High-performance liquid chromatography determination of alpha1-acid glycoprotein in small volumes of plasma from neonates

In order to investigate how the alpha1-acid glycoprotein (AGP) concentrations of neonates change in response to surgical stress, a simple high-performance liquid chromatography (HPLC)-assay for the measurement of alpha1-acid glycoprotein levels was developed. A fraction containing alpha1-acid glycoprotein was isolated from the bulk of plasma protein by addition of 0.6M perchloric acid and was then analysed directly on a short PLRP-S 4000A reversed phase column column. The method was validated by analysis of pooled plasma from healthy adults both in comparison with a calibration curve and by standard additions. The procedure was able to isolate alpha1-acid glycoprotein rapidly (<30 min) and required only 50 microl of plasma. The mean extraction recovery was 79.1% (CV 6.4%). The within-run precision for the analysis of three replicates of quality control sample ranged from +/-1.2 to +/-3.8% and the between-run precision was +/-6.1%. The method was linear (r(2)=0.988) over a concentration range from 6 to 100.0 mg/100 ml. The AGP levels in neonatal samples ranged from 25 to 93 mg/100 ml.

The effect of limited overfeeding during growth on muscle characteristics: a pig model

Energy restriction affects the hypothalamus, leading to a decrease in production of reproductive and thyroid hormones. A decrease in reproductive hormones affects fertility and a decrease in thyroid hormones affects muscle metabolism. A pig model has been used to determine that reproductive function is negatively affected if the normal practice of overfeeding is limited during the late luteal phase of the estrous cycle. We used a sub-set of pigs from this study to examine effects of limiting overfeeding on thyroid hormones and skeletal muscle (i.e. maximal enzyme activities, and muscle fibre characteristics). Eighteen rapidly growing gilts were randomized into three groups: 1) feeding a high plane of nutrition throughout the first 15 days of the estrous cycle; 2) limited overfeeding (25% below the first group) for first 7 days of the estrous cycle (early luteal phase), followed by a high plane of nutrition for days 8-15 (late luteal phase); and 3) high plane of nutrition throughout the first 7 days of the estrous cycle, followed by 8 days of limited overfeeding. Muscle biopsies were collected from the triceps brachii, and blood samples were collected for assessment of thyroid hormones at days 0 (baseline), 8 and 16. There was no effect of limited overfeeding on thyroid hormones, maximal enzyme activities, muscle fibre area or muscle fibre type. Limited overfeeding in rapidly growing pigs does not affect thyroid hormone status or muscle characteristics.

Experimental sexual selection in Chlamydomonas

Sexual and asexual lines of the unicellular chlorophyte Chlamydomonas reinhardtii were propagated for about 100 sexual cycles and 1000 vegetative cycles in contrasted environments, liquid and solid growth media, in order to generate divergent natural and sexual selection. Sexual lines were transferred by many zygotes or by a single zygote in each sexual generation. By the end of the experiment zygote production was in the order sexual mass-transfer>sexual single-zygote>asexual>ancestor. The direct response to sexual selection was large, with zygote production increasing by about two orders of magnitude, mainly because mating had become spontaneous instead of being invoked by nitrogen starvation. Asexual lines became sexually sterilized by the fixation of a single mating type. Sexual selection caused a radical shift in the gender system, with homothallism spreading to high frequency in all sexual lines of this normally heterothallic species. This may have been caused by the transposition of a mating-type gene to an autosome. No substantial degree of environment-specific mating evolved, however, and thus no sexual isolation indicative of incipient speciation. It is possible that selection experiments of this kind are unlikely to induce sexual isolation because mating-type genes evolve in a saltatory fashion.

Epilepsy in the United Kingdom: seizure frequency and severity, anti-epileptic drug utilization and impact on life in 1652 people with epilepsy

OBJECTIVES

To describe the clinical characteristics of epilepsy in a representative sample of the UK population, including seizure frequency and severity; overall severity of epilepsy; patterns of anti-epileptic drug (AED) use; and the impact of epilepsy on patients' lives. Secondly, to determine if these characteristics differ according to age.

METHOD

A large, geographically comprehensive survey of people with epilepsy by means of a postal questionnaire distributed by general practitioners to 3455 unselected patients receiving AEDs for epilepsy, regardless of age or type of epilepsy and including all regions of the UK. Data were collected on age and gender; age of onset of seizures; seizure frequency and severity; AED use and adverse effect levels; and impact on life of epilepsy. Sub-analyses were performed with stratification by epilepsy severity and age-group.

