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Das Hauptziel dieses Manuskripts war ein Upgrading der DGN-Leitlinie „Ambulant erworbene bakterielle (eitrige) Meningoenzephalitis im Erwachsenenalter“ auf ein S2k-Niveau nach den Standards der AWMF. Zehn nominierte Mitglieder der Deutschen Gesellschaft fur Neurologie (DGN), Schweizerischen Neurologischen Gesellschaft (SNG), Osterreichischen Gesellschaft fur Neurologie (OGN), Deutschen Gesellschaft fur Hygiene und Mikrobiologie (DGHM), Paul-Ehrlich-Gesellschaft fur Chemotherapie (PEG), Deutschen Gesellschaft fur Neuroradiologie (DGNR), Deutschen Gesellschaft fur Neurointensiv- und Notfallmedizin (DGNI), Deutschen Gesellschaft fur Infektiologie (DGI), Deutschen Gesellschaft fur Innere Medizin (DGIM) und der Deutschen Gesellschaft fur Liquordiagnostik und Klinische Neurochemie (DGLN) waren an der Formulierung dieser Leitlinie beteiligt. Die Vorstande der Fachgesellschaften stimmten der Leitlinie zu. Die Leitlinie gibt einen Uberblick uber die klinischen Manifestationen und Komplikationen der bakteriellen Meningoenzephalitis im Erwachsenenalter, den notwendigen diagnostischen Schritten, den Therapieempfehlungen und den wichtigsten Praventionsmasnahmen.

Continuing medical education (CME) and its broader term continuing professional development (CPD) are indispensable as part of lifelong learning and may be regarded as equally or more important than undergraduate and postgraduate medical education. Pharmaceutical medicine occupies common ground between the clinical and healthcare professions, pharmaceutical industry and government, and thus, the same principles are applicable. However, the global status of CME/CPD education in pharmaceutical medicine is alarming. Surveys conducted among pharmaceutical medicine associations from 22 countries and pharmaceutical physicians in the US showed that a relatively low number of CME/CPD activities are developed across countries, a high percentage of pharmaceutical physicians lack formal postgraduate education in pharmaceutical medicine and, additionally, training needs in basic knowledge areas were detected. It is evident that further education efforts are necessary. The CME system has many variations across countries. The CME/CPD model, including credits or hours, is the currency by which regulatory bodies often assess competence all over the world. Accreditation systems have been developed primarily in the US and Europe in an attempt to self-regulate and advance practice standards, as well as to respond to environmental pressures for advancement of healthcare quality and insulation of any commercial influence on education. Initiatives for a European and/or global CME harmonization have been developed. However, the major problem is that the various CME systems are very different and fragmented. In spite of the tremendous amount of resources spent on maintaining and upgrading physicians’ knowledge and skills, the effectiveness of CME in producing changes in practice has been questioned. It has been argued that CME programmes, as currently practiced, do not adequately focus on improving clinical performance and patient health outcomes. The emphasis is put on measuring acquired knowledge based on training hours, instead of assessing competences and skills as a result of professional development. A new CME/CPD outcomes-based model for performance improvement through individualized and standardized education has been proposed, including physician’s self-assessment, self-reflection and practice-based learning. PharmaTrain is a public private partnership sponsored by the EU’s Innovative Medicines Initiative including 24 universities, 13 learned societies/associations and several partner training organizations. PharmaTrain aims to provide courses that are designed to meet the needs of pharmaceutical physicians and other professionals working in medicines development (basic diploma, masters and CME/CPD). The PharmaTrain CPD platform will include diploma and master extension and elective modules, both course based and standalone, aimed to facilitate lifelong learning. The successful development and use of the PharmaTrain CPD platform provides a valuable new opportunity to meet the current standards and expectations for CME/CPD posed by stakeholders and society at large.

