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Feline leukaemia vaccine protection against viral latency.

Seventeen cats, which were previously vaccinated with a subunit, feline leukaemia vaccine (Leukocell) and subsequently challenged with virulent feline leukaemia virus (FeLV), were tested at 2 to 4 years postchallenge for reactivation of latent FeLV infections. Administration of weekly doses of methylprednisolone induced significant decreases in lymphocyte numbers, but did not reactivate virus in bone marrow cultures from 15 cats in vivo or in vitro. These cats were observed to be neither persistently or latently viraemic prior to corticosteroid administration. The results of this study indicate that the vaccine is effective in affording significant protection against latent FeLV infections, even after severe immunosuppression. This finding, coupled with previously published results indicating protection against persistent viraemia and tumour formation, makes this vaccine highly effective in protecting against FeLV infections and associated disease.

Animals↗

Drug-nutrient interactions and their implications for safety evaluations.

In order to assess the relevance of the drug-nutrient interactions described in this chapter to routine toxicologic studies, the range of nutrient concentrations within which these interactions may occur must be compared to the range of nutrient concentrations found in routinely used rodent diets. While obviously deficient levels of some nutrients were supplied to demonstrate some of the interactions, others occur when the nutrients are present in adequate or excess levels, such as might be found in commercially available diets. These diets are known to vary from batch to batch in nutrient content. A lifetime toxicity/carcinogenicity bioassay using rodents may last longer than 2 years, during which time several batches of diet will be used. The variation in diet composition, coupled with inadequate diet description, makes nutrient-toxin interactions not only possible, but difficult to recognize. These considerations raise the practical and philosophical question as to what type of diet is most appropriate for rodents used for safety evaluation of drugs and chemicals. Is it appropriate to use diets that vary unpredictably in nutrient content, that infer a degree of protection against chemical carcinogenesis and which supply some nutrients such as protein in great excess of dietary needs? Is the increase in sensitivity to chemical carcinogens of animals fed purified diets desirable or does this increased sensitivity of the bioassay exceed that required to assess the risk of human exposure? In other words, is the use of purified diets likely to increase the number of false positive results? Proper interpretation and extrapolation of safety evaluation studies requires adequate description of the test system. Given the profound influence of diet on the response to some toxins, the composition of the diet should, ideally, be defined with the same rigor as are the test compound and the strain, age, sex, and housing conditions of the animals. It is likely, however, that natural ingredients diets will continue to be the diets of choice in safety evaluation studies. This is largely due to economic reasons. It is possible, however, to use these diets with greater confidence if open-formula diets are used and the concentration of each nutrient is reported. Consideration should also be given to preparing diets for use in adult and aging rodents, diets in which protein content is reduced.(ABSTRACT TRUNCATED AT 400 WORDS)

Animal Feed↗

[First experiences with human blastocyst culture after IVF/ICSI under the conditions of the German embryo protection law].

OBJECTIVE: Due to the improvements in human embryo culture in the recent years, it is now possible to transfer embryos five days after oocyte retrieval and IVF or ICSI at the blastocyst stage with favorable implantation rates. In Germany it is illegal to cultivate more than 3 embryos, therefore the selection has to be done at the pronuclear stage. There we report our experiences of human blastocyst culture in a routine IVF/ICSI programme under the conditions of the German Embryo Protection Law. MATERIALS AND METHODS: The data of 100 couples undergoing the IVF-ICSI programme at the University Clinic of Würzburg were analysed prospectively. 14-18 hours after insemination or micro-injection two or three zygotes with the best pronuclear development were selected for further cultivation. Fertilized oocytes were cultured in sequential media and were then transferred into the uterus 5 days after oocyte recovery. The blastocysts were graded from 1-8. RESULTS: In 100 cycles a total of 859 oocytes were collected, of whom 663 were fertilized and reached the pronuclear stage (median fertilization rate 88.9 %). 251 zygotes were selected at the PN stage. 51 % of the selected zygotes achieved the blastocyst stage after 5 days (grade 1-5), 28 % were morulae (grade 6-7) and 21 % of the embryos arrested in their development (grade 8). The clinical pregnancy rate was 26 %. Women who conceived had a significant better development of blastocysts on day 5 (grade 4 versus grade 6, P < 0.01) than those not achieving pregnancy. CONCLUSIONS: In summary, under the current legal conditions in Germany, blastocyst culture cannot improve pregnancy rates as the rate of arrested embryos of over 20 % limits the chances of implantation.

