Stimulatory effects of vasoactive intestinal peptide and pituitary adenylate cyclase-activating peptide on tuberoinfundibular dopaminergic neuron activity in estrogen-treated ovariectomized rats and their correlation with prolactin secretion

The effects of central administration of vasoactive intestinal peptide (VIP) and pituitary adenylate cyclase-activating peptide (PACAP) on hypothalamic tuberoinfundibular dopaminergic neuron activity and serum prolactin (PRL) levels were reported. Adult female Sprague-Dawley rats overiectomized for 2 weeks, implanted with subcutaneous estrogen-containing capsules and intracerebroventricular (i.c.v.) cannulae for 6 days were used for experiments. I.c.v. injections of VIP or PACAP were performed in conscious rats in the morning, and the injected rats were decapitated at various times afterwards. Serum sample and the median eminence tissue were collected from each rat. The levels of dopamine (DA), 3,4-dihydroxyphenylacetic acid (DOPAC), and 3,4-dihydroxyphenylalanine (DOPA) in the median eminence were determined by high-performance liquid chromatography with electrochemical detection. Serum PRL levels were determined by radioimmunoassay. I.c.v. administration of VIP (1 microgram/3 microliter) significantly increased median eminence DOPAC/DA ratio at 30 min, and serum PRL level at 15 min. The same dose of VIP (1 microgram), but not higher (10 micrograms) or lower (0.1 microgram), was also effective in stimulating the median eminence DOPA accumulation 35 min after the injection. The effect of VIP (1 microgram) on median eminence DOPA could be blocked by coadministration of a VIP antagonist, VIP6-28 in 10- and 30-, but not in 1- or 0.1-microgram doses. On the other hand, i.c.v. administration of PACAP (10 micrograms) stimulated median eminence DOPAC and lowered serum PRL levels at 30 min. All doses of PACAP used (0.1, 1 and 10 micrograms/ rat, i.c.v.) significantly increased median eminence DOPA concentrations at 60 min. The stimulatory effect of PACAP (0.1 microgram) on median eminence DOPA could also be blocked by coadministration of a PACAP antagonist, PACAP6-38 (in 10 to 100 x higher doses). In summary, central administration of either VIP or PACAP exhibited a stimulating effect on TIDA neuron activity through specific receptors. Serum PRL levels, however, were stimulated and inhibited by VIP and PACAP, respectively.

Recurrence of conduction following radiofrequency catheter ablation procedures: relationship to ablation target and electrode temperature. The Atakr Multicenter Investigators Group

INTRODUCTION

More than 1 in 10 patients may develop recurrence of conduction after undergoing a successful radiofrequency catheter ablation procedure. The physiologic basis for recurrence following successful ablation procedures remains uncertain. The purpose of this study was to evaluate the role of electrode temperature as a predictor of recurrence following radiofrequency catheter ablation procedures.

METHODS AND RESULTS

The subjects of this study were 538 patients who underwent a successful attempt at radiofrequency catheter ablation of AV nodal reentrant tachycardia, an accessory pathway, and/or the AV junction. Patients were followed for a mean of 215 +/- 138 days. Conduction recurred in 35 (6.5%) of the 538 patients. Recurrence of conduction occurred in 25 (9.3%) of 270 patients undergoing ablation of an accessory pathway, 7 (3.5%) of 201 patients undergoing ablation of AV nodal reentrant tachycardia, and in 3 (4.5%) of 67 patients undergoing ablation of the AV junction. The electrode temperature achieved at successful sites associated with recurrence was not different from the temperature achieved at successful sites without recurrence (61.1 +/- 8.9 vs 61.6 +/- 9.1; P = 0.8). The likelihood of developing a recurrence was higher following ablation of accessory pathways than following ablation of AV nodal reentrant tachycardia or the AV junction (P = 0.03). Patients experiencing a recurrence following ablation of an accessory pathway had longer procedure durations (P = 0.0001). Ablation of left free-wall pathways was associated with a lower incidence of recurrence as compared with all other locations (P = 0.008).

CONCLUSION

The results of this study suggest that electrode temperature at the successful ablation site cannot be used to identify patients at highest risk of recurrence.

