Report of nine cases of accidental injury to man with Freund's complete adjuvant

Nine cases of accidental injury with Freund's complete adjuvant to man are reported. One case is reported in detail and the other eight have been seen and reviewed retrospectively. Reactions developed in Mantoux positive individuals, who injected Freund's complete adjuvant with another protein. However, not all such injections produced the reaction. Treatment was unsuccessful, although one reaction may have been aborted by early surgical excision of the site of injection.     

Gender differences in N-alkyl protoporphyrin IX production in rats after the administration of porphyrinogenic xenobiotics

OBJECTIVE: To study the effect of an educational intervention on the management of hospitalized infants with bronchiolitis. DESIGN: Sequential, prospective cohort study. SETTING: A 235-bed children's hospital with nearly all private rooms. PATIENTS: Consecutively admitted, previously healthy children younger than 24 months with symptoms of bronchiolitis. The first cohort was enrolled between January 1 and January 21, 1996; the second cohort between January 29 and February 18, 1996, following a 1-week intervention period; the third (follow-up) cohort between December 1996 and February 1997. INTERVENTION: Educational program and practice guidelines aimed at appropriate utilization of diagnostic tests, decreased antibiotic and bronchodilator use, increased compliance with isolation, decreased length of stay, and maintenance of quality care. MAIN OUTCOME MEASURES: Utilization of respiratory syncytial virus (RSV) enzyme immunoassay, initiation and duration of parenteral antibiotic therapy, number of nebulized bronchodilator treatments, isolation orders, length of stay, and readmission rate. RESULTS: A total of 90 patients were studied preintervention, 63 postintervention, and 90 during the follow-up period. The groups were comparable in demographic and clinical features. No patient had a documented serious bacterial infection; however, almost half in each group received parenteral antibiotics, despite recommendations against this. Immediately postintervention, children with positive RSV test results received antibiotics on fewer days than other children (median 0.6 vs 2.4 days; P=.004), suggesting that physicians stopped treatment with antibiotics once a viral diagnosis was confirmed. This effect did not persist into the follow-up period. Viral testing was reduced and isolation orders increased. Use of bronchodilators was reduced from 91% preintervention to 80% during the follow-up period (P=.046), and the median number of treatments was reduced from 15.0 to 10.0 (P=.005). There was no change in length of stay, which was 2 to 3 days, or in readmission rate, which was 1% to 4%. CONCLUSION: Educational efforts centered around practice guidelines can improve some aspects of the treatment of patients hospitalized with bronchiolitis.     

Sexual behavior and alpha-2 adrenoreceptors in the neocortex of male rats after castration and testosterone administration

Castration of male rats inhibited their sexual behaviour and increased the density of the alpha-2 adrenergic receptors in the brain cortex. Treatment of castrated or intact males with testosterone activated their sexual behaviour and decreased the receptor density in the brain cortex. The obtained evidence testify to the involvement of the brain alpha-2 adrenergic receptors in the effect of testosterone on male sexual behaviour.     

Successful administration of cytarabine after a previous anaphylactic reaction

Cytarabine (Cyt) is an antimetabolite used primarily in the treatment of leukemia, and both immediate and delayed hypersensitivity reactions have been reported. We studied a 9-year-old girl with lymphoblastic leukemia, who developed three anaphylactoid reactions during Cyt treatment courses over a 1-year period. Three years later, Cyt was required again. Although a skin test was negative to Cyt at the concentration of 4 micrograms/ml, we decided on placebo-controlled administration of the drug. The Cyt was well tolerated, and urine values of N-methylhistamine showed no important variations throughout this period compared to those during the placebo administration. Skin tests carried out 14 days after the study were positive at the concentration of 4 micrograms/ml. The history of different episodes of allergic reactions to Cyt, the last one being the most severe, indicated the possible participation of an immediate hypersensitivity phenomenon, but because no studies had been carried out initially, we could not establish the presence of IgE antibodies. These results indicate that good tolerance existed after the control administration procedure. The long interval, 3 years, between the allergic episode and our protocol and the appearance of a positive skin test 14 days after the protocol indicated that the subject had lost sensitivity and become resensitized after the controlled administration procedure.     