Adult↗

Psychosocial patient characteristics and GP-registered chronic morbidity: a prospective study.

OBJECTIVE: The aim of this study was to get a profile of patients who are vulnerable to get multiple chronic, recurrent or high-impact diseases in a limited time period. We studied the incidence rates of morbidity and multimorbidity, and the influence of psychosocial characteristics on their occurrences. METHOD: Cohort study with 3551 subjects. Baseline measurement of psychosocial characteristics and a 2-year follow-up period for morbidity. The relations were evaluated using multiple logistic regression analysis. RESULTS: After adjustment for basic socio-demographic variables, a high internal locus of control belief was found to be protective [odds ratio (OR)=0.82] for the occurrence of morbidity, negative life events increased the risk (OR=1.22). Characteristics specifically protective for the occurrence of multimorbidity as compared to monomorbidity were: a high internal locus of control belief (OR=0.73), living as a couple or in a family as compared to living alone (OR=0.68) and a large social network (OR=0.41). CONCLUSION: It appears that certain patient characteristics are specifically related to the occurrence of multimorbidity. This provides opportunities for the future development of preventive interventions.

Adaptation, Psychological↗

Evidence for mitochondrial K+ channels and their role in cardioprotection.

Twenty years after the discovery of sarcolemmal ATP-sensitive K+ channels and 12 years after the discovery of mitochondrial K(ATP) (mitoK(ATP)) channels, progress has been remarkable, but many questions remain. In the case of the former, detailed structural information is available, and it is well accepted that the channel couples bioenergetics to cellular electrical excitability; however, in the heart, a clear physiological or pathophysiological role has yet to be defined. For mitoK(ATP), structural information is lacking, but there is abundant evidence linking the opening of the channel to protection against ischemia-reperfusion injury or apoptosis. This review updates recent progress in understanding the physiological role of mitoK(ATP) and highlights outstanding questions and controversies, with the intent of stimulating additional investigation on this topic.

Adenosine↗

[Occupationally induced hydrofluoric acid burns: an analysis of 9 patients from the aspect of occupational health].

We report here 9 patients suffering from hydrofluoric acid burn who visited our clinic from July, 1979 to February, 2000. These 9 cases occupied 25% of all chemical burn cases experienced in our clinic. All the patients were men ranging in age from 20 to 53 (mean age 35 years; average 36.8 years). At the time of accidental exposures, 6 patients had been engaged in washing or cleaning work, and 2 had been changing the parts of instruments containing hydrofluoric acid. Eight patients received burns on the hands and/or fingers. During the work, 2 patients had used vinyl chloride or rubber gloves, but three patients employed no protection for the hands. After the symptoms began to develop, it was found that the glove of one patient had a pin hole. Coupled with the occasions described in previous reports, the causal factors of hydrofluoric acid burn could be divided as follows: 1) negligence or carelessness of workers, in particular skilled persons, in handling hydrofluoric acid, 2) ignorance of the dangerousness of hydrofluoric acid, 3) the presence of pin hole (s) in protection gloves, and 4) unexpected accident. Hydrofluoric acid is one of the most corrosive inorganic acids, and can produce progressive and serious tissue necrosis with severe pain. To prevent burns due to this chemical, enlightenment and reeducation of the workers regarding the hazard of hydrofluoric acid are necessary.

Accidents, Occupational↗

[Life without DNA repair].