Die hypoxische Enzephalopathie (HE) erfahrt aufgrund des zunehmenden Anteils alterer Menschen in der Bevolkerung und der besseren Reanimationserfolge nach Herz-Kreislauf-Stillstand eine wachsende Bedeutung. Zunehmend mehr Patienten nach kardiopulmonaler Reanimation erreichen die Klinik. Bei Herz-Kreislauf-Stillstand gelten folgende Reanimationsregeln: Der ungeubte Laie soll sich auf eine effektive Herzmassage konzentrieren, ein einheitliches Kompressions-Beatmungs Verhaltnis von 30:2 wird praklinisch vom geubten Helfer bei Erwachsenen wie Kindern verwendet. Die Kompressionsfrequenz betragt 100/min und empfohlen wird die fruhe Defibrillation bei Kammertachykardie/Kammerflimmern. Wird die Klinik erreicht, sollte fur die ersten 24 Stunden mit milder therapeutischer Hypothermie (TH) (32–34 °C) behandelt werden. Hiermit wird eine deutlich bessere Prognose erreicht. Ein wichtiger, neurologischer Aspekt der HE ist die Prognosestellung. Hierbei gilt: Es gibt derzeit keinen einfachen Prognosealgorithmus fur Patienten, die mit TH behandelt wurden. In den ersten 24 Stunden nach Reanimation vermag keine klinische oder technische Testung zuverlassig eine schlechte Prognose vorauszusagen, speziell kein Einzelparameter. Unter den Voraussetzungen eines fehlenden Medikamenteneffekts und einer nicht durchgefuhrten therapeutischen Hypothermie zeigt ein posthypoxisch tiefes Koma mit bis zum Tag 3 anhaltend erloschener Lichtreaktion der Pupille und erloschenem Kornealreflex die schlechte Prognose wahrscheinlich sicher an. Der erloschene okulozephale Reflex nach 24 Stunden und ein GCS Motor-Punktwert unter 3 (d. h. ausgefallene Motorik oder Strecksynergismen) nach 72 Stunden sind weniger verlasslich. Andere klinische Zeichen, einschlieslich des Myoklonus, sind ungeeignet. Der Nachweis des beidseitigen SEP Verlustes innerhalb der Tage 2–3 nach Beginn einer HE spricht unter der Bedingung ausreichender Erfahrung mit der Methode ohne TH fur eine schlechte Prognose. Nach TH ist diese Sicherheit allein aufgrund des kompletten SEP-Ausfalls innerhalb von 3 Tagen nicht gegeben. Die Hohe der NSE-Werte im Serum ist mit dem Ausmas der Hirnschadigung korreliert. Derzeit konnen keine sicheren oberen Grenzwerte, bis zu denen eine Erholung noch moglich ist, definiert werden. Die Zeitintervalle fur die Prognosestellung nach TH mussen verlangert werden und sowohl die klinischen, wie technischen Untersuchungen mit Vorsicht gewichtet werden. In erster Linie wird auf Kongruenz der Untersuchungsergebnisse und Ausschluss von Storfaktoren (z. B. Medikationsuberhang) zu achten sein. Die Konstellation „Ausfall der Lichtreaktionen und der Kornealreflexe oder Motor GCS unter 3 kombiniert mit einem Ausfall bei der N 20 bilateral im Medianus-SSEP oder einem areaktiven EEG nach 3 Tagen weist deutlich auf eine schlechte Prognose hin. Eine uberlebte Reanimation infolge Kammertachykardie/Kammerflimmern stellt nach zerebraler Restitution bei Fehlen einer selbst limitierenden Ursache eine ICD Indikation dar.