Sex and strain differences of acoustic startle reaction development in adolescent albino Wistar and hooded rats

Acoustic startle responses (ASR) were studied in 12 young Wistar albino and in 15 hooded rats of both genders. The six week old animals were first exposed to a 6.9 kHz tone pair of 2 ms pulses of 120 db intensity with the inter-stimulus interval (ISI) between 2 and 11 ms. ASR amplitudes and latencies as a function of the ISI, animal strain and gender were recorded and analyzed for ten consecutive weeks. No differences in the ASR amplitude between Wistar and hooded rats were found. ASR amplitude increased during the experimental period and followed body weight increase. Significant differences were also observed between male and female rats in their startle responses to acoustic stimuli. Generally, male subjects responded with a greater ASR amplitude than females, and the changes may be attributed to the difference in neuromuscular development between genders. This experiment sets a background for further developmental studies.     

Effect of mu-opioids morphine and buprenorphine on the development of adjuvant arthritis in rats

OBJECTIVE AND DESIGN: On the basis that endogenous opioids play a role in the physiological response to inflammation, this study tests the anti-arthritic effects of a mu-opioid agonist, morphine and the partial mu-agonist, buprenorphine. MATERIAL: Male Lewis rats were used. TREATMENT: Rats were inoculated subcutaneously with 0.05 ml of Freund's complete adjuvant (5 mg/ml) into the right hind paw to produce adjuvant arthritis. Morphine (either 10 to 60 mg/kg/day s.c. bolus or 60 mg/kg/day s.c. infusion) and buprenorphine (0.65 +/- 0.06 mg/kg/day, orally), respectively, were administered for 3 days during the primary inflammatory phase of adjuvant arthritis. METHODS: The progression of adjuvant arthritis was monitored every three days by body weight change and hind limb oedema (ipsilateral and contralateral). On day 21 the animals were sacrificed and histology and radiography of the contralateral limb were performed. In rats receiving Freund's adjuvant and no drug treatment, the incidence of arthritis was 89%. Effect was expressed as the pooled severity index (PSI) derived from the arithmetic average of the volume, histology and radiography scores in the contralateral hind limb. RESULTS: Buprenorphine had no effect on experimental arthritis (PSI control vs treated: 242 +/- 28 vs 253 +/- 28%). In contrast, morphine by subcutaneous injection twice daily (10 to 60 mg/kg/day) but not by subcutaneous infusion (60 mg/kg/day) was found to attenuate the progression of adjuvant arthritis in a dose-dependent manner. This indicates that the anti-arthritic effects of morphine are opioid receptor mediated (ED50, 58 +/- 9 mg/kg) and suggests that the local concentration reached effective levels only after subcutaneous injection. It is also possible that the high doses of morphine were anti-inflammatory through effects at the kappa receptor. However, these high doses of morphine produced death in one third of the rats, the calculated lethal dose (LD50, 63 +/- 2 mg/kg) being close to the effective dose. CONCLUSION: Anti-arthritic effects of morphine are opioid receptor mediated but morphine use for this indication is restricted by its adverse effects.     

Kinetics of the acute-phase reaction in rats after tumor transplantation

Transplantation of Yoshida sarcoma (solid type) and Zajdela ascites hepatoma tumors in rats induces a biphasic change in the concentration of the following five acute-phase proteins: alpha-1-acid glycoprotein; alpha-1-antitrypsin; haptoglobin; hemopexin; and ceruloplasmin. These proteins and other plasma proteins were quantitated by two-dimensional immunoelectrophoresis relative to normal serum concentrations. The elevation of most of these acute-phase proteins was greater in the second phase, during which serum levels increased continuously as the tumor burden increased until the animals died. The increase in haptoglobin concentration during the second phase was much higher in rats bearing Yoshida sarcoma than in rats bearing Zajdela tumors. Rats receiving irradiated tumor cells showed neither tumor growth nor second-phase protein changes. Significant increases in uptake of 3H-amino acids by isolated perfused livers of tumor-bearing rats provided evidence for an increase in the hepatic synthesis rates of the acute-phase proteins. Removal of the solid tumor resulted in a gradual decrease of acute-phase protein concentrations with concomitant increase in serum albumin concentration. These alterations in serum acute-phase proteins during tumor growth and after removal of the tumor may make their use attractive as biological markers of the response of the tumor-bearing animal to its tumor.     

