Cardiac arrest following sugammadex administration

A 68-year-old man underwent elective surgical repair of an abdominal wall hernia under general anaesthesia. The operation required muscle relaxation, for which we used rocuronium. Following completion of surgery, 180 mg sugammadex was administered intravenously. Shortly afterwards, the patient became severely bradycardic with hypotension, refractory to treatment with ephedrine. This progressed to a pulseless electrical activity cardiac arrest. After 4 min of cardiopulmonary resuscitation, there was return of spontaneous circulation and, following a period of haemodynamic stability in which general anaesthesia was maintained, the patient emerged from anaesthesia without incident. He remained haemodynamically stable until discharge. Post-resuscitation investigations including the serum tryptase level were unremarkable except for a mild respiratory acidosis and slightly elevated D-dimers. Sugammadex-induced bradycardia has previously been described, but its mechanism remains unknown. We believe that sugammadex was the cause of cardiac arrest in this case because of the timing and sequence of events, the evolution to pulseless electric activity and the relatively uneventful post-arrest clinical course. We hope that our report will help to promote awareness about this potential complication of a now commonly-used drug.

Infrared spectroscopy refines chronological assessment, depositional environment and pyrolysis conditions of archeological charcoals

Based on infrared spectral characteristics, six archeological sample sets of charcoals from German (5) and Brazilian (1) sites, covering the time span from the nineteenth century CE to 3950 BCE, were compared to a chronological (present to the fifteenth century BCE) series of Austrian charcoals. A typical chronological trend of several bands (stretch vibrations: O–C–O of carboxylates at 1,585–1,565 and 1,385–1,375 cm⁻¹, C–O carboxylic acids at 1,260–1,250 cm⁻¹) that indicate oxidation and subsequently increasing hydrophilicity (O–H stretch vibration at about 3,400 cm⁻¹) was also contained in the archive samples. Three sample sets fit in the typical band development according to their age. For three sample sets this conformity was not observed. Despite the age of two sample sets (3950–2820 BCE), most charcoals were assigned to the Modern Period. Apart from the high degree of carbonization, anaerobic depositional conditions over a longer period of time seem to contribute to the surprising conservation. Non-removable mineral components in charcoals, as observed in a third sample set, strongly influence infrared band intensities and positions of organic compounds. The role of inorganic components in terms of charcoal aging, and the information we can obtain from spectral characteristics in an archeological context, are discussed.

Cytokine expression in response to root repair agents

AIM

To evaluate the expression of TNF-α, IL-6, IFN-γ, TGF-β, IL-4, IL-10, RANKL, RANK and OPG on mouse calvarial bone treated with MTA, Geristore^® and Emdogain^® .

METHODOLOGY

Bone wounds were made on the heads of C57BL/6 mice, breaking the periosteum and the cortical surface of the calvaria. Each repair agent was inserted into sectioned Eppendorf microtubes and placed on the bone wound, and soft tissues were sutured. At 14 and 21 days, animals were sacrificed and the treated region was dissected. The calvaria bone was removed, and RNA was extracted. mRNA expression of the aforementioned cytokines was assessed using real-time PCR. Data were analysed by nonparametric methods, including the Mann-Whitney and Kruskal-Wallis tests (P < 0.05).

RESULTS

Following treatment with Emdogain^® and MTA, mRNA expression of RANKL, RANK and OPG increased significantly (P < 0.05) between days 14 to 21. Geristore^® did not alter the basal expression of these mediators during the same period of evaluation. Whilst treatment with Emdogain^® did cause a significant increase in TNF-α mRNA expression between days 14 and 21 (P < 0.05), treatment with MTA did not alter the basal expression of this cytokine at either experimental time point. However, TNF-α mRNA expression was down-regulated significantly at day 21 (P < 0.05) when Geristore^® was applied. A significant increase in the mRNA expression of IL-6, TGF-β, IL-10, IL-4 and IFN-γ was observed with Emdogain^® and MTA treatment between days 14 to 21, whereas Geristore^® reduced significantly the expression of IL-6, TGF-β and IL-4 (P < 0.05).

CONCLUSION

The clinical indication of these repair agents depends on the root resorption diagnosis. Whilst MTA and Emdogain^® induce a pro- and anti-inflammatory response early and late, respectively, Geristore^® was not associated with an inflammatory reaction when compared with both repair agents.

