Characterization of the effect of 2-deoxy-D-glucose(2-DG) on the immune system

This study was designed to characterize the effects of the metabolic stress of administration of 2-deoxy-d-glucose (2-DG, 500 mg/kg) on immune function. Male Lewis rats were exposed to one or five injections (one every 48 h) of 2-DG. Control rats received saline injections. Administration of 2-DG induced a reduction of total leukocytes in the spleen, thymus, and blood. The reduction was most prominent in animals that received five injections of 2-DG. The ratio of CD4(+)/CD8(+) in the spleen was decreased due to a significant increase of CD8(+) T-cell subpopulation. Additionally, 2-DG induced a suppression of mitogenic responsiveness and IFN-gamma production in both whole blood and spleen lymphocytes. The production of IL-1 and IL-2 was significantly reduced in the blood, but not in the spleen. Conversely, there was a significant increase in nitric oxide production in cultures of Con A-, PHA-, and LPS-stimulated splenocytes from 2-DG-injected animals compared with saline-injected controls. In blood cultures stimulated with Con A and PHA, the nitric oxide production of the group that received five injections of 2-DG was significantly higher than in the group that received one injection of 2-DG or saline. These results demonstrated that the metabolic stress 2-DG induced a downregulation of Th 1 cellular immune function in a manner similar to physical and psychological stressors. Additionally, the use of 2-DG in rats provided an important model with which to study metabolic stress.     

Teaching nursing delegation: analyzing nurse practice acts

Teaching delegation to nurses, especially for those nurses who have mostly practiced in primary nursing, is challenging. Many staff development and continuing education instructors are teaching delegation principles to nurses today because good delegation skills are needed to effectively implement current skill-mix and patient-focused care changes. In these courses, nurses almost always want guidelines on what they can and cannot delegate to unlicensed assistive personnel and LPN/LVNs. The best foundation for teaching what can and cannot be delegated is the nursing practice act in the state, even though analyzing state practice acts can be cumbersome. Analyzing practice acts as the basis for teaching delegation principles is a critical requirement for today's staff development/continuing educator.     

Plutonium anomalies in attic dust and soils at locations surrounding the Nevada Test Site

Attic dust and soil samples were collected during the Summer of 1996 and the Spring of 1997 in southern Nevada and southern Utah. Analysis of the samples for radiocesium and plutonium give activity ratios of radiocesium/plutonium that range from 0.7 +/- 0.1 to 27 +/- 2, well below the world-wide fallout ratio of 34 +/- 4 (as of 1 July 1997). This indicates anomalous plutonium throughout the region, including areas to the south of the Nevada Test Site (NTS), generally believed to have received only world-wide fallout. Safety tests and above-ground detonations that resulted in incomplete fission, conducted at the NTS during the 1950's and 1960's, are likely sources of this excess plutonium.     

Incidence and prevalence of symptomatic celiac disease among adults in Denmark

The purpose was: 1) to determine annual incidence rates of adult coeliac disease, 2) to calculate the risk of having developed coeliac disease in adult life, and 3) to calculate the life time prevalence by five-year birth cohorts. All patients fulfilling defined criteria for adult coeliac disease living in the county of Copenhagen and diagnosed during the years 1976-1991 were included. The reference population consisted of 503,283 subjects. The overall incidence had been stable during the period, and was 1.27/10(5). The figures for females and males were 1.55/10(5) and 0.96/10(5), respectively (p = 0.04). The median (range) age at the time of diagnosis was 40.1 (16-81). Age specific incidence rates varied considerably, with the peak rate located in the middle-aged population. The incidence rates were influenced by age at diagnosis (p = 0.01) and sex (p = 0.04), but not by the year when diagnosed. For a subject aged 89 years, the risk was 0.88/1000. The overall prevalence was 45.9/10(5). In conclusion, this incidence/prevalence is one of the lowest reported, and is definitely lower than prevalences reported from our neighbouring Scandinavian countries. Nothing points to higher incidence rates being present in Danish adults to compensate for the previously demonstrated very low rates in Danish children.     

Mechanism of Cdc42-induced actin polymerization in neutrophil extracts

Cdc42, activated with GTPgammaS, induces actin polymerization in supernatants of lysed neutrophils. This polymerization, like that induced by agonists, requires elongation at filament barbed ends. To determine if creation of free barbed ends was sufficient to induce actin polymerization, free barbed ends in the form of spectrin-actin seeds or sheared F-actin filaments were added to cell supernatants. Neither induced polymerization. Furthermore, the presence of spectrin-actin seeds did not increase the rate of Cdc42-induced polymerization, suggesting that the presence of Cdc42 did not facilitate polymerization from spectrin-actin seeds such as might have been the case if Cdc42 inhibited capping or released G-actin from a sequestered pool. Electron microscopy revealed that Cdc42-induced filaments elongated rapidly, achieving a mean length greater than 1 micron in 15 s. The mean length of filaments formed from spectrin-actin seeds was <0.4 micron. Had spectrin-actin seeds elongated at comparable rates before they were capped, they would have induced longer filaments. There was little change in mean length of Cdc42-induced filaments between 15 s and 5 min, suggesting that the increase in F-actin over this time was due to an increase in filament number. These data suggest that Cdc42 induction of actin polymerization requires both creation of free barbed ends and facilitated elongation at these ends.     

Fiberoptic intubation using anesthetized, paralyzed, apneic patients. Results of a resident training program

BACKGROUND: There is no consensus about the best way to teach fiberoptic intubation. This study assesses the effectiveness of a training program in which novice anesthetic residents routinely were taught fiberoptic tracheal intubation of anesthetized, paralyzed, apneic patients. METHODS: Eight inexperienced anesthetic residents learned fiberoptic and conventional tracheal intubation simultaneously during their first 4 months of training. All intubations were performed using general anesthesia and muscle paralysis. Of these intubations, 223 (23%) were fiberoptic and 743 (77%) were laryngoscopic. Subsequently, their intubation skills with the two techniques were studied in a prospective, single-blind randomized trial involving 131 elective patients. Intubation times, SpO2, ETCO2, hemodynamic changes on intubation, and complications were recorded for 71 fiberoptic and 57 laryngoscopic intubations. RESULTS: There were two failures of the rigid and one failure of the fiberoptic technique due to inability to intubate within 180 s. In cases of failure, the tracheas were intubated successfully after mask ventilation by the alterative technique. No hypoxemia or hypercarbia occurred in any patient. There were no differences in hemodynamic indexes nor incidence of sore throat or hoarseness between the two groups. Mean intubation times were 56 +/- 24 s (mean +/- SD) for fiberoptic and 34 +/- 10 s (mean +/- SD) for laryngoscopic (P < 0.001). CONCLUSIONS: Novices taught fiberoptic intubation and rigid laryngoscopic intubation under similar conditions, with similar volumes of experience, learn both techniques well. The safety and effectiveness of this training regimen commend it for inclusion in any residency program.