Catheter ablation in patients with refractory cardiac arrhythmias with radiofrequency techniques

The author suggests a working classification of dermopertorators from analysis of his own designs and devices described in the literature for forming netlike skin grafts in the treatment of patients with large tissue defects. It is shown that the well-known dermoperforators require essential modernization. The most promising model is a device with plane knives whose simple technology allows their production to be organized in Soviet industry.     

Outcome variables for the study of periodontal regeneration

The most reliable outcome variable for assessing periodontal regeneration is human histology; however, the morbidity associated with this technique makes it feasible only in isolated case studies designed to prove that a drug, device, or technique is capable of regenerating the lost periodontium including bone, cementum, and functionally oriented periodontal ligament. In the absence of this genuine variable, other "surrogate" variables must be used. Of these, measurement of new bone is the primary alternative. Direct bone measurements, including linear and volumetric assessment, are by far the best tools; however, the need for a second surgical procedure is a definite drawback of this technique. To overcome this problem, other outcomes have been employed: sounding bone measurements is a less invasive method, albeit it is also less accurate. Another tool that has been tested extensively is radiographic analysis. Conventional radiography is not useful in most regenerative trails where minimal or no crestal changes occur. The use of standardized radiographs and image processing techniques to measure alveolar bone changes has not significantly enhanced the applicability of this method. Digital subtraction radiography (DSR) offers some improvement over previous techniques; however, the correlation between the magnitude of clinical bone changes and changes in the digital image is yet to be substantiated. Other variables have been successfully used in regenerative studies. These include clinical attachment level changes, change in probing depth, and gingival recession. The information derived from these variables, especially attachment level changes, supplement and substantiate the direct bone measurements. Other variables that may be monitored are those associated with plaque formation, periodontal pathogens and gingival inflammation; while not direct measures of regeneration, these variables are likely to affect future prognosis and treatment stability. In summary, direct bone measurements are the most ideal surrogate outcome variable, although clinical attachment level measurements are commonly used in large-scale regenerative clinical trials. Clinical response may be assessed at different time intervals; however, the endpoint measurements for regenerative studies should be taken at least 12-months postoperatively.     

Interneuronal frontal-amygdala interactions in cats trained for the quality of the reinforcement

In eight cats the appetitive instrumental conditioned reflexes to light were elaborated by the method of "active choice" of reinforcement quality: the short-latency bar-pressing responses were reinforced with bread-meat mixture and the delayed responses were reinforced with meat. The animals differed in behavior strategy: six cats preferred the delayed pressings (the so-called "self-control" group), and two cats preferred the pressings with short delay (the so-called "impulsive" group). The multiunit activity in the basolateral amygdala and frontal cortex was recorded by chronically implanted nichrome semimicroelectrodes. The interactions of the neighboring neurons in the basolateral amygdala and the frontal cortex (within the local neuronal networks) and between the amygdalar and cortical neurons (distributed neuronal networks of amygdalar-frontal and fronto-amygdalar directions) were estimated by means of statistical crosscorrelation analysis of spike trains. The interneuronal cross-correlations were studied with delays in the range of 0-100 ms. The number of cross-correlations between the neuronal discharges both in the local and distributed networks was significantly higher in "impulsive" cats, mainly, with delays in the range of 0-30 ms. In both groups of animals the number of correlations was the highest during omissions of conditioned pressings, i.e., in cases of difficult choice of reinforcement. We suggest that the basolateral amygdala, frontal cortex, and amygdalar-frontal distributed neuronal networks are involved in the system of brain structures, which determine the individual features of animal behavior.     

Presence and distribution of collagen II, collagen I, fibronectin, and tenascin in rabbit normal and osteoarthritic cartilage

OBJECTIVE: To investigate changes in the composition of articular cartilage matrix during the development of experimental osteoarthritis (OA), collagen type II, collagen type I, and the noncollagenous proteins fibronectin and tenascin were studied in normal and osteoarthritic cartilage of rabbits. METHODS: OA of the knee joint was induced by a medial meniscectomy and section of the medial collateral ligament and anterior cruciate ligament. Frozen sections of rabbit normal and OA cartilage were stained with monoclonal antibodies against collagen type II, collagen type I, fibronectin, and tenascin. RESULTS: Collagen II manifested a decreased interterritorial staining and seemed to increase territorially in the deeper zones of the OA cartilage. Collagen I was found in normal cartilage as a thin layer covering the surface and also in OA fibrillated cartilage. Fibronectin was present in normal and OA cartilage. Whereas a layer covered the normal cartilage, a thicker layer was observed in OA cartilage. In addition, changes in fibronectin distribution from the pericellular to the interterritorial matrix were observed. Tenascin was also found in normal cartilage matrix, particularly in the territorial and interterritorial matrix of the deeper zones. It showed an increased staining intensity in fibrillated cartilage, in the pericellular matrix of the upper chondrocytes, and on the surface lining in OA cartilage. CONCLUSION: Collagen type II deposition seems to increase in the deeper cartilage zones during the osteoarthritic process, as a sign of tissue repair response. Collagen type I, fibronectin, and tenascin show enhanced deposition in the upper, fibrillated osteoarthritic cartilage, suggesting a common mediator controlled pathway.     