BACKGROUND: Faithful maintenance of the genomic information is crucial for the survival of a species. Consequently, DNA repair processes must have evolved early during evolution. DNA damage left unrepaired might cause mutations leading to cell death, increased cancer incidence and severe syndromes. MATERIAL AND METHODS: In 1968, for the first time a link was found between a human syndrome, xeroderma pigmentosum, and a defect in the machinery for DNA repair. These patients develop skin cancer at an early age if not completely protected against sunlight. More recently, several other DNA repair syndromes with cancer predisposition and premature aging have been identified. RESULTS: A number of DNA repair genes causing such defects have now been cloned and characterised. These genes represent different DNA repair pathways and some of them are involved in the coupling between DNA repair and DNA transcription. INTERPRETATION: It is now possible to produce mice models with defects identical to those identified in humans. During the last 5 years, more than 100 mice models with DNA repair deficiency have been produced. Further characterisation of such mice will provide a unique opportunity for understanding the clinical picture caused by altered DNA repair capacity, and also elucidate the complex interaction of different DNA repair genes.

Animals↗

Euphenic prevention of coronary artery disease.

The purpose of this feasibility study was to incorporate the primary prevention of coronary artery disease (CAD) into periconception care. The first task was the preconceptional screening for CAD. The family and case histories and risk status of prospective mothers and fathers were obtained. Serum total cholesterol was measured in 3,530 female and 3,127 male participants. The mean serum nonfasting cholesterol was 192 +/- 40 mg/dl in women and 204 +/- 49 mg/dl in men. The levels of total cholesterol exceeded the upper limit of desirable total cholesterol (200 mg/dl) in 37% of women and in 49% of men. Only 7% of women and 5% of men had previous knowledge about their high total cholesterol. The second task was risk assessment for CAD in prospective parents and their planned baby and the identification of couples at high risk. The third step was the education of couples at high risk: how to reduce risk factors and how to enhance protective factors. Three months later, the short-term follow-up study indicated a 49 mg/dl (18%) and 43 mg/dl (16%) (range 250 to 300) reduction in total cholesterol in female and male participants, respectively, mainly due to an education program including change in diet, cessation of smoking, and so forth. The long-term follow-up will include both parents and children 3 years after the birth. Periconception care is appropriate for both a general and selective approach to population screening for total cholesterol and for primary prevention of CAD.

Adult↗

Laparoscopic ablation of endometriosis using the cavitational ultrasonic surgical aspirator.

Surgical modalities such as electrosurgery and lasers have been used for many years to treat endometriosis. They are relatively unselective with wide scatter, however, leading to the potential for significant tissue damage and injury. As an alternative, a technique for performing laparoscopic excision and adhesiolysis using a cavitational ultrasonic surgical aspirator (CUSA) was developed and studied in 15 patients. Endometriosis was removed using a prototype titanium probe developed for a 10-mm laparoscopic port. The ultrasonic laparoscopic probe consisted of an acoustic vibrator, a coupling device, a removable tip, and a protective flue. Vibrations from the acoustic vibrator (magnetostrictive device) were conveyed to the operating tip through a coupling piece. The magnetostrictive device consisted of nickel alloy laminations 10.8 cm in length that transformed electrical energy into mechanical motion at the hollow titanium tip, vibrating at a frequency of 23 kHz. The excursion of the tip (amplitude setting) was arbitrarily set, with a fixed stroke of 200 microm in all cases to remove tissue with a 1- to 2-mm radius of the vibrating tip. The tip was tapered to obtain greater amplitude and ablation efficiency. When placed in contact with the endometriotic implants and adhesions, it destroyed and emulsified the cell membranes, which were irrigated and removed through a built-in suction tube. The resulting debris and irrigating fluid were removed through the hollow central portion of the probe. The vibrating tip was moved over the surgical site in a back-and-forth motion to allow continuous, controlled removal. Vessels larger than 0.5 mm in diameter, nerves, and fibrous tissue capsules rebounded with the ultrasonic vibration waves emitted by the CUSA, and thus were unimpaired by the procedure. The consistency of tissues was sensed accurately when the tip of the device was in contact with them. This tactile feedback was helpful in enabling the surgeon to differentiate target tissues. The future application of this instrument awaits the outcome of research.