Long-term outcome after radiofrequency catheter ablation of atrioventricular nodal reentrant tachycardia with the anterior-approach method

Previous studies have reported only short-term (6 to 10 months) follow-up after ablation of atrioventricular (AV) nodal reentrant tachycardia by using the anterior approach. The objective of this study was to determine the long-term efficacy and safety of radiofrequency catheter ablation of AV nodal reentrant tachycardia with the anterior-approach method. In 56 patients (16 men and 40 women; mean [+/-SD] age, 44 +/- 19 years) with symptomatic AV nodal reentrant tachycardia. In 53 patients, ablation was performed initially by using a standard 7F, 2 mm-tipped tripolar His bundle catheter when the large-tip electrode was not as available, and in the remaining 3 patients, ablation was performed with a 7F, 4 mm-tipped catheter. Ablation was successful in the short term in 53 (95%) patients after a median of 7 radiofrequency applications. Three (5%) patients developed complete AV block immediately after ablation. Six (11 %) patients had recurrence of tachycardia within 3 months (n = 5) and 13 months (n = 1) after ablation. Repeated ablation resulted in successful outcome in 4 patients and in complete AV block in 1 patient; the other patient refused a repeated ablation attempt. A total of 51 patients was monitored for 36 +/- 12 months (range, 25 to 72 months), and none had tachycardia recurrence or delayed AV block. In conclusion, our results show that the anterior approach to radiofrequency catheter ablation can be used successfully to treat patients with AV nodal reentrant tachycardia with a good long-term efficacy and safety.

Electrophysiological effects of propofol on the normal cardiac conduction system

To determine the electrophysiological effects of propofol and to explain the potential mechanism(s) whereby it causes bradyarrhythmias, 10 closed-chest pigs weighing 20-25 kg were studied. Each animal was premedicated by intramuscular administration of ketamine hydrochloride, intubated, and mechanically ventilated. Femoral arterial and venous catheters were placed, and a comprehensive electrophysiologic evaluation was performed at baseline and after two doses (1 mg/kg i.v. bolus and 0.1 mg/kg/min infusion and an extra 1- mg/kg i.v. bolus and 0.2 mg/kg/min infusion) of propofol. The electrophysiological effects obtained on low-and high-dose propofol were compared to baseline values. Propofol caused a dose-related decrease in sinus cycle length (baseline 565 +/- 36 ms, low-dose propofol 541 +/- 28, high-dose propofol 527 +/- 26 ms; p < 0.05), a prolongation of the corrected sinus node recovery time (baseline 119 +/- 35 ms, low-dose propofol 126 +/- 32, high-dose propofol 130 +/- 30 ms; p < 0.01), and an increase in the His-ventricular interval (baseline 33 +/- 4 ms, low-dose propofol 36 +/- 4, high-dose propofol 40 +/- 3 ms; p < 0.005). All other electrophysiological parameters remained unchanged, and there were no cases of spontaneous atrioventricular block or sinus pauses. We conclude that propofol causes dose-related depression of sinus node and His-Purkinje system functions, but has no effect on the atrioventricular node function and on the conduction properties of atrial and ventricular tissues in normal pig hearts.

Immunoprophylaxis of allergen-induced immunoglobulin E synthesis and airway hyperresponsiveness in vivo by genetic immunization

The efficacy of an "allergen-gene immunization" protocol in altering allergic response was examined. Intramuscular injection of rats with a plasmid DNA encoding a house dust mite allergen into the muscle results in its long-term expression and the induction of specific immune responses. Significantly, this approach prevents the induction of immunoglobulin E synthesis, histamine release in bronchoalveolar fluids, and airway hyperresponsiveness in rats challenged with aerosolized allergen. Furthermore, this suppression is persistent and can be transferred into naive rats by CD8+ T cells from gene-immunized rats. These findings suggest that allergen-gene immunization is effective in modulating allergic responses, and may provide a novel therapeutic approach for allergic diseases.

