Efficacy of mononitrate retard therapy in patients with advanced congestive heart failure

To determine the efficacy of mononitrate retard therapy in congestive heart failure 54 pts (42 males and 12 females, aged 67.2 +/- 8.7 yrs.) with NYHA functional class 1-3 and left ventricular ejection fraction less than 40% were investigated. Clinical examination, exercise treadmill test (ETT), ecg holter monitoring and echocardiography (echo-2D) were performed before and after 4 weeks of therapy with Olicard 40 mg Retard. 4 weeks treatment with mononitrate improved clinical parameters. The shift to lower functional NYHA class was observed in 12 cases (p < 0.01). Number of anginal pains per week was reduced from average 3.15 to 1.55 (p < 0.01). Mononitrate therapy improved exercise tolerance during ETT. Exercise time increased from 424 +/- 168 to 568 +/- 143 sec. (p < 0.001) as well as total workload in METS (3.6 +/- 1.4 vs. 4.9 +/- 1.9, p < 0.001). The time to 0.1 mV ischemic ST segment depression was extended from 215 +/- 149 to 357 +/- 173 sec. (p < 0.01). Holter monitoring revealed moderate increase in heart rate and significant reduction of ventricular arrhythmia (p < 0.05). No changes in systolic and diastolic echo-2D parameters were observed.     

Advantage of rubber over plastic endotracheal tubes for rapid extubation in a laser fire

The occurrence of airway fires during laser airway surgery necessitates the use of special techniques to improve patient safety. For example, it is recommended that the endotracheal tube cuff be inflated with saline. However, in the event of an endotracheal tube fire, the tube must be quickly removed. This study was designed to determine the time necessary for red rubber (RR) or polyvinylchloride (PVC) endotracheal tubes to be removed from a model airway after inflating the cuffs with saline. A model larynx and trachea was suspended vertically. It was intubated with either 7.0 RR or PVC endotracheal tubes. Six milliliters of saline was used to inflate the endotracheal tube cuffs. After inflation, a clamp was used to occlude the pilot tube on the RR endotracheal tubes. A 4-lb weight was then suspended from the endotracheal tube. The time to spontaneous extubation of the model trachea after unclamping the pilot tubes on 12 RR endotracheal tubes was determined. For the PVC endotracheal tubes, the times to spontaneous extubation using the 4-lb weight were determined in 12 endotracheal tubes after cutting the pilot tube and in 12 by maximum aspiration of the saline from the endotracheal tube cuff with a 10-ml syringe. A time of 0.94 +/- 0.10 sec (mean +/- SD) was required for spontaneous extubation of the RR endotracheal tubes after unclamping the pilot tube. For the PVC endotracheal tubes, extubation occurred 3.28 +/- 1.08 and 1.81 +/- 0.60 sec after cutting the pilot tube or deflating the cuff with a syringe, respectively. The mean times for each of the 3 groups were significantly different (p < 0.05) from each other as determined by the ANOVA. This study shows that if PVC endotracheal tubes are used, deflation of the saline-filled cuff by aspiration with a 10-ml syringe is faster than cutting the pilot tube. Unclamping the pilot tube on the RR endotracheal tubes resulted in the fastest time to endotracheal extubation.     

Changes in urinary excretion of type-I collagen cross-linked C-telopeptide and N-telopeptide in perimenopausal women

