself may decrease oxygen consumption as a way of conserving energy. The present study was undertaken to determine how long the fasting period should be to avoid the thermal effect of feeding without promoting a further decrease in oxygen consumption by the activation of energy-conservation mechanisms. Oxygen consumption was also measured to evaluate the effect of refeeding after different fasting periods. There was a 16% decrease in oxygen consumption from 0 to 12 h fasting related to the thermal effect of feeding, followed by a less intense (12%) decrease from 12 to 48 h fasting resulting from the energy conservation mechanism. During refeeding, oxygen consumption was higher during the first 30-min period than during the last 30-min period of the 1-h measurement, indicating the probable presence of a cephalic phase of postprandial thermogenesis. We conclude that 12-h fasting is the most appropriate period to avoid the thermal effect of feeding without significantly stimulating the energy conservation mechanism.


Total and free amino acids in the "Crinofizin" pineal extract. In order to establish the chemical nature of Crinofizin, a protidic extract obtained from bovine pineal, the amino acids content was analysed using two analytic programs: one for biologic fluids, the other for protein hydrolysates. The results showed that the pineal extract contains besides the common protein amino acids reported earlier, others, rare in proteins, such as hydroxyproline, hydroxylysine and 1-methylhistidine as well as non-protein amino acids. From among the latter, the alpha-aminoadipic acid, beta- alanine, O-cysteine, are found only in a bound form, and are detected only by hydrolysis. Other amino acids, such as taurine, glutamine, citruline are present only in free form whereas the alpha-amino-n-butyric acid, GABA, ethanolamine and ornithine are present in both forms, free or bound. The paper discusses the physiologic significance of some amino acids.


Steroid hormones control on nucleic acid biosynthesis in skeletal muscle. The medical, agricultural and scientific interest of the muscular tissue is well established in the literature. Its formation and function are essential for survival. It is also known that steroid hormones are involved in the growth, development and maturation of skeletal muscles (sexual hormones) as well as in the process of body adjustment to the stress factors in the environment (glucocorticoid hormones). Starting from these considerations, our experiment has made an attempt to clarify part of the mechanisms involved in the action of steroid hormones at muscle level. On this purpose, 3H thymidine and 3H uridine incorporation was followed up in various types of skeletal muscles (femoral biceps, diaphragmatic, psoas) from rats treated with steroid hormones. Though known as anabolic hormones, sexual hormones did not induce significant and persistent changes in the nucleic acid synthesis (NAS), except for testosterone which enhanced RNA synthesis only in the level femoral muscle after 21 days of administration. Progesterone and the glucocorticoid hormones are known as hormones of proteic catabolism but it seems that this effect is more marked in muscles whose structure predominantly consists of white fibres (rapid muscles), as confirmed by our experiment.


Chronobiology of pituitary-thyroid functions. One hundred ninety four children, 11 +/- 1.5 years of age and 166 elderly men and women, 77 +/- 8 years of age were studied over one or (in the case of some of the elderly subjects) over several (up to 4) 24-hours spans. All subjects were diurnally active and rested at night and followed their regular three meal pattern. The subjects were studied in subgroups of 20-25 during all four seasons of the year. During each study, blood was collected at 4 hour intervals over one 24-hour span (6 samples). Circadian and circannual variations were found and described by cosinor analysis in the children as well as in the elderly subjects. The children with endemic goiter (134) as compared to those without endemic goiter (60) showed a slight circadian phase advance in plasma total and free T3, a lower circadian amplitude of total T4 concentrations and the absence of a detectable circadian rhythm in free T4. The children with goiter showed a phase delay in serum TBG. There was no difference between the children with and without goiter in the circadian MESOR of any thyroid parameter or of TSH. The children with endemic goiter in the region of Dimboviţa, Romania, are in clinical and biochemically euthyroid condition with some slight poral abnormalities of thyroid function. Seasonal variations in children and elderly patients showed the highest values of TSH during summer and fall, while the highest values in the plasma concentrations of thyroid hormones were found during the cold season of the years. Thyroglobulin in the children showed a circadian rhythm but no seasonal variation.


A retrospective study on the treatment and evolution of Graves' ophthalmopathy. Although Graves' ophthalmopathy (GO) seems to be unanimously considered as an autoimmune disease, its pathogenesis is still unknown. That is why the different therapeutical formulas led to ambiguous results. We think that a critical retrospective analysis on our therapeutical possibilities in GO will help us to become aware of our limits in treating this pathology. Our study performed on 123 patients with GO-stage III-IV who were admitted several times in the Thyroid Department of our Institute between 1975-1991; mean age 42 yrs (42 in men and 43 in women. One hundred and twelve patients presented GO associated with thyroid hyperfunction and 11 patients--with hypo- and euthyroidism. Thyroid status was evaluated through clinical examination and laboratory investigations (radioiodine uptake--RIU, 2h, 24 hrs, Achillean reflexogram--AR, T4, T3--radioimmunoassay-RIA). Three therapeutical formulas which were available to us were used in our subjects with GO: 1) general corticotherapy (C) was given in 77.6% of the cases; initial doses: 60-40 mg prednisone for 3 weeks followed by decreasing doses for 2 months (number of cures according to GO severity); 2) orbital radiotherapy (RT) alone was administered from the very beginning to the subjects in whom general C was not possible (7.4% of the cases); 3) general C associated with orbital RT were applied in the very severe cases of GO stage IV-VI (15% of the cases). The two available formulas acted particularly on oedematous symptoms (53% with C and 55.55% with RT alone). Muscular changes were improved by C in 30.83% and by RT only in 11.11% of the cases. It was noticed a mild positive effect on protrusion under C in only 11.66%, and under RT in 33% of the cases. The less favourable results in the cases under both C and RT can be explained by the fact that these groups included cases with stages IV-VI of GO with severe evolution. In 24% of the patients we noted an aggravation of the GO evolution regardless the therapy administered. The possible pathological relationship between the exophthalmic syndrome (ES) and hyperthyroidism (HT) is also supported by our data. The onset of ES together with HT occurred in 63% of the cases. On the other hand, we can notice that it was a more severe disease evolution when both ES and HT were associated. The treatment of hyperthyroidism led to GO aggravation (following 131I, thyroidectomy and antithyroid agents (ATD) in 43%, 52% and 29% of the cases, respectively).


Congenital adrenal hyperplasia with female pseudohermaphroditism in a 26-year-old patient. The paper presents the case of a 26-yr-old patient admitted for intersexuality. Clinical examination shows statural deficit, female phenotype, melanoderma, glabrous tegmina except for the pubic area presenting horizontally inserted pilosity, labioscrotum devoid of contents, pseudomicropenis with hypospadias. The Barr cytogenetic test is positive (56%) and hormone assay shows plasma cortisol at the lower limit and adrenal androgenic hormones and their metabolites in excess, suppressible by dexamethasone. The patient had a history of repeated admissions to intensive care units for severe dehydration, vomiting, diarrhea and collapse.


Iodine-enriched milk in goiter endemics. Researches carried out at Cîmpulung-Lereşti-Lăicăi from the north of the Argeş County demonstrated an environmental iodine-deficiency that caused thyroid hypofunction in animals and, consequently, a decrease in the iodine level in the products of animal origin. Administration of KI, KIO3 or of sea weeds powder in the cows nutrition corrected the thyroid function, the quantitative increase in milk production and enrichment of milk in iodine.


The paradoxical sleep-cerebral maturation relationship. Cerebral maturation (CM) is a complex genetically determined process which consists of four stages (neuritogenesis, synaptogenesis, elimination of the abnormal synapses and myelinization), all modulated or fine-tuned by endo- or exogenous factors, among which the paradoxical sleep (PS) is the most important. In the present review it is stated by direct and indirect evidence that PS is the only state of vigilance compatible with such a modulation of the CM. Many results from literature as well as our data give strong support in demonstrating that PS is involved in all four stages of the CM. In the light of the two hypotheses concerning the role of the PS in CM (the ontogenetic and the specific behaviour one), the results and data presented here support the idea that these are not reciprocally exclusive and suggest some real biochemical mechanisms by which PS could achieve its maturational role.


The negative impact of oxidative stress in chronic cardiac failure and coronary heart disease calls for a new pathophysiologic and therapeutic approach. Oxidative stress, when associated with ECG aspects of "coronary disease", indicates an accelerated course of atherosclerosis in the onset phase (by cellular involvement, migration, proliferation, etc.) and an additional thrombogenic risk in the "ischemic disease" phase, when associated with chronic cardiac failure, it indicates a progressive form with "replacement fibrosis". The therapy that reduces the oxidative stress can slow down the physiopathologic process, and clinically improves the patients' condition and prognosis.


Prenatal growth and asymmetry of thyroid gland in the cattle (Bos primigenius f. taurus). Growth and bilateral asymmetry of thyroid gland were studied in 291 fetuses (from 219 to 31,300 g) of the black-white cattle divided into 4 groups according to body weight. Relation between body weight (X) and thyroid weight (Y) was described using allometric equation Y = aXb. Allometric coefficient b was different in each of the four groups (1.198; 1.179; 1.314; 0.941) and amounted to 1.076 for the entire fetal period. The coefficient of fluctuating asymmetry of the thyroid gland decreased with increased fetal weight in the following way: 0.16; 0.10; 0.09; 0.07; this coefficient amounted to 0.02 for all the fetuses examined.


Monthly variations in the pharmacokinetics of antipyrine in calves. In the experiment (on the basis of values of antipyrine (phenazone) pharmacokinetics parameter), biotransformation activity of calves liver during a year was determined. The experiment was carried out on calves aged 28-30 days. Volume of distribution (Vd), half-life (t0.5) and metabolic clearance (CA) of antipyrine were from month to month determined. Not significant changes between values of Vd, t0.5 and CA in several months were observed. Results of experiment indicated that calves' liver is characterized by the relatively stabile biotransformational activity during the whole year.


