Slime-producing Staphylococcus epidermidis and S. aureus in acute bacterial conjunctivitis in soft contact lens wearers

In recent years, an increase in ocular pathologies related to soft contact lens has been observed. The most common infectious agents were Staphylococcus spp. Some strains produce an extracellular polysaccharidic slime that can cause severe infections. Polysaccharide synthesis is under genetic control and involves a specific intercellular adhesion (ica) locus, in particular, icaA and icaD genes. Conjunctival swabs from 97 patients with presumably bacterial bilateral conjunctivitis, wearers of soft contact lenses were examined. We determined the ability of staphylococci to produce slime, relating it to the presence of icaA and icaD genes. We also investigated the antibiotic susceptibility and Pulsed Field Gel Electrophoresis (PFGE) patterns of the clinical isolates. We found that 74.1% of the S. epidermidis strains and 61.1% of the S. aureus strains isolated were slime producers and showed icaA and icaD genes. Both S. epidermidis and S. aureus slime-producing strains exhibited more surface hydrophobicity than non-producing slime strains. The PFGE patterns overlapped in S. epidermidis strains with high hydrophobicity. The similar PFGE patterns were not related to biofilm production. We found scarce matching among the Staphylococcus spp. studied, slime production, surface hydrophobicity and antibiotic susceptibility.

Can We Utilize Photorefractive Keratectomy to Improve Visual Acuity in Adult Amblyopic Eyes?

PURPOSE

To report the results of photorefractive keratectomy (PRK) in adult amblyopic patients.

DESIGN

Noncomparative case series.

PARTICIPANTS

Thirty-eight amblyopic eyes of 36 adult patients who had undergone PRK ranging from -14.63 diopters (D) to +3.75 D (mean, -6.38+/-4.10) were analyzed.

METHODS

Preoperative and postoperative (1, 3, and 6 months) refractions and measurements of the best spectacle-corrected visual acuity (BSCVA) were reviewed. Statistical evaluation was performed using a paired Student's t test.

MAIN OUTCOME MEASURES

Best-corrected visual acuity before and after PRK.

RESULTS

Before PRK, BSCVA ranged between 0.2 and 0.7 lines (mean, 0.60+/-0.13). One month after PRK, BSCVA ranged between 0.2 and 1.2 lines (mean, 0.77+/-0.24), with a significant difference (P = 3x10(-5)). Three months after PRK, BSCVA ranged between 0.15 and 1.15 lines (mean, 0.84+/-0.23), with a significant difference (P = 5x10(-7)). Six months after PRK, BSCVA ranged between 0.25 and 1.3 lines (mean, 0.88+/-0.25), with a significant difference (P = 8x10(-8)).

CONCLUSIONS

Our study does not imply that refractive surgery should or may be performed in young children but, rather, that adults wishing to undergo refractive surgery may undertake such procedures despite an amblyopic eye thought to be refractory to visual rehabilitation by conventional methods, such as spectacles and contact lenses.

Reliability of a new correcting factor in calculating intraocular lens power after refractive corneal surgery

PURPOSE

To test the reliability of a corneal radius correcting factor (R factor) in calculating intraocular lens (IOL) power in eyes that developed cataract after refractive surgery and compare it with the clinical history (CHM) and double-K (DKM) methods.

SETTING

Department of Ophthalmology, Second University of Naples, Naples, Italy.

METHODS

Nineteen eyes from the literature that underwent cataract extraction and IOL implantation after refractive surgery were used to compare actual postoperative and expected refractive errors utilizing the R factor, CHM, and DKM. Intraocular lens powers were calculated with 3 formulas: SRK/T, Hoffer Q and Holladay 1. The differences were evaluated with the Wilcoxon test and Spearman correlation.

RESULTS

With the R factor SRK/T and Holladay 1 formulas gave the best results; 16 (84.2%) and 17 (89.5%) eyes were within +/-2 diopters (D) of emmetropia. With CHM, the best results were obtained using the SRK/T and Holladay 1 formulas; with both formulas 12 (63.2%) eyes were within +/-2 D of emmetropia. With DKM, the best results were obtained using SRK/T and Holladay 1 formulas; with both formulas 10 eyes (52.63%) were in the range of +/-2 D from emmetropia.

CONCLUSIONS

The R factor can be used with the SRK/T or Holladay 1 formula because this method seems comparable or superior to DKM and CHM.

Axial Eye Length Evaluation Before and After Myopic Photorefractive Keratectomy

PURPOSE

To test the accuracy of a new device (IOL Master; Carl Zeiss, Jena, Germany) in detecting axial eye length changes after photorefractive keratectomy (PRK).

