Left ventricular function during exercise in athletes and in sedentary men

Aim of this study was to evaluate left ventricular function during exercise in 10 male elite runners and in 10 sedentary males. End-diastolic (EDV) and end-systolic volume (ESV), left ventricular ejection fraction (EF), early peak transmitral flow velocity (peak E), time-velocity integral of mitral inflow (m-TVI); mitral cross sectional area (m-CSA); mitral stroke volume (SV), and cardiac output (CO) were measured by echo-Doppler. We simultaneously analyzed: VO2max by spirometric method, mean arterial blood pressure (MAP) by sphygmomanometer, and heart rate (HR) by ECG. The parameters were measured under basal conditions (level 1), at 50% of maximal aerobic capacity (level 2), at peak of exercise (level 3) and during recovery. Ejection fraction in athletes increased significantly at peak of exercise through Frank-Starling mechanism. Stroke volume and cardiac output increased significantly in athletes at peak of exercise. Left ventricular diastolic function was superior in athletes versus controls: in fact, higher peak E in athletes enhanced early diastolic ventricular filling. Therefore, the athletes showed complex cardiovascular adjustments induced by training, which allowed an higher peak working power, a greater cardiac output, and VO2max when compared with an untrained control population.

High-level expression and purification of a human "mini"-hexokinase

Human hexokinase type I is a 100-kDa enzyme with the catalytic site located in the C-terminal domain. We had previously expressed this domain in Escherichia coli, however only a small amount of the recombinant enzyme was catalytically active. To overcome this problem we have now expressed the "mini"-hexokinase using the pET expression system. An average of 1000 U of enzyme per liter of culture was obtained. The recombinant enzyme was purified to homogeneity by a combination of ion-exchange chromatography, affinity chromatography, and dye-ligand chromatography. The enzyme was unstable under ultrafiltration; thus, a multicolumn purification procedure was developed in order to avoid the ultrafiltration steps. The recombinant "mini"-hexokinase was found to have the same kinetic properties as the entire enzyme. Using the method described, the enzyme can be obtained in sufficient quantities for biophysical and biochemical investigations.

High-performance liquid chromatographic method for guanylhydrazone compounds

A high-performance liquid chromatographic method has been developed for a series of aromatic guanylhydrazones that have demonstrated therapeutic potential as anti-inflammatory agents. The compounds were separated using octadecyl or diisopropyloctyl reversed-phase columns, with an acetonitrile gradient in water containing heptane sulfonate, tetramethylammonium chloride, and phosphoric acid. The method was used to reliably quantify levels of analyte as low as 785 ng/ml, and the detector response was linear to at least 50 micrograms/ml using a 100 microliters injection volume. The assay system was used to determine the basic pharmacokinetics of a lead compound, CNI-1493, from serum concentrations following a single intravenous injection in rats.

The dose-related effects of paracetamol on hyperalgesia and nociception in the rat

1. We have studied the effects of 3 low doses of paracetamol (25, 50 and 100 mg kg-1 p.o.) on inflammatory hyperalgesia, inflammatory oedema, and nociceptive thresholds in rats. 2. At the lower dose (25 mg kg-1), paracetamol reduces only central hyperalgesia. 3. At the doses of 50 and 100 mg kg-1, paracetamol reduces also peripheral hyperalgesia; moreover, it enhances nociceptive thresholds to a mechanical stimulus in the non-inflamed paws. 4. Neither paw inflammatory oedema nor tail nociceptive thresholds to a thermal stimulus were modified by paracetamol administration. 5. Our results suggest that paracetamol can reduce hyperalgesia without affecting physiological nociception and inflammation.