Adult↗

Provoking neuroprotection by peroxynitrite.

Peroxynitrite, the product of the reaction between nitric oxide and superoxide, is spontaneouly formed within most mammalian cells under physiological conditions. Initial work addressing the pathophysiology of peroxynitrite afforded the generally accepted notion that this compound would be the long-term neurotoxic nitric oxide-derivative. However, over the past six years a number of interesting studies have reported direct in vivo and in vitro evidence that, at nanomolar-low micromolar concentrations, peroxynitrite is actively involved in triggering cellular survival signals. Most such evidence came from studies demonstrating protection against myocardial ischemia-reperfusion injury and neuronal apoptosis. Although full elucidation of the precise mechanism responsible for such protection still requires further research, peroxynitrite has been shown to promote the nitration and/or phosphorylation of regulatory sites at tyrosine kinase receptors coupled to well-known antiapoptotic pathways, such as those involving phosphoinositide 3-kinase/Akt or mitogen-activated protein kinases. In addition, peroxynitrite-mediated transient protection of neurons against apoptotic death is associated with rapid stimulation of glucose metabolism and glutathione regeneration. In view of the potential cytoprotective function of peroxynitrite, further studies specifically focused on elucidating the possible therapeutic potential of peroxynitrite are sure to appear.

Animals↗

A water-stable protected isocyanate glass array substrate.

We describe the performance of a new glass attachment chemistry for arrays that is particularly well suited to attachment of small molecules, such as peptides. The attachment chemistry is a protected isocyanate (PI) group. Isocyanate groups are well suited to serving as a glass coating for arrays, in that they are highly reactive with many different types of biological compounds. However, they are generally so reactive as to be unstable. The new feature of the PI slide coating is its stability. It can withstand immersion in water without loss of reactivity and has at least a 1-year shelf life. The high reactivity of the PI group results in a rapid coupling reaction (< 15min) and is particularly useful for attaching small molecules, such as peptides. Since isocyanates bind to both amines (forming a urea linkage) and hydroxyl groups (forming a carbamate bond), we tested the ability of the PI coating to bind to a wide variety of compounds. We found that the PI slide coating can directly attach to peptides, proteins, carbohydrates, lipooligosaccharides, and DNA. The sensitivity of detection for these compounds is comparable to that of other previously published array substrates.

Animals↗

Natural family planning with and without barrier method use in the fertile phase: efficacy in relation to sexual behavior: a German prospective long-term study.

A large prospective long-term study with users of natural family planning (NFP) methods has been conducted to analyze the relation between unintended pregnancy rates and sexual behavior with special reference to barrier method use in the fertile phase. Seven hundred and fifty eight NFP beginners, 19-45 years of age, 14870 cycles, 28 unintended pregnancies were studied. Of the couples, 54.2% use NFP only or predominantly and 45.9% use mixed methods (additional barrier method use in the fertile phase in 55.7% of the cycles). The overall pregnancy rate after 12 cycles of exposure is 2.2% according to the actuarial method. There is no significant difference between NFP users and mixed methods users and also no significant effect of duration of use in the first 5 years of exposure. During "perfect use" the pregnancy rate at 12 months is 0.63%. When only protected intercourse takes place in the fertile phase the pregnancy rate is 0.45%. The symptothermal method of NFP is most unforgiving for imperfect use (unprotected intercourse in the fertile phase). However, it is extremely effective when either abstinence or protected intercourse is used in the fertile phase.

Adult↗

Immunization against diphtheria with special emphasis on immunization of adults.