Use of cholesterol-loaded cyclodextrin in donkey semen cryopreservation improves sperm viability but results in low fertility in mares

The use of cholesterol-loaded cyclodextrin (CLC) on semen cryopreservation has been related with better sperm viability in several species; however, the effect on fertility is not known in donkey semen. Ejaculates (n = 25) from five donkeys were diluted in S-MEDIUM with 0, 1, 2 or 3 mg of CLC/120 × 10(6) spermatozoa. Semen was frozen, and thawed samples were evaluated by computer-assisted sperm analyser system (CASA), supravital test, hyposmotic swelling test and fluorescent dyes to assess the integrity of sperm membranes. Mares (n = 60) were inseminated with frozen-thawed semen treated with the doses of 0 or 1 mg CLC. Percentages of sperm with progressive motility and with functional plasma membrane were greater (p < 0.05) in the CLC-treated groups than in the control. Percentages of intact plasma membrane and intact plasma membrane and acrosome detected by fluorescent dyes were also greater (p < 0.05) in CLC-treated groups. Although no difference (p > 0.05) in conception rates was detected between groups (control, 3/30, 10%; CLC-treated, 1/30, 3.3%), fertility was low for artificial insemination programs in mares. Therefore, we firstly demonstrated that frozen semen treated with CLC in S-MEDIA extender before freezing improves the in vitro sperm viability, but semen treated or not with CLC in S-MEDIUM extender results in a very low conception rate in mares inseminated with thawed donkey semen.

First Report of Leaf Spot Caused by Cladosporium perangustum on Syagrus oleracea in Brazil

Syagrus oleracea (Mart.) Becc. (bitter coconut), a palm tree species that is native to central Brazil, has been increasingly cultivated in this country for heart-of-palm production. Epidemics of a necrotic leaf spot of unknown etiology have been recorded on bitter coconut plants in transplant nurseries and plantation since 2008. The first symptoms appear as small, yellow, hydrotic flecks on young or mature leaves that evolve to necrotic brown streaks that run parallel to the leaf veins. Usually, yellow halos occur around the lesions and hydrosis is common during lesion expansion. Necrotic lesions can reach up to 40 mm in length and 10 mm in width, and the lesions often coalesce, causing extensive tissue damage. During a survey in a 3-year-old bitter coconut plantation in Maringá County (coordinates: 23°23'51.25″ S, 51°57'02.09″ W; elevation: 507 m) in the state of Parana, a dozen symptomatic leaves were collected with the aim of elucidating the etiology of this disease. Conidia and conidiophores typical of Cladosporium were frequently observed on the diseased leaf tissue under natural field conditions as well on the surfaces of disinfected leaf tissues kept in a humid chamber for 48 h at 25 ± 2°C with a 12-h photoperiod. Five monoconidial cultures growing on potato dextrose agar (PDA) medium were obtained from different leaves showing leaf spot symptoms. The cultures were grown on PDA to induce sporulation. At 7 days after incubation at 25 ± 2°C and a 12-h photoperiod, gray to gray-olive colonies were observed. The conidiophores were macronematous, erect, oblong, branched, 1 to 5 septate, and 75.0 to 120.0 × 1.90 to 3.20 μm. The ramoconidia were cylindrical or oblong, 0 to 2 septate, and 28.0 to 40.0 × 2.8 to 3.6 μm, with a truncate base of 1.9 to 2.2 μm; secondary ramoconidia were cylindrical or oblong, 0 to 2 septate, 8.0 to 31.0 × 2.2 to 3.1 μm, with 3 to 5 distal conidial hila; intercalary 1-septate conidia were 5.5 to 17.0 × 2.1 to 3.4 μm, with 1 to 3 distal conidial hila; terminal 1-septate conidia were catenulate and 2.2 to 4.2 × 1.8 to 3.1 μm. Species identification was performed based on morphology and DNA sequence data (1). Portions of the elongation factor 1α (551 bp; TEF) and actin (213 bp; ACT) genes were amplified by PCR. A BLAST search of the GenBank database revealed that the TEF (KC484658 to KC484662) and ACT (KC484663 to KC484667) sequence fragments from isolates Gua1, Gua2, Gua3, Gua4, and Gua5 had 100% identity with the accessions HM148616 and HM148371 of Cladosporium perangustum (1). Isolates were tested for pathogenicity against bitter coconut. Ten potted plants with 4 to 6 fully expanded leaves were inoculated with each isolate by spraying a suspension of conidia (10⁵ spores per ml) onto leaves until runoff using a handheld spray bottle. Non-inoculated controls (10 plants) were sprayed with distilled water. The plants were kept in a humid plastic chamber at 20 to 26°C. All examined isolates were pathogenic to bitter coconut, causing symptoms identical to those described above 12 days after inoculation. All inoculated tissues were plated onto PDA to confirm the presence of the pathogen. Live cultures are being maintained at the Micoteca/URM/UFPE ( www.ufpe.br/micoteca ), Brazil. To our knowledge, this is the first report of a disease caused by C. perangustum on S. oleracea worldwide, and the study provides valuable plant disease diagnostic information for the palm hearth industry in Latin America. Reference: (1) K. Bensch et al. Stud Mycol. 67:1, 2010.