[Urachal cyst. A case report and review of the literature]

The pathology of urachal disease is rarely seen. This article refers to a case of urachal cyst in a twenty-five-year-old male. In order to discuss the pathogenic, clinical and therapeutic aspects of this rare pathology, it is necessary to carry out a complete revision of the literature. Diagnosis is helped by ultrasound and CT scan of the lower abdomen, while fistulography is necessary when there is cutaneous drainage. The treatment consists of surgical approach which includes complete en-bloc excision of the cyst together with possible urachal residue. Such treatment is indispensable in order to avoid acute infection and/or malignant degeneration, frequent complications which are very serious.

Peripheral mononeuropathy affects hypothalamic and splenocyte beta-endorphin levels but not immune function in the rat

Beta-endorphin and substance P levels were measured in the hypothalamus of rats 14 days after chronic constriction injury of right sciatic nerve. Furthermore, beta-endorphin concentrations in splenocytes, phytoemoagglutinin-induced proliferation of splenocytes, and natural killer activity were assessed. We observed a significant increase of beta-endorphin and substance P hypothalamic levels, and a significant decrease of beta-endorphin concentrations in the immune cells. In contrast, the peripheral mononeuropathy did not affect the immune function. This study presents a picture of central and peripheral peptide changes consistent with a painful condition, but different from what previously observed in rats which underwent peripheral nerve deafferentation or stressful conditions.

Osteogenic sarcoma of the urinary tract. personal experience

Osteosarcoma is one of the most frequent bone tumours in paediatric age. It has a strong tendency to metastatic spread. Secondary involvement of the kidney with clinical evidence is a rare event (6 cases have been reported in literature). Primary osteogenic sarcoma of the urinary tract is also very unusual (20 cases of primary renal osteosarcoma have been reported until now). To our knowledge primary ureteral osteosarcoma has never been described. We present here one case of symptomatic kidney metastasis of osteosarcoma in a 20-year-old female patient and the first case of primary osteosarcoma of the ureter in an 81-year-old male patient.

Carbamazepine exerts anti-inflammatory effects in the rat

In a first set of experiments, we evaluated the effects of different doses (5.0, 10, 20 and 40 mg/kg p.o.) of carbamazepine on nociceptive thresholds to thermal and mechanical stimuli, and on paw inflammatory hyperalgesia induced by the injection of brewer's yeast. Moreover, we studied the effect of carbamazepine on paw inflammatory edema by plethysmometry. Carbamazepine did not modify nociceptive latencies, but dose dependently reduced the hyperalgesia and the edema induced by the brewer's yeast injection in the rat hindpaw. In a second set of experiments, we studied the effects induced by the same doses of the drug on subcutaneous carrageenin-induced inflammation. Carbamazepine dose dependently reduced the inflammatory exudate, the prostaglandin E2-like activity in the exudate, and the substance P concentrations in the exudate. Our results demonstrate that carbamazepine is able to inhibit the development of different types of inflammation in the rat.

Pre-B acute lymphoblastic leukemia in a patient with partial lipodystrophy and acanthosis nigricans

In patients with lipodystrophies a post binding defect in insulin action has been described involving phosphorylation of the beta subunit of the insulin receptor, suggesting the presence of a genetically determined defect in insulin action; the receptor gene has been mapped to the distal short arm of chromosome 19 close to the break-point of a specific chromosome translocation frequently found in pre-B Acute Lymphoblastic Leukemia (ALL). We report on a 13 years old female patient with partial lipodystrophy, acanthosis nigricans and insulin resistance who developed a pre-B ALL. Since lipodystrophy and pre-B ALL are rare disorders, a possible causal relationship between the two diseases is suggested possibly mediated by a mutation in the insulin receptor gene.

Effects of chlomipramine and fluoxetine on subcutaneous carrageenin-induced inflammation in the rat

We have previously shown that, after acute administration, antidepressant drugs exert anti-inflammatory actions in rats. In this study we evaluated the effects of 3 different doses of chlomipramine (10, 20, and 40 mg/kg i.p), and fluoxetine (5.0, 10, and 20 mg/kg i.p.) on subcutaneous carrageenin-induced inflammation. Both drugs dose-dependently reduced the inflammatory exudate, as well as the PGE2-like bio- and immunoactivity in the exudate. Chlomipramine dose-dependently reduced substance P concentrations in the exudate, whereas fluoxetine was effective only at the highest dose. Our results confirm that antidepressant drugs are able to reduce the development of inflammation in the rat and suggest that the inhibition of substance P production might play a role in mediating the anti-inflammatory effects of chlomipramine.