Embolic complications associated with radiofrequency catheter ablation. Atakr Investigator Group

Both early and late thromboembolic events are known complications of radiofrequency catheter ablation. This review of 758 patients undergoing 830 radiofrequency ablation procedures finds that embolic complications after radiofrequency ablation in patients without other risk factors for thromboembolism are rare (<0.2%).

Influence of Holter monitor and electrophysiologic study methods and efficacy criteria on the outcome of patients with ventricular tachycardia and ventricular fibrillation in the ESVEM trial

Because not all laboratories use the monitoring and stimulation protocols used in the Electrophysiologic Study Versus Electrocardiographic Monitoring (ESVEM) trial, we reanalyzed the ESVEM patients' data using alternative, commonly used Holter monitor (HM) and programmed stimulation efficacy criteria to determine if different criteria would have changed the trial's conclusions. Also, because beta-blocker use and coronary artery disease frequency were not equally distributed between the two limbs in ESVEM, we reanalyzed the ESVEM data adjusting for the possible effect of these variables. In the HM limb, drug efficacy in the original ESVEM analysis was declared by reduction of total premature ventricular complexes (PVCs) by 70%, pairs by 80%, runs of 3 to 15 beats by 90%, and all ventricular tachycardia (VT) more than 15 beats by 100%. In this analysis, we examine outcome in subjects meeting two more stringent sets of criteria, (1) reduction of total PVCs by 70%, of pairs by 80%, and of all VT by 100% (new criteria set 1) and (2) reduction of total PVCs by 80%, of pairs by 90%, and of all VT by 100% (new criteria set 2). In electrophysiology (EPS) limb patients, we compared arrhythmia recurrence when efficacy was declared with triple extrastimuli as compared with maximally testing with double extrastimuli, and arrhythmia recurrence was compared in patients tested with identical versus any more aggressive protocol on drug than was used before drug. We also compared the predictive accuracy of zero versus 3 to 15, and 0 to 5, 6 to 10, and more than 10 induced beats on drug. Additionally, we compared predictive accuracy of the HM- and EP-guided limbs excluding patients on beta blockers and those with noncoronary disease. Lastly, to determine whether concordant results on HM and EPS testing would provide more accurate efficacy predictions than EP testing alone, HM recordings obtained in EPS-limb patients but not processed or used during the course of the EVSEM study were analyzed. The original ESVEM HM criteria, new set 1, and new set 2 yielded predicted drug efficacy rates of 77%, 68%, and 58%, respectively; however, arrhythmia recurrence rates were unchanged. Similarly, arrhythmia recurrence rates for patients tested with triple versus less than triple extrastimuli (p=.238), more aggressive versus identical protocols (p=.955), and 0 to 5 v 6 to 10 v more than 10 induced beats (p=.263) or 0 v 3 to 15 induced beats (p=.106) were unchanged. in the 215 (of 286) patients with coronary disease and not receiving beta blockers, there was still no difference in arrhythmia recurrence or mortality between the noninvasive and invasive limbs in ESVEM. Lastly, in patients with drug efficacy predictions by EPS testing, there was no difference in outcome in patients who had concordant versus discordant efficacy prediction by simultaneously obtained HMs. The use of more stringent testing methods and efficacy criteria would not have significantly improved the predictive accuracy of drug assessment by HM or EPS in the ESVEM trial. Additionally, excess noncoronary disease in EP-guided patients and excess beta-blocker used in HM-guided patients did not influence the results in the ESVEM trial.

Characterization of ovomucoid-specific T-cell lines and clones from egg-allergic subjects

In the pathogenesis of allergic reactions, T cells and cytokines play a major role. However, characterizations of food allergen-specific T cells are very limited. In this study, we screened the peripheral blood mononuclear cells (PBMC) of 14 patients for reactivity to ovomucoid (Gal d I), the major hen's egg allergen, and ovalbumin (Gal d II). Cell lines and clones specific to ovomucoid were generated from PBMC of four egg-allergic subjects, in order to study antigen domain specificity and cell cytokine production profiles. The results demonstrated, firstly, that egg-allergic patients respond to ovomucoid rather than to ovalbumin, and, secondly, that antigen specificity is predominantly directed toward the second and third domains of ovomucoid. The T-cell cytokine message was characterized by reverse transcriptase polymerase chain reaction (RT-PCR). Cell lines and clones from all four patients consistently expressed interleukin (IL)-5. IL-4, IL-13, and interferon-gamma were found to be expressed only by certain lines or clones. This observation suggests a central pathogenic role for IL-5 in food allergy-related symptoms.

