Vasoreactivity and prostacyclin release in streptozotocin-diabetic rats: effects of insulin or aldose reductase inhibition

1. Alterations in vasoreactivity and endothelial cell function could underlie some of the vascular abnormalities in diabetes. To examine aspects of these phenomena we studied the effects of 4-6 weeks streptozotocin-induced diabetes in the rat on basal and angiotensin II (AII)-stimulated prostacyclin release from isolated lung, perfused at constant flow. In addition, pressure was monitored throughout the lung perfusion as an index of vasomotor tone. 2. The experiment also included lungs from groups of diabetic rats treated with either insulin or an aldose reductase inhibitor (imirestat), to determine whether these treatments influenced the development of any defects seen in untreated diabetes. 3. Despite some indication of a trend towards reduced prostacyclin release in lungs from diabetic rats, neither the basal nor AII-stimulated release was significantly different from that seen in tissues from control animals. There were no significant differences between groups in the average basal perfusion pressure and in either the absolute pressure response to AII or the time of this peak. 4. The area under the perfusion pressure curve during AII infusion was greater in lungs from diabetic animals than in controls indicating a prolonged vasoconstrictor response. This increased pressor response may indicate increased sensitivity of diabetic tissue to AII or a reduced production of vasodilators in response to the vasoconstriction. 5. Whichever mechanism was responsible, this alteration was prevented by insulin treatment but not by aldose reductase inhibition, implicating mechanisms probably unrelated to exaggerated polyol pathway flux.     

Outcome of tunneled hemodialysis catheters placed by radiologists

PURPOSE: To compare the outcomes of hemodialysis catheters placed by interventional radiologists with those placed by surgeons. MATERIALS AND METHODS: The outcomes were retrospectively analyzed of 237 hemodialysis catheters placed in 140 patients by a radiology service from January 1991 through December 1992. Follow-up data were available for 222 catheters (94%). Catheter secondary patency and freedom from infection were analyzed statistically and by means of life-table analysis. RESULTS: Pneumothorax occurred after the placement of six catheters (2.5%); in two patients, a chest tube was required for decompression. Other short-term complications included air embolism with no clinical sequelae (two procedures) and prolonged oozing from the tunnel (two procedures). Long-term complications included infection and catheter failure. Infection occurred in 26 patients (18%) with 32 catheters (14%) and resulted in removal of 25 catheters. Ninety-three catheters (42%) failed, and 63 catheters (28%) were removed because of failure. CONCLUSION: Hemodialysis catheters placed by radiologists do not have a higher rate of complications or failure than catheters placed by surgeons.     

The Influence of Various Air Exchange Rates on Airborne Particles and Microorganisms in Conventionally Ventilated Operating Rooms

Abstract Concentrations of airborne particles and microorganisms were assessed as a function of the air exchange rate in two operating theatres equipped with conventional air ventilation systems. The measurements were made with and without human activity (surgery). Under conditions without human activity the effect of the air exchange rate on viable (=microorganisms) and non-viable airborne particles was measured. Under conditions with human activity an investigation was made to determine whether the air exchange rate has a significant influence on airborne particle and bacteria concentrations. In addition, the influence of the number of persons in the operating theatres and the various operating activities were calculated. Statistical differences were found for airborne particle and airborne bacteria concentrations in supply and room air with and without human activity. From the point of view of hygiene, these differences must be considered irrelevant because of the slight margin (less than one logarithmic step) between the values. A comparison of all air exchange rates clearly shows that the number of personnel present in the operating theatre exerts the strongest influence on airborne particle concentration variance in room air. As regards airborne bacteria concentrations in room air, explanation of variance by the parameters air exchange rate, number of persons and operating activity is negligible. Summarizing the low (7.5 and 10/h) and high (15 and 20/h) air exchange rates did not increase the explanation of variance for airborne particle and bacteria concentrations although the differences were significant.     