Evaluation of maximal left ventricular performance in elite bicyclists

Aim of this work was to study in a group of elite cyclists, undergoing laboratory testing, the trend of the left ventricular systolic and diastolic function, echocardiographically and Doppler derived, simultaneously with the evaluation of ergospirometric parameters during maximal exercise. We studied a group of male subjects, consisting of 10 professional elite bicyclists (mean age: 25.1 +/- 3.2 years) during competitive activity (VO2/kg max: 78.5 +/- 7.7 ml.kg.min-1). The maximal exercise test, conducted with Wind Loaded Simulator for optimisation of ergometric capacity, showed, at the end of exercise, at a speed of 49.2 +/- 2.4 km/h, a VO2max of 5365 +/- 543.4 ml/min, with a calculated Cardiac Output (CO) of 19.3 +/- 3.7 l/min. A linear regression relationship was found between VO2max and CO (r = 0.84; p < 0.0001) as well as between VO2max and maximal reached speed (r = 0.97; p < 0.0001). During the aerobic period a slight but significant increase in End Diastolic Volume (EDV) was observed due to the greater venous return from exercising muscles. At stop, in anaerobic period, the EDV remained substantially constant. Ejection Fraction (EF) also increased during exercise through the Frank-Starling mechanism activation. The slight, but not significant, increase in EF at stop level may be explained by an activation of homeometric control of contractility with a sympathetic modulation on myocardial fibres. The early diastolic mitral flow velocity (Peak E) increased significantly during exercise, in comparison with basal upright values. The left ventricular diastolic compliance observed in athletes permits a good left ventricular filling, particularly in early diastolic phase; this allows an excellent left ventricular systolic performance. Based on echocardiography and pulsed Doppler measurements, calculated cardiac output is underestimated by approximately 20%.

Detection of Cryptococcus neoformans capsular polysaccharide antigen in asymptomatic HIV-infected patients

Serum samples from 242 HIV-positive persons were studied for the detection of capsular polysaccharide antigen of Cryptococcus neoformans; 193 of these patients presented less than 300 CD4+ cells/microliters of blood and 49 patients had more than 300 CD4+ cells/microliters. None of them had symptoms or signs characteristic of cryptococcosis. The capsular antigen of C. neofarmans was detected by latex agglutination technique with pronase pretreatment (IMMY, Crypto-Latex Antigen Detection System, Immunomycologics Inc., OK, USA); in 61% of the samples, ELISA technique was also used (Premier, Cryptococcal Antigen, Meridian Diagnostic Inc., Cincinnati, Oh, USA). The comparative study of both methods showed that the results obtained were similar in 96.9% of the cases. The capsular antigen was detected in 13 out of 193 (6.7%) patients with less than 300 CD4+ cells/microliters. Cryptococcosis was confirmed mycologically in 3 of these 13 cases (23%) by the isolation of C. neoformans in CSF or blood cultures. Three patients, who had presented negative results of both tests for capsular antigen, suffered disseminated cryptococcosis 4 to 8 months later. The predictive diagnostic value of capsular antigen detection of C. neoformans seems to be low and we believe that it should not be done routinely in asymptomatic HIV-positive persons.