Does the baseline impedance measurement during radiofrequency catheter ablation influence the likelihood of an impedance rise?

Most radiofrequency energy delivery systems provide a baseline (pre-ablation) impedance measurement; however, the application of this value, particularly in avoiding catheter overheating and coagulum formation, has not been described. We evaluated the ability of the product of the power output P and the baseline impedance Z (P x Z) to predict the likelihood of an impedance rise and coagulum formation during radiofrequency energy delivery in 62 consecutive patients undergoing successful catheter ablation of the slow atrioventricular (AV) nodal pathway or an accessory pathway. The mean P x Z during the 114 pulses resulting in an impedance rise was 3,770 +/- 846 W omega; only 42 impedance rises in 14 patients occurred at a P x Z < 3,5000. For comparison, the P x Z during the single radiofrequency pulse that resulted in loss of preexcitation or the slow AV nodal pathway in the entire patient group was 3,118 +/- 590 (p = 0.001) and in only 9 patients was the P x Z > 3,500. this data suggest that adjusting the power during each radiofrequency pulse to maintain the P x Z < 3,500 should enable the operator to avoid most impedance rises.

Optimization of the atmospheric pressure chemical ionization liquid chromatography mass spectrometry interface

Use of optimized instrument parameters that result from statistical experimentation revealed that the sensitivity of atmospheric pressure chemical ionization (APCI) liquid chromatography-mass spectrometry (LC/MS) is greater than the sensitivity of an optimized Thermabeam™ LC/MS interface by about 3 orders of magnitude, when tested on aromatic compounds. APCI is one of the few LC/MS techniques in which the chromatogram is directly comparable with liquid chromatographs that use ultraviolet detection. The optimum instrument parameters for a Finnigan SSQ-7000 APCI LC/MS interface were found at low flow rates (e. g., 0. 1 mL/min), relatively low capillary heat (e. g., 225 °C), and high sheath-gas pressure (e. g., 60 lb/in(2)). The optimization was achieved by monitoring the responses of sensitivity, fragmentation, and cluster ion formation. The fine tuning for high sensitivity calls for a high percentage of water in the mobile phase. In contrast, a high percentage of organic content in the mobile phase is required to obtain abundant protonated molecular ions with respect to fragmentation and clustering. This is an important consideration for analyses of unknowns.

Effects of nonselective and isozyme selective cyclic nucleotide phosphodiesterase inhibitors on antigen-induced cytokine gene expression in peripheral blood mononuclear cells

Cyclic nucleotide phosphodiesterase (PDE) enzymes may participate in regulation of the inflammatory response through their effects on second messengers. In the present study, we have investigated the role of nonselective and isozyme selective PDE inhibitors in altering the antigen-driven cytokine gene expression of peripheral blood mononuclear cells (PBMCs) from atopic individuals. Ragweed and tetanus toxoid were used as model antigens. The nonselective PDE inhibitor, 3-isobutyl-1-methylxanthine (IBMX), and the selective PDE4 inhibitor, rolipram, markedly suppressed interleukin-5 (IL-5) and interferon gamma (IFN gamma) gene expression in both antigen-driven systems. Gene expression for IL-4 was unaffected by these agents in the ragweed-driven system. Message for IL-4 could not be detected in the tetanus toxoid-driven system, despite the use of a quantitative, competitive reverse transcription-polymerase chain reaction (RT-PCR) assay sensitive to less than 10 fg of target template. The PDE3 inhibitor, siguazodan, was ineffective in downregulating gene expression for the proinflammatory cytokines assayed; when used in combination with the PDE4 inhibitor, the PDE3 inhibitor provided no increase in efficacy over that seen with the PDE4 inhibitor alone. Gene expression for the A and B isoforms of the PDE4 in PBMCs was unaffected by antigen stimulation or treatment with the PDE4 inhibitor; however, differences in expression of these two isoforms were apparent when a variety of immune cell lines were studied. These data support the hypothesis that the primary anti-inflammatory target for PDE inhibition in PBMCs is the PDE4. Furthermore, the expression of various isoforms of this enzyme may differ between immune cell types. Finally, PDE4 isoform expression in PBMCs is independent of treatment with an isozyme selective inhibitor.

