An embryonic Ca++ mobilizing muscarinic system in the chick embryo heart

In the embryonic and in the adult heart muscarinic stimulation reduces the heart rate. Here we demonstrate that in the embryonic heart an additional muscarinic system is present, which is characterized by Ca++ mobilization and corresponds to the embryonic muscarinic system in other organ anlagen. In suspensions of embryonic chick heart cells we measured release of Ca++ from intracellular stores and influx of extracellular Ca++ with fura-2 and chlorotetracycline after muscarinic stimulation and determined the [3H]quinuclidinylbenzilate binding sites. We observed intense Ca++ mobilization at day 4, weaker reactions between day 4.5 and 11, and no Ca++ response at day 13. The pharmacological profile was identical to the profile of Ca++ mobilization in cells from other embryonic tissues in which the general embryonic muscarinic system is expressed. In parallel, we studied the effect of muscarinic agonists and antagonists on the heart rate of isolated embryonic hearts at day 4 and 5 in a perfusion chamber. Oxotremorine and bethanechol being antagonists or weak partial agonists in Ca++ mobilization, behaved as full agonists in frequency regulation. Thus, the pharmacological profile of the transient embryonic muscarinic system was different from that of the definitive adult form.     

Staphylococcus aureus in the hospital milieu]

This study concern the distribution and sensibility towards some antibiotics of 318 Staphylococcus aureus strains isolated in bacteriological samples coming from la Rabta hospital units. The study of distribution shows that 75% of these strains are isolated in bacteriological samples coming from surgery and intensive care unit dermatology unit, and ear nose and throat unit. The bacteriological samples are matter, blood, and intensive care materials. The study of sensibility found a high frequency of methicillin resistant Staphylococcus aureus. These strains are also resistant towards macrolide and lincosamide. MLSB resistance is the predominant phenotypic aspect. It was also observed that all of Staphylococcus aureus gentamicin resistant strains were also resistant toward methicillin. At last is seems that pritinamicin, sulfamethoxazole-trimethoprim, and ofloxacin, are good alternatives for treatment of staphylococcus aureus infections diseases.     

Intensification of human myocardial contractile activity as affected by blood serum

The effect of human serum diluted in Tyrode solution (1:1) on the cardiac contractility has been studied. Fragments of the right auricle myocardium from patients with congenital and acquired heart disease have been used to study serum effect on the contraction force. Myocardial strips were repeatedly stimulated with electrical impulses at a frequency of 0.1 to 1.5 Hz. All the perfusion solutions were maintained at 31-33 degrees C and Ca++ ion concentration was 2 +/- 0.2 mM/l. The serum increased the contraction force in the isolated myocardial fibers from patients with congenital and acquired heart disease. Positive inotropic serum action on the myocardium of patients with acquired heart disease was accompanied by a marked diminution of mechanical oscillations. At the same time human serum does not affect the form of force-frequency curves in both types of the preparations. The results suggest that human serum increases calcium ion homeostasis in the cardiac cells of patients during contraction-relaxation cycle.     

Elevated interstitial adenosine concentrations do not activate the muscle reflex

The purpose of the present study was to examine the effects of adenosine perfusion of the isolated triceps surae muscle group in the decerebrate cat on interstitial adenosine concentrations as well as heart rate and blood pressure responses. In six male cats (6.0 +/- 0.21 kg), the triceps surae muscle group of both legs was perfused with an artificial blood solution containing no additives (control) and then with blood containing 20 mM or 100 microM adenosine for 10 min. An intact muscle reflex was confirmed by bolus injections of 50 mM phosphate and/or saturated KCl administered into the triceps surae muscle via the cannulated popliteal artery before and after adenosine blood perfusion. Microdialysis of the triceps surae muscle group during muscle perfusion revealed that interstitial adenosine was elevated (P < 0.05) from 0.9 +/- 0.3 microM during control blood perfusion to 2,421 +/- 547 microM during 20 mM adenosine perfusion. In addition, interstitial adenosine levels were increased (P < 0.05) from 1.1 +/- 0.3 microM during control blood perfusion to 4.1 +/- 1.2 microM during perfusion with 100 microM adenosine. Despite the large increases in interstitial adenosine levels, perfusion of the triceps surae muscle group with the two blood adenosine solutions resulted in no significant increases in heart rate or blood pressure. These data strongly suggest that elevated interstitial adenosine concentrations do not play a role in activating the muscle reflex and confirm our previous in vivo human findings (J Appl Physiol 83: 1045-1053, 1997).     