Structural changes in the tissues of white rats after capsaicin administration

Attitudes to health and illness may differ between rural and urban dwellers. Issues that may relate to the provision of health services to rural dwellers are raised for consideration. The response of urban dwellers to illness or disability has often been linked to discomfort caused by pain or cosmetic attractiveness, while for rural dwellers the response to illness or disability is often related to the degree to which the illness or disability affects productivity. Often the rural resident will postpone seeking medical or associated services until it is economically or socially convenient. The notion of exposing their private lives to strangers or acquaintances from the local based services or to undertake the journey to distant services where the cultural or behavioural differences could be misunderstood, may impact on rural dwellers' well-being. Health service providers in rural areas need to understand such differences and difficulties when offering services.     

Systemic distribution of talc after intrapleural administration in rats

BMS-200475 was recently shown to have potent antiviral activity against hepatitis B virus (50% effective concentration = 3.7 nM; 50% cytotoxic concentration = 30 microM). In metabolic studies in both HepG2 and hepatitis B virus-transfected 2.2.15 human hepatoma cell lines, the metabolism was similar, the primary products being the di- and triphosphates. The accumulation of triphosphate was rapid and detectable down to a 5 nM concentration of added drug. When cells were labeled at 25 microM, the intracellular triphosphate concentration attained 30 pmol/10(6) cells ( approximately 30 microM). The intracellular half-life of the triphosphate was about 15 h. Compared with five other nucleoside analogs of medical interest (lamivudine, penciclovir, ganciclovir, acyclovir, and lobucavir), BMS-200475 was most efficiently phosphorylated to the triphosphate in HepG2 cells.     

Suppression of adjuvant arthritis by kappa-opioid receptor agonist: effect of route of administration and strain differences

It is well established that kappa-opioid receptor agonists exert antiinflammatory and antihyperalgesic effects during nonspecific inflammation as well as suppressive effects on the development of humoral and cell-mediated immune responses to foreign antigens. The aim of this study was to investigate the ability of the kappa-opioid receptor agonist MR 2034 to modulate adjuvant arthritis in the rat. In the first series of experiments, treatments of Wistar rats were performed using several routes of drug administration: intraperitoneal (ip), intracaudal (ic), intracerebroventricular (icv) and intraplantar (ipl). MR 2034 significantly suppressed joint swelling after ip and ic treatment, slightly reduced inflammation after ipl treatment, and did not produce any effect after icv treatment. In the second series of experiments, the suppressive effect of ip injected MR 2034 was investigated using Wistar, Dark August (DA) and Lewis rats. In Wistar rats, MR 2034 significantly decreased the incidence of adjuvant arthritis, and suppressed mean joint score and aggregate joint score. Similarly, in DA rats treated with MR 2034, mean arthritic score was significantly suppressed, but other clinical parameters were not affected. In Lewis rats, however, ip treatment with MR 2034 failed to produce any suppressive effect on joint disease and even potentiated the initial development of arthritis. These data suggest that immunosuppressive and antiinflammatory action of MR 2034 markedly depend on the route of drug administration and strain susceptibility to opioids.     

Intraperitoneal hyperthermic treatment of implanted peritoneal cancer in rats

The feasibility and efficacy of treating peritoneal cancer implants by applying heat to the peritoneal surfaces were studied in inbred Buffalo A rats given i.p. injections of Morris hepatoma 5123TC tumor cells. Heat was delivered to the peritoneum by contact with a heated physiological salt solution (Normosol-R) in the peritoneal cavity. A treatment temperature of 43.3 +/- 0.3 degrees was maintained for 30 min by an immersed stainless steel coil through which hot liquid circulated. Rats implanted with 0.5 to 1.0 x 10(8) tumor cells were treated at 1 to 4 hr (Group I), 4 to 5 days (Group II), and 22 to 24 days (Group III) after tumor implantation to simulate treatment for the clinical conditions of surgically spilled cancer cells, established microscopic cancer implants, and macroscopic cancer implants, respectively. A statistically significant improvement in survival was observed in Groups I and II compared with sham-treated control animals; 58% of the heat-treated animals were cured. Only a slight but statistically insignificant improvement was noted in Group III. These observations indicate that i.p. surface heat treatment of peritoneal implanted cancer is feasible and effective.     