Effect of short-term starvation and water deprivation on pharmacokinetics of antipyrine in calves. The experiment was carried out on 15 calves of black and white breed at the age of 21-22 days. The effect of 72 hours simultaneous starvation and water deprivation on pharmacokinetics of antipyrine (phenazone) was studied. The following parameters were determined: Vd--volume of distribution, delta Vd--apparent volume of distribution, t0.5--half-life, ClA--metabolic clearance rate. There were shown statistically significant increase of half-life and decrease of metabolic clearance rate and volume of antipyrine distribution in fasted and water deprived calves. Apparent volume of antipyrine distribution in the control and experimental groups did not differ significantly. The obtained results indicate that starvation and water deprivation considerably inhibits liver biotransformation process (estimated on the basis of antipyrine test) in calves during neonatal period.


The influence of normobaric hyperoxia on lung surfactant phospholipids in rats. The influence of 12-, 24- and 48-h normobaric hyperoxia on phospholipid composition of lung surfactant in rats was investigated. Both in surfactant isolated from bronchoalveolar lavage and in surfactant isolated from lung tissue after 12 h breathing of pure oxygen, a decrease in both phosphatidylcholine (particularly in disaturated ones) and phosphatidylglycerol content was observed. This decrease was compensated with concomitant increase in lysophosphoglyceride content. A drop in total phospholipid level in surfactant of oxygen-exposed rats was observed. These data suggest that normobaric hyperoxia causes a substantial changes in lung surfactant composition and type II pneumocyte metabolism.


The influence of normobaric hyperoxia on anti-oxidant enzymes activities and peroxidation product levels in rat lungs. The aim of this study was to investigate superoxide dismutase, glutathione peroxidase, glutathione reductase, catalase and glucose-6-phosphate dehydrogenase as well as malondialdehyde, conjugated dienes and hydroperoxide levels in rat lungs after 12-, 24-, and 48-h normobaric hyperoxia. It was stated that activities of the above-mentioned enzymes and peroxidation products are increased as early as after 12 hours of hyperoxia. It is suggested that normobaric hyperoxia can induce anti-oxidant enzymes and lipid peroxidation as early as in 12th hour of hyperoxia.


Antigen structure of Pityrosporum pachydermatis. The purpose of the present work was to define the antigen structure of Pityrosporum pachydermatis. The prepared antigens and their respective antisera were studied by means of double diffusion test in an agar gel and crossed immunoelectrophoresis. The study made it possible to prove marked quantitative differences between some antigen fractions of a few strains of P. pachydermatis. It has not been reported, however, that there occur either of specific antigens or reaction of partial serological identity, which was the basis to ascertain no antigen differences within the strains of P. pachydermatis under study.


Amino acids and cholesterol levels of leukemic lymphocytes infected with bovine leukemia virus (BLV). We performed qualitative and quantitative amino acids analysis of lymphocytes from normal and leukemic cattle (infected with bovine leukemia virus) to determine cellular cholesterol levels. Leukemic lymphocytes exhibited quantitative differences in the levels of some "glycogenic", "ketogenic" and "glyco-ketogenic" amino acids. These differences may reflect the disturbances of Krebs cycle. Evidence was produced that increased cholesterol content in the above lymphocytes was associated with disorders in beta-oxidation processes of leukemic cells.


Lymphocyte subpopulations in peripheral blood of pregnant sows. Theophylline-sensitive, theophylline-resistant and theophylline-dependent populations of peripheral blood lymphocytes in pregnant sows were defined. Theophylline-sensitive lymphocytes were cautiously considered as helper and theophylline-resistant lymphocytes seemed to represent the population of suppressor cells. During the first two months of pregnancy the number of helpers increased, while decrease of suppressor cells during the second and third month of gestation was observed. Increase of population of helper T-cells was accompanied by increase of absolute number of B-lymphocytes. Rapid decrease of B-cells after farrowing accompanied the decline of suppressor population. The changes in percentage and in absolute number of these populations of immune cells do not indicate the general immunosuppression during pregnancy in sows.


Relationship between the count of milk somatic cells and the peripheral blood lymphocyte subpopulations in sows. The aim of the study was to examine subpopulations of peripheral blood lymphocytes of mastitic and normal sows. Since number of cells in the milk reflects the intensity of response to mastitis process, relationship between level of milk somatic cells and peripheral blood lymphocytes was determined. No differences were found between mastitic and healthy sows in the percentage and absolute number of blood neutrophils and lymphocytes, T- and B-lymphocytes as well as in subpopulations of T-lymphocytes. It was found that milk somatic cell count positively correlates with the percentage but not with number of neutrophils and lymphoblasts and negatively correlates with the number of blood total T-lymphocytes and helper T-cells.


The ultrastructure of Pityrosporum pachydermatis. The purpose of the present work was to make a thorough study of the ultrastructure of yeasts Pityrosporum pachydermatis under transmission electron microscope. The study revealed an additional layer, that has not been described so far, situated outside the cell wall. Because its presence could be proved exclusively in the specimens prepared by means of a method which permits minimal washing out of lipids from biological material (dehydration by means of hexylene glycol and immersion in the resin of low viscosity), one can assume, that lipids are one of the components of this outer layer and they bind its structure together.


Effects of acetylsalicylic acid, chlormethine and glucose on cow's mammary gland. It was found that 100 ml of 5% glucose solution, 200 ml of acetylsalicyclic acid or 200 ml of chlormethine introduced into udder quarter caused a temporary irritation of mammary gland in healthy cows after a single intramammary inlocation. The changes in milk manifested by an increase of somatic cells number, serum albumins level and LDH activity, and decreased lactose content disappeared after 48-60 hours.


Concentrations of antibiotics in alveolar milk after intramammary inlocation of their different doses together with glucose, acetylsalicylic acid or chlormethine. After intramammary introduction of penicillin (600 th. i.u.), streptomycin (0.5 g), cloxacillin (0.5 g), neomycin (0.5 g), erythromycin (0.5 g) and cefoperazone (0.25 g) in 100 ml of 5% glucose solution the antibiotics' concentrations in the alveolar milk remained for 24 hours or longer on the level higher than MIC in relation to staphylococci and streptococci isolated from cows mastitis. In the first 24 hours the growth of antibiotic activity was little influenced by chlormethine supplement. While addition of ASA increased concentration and prolonged the time of antibiotics remaining on the therapeutic level.


Effect of phytooestrogen--coumestrol and oestrone on some aspects of carbohydrate metabolism in ovariectomized female rats. The purpose of the presented study is a comparison of phytooestrogen--coumestrol and oestrone effects on carbohydrate metabolism in ovariectomized female rats and to examine the participation of pancreatic hormones in changes of this metabolism. Administration of coumestrol diminished muscle glycogen in investigated animals. There were no significant changes in insulin and glucagon blood level but decrease in the specific insulin binding in the muscle membranes was observed. It suggests that coumestrol effects the insulin receptor activity in this tissue and it could be a cause of glycogen deficiency.


Effect of different diurnal lighting conditions on serotonin content in the pig pineal gland. Subcellular fractions of the tissue. Serotonin content in the pineal glands and in their subcellular fractions of the pig housed under natural and limited to circa 2.5 hours per day lighting conditions has been examined spectrofluorometrically. The shortened circadian light phase caused dramatically high drop of serotonin content in the evening (1900-2000). Correlation between presence of dense bodies in subcellular fractions and content of serotonin has been not observed.


Electron microscopic studies of neurocytes of the pterygopalatine ganglion in the rat after immobilization. The ultrastructure of rat's pterygopalatine ganglionic neurocytes under immobilization stress was investigated. The following ultrastructural picture was observed. The rough endoplasmic reticulum occurring in large amounts, was placed predominantly on the circumference of cells. The insular arrangement was noticed there, especially after seven and fifteen times repeated immobilization. The smooth reticulum, conversely, occupied mainly the perinuclear part of cytoplasm. The Golgi apparatus was much developed in comparison to the control group. Increase in number of lysosomes and lipophuscin, especially in the groups of seven and fifteen times immobilized, was observed. In all experimental groups changes within mitochondria were noticed (atrophy of cristae and matrix, presence of myelin bodies and swellings). The extent of these changes is variable and generally depends on the time period of immobilization.


Fetal and neonatal alloimmune thrombocytopenia: current trends in diagnosis and therapy. Neonatal thrombocytopenia affects 20-40% of the infants in intensive care units. The frequency of neonatal alloimmune thrombocytopenia (NAIT) is estimated at 1/1500 to 1/5000 live births. The risk of morbidity is significant with 20% neurological sequelae and the death rate is estimated at 10% of affected infants. During recent years considerable efforts have been made to prevent fetal bleeding and to avoid birth trauma, which have significantly changed the natural history of NAIT.


Anti-HPA-4b (anti-Yuk(a)) neonatal alloimmune thrombocytopenia: first report in a Caucasian family. Neonatal alloimmune thrombocytopenia (NAIT) is caused by platelet antigen incompatibility between the mother and fetus. NAIT is mainly due to alloimmunization; the frequency varying among ethnic groups. In Caucasians HPA-1a is the antigen most frequently implicated. In Japan, NAIT due to anti-HPA-4b antibody has already been described, but this is the first case to be reported in Caucasians.


Neonatal alloimmune thrombocytopenia due to anti-HPA-5b (Br(a), Zav(a), Hca): the importance of third-generation platelet antibody detection techniques, a case report. Investigation of the maternal serum in a case of suspected alloimmune neonatal thrombocytopenia by conventional, second-generation platelet serological assays (platelet radioactive antiglobulin test [PRAT], platelet suspension immunofluorescence test [PSIFT] and solid-phase adherence assay (SPAA, 'Capture-P') demonstrated only the presence of HLA class-I antibodies of limited specificities: no platelet-specific antibodies were detectable. The use of a third generation, glycoprotein capture assay (monoclonal antibody-specific immobilization of platelet antigens, MAIPA) revealed the additional presence of anti-HPA-5b with a titre of 1 in 32. Despite this relatively high titre, and the fact that it was able to induce a prolonged thrombocytopenia, this antibody was not detectable by conventional assays. In view of these findings we conclude that the use of MAIPA is essential when investigating cases of suspected alloimmune neonatal thrombocytopenia.