RESULTS

There were 1652 completed replies. The mean age was 44.2 years; there were 47.2% males, 48.5% females (4.4% not recorded). The mean age at first seizure, 25.1 years, and the mean duration of epilepsy, 19.7 years, were comparable with previous studies. In the preceding one year, 51.7% of patients had no seizures; 7.9% one seizure, 17.2% 2-9 seizures and 23.2% 10 or more. Sixty-four percent of patients had epilepsy classified as mild and 32% severe. There was a marked and significant decrement of seizure frequency with increasing age. The most commonly used AEDs were carbamazepine (37.4%), valproate (35.7%), phenytoin (29.4%), phenobarbitone or primidone (14.2%) and lamotrigine (10.3%). Monotherapy was used in 68% of patients. Patients taking multiple AEDs reported significantly higher levels of adverse effects and worse seizure control. The major impacts of epilepsy on life were work and school difficulties, driving prohibition, psychological and social life. The impacts listed varied with the epilepsy severity and age.

CONCLUSIONS

Seizures remain uncontrolled in up to half of all people with epilepsy in the UK with significant impact on work, family and social life. Previously, there has been a deficiency of data on the characteristics of epilepsy in older people, although it is recognized that the condition is of increasing epidemiological importance in this age group. We have found clear differences in the clinical characteristics of epilepsy in older people, particularly that seizure frequency appears to decline with increasing age.

Remifentanil vs fentanyl/morphine for pain and stress control during pediatric cardiac surgery

BACKGROUND

Remifentanil is a short acting, potent synthetic opioid that does not accumulate after infusion or repeated bolus doses. It may be rapidly titrated to the requirements of individual patients. Titrated infusion of remifentanil may be able to provide potent analgesia required for pediatric cardiac surgery and obtund the stress response in theater whilst not having the persistent respiratory depression and sedation seen with longer acting opioids.

METHODS

Twenty patients were randomized to receive a titrated infusion of remifentanil (0-1 microg x kg(-1) x min(-1)) or a standard dose of fentanyl (30 microg x kg(-1)) prebypass plus morphine (1 mg x kg(-1)) on rewarming. Blood samples for glucose and cortisol were taken at regular intervals from induction through bypass and into the first 24 h of postoperative intensive care. In addition to biochemical indicators of the stress response we recorded baseline hemodynamic parameters and any acute physiological events.

RESULTS

Ten patients received morphine, seven received remifentanil. There were no statistically significant differences between the two treatment groups in cortisol measurements, mean arterial pressure or heart rate recordings. In the last time period the remifentanil group had a larger rise in blood glucose concentration (baseline 3.9, rise 3 mmol x l(-1)) than the fentanyl/morphine group (baseline 4.2 rise 1.9 mmol x l(-1)), CI -4.3 to -0.2.

CONCLUSIONS

The only significant difference was in glucose in the postbypass time periods. Although statistically significant, this difference is insufficient evidence of increased stress in the remifentanil group. The results show that in the patients studied there was no clinically important difference between the two techniques.

A Time and a Place for Standards

Over the next decade, we will encounter at least three major opportunities where success will hinge largely on our ability to define appropriate standards. That’s because intelligently crafted standards that surface at just the right time can do much to nurture nascent industries and encourage product development simply by creating a trusted and reliable basis for interoperability. From where I stand, the three specific areas I see as particularly promising are: (1) all telecommunications and computing capabilities that work together to facilitate collaborative work; (2) hybrid computing/home entertainment products providing for the online distribution of audio and/or video content; and (3) wireless sensor and network platforms (the sort that some hope the 802.15.4 and ZigBee Alliance standards will ultimately enable). No doubt there will be others, but for the purposes of this discussion, these should suffice.