METHODS

Pre- and postoperative (1, 3, and 6 months) subjective refraction and axial eye length measurements were performed in 184 consecutive eyes that underwent PRK with the Nidek EC5000 excimer laser (Nidek Technologies, Gamagori, Japan) to treat refractive errors from +0.25 to -16.25 diopters (D) (mean: -5.12 +/- 3.01 D).

RESULTS

The axial eye length measurements ranged from 22.51 to 31.32 mm (mean: 25.61 +/- 1.47 mm) before PRK; from 22.39 to 31.10 mm (mean: 25.48 +/- 1.43 mm) 1 month after PRK; from 23.17 to 31.14 mm (mean: 25.61 +/- 1.36 mm) 3 months after PRK; and from 23.36 to 29.68 mm (mean: 25.58 +/- 1.35 mm) 6 months after PRK. Preoperative and 1-month postoperative data showed a statistically significant difference (P<.001), whereas no significant difference was found between 1 and 3 months (P=.0137) or 3 and 6 months (P=.2422).

CONCLUSIONS

The IOL Master showed a decrease in the axial eye length measurement larger than the theoretical ablation depth and the difference increased as the correction became higher.

Reliability of the IOLMaster in measuring corneal power changes after photorefractive keratectomy

PURPOSE

To test the accuracy of the IOLMaster (Carl Zeiss) in detecting corneal power changes after photorefractive keratectomy (PRK).

SETTING

Department of Ophthalmology, 2nd University of Naples, Naples, Italy.

METHODS

Two hundred twenty-five consecutive eyes that had PRK (mean -5.13 diopters [D] +/- 2.98 [SD] [range +0.25 to -16.25 D]) were analyzed. The data included preoperative and postoperative (1, 3, and 6 months) subjective refraction and computerized keratometry. Statistical analysis was performed to determine the correlation between the changes in the subjective refraction at the corneal plane and the changes in keratometry.

RESULTS

The mean difference between the changes in refraction and the measured corneal changes was 0.75 +/- 1.13 D (range -3.84 to +7.68 D) at 1 month, 0.92 +/- 1.10 D (range -0.87 to +7.93 D) at 3 months, and 0.75 +/- 0.98 D (range -1.70 to +3.85 D) at 6 months. The difference was significant (P<.001).

CONCLUSION

Automated keratometry provided by the IOLMaster did not accurately reflect the effective refractive changes after PRK, particularly in eyes that had a high dioptric treatment.

Correlation of Changes in Refraction and Corneal Topography After Photorefractive Keratectomy

PURPOSE

To establish which corneal power evaluation measured with corneal topography correlates best with refractive changes after photorefractive keratectomy (PRK) for myopia.

METHODS

Two hundred fifty-one consecutive eyes of 171 patients who had PRK for myopia ranging from -14.80 to -0.50 D (mean -5.43 +/- 2.978 D), calculated at the corneal plane, were included in the analysis. Data included preoperative and postoperative (1, 3, and 6-mo) subjective refraction and videokeratography with a Keratron Scout (Optikon 2000). Statistical analysis was performed to determine the correlation between the change in subjective refraction at the corneal plane and changes in six corneal power measurements: best fit sphere, simulated keratometry (Sim K), corneal apex, and center of the pupil (last two evaluated for axial and meridional curvatures).

RESULTS

The closest correlation between subjective refraction change and corneal power measurement during the three follow-up evaluations was found with Sim K (R2 = 0.904; 0.889; 0.854) and best fit sphere (R2 = 0.919; 0.909; 0.872), whereas the other measurements showed poor correlation with the different curvatures.

CONCLUSIONS

The best fit sphere corneal topography parameter correlated best with the refractive changes, primarily for low treatment amounts, whereas it showed a clear-cut underestimation in eyes that had undergone high dioptric treatments.

[Complete rectal prolapse in a patient with Hirschsprung disease: a clinical case]

The disease of Mya-Hirschsprung (HD) it's rare and congenital, usually diagnosed in child age, but that it can also remain unknown until the adult age. It's associated to genetic mutations and it can involve other pathologies and malformations. The variability of the anatomopathological and clinical phenomena is correlated to the length of the aganglionic segment. The Authors describe the clinical case of one young female patient, who presented chronic constipation (less than 3 evacuations to week), tenesm, meteorism, abdominal pain. To the inspection of the anal region after the evacuation the presence of complete rectal prolapse (3) cylinders of the length of 30 cm was appraised, with presence of ulcerations of the mucosa. The patient came subordinate to diagnostic study that they demonstrated the presence of HD. The Authors operated the patient with the technique of Frykman and Goldberg. In the follow-up the patient had the complete remission of the symptomatology and resumption of the rectoanal inhibitory reflex, remarkable diminished in the preoperative manometric examination. The pathogenesis of the association of HD and rectal prolapse goes searched in the presence of ultrashort HD (aganglionic defect of a limited segment of rectum), pathological variety somewhat rare that can determine subocclusive phenomena and that it favors the prolapse of the rectum for the continuous evacuating strains.