Reactions to platelet transfusion: the effect of the storage time of the concentrate. Random platelet concentrates were pooled and depleted of leucocytes by centrifugation immediately prior to transfusion. The incidence and severity of reactions to 570 leucocyte-poor platelet transfusions in 74 patients were studied. An overall transfusion reaction rate of 13.7% was observed. The reaction rate to platelets stored for less than 3 days (8.7%) was significantly different from the reaction rate to platelets stored for 3 days or more (17.6%). Minor reactions as well as moderate and severe reactions were more frequent in the latter group. As most of the white blood cells were removed prior to transfusion, it is suggested that the reactions result from the transfusion of pyrogenic and/or vasoactive substances accumulated in the plasma of the concentrate during storage.


Guidelines for platelet transfusions. British Committee for Standards in Haematology, Working Party of the Blood Transfusion Task Force. Recommendations for the optimal transfusion support of patients likely to receive repeated platelet transfusions. 1. Determine policy for prophylactic platelet support, and select the platelet count below which platelet transfusions will be used. 2. Consider using leucocyte depletion of red cell and platelet concentrates to prevent HLA alloimmunization from the outset. 3. Type patients for HLA-A and B antigens at an early stage. 4. Use random donor platelet concentrates for initial platelet support (either single or multiple donor, depending on availability). 5. If refractoriness occurs, determine whether clinical factors, which may be associated with non-immune consumption of platelets, are present and test the patient's serum for HLA antibodies. 6. Use HLA-matched platelet transfusions if HLA alloimmunization is the most likely cause of refractoriness. 7. If there is no improvement with HLA-matched transfusions, platelet crossmatching may identify the cause of the problem and help with the selection of compatible donors. 8. Discontinue prophylactic platelet support if a compatible donor cannot be found. Use platelet transfusions from random donors to control bleeding and increase the dose, if necessary.


Self help for platelet serologists: the Australian Platelet Antibody Workshops. The first three Australian Platelet Antibody Workshops (APAW) were held under the auspices of the Australasian Society of Blood Transfusion (ASBT) in 1989, 1990 and 1991. Participants submitted serum samples to the convenor who coded and distributed samples to laboratories routinely performing platelet serology. Results were summarized and discussed at the annual ASBT meetings. This report documents the evolution of platelet antibody tests in Australia and demonstrates the marked improvements in the participants' ability to differentiate platelet-specific antibodies from HLA antibodies and to identify the alloantigenic specificity of platelet antibodies. Five reference laboratories in Australia now hold panels typed for at least three platelet alloantigens.


[Angiotensin converting enzyme (kininase II). Molecular and physiological aspects]. The angiotensin I-converting enzyme (kininase II, ECA) is a membrane bound enzyme anchored to the cell membrane through a single transmembrane domain located near its carboxyterminal extremity. Secretion of ACE by the cell occurs most likely as a result of a posttranslational cleavage of the membrane anchor and intracellular region. The ACE molecule is organized into two large highly homologous domains, each bearing consensus sequences for zinc binding in metallopeptidases. Site directed mutagenesis allowed to establish that both domains bear in fact a functional active site, able to convert angiotensin I into angiotensin II and to hydrolyze bradykinin or substance P. The two active sites of ACE, however, do not display the same sensitivity to anion activation (the C terminal active site being more chloride activatable) and also differs in kinetic parameters for peptide hydrolysis. The C terminal active site can hydrolyze faster angiotensin I and substance P and the N terminal active site is able to perform a peculiar endoproteolytic cleavage of an in vitro substrate of ACE, the luteinizing hormone releasing hormone. Both active sites bind with a high affinity, competitive inhibitors but the Kd of the reaction can vary up to 10 between the two active sites. All together, these observations suggest that ACE contains two active sites, whose structure is not exactly identical. They may have a different substrate specificity, however this remains speculative at the present time. Concerning the regulation of ACE gene expression in man, population studies indicated that the large interindividual variability in plasma ACE levels is genetically determined. An insertion/deletion polymorphism located in an intron of ACE gene is associated with differences in the level of ACE in plasma and cells. The physiological and clinical implications of these observations is discussed.


[Identification and characterization of neutral endopeptidase in endothelial cells of arterial or venous origin]. Neutral endopeptidase (NEP; enkephalinase, EC 3.4.24.11) is a cell membrane associated zinc metalloprotease, which cleaves peptides like atrial natriuretic peptide (ANP) on the amino-side of hydrophobic amino acids. Although NEP is mainly located in reabsorptive epithelia (kidney proximal tubule), it is also present in non-epithelial cells like neuronal cells. As the renal NEP cannot account for the entire ANP metabolism, other locations were postulated. The present experiments show its expression in endothelial cells (EC) from arterial (bovine pulmonary, porcine and human aorta) and venous (human umbilical, rabbit ear marginal) origins. Three different methods were used to demonstrate the presence of the protein and its mRNA: 1) NEP enzymatic activity was estimated using both a synthetic ([D-Ala2, Leu5] enkephalin) and a natural substrate (bradykinin). Using the synthetic substrate, the enzymatic activity in EC was completely blocked by thiorphan, a specific NEP inhibitor with an IC50 value in the nM range. In contrast, captopril, bestatin, GEMSA, inhibitors of angiotensin-converting enzyme, aminopeptidases and carboxypeptidases, respectively, were 10,000 times less active, revealing an inhibition profile similar to that of the purified enzyme. Bradykinin, a natural substrate of NEP, was in part metabolized by NEP, in presence of captopril, since 50% of the formation of the major metabolite bradykinin 1-7 was inhibited by thiorphan. 2) Immunoreactive NEP was detected on the plasma membrane of rabbit EC using a monoclonal antibody directed against the homologous renal enzyme. 3) NEP mRNA was detected by Northern blot analysis on rabbit EC as a major transcript of 3.9 kb. Reverse transcriptase PCR amplification showed the presence of a specific transcript in all EC tested. Therefore, endothelial NEP could play an important role in the inactivation of ANP, bradykinin and endothelins by its localization facing the circulating vasoactive peptides.


[Dual inhibition of converting enzyme and neutral endopeptidase: a research new way in the field of hypertension]. Two metallopeptidases, angiotensin converting enzyme (ACE) and neutral endopeptidase (NEP) are involved respectively in the release of angiotensin II which is a vasoconstrictor, and in the metabolism of atrial natriuretic peptide which is diuretic and bradykinin which is a vasodilatator. The dual inhibition of these two peptidases represents a new way to regulate the blood pressure in various cardiovascular diseases. Taking into account the mechanism of action of metallopeptidases and the substrate specificity of ACE and NEP, dual inhibitors corresponding to the general formula HS-CH2-CH(R1)CONH-CH(R2)COOH and HS-CH(R1)CONH-CH(R2)CONH-CH(R3)COOH and having inhibitory potencies on each enzyme in the nanomolar range were designed. The most efficient inhibitors have been transformed into lipophilic prodrugs which were found to be active after oral administration. These compounds have been tested on an experimental model of hypertension in rats and, as expected, have been shown to be both diuretic (NEP inhibition) and hypotensive (ACE inhibition).


[Ectoenzymes of peptidic metabolism in renal glomerular and vascular cells]. The ectoenzymes acting in the metabolism of peptides play an essential role in renal cell-cell communication. We have studied four of these ectoenzymes, aminopeptidases N and A (APN, APA), dipeptidylpeptidase IV (DPP IV) and neutral endopeptidase (NEP) in cultured human glomerular mesangial and epithelial cells and cultured rabbit renal cortical vascular smooth muscle cells. APN is present at the surface of both mesangial and epithelial cells with identical characteristics. Its expression (enzyme activity and immunoreactive protein) is induced by phorbol-esters and other protein kinase C-stimulating agents. APA is present only in glomerular epithelial cells. Its expression is induced by glucocorticoids and cyclic AMP-stimulating agents. DPP IV is also present only in glomerular epithelial cells. Its expression (enzyme activity, immunoreactive protein and mRNA) is induced by interferon gamma. NEP is present in glomerular epithelial cells and vascular smooth muscle cells. The expression of the latter enzyme is inhibited in the presence of serum via the combined effect of Ca2+i and PKC-stimulating agents. In contrast, glucocorticoids and cyclic GMP induce its expression. NEP plays a major role in the catabolism by these cells of atrial natriuretic factor. All these data emphasize the multiplicity of the mechanisms controlling ectopeptidase expression in cultured glomerular and renal vascular cells.


[Control of homologous recombination by mismatch base repair system in bacteria: implications concerning the chromosome stability and the evolution of species]. The generalized mismatch repair system controls, in bacteria, the homologous recombination between diverged (homologous) DNA. It thus constitute, together with the sequence divergence, a barrier to recombination between bacteria of different species as we have shown for E. coli and S. typhimurium. It is moreover, by preventing the recombination between diverged repeated sequences, a key component of the chromosome stability.