The toxicosis of Embellisia fungi from locoweed (Oxytropis lambertii) is similar to locoweed toxicosis in rats1

Locoweeds cause significant livestock poisoning and economic loss in the western United States. The toxicity of Embellisia sp. fungi isolated from locoweed was compared with locoweed toxicity using the rat as a model. Rats were fed diets containing locoweed, fungus and alfalfa, or alfalfa. Locoweed- and fungus-fed rats consumed swainsonine-containing food at approximately 1.3 mg x kg(-1) x d(-1), gained less weight (P = 0.001) and ate less than controls. Swainsonine is the principal agent responsible for inducing locoism in animals. The concentrations of alkaline phosphatase and aspartate aminotransferase enzymes were greater (P < 0.05) in serum of locoweed- and fungus-fed rats compared with control rats. Similar intracellular vacuolation was observed in renal, pancreatic, and hepatic tissues of rats that consumed either locoweed or fungus. Rats that ate locoweed or Embellisia fungi displayed indistinguishable toxicity symptoms. The Embellisia fungi from locoweed can induce toxicity without the plants. Locoism management strategies need to involve management of the Embellisia fungi.

Persistence of two genotypes of Neisseria gonorrhoeae during transmission

Isolates of Neisseria gonorrhoeae were tested using a highly discriminatory typing method, opa typing, to examine the genetic diversity over a 2-year study period of isolates from all consecutive patients with gonorrhea attending the Genitourinary Medicine clinic in Sheffield, United Kingdom. Two opa genotypes were detected throughout the 2-year time period and comprised 41% of all strains tested. The persistence of two opa types was investigated further to determine the apparent genetic stability, by examining the ability of isolates to undergo intragenic and intergenic recombination and mutation in vitro. Intragenic recombination or mutation involving the opa genes of N. gonorrhoeae in the selected isolates was not detected, but intergenic recombination did occur. opa genes of N. gonorrhoeae in vivo appear to diversify primarily through intergenic recombination. Intergenic recombination in vivo would require the presence of a mixed gonococcal infection, in which an individual is concurrently colonized with more than one strain of N. gonorrhoeae. We propose that the level of diversity of opa genotypes in a population is linked to the degree of sexual mixing of individuals and the incidence of mixed infections of N. gonorrhoeae.

Intact sympathetic nervous system is required for leptin effects on resting metabolic rate in people with spinal cord injury

Compared with able-bodied (AB), people with spinal cord injury (SCI) have a 3- to 5-fold higher risk of developing type 2 diabetes mellitus, which may be associated with increased fat mass. Evidence suggests that leptin regulates body adiposity through the sympathetic nervous system, which is impaired in people with high lesion SCI. The purpose of this study was to determine the relationship among leptin levels, body composition, and resting metabolic rate (RMR) in people with high lesion SCI and body mass index-, weight-, height-, and waist circumference-matched AB subjects. Fourteen subjects (seven SCI and seven AB) participated in the study. After an overnight fast, various hormones, glucose, and RMR were measured. There was no significant difference in plasma glucose, insulin, GH, cortisol, and glucagon levels between the two groups. The SCI group had 105% higher plasma leptin levels than the AB group (P < 0.05). Plasma leptin levels correlated with body mass index (SCI: r = 0.80; P = 0.028; AB: r = 0.79; P = 0.035) and fat mass (SCI: r = 0.95; P = 0.001; AB: r = 78; P = 0.038) in both groups. The plasma leptin level correlated with the absolute RMR (SCI: r = 0.15; P = 0.75; AB: r = 0.99; P < 0.006) and the RMR per unit fat-free mass (SCI: r = -0.70; P < 0.08; AB: r = 0.845; P < 0.017) in the AB group, but not in the SCI group. The absolute RMR was significantly reduced in the SCI group compared with the AB group, but there was no difference in the relative RMR between the groups. In conclusion, the SCI group has a significantly higher plasma leptin level than the AB group. The absolute and relative RMR correlated with leptin only in the AB group.

Improved glucose tolerance and insulin sensitivity after electrical stimulation-assisted cycling in people with spinal cord injury

DESIGN

Longitudinal training.

OBJECTIVES

The purpose was to determine the effect of electrical stimulation (ES)-assisted cycling (30 min/day, 3 days/week for 8 weeks) on glucose tolerance and insulin sensitivity in people with spinal cord injury (SCI).

SETTING

The Steadward Centre, Alberta, Canada.

METHODS

Seven participants with motor complete SCI (five males and two females aged 30 to 53 years, injured 3-40 years, C5-T10) underwent 2-h oral glucose tolerance tests (OGTT, n=7) and hyperglycaemic clamp tests (n=3) before and after 8 weeks of training with ES-assisted cycling.