PURPOSE: The overall goal was to develop a simple test of random dot stereoacuity that can be used during the first 24 months of life to measure sensory outcomes following treatment of ophthalmopediatric disorders, both in the context of clinical trials and in the context of clinical management. METHODS: A series of random dot stereoacuity test cards were constructed using vectographic vertical bar stimuli with crossed disparities ranging from 1735 to 45 sec. A two-alternative, forced-choice, preferential-looking test protocol was used to measure stereoacuity in 95 healthy term infants (173 tests) over the 1.5-to-24-month age range. Success rate, validity, and tolerance limits for normal performance as a function of age were evaluated. RESULTS: The success rate was high (158 of 173 tests; 91.3%). The maturation of random dot stereoacuity was similar to that measured in earlier lab-based preferential-looking and visual evoked potential protocols; few infants younger than 2 months of age demonstrated stereopsis although by 12 months, mean stereoacuity was 2.1 log sec (120 sec). A further improvement to 1.7 log sec (56 sec) was seen during months 18 to 24, consistent with data obtained in an earlier operant random dot protocol. Tolerance limits for normal ranged from approximately 1000 sec at 6 months to 100 sec after 12 months. CONCLUSIONS: The infant random dot stereoacuity cards provide a simple, quick, and portable preferential-looking test of random dot stereoacuity for infants that has a high success rate and excellent concordance with stereoacuity outcomes from laboratory-based protocols.     

Cytokinetic evaluation of erythropoiesis on prolonged orbital flights

The purpose of the investigation was to understand better the mechanisms of erythropoietic changes at the cellular level during a prolonged exposure to weightlessness. Following 96-, 140- and 175-day space flights cytokinetic and morphological changes in erythropoiesis were observed. The count of circulating erythrocytes decreased inflight and their life time reduced postflight. The shortening of the life time of erythrocytes postflight was paralleled by increased proliferative activity of erythroid cells. The erythrocytic balance was not reached as late as R + 36. It is recommended that the number of research methods be enlarged.     

Role of experience in acquisition and loss of tolerance to the effect of delta-9-THC on spaced responding

Albino rats were given extensive training in spaced responding, using a DRL 30 sec schedule of food reinforcement (only lever presses more than 30 sec apart were reinforced). All rats then went 12 days without behavioral testing. During this period half the rats received daily intragastric doses of delta-9-tetrahydrocannabinol (THC) and the rest equal volumes of the THC vehicle. On day 13, some rats received THC 3 hr before behavioral testing while others received only vehicle. The former showed a sharp increase in lever press rate over baseline levels, but the vehicle control rats were unaffected. The rats with 12 prior THC doses were no less affected than those with no previous drug history. Continued testing resulted in recovery of baseline performance within 5 sessions, again with no effect of previous drug history. Similar results were obtained with doses of 4 mg/kg and 16 mg/kg, though the drug's effects were more pronounced at the higher dose. These results demonstrate that performance in the drug state can be a far more important determinant of tolerance than mere exposure to THC. Drug administration was then suspended for 1 week. Rats that had become tolerant to 4 mg/kg THC were then redivided into 3 new groups. One group received daily doses of vehicle and DRL sessions, a second received DRL sessions without vehicle, and 1 group received neither vehicle nor DRL sessions for this week. Subsequent DRL testing after THC administration showed that only the groups receiving DRL sessions in the intervening week lost their previously acquired tolerance. Experience thus appears to play an important role in loss of tolerance to THC as well as in acquisition of tolerance.     

Physiological effects of solar heat load in a fighter cockpit

The use of bubble canopies to improve vision in fighter aircraft exposes the cockpit to a high radiant heat load. Incoming sunlight increases the heat stress on crewmembers, both by raising air temperature and by directly heating exposed skin and clothing. An F-15 aircraft at Edwards AFB was modified to permit cockpit ventilation by external ground carts. Eight volunteers from the Test Pilot School were studied during 1-h periods in the closed cockpit, in sun and in shade. Mean cockpit air temperatures were 35.2 degrees C in shade and 51.9 degrees C in sun with PH2O less than 10 torr. The corresponding WBGT's were 22.6 and 36.4 degrees C. Sunlight added significantly to overall heat stress, as indicated by a rising heart rate and evaporative weight loss of 284 g/m2 - h (shade value was 109 g/m2 - hr). Mean skin temperatures were 34.3 degrees C in shade and 35.8 degrees C in sun. Particularly high skin temperatures were observed on the chest, the forehead and the top of the head under the helmet. The legs remained cool due to the flow of conditioned air, and this may explain why rectal temperature showed no meaningful change. Heat stress, which alone poses no physiological hazard, may cause crew performance decrements as well as diminishing acceleration tolerance. Possible means of eliminating or ameliorating these effects are discussed.     

