Surfactant therapy for patients with ARDS after cardiac surgery

This multicenter study investigated the possibility of reducing mortality rate by administering natural lung surfactant additional to standard therapy to treat patients after cardiac surgery who developed an acute respiratory failure (ARDS/ALI).A total of 78 patients (1998-2002) diagnosed with ALI or ARDS were enrolled in the study; patients were considered for study entry only if they developed ALI/ARDS within 72 h after cardiac surgery. A total of 36 patients (2000-2002) received Surfactant-BL via bronchoscope at a dose of 3 mg/kg twice a day, and 42 patients (1998-2000) served as the historical control.Within 24 h after the first Surfactant-BL administration the PaO2/FiO2 ratio increased from (mean+/-SEM) 129.7+/-9.9 mm Hg to 187.6+/-17.6 mm Hg (p<0.01), FiO2 decreased from (mean+/-SEM) 0.71+/-0.03 to 0.56+/-0.03 (p<0.01), and 69.4% of the patients treated with surfactant were weaned from the ventilator compared with 50% of the control group during a 28-day period. The mortality rate among patients treated with Surfactant-BL was 30.6% compared with 50% in the control group.In conclusion, early administration of Surfactant-BL leads to the reduction of mortality in cardiac patients who develop postoperatively an ALI or ARDS.     

Surfactant Therapy for Patients with ARDS After Cardiac Surgery

This multicenter study investigated the possibility of reducing mortality rate by administering natural lung surfactant additional to standard therapy to treat patients after cardiac surgery who developed an acute respiratory failure (ARDS/ALI).

A total of 78 patients (1998–2002) diagnosed with ALI or ARDS were enrolled in the study; patients were considered for study entry only if they developed ALI/ARDS within 72h after cardiac surgery. A total of 36 patients (2000–2002) received Surfactant-BL via bronchoscope at a dose of 3 mg/kg twice a day, and 42 patients (1998–2000) served as the historical control.

Within 24h after the first Surfactant-BL administration the PaO₂/FiO₂ ratio increased from (mean ± SEM) 129.7 ± 9.9 mm Hg to 187.6 ± 17.6 mm Hg (p < 0.01), FiO₂ decreased from (mean ± SEM) 0.71 ± 0.03 to 0.56 ± 0.03 (p < 0.01), and 69.4% of the patients treated with surfactant were weaned from the ventilator compared with 50% of the control group during a 28-day period. The mortality rate among patients treated with Surfactant-BL was 30.6% compared with 50% in the control group.

In conclusion, early administration of Surfactant-BL leads to the reduction of mortality in cardiac patients who develop postoperatively an ALI or ARDS.     

Missense mutation in the PAS2 domain of phytochrome A impairs subnuclear localization and a subset of responses

Phytochrome A signaling shows two photobiologically discrete outputs: so-called very-low-fluence responses (VLFR) and high-irradiance responses (HIR). By modifying previous screening protocols, we isolated two Arabidopsis mutants retaining VLFR and lacking HIR. Phytochrome A negatively or positively regulates phytochrome B signaling, depending on light conditions. These mutants retained the negative but lacked the positive regulation. Both mutants carry the novel phyA-302 allele, in which Glu-777 (a residue conserved in angiosperm phytochromes) changed to Lys in the PAS2 motif of the C-terminal domain. The phyA-302 mutants showed a 50% reduction in phytochrome A levels in darkness, but this difference was compensated for by greater stability under continuous far-red light. phyA-302:green fluorescent protein fusion proteins showed normal translocation from the cytosol to the nucleus under continuous far-red light but failed to produce nuclear spots, suggesting that nuclear speckles could be involved in HIR signaling and phytochrome A degradation. We propose that the PAS2 domain of phytochrome A is necessary to initiate signaling in HIR but not in VLFR, likely via interaction with a specific partner.     

Divergence in foraging behavior of foliage-gleaning birds of Canadian and Russian boreal forests

We compared foraging behavior of foliage-gleaning birds of the boreal forest of two Palaearctic (central Siberia and European Russia) and two Nearctic (Mackenzie and Ontario, Canada) sites. Using discriminant function analysis on paired sites we were able to distinguish foliage-gleaning species from the Nearctic and Palaearctic with few misclassifications. The two variables that most consistently distinguished species of the two avifaunas were the percentage use of conifer foliage and the percentage use of all foliage. Nearctic foliage-gleaner assemblages had more species that foraged predominantly from coniferous foliage and displayed a greater tendency to forage from foliage, both coniferous and broad-leafed, rather than twigs, branches, or other substrates. The greater specialization on foliage and, in particular, conifer foliage by New World canopy foliage insectivores is consistent with previously proposed hypotheses regarding the role of Pleistocene vegetation history on ecological generalization of Eurasian species. Boreal forest, composed primarily of spruce and pine, was widespread in eastern North America, whereas pockets of forest were scattered in Eurasia (mostly the mountains of southern Europe and Asia). This may have affected the populations of birds directly or indirectly through reduction in the diversity and abundance of defoliating outbreak insects. Loss of habitat and resources may have selected against ecological specialization on these habitats and resources. Received: 11 May 1998 / Accepted: 24 June 1999