[P transposable element in Drosophila melanogaster: horizontal transfer]. The P transposable element family in Drosophila melanogaster is responsible for the syndrome of hybrid dysgenesis which includes chromosomal rearrangements, male recombination, high mutability and temperature sensitive agametic sterility (called gonadal dysgenesis sterility). P element activity is controlled by a complex regulation system, encoded by the elements themselves, which keeps their transposition rate low within the strain bearing P elements and limits copy number by genome. A second regulatory mechanism, which acts on the level of RNA processing, prevents P mobility to somatic cells. The oldest available strains, representing most major geographical regions of the world, exhibited no detectable hybridization to the P-element. In contrast, all recently collected natural populations that were tested carried P-element sequences. The available evidence is consistent with the hypothesis of a worldwide P-element invasion of D. melanogaster during the past 30 years. Timing and direction of the invasion are discussed. The lack of P-element in older strains of Drosophila melanogaster as well as in the species must closely related to Drosophila melanogaster, suggests that P entered the Drosophila melanogaster genome recently, probably by horizontal transfer from an other species. The analysis of P-element elsewhere in the genus Drosophila reveals that several more distantly related species carried transposable elements with sequences quite similar to P. The species with the best-matching P-element is D. willistoni. A P-element from this species was found to match all but one of the 2907 nucleotides of the Drosophila melanogaster P-element. The phylogenic distributions and the likely horizontal transfers of the two other Drosophila transposable elements are discussed.


[Eukaryogenesis: a model derivated from ribosomal RNA molecular phylogenise]. We have undertaken the construction of a broad molecular phylogeny of protists through the comparison of 28S rRNA molecules. The sequences from several major protistan phyla were aligned and combined with a broad database of metazoans, metaphytes, fungi and bacteria and we have derived dendrograms from both distance matrix and parsimony methods. In agreement with classical systematics, a number of monophyletic groups separated by large evolutionary distances were observed (those of the ciliates, the chlorophytes, etc.). From this analysis, several inferences on the eukaryogenesis can be made among which the ancient origin of the cytoskeleton, the late occurrence of the chloroplastic endosymbiosis and the simultaneous emergence of the triploblastic and diploblastic metazoan patterns.


[Genes of the lipase family: comparison of nucleic and proteinic sequences]. Vertebrates' plasmatic apolipoproteins and a few number of lipases in their metabolism present sequence homologies. They are grouped in genes families. The four exons apolipoproteins gene family includes nine human genes: the divergence rate of their sequences allows to place the first ancestral gene very high in the phylogenetic tree of the evolution. However, a more recent duplication of apolipoprotein C-I gene dating from 40 millions years, may be a phylogenetic marker for the radiation of Monkeys. Pancreatic lipase and isoforms, lipoprotein-lipase and hepatic triacylglycerol-lipase form by their homologies a "superfamily" of genes, which also includes yolk proteins of Dipterians eggs. Sequence homologies of PL, LPL and HL are analysed and compared with multiple alignments of amino-acids and nucleotides on spreadsheets. From these comparisons we may characterize four classes of phylogenetic markers: 1) repetitive DNA sequence (Alu, B1, PRE-1) appeared during Mammals evolution, 2) short insertions or deletions (within N-terminal domain) and a gene conversion in guinea-pig lineage, 3) a progressive reduction of intron number during the lipases evolution, 4) several duplications of genes which have produced the five genes of this superfamily currently known in the human genome.


[Study of equivalents of rhesus antigens in non-human primates]. Human alloantibodies specific of some Rh antigens cross-react with non human primates red blood cells. These crossreactions demonstrated that only African apes express equivalents of Rho (D) and hr' (c). The antigenic resemblance between these two human antigens and their primate homologues is confirmed by the reactivities of human anti-D and anti-c monoclonal antibodies. The use of a human Rh cDNA probe allowed to confirm by Southern blot hybridization that nonhuman primates possess Rh-like genes. The number of Rh-like genes per haploid genome was deduced from the results obtained with exon-specific probes.


[New findings in emergency care and resuscitation in patients at risk for endotoxic shock]. Endotoxin shock is not only the reflexion of Gram-negative focal infection but also the consequence of dysfunction of the intestinal mucous barrier and a decline of the detoxication capacity, in particular of the hepatic mesenchymal phagocytic system during a critical state. Cytokines and the primary LPS complex and its lipid A resp. are of basic importance. They start the release of a large amount of TNF alpha, IL-1, IL-6, IL-8 and other cascades. Acute shock is controlled nowadays more frequently than in the past, however, there is a high risk of a very adverse reaction of remote organs, which is very adverse from the prognostic aspect. A series of laboratory markers has a greater validity than the clinical picture alone. For screening derived markers are used not primary markers. Despite this they provide adequate information. Prophylaxis and treatment include selective bacterial decontamination, or active or passive immunization (PSAEVA, hyperimmune sera), minidoses of dopamine in a continuous infusion, early enteral nutritional intervention, in particular enteral nutrition containing glutamine. Monoclonal and polyclonal antibodies against the LPS complex and cytokines are tested, blocking their receptors or possibly early plasmapheresis. Permanent pillars of therapeutic tactics are still a radical and early elimination of possible infectious foci and targeted administration of antibiotics and maintenance of the perfusion pressure and adequate oxygenation.


[Present possibilities of therapy of septic shock in surgical patients]. The authors present a review of contemporary possibilities of septic shock in surgical patients. As mentioned by the authors, the most frequent cause of Gram-negative sepsis in surgery are intraabdominal inflammatory diseases or septic complications after planned surgery. Based on an experimental study on acute endotoxin shock in dogs and treatment with hydrocortisone, dopamine and antihypertensive drugs (mepamil and metazosine), the authors present some principles of the therapeutic procedure in endotoxin shock under clinical conditions. They emphasize in particular administration of antibodies against endotoxin and cytokines. In the clinical part they submit results of comprehensive therapy of intraabdominal sepsis in patients hospitalized at the intensive care unit of the Surgical Clinic at the Third Medical Faculty in Prague. They give an account of the principles of peroperative and postoperative treatment within the framework of differentiated care. During the postoperative period it is important to ensure prevention and treatment of septic complications such as septic shock and the syndrome of multiorgan systemic failure as well as rational antimicrobial therapy, immunotherapy and adequate nutrition. The authors emphasize that it is essential that specific antibodies are available and indications of their administration must be defined. The expected effect of immunotherapy is limited by the period of administration in relation to early stages of sepsis.


[Secondary post-traumatic immunodeficiency syndrome in patients in the anesthesiology-resuscitation department. Possibilities of immunomodulation therapy]. The most frequent cause of death of patients with multiple injuries are infectious complications developing on the basis of secondary posttraumatic immunodeficiency syndrome. The authors submit their experience with monitoring of some immunological parameters of these patients and with the use of immunomodulation therapy with transfer factor--a leucocyte dialysate (TF, DLE, Immodin Sevac). They discuss problems pertaining to the mode of therapy, amounts and time of immunomodulation treatment in these patients.


The evolution and implementation of a PICU standard nursing care plan. A nursing process. The staff of an intensive care unit in a Pediatric Hospital in Ottawa believed in the philosophy of nursing care plans. They decided to develop a pediatric critical care standard nursing care plan that would be useful for care giving and user friendly. This article describes the evolution and implementation of their plan.


[A program for prevention of pseudomonas infections and immunoprophylaxis with PSAEVA vaccine]. The authors present three main trends of prevention of Gram-negative opportunistic infections investigated at the Cardiosurgical Clinic of the Institute of Clinical and Experimental Medicine. An important part is played by active and systematic surveillance with early signalling and analysis of new infections with subsequent aimed interventions against concrete sources of infection and mechanisms of transmission. It is necessary to think more of activation of endogenous infection the specific features of which make repression difficult and motivate investigations of preventive approaches. Rational antibiotic policy has so far not appreciated the danger of selection of endogenous and exogenous agents in standard situations where antibiotic therapy lacks an aimed and restrained approach. Immunoprophylaxis with the PSAEVA vaccine in the first preliminary controlled clinical investigation was characterized by the absence of nosocomial epidemics and septicaemia and a significant (fivefold) reduction of the incidence of non-pyocyanic Gram-negative bacteriaemia. The success of vaccination seems to be related to the anti-colonization and anti-invasive mechanism of specific and unspecific nature.


Noise in the intensive care setting.

Noise in the intensive care setting. Noise in the Intensive Care Unit not only deprives the patient of vital uninterrupted sleep, it also sets in motion stressful psychological and physiological responses which are harmful to the patient. This brief overview of noise as a stressor will serve to encourage nurses to provide an optimum environment for healing.


[The effect of oral colonization by non-pathogenic E. coli on the immune response in neonates and possibilities of its use in the prevention of nosocomial infections in children at risk]. Oral colonization with the non-pathogenic strain of E. coli 083:K24:H31 stimulated in a significant way the local antibody formation in the gut, saliva and milk of mothers of the colonized infants. Early induction of SIgA formation is important in particular in infants who are not breastfed where it replaces partially the lacking immunoglobulin supplied in breast milk. In premature and risk infants colonization had a favourable effect on reduction of the number of infections, deaths in conjunction with infection, a reduced presence of pathogenic microflora in the alimentary tract and elsewhere. In carriers the strain replaced successfully pathogenic strains and assisted the restitution of the impaired intestinal microflora.


[Epidemiology and public health].

[Epidemiology and public health]. The author analyzes the development and perspectives of epidemiology as a scientific discipline and as a component in the organization of the public health system. As a basis serve mainly evaluations and views of WHO on these problems.


[Occurrence of Toxoplasma gondii antibodies in blood donors 1980-1990]. In 1980-1990 in the Strakonice district parallel serological examinations, using the Sabin-Feldman test (SFT) and complement fixation test (CFT), were made in 2,758 blood donors for the presence of antibodies against toxoplasmosis. The total number of examinations was 8,245. In the course of the mentioned time interval no significant increase or decrease of the serological prevalence occurred. During the first examination of blood donors the SFR antibodies (titre > or = 4) were detected in 45.4%, CFT (titre > or = 10) in 24.6% donors. 651 blood donors were examined four times or more frequently after 6-month intervals. 22.9% donors lacked antibodies (SFT and CFT) permanently, a rarely present low titre was recorded in another 22.9% donors, a repeated low titre in 43.6% and a repeatedly encountered medium or high titre in 10.6% of blood donors.