Primary central nervous system lymphoma in a child with acute B-cell lymphoblastic leukaemia: consecutive Epstein-Barr virus-related malignancies

OBJECTIVE: The aim of the study was to evaluate the optimization of injection rates with an automatic power injector versus manual injection for contrast-enhanced breath-hold three-dimensional (3D) MR angiography of the abdominal aorta and its branches. SUBJECTS AND METHODS: In a prospective study, 50 patients underwent breath-hold 3D MR angiography (5/2 [TR/TE]; flip angle, 30 degrees) of the abdominal vessels on a 1.5-T system. Each patient received 0.15 mmol/kg of gadopentetate dimeglumine. All patients were randomly assigned to one of five equally sized groups. The contrast bolus was injected manually in group 1, always by the same investigator, who tried to perform a steady injection rate of 2 ml/sec. An automatic injector was used in groups 2-5 with injection flow rates of 0.5 ml/sec, 2 ml/sec, 4 ml/sec, and 6 ml/sec. The start of the MR sequence was tailored individually to the applied volume of contrast material after determination of circulation times by a test bolus. We measured the signal-to-noise and contrast-to-noise ratios as well as the relative vascular enhancement. The visualization of different abdominal vessel segments was independently ranked on a scale of 1-5 (1 = not visible; 5 = excellent visualization) by three reviewers who were unaware of the applied contrast material injection rate. RESULTS: The signal-to-noise and contrast-to-noise ratios of groups 3 and 4 (2 ml/sec and 4 ml/sec, respectively) were significantly (p < .05) higher than the ratios of groups 1, 2, and 5. The average relative vascular enhancement of groups 3 and 4 was significantly higher (p < .05) than the enhancement of all other groups. The contrast bolus applied with a faster injection rate (group 5) did not cover large parts of the K-space, resulting in increased blurring of the vessel contours. The subjective evaluation of large and small diameter vessels showed significantly better results in groups 3 and 4 than in groups 1, 2, and 5. CONCLUSION: The use of an automatic MR power injector proved superior to manual injection of contrast material. The optimal injection rate was 2 ml/sec for 3D breath-hold MR angiography of the abdominal vessels.     

New nortriterpenoid isolated from anti-rheumatoid arthritic plant, Tripterygium wilfordii, modulates tumor growth and neovascularization

Noninvasive measurement of blood flow velocity through the cardiac valves has important clinical applications. A wide variety of MR methods are available for flow measurement. The aim of this study was to investigate the ability of cine MR Fourier velocimetry to measure flow through healthy cardiac valves and to compare MR and Doppler peak velocity measurements. Ten healthy volunteers (age mean +/- SD, 24 +/- 4 years) without history of valvular disease were studied. Four of the subjects were females. In each subject, aortic, pulmonary, mitral, and tricuspid valves were evaluated with MR and Doppler imaging. A whole-body mobile MR machine was used, operating at .5-T with actively shielded magnetic field gradient coils on all three axes capable of 20 mT/m at a slew rate of 60 mT/ m/msec. The heart rate during MR and Doppler studies was not significantly different. The mean difference between the two studies was 2 beats/min, with a 95% confidence interval of -22 beats/min, +25 beats/ min. Peak systolic flow velocity in the aortic and pulmonary valves and peak diastolic flow velocity in the mitral and tricuspid valves measured with MRI and Doppler echocardiography correlated well. The mean difference between the two measurements (MR-Doppler) was 63 mm/sec, with a 95% confidence interval of -180 mm/sec, +310 mm/sec. The agreement between two observers interpreting the same MR velocity maps was close. The mean difference between their two measurements was 23 mm/sec, with a 95% confidence interval of -20 mm/sec, +60 mm/sec. There was no significant difference between MR and Doppler imaging or between the two MR observers. MR Fourier velocimetry has the necessary ease, reliability, and speed to measure blood flow through the cardiac valves, although measurement of late diastolic flow in the atrioventricular valves is limited. Measurement of peak blood velocity through the cardiac valves by this method showed satisfactory agreement with Doppler, but its clinical application for assessing diseased cardiac valves must be established.     