The rapidly varying (~10 minute timescale) non-thermal X-ray emission observed from Sgr A* implies that particle acceleration is occuring close to the event horizon of the supermassive black hole. The TeV gamma-ray source HESS J1745-290 is coincident with Sgr A* and may be closely related to its X-ray emission. Simultaneous X-ray and TeV observations are required to elucidate the relationship between these objects. We report on joint H.E.S.S./Chandra observations performed in July 2005, during which an X-ray flare was detected. Despite a factor of 9 increase in the X-ray flux of Sgr A*, no evidence is found for an increase in the TeV gamma-ray flux from this region. We find that an increase in the gamma-ray flux of a factor of 2 or greater can be excluded at a confidence level of 99%. This finding disfavours scenarios in which the keV and TeV emission are associated with the same population of accelerated particles and in which the bulk of the gamma-ray emission is produced within ~10^{14} cm (~100 R_S) of the supermassive black hole., 5 pages, 2 figures

Acute partial transverse myelitis (APTM) may be the first clinical manifestation of multiple sclerosis (MS), of relapsing myelitis, or remain a monophasic event. Identification of risk factors associated with relapse or conversion to MS is important, as prognostic information might help to guide management. The objective of this study was to define clinical, laboratory and neuroimaging factors in patients with first-ever APTM that predict relapses or conversion to MS. We identified 73 patients with a first-ever APTM admitted to our institution from January 1999 to June 2005. The follow-up time ranged from 12 to 90 months (mean follow-up 46 months). Patient demographics, clinical impairment at onset and after 3 months, ancillary tests including cerebrospinal fluid (CSF), magnetic resonance imaging (MRI), evoked potentials, recurrent and new symptoms and signs during follow-up were analysed. APTM remained a monophasic event in 35 patients (47.9%), conversion to MS occurred in 32 (43.8%) and recurred as relapsing myelitis in six patients (8.2%). According to univariate analysis, a family history of MS (P = 0.02), higher expanded disability status scale (EDSS) at onset (P = 0.03) and lesions on brain MRI (P = 0.03) were predictive factors for conversion to MS. CSF-specific oligoclonal bands (P = 0.04) or abnormal IgG-index (P = 0.04) were associated with increased risk for MS as well. In patients with a first-ever APTM, a family history of MS, high EDSS at presentation, lesions on brain MRI, CSF-specific oligoclonal bands or abnormal IgG-index may indicate an increased risk for conversion to MS.

Aims. Search for Very High Energy gamma-ray emission in the Kookaburra complex through observations with the H.E.S.S. array. Methods. Stereoscopic imaging of Cherenkov light emission of the gamma-ray showers in the atmosphere is used for the reconstruction and selection of the events to search for gamma-ray signals. Their spectrum is derived by a forward-folding maximum likelihood fit. Results. Two extended gamma-ray sources with an angular (68%) radius of 3.3-3.4' are discovered at high (>13sigma) statistical significance: HESS J1420-607 and HESS J1418-609. They exhibit a flux above 1 TeV of (2.97+/-0.18stat +/-0.60sys)x10-12 and (2.17+/-0.17stat +/-0.43sys)x10-12 cm-2 s-1, respectively, and similar hard photon indices ~2.2. Multi-wavelength comparisons show spatial coincidence with the wings of the Kookaburra. Two pulsar wind nebulae candidates, K3/PSR J1420-6048 and the Rabbit, lie on the edge of the H.E.S.S. sources. Conclusions. The two new sources confirm the non-thermal nature of at least parts of the two radio wings which overlap with the gamma-ray emission and establish their connection with the two X-ray pulsar wind nebulae candidates. Given the large point spread function of EGRET, the unidentified source(s) 3EG J1420-6038/GeV J1417-6100 could possibly be related to either or both H.E.S.S. sources. The most likely explanation for the Very High Energy gamma-rays discovered by H.E.S.S. is inverse Compton emission of accelerated electrons on the Cosmic Microwave Background near the two candidate pulsar wind nebulae, K3/PSR J1420-6048 and the Rabbit. Two scenarios which could lead to the observed large (~10 pc) offset-nebula type morphologies are briefly discussed.