Doxorubicin coupled to lactosaminated human albumin remains confined within mouse liver cells after the intracellular release from the carrier

BACKGROUND

The hepatocyte receptor for asialoglycoproteins, which binds and internalises galactosyl terminating peptides, was found to be expressed also on the cells of the majority of hepatocarcinomas.

AIMS

To verify whether doxorubicin coupling to lactosaminated albumin, a galactosyl terminating neoglycoprotein, produces selective drug accumulation in hepatocytes with reduced concentrations in extra-hepatic tissues, thus facilitating the use of the drug in hepatocarcinoma treatment.

METHODS

Doxorubicin concentrations were measured in organs of mice injected with the free or coupled drug.

RESULTS

In mice injected with the coupled drug, the ratios between doxorubicin concentrations in liver and those in heart, intestine, spleen and kidney were 8-14 times higher than in animals that received the same dose of the free drug.

CONCLUSIONS

Due to the very efficient liver targeting of doxorubicin, the lactosaminated human albumin-doxorubicin conjugate appears to have the potential of improving the chemotherapy of hepatocellular carcinomas through the asialoglycoprotein receptor.

Right ventricular myocardial infarction: when the power fails

Learn how to recognize this common complication of an acute inferior or posterior wall myocardial infarction and to give patients the correct treatment.

Anterior Corneal Surface After Nidek EC-5000 Multipass and Multizone Photorefractive Keratectomy for Myopia

PURPOSE

To evaluate the correlation between the presence of irregularities in corneal ablation and the number of ablation zones with multipass and multizone photorefractive keratectomy (PRK).

METHODS

The differential maps obtained from corneal topography performed before and 1 month after PRK in 62 eyes that had undergone PRK with the Nidek EC-5000 excimer laser were assessed for irregularities. PRK treatment ranged from -1.00 to -16.00 D (mean -5.25 +/- 2.72 D), and the number of zones ranged from one to five.

RESULTS

Of 62 differential maps, 27 had an irregular pattern according to the Hersh classification, with a non-significant correlation with the number of treatment zones (chi2 = 5.09, P >.1).

CONCLUSION

Our results suggest that corneal topography irregularities arising from multizone PRK were not related to the amount of treatment or to the number of ablation zones.

Identification of the gene altered in Berardinelli-Seip congenital lipodystrophy on chromosome 11q13

Congenital generalized lipodystrophy, or Berardinelli-Seip syndrome (BSCL), is a rare autosomal recessive disease characterized by a near-absence of adipose tissue from birth or early infancy and severe insulin resistance. Other clinical and biological features include acanthosis nigricans, hyperandrogenism, muscular hypertrophy, hepatomegaly, altered glucose tolerance or diabetes mellitus, and hypertriglyceridemia. A locus (BSCL1) has been mapped to 9q34 with evidence of heterogeneity. Here, we report a genome screen of nine BSCL families from two geographical clusters (in Lebanon and Norway). We identified a new disease locus, designated BSCL2, within the 2.5-Mb interval flanked by markers D11S4076 and D11S480 on chromosome 11q13. Analysis of 20 additional families of various ethnic origins led to the identification of 11 families in which the disease cosegregates with the 11q13 locus; the remaining families provide confirmation of linkage to 9q34. Sequence analysis of genes located in the 11q13 interval disclosed mutations in a gene homologous to the murine guanine nucleotide-binding protein (G protein), gamma3-linked gene (Gng3lg) in all BSCL2-linked families. BSCL2 is most highly expressed in brain and testis and encodes a protein (which we have called seipin) of unknown function. Most of the variants are null mutations and probably result in a severe disruption of the protein. These findings are of general importance for understanding the molecular mechanisms underlying regulation of body fat distribution and insulin resistance.

Citrus pulp and wheat straw silage as an ingredient in lamb diets: effects on growth and carcass and meat quality

Twenty "Merinizzata Italiana" lambs were introduced to two experimental diets. Ten animals (five males and five females, control group) received the traditional diet that is supplied by farmers in southern Italy, which comprised of oat hay ad libitum and commercial concentrate. The second group (the same number of lambs, silage group) received citrus pulp and wheat straw silage ad libitum and 70% of the commercial concentrate supplied to the control group. The animals were slaughtered after 80 days of feeding and carcass and some meat quality parameters were measured. No differences were observed for live weight between treatments, and carcass weights were similar for the two diets, but with obvious differences between sexes. Animals on silage produced carcasses with a better muscular conformation and with a lower fatness score (P<0.05). Subcutaneous fat colour was influenced by sex, being lighter in the female carcasses (P<0.05). Dissection of different anatomical parts showed a higher percentage of lean and a lower proportion of fat in silage samples compared to control ones. Ultimate pH was highly affected by sex being higher in the samples from male lambs (P<0.01), but was unaffected by diet treatment. Diet tended to affect meat shear force value which was lower in the silage samples, although, samples from all the animals were extremely tender. Meat from silage samples had a higher water content (P<0.05). Overall, in our experimental conditions, the use of citrus pulp silage seemed to be economically convenient for producing animals with substantially unmodified carcass and meat quality characteristics.