Use of double ventricular extrastimulation to determine the preexcitation index in atrioventricular nodal reentrant tachycardia

The ability of single paced ventricular beats during tachycardia to penetrate the tachycardia circuit and reset the subsequent atrial depolarization (atrial preexcitation), enabling calculation of the "preexcitation index," can be helpful in analyzing supraventricular tachycardias. However, the ventricular refractory period often prevents ventricular capture of beats with the necessary prematurity to demonstrate atrial preexcitation, particularly in atrioventricular nodal reentrant tachycardia (AVNRT). We hypothesized that the use of double premature stimuli could overcome this limitation. In 25 consecutive patients with either AVNRT or atrioventricular reciprocating tachycardia (AVRT) we attempted to demonstrate atrial preexcitation with single and double ventricular extrastimuli. Whereas atrial preexcitation with a single extrastimulus could only be achieved in 3 of 11 patients with AVNRT, all but 1 patient demonstrated atrial preexcitation with the use of double ventricular extrastimuli. On the other hand, in all but 1 patient with AVRT, atrial preexcitation could be achieved with single and double extrastimuli. A formula was derived for obtaining a preexcitation index with double extrastimuli and shown to correspond closely with the preexcitation index obtained with a single extrastimulus in the 16 patients in whom atrial preexcitation could be achieved with single and double extrastimuli. Thus, this technique significantly enhances the ability to achieve atrial preexcitation and to calculate the preexcitation index in patients with AVNRT, and thus may be useful in deciphering tachycardia mechanism in some patients, as well as being a useful technique in studying the electrophysiological properties of the antegrade and retrograde limbs of AVNRT.

Interleukin 12 inhibits antigen-induced airway hyperresponsiveness, inflammation, and Th2 cytokine expression in mice

Allergic asthma is characterized by airway hyperresponsiveness and pulmonary eosinophilia, and may be mediated by T helper (Th) lymphocytes expressing a Th2 cytokine pattern. Interleukin (IL) 12 suppresses the expression of Th2 cytokines and their associated responses, including eosinophilia, serum immunoglobulin E, and mucosal mastocytosis. We have previously shown in a murine model that antigen-induced increases in airway hyperresponsiveness and pulmonary eosinophilia are CD4+ T cell dependent. We used this model to determine the ability of IL-12 to prevent antigen-induced increases in airway hyperresponsiveness, bronchoalveolar lavage (BAL) eosinophils, and lung Th2 cytokine expression. Sensitized A/J mice developed airway hyperresponsiveness and increased numbers of BAL eosinophils and other inflammatory cells after single or repeated intratracheal challenges with sheep red blood cell antigen. Pulmonary mRNA and protein levels of the Th2 cytokines IL-4 and IL-5 were increased after antigen challenge. Administration of IL-12 (1 microgram/d x 5 d) at the time of a single antigen challenge abolished the airway hyperresponsiveness and pulmonary eosinophilia and promoted an increase in interferon (IFN) gamma and decreases in IL-4 and IL-5 expression. The effects of IL-12 were partially dependent on IFN-gamma, because concurrent treatment with IL-12 and anti-IFN-gamma monoclonal antibody partially reversed the inhibition of airway hyperresponsiveness and eosinophilia by IL-12. Treatment of mice with IL-12 at the time of a second antigen challenge also prevented airway hyperresponsiveness and significantly reduced numbers of BAL inflammatory cells, reflecting the ability of IL-12 to inhibit responses associated with ongoing antigen-induced pulmonary inflammation. These data show that antigen-induced airway hyperresponsiveness and inflammation can be blocked by IL-12, which suppresses Th2 cytokine expression. Local administration of IL-12 may provide a novel immunotherapy for the treatment of pulmonary allergic disorders such as atopic asthma.