Objective : To quantify the percentage of motor units of a foot muscle that can be activated by transcranial magnetic stimulation (TMS) in normal subjects and patients. Methods : We adapted the recently described triple stimulation technique (TST) for recordings from abductor hallucis (AH). Conventional motor evoked potentials (MEPs) of this muscle are usually small and variable in shape, because of an important temporal desynchronization of the TMS induced spinal motor neuron discharges. The TST allows ‘resynchronization’ of these discharges and thereby a quantification of the proportion of motor units activated by TMS. The lower limb (LL-) TST was applied to 33 sides of 18 normal subjects and 51 sides of 46 patients with multiple sclerosis, amyotrophic lateral sclerosis, or spinal cord disorders. Results : In healthy subjects, the LL-TST demonstrated that TMS achieves activation of virtually all motor neurons supplying the AH. In 33 of 51 patient sides, abnormal LL-TST responses suggested corticospinal conduction failures of various degrees. The LL-TST was 2.54 times more sensitive to detect central conduction failures than the conventional LL-MEPs. Combining the LL-TST with TST of the upper limbs further increased the sensitivity to detect a conduction failure by 1.50 times. Conclusion : The LL-TST markedly improves the examination of corticospinal pathways.

Using ligand blotting techniques, with low-density lipoprotein (LDL) as ligand, we have previously described the existence of atypical lipoprotein-binding proteins (105 kDa and 130 kDa) in membranes from human aortic medical tissue. The present study demonstrates that these proteins are also present in membranes from cultured human (aortic and mesenteric) and rat (aortic) vascular smooth-muscle cells (VSMCs). To assess the relationship of 105 and 130 kDa lipoprotein-binding proteins to known lipoprotein receptors, ligand binding specificity was studied. We tested effects of substances known to antagonize ligand binding to either the LDL [apolipoprotein B,E (apo B,E)] receptor (dextran sulphate, heparin, pentosan polysulphate, protamine, spermine, histone), the scavenger receptor (dextran sulphate, fucoidin), the very-low-density-lipoprotein (VLDL) receptor [receptor-associated protein (RAP)], or LDL receptor-related protein (RAP, alpha 2-macroglobulin, lipoprotein lipase, exotoxin-A). None of these substances, with the exception of dextran sulphate, influenced binding of LDL to either 105 or 130 kDa proteins. Sodium oleate or oleic acid, known stimuli for the lipoprotein binding activity of the lipolysis-stimulated receptor, were also without effect. LDL binding to 105 and 130 kDa proteins was inhibited by anti-LDL (apo B) antibodies. LDL and VLDL bound to 105 and 130 kDa proteins with similar affinities (approximately 50 micrograms/ml). The unique ligand selectivity of 105 and 130 kDa proteins supports the existence of a novel lipoprotein-binding protein that is distinct from all other currently identified LDL receptor family members. The similar ligand selectivity of 105 and 130 kDa proteins suggests that they may represent variant forms of an atypical lipoprotein-binding protein.

Abstract Mibefradil is a novel calcium antagonist that is selective for the T-type voltage-operated calcium channel rather than the L type. Because T-type calcium channels are present on rapidly proliferating cells and mediate the increase of intracellular calcium induced by some growth factors, such as platelet-derived growth factor, we hypothesized that the blockade of T channels could prevent the excessive smooth muscle cell proliferation that occurs in conditions such as vascular injury. To test this hypothesis, we evaluated in rats the effects of mibefradil (which blocks both L- and T-type channels) on neointima formation after vascular injury, and we compared them with those of equihypotensive doses of amlodipine and verapamil (which block only L-type channels). Mibefradil (30 mg/kg) decreased the area of neointima formed 14 days after balloon injury by 54% ( P