Hyperthermic isolated limb perfusion increases circulating levels of inflammatory cytokines

Hyperthermic isolated limb perfusion is an established method of treatment for regionally advanced melanoma. Recent studies suggest that exogenously administered cytokines potentiate tumor response in patients with in-transit melanoma. We hypothesized that isolated limb perfusion induces an immunogenic response characterized by increased circulating levels of cytokines in the pump circuit, potentially contributing to the antitumor effect. We obtained blood samples from the perfusion circuit and systemic circulation at various intervals from patients undergoing isolated chemotherapeutic perfusion for melanoma. Samples were analyzed for serum cytokine profiles by enzyme-linked immunosorbent assay. When compared with baseline values, significant increases in serum levels of interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor (TNF) occurred within the perfusion circuit during isolated limb perfusion (P<0.05). In addition, there was a corresponding increase in IL-8 within the systemic circulation at the 60-min interval (P<0.05), suggesting some degree of leakage from the isolated circuit due to the extremely high levels of IL-8 in the perfusion circuit. A transient but insignificant decrease in circulating levels of neutrophils was also observed during the perfusion process, which may be attributed to margination. Increased levels of cytokines IL-6, IL-8, and TNF occurred within the isolated circuit during hyperthermic limb perfusion and may contribute to tumor response seen in patients treated with isolated limb perfusion.Presented at the Annual Meeting of the Society of Surgical Oncology, 17–20 March 1994 Houston, Texas     

Characteristics of the agents of acute suppurative destruction of the lungs in children]

The authors carried out bacteriological studies of the blood, the pleural cavity puncture material, the discharge from the bronchi in bronchoscopy, and also of smears from the nasopharynx of 40 children with acute purulent destruction of the lungs. Staphylococci, often in association with various Gram-negative bacilli, chiefly of the Pseudomonas genus, and Enterobacteriaceae family, prevailed in the cultures of the pathological material. Pathogenic staphylococcus was found in the nasopharynx of patients in 65% of cases. Along with staphylococci in over half of the patients there were revealed Gram-negative bacteria, and yeast-like Candida fungi. In the majority of patients the microbes isolated from the pharynx and the lungs were identical. In these cases bacteriological examination of pharyngeal smears can serve as an auxiliary method of laboratory diagnosis. The isolated straphylococcus strains possessed the majority of the pathogenicity signs; in the great majority of cases they were resistant to the antibiotics the most widely used in the therapeutic practice; among them strains of phage types 80, 54, 75, 77, and 81 prevailed. Thus, at different periods of the disease various types of the microbes prevailed in the materials obtained from the patients. In acute purulent destruction of the lungs bacteriological examination should be carried in dynamics.     

Use of cephalosporins for the prevention of mixed infection during surgical treatment of rectal cancer

Cephalosporin antibiotics such as cephaloridine, cephazolin and cephalothin++ were used during operations for rectum cancer. The antibiotics were administered intravenously and immediately into the superior rectal artery. It provided high levels of the antibiotics in blood and discharge of the small pelvis cavity and prevented development of infectious complications during the postoperative period.     

Anaerobic rat heart: mitochondrial role in calcium uptake and contractility.

In order to evaluate the manner by which fumarate enhances contractility in the anaerobic heart, we examined Ca++ movements in isolated heart mitochondria and in the isolated perfused heart. Our experiments showed that in isolated antimycin A plus cyanide treated mitochondria: (a) Ca++ uptake was promoted by electron transport generated by fumarate-dependent oxidation of NADH, (b) Ca++ stimulated fumarate-dependent oxidation of NADH, (c) the ratio of Ca++ uptake:NADH oxidized was 1.7 and (d) the Ca++ sequestered is transiently highly mobile and is rapidly released upon collapse of the membrane potential. In anaerobic hearts perfused with glucose plus fumarate, malate and glutamate Ca++ levels were the same as those in oxygenated hearts while in anaerobic organs perfused with or without glucose Ca++ content was appreciably lower. Succinate production in anaerobic heart perfusions was related to: (a) an increased retention of Ca++ by the heart, (b) a diminution in peak aortic pressure generated by cardiac contractions and (c) an increase in heart rate. The information obtained indicates that mitochondria have a capability for Ca++ movement which be used physiologically, particularly in fumarate perfused anaerobic hearts, to assist the mechanism for contraction and relaxation of the heart.     