111In platelet scintigraphy for the noninvasive detection of carotid plaque thrombosis

BACKGROUND AND PURPOSE

Thrombosis on atherosclerotic lesions in the large extracranial arteries is the main cause of embolization in the distal cerebral circulation and thus is involved in the pathogenesis of ischemic stroke. The assessment of biological characteristics of lesions that are predictive of thrombotic complications might help in stratification of the risk for stroke but is currently imperfect.

METHODS

We compared the performance of (111)In-platelet scintigraphy with blood pool subtraction, ultrasound-based tissue texture analyses, and transcranial Doppler techniques in their ability to predict the occurrence of superficial thrombosis or the presence of a lipid pool in carotid artery plaque specimens removed at the time of carotid endarterectomy in 22 patients with unilateral carotid artery stenosis of >70%.

RESULTS

Positivity at (111)In-platelet scintigraphy was present in 8 patients and correctly identified the presence of thrombosis superimposed on a complicated plaque. Neither tissue texture analysis nor emboli detection by transcranial Doppler, performed in 12 patients, significantly identified plaque thrombosis. None of the techniques used were able to detect the presence of a significant lipid pool inside the plaque.

CONCLUSIONS

Indium-platelet scintigraphy is an accurate noninvasive diagnostic tool to detect thrombotic complications in carotid plaques. Prospective studies should assess its ultimate value in risk stratification, possibly to guide the decision of whether to perform endarterectomy in selected patient categories.

Polyethylene glycol as a means for reducing the impact of condensed tannins in carob pulp: effects on lamb growth performance and meat quality

We conducted an experiment to evaluate the effects that a diet containing condensed tannins with and without polyethylene glycol (PEG) has on lamb growth and meat quality. Twenty-three male Comisana lambs were introduced to the three experimental diets between 45 and 50 d of age. Eight were given a diet containing 56% of Ceratonia siliqua (carob) pulp (tannin group), another eight received the same diet with a supplement of 40 g of PEG for each kilogram of diet (PEG group), and the remaining seven lambs were given a conventional maize-based diet (maize group). Voluntary feed intake and live weights were measured until slaughter at 105 d of age, and digestibility measurements were undertaken toward the end of the feeding trial. Carcass yield, meat quality characteristics, and a taste panel evaluation were conducted. The tannin-based diet contained 2.5% condensed tannins (DM basis), and lambs given this diet had lower growth rates and poorer feed efficiencies (P < .01) compared with the other treatment groups. Daily gain was similar between the maize and PEG lambs, although the efficiency of feed conversion was highest in the maize group. The digestibility of DM, N, and fiber was reduced (P < .05) by the condensed tannins. Lambs fed the tannin diet had a lower carcass yield (P < .05) and had less fat (P < .05), and the meat had a higher ultimate pH (P < .01) than those given the PEG or maize diets. Condensed tannins affected meat color, which was lighter (L*) than meat from lambs given the PEG-containing diet (P < .01). Sensory evaluation showed that panelists preferred meat from lambs receiving PEG and maize treatments compared with those receiving the tannin diet, and this could be related to differences in meat ultimate pH and carcass fatness. These results show that condensed tannins from carob pulp are very detrimental to feed digestibility and lamb performance. Inclusion of 40 g of PEG/kg diet eliminated the effects of condensed tannins so that lamb performance and meat quality were similar to lambs given a maize-based diet.

Cholecystokinin (CCK) increases GABA release in the rat anterior nucleus accumbens via CCK(B) receptors located on glutamatergic interneurons