Carrier-mediated entry of 4-methylumbelliferyl sulfate: characterization by the multiple-indicator dilution technique in perfused rat liver

The hepatocellular entry of 4-methylumbelliferyl sulfate (4MUS) a highly ionized and highly bound anion capable of futile cycling, was examined in the single-pass albumin-free perfused rat liver preparation. Desulfation of 4MUS to 4-methylumbelliferone (4MU) was verified in vitro to be a low-affinity, high-capacity process (Km = 731 micromol/L; Vmax = 414 nmol min(-1) g(-1) liver). With 4MUS given to the perfused rat liver, sulfation of 4MU, the formed metabolite, was attenuated in the presence of 2,6-dichloro-4-nitrophenol (DCNP), a sulfation inhibitor, and when sulfate ion was substituted by chloride ion. 4MU sulfation, being a high-affinity system, was reduced most effectively at the lowest 4MUS concentration (15 micromol/L) used, evidenced by the increased (24%) net hepatic extraction ratio of 4MUS and reduced utilization (72%) of infused tracer 35SO4(2-) by 4MU for 4MU35S formation. Single-pass multiple indicator dilution (MID) studies were thus conducted under identical conditions (DCNP and absence of inorganic sulfate), with injection of [3H]4MUS and a set of noneliminated vascular and cellular reference indicators into the portal vein (prograde) or hepatic vein (retrograde), against varying background bulk concentrations of 4MUS (5 to 900 micromol/L). The steady-state removal rate of 4MUS and formation rates of 4MU and its glucuronide conjugate (4MUG) were not altered with perfusion flow direction, suggesting the presence of even or parallel distributions of 4MUS desulfation and 4MU glucuronidation activities. When the outflow dilution profile of [3H]4MUS was evaluated with the barrier-limited model of Goresky, a slight red cell carriage effect was found for 4MUS. The permeability surface area product for cellular entry for prograde showed a dramatic concentration-dependent decrease (from 0.13 to 0.01 mL sec(-1) g(-1), or 7.4 to 0.56 times the blood perfusate flow rate) and was resolved as saturable and nonsaturable components, while data for retrograde were more scattered, varying from 2.8 to 1 times the blood perfusate flow rate. Efflux (coefficient = 0.0096 +/- 0.0024 and 0.0088 +/- 0.0062 mL sec(-1) g(-1), respectively) was relatively insensitive to concentration and flow direction. The same was observed for the removal capacity for metabolism and excretion (sequestration coefficient: for prograde, 0.0056 +/- 0.0017 mL sec(-1) g(-1); for retrograde, 0.0056 +/- 0.003 mL sec(-1) g(-1)). The decrease in the apparent partition coefficient (ratio of 4MUS concentration estimated in tissue to unbound plasma concentration) and the increase in relative throughput component with concentration further substantiate the claim on the presence of concentrative processes at the sinusoidal membrane.     

Glucose induces glucose 6-phosphatase hydrolytic subunit gene transcription in an insulinoma cell line (INS-1)