Septin localization in the dimorphic fungus Paracoccidioides brasiliensis

Septins are evolutionarily conserved proteins that contain a GTPase domain and are capable of forming filaments at the cell periphery. Septins are involved in many essential cellular processes, such as cytokinesis and cell polarization, and are used as markers of morphogenesis in several fungi. Dimorphism in fungi enables cells to switch between morphologies (yeast or filament forms), due to changes in the temperature of the environment. We analysed the localization of septin proteins in yeast and filamentous cells of the dimorphic fungus Paracoccidioides brasiliensis, a common cause of granulomatous mycosis. In order to determine septin localization, we first cloned Cdc12p, a septin homolog from P. brasiliensis, and expressed it in Escherichia coli. Following PbCdc12p purification, specific serum against PbCdc12p were raised for use in immunofluorescence assays. We observed the hourglass and ring forms of septin filaments during cell division in yeast. Septin filaments were also simultaneously localized in the necks of multiple budding cells. A distinctive pattern of punctuate and/or diffuse localization was also seen in the periphery of multinucleate yeast cells and at the tips and septa of filamentous cells. A more diffuse and punctuate pattern of localization observed in P. brasiliensis cells seems to be unique to filamentous and dimorphic fungi and may be related to their specialization in cell wall deposition, morphogenesis and cell cycle control.

Schistosoma mansoni antigens modulate the allergic response in a murine model of ovalbumin-induced airway inflammation

Schistosoma mansoni infection has been associated with protection against allergies. The mechanisms underlying this association may involve regulatory cells and cytokines. We evaluated the immune response induced by the S. mansoni antigens Sm22.6, PIII and Sm29 in a murine model of ovalbumin (OVA)-induced airway inflammation. BALB/c mice were sensitized with subcutaneously injected OVA-alum and challenged with aerolized OVA. Mice were given three doses of the different S. mansoni antigens. Lung histopathology, cellularity of bronchoalveolar lavage (BAL) and eosinophil peroxidase activity in lung were evaluated. Immunoglobulin (Ig)E levels in serum and cytokines in BAL were also measured. Additionally, we evaluated the frequency of CD4+forkhead box P3 (FoxP3)+ T cells in cultures stimulated with OVA and the expression of interleukin (IL)-10 by these cells. The number of total cells and eosinophils in BAL and the levels of OVA-specific IgE were reduced in the immunized mice. Also, the levels of IL-4 and IL-5 in the BAL of mice immunized with PIII and Sm22.6 were decreased, while the levels of IL-10 were higher in mice immunized with Sm22.6 compared to the non-immunized mice. The frequency of CD4+FoxP3+ T cells was higher in the groups of mice who received Sm22.6, Sm29 and PIII, being the expression of IL-10 by these cells only higher in mice immunized with Sm22.6. We concluded that the S. mansoni antigens used in this study are able to down-modulate allergic inflammatory mediators in a murine model of airway inflammation and that the CD4+FoxP3+ T cells, even in the absence of IL-10 expression, might play an important role in this process.