Contribution of delta1-opioid receptors in regulation of cardiac resistance to ischemia-reperfusion

It has been found that pretreatment with a delta 1-opioid receptor agonist, DPDPE, in dose of 0.1 mg/kg intravenously 15 min before heart isolation, prevents appearance of reperfusion, ventricular arrhythmias during total global ischemia (45 min) and reperfusion (10 min) of isolated rat heart. This effect was dose-dependent. Addition of DPDPE to the perfusion solution in a final concentration of 0.1 mg/L and/or 0.5 mg/L 15 min before ischemia also decreased the incidence of reperfusion arrhythmias in a concentration-dependent manner. Addition of DPDPE to the perfusion solution in a final concentration of 0.1 mg/L also decreased creatine kinase levels in the coronary sinus. However DPDPE had no cardio-protective effect in concentration of 0.5 mg/L or after intravenous administration. A previous intravenous injection of DPDPE in dose of 0.5 mg/kg exacerbated reperfusion-induced contractile dysfunction of isolated heart but exerted no effect in dose of 0.1 mg/kg. Previous perfusion of the rat isolated heart by DPDPE in concentration of 0.1 mg/L and 0.5 mg/L 15 min before ischemia also exacerbated myocardial contractile dysfunction during reperfusion. It is proposed that the antiarrhythmic, cardio-protective and negative inotropic effect of DPDPE during reperfusion may be due to stimulation of cardiac delta-1 receptors.     

Acute Renal Failure and Open Heart Surgery

A retrospective study of 428 open heart operations showed the incidence of mild and severe renal failure to be 26% and 4·7% respectively. The mortality rate was 38% in the mild cases and 70% in the severe cases. Only half of the patients whose death was associated with renal failure showed macroscopic or microscopic renal lesions at necropsy. The patients who developed renal impairment had significantly higher mean preoperative blood urea (40 mg/100 ml) than the non-renal-failure cases (33 mg/100 ml). Periods of perfusion over 60 minutes, mean perfusion pressures below 80 mm Hg, and multiple valve replacement operations also increased the incidence of renal failure. There was no statistical correlation between the age of individual patients, the degree of cooling, and postoperative blood urea values. There was no evidence to suggest that frusemide or mannitol separately or together influenced the development of renal failure. Peritoneal dialysis was preferred for initial treatment of patients with severe renal failure, and haemodialysis was required only in special cases.     

Microbiological diagnosis of suppurative-inflammatory processes of the E. N. T. organs and the maxillo-mandibulo-facial region under suspicion of anaerobic non-clostridial infection

The etiological role of non-sporulating anaerobic bacteria as causative agents of suppurative-inflammatory diseases (SID) of the maxillo-mandibulo-facial region and the E. N. T. organs as studied. Express diagnosis of anaerobic infection was carried out by means of gas-liquid chromatography. The species-specific composition of the microflora of the suppurative focus was investigated. It was established that only obligate anaerobes in monoculture or in association were isolated from patients with so-called "sterile" inoculations when strictly anaerobic bacteriological technique was used. The use of anaerobic bacteriological technique of investigation enlarged the spectrum of the microflora isolated from the suppurative focus from 5 to 26 species. Results of chromatographic and bacteriological examinations were compared; the main causes of obtaining false-positive and false-negative results of chromatography were analysed. Statistical processing using factor analysis has shown that the information power of chromatographic examination of the metabolites of anaerobic bacteria is higher in comparison with the main clinical-laboratory indices, but statistical processing using cluster analysis and correlation analysis has revealed that an index like metabolic activity reflects the degree of real participation of anaerobic microflora in the development of the pathological process, and can be used in the clinic for the evaluation of the degree of severity of the course of the SID and of the effectiveness of treatment.     

Salient effects of l-carnitine on adenine-nucleotide loss and coenzyme A acylation in the diabetic heart perfused with excess palmitic acid: A phosphorus-31 NMR and chemical extract study

The beneficial effects of l-carnitine perfusion on energy metabolism and coenzyme A acylation were studied in isolated hearts from control and diabetic rats. All hearts were perfused at a constant flow rate with a glucose/albumin buffer which contained 2.0 mM palmitate. ³¹P-NMR was utilized to assess sequential phosphocreatine and ATP metabolism during 1 h of recirculation perfusion. l-Carnitine (5.0 mM final concentration) was added after 12 min of baseline recirculation perfusion. Frozen samples were taken after 1 h of recirculation perfusion for spectrophotometric analysis of high-energy phosphates and the free and acylated fractions of coenzyme A. l-Carnitine perfusion of diabetic hearts attenuated or prevented the reduction of ATP observed in untreated diabetic hearts. It also attenuated the accumulation of long-chain fatty-acyl coenzyme A. Although l-carnitine improved myocardial function in diabetic hearts, this was independent of any direct effect on physiological indices. Thus, the salutory effect of acute perfusion with l-carnitine on energy metabolism in the isolated perfused diabetic rat heart appears to be a direct effect on lipid metabolism.     