Migration of a fractured retention wire in the pulmonary artery from an active fixation atrial lead

A fragment of fractured retention wire of an atrial J lead (Accufix) was found in the pulmonary artery in an asymptomatic patient by routine chest X ray, fluoroscopy, and pulmonary angiography. The lead itself looked normal in these imaging studies. Results after successful surgical removal was reported.

Thermosensitive sterically stabilized liposomes: formulation and in vitro studies on mechanism of doxorubicin release by bovine serum and human plasma

PURPOSE

To formulate thermosensitive sterically stabilized liposomes and to study the effects of plasma and serum components in vitro.

METHODS

The rate of release of encapsulated doxorubicin (Dox) from liposomes of various compositions was followed by fluorometric assay at 37 degrees, 42 degrees and 45 degrees C, in buffer and also in both calf serum and human plasma up to 50% by volume.

RESULTS

The optimal composition for the maximal differential release of doxorubicin between 37 degrees C and 42 degrees C in human plasma was a mixture of dipalmitoylphosphatidylcholine/hydrogenated soy phosphatidylcholine/cholesterol and distearoylphosphatidylethanolamine derivatized with polyethylene glycol at a molar ratio of 100:50:30:6. In experiments designed to study the mechanism causing increased permeability of liposomes in bovine serum, we found two different distinct release patterns: a slow linear rise of rate of Dox release for fluid liposomes and fast exponential rise reaching plateau within 5 minutes for solid phase (rigid) liposomes. This release of Dox from rigid but not fluid liposomes was inhibited by pre-heating serum at 55 degrees C for 30 minutes or by addition of EDTA (but not EGTA) or antiserum to the C3 component of complement.

CONCLUSIONS

A formulation of sterically stabilized liposomes with the proper thermal sensitivity in human plasma has been obtained. In addition, the results suggest that complement may play an important role in the interaction of rigid but not fluid liposomes with bovine serum. Human plasma did not show this effect.

IL-13 expression at the sites of allergen challenge in patients with asthma

Atopic asthma is characterized by inflammatory responses of the airway and is associated with up-regulation of Th2 cytokines, notably IL-4 and IL-5. A recently described human cytokine, IL-13, is a potent in vitro modulator of various cell types, including monocytes, B cells, and endothelial cells. Similar to IL-4, it is also involved in the induction of IgE synthesis. However, the in vivo expression and function of IL-13 and its relation to disease remain to be defined. Using a segmental allergen challenge model, we have examined the in vivo expression of IL-13 in the bronchoalveolar lavage (BAL) cells of atopic patients. We found a significant enhancement of both IL-13 transcripts and secreted proteins in the allergen-challenged BAL compared with the saline-challenged control sites of asthmatic and rhinitic patients. In contrast, the expression of IL-13 transcripts was not detected in the BAL of two normal subjects challenged with the same dose of ragweed allergen. The cellular source of IL-13 mRNA was identified in the mononuclear cell fraction of the allergen-challenged BAL. The allergen-induced quantitative differences in the level of transcripts were confirmed by competitive PCR assays. These results suggest that the significant increase in IL-13 in the allergen-challenged BAL is primarily from the mononuclear cells and is involved in the regulation of allergen-induced late phase inflammatory responses.

IL-13 expression at the sites of allergen challenge in patients with asthma

Atopic asthma is characterized by inflammatory responses of the airway and is associated with up-regulation of Th2 cytokines, notably IL-4 and IL-5. A recently described human cytokine, IL-13, is a potent in vitro modulator of various cell types, including monocytes, B cells, and endothelial cells. Similar to IL-4, it is also involved in the induction of IgE synthesis. However, the in vivo expression and function of IL-13 and its relation to disease remain to be defined. Using a segmental allergen challenge model, we have examined the in vivo expression of IL-13 in the bronchoalveolar lavage (BAL) cells of atopic patients. We found a significant enhancement of both IL-13 transcripts and secreted proteins in the allergen-challenged BAL compared with the saline-challenged control sites of asthmatic and rhinitic patients. In contrast, the expression of IL-13 transcripts was not detected in the BAL of two normal subjects challenged with the same dose of ragweed allergen. The cellular source of IL-13 mRNA was identified in the mononuclear cell fraction of the allergen-challenged BAL. The allergen-induced quantitative differences in the level of transcripts were confirmed by competitive PCR assays. These results suggest that the significant increase in IL-13 in the allergen-challenged BAL is primarily from the mononuclear cells and is involved in the regulation of allergen-induced late phase inflammatory responses.