RESULTS

Results indicated that subjects' glucose level were significantly lower at 2 h OGTT following 8 weeks of training (122.4+/-10 vs 139.9+/-16, P=0.014). Two-hour hyperglycaemic clamps tests showed improvement in all three people for glucose utilisation and in two of three people for insulin sensitivity.

CONCLUSIONS

These results suggested that exercise with ES-assisted cycling is beneficial for the prevention and treatment of Type 2 diabetes mellitus in people with SCI.

SPONSORSHIP

Supported by Alberta Paraplegic Foundation, Therapeutic Alliance.

Musculoskeletal fitness, health outcomes and quality of life

The health benefits and quality-of-life outcomes of a fit musculoskeletal system (musculoskeletal fitness) are reviewed in this article. The World Health Organization suggests health is a state of complete physical, mental or social well-being and not merely the absence of disease or infirmity. Physical health includes such characteristics as body size and shape, sensory acuity, susceptibility to disease and disorders, body functioning, recuperative ability and the ability to perform certain tasks. One aspect of physical health is the musculoskeletal system, which consists of 3 components; muscular strength, endurance and flexibility. Muscular strength (dynamic) is defined as the maximum force a muscle or muscle group can generate at a specific velocity. Muscular endurance is the ability of a muscle or muscle group to perform repeated contractions against a load for an extended period of time. Flexibility has 2 components, dynamic or static, where dynamic flexibility is the opposition or resistance of a joint to motion, that is, the forces opposing movement rather than the range of movement itself. Static flexibility is the range of motion about ajoint, typically measured as the degree of arc at the end of joint movement. If strength, endurance and flexibility are not maintained, musculoskeletal fitness is then compromised which can significantly impact physical health and well-being. Many health benefits are associated with musculoskeletal fitness, such as reduced coronary risk factors, increased bone mineral density (reduced risk of osteoporosis), increased flexibility, improved glucose tolerance, and greater success in completion of activities of daily living (ADL). With aging, the performance of daily tasks can become a challenge. Additionally, falls, bone fractures and the need for institutional care indicate a musculoskeletal weakness as we age. The earlier in life an individual becomes physically active the greater the increase in positive health benefits; however, becoming physically active at any age will benefit overall health. Improved musculoskeletal fitness (for example, through resistance training combined with stretching) is associated with an enhanced health status. Thus, maintaining musculoskeletal fitness can increase overall quality of life.

Neutral macroecology

The central themes of community ecology-distribution, abundance, and diversity-display strongly marked and very general patterns. These include the log-normal distribution of abundance, the relation between range and abundance, the species-area law, and the turnover of species composition. Each pattern is the subject of a large literature that interprets it in terms of ecological processes, typically involving the sorting of differently specialized species onto heterogeneous landscapes. All of these patterns can be shown to arise, however, from neutral community models in which all individuals have identical properties, as the consequence of local dispersal alone. This implies, at the least, that functional interpretations of these patterns must be reevaluated. More fundamentally, neutral community models provide a general theory for biodiversity and conservation biology capable of predicting the fundamental processes and patterns of community ecology.

Variation in growth rate in a natural assemblage of unicellular green soil algae

Unicellular, motile, phototropic green algae were extracted from soil samples taken at metre intervals along a 25-m transect in a wheat field. The vegetative growth of 61 randomly selected isolates (henceforth called spores) was measured in dark and light conditions, and at high and low nutrient concentrations in liquid media. The among-spore variance was dominated by a spore-by-environment interaction. The increase of among-spore variance with distance was detectable but slight, showing that most of the diversity found on the transect was present at a scale of metres. A mixture of all spores, constituting the founder assemblage, was propagated for 50-70 generations in three environments to study the sorting of variation initially present in the assemblage. Adaptation to the new environments was measured by improvement in growth relative to the founder assemblage. All three sets of lines became adapted to their selection environment, although the extent of the advance depended on the amount of among-spore variance in the founder assemblage. Selection for increased growth in the dark, or at high nutrient conditions in the light, caused the assemblage to evolve to the limit of the variation initially present, strongly reducing among-spore variance as a consequence. At low nutrient concentrations selection was less effective, and there was little reduction of the among-spore variance. The correlated responses of each group, again relative to the founder assemblage, were measured over the entire experimental range. Correlated responses were negative when performance in widely different (light and dark) environments was compared, but positive for more similar environments (high and low nutrient concentrations).