This study investigated the role of the endothelium and angiotensin II (Ang II) in regulating medial smooth muscle cell (SMC) proliferation. [3H]-thymidine incorporation into medial SMC of rat arteries was examined in vivo, using ballooned rat carotid arteries, as well as in vitro, using cultures of aortic tissue rings (organoids). In vivo, maximal medial [3H]-thymidine incorporation occurred within 3 days post-ballooning. In endothelium-denuded organoids, maximum medial DNA synthesis was achieved after 7 days of culture. [3H]-thymidine-labelling of SMC in intact organoids (with endothelium) increased minimally during culture, indicating that the endothelium provided protection with respect to medial proliferation under basal conditions (culture in the presence of 1% plasma-derived serum). Inclusion of 10(-7) M Ang II significantly elevated medial [3H]-thymidine incorporation above that in control cultures. The stimulatory effect of Ang II was much more pronounced in intact organoids that in endothelium-denuded organoids, indicating synergistic growth regulation by Ang II and endothelium-derived factors. When organoids were cultured in the combined presence of Ang II and the ACE inhibitor cilazaprilat, labelling indices of intact organoids were also significantly increased above control, but to a lower level than those obtained in the presence of Ang II alone. However, for endothelium-denuded organoids, medial [3H]-thymidine incorporation in the combined presence of Ang II and cilazaprilat was not significantly different from that in untreated controls. Thus, cilazaprilat exerts both endothelium-dependent and endothelium-independent negative regulatory effects on medial SMC proliferation.

The arterial tenascin C expression in vivo and in vitro has been studied using immunohistochemistry. The functional relevance of localized tenascin C expression was assessed in vitro using various human cell types involved in the progression of vascular disease. Normotensive and hypertensive rats exhibited age-dependent patterns of vascular (aorta) tenascin expression, but the lumen-to-media-directed progression of tenascin induction was accelerated in hypertensive rats. Tenascin-rich neointimal lesions (spontaneous) were observed at branching sites of aorta from aged (80 weeks) hypertensive rats. Subendothelial tenascin foci contained lipid-laden smooth muscle cells and monocytes/macrophages. Medial tenascin foci encaged smooth muscle cells which synthesized DNA. Tenascin was expressed both in vivo and in vitro by endothelial and smooth muscle cells but not by monocytes/macrophages; angiotensin II, oxidized-low density lipoprotein and transforming growth factor beta 1 induced expression of tenascin transcripts and glycoprotein in vitro. Endothelial and smooth muscle cells, but not monocytes, adhered to tenascin substrata. Tenascin reduced focal adhesion integrity in confluent endothelial and smooth muscle cell cultures. Angiotensin II-induced migration of endothelial and smooth muscle cells was accompanied by tenascin deposition within extracellular matrix migration trails. Tenascin may function both as a defense against monocyte invasion and medial smooth muscle replication, as well as a substratum for directed endothelial and smooth muscle cell migration.

Denitrification in secondary clarifiers is primarily due to hydrolysis of particulate degradable COD and decay of biomass. The reduction factor of these processes under anoxic as compared to aerobic conditions was investigated in the treatment plants of the City of Zurich. The Zürich-Glatt plant has circular clarifiers with central inlet. The treatment plant Zürich-Werdhölzli has rectangular clarifiers with cross flow and scrapers with vacuum removal of the sludge. At Zürich Glatt denitrification capacity in the clarifiers was 30% of total denitrification, whereas at Zürich-Werdhölzli only 15 % was observed. The sludge mass in the secondary clarifier depends on inlet flow, return sludge flow, activated sludge concentration, sedimentation properties of the sludge and scraper intervals. During dry weather and due to good sedimentation properties the activated sludge blanket in the thickening zone of the rectangular clarifiers at Zürich-Werdhölzli is almost completely removed after passage of the scraper. Denitrification volume in the secondary clarifier can therefore be modelled in relation to the ratio of inlet to return sludge flow and scraper interval. With the aid of control of return sludge flow and scraper intervals denitrification capacity in the secondary clarifiers may be improved. In order to control denitrification in the secondary clarifier the model must include a variable sludge volume in the clarifier related to scraper interval under the assumption of constant sludge mass in the entire system.

The emissions of polychlorinated dibenzo-p-dioxins (PCDD) and polychlorinated dibenzofurans (PCDF) from combustion of different kinds of wood have been determined. Emissions from natural beech wood sticks (0.019 to 0.064 ng TE/m3), natural wood chips (0.066 to 0.214 ng TE/m3) and uncoated chipboard chips (0.024 to 0.076 ng TE/m3) were low, whereas the combustion of waste wood chips resulted in higher dioxin emissions (between 2.70 and 14.42 ng TE/m3). Additionally, two specific fuels were investigated: charcoal and household waste. Charcoal used for grilling of meat resulted in the very low PCDD/PCDF emissions of 0.028 ng TE/m3, whereas the emissions from the combustible part of household waste were very high (114 ng TE/m3). Based on the specific dioxin emissions per kg of fuel, the annual emissions from combustion of wood and the specific fuels were calculated in Switzerland to be 6.9 to 43.8 g TE.