Coronary flow reserve and the J curve relation between diastolic blood pressure and myocardial infarction.

The results of several large studies of hypertension and follow up studies on insured people have indicated that the lower the blood pressure the better for longevity. These studies excluded subjects with overt ischaemia. More recently long term studies of hypertension that included patients with more severe forms of hypertension and did not exclude those with overt ischaemia have shown a J shaped relation between diastolic blood pressure during treatment and myocardial infarction; the lowest point (the J point) was at a diastolic blood pressure (phase V) between 85 and 90 mm Hg. The J curve seems to be independent of treatment, pulse pressure, and the degree of fall in diastolic blood pressure and is unlikely to be caused by poor left ventricular function. The most probable explanation is that subjects who have severe stenosis of the coronary artery as well as hypertension have a poor coronary flow reserve, which makes the myocardium vulnerable to coronary perfusion pressures that are tolerated by patients without ischaemia, particularly at high heart rates. An optimal diastolic blood pressure (phase V) for such patients is about 85 mm Hg, though particular caution is appropriate when treating very old patients (84 and over) and patients aged 60-79 who have isolated systolic hypertension.     

The effect of lidocaine on lysophosphatidylcholine-induced cardiac arrhythmias and cellular disturbances

The production of arrhythmias in the isolated heart by perfusion with lysophosphatidylcholine has been well documented. However, the role of the lysophospholipid as a physiological factor in the generation of cardiac arrhythmias is not clear. In this study, a pharmacological approach was used to delineate the physiological significance of lysophosphatidylcholine during this cardiac dysfunction. Lidocaine (5-20 mg/L) was found to be effective in the protection of the isolated rat heart from the lysophospholipid-induced arrhythmias at pharmacological concentrations. The effect of lidocaine in the protection of lysophospholipid-induced membrane dysfunction was studied with red blood cells. Lidocaine (2 mg/mL) protected red blood cells from hemolysis in the presence of lysophosphatidylcholine. Lidocaine did not inhibit the binding of the lysophospholipid to the red cell membrane, but inhibited hemolysis in a manner similar to cholesterol. The results are consistent with the postulate that lysophosphatidylcholine is a physiological factor in the pathogenesis of cardiac arrhythmias during myocardial ischemia.     

Streptococcus group B in meningitis and infection of newborn infants

Streptococci were isolated from the liquor or blood of 102 newborn infants and 16 infants in the first month of their life, suspected of having purulent meningitis, in 22 cases (18,5%). 5 isolated streptococcal strains were classified with group B on the basis of their cultural, biochemical and serological features. All of these strains were isolated from newborn infants during the first 3-4 days of their life. The occurrence of group B streptococci among all examined newborn infants was 4.8%; among the newborns with the positive results of bacteriological examination (73 infants) this figure was as high as 6.8%. The authors emphasize the necessity of producing, on an industrial scale, diagnostic preparations for the identification of group B streptococci playing a significant role in septic diseases and meningitides in newborns.     

The site of cartilage matrix degradation.

1. The metabolism of VLD lipoproteins (very-low-density lipoproteins) was studied in intact isolated beating-heart cells and isolated perfused rat heart from starved animals by using [14C]triacylglycerol fatty acid-labelled VLD lipoprotein prepared from rats previously injected with [1-14C]palmitate. 2. 14C-labelled VLD lipoprotein was metabolized by the isolated perfused heart, but was only minimally metabolized by the heart cells unless an exogenous source of lipoprotein lipase was added. 3. Measurements of lipoprotein lipase at pH 7.4 with the natural substrate 14C-labelled VLD lipoprotein indicated that during collagenase perfusion of the heart the enzyme was released into the perfusate, the activity released being proportional to the concentration of collagenase used. Lipoprotein lipase activity in homogenates of hearts that had been perfused with collagenase showed a corresponding loss of activity. 4. At high perfusate concentrations of collagenase, inactivation of the released lipoprotein lipase occurred. 5. Lipoprotein lipase activity was largely undetectable in the homogenate of the isolated heart cells. 6. It is concluded that the lipoprotein lipase responsible for the hydrolysis of VLD lipoprotein triacylglycerol is predominantly located externally to the heart muscle cells and that its release can be facilitated by perfusion of the heart with bacterial collagenase.     