A dominant T cell receptor beta-chain in response to a short ragweed allergen, Amb a 5

HLA-DR alpha, beta 1 *1501 (and the closely related DR alpha, beta 1 *1502) heterodimers are the primary class II MHC restriction elements controlling T cell responses to a ragweed pollen allergen, Amb a 5 (M(r) = 5000). Using a novel, quantitative, competitive PCR (QC-PCR) assay and a TCR beta-gene internal standard (IS), we have examined the TCR beta-gene use in Amb a 5-specific T cells. Multiple TCR V beta (and V alpha) genes were found in polyclonal T cell lines from two unrelated subjects, and 30% of the cells were stained positive for V beta 5.2/5.3 as judged by a flow cytometry analysis. An Amb a 5-specific Th2 clone (AP1.2) was found to express V beta 5.2 (and V alpha 8) and to have a unique V-D-J junctional region sequence. To determine the relative frequency of clone AP1.2 beta-gene expression in the polyclonal T cell lines and in the PBMC using a QC-PCR assay, we first created a TCR IS by duplicating the J beta 1.5 gene segment of the AP1.2 beta-gene. A QC-PCR assay was performed using the modified AP1.2 beta-gene as a competitor and a V beta 5.2 or a D beta-specific primer, each paired with a C beta primer. Results showed the presence of 30% of AP1.2 beta transcripts in the polyclonal T cell lines, but no detectable amplified products were found in the total RNAs (200 ng) of autologous PBMC. These findings were confirmed by sequencing independent clones of PCR-amplified V beta 5.2-C beta fragments (from two unrelated subjects) from each cell line, which suggested that the frequency of the clone AP1.2 beta sequence is quite low in the PBMC but is dominant in polyclonal Amb a 5-specific cell lines.

Optimization of the Hewlett-Packard particle-beam liquid chromatography-mass spectrometry interface by statistical experimental design

Optimization of both sensitivity and ionization softness for the Hewlett-Packard particle-beam liquid chromatography-mass spectrometry interface has been achieved by using a statistical experimental design with response surface modeling. Conditions for both optimized sensitivity and ionization softness were found to occur at 55-lb/in.(2) nebulizer flow, 35°C desolvation chamber temperature with approximately 45% organic modifier in the presence of 0.02-F ammonium acetate and a liquid chromatography flow rate of 0.2 mL/min.

[Synaptic connections between the neurons and catecholaminegic fibres in the hippocampal transplant of rat]

The foetal hippocampal tissue (transplant) at 17th day of embryonic age was implanted into the ventral hippocampus of adult rats (host). The catecholaminergic fibre projections in the hippocampal transplants 90 days after operation were studied by immunohistochemical technique. It was observed that in the host hippocampus there was a large population of TH- immunoreactive slender fibres of only 0.5-1 microns in diameter. These fibres were distributed more densely in the hippocampal hilus and CA3 transparent layers than in molecular layers, but sparsely in pyramidal or granular layers. In the molecular and cellular layers of transplanted hippocampus some thicker (> 1 micron) TH-positive fibers were ended in a relatively dense branching. The immunoelectron-microscopic observations showed that many TH-positive boutons made synaptic contacts with immunonegative dendrites and dendritic spines in the hippocampal transplants, the majority of which were asymmetrical synapses with a 30 nm synaptic cleft and conspicuously thickened postsynaptic membranes. It is concluded that catecholaminergic fibres extend from the host brain into the hippocampal transplant to establish synapses with the target neurons.