Free radicals produced by water radiolysis were used to study the inactivation of the enzymatic activity of the Na,K-ATPase. A decrease of the activity to virtually zero with a mono-exponential dependence on the radiation dose was observed. The inactivation process is initiated by hydroxyl radicals. This was shown by the effect of appropriate radical scavengers such as t -butanol, formate and vitamin C. In all cases a significant increase in the characteristic D 37 dose of inactivation was observed. Inactivation was found to show a so-called inverse dose-rate effect, i.e, the sensitivity of the enzyme to radical attack is increased if the dose rate is reduced. The data were found to agree with the relationship 1/ D 37 1/ D 1/2, which is known to be a strong indicator of a radical chain mechanism. This means that the inactivation, after initiation by single radicals, is amplified by a subsequent chain mechanism.

BACKGROUND Smoking is a major risk factor for the development of atherosclerosis. Because endothelial dysfunction may be a marker for future atherosclerosis, we investigated the effects of smoking on endothelium-dependent control of vascular tone. METHODS AND RESULTS The effects of brachial arterial infusions of NG-monomethyl-L-arginine (L-NMMA), a nitric oxide synthesis inhibitor; sodium nitroprusside; endothelin-1; and norepinephrine on forearm blood flow (strain-gauge plethysmography) were compared in 29 long-term smokers and 16 nonsmokers. The acute effects of smoking on systemic hemodynamics, plasma catecholamines, and forearm vascular responses to these compounds were investigated in smokers only. Smokers did not differ from nonsmokers (n = 16) regarding the vascular effects of sodium nitroprusside (n = 13) or vasoconstriction due to norepinephrine and endothelin-1 (n = 16). Low-dose endothelin-1-induced vasodilation, believed to reflect endothelial prostacyclin or nitric oxide release, was absent in smokers (n = 16), and their increase of forearm vascular resistance (FVR) after L-NMMA (n = 13) was impaired (35.6 +/- 27.9% versus 118.8 +/- 43.2%, P < .001). Short-term smoking (n = 11) increased blood pressure, heart rate, and plasma epinephrine concentrations (P < .05 or less); enhanced endothelin-1-induced vasoconstriction (delta FVR, 457 +/- 192% versus 254 +/- 143%, P < .01); and decreased norepinephrine-induced vasoconstriction (P < .05), but had no effect on the other interventions. CONCLUSIONS Long-term smoking is associated with a diminished nitric oxide-dependent component of basal vascular tone and an impaired endothelium-dependent vasodilator response to low-dose endothelin-1 and short-term smoking enhances endothelin-1-induced vasoconstriction. Impaired endothelial control of vascular tone might reflect impairment of normal antiatherosclerotic endothelial functions in smokers, but the relevance of smoking-induced enhancement of endothelin-1 vasoconstriction remains to be determined.