Usefulness of the latex test for rapid detection of Salmonella O antigen in bacterial culture fluids and clinical specimens. III. Diagnostic field studies]

The aim of this study was to evaluate a latex reagent prepared in our laboratory for a routine diagnosis of Salmonellosis in humans. Liquid cultures in selenite broth (SF) (18-24 hr), previously inoculated with faeces samples of individuals suspected of being infected with Salmonella were subjected to the study. In these cultures, after 15 min. of heating at boiling temperatures, group antigens of Salmonella with an aid of polyvalent latex reagent A-E and monovalent reagents B, C1, C2, D, and E were searched. The results of latex test were compared to the results obtained by routine bacteriological examination. Studies performed in 13 laboratories of Sanitary Epidemiological Stations included 5246 faeces samples. Out of these samples 1835 (35%) reacted with monovalent latex reagent and 1897 (36.2%) samples were positive, for Salmonella by culture technique and belonged to 14 genera of group B, C1, D, and E. S. enteritidis was the most frequently isolated and encountered for 98.6% of all isolated strains. Latex test with A-E reagent was positive in 2246 (42.8%) of culture samples in SF medium, of which 1736 were positive by culture and 510 samples were negative for Salmonella in routine bacteriological examination. The samples positive in culture and with A-E latex reagent reacted in 97.2% with one monovalent reagent. Out of bacteriologically negative samples and reacting with A-E latex reagent 28.8% were positive with monovalent latex reagents. In summary, we can conclude that latex test used in a survey studies can be an usefull test in addition to routine bacteriological examination, since after 18-24 hr it allows with high credibility of 95% to confirm or exclude Salmonella in a tested sample. Such a procedure due to a shortening of routine diagnostic course brings significant savings. Moreover, latex test makes possible rapid detection of mixed infections with Salmonella of different serological groups. The use of extremely carefully, properly prepared selenite broth constitutes a basic condition for agreement between results of latex test and routine bacteriological investigation.     

Palmitic and erucic acid metabolism in isolated perfused hearts from weanling pigs

Hearts from 4 week-old weanling pigs were capable of continuous work output when perfused with Krebs-Henseleit buffer containing 11 mM glucose. Perfused hearts metabolized either glucose or fatty acids, but optimum work output was achieved by a combination of glucose plus physiological concentrations (0.1 mM) of either palmitate or erucate. Higher concentrations of free fatty acids increased their rate of oxidation but also resulted in a large accumulation of neutral lipids in the myocardium, as well as a tendency to increased acetylation and acylation of coenzyme A and carnitine. When hearts were perfused with 1 mM fatty acids, the work output declined below control values. Erucic acid is known to be poorly oxidized by isolated rat heart mitochondria and, to a lesser degree, by perfused rat hearts. In addition, it has been reported that erucic acid acts as an uncoupler of oxidative phosphorylation. In isolated perfused pig hearts used in the present study, erucic acid oxidation rates were as high as palmitate oxidation rates. When energy coupling was measured by 31P-NMR, the steady-state levels of ATP and phosphocreatine during erucic acid perfusion did not change noticeably from those during glucose perfusion. It was concluded that the severe decrease in oxidation rates and ATP production resulting from the exposure of isolated pig and heart mitochondria to erucic acid are not replicated in the intact pig heart.     

La place de l’examen direct des prélèvements bactériologiques dans le diagnostic des infections bactériennes

Routine examination of bacteriological sample presents two steps: direct examination and culture. Final aim of these examinations is to identify most of bacteria responsible of infection in order to justify an antibiotic treatment. Interest of direct examination in the identification of bacterial colony is well-established; however its importance in the appreciation of bacteriological samples is sometimes neglected by technician and intern of bacteriology. This presentation aim to remind us this importance in current bacteriological diagnosis by relating what responses it could bring in asked bacteriological analyses which are: cerebrospinal fluid, urine collection and cervicovaginal secretion.     

An improved apparatus for blood perfusion of the canine cerebral vasculature

An improved perfusion apparatus is described which consists of a membrane oxygenator, roller pump, reservoir, heat exchanger, blood filter, and inert tubing. Heparinized blood may be used and is delivered at flow rates from 10 to 250 ml/min. Dogs are anesthetized with halothane and their cerebral arterial blood supply isolated by the method of Gilboe et al. (8). When the canine brain is perfused for 5 hr using the described apparatus, the rates of cerebral oxygen and glucose consumption are 5.19±0.12 ml/100 g/min and 39.9±6.5 mol/100 g/min, respectively. Of the total glucose consumed by the brain, about 1/4 is contributed by the erythrocytes. An equivalent of about 9% of the consumed glucose is returned to the blood as lactate. Electron microscopic examination of cerebral cortex samples reveals no differences between 5-hr perfused brain and appropriate nonperfused controls. It is concluded that the apparatus is a useful system for organ perfusion and that the canine brain perfused by this method remains physiologically and metabolically active for at least 5 hr.With the technical assistance of Evelyn Townsend.