37 USE OF THERMO-RESISTANCE TEST (TRT) TO EVALUATE EQUINE COOLED SEMEN STORED AT 5°C

Evaluation of seminal characteristics is an important step to predict the reproductive potential of equine semen in natural or AI programs. Thermo-resistance test (TRT) has wide acceptance among tests in the bovine species, mainly because of its high correlation with fertility field. However, the TRT for stallion semen has not been widely studied. The objective of this study was to evaluate the effective use of TRT for equine cooled semen diluted with different extenders. Three stallions of Mangalarga Marchador breed aged between 8 and 14 years were used. Five semen samples per stallion were obtained, collected 3 times a week, with the aid of an artificial vagina (adapted Hannover model) using mares in natural estrus as dummy. The semen was diluted in 2 extenders: skim dried milk-glucose (E1) and glycine-egg yolk (E2), packaged in samples containing 12 mL of diluted semen to reach a final concentration of 30 million viable spermatozoa mL-1 and then stored at 5°C in an Equitainer® for 24 h. The cooled semen was warmed at 37°C in a water-bath. Spermatozoal progressive motility and vigor of semen were evaluated at 0 (TRT0), 30 (TRT30), 60 (TRT60), and 90 (TRT90) min after the start of warming. Treatment differences for sperm parameters were determined using ANOVA. The average values of sperm motility during TRT0, TRT30, TRT60, and TRT90 in E1 and E2 were, respectively, (E1) 37.0, 31.3, 23.7, and 19.7 and (E2) 30.3, 23.7, 18.3, and 15.7. The average values of vigor during TRT0, TRT30, TRT60, and TRT90 in E1 and E2 were, respectively, (E1) 2.4, 2.03, 1.53, and 1.43 and (E2) 1.97, 1.53, 1.33, and 1.17. During the test, the progressive motility obtained with E1 was higher (P < 0.05) than that with E2, and is within the patterns of motility considered acceptable only at 0 and 30 min of TRT. The E2 extender gave the worst result of the test, which was below the standards recommended for cooled semen. The seminal characteristics decreased in a very short time of TRT (30 min). This test is for use in insemination program. Thus, this demonstrates that changes in interpretation of the test need to be made in equine semen evaluation. A marked reduction of progressive motility at 30 min of test can be caused by loss of intracellular components or lesions in sperm movement structures. Possibly, availability of cyclic nucleotides involved in oxidative phosphorylation and motility are insufficient, although the mitochondria have the ability to produce energy. The TTR time of 90 min is long for equine cooled semen, and a duration for TTR of 30 min may be more appropriate in this species. Supported by grants from CNPq and CAPES.

The effect of mineral trioxide aggregate on phagocytic activity and production of reactive oxygen, nitrogen species and arginase activity by M1 and M2 macrophages

AIM

To assess the influence of co-culture with mineral trioxide aggregate (MTA) on phagocytosis and the production of reactive oxygen intermediates (ROI) and nitrogen (NO) species and the arginase activity by M1 and M2 peritoneal macrophages.

METHODOLOGY

Cellular viability, adherence and phagocytosis of Saccharomyces boulardii were assayed in the presence of MTA. Macrophages were stimulated with zymosan for ROI assays and with Fusobacterium nucleatum and Peptostreptococcus anaerobius and IFN-gamma for NO production and arginase activity, when in contact with capillaries containing MTA. Data were analysed by T, anova, Kruskall-Wallis and Mann-Whitney tests.

RESULTS

M2 macrophages displayed greater cellular viability in polypropylene tubes, greater ability to ingest yeast and smaller production of ROI and higher arginase activity when compared with M1 macrophages. Both macrophages, M1 and M2, presented similar cell adherence and NO production. The addition of bacterial preparations to macrophages interfered with NO and arginase productions. MTA did not interfere with any of the parameters measured.

CONCLUSIONS

Phagocytosis and the ability of the two macrophage subtypes to eliminate microbes were not affected by MTA.

High-speed countercurrent chromatography as a valuable tool to isolate C-glycosylflavones from Cecropia lyratiloba Miquel

A new apigeninglycoside, apigenin 6-C-galactosyl-6"-O-beta-galactopyranoside (1), isoorientin, and a mixture of orientin and isovitexin were isolated from leaves of Cecropia lyratiloba by high-speed countercurrent chromatography using a solvent system containing ethyl acetate, butanol, methanol and water. The structural elucidation of 1 was based on NMR spectroscopy.