[Candidiasis and its therapy].

[Candidiasis and its therapy]. The author draws attention to some aspects of the development and treatment of candidosis. She describes in detail factors which have a dominant importance in the development of the disease, and the most important components of the protective barrier of the host against the infection. She presents also a classification of known antifungal substances, their mechanism of action and use in therapeutic practice.


[A study on the count of living BCG bacilli using BL and FS methods]. Counting of living BCG bacilli is an important indicator for surveillance of BCG quality. Presently the method of CFU recommended by WHO is still widely used. This study employs rapid bioluminescent technique which measures ATP in the BCG and the fluorescent staining method which determines living bacilli rate in the BCG. CFU technique is used as control. Combining the results of OT tests in newborn children, we can evaluate the effects of BL and FS techniques used in surveillance of BCG quality. It is show that there is a significant correlation between BL and CFU techniques (r = 0.973, P < 0.005). Coefficient of variation in BL test group (ev = 2.72%) is much smaller than that in CFU group (cv = 39.5%). The results are also compatible with that of FS and OT reaction.


[Preliminary observation on tuberculous allergy and cross reaction with atypical mycobacteria PPD (purified protein derivative) in babies immunized by BCG]. In order to know the cross reaction between BCG and Atypical Mycobacteria (AM) antigenicity, 1150 babies immunized by BCG, aged 12-24 week, undertook a bilateral arm control test with H-PPD. type 11 AM-PPD and BCG-PPD. The results showed that all the AM-PPD tested can bring about a delayed allergy in these babies. but the total positive rate (42.87%) and mean reactive diameter (3.87 mm) were the lowest and smallest among the above mentioned three types of PPD. The BCG-PPD derived allergy has highest positive rate and largest reactive diameter, but there is no statistical difference when compared to those of allergy caused by H-PPD.


[Determination of red blood cell immune functions in patients with pulmonary tuberculosis]. Red blood cell immune functions were determined in 106 patients with pulmonary tuberculosis (tbc) and in 37 blood donors as a control group. In control group, RBC-C3bRR was 17.2 +/- 6.5%, RBC-ICR was 4.0 +/- 2.2%. In the group, both RBC-C3bRR and RBC-ICR levels were elevated in 23 patients, only RBC-C3bRR level or RBC-ICR level rose in 40 or 31 cases respectively. so, 88.6% of patients showed elevation of RBC immune function. The pathological changes were also correlated with the level of RBC-ICR, RBC-C3bRR significantly (P < 0.01). The authors suggested that the measurement of RBC immune functions might be useful in diagnosis, assessment of the severity and outcome of pulmonary tuberculosis.


[A survey of atypical mycobacterial infection in China]. A survey of atypical mycobacterial infection in China was conducted in 1990. The infection rate of the country was 15.4%. Zhejing province had the highest rate (44.9%) and Xizang had the lowest (1.9%). The infection rate of the southern part of the country was higher than the northern part; the rate was higher in the worm areas than the cold areas. The rate increased with the age. The highest peak was on the sixty and then decreased. There was no significant difference of the infection rate in sex or minority races. The reagents used for the identification of atypical mycobacterium, the criteria for the positive reaction, the epidemiological trend of atypical mycobacterial infection and the further surveillance approaches in the country and been discussed.


[Penicilliosis marneffei. Report of a case and review of literatures]. Penicilliosis marneffei is a rare deep fungal infection. The endemic area especially located in the Southeast of Asia. In the former literatures till 1990, 29 cases were reported, most of them were diagnosed pathologically from autopsy. Since 1989 there were more reports of P. marneffei in the HIV infected individuals and graft recipient, so far as the increased immunocompromised hosts systemic fungi infection would be a crucial problem. In this report, a case of systemic Penicilliosis marneffei according to biopsy and cultural identification was reported. Amphotericin B was administered in a total dose of 873 mg, and got a good response. The pathogenesis, clinical manifestations and diagnosis were reviewed.


[Laboratory study and clinical evaluation of ABC-ELISA for detection of mycoplasma pneumoniae antigens]. Using anti-M. pneumoniae IgG obtained by immunizing rabbits with whole cell antigen of M. pneumoniae strain FH, we established an ABC-ELISA for detection of M. pneumoniae in simulated positive specimens, ABC-ELISA had a detection limit of 10(4) cfu/ml of specimen. There were no cross-reaction with 4 other species of human mycoplasmas and 12 common species of bacteria in respiratory tract. In 47 patients suspected of being M. pneumoniae infection, we compared the results of ABC-ELISA with the combined results from serodiagnostic methods and M. pneumoniae culture. The coincident rate between them was 80.9%.


[Follow-up study of the effect of acute lower respiratory tract infection during childhood on chronic bronchitis in adults]. In order to study the relationship between the acute lower respiratory tract infection (ALRTI) during childhood and the occurrence of chronic bronchitis in adults, 90 cases (infection group) admitted to hospital for ALRTI before 7 yr old were followed up 24-31 years later. Their siblings without ALRTI during childhood were selected as the control group. The prevalence of chronic bronchitis in the infection group (12.2%) is significantly higher than that of the control group (2.2%). It is concluded that ALRTI during childhood may play an important role in the occurrence of chronic bronchitis in adults. Further analysis showed that infection and smoking have synergic effects on the occurrence of chronic bronchitis.


[Acute pulmonary embolism and pulmonary infarction]. 32 cases of pulmonary embolism were reported, 18 cases had been autopsied (massive pulmonary embolism 9 cases. moderate pulmonary embolism 23 cases). The incidence risk factors pathogenesis, clinical manifestations of pulmonary embolism were presented. The relation between pulmonary embolism and pulmonary infarction and treatment of massive pulmonary infarction were discussed.


[Interference of platelet-activating factor antagonist, BN50739 with the releasing of inflammatory mediators from anaphylactic lung of guinea pig]. BN50739 is a new and potent PAF antagonist. In this experiment, we have further confirmed that it is a selective PAF antagonist by means of rabbit platelet aggregating test. And also, when BN50739 was applied, in the concentration of 10 uM, to the isolated lung of guinea pig sensitized by ovalbumin, we observed that the amount of histamine and thromboxane A2 released was a little less (about 19.0% and 19.2%, respectively) than that of controls (P < 0.05). Whereas, the ratio of PGI2/TxA2 was increased by 17.6% comparing to that in control group (P < 0.05). But the level of LTC4 remained unchanged regardless of the presence of BN50739. We conclude that PAF may play a role in allergic reaction.


[A study about the ability of interleukin-2 production, interleukin-2 receptor expression by lymphocytes from patients with lung cancer]. The ability of Interleukin-2 (IL2) production, IL2 receptors expression and proliferative response by lymphocytes from 48 patients with primary lung cancer and 50 normal controls were studied. The results indicated that after lymphocytes were stimulated with PHA for 48 hours, the IL2 activity produced by lymphocytes from lung cancer patients was significantly reduced, the mean IL2 activity was only about 30% of that of normal controls, with lung cancer progression, the lymphocytes IL2 production tended to be more depressed. The lymphocytes IL2 receptors expression and proliferative response in cancer patients were also significantly decreased. Our study suggested that impaired IL2 production and IL2 receptors expression by lymphocytes from lung cancer patients may depress the IL2 dependent anti-tumor reaction in vivo.


[Comparative studies between the effects of captopril and nitrendipine on the hemodynamics and angiotensin converting enzyme of pigs with acute hypoxic pulmonary hypertension]. Pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PCWP), cardiac output (CO), blood pressure (BP) were monitored before and after hypoxia, Captopril and Nitrendipine injected (7 mg/kg and 100 micrograms/kg) in group A(n = 9), and group B(n = 7) respectively results showed that during hypoxia PAP in all the pigs increased significantly (P < 0.05), compared with normoxia, and after captopril and nitrendipine intravenous injection, the PAP dropped significantly (from 3.76 +/- 0.25 to 3.43 +/- 0.1 kPa versus from 4.21 +/- 0.19 to 3.18 +/- 0.17 kPa. ACE in captopril group was significant reduced P < 0.05 (58.4 +/- to 27.0 +/- 3.0 mumol.min-1/L), but in nitrendipine group was not markedly changed (P > 0.05), we found that reducing the degree of PAP and its duration time, lowered the pulmonary vascular resistance (PVR) and right ventricle stroke index (RVSWI), also improved capacity of oxygen delivery. Nitrendipine was better than captopril, maybe it is an useful drug for patients with pulmonary hypertension.


[Influence of different types of syndrome on the rising of excellent response rate in hernia repair with acupuncture anesthesia]. In order to raise the rate of excellent response in repair of hernia with acupuncture anesthesia, we valued individual difference in the light of basic theory of traditional Chinese medicine. 70 cases were typed by symptoms and signs before hernia operation with acupuncture anesthesia in which 48 cases were yang-deficiency type and 22 cases yin-deficiency type, besides, 30 cases of peridural anesthesia were as the controls. 1. Acupuncture Group: 1. Low-frequency electro-needling (1/sec) was applied to Zusanli (ST36) and Sanyinjiao (SP 6), while high-frequency electro-needling (10/sec) applied to the incisional edge. 2. The electrowaves and intension of stimulation were changed by regular time to maintain the best needling sensation. 3. Small doses of adjuvants were used together with acupuncture, which shows synergism clearly (fentanyl, 2 micrograms/kg, fentanyl/droperidol, 1/50, the dose depending on the condition of patients in operation). 2. The Controls: Routine peridural anesthesia and adjuvants were used. The same observation was given as the acupuncture group. I. the response rate of yang-deficiency type was 97.9%, the excellent response rate 75%, while the response rate of yin-deficiency type was 90.8% and its excellent response rate 45.4%. The response rate of the groups was no significant difference (P > 0.05), but the excellent response rate of the two differed significantly, the excellent response rate of yang-deficiency type was better than that of yin-deficiency type (P < 0.05). II. The total dose of adjuvants in the acupuncture group was small.(ABSTRACT TRUNCATED AT 250 WORDS)


[Responses of neurons in the somato-sensory area I to noxious electric stimulation of nervus peroneus communis. The study of intracellular potentials]. Noxious electric stimulation of nervus peroneus communis (PN) results in pain. It hasn't been reported that the neurons in somatosensory area I (SI) may respond to the noxious stimulation. In this paper, using intracellular microelectrode technique, we have studied the responses of neurons in SI to noxious electric stimulating PN. 33 neurons were recorded in 18 cats. 16 neurons were related with the noxious stimulation. The responses of these neurons to noxious stimulation were mainly inhibitory postsynaptic potentials (IPSP). Some neurons responded with two IPSPs. A few neurons responded with EPSP (Excitatory postsynaptic potential)-IPSPs. The latencies of the first IPSPs were short (8.25 +/- 5.90ms) and showed that the first IPSPs might be induced by the input of A beta fiber. The latencies of the second IPSPs (In the neurons with two IPSPs) were long (60.33 +/- 6.62 ms) and showed that the second IPSPs might be induced by the input of A delta fiber. Above results show that: 1) SI neurons can respond to the noxious electric stimulation of PN. 2) The responses of SI neurons to the noxious stimulation were mainly IPSPs. 3) The second IPSPs might be related with pain.