The effects of cholecystokinin sulfate octapeptide (CCK-8S) on [3H]gamma-aminobutyric acid (GABA) release have been studied in the anterior side of the rat nucleus accumbens on tissue punches exposed in superfusion to 30 mM KCl. CCK-8S in a concentration dependent manner (10-3000 nM) increased K+-evoked [3H]GABA release (EC50=192 nM). The increase caused by 1 microM CCK-8S ranged from 37% to 42%. CR 2945, (beta-[2-[[2-(8-azaspiro[4.5]dec-8-ylcarbonyl)-4,6-dimethylp henyl]-amino]-2-oxoethyl]-(R)-1-naphthalenepropanoic acid), a potent and selective nonpeptidergic CCK(B) antagonist, concentration-dependently blocked CCK-8S effect (IC50=2.16 nM). CCK-8S-induced increase in [3H]GABA overflow was completely blocked by 1 microM tetrodotoxin. Both the alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate (AMPA)/kainate receptor antagonist 6,7-dinitroquinoxaline-2,3-dione (DNQX) and the N-methyl-D-aspartic acid (NMDA) receptor antagonist dizocilpine (MK-801) antagonized the CCK-8S effect. By contrast, (+)-bicuculline, a GABA(A) receptor antagonist, was completely ineffective. Phaclofen, a selective GABA(B) antagonist, increased K+-evoked [3H]GABA release but did not affect the facilitative effect of CCK-8S. Moreover, tetrodotoxin failed to block AMPA-evoked [3H]GABA release but completely prevented the effect of NMDA (Mg2+ free conditions). The data presented suggest that CCK(B) receptors modulating [3H]GABA release from anterior accumbal punches may not be present on GABAergic terminals but could be located on glutamatergic interneurons.

Characterization of a novel putative cognition enhancer mediating facilitation of glycine effect on strychnine-resistant sites coupled to NMDA receptor complex

The effects of (S)-4-amino-5-[(4,4-dimethylcyclohexyl)amino]-5-oxo-pentanoic acid ((S)CR 2249), a new chemical entity selected among a series of glutamic acid derivatives, were investigated on N-methyl-D-aspartate (NMDA)-evoked release of [3H]noradrenaline from rat hippocampal slices. (S)CR 2249 facilitated glycine-mediated reversion of kynurenate antagonism at strychnine-insensitive glycine receptors coupled to the NMDA receptor. The potency of glycine (EC50 = 21.5 microM +/- 4.2) was not significantly influenced by (S)CR 2249. Nevertheless, the efficacy of the glycine effect was enhanced in a concentration-dependent manner (3-10-30 microm) by (S)CR 2249. The interaction of (S)CR 2249 with NMDA receptors was also studied with binding experiments, in which we examined the effect of (S)CR 2249 on the modulation by glutamate, glycine and spermine of [3H]dizocilpine (MK-801) binding. (S)CR 2249, increased [3H]MK-801 binding in a concentration-dependent manner and we found positive cooperative interactions between glycine and (S)CR 2249, indicating that (S)CR 2249 probably acts at a separate allosteric site to increase NMDA receptor functionality.

Changes in the permeability of the blood-brain barrier following sodium dodecyl sulphate administration in the rat

The blood-brain barrier (BBB) arises from epithelial-like tight junctions that virtually cement adjoining capillary endothelium together in the brain microvasculature. Several experimental manipulations have been shown able to increase the permeability of brain capillaries, by altering endothelial cell membrane integrity or activating specific biochemical pathways involved in regulation of BBB functionality. Because of its amphiphilic nature, sodium dodecyl sulphate (an anionic surfactant widely used as solubilizer or stabilizer in several pharmaceutical preparations; SDS) may enter into interactions with the major membrane components, which are lipids and proteins. The aim of the present study was to determine the effect of an intracarotid infusion of SDS (25, 50 and 100 microg/kg; infusion rate: 3 ml/min for 30 s) on the functionality of the BBB in the rat. An extensive, dose-dependent Evans blue extravasation was observed, in the ipsilateral brain hemisphere, 15 min following SDS infusion. These results were confirmed by the significant increase in [14C]alpha-aminoisobutyric acid ([14C]AIB) transport (evaluated by calculating a unidirectional transfer constant, Ki, for the tracer from blood to brain) measured in several ipsilateral brain regions 2 min after SDS infusion; this SDS-elicited BBB opening to [14C]AIB proved to be reversible. Since the BBB is created by the plasma membrane and tight junctions of the endothelial cells, the change in BBB permeability caused by SDS might be explained as a nonspecific surfactant-membrane interaction. Furthermore, SDS might affect the functional characteristics of brain vascular endothelial cells by an interaction with specific BBB proteins and/or biochemical pathways. In conclusion, one can suggest that intracarotid infusion of SDS might provide a useful clinical approach for the intentional introduction of different substances into the brain. On the other hand, these findings should call attention to possible dangerous consequences of using SDS as solubilizer in drug excipients.