A dominant T cell receptor beta-chain in response to a short ragweed allergen, Amb a 5

HLA-DR alpha, beta 1 *1501 (and the closely related DR alpha, beta 1 *1502) heterodimers are the primary class II MHC restriction elements controlling T cell responses to a ragweed pollen allergen, Amb a 5 (M(r) = 5000). Using a novel, quantitative, competitive PCR (QC-PCR) assay and a TCR beta-gene internal standard (IS), we have examined the TCR beta-gene use in Amb a 5-specific T cells. Multiple TCR V beta (and V alpha) genes were found in polyclonal T cell lines from two unrelated subjects, and 30% of the cells were stained positive for V beta 5.2/5.3 as judged by a flow cytometry analysis. An Amb a 5-specific Th2 clone (AP1.2) was found to express V beta 5.2 (and V alpha 8) and to have a unique V-D-J junctional region sequence. To determine the relative frequency of clone AP1.2 beta-gene expression in the polyclonal T cell lines and in the PBMC using a QC-PCR assay, we first created a TCR IS by duplicating the J beta 1.5 gene segment of the AP1.2 beta-gene. A QC-PCR assay was performed using the modified AP1.2 beta-gene as a competitor and a V beta 5.2 or a D beta-specific primer, each paired with a C beta primer. Results showed the presence of 30% of AP1.2 beta transcripts in the polyclonal T cell lines, but no detectable amplified products were found in the total RNAs (200 ng) of autologous PBMC. These findings were confirmed by sequencing independent clones of PCR-amplified V beta 5.2-C beta fragments (from two unrelated subjects) from each cell line, which suggested that the frequency of the clone AP1.2 beta sequence is quite low in the PBMC but is dominant in polyclonal Amb a 5-specific cell lines.

Use of the saline infusion electrode catheter for improved energy delivery and increased lesion size in radiofrequency catheter ablation

Although radiofrequency catheter ablation has undergone explosive growth as the treatment for a variety of arrhythmias, a limiting factor with the existing catheter delivery system has been the relatively small size of the lesions, which appears to be in part due to coagulum formation around the catheter tip, producing a rise in impedance and limiting energy delivery. In order to test the hypothesis that infusion of saline during radiofrequency current application can increase the lesion size and decrease the incidence of impedance rise, ten dogs were each given two radiofrequency ablation lesions to the left ventricular endocardium. One of these lesions was delivered with a standard 7 French quadripolar catheter with a 2-mm tip, and the second was done with a 7 French luminal electrode catheter (also with a 2-mm tip) for the infusion of normal saline during the delivery of radiofrequency energy. Energy was delivered for 60 seconds at either 10 or 20 watts at two distinct sites in the left ventricle for each animal. Four to 7 days following ablation, the animals were sacrificed for pathological examination. The lesions created with the saline infusion catheter were significantly bigger than those produced with a standard catheter (7.3 x 7.0 x 5.1 vs 5.2 x 4.9 x 3.5 mm, respectively, P < 0.001). At the lower energy level (10 W), none of the animals with the saline infusion catheter experienced an impedance rise versus 3 of 5 of the animals in whom the standard catheter was used.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias and conduction disturbances after coronary artery bypass graft surgery: epidemiology, management, and prognosis

CABG is associated with many perioperative complications, including supraventricular and ventricular arrhythmias and conduction disturbances. Atrial fibrillation occurs in < or = 40% of patients after CABG and is especially common in older patients. Although it is often benign and self-limited, it can lead to complications such as stroke. Treatment consists primarily of control of the ventricular response rate; in some cases, antiarrhythmic drugs or electrical cardioversion are needed. Anticoagulation should be considered in appropriate cases of persistent (48 to 72 hours) atrial fibrillation after initial treatment. Prophylaxis, especially with beta-blocking agents, seems to be effective and should be considered in appropriate cases. Simple ventricular arrhythmias are common after CABG and do not affect the patient's prognosis; however, sustained VT/VF occur infrequently (< 2% of patients) and carry a high mortality rate. Treatment is aimed at correcting precipitating factors (e.g., myocardial ischemia). Electrophysiologically guided drug therapy and implantation of an ICD should be considered in appropriate cases for patients who survive the initial events. Transient minor conduction disturbances are common after CABG; in some patients persistent AV block and sinus node dysfunction develop and may require treatment with permanent pacemaker.