OBJECTIVE: The goal of our study was to determine the effect of contrast material injection rate and patient demographic variables on vascular enhancement for abdominal CT angiography and compare test injection results with actual patterns of vascular enhancement. SUBJECTS AND METHODS: One hundred twenty-five patients underwent abdominal CT angiography. For each patient, CT attenuation values (Hounsfield units) of the aorta were determined before and after IV contrast administration, every 3 sec between 21 and 60 sec. A peak aortic enhancement value and the time needed to reach peak and aortic enhancement thresholds of 150 and 200 H were determined. All patients received 150 ml of nonionic contrast material at 3 ml/sec in 25 patients and 4 ml/sec in 100 patients. A test injection of 15 ml was used to compute a scan delay in 46 patients. Patient age, sex, weight, injection rate, and test injection results were compared with vascular enhancement patterns. RESULTS: For the 125 patients, the mean aortic enhancement at each time point was greater than 150 H. Patient weight was inversely correlated (r2 = -.62) with aortic enhancement. The test injection did not accurately predict actual aortic enhancement peak value or time. Test injection delay time was significantly correlated with time to reach aortic enhancement thresholds of 150 and 200 H. The 4 ml/sec rate resulted in a higher peak aortic enhancement (320+/-58 H versus 281+/-49 H) (mean +/- SD, p < .01) that was reached quicker than with the 3 ml/sec injection rate (45+/-5 sec versus 52+/-5 sec) (p < .01). Injecting at 4 ml/sec resulted in greater aortic enhancement values at 24-45 sec, whereas 3 ml/sec produced significantly better aortic enhancement at 54-60 sec. CONCLUSION: The test injection correlated better with time to reach specific aortic enhancement thresholds than with time to peak aortic enhancement. For a given amount of contrast material, faster injection rates resulted in greater vascular enhancement that occurred earlier.     

Hereditary nephritis and the heart

Twelve women (23-34 yr), comprising a bed-rest (BR) group of eight subjects and an ambulatory (AMB) group of four subjects, were centrifuged after 14 days of ambulatory control (C),after 15 days of a 17-day BR period, and on the third day of recovery (R). Venous blood was taken before and after the third +3.0 G acceleration run (1.8 G/min). Relative to (C), the +Gz tolerance after BR was reduced -49.0% (P less than 0.05) in the BR group and -38.7% (NS) in the AMB group; during (R) the BR group regained up to 89.4% and the AMB group up to 87.1% of their (C) tolerances. In each of the three test periods, the shifts in plasma Na, Cl, PO4, and osmotic contents, which accompanied +Gz, followed the outward shift of plasma volume (PV). The correlation of the shift of PV during acceleration with the +Gz tolerance was 0.72 (P less than 0.01). During acceleration, the PV and electrolyte loss for both groups after BR was about half the loss of (C) and (R). Compared with (C) and (R) values, potassium shifts were variable but the mean corpuscular volume and mean corpuscular Hb contents and concentrations were unchanged during all +Gz runs; The results indicate that: 1) the higher the (C) + Gz tolerance, the greater the tolerance decline due to BR; 2) relative confinement and reduced activity contribute as much to the reduction in tolerance as does the horizontal body position during BR; 3) bed-rest deconditioning has no effect on the erythrocyte volume during +3.0 Gz; and 4) about one-half the loss in tolerance after BR can be attributed to PV and electrolyte shifts.     

Characterization of propagating contractions in proximal colon of ambulatory mini pigs

The aim of this study was to characterize propagating contractions in the unprepared colon of freely ambulating mini pigs. A telemetric method was used to record colonic motility continuously for six consecutive days in a 40-cm segment of proximal colon. Propagating contractions occurred over a wide range of propagation rates (0.4-16.7 cm/sec), peak amplitudes (10-116 mm Hg) and pressure wave durations (5.3-40.0 sec). Propagating contractions were divided into two groups by duration and wave-form: short-duration symmetrical and long-duration asymmetrical. Short-duration (7.8 +/- 0.9 sec) symmetrical wave-from propagating contractions exhibited a higher frequency (27.9 +/- 2.6 events/day), more rapid propagation rate (3-16.7 cm/sec; mean +/- SEM: 4.9 +/- 1.7 cm/sec), and a lower peak amplitude (31.2 +/- 0.9 mm Hg) compared to long-duration (19.2 +/- 5.1 sec) asymmetrical propagating contractions, which were less frequent (6.1 +/- 0.7 events/day), slower in propagation rate (0.4-2 cm/sec; mean +/- SEM: 1.5 +/- 0.7 cm/sec), and higher in peak amplitude (51.6 +/- 2.4 mm Hg). The results show that propagating contractions occur over a wide spectrum, from short-duration, low-amplitude, rapidly propagating contractions to long-duration, high-amplitude, slowly propagating contractions.     