Preoperative serum intercellular adhesion molecule-1 (ICAM-1) and E-selectin (endothelial cell leukocyte adhesion molecule, ELAM-1) in patients with epithelial ovarian cancer

The serum levels of intercellular adhesion molecule-1 (ICAM-1) and E-Selectin (endothelial cell leukocyte adhesion molecule, ELAM-1) were retrospectively measured in serum samples drawn at diagnosis from 66 patients with epithelial ovarian cancer and 128 patients with benign ovarian masses. The preoperative serum ICAM-1 levels were higher in the former group (p < 0.0001), while serum E-Selectin concentrations were similar in the two groups (p = NS). Among patients with epithelial ovarian cancer, neither serum ICAM-1 nor E-selectin levels correlated with FIGO stage and with histologic type. The serum assay of ICAM-1 and E-Selectin seems to have limited value in the management of patients with epithelial ovarian cancer.

Effects of interleukin-1 beta and interleukin-2 on amino acids levels in mouse cortex and hippocampus

We measured the levels of glutamine, aspartic acid, glutamic acid and GABA in cortex and hippocampus of mice acutely treated with i.p. human recombinant interleukin-2 (IL-2) or human recombinant interleukin-1 beta (IL-1 beta). Administration of IL-2 (5.0 micrograms kg-1) induced a slight but statistically significant increase in glutamine concentrations in both brain areas, while similar administration of IL-1 beta (20 micrograms kg-1) significantly reduced the hippocampal levels of glutamine, glutamic acid and GABA. Our data suggest that brain amino acid pathways are involved in the central modifications induced by IL-1 beta.

[Peritoneal echinococcus: report of a case]

The Authors report a case of peritoneal echinococcal cyst and discuss the pathogenetic and clinical aspects as well as the diagnostic and therapeutic approaches of such a particular localization. They underline the need of a radical surgical treatment in order to definitively eliminate the parasite and the disease.

Neurotoxicity of advanced glycation endproducts during focal stroke and neuroprotective effects of aminoguanidine

Cerebral infarction (stroke) is a potentially disastrous complication of diabetes mellitus, principally because the extent of cortical loss is greater in diabetic patients than in nondiabetic patients. The etiology of this enhanced neurotoxicity is poorly understood. We hypothesized that advanced glycation endproducts (AGEs), which have previously been implicated in the development of other diabetic complications, might contribute to neurotoxicity and brain damage during ischemic stroke. Using a rat model of focal cerebral ischemia, we show that systemically administered AGE-modified bovine serum albumin (AGE-BSA) significantly increased cerebral infarct size. The neurotoxic effects of AGE-BSA administration were dose- and time-related and associated with a paradoxical increase in cerebral blood flow. Aminoguanidine, an inhibitor of AGE cross-linking, attenuated infarct volume in AGE-treated animals. We conclude that AGEs may contribute to the increased severity of stroke associated with diabetes and other conditions characterized by AGE accumulation.

[Treatment of metastatic osteosarcoma with verapamil, cyclosporine and chemotherapy. A case report]

Studies on the use of revertants to overcome MDR have aroused a great interest even if they failed to prove their actual usefulness. A case of 10 years and 6 months old boy is described. He suffered from osteoblastic osteosarcoma and underwent chemotherapy following CNR-NEO3 protocol, wide surgical resection and postoperative chemotherapy. Nineteen months after diagnosis he underwent the removal of a little subpleural nodule in the right lung. Forty-five days later, in the same site, a large local metastasis was observed together with many others secondaries localizations spred in both lungs. Because of the rapid evolution they were considered not suitable for surgical treatment. A cyclosporine and verapamil treatment in association with adryamicin and etoposide was begun with the aim overcoming multidrug resistance. Five treatments were provided. ECG monitoring during verapamil infusion did not show any trouble; mielotoxicity was mild, with no need of transfusions. A lung CT scan at the end of the therapy demonstrated an important decrease of the subpleural metastasis and the vanishing of lung nodules. Another surgical intervention was provided together with 2 postoperative chemotherapy treatments. Twenty-six months later no sign of the disease was observed. Association of verapamil and cyclosporine with chemotherapy allowed to get a good clinical response with a very low toxicity, in a critical situation in which chemotherapy alone did not seem to offer any real possibility.

