The conservative treatment of major kidney injuries

The choice of treatment (surgical or conservative) for major renal trauma still remains controversial. The objective of this study was to compare the results of patients with major renal trauma (grade III and IV) primarily treated by surgical intervention (1980-1992) with those in patients mainly treated conservatively (1992-1995). Between 1980 and 1995, 83 patients with major renal trauma were hospitalized at our institution. Our results show a higher nephrectomy rate of 44% in the case of primary surgical intervention compared to conservative management (27%). The outcome of twenty-two patients treated conservatively was analyzed prospectively with repeated radiological imaging, blood pressure profiles, and renal function assessment by means of MAG 3 renal scintigraphy. No patient developed renovascular hypertension and the relative function of the traumatized kidney was greater than 40% in 95% of patients. In conclusion, our results confirm a lower nephrectomy rate in the case of conservative management without any increase of the immediate or long-term morbidity. Major renal trauma (grade III, IV) can therefore be effectively treated by conservative management and primary surgical repair is only indicated in patients with hemodynamic instability, persistent hematuria and associated visceral injuries.     

Chemosensory and photosensory perception in purple photosynthetic bacteria utilize common signal transduction components

The chemotaxis gene cluster from the photosynthetic bacterium Rhodospirillum centenum contains five open reading frames (ORFs) that have significant sequence homology to chemotaxis genes from other bacteria. To elucidate the functions of each ORF, we have made various mutations in the gene cluster and analyzed their phenotypic defects. Deletion of the entire che operon (delta che), as well as nonpolar disruptions of cheAY, cheW, and cheR, resulted in a smooth-swimming phenotype, whereas disruption of cheB resulted in a locked tumbly phenotype. Each of these mutants was defective in chemotactic response. Interestingly, disruption of cheY resulted in a slight increase in the frequency of tumbling/reversal with no obvious defects in chemotactic response. In contrast to observations with Escherichia coli and several other bacteria, we found that all of the che mutant cells were capable of differentiating into hyperflagellated swarmer cells when plated on a solid agar surface. When viewed microscopically, the smooth-swimming che mutants exhibited active surface motility but were unable to respond to a step-down in light intensity. Both positive and negative phototactic responses were abolished in all che mutants, including the cheY mutant. These results indicate that eubacterial photosensory perception is mediated by light-generated signals that are transmitted through the chemotaxis signal transduction cascade.     

A role for the Ras signalling pathway in synaptic transmission and long-term memory

Members of the Ras subfamily of small guanine-nucleotide-binding proteins are essential for controlling normal and malignant cell proliferation as well as cell differentiation. The neuronal-specific guanine-nucleotide-exchange factor, Ras-GRF/CDC25Mm, induces Ras signalling in response to Ca2+ influx and activation of G-protein-coupled receptors in vitro, suggesting that it plays a role in neurotransmission and plasticity in vivo. Here we report that mice lacking Ras-GRF are impaired in the process of memory consolidation, as revealed by emotional conditioning tasks that require the function of the amygdala; learning and short-term memory are intact. Electrophysiological measurements in the basolateral amygdala reveal that long-term plasticity is abnormal in mutant mice. In contrast, Ras-GRF mutants do not reveal major deficits in spatial learning tasks such as the Morris water maze, a test that requires hippocampal function. Consistent with apparently normal hippocampal functions, Ras-GRF mutants show normal NMDA (N-methyl-D-aspartate) receptor-dependent long-term potentiation in this structure. These results implicate Ras-GRF signalling via the Ras/MAP kinase pathway in synaptic events leading to formation of long-term memories.     

A disease locus for familial hypertrophic cardiomyopathy maps to chromosome 1q3

Familial hypertrophic cardiomyopathy (FHC) is caused by missense mutations in the beta cardiac myosin heavy chain (MHC) gene in less than half of affected individuals. To identify the location of another gene involved in this disorder, a large family with FHC not linked to the beta MHC gene was studied. Linkage was detected between the disease in this family and a locus on chromosome 1q3 (maximum multipoint lod score = 8.47). Analyses in other families with FHC not linked to the beta MHC gene, revealed linkage to the chromosome 1 locus in two and excluded linkage in six. Thus mutations in at least three genetic loci can cause FHC. Three sarcomeric contractile proteins--troponin I, tropomyosin and actin--are strong candidate FHC genes at the chromosome 1 locus.     

Event related potentials in adults diagnosed as reading disabled in childhood

The purpose of this study was to identify electrophysiological correlates of reading disability (RD) in adults with psychometrically documented childhood reading histories. Specific a-priori hypotheses for these correlates were generated from the findings of Harter, Anllo-Vento, Wood & Schroeder (1988a); Harter, Diering & Wood (1988b). The subjects were 32 males with normal intelligence and no history of attention deficit disorder or current major psychopathology. Event related potentials were recorded over O1, O2, C3', C4', F3, and F4 to letter stimuli using an intralocation selective attention paradigm. Subjects with RD showed a general reduction in positivity starting at 150 ms and continuing up to 500 ms. The reduced positivity at left central P240 replicated the findings of Harter et al. (1988b) with children. However, adult RD was associated with more diffuse, bilateral reduction in electrophysiological response to all stimuli. A possible relationship between the bilaterality of the neural deficit and the severity of the dyslexia was proposed: that a bilateral deficit may be involved in severe cases.     