[Corticofugal modulation of somatosensory area II on acupuncture effect in nucleus ventralis posterolateralis of the thalamus]. In order to explore whether cortical somatosensory area 11 (SII) was involved in descending modulation of the effect of electroacupuncture (EA) on nucleus ventralis posterolateralis (VPL), the present study was designed to investigate the influence of topical application of lidocaine at SII on the EA effects in VPL nucleus. Experiments were performed on 23 adult cats anaesthetized with pentobarbital sodium (35-40 mg/kg i.p.) and immobilized with gallamine triethiodide. The single unit activities of VPL neurons were extracellularly recorded using glass microelectrodes. The results were as follows: 1. The nociceptive responses of VPL were obviously attenuated after EA at "Huantiao (G30)" and "Yanlingquan (G34)". The difference was statistically significant at 0-10 minutes after cessation of EA (n = 13, P < 0.001 or P < 0.05), then it was gradually recovered. The results showed that EA could inhibit the nociceptive responses of VPL neurons. 2. The inhibitory effect of acupuncture on nociceptive responses were reduced or abolished after topical application of lidocaine (n = 14, P > 0.05). However, it exerted marked inhibition at 0-10 minutes after cessation of EA in the saline control group (n = 14, P < 0.05). There was a statistical difference between these two groups (P < 0.05). The results showed that SII was involved in descending modulation of acupuncture effect in VPL nucleus.


[Electrophysiological observation on the role of the hypothalamic paraventricular nucleus in acupuncture analgesia]. In this experiment, the role of PVN in acupuncture analgesia was further investigated with electrophysiological technique. In wistar rats the unit discharge was recorded extracellularly, Noxious stimulation was applied to sciatic nerve, and the electroacupuncture was performed on acupoints "Zusanli" and "Sanyinjiao". Totally eighty-two units were recorded successfully from PVN. 49 units of them reacted to electroacupuncture with excitatory (14), inhibitory (23) or on significant effect (12). Various types of reactions including excitation (12), inhibition (6), excito-inhibition (4) or inhibito-excitation (3) were observed on 43 units during noxious stimulation of sciatic nerve. The remainder 18 units had no significant reaction. After electroacupuncture those units reacting with excitatory effect on noxious stimulation decreased their firing rate, and those with inhibitory effect increased their firing rate. The duration of nociceptive reaction was shortened after electroacupuncture in both types of units. It was suggested that electroacupuncture could influence the activities and decrease the nociceptive reactions of PVN neurons, which might be considered as electrophysiological evidence of the involvement of PVN in acupuncture analgesia.


[The analgesic effect of red nucleus and preliminary research on its mechanism]. The spontaneous discharges of neurons in red nucleus (RN) of rats have been recorded with microelectrode. The discharge frequency of most RN neurons was changed by nociceptive electrical stimulation of nervi peronaeus communis or nervi tibialis or by nociceptive mechanical stimulation of tail or hind leg. The electrical activities of the somatic sensory neurons in the nucleus ventralis posterolateralis (VPL) of thalamus and of the visceral sensory neurons in the nucleus anterior and nucleus parafascicularis of thalamus have been recorded. According to the form of response to the peripheral nociceptive stimulation the neurons concerned could be divided into three types: pain-excited, pain-inhibited and pain-nonrelated. Electrical stimulating RN could change the spontaneous discharge frequency of somatic pain-related neurons of VPL and visceral pain-related neurons of nucleus anterior and nucleus parafascicularis, and could inhibit their response to somatic and visceral nociceptive stimulation respectively, but did not have influence on the activity of most pain-nonrelated neurons in VPL. The effects of electrical stimulating RN and microinjecting Ach into RN on the same pain-related neuron in VPL were similar. The experimental results show that RN can receive the somatic afferent impulses, that the excited RN can inhibit the transmission of somatic and visceral nociceptive impulses into the thalamus, and that the analgesic effect of RN is concerned with Ach.


[Effect of Asu-AVT on electroacupuncture (EA) analgesia]. The Asu-AVT (1,6-aminosuberic acid -8-arginine-vasotocin) in an analogue of 8-arginine-vasotocin (AVT) which is one of pineal hormones. The effect of Asu-AVT on the pain threshold and EA analgesia was studied in rats. An increase of 16.2-41.5% in pain threshold was observed within 70 min. after ivc of Asu-AVT (75ng), while the Asu-AVT injection in combination with EA produced a significant increase of 164.6-309.1% in pain threshold, which was much higher than that in the saline-EA group (p < 0.05-0.01). The effect of Atu-AVT is analogous to that of oxytocin and arginine-vasopressin. The data indicate ivc of ASu-AVT not only elevates the pain threshold, but also enhances the EA analgesia. These results suggest that the pineal hormone, AVT may play a role in the EA analgesia.


[Effect of electroacupuncture tolerance by different frequencies on the cardiovascular inhibition of spinal opioid peptides of the rats]. Continuous 6 hour's electroacupuncture (EA) of 2-15Hz or 2Hz applying to both legs of the rats resulted in the electroacupuncture tolerance (ET). Then, we observed: (1) The effect of 2-15Hz ET on the recovery of mean arterial blood pressure (MAP) and heart rate (HR) of rats after hemorrhagic shock; (2) The change in MAP and HR of rats subjected to 2Hz ET after intrathecally (i. t.) administration of DADLE 25 micrograms, a delta opioid agonist. The results showed that, firstly, there was no difference between 2-15Hz ET group and control group in the recovery of MAp and HR after hemorrhagic shock. Secondly, DADLE (25 micrograms) caused almost the same suppression effect both in 2Hz TE group and in control group. These results suggest that unlike the spinal dorsal horn cells (regulating algesia, the spinal lateral horn cells (regulating blood pressure) are insensitive during EA analgesia and can not be made tolerance to continuous EA.


[A study of the regularity of pain threshold changes after trauma and the effect of electroacupuncture]. Pain threshold of rats was measured by the latent period of tail flick and limb withdrawal elicited by radiant heat. 52 male SD rats were used and trauma was produced by aseptic amputation just beneath the right ankle joint. The effect of nerve block and electroacupuncture (EA) was studied and non-traumatic groups were arranged as control. The pain threshold was reduced right after trauma and the lowest level appeared on the 3rd day and then recovered gradually up to the 7th day after trauma. Nerve block and EA markedly raised the pain threshold. Particularly, EA elevated pain threshold of traumatic rats more marked and long-lasted than the effect of nerve block. This may be resulted by mobilizing the functions of the endogenous analgesic systems.


[Research on serotonergic neurons in lateral raphe nucleus of rat with intracellular injection HRP technique]. This experiment was carried out on 35 rats with stereotaxic apparatus following a new coordinate which was designed by ourselves. The microelectrode was pushed into the lateral dorsal raphe nucleus (LDR) under direct vision. The neurons with regular rhythm and slow firing rate were searched by intracellular recording, then the singular cell in LDR was filled with HRP by intracellular iontophoresis. 7 HRP labelling neurons with serotoninergic firing characteristics were observed in LDR. The labelling dendrites were found in neighboured structure (periaqueductal gray, laterodorsal tegmental nucleus, dorsal tegmental nucleus, 4th ventricle). This work demonstrated that LDR plays some role in acupuncture analgesia.


[The effect of stimulating the auricular liver-gall acupoint with electrode on synaptic of nucleus originis dorsalis nervi vagi in rabbits]. In this experiment, several ultrastructural parameters of Gray's type I synapses in nucleus originis dorsalis nervi vagi were observed and quantitatively analysed by use of electron microscopy in condition gallbladder contraction by stimulating the auricular liver-gall acupoint of rabbits with electrode. It was found that the synaptic contact length was increased extremely significantly, and the postsynaptic thickening length lengthened significantly. There were no changes in the area and the perimeter of presynaptic bouton as well as synaptic vesicle density. The percentages of synaptic perforation and negative synaptic interface tended towards increase. But there were no differences in synapses of positive and straight interface. It is suggested that the nucleus is involved in the regulation of gallbladder activity induced by auricular acupoint stimulation.


[The effect of acupuncture on rabbits with fever caused by endotoxin]. Forty-eight rabbits were used to investigate the effect of puncturing GV14, LI11 on the change of temperature and the level of plasma endotoxin. The animals were divided into 5 groups: reinforcing manipulation, reducing manipulation, electroacupuncture, endotoxin-control, N.S.-control group. The result shows that there is no influence on the fever caused by endotoxin and the level of plasma endotoxin in the treatments by the different acupuncture techniques.