Outcomes of inpatients treated on a VA psychiatric unit and a substance abuse treatment unit

OBJECTIVE: The utility of the Treatment Outcome Profile (TOP) for measuring the effectiveness of acute inpatient psychiatric and substance abuse treatment was tested, including its internal reliability, validity, and sensitivity to treatment gains. The relationship between patients' satisfaction with services and treatment gains in quality of life, symptoms, and level of functioning was explored. METHODS: A pre-post research design was used with consecutive admissions to an inpatient psychiatric unit (N = 66) and a substance abuse treatment unit (N = 88) at a VA medical center. At admission and at discharge, the TOP, a self-report instrument assessing quality of life, symptoms, level of functioning, and patient satisfaction with services (at discharge only) was completed. Multivariate analysis of variance and univariate analysis of variance were used to test differences in scores between admission and discharge. RESULTS: Patients demonstrated significant treatment gains. Overall, compared with patients on the substance abuse unit, those receiving psychiatric treatment were more impaired at admission and had lower levels of self-reported therapeutic gain at discharge. Improvement for both groups occurred in quality of life, symptoms, and level of functioning. Both groups reported high levels of patient satisfaction, comparable with levels in other service industries. A high positive correlation (alpha = .61) was found between patient satisfaction and overall self-reported treatment gain. CONCLUSIONS: The results indicate that it is important to compare treatment effectiveness as well as costs when seeking less costly alternatives to inpatient care. The TOP is a valid and sensitive outcome measurement tool. Patient satisfaction is an important outcome variable and positively related to treatment gains in quality of life, symptoms, and level of functioning.     

Successive transperitoneal migration of ova in a woman with extensive pelvic adhesions

Our case report describes three conceptions after transperitoneal migration of the ovum in a woman with only one ovary, the contralateral oviduct, and extensive postoperative pelvic adhesions obliterating the Douglas cul-de-sac. This suggests that anatomic integrity of the pelvis is not always essential for ovum pick-up.     

Inactivation kinetics of γ-glutamyltransferase during the heating of milk

The inactivation of γ-glutamyltransferase (GGT, E.C. 2.3.2.2) during the heating of milk to between 65.0°C and 76.0dgC for periods of 5 s to 1000 s follows a first-order reaction (energy of activation 457 kJ/mol) and can be used to monitor the process of milk pasteurisation. GGT activity in raw milks from individual cows showed only little variation (5.92±0.59 units). Residual GGT activity in 17 commercial milks ranged between 1% and 20%, indicating a heat treatment at the upper limit of the permitted pasteurisation conditions.     

Mapping of antigenic sites in human neuron-specific enolase by expression subcloning

Human serum neuron-specific enolase (NSE) is a marker of neurons and of small-cell carcinoma of the lung; improved immunoassays of NSE remain an important goal. Here, we used overlapping complementary DNA (cDNA) clones for reconstruction to express full-length recombinant NSE, and also to express a set of cloned subfragments through the prokaryotic expression vectors pUEX and pUBEX. Subfragments expressed as fusion proteins were used to characterize immunogenic and antigenic regions and epitopes and, expressed as affinity matrices, to derive purified, fractionated polyclonal antibodies. NSE epitope data can be visualized with yeast enolase-1 crystal structure coordinates: The two protein sequences align almost perfectly and are 61% identical. This approach demonstrates the complementarity of cDNA expression with techniques of polyclonal antiserum and monoclonal antibody production and with chemical peptide synthesis in the refinement of immunodiagnostic reagents.     

Enhancement of self-association of human spectrin by polyethylene glycol

1. In the presence of polyethylene glycol, the self-association of human spectrin is enhanced in a manner that depends approx. exponentially on the mass concentration of polyethylene glycol. 2. For a given mass concentration, the enhancement is independent of the molecular weight of the polyethylene glycol. 3. These data are consistent with the operation of excluded volume effects, and support the contention that the association of spectrin is likely to be increased in the presence of the high concentration of hemoglobin within the erythrocyte in vivo.