CR 2249: a new putative memory enhancer. Behavioural studies on learning and memory in rats and mice

The effects of S-4-amino-5-[4,4-dimethylcyclohexyl)amino]-5-oxopentanoic acid (CR 2249), a new entity selected from a new series of glutamic acid derivatives, has been investigated in different paradigms for screening nootropics. CR 2249 ameliorated the memory retention deficit produced by scopolamine in step-through-type passive avoidance in rats and by electroconvulsive shock in step-down-type passive avoidance in mice. CR 2249 was also capable of improving performance in behavioural tests of learning and memory in the absence of cholinergic hypofunction or cognitive deficit. The activity was determined using different passive and active avoidance behavioural test procedures on rats. CR 2249 was active only when given 45 min before training and did not show any effect when administered immediately after the learning training or before the retention trial. No changes in the general behaviour or motor activity of the animals were observed, indicating that CR 2249 effects cannot be attributed to sensory-motor deficit. Microdialysis experiments have shown that CR 2249 significantly increased noradrenaline release in the hippocampus of freely moving rats and reduced 3,4-dihydroxyphenylglycol efflux. These effects have led us to hypothesize that CR 2249 memory effect might be mediated by a direct or indirect action on noradrenergic transmission. These behavioural results suggest that this new agent has clinical application in memory disorders.

Transport of alpha-tocopherol and its derivatives through erythrocyte membranes

PURPOSE

To investigate the transport of alpha-tocopherol (T), tocopherol succinate (TS) and tocopherol succinate-3-glucose (a newly synthetized, less hydrophobic T ester; TSG) through bovine erythrocyte membranes.

METHODS

Our experiments were carried out on erythrocytes (obtained from heparinized fresh bovine blood), because they represent a suitable model for investigations of membrane transport.

RESULTS

T was shown to reside almost completely in the suspension medium, while the greater part of TS disappeared from the suspension medium and was mainly incorporated into erythrocyte membranes. In comparison with T, a larger amount of TSG was incorporated into erythrocyte membranes and taken up by cells; however the TSG intracellular accumulation was significantly lower than that observed with TS. Furthermore, the transport of TS and TSG was partially inhibited by p-chloromercuribenzenesulfonate (which inhibits monocarboxylate uptake; PCMBS) and by maltose (a competitive inhibitor of glucose transport) respectively, with a concomitant increase in drug membrane incorporation. No significant change in drug transport was observed in the presence of 4,4'-diisothiocyanostilbene-2,2'-disulfonate, a selective and irreversible blocker of band 3 protein (DIDS).

CONCLUSIONS

Our results show 1) the existence of large differences in membrane incorporation of T, TS and TSG (very likely caused by differing abilities to fill spaces in the lipid bilayer) and 2) a specific contribution of the monocarboxylate transport protein and of the glucose transport protein in the cellular uptake of TS and TSG, respectively. A tempting suggestion is that the unique cytoprotective properties of TS may be related to the differences in the transmembrane mobility observed between T and its succinate ester. Furthermore, T conjugation to a monocarboxylate or glycoside moiety could provide suitable substrates for active membrane transport, thus appearing as a promising pharmaceutical strategy for the improved delivery of tocopherol derivatives.

Flavonoids as antioxidant agents: importance of their interaction with biomembranes

Flavonoids, a group of phenolic compounds widely occurring in the plant kingdom, have been reported to possess strong antioxidant activity. In the present study, four flavonoids (quercetin, hesperetin, naringenin, rutin), chosen according to their structural characteristics, were tested in two different in vitro experimental models: (1) Fe(2+)-induced linoleate peroxidation (Fe(2+)-ILP), by detection of conjugated dienes; and (2) autooxidation of rat cerebral membranes (ARCM), by using thiobarbituric acid for assay of free malondialdehyde production. The results obtained were also interpreted in the light of flavonoid interactions, studied by differential scanning calorimetry, with dipalmitoylphosphatidylcholine (DPPC) vesicles as a biological membrane model. The antilipoperoxidant activity of the flavonoids tested can be classified as follows: rutin > hesperetin > quercetin > naringenin in the Fe(2+)-ILP test: quercetin > rutin > hesperetin > naringenin in the ARCM test. Quercetin, hesperetin, and naringenin interacted with DPPC liposomes causing different shifts, toward lower values, of the main transition peak temperature (Tm) typical for DPPC liposomes; however, no change in Tm of DPPC dispersion was observed in the presence of rutin. The hypothesis will be discussed that flavonoid capacity to modify membrane-dependent processes, such as free-radical-induced membrane lipoperoxidation, is related not only to their structural characteristics but also to their ability to interact with and penetrate the lipid bilayers.