Comparison of Freund's adjuvant and TiterMax in inducing anti-idiotype to idiotypic antibodies against pseudorabies virus antigens

Freund's adjuvant (FA) and TiterMax (TM) were compared for their effectiveness in the induction of the anti-idiotypic antibodies (anti-Id or Ab2) in pigs, goats and mice against swine polyclonal anti-pseudorabies virus (PRV) antibodies (Ab1) by sequential immunization procedures. Both adjuvants had similar effects on inducing anti-swine immunoglobulin antibodies in the animals. However, high levels of the anti-Id were only generated in animals that received FA. Serological characterization of the anti-Id antisera indicated that internal image anti-Id (Ab2 beta) was generated that recognized shared idiotype (IdX) on the antibodies to PRV. The internal image Ab2 was capable of blocking the anti-PRV antibodies from binding to the PRV antigens, and their interaction with anti-PRV antibodies could be inhibited by PRV antigens.     

Ultrastructure of B-cells of Langerhans islets in rats after the administration of L-leucine

Six women aged 31 to 70 years had folate deficiency and neuropsychiatric disorders. The three with acquired folate deficiency were depressed and had permanent muscular and intellectual fatigue, mild symptoms of restless legs, depressed ankle jerks, diminution of vibration sensation in the legs, stocking-type hypoesthesia and long-lasting constipation; D-xylos absorption was abnormal. The bone marrow was megaloblastic in only one patient, and she and one other had atrophy of the jejunal mucosa. The third was a vegan. All three recovered after folic acid therapy. The other three were members of a family with the restless legs syndrome, fatigability and diffuse muscular pain. One also had subacute combined degeneration of the spinal cord and kidney disease but no megaloblastosis; she improved spectacularly after receiving large daily doses of folic acid. The other two also had minor neurologic signs, controlled with 5 to 10 mg of folic acid daily. Unrecognized and treatable folate deficiency (with low serum folic acid values but normal erythrocyte folate values) may be the basis of a well defined syndrome of neurologic, psychiatric and gastroenterologic disorders, and the restless legs syndrome may represent the main clinical expression of acquired and familial (or inborn) folate deficiency in adults.     

Effects of cortisol administration on development of the thyroid and adrenal axes in rats

Intraperitoneal (IP) injections of cortisol were administered to neonatal male rats on postnatal days 1 to 4. Plasma triiodothyronine (T3), thyroxine (T4) and corticosteroids were determined on days 5, 10, 13, 16, 20, 30 and 60 of age, and all animals were weighed weekly. Neonatal cortisol treatment resulted in depressed body weight gain and transient depression in plasma T4. These results indicate that while body weight is significantly affected by cortisol treatment ontogenic patterns of plasma T3, T4 and corticosteroids develop normally.     

Life-threatening anaphylactoid reaction after intravenous gadoteridol administration in a patient who had previously received gadopentetate dimeglumine

We report a case of a life-threatening anaphylactoid reaction to gadoteridol. The reaction resulted in hospitalization but did respond to medical treatment. Resuscitation equipment and properly trained personnel should be available if these agents are being administered.     

Role of renal gluconeogenesis in the maintenance of glycaemia after L-tryptophan administration to rats

The time-course of liver and kidney gluconeogenesis after L-tryptophan administration has been studied. Two and half hours after injection of L-tryptophan (0.5 g/kg body wt) a 97% inhibition of hepatic gluconeogenesis in starved rats was observed. Twelve hours later, the inhibition remained 35%. Hepatic glycogen was almost completely depleted (97%) in fed rats after 5 hours. At this time there was a severe hypoglycaemia in fed and 48 h starved rats which gradually disappeared with time, the values going back to normal after 12 hours. Tryptophan treatment was associated with a significant increase in renal gluconeogenesis in fed and 48 h starved rats with a maximum at 5 h (165% and 190% respectively). When hepatic gluconeogenesis was constantly inhibited in fed rats by periodic injection (every 4 h) of L-tryptophan, renal gluconeogenic ability remained increased throughout the experiment while blood glucose concentrations did not change. These observations suggest that kidney contributes to maintain glycaemic homeostasis under these conditions of liver gluconeogenesis impairment.