Trace metal retention in mangrove ecosystems in Guanabara Bay, SE Brazil

Along contrasting environmental conditions (e.g., degree of trace metal contamination and mangrove forest structural development), sediments of Laguncularia racemosa-dominated mangrove stands in Guanabara Bay (SE Brazil) presented a trend of trace metal accumulation in forms with low potential of remobilization and biotic uptake. Concurrently, a relatively low transfer of sediment-bound metals to L. racemosa leaves was observed, which may moderate the metal export from the forests via leaf litter transport and the metal availability to enter in food chains based on leaf consumption.

Photosensitization and mutation induced in Escherichia coli and Saccharomyces cerevisiae strains by dorstenin, a psoralen analog isolated from Dorstenia bahiensis

Dorstenin, 5-[3-(4,5-dihydro-5,5-dimethyl-4-oxo-2-furanyl)-butoxy]-7H-furo[3, 2-g] benzopyran-7-one, is a psoralen analog recently isolated from Dorstenia species (Moraceae). In order to characterize its biological activity, its photosensitizing and mutational properties were measured in wild-type E. coli and S. cerevisiae and also in strains carrying mutations which affect DNA repair. Compared to the high activities of psoralen and bergapten, dorstenin showed lower genotoxic effect.

Total agenesis of the left pericardium

This is the report of a 46-year-old patient with the preoperative diagnosis of an atrial septal defect (ASD) of the ostium secudum type. After sternectomy, partial agenesis of the left pericardium was diagnosed. It is our opinion that, if the radiographic picture is suggestive of this entity, a clinical search for cardiopulmonary anomalies should be performed, because the majority of these associated anomalies can and should be surgically corrected.

[Surgical treatment of blepharospasm. Report of 2 patients]

Essential blepharospasm can be approached by several types of treatment: clinical in which the most important is the botulinum toxin with advantages and limitations; and some options of surgical treatment. The surgical technique described by Gillum and Anderson offers an alternative to patients resistant to the clinical treatment or with secondary complications. Two cases are analysed. Myectomy of all accessible orbicularis oculi, procerus and corrugator superciliaris muscle associated with blepharoplastic surgery and frontal lifting was indicated due to poor answer to clinical treatment. The results were satisfactory and both patients returned to their normal activities.

Effects of prostaglandins and nitric oxide on rat macrophage lipid metabolism in culture: implications for arterial wall-leukocyte interplay in atherosclerosis

Macrophages/foam cells have a pivotal role in atherogenesis although little is known about the way lipid imbalance, a hallmark of atherosclerosis, leads to lipid accumulation in these cells. Modified low-density lipoproteins are associated with macrophage lipid dysfunction in atherosclerosis, but a possible role for altered lipogenesis leading to lipid accumulation remains to be elucidated. Since endothelium-derived nitric oxide (NO) and prostaglandins (PGs) are physiological autacoids whose production may be impaired in atherosclerosis, the effects of these mediators on de novo lipid synthesis in 24-h cultured rat peritoneal macrophages is investigated. In resident (unstimulated) cells, 1 microM PGE2 and the stable analog of PGI2 carbaprostacyclin (cPGI2, 1 microM) deviated the overall [1-14C]acetate from incorporation into cholesterol, free fatty acids and triacylglycerols favoring the formation of phospholipids. In inflammatory (thioglycollate-elicited) macrophages, these eicosanoids likewise reduced 14C-incorporations into all the lipid fractions tested. Also, cPGI2 and PGE2 reduced [4-14C]cholesterol uptake from inflammatory cells but did not interfere in 14C-cholesterol export. The PGE2-derivative PGA2 (10-20 microM) reduced 14C-incorporations into all the lipids in resident cells while it enhanced phospholipid synthesis by up to 129% at the expense of reduced incorporations into the other test lipids. The NO donor S-nitroso-N-acetylpenicillamine (SNAP, 1-10 microM), when added to macrophages in the presence of superoxide dismutase (SOD, to avoid the reaction of superoxide with NO), significantly reduced lipogenesis especially in inflammatory cells. These findings suggest that endothelium-derived NO and PGs may be associated with macrophage lipid accumulation by modulating lipogenesis and cholesterol uptake within these cells.