Extracorporeal membrane oxygenator support for cardiopulmonary failure. Experience in 28 cases

We have used extracorporeal membrane oxygenation (ECMO) for 28 patients (14 children and 14 adults) over a 5 year period. Nine patients improved on ECMO and 5 were long-term survivors. ECMO was used for pulmonary insufficiency in 24 patients. Initially, only moribund patients were treated, but recently the combination of open lung biopsy and pulmonary insufficiency index (PII) has been used to select patients. The best results have been obtained in newborn cases and the adult capillary leak syndromes; the major problem has been progression to fibrosis despite ECMO support. ECMO was used for cardiac failure in 4 patients. Children with postoperative cardiac failure did the best; profound shock was not reversed with venoarterial bypass. ECMO support is lifesaving in selected cases of pulmonary insufficiency. Initial trials in cardiac failure and the infant age group in this series suggest that ECMO will have an even greater role in those applications.     

Effect of carboxylic acids on permeation of chlorpromazine through dimethyl polysiloxane membrane

The effect of carboxylic acids on the permeation of chlorpromazine was investigated through a dimethyl polysiloxane nonpolar membrane. The permeability of the diffusate, at pH 5.8, increases considerably in the presence of carboxylic acids or phosphate, probably due to an ion-pair formation between the relative anions and chlorpromazine.     

Quantitative cytochemical changes induced by dexamethasone and adrenalectomy in rat liver chromatin

A wild-type strain of Staphylococcus aureus, which inactivates a wide variety of aminoglycosides (except the gentamicin components), has been found to harbor a plasmid (RAp01) that mediates the biosynthesis of a nucleotidyltransferase. This enzyme modifies the 4'-hydroxy function of these antibiotics. The plasmid has been studied, the enzyme responsible for this resistance pattern has been isolated by affinity chromatography, and its kinetics and physicochemistry have been characterized. The target of this enzyme has also been located by demonstrating the structure of one inactivated compound, 4'-(O)-adenylyltobramycin.     

Transformation-induced alterations in adhesion. Binding of pre-formed cell aggregates to cell layers

Male and female college students were shown videotapes of supposed male offenders describing the details of thefts they had committed. Videotaped sequences were varied so that offenders were 9 to 10 years old or of college age. Also, actors varied in their mode of emotional self-presentation. Comparisons of punishments suggested by subjects indicated that joyful actors received the highest level of punishment while distressed offenders received the lowest level of suggested punishment. It was also found that the emotions of children exerted a greater persuasive effect on subjects' ratings than did the emotions of adults although the pattern of results was similar across ages. These results were discussed as demonstrating that the age and emotion of an offender can exert considerable influence on the attribution of blame made by a disciplinarian.     

Evaluation of a one-dimensional cloud model for yellow and green thunderstorms

Many observers have reported observations of green light emanating from severe thunderstorms in the midwestern United States. Spectral measurements have demonstrated that the dominant wavelength of the light is in the green portion of the visible spectrum and that this is not just a subjective impression. According to the theory proposed by Bohren and Fraser [Bull. Am. Meteorol. Soc. 74, 2185 (1993)], two effects combine to produce green light from thunderstorms. First, incident solar radiation is reddened by selective scattering by air molecules and particles in the atmosphere before it enters the cloud. Second, the radiation that passes through an optically thick cloud is attenuated in the longer wavelengths because of selective absorption by liquid water. Model calculations indicate that realizable combinations of mean drop diameters, mean liquid-water contents, and cloud thicknesses can satisfy the conditions required for shifting the dominant wavelength of the incident solar radiation to green.     

The cytoplasmic membrane is a primary target for the staphylocidal action of thrombin-induced platelet microbicidal protein

Thrombin-induced platelet microbicidal protein (tPMP-1) is a small, cationic peptide released from rabbit platelets exposed to thrombin in vitro. tPMP-1 is microbicidal against a broad spectrum of bloodstream pathogens, including Staphylococcus aureus. Preliminary evidence suggests that tPMP-1 targets and disrupts the staphylococcal cytoplasmic membrane. However, it is not clear if the cytoplasmic membrane is a direct or indirect target of tPMP-1. Therefore, we assessed the in vitro activity of tPMP-1 versus protoplasts prepared from logarithmic-phase (LOG) or stationary-phase (STAT) cells of the genetically related S. aureus strains 19S and 19R (tPMP-1 susceptible and resistant, respectively). Protoplasts exposed to tPMP-1 (2 microg/ml) for 2 h at 37 degrees C were monitored for lysis (decrease in optical density at 420 nm) and ultrastructural alterations (by transmission electron microscopy [TEM]). Exposure to tPMP-1 resulted in substantial lysis of LOG but not STAT protoplasts of 19S, coinciding with protoplast membrane disruption observed by TEM. Thus, it appears that tPMP-1-induced membrane damage is influenced by the bacterial growth phase but is independent of the staphylococcal cell wall. In contrast to 19S, neither LOG nor STAT protoplasts of 19R were lysed by tPMP-1. tPMP-1-induced membrane damage was further characterized with anionic planar lipid bilayers subjected to various trans-negative voltages. tPMP-1 increased conductance across bilayers at -90 mV but not at -30 mV. Once initiated, a reduction in voltage from -90 to -30 mV diminished conductance magnitude but did not eliminate tPMP-1-mediated membrane permeabilization. Therefore, tPMP-1 appears to directly target the staphylococcal cytoplasmic membrane as a primary event in its mechanism of action. Specifically, tPMP-1 likely leads to staphylococcal death, at least in part by permeabilizing the bacterial membrane in a voltage-dependent manner.