Pulmonary hypertensive response to foreign body microemboli

Pulmonary hypertension and foreign body granulomas are recognized sequelae of chronic intravenous drug abuse. We have recently described the development of transient pulmonary hypertension and increased permeability pulmonary edema after the intravenous injection of crushed, suspended pentazocine tablets in both humans and dogs. To determine the role of vasoactive substances in the development of this transient pulmonary hypertension, we measured pulmonary hemodynamics and accumulation of arachidonic acid metabolites in dogs during the infusion of indomethacin, a cyclooxygenase inhibitor, diethylcarbamazine (DEC), a lipoxygenase inhibitor, and FPL 55712, a receptor antagonist for leukotriene C4/D4 (LTC4/D4). Following the intravenous administration of crushed, suspended pentazocine tablets (3-4 mg/kg of body weight), mean pulmonary artery pressure increased from 14 +/- 2 mmHg to 30 +/- 6 mmHg (p less than 0.05) at 60 secs with a concomitant increase in plasma concentrations of 6-keto-PGF1 alpha from 187 +/- 92 pg/ml to 732 +/- 104 pg/ml and thromboxane B2 from 206 +/- 83 pg/ml to 1362 +/- 117 pg/ml (both p less than 0.05). Indomethacin prevented the increase in both cyclooxygenase metabolites, but had no effect on the pulmonary hypertension. In contrast, DEC had no effect on the increase in cyclooxygenase products, but blocked the pulmonary hypertension. FPL 55712 did not effect either the increase in cyclooxygenase metabolites or the pulmonary hypertension. We conclude that the transient pulmonary hypertension, induced by the intravenous injection of crushed, suspended pentazocine tablets, is not mediated by cyclooxygenase products but may be mediated by lipoxygenase product(s) other than LTC4/D4.     

Protease inhibitors do not prevent the killing of cultured hepatocytes by cystamine

A study was made of the conditions of the killing of cultured hepatocytes by the reactive disulfide cystamine. Six to 12 mM cystamine killed up to 60% of the hepatocytes within 3 hours. The cytosolic calcium ion concentration rose prior to the loss of viability. Treatment with EGTA in a Ca2+-free medium lowered the initial Ca2+ concentration and prevented the rise in response to cystamine. However, there was no change in the number of dead cells. Furthermore, the sensitivity of cultured hepatocytes to cystamine was unaffected by the concentration of calcium in the culture medium. Addition to the culture medium of 3 protease inhibitors, leupeptin, antipain, or chymostatin, did not reduce the extent of cell killing by cystamine despite an inhibition of protein degradation. These data do not support the hypothesis that the toxicity of cystamine is necessarily mediated by proteases activated by a rise in the cytosolic calcium ion concentration.     

Somatic cell hybrid mapping of human chromosome band 5q31: a region important to hematopoiesis.

As a means of characterizing the distal long arm of chromosome 5, in particular, the region spanning 5q23-->q31, we analyzed somatic cell hybrids prepared from cells with overlapping chromosomal rearrangements. In one hybrid, the derivative chromosome 5 from a patient with acute myeloid leukemia (AML) de novo, whose bone marrow cells had a balanced translocation, t(5;7)(q31;q22), involving chromosome band 5q31, was isolated in a somatic cell hybrid (B294). In addition, we prepared somatic cell hybrids from a lymphoblastoid cell line (CC) derived from a patient who has a constitutional interstitial deletion of chromosome 5 spanning 5q23.1-->q31.1. By a combination of Southern hybridization analysis and fluorescent in situ hybridization, we constructed a map dividing 5q23-->q31 into four regions. We can assign genes to these regions and relate them to anonymous RFLP markers that have been genetically mapped.     

The use of digital subtraction angiography in diseases of the arteries of the pelvis and lower limbs

The diagnostic potentialities of digital subtraction angiography (DSA) in diseases of the pelvic arteries and lower limbs were studied. Intravenous (iv) and intraarterial (ia) DSA were performed in 613 patients, among them were patients with obliterating atherosclerosis and endarteritis, thromboembolism, aneurysms and arteriovenous fistulas. Iv DSA provided good information for the solution of therapeutic and tactical problems in pelvic, femoral and popliteal arterial lesions but in 16% of the cases it gave no opportunity to assess the status of the crural arteries. Ia DSA was shown to be no inferior to routine arteriography in the visualization of the lower limb arteries. This method is economical, well tolerated by patients, permits the intensification of examination of patients with acute and chronic arterial pathology. It can be employed under outpatient conditions and in the early postoperative period.     

Differential effects of physiologically relevant hypoxic conditions on T lymphocyte development and effector functions.

Direct measurements revealed low oxygen tensions (0.5-4.5% oxygen) in murine lymphoid organs in vivo. To test whether adaptation to changes in oxygen tension may have an effect on lymphocyte functions, T cell differentiation and functions at varying oxygen tensions were studied. These studies show: 1) differentiated CTL deliver Fas ligand- and perforin-dependent lethal hit equally well at all redox conditions; 2) CTL development is delayed at 2.5% oxygen as compared with 20% oxygen. Remarkably, development of CTL at 2.5% oxygen is more sustained and the CTL much more lytic; and 3) hypoxic exposure and TCR-mediated activation are additive in enhancing levels of hypoxia response element-containing gene products in lymphocyte supernatants. In contrast, hypoxia inhibited the accumulation of nonhypoxia response element-containing gene products (e.g., IL-2 and IFN-gamma) in the same cultures. This suggests that T cell activation in hypoxic conditions in vivo may lead to different patterns of lymphokine secretion and accumulation of cytokines (e.g., vascular endothelial growth factor) affecting endothelial cells and vascular permeabilization. Thus, although higher numbers of cells survive and are activated during 20% oxygen incubation in vitro, the CTL which develop at 2.5% oxygen are more lytic with higher levels of activation markers. It is concluded that the ambient 20% oxygen tension (plus 2-ME) is remarkably well suited for immunologic specificity and cytotoxicity studies, but oxygen dependence should be taken into account during the design and interpretation of results of in vitro T cell development assays and gene expression studies in vivo.     

The effect of acid shock on the heat resistance of Listeria monocytogenes

The effect of acid shock on the heat resistance of Listeria monocytogenes was investigated. After growth for 24 h at 30°C in tryptic soy broth containing 0.6% yeast extract, cell culture suspensions of L. monocytogenes were acidified with HCl or acetic acid over various time periods before being heated in whole milk to a temperature of 58°C. When cells were acid-shocked immediately with HCl for 1, 2 or 4 h, those acid-shocked for 1 h demonstrated the largest increase in thermotolerance as compared to control cells, when heated at 58°C in whole milk. In fact, cells acid-shocked for longer than 1 h with HCl demonstrated in some instances a decreased recovery as compared to control cells. Other types of acid-shock treatments included lowering the pH gradually either over a 4 h or a 24 h period. However, regardless of the type of acid-shock treatment, cells acid-shocked with HCl (but not acetic acid) prior to heating had significantly greater heat resistance as compared to control (non-acid-shocked) cells. It appears that acidification with HCl prior to final heating can enhance the heat resistance of L. monocytogenes.     

Psoriasis in Childhood

Psoriasis beginning in childhood is more common in girls than in boys, and commonly other members of the patient''s family also have the disease. When it begins in childhood, the course of the disease is generally more severe than when it begins in adult life. It is important to avoid therapy or trauma that will aggravate the course of the disease. Care should be taken to fully educate the psoriatic patient and his family.