Systemic cytokine administration can affect blood-brain barrier permeability in the rat

The aim of the present study was to clarify the effect of intracarotid injection of interleukin-1 beta (IL-1 beta), interleukin-2 (IL-2), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) on the permeability of the blood-brain barrier (BBB) in the rat. A regional blood-to-brain transfer constant (Ki) for [14C] alpha-aminoisobutyric acid ([14C]AIB) and the cerebral residual blood volume were calculated 10 min following administration of cytokines (CKs; 1000 U/rat). The injection of IL-2 and IL-6 (but not of IL-1 beta) induced a significant enhancement of Ki values for [14C]AIB within several brain areas; conversely, when the rats were given TNF-alpha, a striking decrease in BBB permeability was observed. The cerebral regional blood volumes appeared significantly lower in the rats injected with IL-6 than in the control animals, but markedly increased following TNF-alpha administration. Our findings confirm the ability of some CKs to affect the permeability of the BBB and/or to act, probably indirectly, as vasomodulator agents of the cerebral microvessel endothelium.

Bleeding time and bleeding: an analysis of the relationship of the bleeding time test with parameters of surgical bleeding

The bleeding time is currently the only clinically available comprehensive test to explore primary hemostasis. It is currently performed mostly as a screening procedure before surgery, to detect otherwise unknown defects in platelet-vessel wall interactions, but its use in this specific setting has been seriously questioned by recent reanalyses of previously published literature. We studied the relationship of the bleeding time from a standardized cutaneous incision with other parameters of bleeding derived from the analysis of the bleeding time curve and prospectively investigated possible correlations of these alternative parameters, as well as of the bleeding time, with a number of indices of actual bleeding during or after coronary bypass surgery. Four parameters (bleeding time, total bleeding, peak bleeding rate, and time to peak bleeding) were derived from the analysis of bleeding time curves measuring blood losses from a standardized cutaneous incision at 30-second intervals in 118 subjects. Parameters from the bleeding time curve were subsequently obtained in duplicate as a preoperative assessment in 40 patients with a negative bleeding history and no recent intake of non-steroidal anti-inflammatory drugs who were undergoing elective pure coronary bypass surgery performed by the same operator. These parameters were correlated in simple linear regression analysis with estimates of surgical bleeding (chest tube drainage, transfusion requirements, percentage of hematocrit, percentage of platelet level decrease, and times to hematocrit and platelet level nadir) and then, in multiple regression analysis, with indices of operation complexity (number of bypasses, total duration of the operation, and duration of the extracorporeal circulation). Bleeding time was significantly correlated, among parameters derived from the bleeding time curve, with total bleeding and peak bleeding rate, but not with time to peak bleeding. Bleeding time, total bleeding, and peak bleeding rate were similarly affected by acute interventions with intravenous aspirin (500 mg) and sublingual nitroglycerin (0.3 mg). None of these parameters, which were obtained in duplicate in each patient preoperatively, was significantly related to actual indices of bleeding at surgery. Thus, in patients with a negative history of bleeding and no recent intake of non-steroidal anti-inflammatory drugs, higher values for bleeding time and bleeding time-related parameters are not associated with higher indices of perioperative and postoperative bleeding at coronary bypass surgery. Therefore, we do not recommend the use of the test in this setting to predict perioperative or postoperative bleeding.

Protective effect of glutathione on kainic acid-induced neuropathological changes in the rat brain

1. Glutathione (GSH), injected by slow intravenous (i.v.) infusion (7.9 microliters/min, for 4 hr; total dose: 1.5 g/kg), starting 10 min after i.v. injection of kainic acid (KA; 12 mg/kg) in the rat reduced the decrease in local cerebral glucose utilization observed 48 hr following the administration of the neurotoxin. 2. Furthermore, it blocked the neuronal loss in hippocampal CA1 and CA3 regions, and prevented, in the hippocampus, the development of edema and the marked depletion in the endogenous brain GSH pool. 3. One can speculate that this protective effect of exogenous GSH is correlated to its capacity to scavenge free radicals, thus preventing the accumulation of oxidant chemical species and the consequent reduction of cellular antioxidant defense.

Genetically epilepsy-prone rodents show some changes of ion levels in the brain

In the present study the water and ion (Na+, K+, Ca2+, Fe3+, Se4+, Mg2+, Mn2+, Mn2, Se4+, Cu2+) content in the brain of genetically epilepsy-prone rats (GEPRs) and of 21-, 45-, and 60-day-old DBA/2 mice were determined, and compared with those measured in normal controls (Sprague-Dawley rats and Swiss mice), to verify whether the predisposition to audiogenic seizures (AGS) may be partially related to changes in the cerebral osmotic and ionic state. Our findings clearly evidenziate two points: a) a more complex shift in brain ionic balance (rather than a peculiar modification in the concentration of a single ion) seems very likely involved in AGS susceptibility; (b) brain Ca2+ and Se4+ amounts, together with the water content, appear to be really important factors to which a role in abnormal seizure predisposition may be attributed.