Differences in caries recording with and without bitewing radiographs. A study on 5-year old children in the County of Bohusl?n, Sweden

OBJECTIVE: To evaluate the cerebral blood flow parameters assessed by transcranial Doppler during aortic cross-clamping and unclamping in patients undergoing abdominal aortic aneurysmectomy. METHODS: Invasive intraoperative monitoring of mean arterial pressure (MAP) and PaCO2, and right middle cerebral artery (RMCA) monitoring of blood flow parameters (mean velocity "Vm" and pulsatility index "PI") by transcranial Doppler were performed as well as evaluation of the four parameters during these subsequent periods: pre-cross-clamping, pre-unclamping, unclamping and 1-5-10-20 minutes after abdominal aortic unclamping. RESULTS: No significative changes of MAP, PaCO2, Vm and PI were noticed during the aortic cross-clamping period (77.5 +/- 18.5 SD minutes). During aortic unclamping Vm and MAP decreased (64 +/- 20 vs 52 +/- 20 cm/sec, p < 0.05, and 101 +/- 8 vs 80 +/- 15 mmHg, p < 0.01, respectively). At the 1th post-unclamping minute there was an increase from pre-unclamping values of Vm (75 +/- 20 cm/sec, p < 0.05) and PaCO2 (42 +/- 1.5 vs 36 +/- 2 mmHg, p < 0.05), with persistent reduction of MAP (92 +/- mmHg, p < 0.05), even more evident at the 5th post-unclamping minute (Vm = 93 +/- 25 cm/sec; PaCO2 = 46 +/- 1.2 mmHg, p < 0.001, and MAP returned to pre-unclamping value), in which there was also a decrease of PI (0.65 +/- 0.16 vs 0.78 +/- 0.2, p < 0.05). At the 10th minute Vm (83 +/- 24 cm/sec, p < 0.02) and PaCO2 (41 +/- 1.5 mmHg, p < 0.05) increments were present together with persistent reduction of PI (0.69 +/- 0.17, p < 0.05), while at the 20th post-unclamping minute also Vm, PaCO2 and PI returned to their pre-unclamping values. CONCLUSIONS: The Vm decrease at aortic unclamping might correlate with the acute changes in MAP (blood steal hypovolemia) and is likely due to an inadequate cerebral autoregulatory response to abrupt MAP changes. The arterial CO2 increase after aortic unclamping could lead to a dilation of cerebral arterioles and a rise of CBF (increase of Vm and decrease of PI). Transcranial Doppler is a simple and reliable technique for the monitoring of cerebral blood flow parameters and seems to be quite suitable for the recognition and the quantification of changes in these parameters induced by surgical manoeuvres able to produce hemodynamic instability.     

Safety, tolerance, and pharmacokinetics of a small unilamellar liposomal formulation of amphotericin B (AmBisome) in neutropenic patients

The safety, tolerance, and pharmacokinetics of a small unilamellar liposomal formulation of amphotericin B (AmBisome) administered for empirical antifungal therapy were evaluated for 36 persistently febrile neutropenic adults receiving cancer chemotherapy and bone marrow transplantation. The protocol was an open-label, sequential-dose-escalation, multidose pharmacokinetic study which enrolled a total of 8 to 12 patients in each of the four dosage cohorts. Each cohort received daily doses of either 1.0, 2.5, 5.0, or 7.5 mg of amphotericin B in the form of AmBisome/kg of body weight. The study population consisted of patients between the ages of 13 and 80 years with neutropenia (absolute neutrophil count, <500/mm3) who were eligible to receive empirical antifungal therapy. Patients were monitored for safety and tolerance by frequent laboratory examinations and the monitoring of infusion-related reactions. Efficacy was assessed by monitoring for the development of invasive fungal infection. The pharmacokinetic parameters of AmBisome were measured as those of amphotericin B by high-performance liquid chromatography. Noncompartmental methods were used to calculate pharmacokinetic parameters. AmBisome administered as a 1-h infusion in this population was well tolerated and was seldom associated with infusion-related toxicity. Infusion-related side effects occurred in 15 (5%) of all 331 infusions, and only two patients (5%) required premedication. Serum creatinine, potassium, and magnesium levels were not significantly changed from baseline in any of the dosage cohorts, and there was no net increase in serum transaminase levels. AmBisome followed a nonlinear dosage relationship that was consistent with reticuloendothelial uptake and redistribution. There were no breakthrough fungal infections during empirical therapy with AmBisome. AmBisome administered to febrile neutropenic patients in this study was well tolerated, was seldom associated with infusion-related toxicity, was characterized by nonlinear saturation kinetics, and was effective in preventing breakthrough fungal infections.     