[Effect of acupuncture on the contents of vasopressin and oxytocin in the rat]. This work was to investigate the change of the contents of vasopressin and oxytocin during acupuncture in rat. Acupuncture could not only cause a change of immunoreactive arginine vasopressin, but also cause a change of immunoreactive oxytocin in many regions of rat brain. These results suggest that arginine vasopressin and oxytocin might be through the central nervous system to participate acupuncture analgesia.


[The relation between acupuncture manipulations and responsive discharges of cutaneous receptors]. Nine types of mechanoreceptors of hair skin in 46 rabbits were identified by recording discharges of single afferent fiber in posterior femoral cutaneous nerve from fine filaments by dissection. When seven manipulations, i.e. lift and thrust, twist and twirl, rotate, serape, flike the needle and finger-pressure were used to stimulate each receptor, their responsive discharges were observed. Data at 165 units were collected totally, 89 units in which were for the relation between manipulations and discharge patterns, and the other 76 units for discharges responding to manipulations at different distances from the receptive field. Nine types of receptors having been observed are able to respond to any acupuncture manipulations, it is thus clear that there is not any special "acupuncture receptor." Same kind of discharge pattern existed in different types of receptor when stimulated by the same acupuncture manipulation, whereas different discharge patterns can be found at the same unit when the manipulation changes. We believe that it is due to the movement form; force amount and time duration of the manipulations. Receptors responding to acupuncture were not limited to one point only, but involving a certain field surrounding the needle point. The size of this field varied with the types of receptors and kinds of manipulations. Our previous articles had reported that the acupuncture photograph leading from nerve and building on impulses induced by acupuncture and the groups of afferent fibers conducting acupuncture signals changed with different manipulations, in this paper the reasons for that have been expounded by presenting the relationship between the responsive discharges of receptors and the manipulations.(ABSTRACT TRUNCATED AT 250 WORDS)


Free flap surgery. The second decade.

Free flap surgery. The second decade. After 2 decades of increasing expertise, microvascular free tissue transfer has gradually evolved from being a procedure of last resort to become a first choice reconstructive procedure. Improved success rates, reduced operative time, and patient morbidity have widened the indications for the procedure. This has profoundly affected our reconstructive principles and, in many instances, reversed some well-established dogmas of wound care, cancer resectability, and salvage of multilated parts. As the constraints of tissue survival decrease, more attention can be given to the artistry and functional restoration.


Avoiding free flap failure.

Avoiding free flap failure. To obtain up-to-date statistics on free flap success rates, a survey of 644 consecutive free flaps performed by nine expert microsurgeons was conducted in 1991. Analysis of the failures shed light on the current problem areas. Because operative experience is the most important factor related to improved success rates, a questionnaire aimed at probing the experts for the lessons learned as their success rates improved was sent to 12 expert microsurgeons. From this source of data, and from the author's experience, a breakdown of the causes of free flap failure is given.


Intraoperative and postoperative monitoring of microsurgical free tissue transfers. Numerous techniques have been described for monitoring the postoperative viability of microsurgical free tissue transfers, and their sensitivity and reliability continue to be evaluated in animal experiments and clinical trials. Relative advantages and disadvantages of these various postoperative monitoring techniques are discussed. The concept of intraoperative monitoring of the microsurgical anastomoses during closure and inset of a free flap is introduced because many free flaps may fail on the operating table, but this only becomes clinically apparent several hours later in the early postoperative period.


Refinements in mandibular reconstruction. The new advances in the application of the prevascularized bone grafts, i.e., fibula and inner cortex iliac crest, have contributed a major advance in the field of mandibular reconstruction. Better understanding of rigid skeletal fixation and its ability during vascularized bone graft transfers further enhances flap survival and patient rehabilitation. Additional advances in techniques of osteointegration, TMJ reconstruction, and soft-tissue reconstruction have greatly augmented our ability for further refinements in this field.


The role of microsurgery in pediatric craniofacial reconstruction. Great strides have been made in both microsurgery and craniofacial surgery. Situations arise in which practitioners of both disciplines must work closely together to achieve a satisfactory reconstruction for the patient. This unified approach has set the stage for a new era in the treatment of pediatric craniofacial problems.


Refinements in hand coverage with microvascular free flaps. The specialized tissue requirements or dorsal and palmar skin are analyzed and options for full-thickness replacement outlined in detail. Thoughtful and accurate preoperative planning is the key to success. Dorsal coverage with a variety of pedicled and free fasciocutaneous flaps are quite satisfactory. Palmar coverage is more difficult and the need for sensation more critical. Free vascularized temporoparietal fascial flaps covered with full-thickness skin grafts are currently the treatment of choice for most complex wounds.


Hand reconstruction with partial toe and multiple toe transplants. Microsurgical transplantation of toes to the hand can serve as an excellent method of reconstructing the severely traumatized hand. This article reviews the authors' experience with 188 great-toe and second-toe transplants. Detailed operative sequence and postoperative care are also discussed.


Salvage of the massively traumatized lower extremity. The prognosis of massive lower extremity injuries has been significantly altered by improved free flap success rates and a better appreciation for the need to perform an early aggressive debridement and reconstruction. Although some successes may be spectacular, many functional failures have been observed despite successful flap transfer. Reflections on the emerging principles and the lessons learned from the past decade of heroic efforts spent treating these injuries will reveal methods that may decrease the number of functional failures. These methods were observed by comparing the functional results of tibial reconstruction patients versus foot resurfacing procedures.


Microsurgical adjuncts in salvage of the ischemic and diabetic lower extremity. Revascularization of distal occlusive disease in the diabetic has been markedly enhanced by microsurgical techniques. Extremely small, heavily calcified vessels are able to be reliably reconstructed using microsurgical techniques and high magnification. Additionally, revascularization followed by microsurgical free tissue transfer has proven to be a valuable alternative to amputation in patients with major soft-tissue loss, or bony or tendon lesions requiring soft-tissue reconstruction. Although metabolic risks are potentially high, we have experienced a very low morbidity and mortality with a thorough medical work-up and follow-through in conjunction with these major procedures. It is our expectation that judicious application of microsurgical techniques in treatment of the ischemic diabetic lower extremity will continue to improve the chances for long-term bipedal ambulation in this patient population.


Treatment of chronic osteomyelitis of the lower extremities with debridement and microvascular muscle transfer. Of our 55 patients treated for lower extremity osteomyelitis, 91% underwent debridement and microvascular muscle flap coverage with eradication of their infections and restoration of ambulation. This series of patients helps to solidly establish the efficacy of this approach to the treatment of osteomyelitis.


Bony reconstruction in the lower extremity. The reconstructions of large debridement defects of the tibia are difficult and, at times, discouraging. To maximize the potential for limb salvage, a rigorous patient selection algorithm is essential. Each therapeutic option must consider various host factors, anatomic restraints, physician skills, and institutional resources. In this article, the cost effectiveness and morbidity of two distinct methodologies are compared to bring the guidelines for patient selection to perspective.


Microvascular free flaps in breast reconstruction. There is no longer any doubt that free flaps can achieve the best breast reconstruction. Proof is the rapidly increasing popularity of the method. Its many advantages, the indications for each flap, and the technical refinements are presented.


Advances in total phalloplasty and urethroplasty with microvascular free flaps. This article focuses on the lateral arm free flap as the option that comes closest to meeting the diverse aesthetic and functional goals of phalloplasty. The authors introduce a new technique for incorporating a prefabricated neourethra within the lateral arm to permit the coexistence of an erectile prosthesis alongside a fully vascularized urethra that extends to the distal tip. The unrecognized value of the radial forearm free flap for urethroplasty is also discussed and a case of reconstruction following urethral loss is presented. Also described is how the prefabricated urethra technique may be useful for repairing severe hypospadias defects.


Receptor protein tyrosine kinases and phosphatases. It is clear that the number of receptor PTKs and PTPs encoded by a typical vertebrate genome is rather large. Although the signal pathways activated by the receptor PTKs may in many cases be common, specificity is provided by the ligand-binding domain and the availability of ligand. In addition, the precise spectrum of substrates that bind to and are phosphorylated by each receptor PTK can differ based on the number and nature of the autophosphorylation sites and on the repertoire of SH2-containing proteins and other substrates expressed in each cell type. It is also clear that receptor PTKs can activate multiple independent signaling pathways and that the output of these pathways can be integrated to provide a specific cellular response. The role of receptor PTPs in such integrated signaling networks is not yet obvious. In some cases, they may activate nonreceptor PTKs, whereas in other cases, they may counteract the effects of activated receptor and nonreceptor PTKs by dephosphorylating the PTKs themselves or their substrates. We know very little about the substrate specificity of PTPs, but in part this must be dictated by their subcellular location. It is possible that there are specific pairs of receptor PTKs and PTPs, which act in concert at the cell surface to activate and down-regulate specific signal pathways. Progress in understanding the function of receptor PTPs will depend on identifying ligands for receptor PTPs and then determining how ligand binding influences their activity.


The Trk family of tyrosine kinases: receptors for NGF-related neurotrophins. Neurotrophins are known to have important functions in the survival of embryonic and adult subpopulations of neurons. The identification of Trk family RTKs as receptors for NGF-related neurotrophins indicates phosphotyrosine-mediated signal transduction as a principal mechanism for neurotrophin signaling. Previous trk and trkB expression studies (Klein et al. 1989, 1990b; Martin-Zanca et al. 1990) and more recent studies with trkC (L. Tessarollo et al., in prep.) provide important clues about function. Thus, trkB and trkC expression in motor neurons and in many nonneuronal cells suggests that these cells are targets for neurotrophin action in vivo, even though this has not been demonstrated in the classic in vitro survival assays. Expression of trkB and trkC in nonneuronal cells implies that these receptors may act in additional aspects of organogenesis and development. Current approaches to assay Trk receptor and neurotrophin function will be complemented by further studies in the living organism. Transgenic approaches aimed at ectopic expression and at interfering with normal receptor function should provide additional insights. Finally, reverse genetic approaches using targeted mutation of Trk receptors in embryonic stem cells (Stanton et al. 1992) will allow assessment of critical receptor requirements and provide powerful reagents for studying nervous system development and function.