Hexokinase mutations that produce nonspherocytic hemolytic anemia

Among glycolytic enzyme defects, hexokinase (ATP: D-hexose 6-phosphotransferase, EC 2.7.1.1; HK) deficiency is a very rare disease where the predominant clinical effect is nonspherocytic hemolytic anemia. Here we report the characterization at molecular level of the HK type I cDNA from a patient with hemolytic anemia due to hexokinase deficiency. PCR amplification and sequence of the cDNA revealed the presence of a deletion and of a single nucleotide substitution, both in heterozygous form. In particular, the deletion, 96 bp long, concerns nucleotides 577 to 672 in the HK cDNA sequence and was never found in the cDNAs of 14 unrelated normal subjects. The sequence of the HK allele without deletion showed a single nucleotide substitution from T to C at position 1667 which causes the amino acid change from Leu529 to Ser. This heterozygous mutation at nt 1667 was confirmed by direct sequencing of the patient genomic DNA, but when DNAs from 10 normal controls were examined by this technique the substitution at nt 1667 was never found. From these results we concluded that the patient is carrying a point mutation at nt 1667 of one HK allele and a 96 nt deletion in the other allele. In normal subjects two differences from the published cDNA sequence were documented.

An inhibitor of macrophage arginine transport and nitric oxide production (CNI-1493) prevents acute inflammation and endotoxin lethality

BACKGROUND

Nitric oxide (NO), a small effector molecule produced enzymatically from L-arginine by nitric oxide synthase (NOS), is a mediator not only of important homeostatic mechanisms (e.g., blood vessel tone and tissue perfusion), but also of key aspects of local and systemic inflammatory responses. Previous efforts to develop inhibitors of NOS to protect against NO-mediated tissue damage in endotoxin shock have been unsuccessful, largely because such competitive NOS antagonists interfere with critical vasoregulatory NO production in blood vessels and decrease survival in endotoxemic animals. Accordingly, we sought to develop a pharmaceutical approach to selectively inhibit NO production in macrophages while sparing NO responses in blood vessels.

MATERIALS AND METHODS

The process of cytokine-inducible L-arginine transport and NO production were studied in the murine macrophage-like cell line (RAW 264.7). A series of multivalent guanylhydrazones were synthesized to inhibit cytokine-inducible L-arginine transport. One such compound (CNI-1493) was studied further in animal models of endothelial-derived relaxing factor (EDRF) activity, carrageenan inflammation, and lethal lipopolysaccharide (LPS) challenge.

RESULTS

Upon activation with cytokines, macrophages increase transport of L-arginine to support the production of NO by NOS. Since endothelial cells do not require this additional arginine transport to produce NO, we reasoned that a competitive inhibitor of cytokine-inducible L-arginine transport would not inhibit EDRF activity in blood vessels, and thus might be effectively employed against endotoxic shock. CNI-1493, a tetravalent guanylhydrazone, proved to be a selective inhibitor of cytokine-inducible arginine transport and NO production, but did not inhibit EDRF activity. In mice, CNI-1493 prevented the development of carrageenan-induced footpad inflammation, and conferred protection against lethal LPS challenge.

CONCLUSIONS

A selective inhibitor of cytokine-inducible L-arginine transport that does not inhibit vascular EDRF responses is effective against endotoxin lethality and significantly reduces inflammatory responses.

CRH and the noradrenergic system mediate the antinociceptive effect of central interleukin-1 alpha in the rat

After intracerebroventricular administration, both interleukin-1 alpha and corticotropin-releasing hormone increase nociceptive thresholds evaluated by the hot-plate test in the rat. Pretreatment with 6-hydroxydopamine or prazosin fully prevents the action of both substances. Moreover, the effect of interleukin-1 alpha is completely blocked by the intracerebroventricular administration of the corticotropin-releasing hormone antagonist alpha-helical CRH 9-41. Our results suggest an involvement of CRH and the noradrenergic system in the antinociceptive effect of central interleukin-1 alpha.