A massive diphtheria epidemic in Eastern Europe has resulted in increased anxiety that this disease could spread to other countries. This fear is realistic because there is a gap in the diphtheria immunity in large segments of the adult population in many industrialized countries. Experience to date suggests that an immunity gap in adults coupled with the presence of large numbers of susceptible children and adolescents creates the potential for an extensive epidemic. To prevent epidemics, countries should consider the immunogenicity and duration of protection provided by diphtheria toxoid given to children in the primary series and as booster doses. This paper reviews general issues related to the formulation of diphtheria immunization strategies, especially the need for booster doses in adults and the rationale for use of lower-strength diphtheria toxoid for persons older than 6 years of age.

Adult↗

Pregnancy and lifestyle study: the long-term use of the contraceptive pill and the risk of age-related miscarriage.

Maternal ageing is a very important factor in aneuploidy. It is associated with an increased risk of a liveborn trisomy, especially Down's syndrome, and with a dramatic increase in trisomic conceptions, the majority of which miscarry. A total of 585 volunteer couples who were planning pregnancies participated in a prospective study of reproduction. The couples answered extensive questionnaires and early pregnancy tests (day 28) were conducted each month. The number of years of contraceptive pill use was correlated with pregnancy outcome. Lowered rates of miscarriage were found with increased years of pill use. The cut-off point for this positive effect appeared to be 9 years. Use of oral contraceptives for > or = 9 years was associated with a spontaneous abortion rate of 11.3%, which is about half the rate (23%) which was found in couples who had not used the pill. However, the effect of pill taking was correlated with female age, and when age was examined as an independent factor, the reduction in miscarriage was only statistically significant in women > 30 years old, where the rate of abortion reduced from 28 to 7%. Because age-related aneuploidy in humans probably occurs as a direct or an indirect result of follicle depletion, it is proposed that the long-term use of the oral contraceptive pill protects against abortion due to aneuploidy by preserving the number of follicles.

Abortion, Spontaneous↗

A conjugate vaccine for the prevention of pediatric pneumococcal disease.

The use of the pneumococcal 7-valent conjugate vaccine (PCV7 [Prevnar], Wyeth Lederle Vaccines), and the impact it is likely to have on pneumococcal disease are reviewed. Pneumococcal disease in infants and young children is a major health care burden, and the increase in antibiotic resistance among pneumococci has complicated disease management. The 23-valent polysaccharide pneumococcal vaccines do not protect infants and children younger than 2 years of age. PCV7 is effective in this population and should dramatically reduce the incidence of invasive pneumococcal disease and have an impact on the incidence of infections caused by Streptococcus pneumoniae serotypes present in the vaccine. Research has shown that pneumococcal conjugate vaccines reduce nasopharyngeal carriage of vaccine serotype S. pneumoniae, including antibiotic-resistant strains. Routine immunization is expected to substantially reduce the morbidity and mortality associated with invasive pneumococcal disease in children, and coupled with expected herd immunity and decreased antibiotic selective pressure, it should have a positive impact beyond the immunized population.

Child↗

Signaling: cellular insights into the pathophysiology of bipolar disorder.

Clinical studies over the years have provided evidence that monoamine signaling and hypothalamic-pituitary-adrenal axis disruption are integral to the pathophysiology of bipolar disorder. A full understanding of the pathophysiology from a molecular to a systems level must await the identification of the susceptibility and protective genes driving the underlying neurobiology of bipolar disorder. Furthermore, the complexity of the unique biology of this affective disorder, which includes the predisposition to episodic and often progressive mood disturbance, and the dynamic nature of compensatory processes in the brain, coupled with limitations in experimental design, have hindered our progress to date. Imaging studies in patient populations have provided evidence of a role for anterior cingulate, amygdala, and prefrontal cortex in the pathophysiology of bipolar disorder. More recent research strategies designed to uncover the molecular mechanisms underlying our pharmacologic treatments and their interaction in the regulation of signal transduction as well as more advanced brain imaging studies remain promising approaches. This experimental strategy provides data derived from the physiologic response of the system in affected individuals and addresses the critical dynamic interaction with pharmacologic agents that effectively modify the clinical expression of the pathophysiology.