Spatial dynamics of GFP-tagged proteins investigated by local fluorescence enhancement

We describe a method of monitoring the spatial dynamics of proteins in intact cells by locally enhancing the blue excited fluorescence of green fluorescent protein (GFP) using a spatially focused ultraviolet-laser pulse. GFP fusion proteins were efficiently expressed by micro-electroporation of in vitro synthesized mRNA into adherent mammalian cells. We found that the diffusion coefficient of cycle 3 mutant GFP was 43 microns2/sec, compared to 4 microns2/sec for wild-type GFP, suggesting that cycle 3 GFP diffuses freely in mammalian cells and is ideally suited as a fusion tag. The local fluorescence enhancement method was used to study the membrane dissociation rate of GFP-tagged K-ras, a small GTP binding protein that localizes to plasma membranes by a farnesyl lipid group and a polybasic region. Our data suggest that K-ras exists in a dynamic equilibrium and rapidly switches between a plasma membrane bound form and a cytosolic form with a plasma membrane dissociation time constant of 1.5 sec.     

Electrodermal and plethysmographic OR components: Repetition of and change from USC-CS trials with surrogate UCS.

For 40 undergraduates a tone and a light were repeatedly paired (P) in the same order (e.g., tone-light) for 15 trials, after which the 2nd member of the pair (e.g., light) was presented alone as the change trial. For another 40 Ss the repetition consisted of 15 single (S) tone (or light) presentations followed by the light (or tone) as the change trial. The duration of both stimuli was .3 sec., the interstimulus interval (on P trials) was .75 sec., and the mean ITI approximated 45 sec. The GSR and digital-blood-volume-pulse change (VPC) were recorded. The GSR habituated reliable and at the same rate to both repeated patterns over Trials 1-15, but the VPC did not habituate to either pattern. Change from both S and P repetition produced response increases, but the increase under the P condition was not so pronounced as to inspire confidence in explanations of UCS-CS conditioning in terms of orienting reaction reinstatement to change. (French summary) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Human endothelial cells do not exert heparin like accelerating effects on thrombin-antithrombin-complex formation

In the present study the formation of thrombin-antithrombin-complexes (TAT) during incubation of thrombin (0.89, 4.5, 8.9 nmol/l) and antithrombin (4.6 micromol/l) on the surface of cultured human EC, derived from different parts of the circulation, and on the surface of human vessel segments was studied. In the absence of EC TAT increased over time reaching a maximum at 60 sec; 10 sec (8.9 nmol/l thrombin): 6.35+/-0.72 nmol/l, 60 sec: 10.49+/-1.04 nmol/l. In the presence of exogenous heparin (0.1 IU/ml) maximum TAT levels were already reached after 10 sec (10.75+/-0.97); cultured EC and EC on vessel segments did not show such heparin effects. Incubation of EC with heparin resulted in an EC-surface localized heparin activity only when very high doses (3.0 IU/ml) of the drug were used. When thrombin was incubated on the EC surface in the presence of AT the efficiency of the thrombomodulin(TM)-protein C(PC)-system was markedly reduced, while in the presence of exogenous heparin (0.5 IU/l) the activity of this pathway was nearly abolished. Our results demonstrate that 1) human EC do not exert heparin-like accelerating effects on TAT formation, 2) an EC localized heparin activity is only generated when EC are incubated with amounts clearly exceeding therapeutical doses, and 3) an acceleration of TAT formation at the EC surface by heparin causes a switching off of the TM-PC-system.     