Repetitive conundrums of centromere structure and function

BACKGROUND: Adult participants in randomized controlled trials often have better outcomes than patients who are eligible but not enrolled. OBJECTIVE: To examine whether newborn infants who were allocated to placebo in an investigational drug trial had better outcomes than infants who were eligible but not randomized (eligible NR). Study design: During a randomized controlled trial of antithrombin therapy in premature infants with respiratory distress syndrome, data were collected prospectively on all 76 infants in the eligible NR group. Study outcomes were compared with those of all 61 infants who were randomized to placebo. The same exogenous surfactant was used in all patients. RESULTS: In the placebo group the mean (SD) birth weight was 1201 (314) g, mean (SD) gestational age was 28.8 (2.3) weeks, and 51% were male. In infants in the eligible NR group, mean (SD) birth weight was 1141 (262) g, mean (SD) gestational age was 28.3 (2. 3) weeks, and 58% were male; 57% of infants in both groups had been exposed to steroids before birth. The median duration of mechanical ventilation was reduced from 6.2 days in the eligible NR group to 4. 8 days in the placebo group (P =.008). There was also a trend toward less frequent and less severe intraventricular hemorrhage in trial participants. CONCLUSIONS: These data are consistent with the hypothesis that sick newborn infants may benefit from participation in a randomized controlled trial.     

Regulation of mesangial cell ion channels by insulin and angiotensin II. Possible role in diabetic glomerular hyperfiltration

We used patch clamp methodology to investigate how glomerular mesangial cells (GMC) depolarize, thus stimulating voltage-dependent Ca2+ channels and GMC contraction. In rat GMC cultures grown in 100 mU/ml insulin, 12% of cell-attached patches contained a Ca(2+)-dependent, 4-picosiemens Cl- channel. Basal NPo (number of channels times open probability) was < 0.1 at resting membrane potential. Acute application of 1-100 nM angiotensin II (AII) or 0.25 microM thapsigargin (to release [Ca2+]i stores) increased NPo. In GMC grown without insulin, Cl- channels were rare (4%) and unresponsive to AII or thapsigargin in cell-attached patches, and less sensitive to [Ca2+]i in excised patches. GMC also contained 27-pS nonselective cation channels (NSCC) stimulated by AII, thapsigargin, or [Ca2+]i, but again only when insulin was present. In GMC grown without insulin, 15 min of insulin exposure increased NPo (insulin > or = 100 microU/ml) and restored AII and [Ca2+]i responsiveness (insulin > or = 1 microU/ml) to both Cl- and NSCC. GMC AII receptor binding studies showed a Bmax (binding sites) of 2.44 +/- 0.58 fmol/mg protein and a Kd (binding dissociation constant) of 3.02 +/- 2.01 nM in the absence of insulin. Bmax increased by 86% and Kd was unchanged after chronic (days) insulin exposure. In contrast, neither Kd nor Bmax was significantly affected by acute (15-min) exposure. Therefore, we concluded that: (a) rat GMC cultures contain Ca(2+)-dependent Cl- and NSCC, both stimulated by AII. (b) Cl- efflux and cation influx, respectively, would promote GMC depolarization, leading to voltage-dependent Ca2+ channel activation and GMC contraction. (c) Responsiveness of Cl- and NSCC to AII is dependent on insulin exposure; AII receptor density increases with chronic, but not acute insulin, and channel sensitivity to [Ca2+]i increases with both acute and chronic insulin. (d) Decreased GMC contractility may contribute to the glomerular hyperfiltration seen in insulinopenic or insulin-resistant diabetic patients.     

Ligand migration in sperm whale myoglobin

Geminate oxygen rebinding to myoglobin was followed from a few nanoseconds to a few microseconds after photolysis for more than 25 different oxymyoglobin point mutants in the presence and absence of 12 atm of xenon. In all cases, two relaxations were observed: an initial fast phase (half-time 20 ns) and a slower, smaller phase (half-time 0.5-2 micros). Generally, xenon accelerates the fast reaction but slows the slower reaction and diminishes its amplitude. The rates and proportions of the two components and the effects of xenon on them vary widely for different mutants. The locations of specific xenon binding sites [Tilton, R. F., Kuntz, I. D. Jr., and Petsko, G. A. (1984) Biochemistry 23, 2849-2857], the effects of point mutations on the geminate reactions, and molecular dynamics simulations were used to suggest locations in the protein interior occupied by ligands on the nanosecond to microsecond time scale. Photodissociated ligands may occupy xenon site 4 in the distal pocket and xenon site 1 below the plane of the heme. Rebinding from these positions corresponds to the slower geminate phase for O2 rebinding. The rapid geminate component is determined by competition between rebinding from a position closer to the iron atom and escape to solvent or more distant locations in the protein.