Intake, digestion, and nitrogen utilization by sheep fed tropical legumes with contrasting tannin concentration and astringency

We conducted an experiment to determine the effects of concentration and astringency of extractable and bound condensed tannins (CT) in tropical legumes on intake, digestibility, and nitrogen (N) utilization by sheep. The test legumes (Desmodium ovalifolium and Flemingia macrophylla) had similar concentrations of extractable CT (90 g/kg DM) but different concentrations of bound CT and astringency of tannins. Chopped, sun-dried forage of each legume was sprayed with either water (control) or polyethylene glycol (PEG, 35 g/kg of DM) to bind extractable CT and fed daily (26 g/kg BW) to eight sheep with ruminal and duodenal cannulas. The sheep also received starch-extracted cassava meal intraruminally (4 g/kg BW) as a constant source of readily fermentable carbohydrates. Intake of the two legumes was not different (P > .05), but it increased an average of 10% (P < .01) when extractable CT were reduced from 90 to 50 g/kg of DM with PEG. Ruminal and total tract digestibilities of OM, NDF, and ADF were greater (P < .01) with D. ovalifolium than with F. macrophylla and increased for both legumes with the addition of PEG. Greater (P < .01) N flow to the duodenum, N absorbed from the intestine, and fecal N were observed with F. macrophylla than with D. ovalifolium. Extraction of CT with PEG resulted in less (P < .05) ruminal escape protein and less (P < .01) fecal N with both legumes, but apparent postruminal N digestion was not affected. Changes in the concentration of extractable CT in tropical legumes can significantly affect forage intake, digestion, and N utilization by sheep.     

Regional changes in cerebral haemodynamics as a result of a visual stimulus measured by near infrared spectroscopy

Near infrared spectroscopy (NIRS) is used to measure global changes in cerebral haemodynamics. We have adapted the technique to measure regional changes in response to a visual stimulus. Ten volunteers were exposed to a computer generated visual stimulus designed to activate a large area of the visual cortex, including V1, V2, V3, V4 and V5. The stimulus was on for 30 s and off for 30 s. Changes in the concentrations of oxyhaemoglobin ([HbO2]) and deoxyhaemoglobin ([Hb]) were measured using a commercial spectrometer (NIRO500), over the occipital cortex. The data were summed over ten cycles. As a control, the experiment was repeated over the frontal cortex. For each subject [HbO2] increased during stimulation, and decreased when the stimulus was off. The mean (+/- s.e.m.) change in [HbO2] was 0.54 +/0 0.14 micromol 1(-1). The change in total haemoglobin concentration, given by [HbO2] + [Hb] was 0.61 +/- 0.21 micromol 1(-1), equivalent to a rise in cerebral blood volume of 0.04 +/- 0.01 ml 100 g(-1) which is about 2% of the total cerebral blood volume. There was no significant change in [HbO2] over the frontal cortex, implying that the changes in blood volume originated in the occipital lobe. This demonstrates that NIRS provides a non-invasive method of measuring regional changes in cerebral haemodynamics as a result of visual stimulation.     

Selective inhibition of factor Xa is more efficient than factor VIIa-tissue factor complex blockade at facilitating coronary thrombolysis in the canine model

OBJECTIVES: We determined the effect of adjunctive inhibition of the extrinsic coagulation pathway by factor VIIa-tissue factor complex inhibitors, DEGR VIIa and tissue factor pathway inhibitor (TFPI), and the selective factor Xa inhibitor, tick anticoagulant peptide (TAP), after thrombolytic therapy with tissue-type plasminogen activator (t-PA) in a canine model of electrically induced coronary thrombosis. BACKGROUND: Ongoing thrombin generation is considered an important component of the heightened thrombin activity associated with thrombolytic therapy and may be responsible for reperfusion failure and reocclusion. METHODS: Forty-two dogs with electrically induced coronary thrombus undergoing thrombolysis with t-PA (1 mg/kg over 20 min) were randomly assigned to one of the following adjunctive regimens: TAP (30 micrograms/kg body weight per min for 90 min, n = 10); TFPI (100 to 150 micrograms/kg per min for 90 min, n = 10); DEGR VIIa (1- to 2-mg/kg bolus, n = 10) and saline control (n = 12). The dogs were observed for 120 min after thrombolysis for reocclusion. RESULTS: All three active study agents accelerated the time to reperfusion by an average of 12 min (all p < 0.05). Duration of reflow was greatest with TAP (117 +/- 8 min, p < 0.05 compared with saline control), whereas DEGR VIIa and TFPI did not prolong the duration of reflow. Reocclusion rates were similar among control, DEGR VIIa and TFPI groups (70%, 78% and 67%, respectively). Tick anticoagulant peptide reduced the occurrence of reocclusion (0%, p < 0.05 compared with saline control). CONCLUSIONS: In this experimental model, during systematic blockade of various extrinsic coagulation pathway proteins, we demonstrated that whereas acceleration of thrombolysis occurs with factor VIIa-tissue factor complex inhibition, optimal enhancement of thrombolysis was achieved through specific factor Xa blockade.