Antipsychotic Agents↗

Adenosine kinase inhibitors.

Adenosine (ADO) is an endogenous modulator of intercellular signaling that provides homeostatic reductions in cell excitability during tissue stress and trauma. The inhibitory actions of ADO are mediated by interactions with specific cell-surface G-protein coupled receptors regulating membrane cation flux, polarization, and the release of excitatory neurotransmitters. ADO kinase (AK; EC 2.7.1.20) is the key intracellular enzyme regulating intra- and extracellular ADO concentrations. Inhibition of AK produces marked increases in extracellular ADO levels that are localized to cells and tissues undergoing accelerated ADO release. Thus AK inhibition represents a mechanism to selectively enhance the protective actions of ADO during tissue trauma without producing the nonspecific effects associated with the systemic administration of ADO receptor agonists. During the last 10 years, specific inhibitors of AK based on the endogenous purine nucleoside substrate, ADO, have been developed. Potent AK inhibitors have recently been synthesized that demonstrate high specificity for this enzyme as compared to other ADO metabolic enzymes, transporters, and receptors. In both in vitro and in vivo models, AK inhibitors have been shown to potently increase ADO concentrations in a tissue and event specific fashion and to demonstrate potential clinical utility in animal models of epilepsy, ischemia, pain, and inflammation. AK inhibitors have demonstrated superior efficacy in these models as compared to other mechanisms of modulating ADO availability, and these agents exhibit reduced side-effect liabilities compared to direct acting ADO receptor agonists. The preclinical profile of AK inhibitors indicate that these agents may have therapeutic utility in a variety of central and peripheral diseases associated with cellular trauma and inflammation. Clinical trials are currently underway to evaluate the efficacy of AK inhibitors in seizure disorders and pain.

Adenosine↗

[The many faces of parasystolic rhythm].

BACKGROUND: Parasystole is the expression of a pacemaker that is protected from, and thus independent of, the dominant rhythm. The arrhythmia is not always associated with the 3 classic signs: variable coupling, mathematically related interectopic intervals, and fusion beats. A large amount of experimental and clinical data have pointed out several atypical phenomena that make the recognition of parasystole difficult. This especially occurs in the presence of influence exerted from sinus impulses upon the parasystolic rhythm. METHODS: A pattern of ventricular parasystole was evident throughout a 24-hour Holter recording obtained from a 55-year-old female. The following data were analyzed: a) distribution of ectopic complexes; b) parasystolic cycle duration; c) regularity of parasystole, as assessed by means of the variation index. In some sections of the tracing in which an electrotonic influence (modulation) exerted by the sinus rhythm on the parasystolic rhythm appeared as very likely, phase-response curves were constructed in order to express the time-dependent modulation effected by sinus impulses. RESULTS: Parasystole occurred in two separate periods, lasting 4 hours and 90 minutes, respectively. On both occasions, the arrhythmia was apparently precipitated by a brief episode of atrial tachycardia. Phases of regular parasystole, as well as periods of irregular modulated parasystole, were observed. The distribution of ectopic complexes was at times typical for concealed bigeminy (intervening beats always in odd numbers), but on other occasions reflected the even variant of concealed bigeminy where the intervening beats conform to the formula 1 + n (n being zero or an odd number). Some couplets of identical ectopic complexes were also observed. CONCLUSIONS: The study shows that several different expressions of parasystolic rhythm may be present within the same tracing. A minimal or absent modulation results in the classical picture of parasystole; when a mild modulating influence is present, the typical pattern of modulated parasystole ensues, whereas a strong modulation leads to disappearance of the typical features of parasystole and manifestation of concealed bigeminy. Finally, supernormal modulation is responsible for the occurrence of couplets.

Electrocardiography, Ambulatory↗