CGP 52432: a novel potent and selective GABAB autoreceptor antagonist in rat cerebral cortex

As previously reported GABAB receptors are heterogeneous. Three pharmacologically distinct receptor subtypes mediating inhibition of gamma-aminobutyric acid (GABA), glutamate or somatostatin release, respectively, exist on axon terminals of rat cerebral cortex. We investigated the novel GABAB receptor antagonist, [3-[[(3,4-dichlorophenyl)methyl]amino]propyl](diethoxy-methyl) phosphinic acid (CGP 52432), on the above receptor subtypes. The effects of (-)-baclofen on the K(+)-evoked release of GABA, glutamate or somatostatin from rat cortical synaptosomes were antagonized by CGP 52432. The IC50 of the drug at GABA autoreceptors (0.085 microM) was 35- and 100-fold lower than at the receptors regulating somatostatin and glutamate overflow, respectively. At the autoreceptor the calculated pA2 for CGP 52432 amounted to 7.70, which makes the drug about 1000-fold more potent than phaclofen at this receptor. The potency and selectivity characteristics of CGP 52432 indicate that the drug is by far the most appropriate tool to investigate the terminal GABAB autoreceptors of the rat cerebral cortex.

[A rare cause of hypercalcemia: familial hypocalciuric hypercalcemia]

BACKGROUND

Familial hypocalciuric hypercalcemia is a rare disease with autosomal dominant transmission. Its basic defect is unknown and it requires no treatment.

CASE REPORT

A 4 month-old girl was admitted for unexplained crying. She was found to have hypercalcemia (2.8 mmol/l) and later values of blood calcium were 3, 3.1 and 3 mmol/l. The serum free ionic calcium level was also elevated. The serum concentrations of protein, phosphorus, magnesium and the alkaline phosphatase activity were all normal. Serum concentrations of 25-(OH)-D3, 1.25-(OH)-2-D3 and PTH were also normal. The urinary calcium/creatinine ratio was normal and the urinary calcium excretion was 1.08 mg/kg/d. Screening of family members showed hypercalcemia in the father (2.8 mmol/l) and a brother aged 7 years (2.9 mmol/l). Short-term treatment with disodium etidronate lowered the serum calcium level to normal, but hypercalcemia reappeared once the treatment was discontinued.

CONCLUSIONS

This asymptomatic familial hypercalcemia has the characteristics of familial hypocalciuric hypercalcemia. There was no associated endocrine disorder. Screening of family members is worthwhile.

Release of endogenous glutamic and aspartic acids from cerebrocortex synaptosomes and its modulation through activation of a gamma-aminobutyric acidB (GABAB) receptor subtype

The depolarization-evoked release of endogenous glutamate (GLU) and -aspartate (ASP) and its modulation mediated by gamma-aminobutyric acid (GABA) heteroreceptors was investigated in superfused rat cerebrocortical synaptosomes. Exposure to 12 mM K+ enhanced the release of GLU and ASP. The K(+)-evoked overflow of both amino acids was largely Ca(2+)-dependent. Exogenous GABA inhibited the K(+)-evoked overflow of GLU (EC50 2.8 microM) and ASP (EC50 2.7 microM). The effect of GABA was mimicked by the GABAB receptor agonist (-)-baclofen (EC50 2.0 microM for GLU and 1.3 microM for ASP release) but not by the GABAA receptor agonist muscimol, up to 100 microM. Accordingly, the GABA-induced inhibition of GLU and ASP release was not affected by the GABAA receptor antagonists, bicuculline or picrotoxin, but was antagonized by the GABAB receptor antagonist, 3-amino-propyl(diethoxymethyl)phosphinic acid (CGP 35348). The GABA effect was, however, insensitive to another GABAB receptor antagonist, phaclofen, up to 1,000 microM. It can be concluded that GABA heteroreceptors of the GABAB type regulating the depolarization-evoked release of GLU and ASP are present on cortical GLU/ASP-releasing nerve terminals. These receptors may be classified as a phaclofen-insensitive GABAB receptor subtype.

[Research on Kathon CG in cosmetic and personal hygiene products]

Kathon is an anti-microbial agent that is used as a preservative in cosmetics and bodily hygiene products. At the recommended levels of usage Kathon is innocuous and has a recognised efficacy. Nevertheless, following reappearance of contact allergic eczemas due to cosmetics and bodily hygiene products different authors have reported increase in sensitisation to it. We have met the same problems in the Service de Dermatology++ of the Hospital Sainte Marguerite at Marseille and we wished to make a deeper examination of the question and to ascertain whether the current cosmetics contained Kathon CG. For this we have developed a technique of liquid chromatography and tested 44 creams. Eight contained Kathon CG, of which 2 were responsible for contact eczema in patients.

[The safe transportation of children in automobiles]

The Author emphasizes the significant number of children who sustain fatal accidents during their transport on motor vehicles and relates the Act recently promulgated by the Italian Parliament on the mandatory use of particular restraining devices as well as safety harness for children.