Mechanisms of sensitivity and specificity in olfaction. The sensitivity and specificity of the mammalian olfactory system is the result of the contributions at the anatomical, cellular, and biochemical levels. The recent identification of a large gene family encoding putative olfactory receptors suggests that genetic diversity may play an important role in this system. Future challenges lie in understanding the mechanism that regulates expression of each of the receptors and establishes the complex neural processing network that interprets the primary neuronal responses.


Myocardial extraction of lactates, non-esterified fatty acids and their fractions in patients with dilated cardiomyopathy at rest and after the cold pressor test. A decrease in the myocardial extraction or excretion of lactates indicates its hypoxia. The authors analyzed changes in the extraction of lactates, non-esterified fatty acids (NEFA) and their fractions: C 14:0, C 16:0, C 16:1, C 18:1, C 18:2 in a group of 15 patients with dilated cardiomyopathy (DC) and in 10 controls at rest and after the cold pressor test (CPT). At rest, 5 patients with DC produced lactates or extracted less than 10%. During CPT, production of lactates was observed in another four patients (mean values: 17.9 +/- 32.6% vs 24.5 +/- 5.2%, ns). NEFA extraction was found in the DC group: 18.4 +/- 20.6% vs. 13.9 +/- 33.3% /p < 0.05/). The acids involved were C 14:0, C 16:0, C 16:1 and C 18:0. In the controls, NEFA extraction did not change significantly: 12.1 +/- 8.6% vs 29.7 +/- 33.2%. 1. In part of patients with DC, production of lactates was found. The degree of lactate excretion increased due to CPT; 2. In DC, adrenergic stimulus (CPT) impairs the myocardial utilization of NEFA. This applied mainly to myristic acids, palmitic acid, palmitooleic acid and stearic acid; 3. This phenomenon probably is a result of profound functional and morphological damage to the mitochondrial system in DC.


The influence of the haemodynamic factor on the development of left ventricular hypertrophy in patients with arterial hypertension. One hundred and forty-seven patients with essential hypertension (EH) and 126 patients with secondary arterial hypertension (AH) on the basis of chronic pyelonephritis were studied by means of radiocardiography with 131I-albumin and M-mode echocardiography. The importance of the haemodynamic type of circulation for the development of left ventricular hypertrophy (LVH) was established. Correlative analysis revealed that the influence of arterial pressure (AP) on LVH is increased by stabilization of AH, especially in patients with the normo- and hypokinetic types of circulation; interestingly, the relation between LVH and systolic pressure was closer than that between LVH and diastolic pressure, especially in patients with secondary AH. Moreover, it was shown that the development of LVH is due to a preferential increase in posterior wall thickness in essential hypertensives and in ventricular septal thickness in secondary hypertensives, although all patients with LVH had dilatation of the left ventricular cavity.


The effect of allopurinol on free oxygen radicals in myocardial reperfusion. The transmyocardial turnover of lactate, oxidized and reduced glutathione, malondialdehyde, and the isoenzyme CK-MB before and after restoration of myocardial blood flow was studied in 18 patients undergoing coronary artery surgery. Of this number, ten patients were given oral allopurinol preoperatively; the remaining patients made up the control group. Allopurinol significantly reduced the levels of free oxygen radicals. The enzymatic methods employed did not make it possible to evaluate the protective effect of allopurinol on reperfusion myocardial injury.


Analgosedation raises baroreflex sensitivity in acute myocardial ischaemia. Acute local myocardial ischaemia is associated with a decrease in baroreflex sensitivity while electrical instability (vulnerability) of ventricles increases. Co-administration of a benzodiazepine and a potent analgesic (analgosedation) has been found to raise both baroreflex sensitivity and ventricular fibrillation threshold. Pharmacological modulation of neurovegetative ionization of the heart in the early phase of ischaemia is a promising method for preventing sudden coronary death.


Abnormal effect of sera from patients with atherosclerosis on calcium influx into normal erythrocytes. The rheology of red blood cells in patients with atherosclerosis is abnormal. To investigate this further, the authors examined the effect of sera from patients with atherosclerosis on the handling of calcium by the erythrocyte membrane. Normal erythrocytes were filled with a photoprotein (aequorin) which emits light on contact with calcium. These photoprotein-loaded normal erythrocytes were then incubated overnight with the serum from normal subjects (n = 34) and from patients with atherosclerosis (n = 30). There was a significant decrease in basal calcium leakage, as measured by the amount of light produced following the addition of triton X-100. Induced calcium influx, as measured by the amount of light produced following the addition of ionophore A23817, was significantly greater in the photoprotein-loaded erythrocytes incubated overnight with the serum from patients with atherosclerosis compared with those incubated with the serum from normal subjects (p < 0.01). This modulation of Ca2+ handling in erythrocytes by a serum factor from patients with atherosclerosis could account for the alterations in erythrocyte function, such as red cell deformability, observed in atherosclerosis.


A contribution to the morphology of tortuosity of arteries, aneurysms and arteriomegaly. Using the electron microscope, the authors examined the structure of the wall in a case of arteriomegaly of the inferior mesenteric artery in man. Structural changes concerned the elastic material showing signs of degeneration. Based on a comparison with literary findings, the authors conclude that tortuosity of the arteries, aneurysms and arteriomegaly are caused by congenital, age-dependent and pathological changes in the elastic material in the vessel wall. There exist basic structural differences in the arterial wall in arteriomegaly and in atherosclerosis.


[Abrikossof's tumor of the esophagus. An original case. Review of the literature]. Granular-cell tumors (GCT), also called Abrikossof's tumors, are generally benign, ubiquitous tumors. An original case of granular-cell tumor of the esophagus is reported. The symptoms included dysphagia and pyrosis. Fiberendoscopy showed a peptic esophageal stenosis with ulcerations confirmed by biopsy. CT showed a round thickening of the esophageal wall, localized in height. This lesion had previously been the object of several dilatation attempts. Esophagectomy with esogastric anastomosis in the thorax was performed. The histological study allowed diagnosing a granular-cell tumor, though one of a very peculiar type: misleading symptoms, tumor infiltrating the whole height of the esophagus and a circular area. Ninety cases of granular-cell tumors are reported in the literature; they are associated with a cancer of the air passages or of the digestive tract in 11% of cases. The cancer often appears secondarily, which requires lengthy surveillance. We do not know if this association is directly related or accidental. We have found no identical case of such a lesion, involving both the whole circumference and the whole height of the esophagus, in the literature.


[Experimental study of the trophic effects of reinnervation of pedicled muscle flaps]. Any transplanted muscle flap undergoes atrophy to an extent depending mainly on its innervation. Other factors such as the tension at rest and the duration of ischemia play a secondary role. An experimental study was carried out in rats to quantitatively assess the extent of atrophy according to the mode of transplant reinnervation. The gracilis muscle was used as an experimental model of pedicled flap after verifying the axial nature of its vasculature. Results were assessed after three months from a histological point of view and in terms of postoperative weight in four different groups of 13 rats. The first three groups reproduced situation encountered in clinic: intact nerve, sutured nerve, resected nerve. A graft sensory neurotization technique was implemented in the fourth group by diverting a neighboring sensory nerve. The best trophic results were obtained when the motor nerve remained continuous. The sensory neurotization technique did not significantly influence the trophic evolution after three months.


[Use of intraosseous resorbable implants. Experimental evaluation and clinical applications in hand surgery]. The authors report about their experience with the use of absorbable intramedullary nails. After an experimental phase comprising mechanical tests and animal experiments in rabbits, the first clinical applications were for 24 cases of metacarpophalangeal arthrodesis of the thumb. For this indication, bone stabilization was achieved by associating an absorbable intramedullary nail and a metallic oblique pin. Evaluation in animals included, on one hand, a magnetic resonance imaging study, and on the other hand a histological study after the staggered sacrifice of the animals. This histological study was performed on non-decalcified bones by inclusion in methyl methacrylate resin. The mechanical results confirmed the appropriate resistance of these materials for use in the digital skeleton. The histological assessment showed that absorption begins around the 4th month by progressive fragmentation of the material and lasts over 3 years. The encouraging clinical experience and some obstacles encountered during its implementation hav led to two modifications: on one hand, a larger nail was used, on the other hand an absorbable oblique pin was developed, thus ensuring a fully absorbable osteosynthesis.


[Cryosurgery in ventricular tachycardia. Value of myocardial hypothermia in the extension of thr depth of cryogenic lesions]. A desirable goal in surgery for ventricular tachycardia seems to be the development of a direct technique avoiding ventriculotomy, which has well-known harmful effects on the function of the left ventricle. This study is aimed at creating deep cryolesions, reaching to the subendocardial layers, on a closed ventricle. Forty-five cryolesions were performed with extracorporeal circulation in 15 piglets, applying a nitrogen protoxide tube (8 mm, -80 degrees C) on the left ventricle for two minutes. In each animal, 3 cryolesions were created at three different myocardial temperatures: 37 degrees C, 28 degrees C and 10 degrees C. The lesions created at a myocardial temperature of 10 degrees C were significantly (p < 0.01) larger and deeper than those performed at 37 and 28 degrees C. Two cryolesions made at 10 degrees C appeared to extend through the wall. The diameter of the lesions was not as greatly influenced by myocardial temperature. Myocardial temperature very significantly increases the depth of cryolesions, thus allowing them to extend to the subendocardial myocardial layers. Thus the destruction of subendocardial ventricular arrhythmogenic targets by the epicardial application of low temperatures, while preserving the function of the left ventricle as much as possible, may be considered.