Can endothelial function be assessed in vivo by measuring acetylcholine induced changes in nitrate in the forearm in man?

A 26-yr-old AC-130 gunner developed unilateral temporomandibular joint (TMJ) pain while flying a combat support mission. A diagnosis of decompression sickness (DCS) was made based on his symptoms and risk factors that included prolonged exposure to high altitude (60 to 90 min at 18,000 ft), cold temperature (-11 degrees C), and increased inflight activity. His symptoms resolved with 100% oxygen and he was returned to flying status after 72 h. Altitude related DCS is an unusual occurrence and this is the first reported case of inflight DCS affecting the temporomandibular joint.     

Paradoxical improvement of residual vision following corpus callosotomy in brain damaged cats

The current study was designed to evaluate tubing sets with either polymeric phospholipids or ionically bound heparin in six bovine experiments (body weight, 70 +/- 5 kg). No heparin was given systemically. Left heart bypass was started with 300 ml of clear priming solution and maintained over 6 hours (50 ml/kg/min). Coagulation studies included platelet counts, activated coagulation time (ACT), thrombin time (TT), fibrinogen (Factor I), antithrombin III (AT III), and fibrinopeptide A (FPA). Normalized platelet levels dropped from 100 +/- 12% before to 86 +/- 13% after 6 hours of left heart bypass for heparin, compared with 100 +/- 46% to 90 +/- 44% for phospholipid coating (NS). The ACT increased from 146 +/- 7 sec at 10 min to 159 +/- 16 sec after 6 hours for heparin, compared with 122 +/- 4 to 126 +/- 5 sec for phospholipid (p < 0.05). Thrombin time changed from 18 +/- 0 sec before to 19 +/- 1 sec after 6 hours for heparin, as compared with 16 +/- 1 sec to 18 +/- 1 sec for phospholipid (NS). Factor I levels decreased from 1.5 +/- 0.3 g/L to 1.3 +/- 0.1 g/L for heparin, compared with 1.5 +/- 0.2 g/L to 1.4 +/- 0.3 g/L for phospholipid. Antithrombin III levels changed from 102 +/- 26% to 91 +/- 7% for heparin, compared with 123 +/- 12% to 118 +/- 12% for phospholipid. Fibrinopeptide A levels changed from 100 +/- 60% to 130 +/- 13% for heparin, compared with 100 +/- 11% to 99 +/- 6% for phospholipid (P < 0.05). No macroscopic red clots were found in either group.(ABSTRACT TRUNCATED AT 250 WORDS)     

Intraoperative monitoring of facial nerve antidromic potentials during acoustic neuroma surgery

The present paper presents monopolar recording of facial nerve antidromic potentials as an alternative technique to facial electromyography for the continuous monitoring of the facial nerve during acoustic neuroma surgery. The investigation involved 22 patients undergoing acoustic neuroma surgery via a retrosigmoid approach (tumour sizes ranging from 5 to 28 mm). Bipolar electrical stimulation of the marginalis mandibulae was performed to elicit facial nerve antidromic potentials. Stimulus intensity ranged from 2 to 6 mA with a delivery rate of 7/sec. A silver wire monopolar electrode positioned intracranially on the proximal portion of the acoustic facial bundle was used to record antidromic potentials. To define the specific origin of the action potentials and acquire normative data, monopolar and bipolar recordings of facial nerve antidromic potentials were performed in 15 subjects undergoing retrosigmoid vestibular neurectomy for Meniere's disease. The average facial nerve antidromic potential latency was 4.2 (+/- 0.6) msec in subjects with acoustic neuroma and 3.3 (+/- 0.2) msec in subjects with Meniere's disease. Facial nerve antidromic potentials furnished near real-time information about intraoperative facial nerve damage and postoperative facial nerve function during acoustic neuroma surgery. Facial nerve antidromic potentials may provide additional information to conventional EMG. They allow the use of endplate blockers, yield quantitative estimation of facial nerve conduction properties in terms of amplitude and latency, and allow actual continuous monitoring of the facial nerve.