Laminin, a major structural glycoprotein complex of basement membranes has been found to be modulated by angiotensin II in vitro and in vivo. In cultures of aortic organoids and vascular smooth muscle cells, expression of laminin was stimulated by exogenous vasoconstrictor peptide. Stimulation of laminin protein and mRNA expression was observed for both laminin B1/B2-chains and an unknown laminin heavy chain. Compared with PYS-2 cells, a mouse teratocarcinoma cell line which constitutively expresses a 10-kb mRNA transcript for 'classical' laminin A-chain, cultured vascular smooth muscle cells (VSMC) did not express a corresponding mRNA. However, cultured VSMC were found to express laminin A-chain-related mRNAs of approximately 1.8 kb and approximately 3.8 kb, respectively. The 1.8-kb species of transcript was expressed in a constitutive manner, whereas the 3.8-kb mRNA was found to be regulated by angiotensin II. Laminin complexes secreted by cultured cells contained a approximately 300 kD heavy chain which did not immunoreact with immunoreagents raised against either the classical laminin complex secreted by EHS tumor cells or the merosin heavy chain. The putative A-chain analogue possibly represents a new form of a tissue-specific laminin heavy chain, distinct from the A- and M-chains thus far described. Translation products encoded by the A-chain-related transcripts of cultured smooth muscle cells could not be specified using currently available antibodies. The putative protein(s) is speculated to contain the biological features of the N-terminus of the laminin A-chain, namely self-assembly and association with collagen type IV.

Low-density (LDL) and high-density (HDL3) lipoproteins dose-dependently activate phosphoinositide turnover and elevate cytosolic free Ca2+ concentrations ([Ca2+]i) in cultured vascular smooth muscle cells (VSMCs) from either human (microarterioles and aorta) or rat (aorta) sources. High-performance liquid chromatography analysis of cell extracts revealed comparable spectra of inositol phosphate isomers generated in response to either LDL, HDL3, or angiotensin II (Ang II). Thus, lipoproteins and Ang II may use similar, if not identical, signal transduction pathways for the generation and metabolism of inositol phosphates and intracellular Ca2+ mobilization in VSMCs. When Ang II was added in combination with either LDL or HDL3, the phosphoinositide and [Ca2+]i responses of VSMCs were either equal to or even greater than the sum of the effects elicited by the agonists individually. This additivity/synergy between Ang II and the lipoproteins was not accompanied by alteration in the half-maximally effective dose requirements of VSMCs for either Ang II (approximately 2 nmol/L, with or without lipoproteins) or lipoproteins (approximately 50 micrograms/mL for LDL and HDL3, with or without Ang II). Neither short-term (up to 10 minutes) nor long-term (48 hours) exposure of VSMCs to lipoproteins caused desensitization of phospholipase C and intracellular Ca2+ mobilization responses to either Ang II or lipoproteins. Since constant exposure of VSMCs to lipoproteins is a physiological circumstance, and because elevation of [Ca2+]i and activation of phosphoinositide turnover are pivotal events for VSMC contraction and growth, we suggest that the low concentrations of lipoproteins in the vessel intima may play an important role in regulating the response of the vasculature to Ang II.

Type A behaviour has been related to coronary heart disease (CHD) as an independent risk factor. Therefore, ischemic electrocardiographic (ECG) changes may be more prominent in Type A than in Type B individuals. ECG abnormalities were assessed by the Cardiac Infarction Injury Score (CIIS), which has predictive power for sudden death. In 100 healthy men aged 30–45 yr, the CIIS was related to cardiovascular risk factors such as age, blood pressure, smoking, family history of CHD and behaviour pattern groups defined by the Structured Interview (46 Type A, 20 Type X and 34 Type B subjects). The distribution of the CIIS was different among the behaviour pattern groups (p< 0.05) and was shifted towards higher ischemic scores in Type A subjects. These findings suggest that clinically asymptomatic persons with Type A behaviour have a greater probability of suffering ischemic heart disease and possible sudden death.

This study has investigated the influence of the vasoconstrictor peptides angiotensin II (Ang II) and endothelin-1 (ET-1) on fibronectin expression by vascular smooth muscle cells (VSMC). In confluent, quiescent cultures of VSMC, Ang II and ET-1 elevated fibronectin mRNA levels in a time- and dose-dependent fashion. ET-1 and Ang II also induced a time-dependent expression of immunoreactive fibronectin in cultures of aortic organoids, and for both peptides the fibronectin immunoreactivity was most prominent within those medial smooth muscle cell layers close to the vessel lumen. Immunoprecipitation of biosynthetically labelled fibronectin elaborated by cultured VSMC revealed a predominant expression of soluble fibronectin in response to Ang II, whereas for ET-1 the newly synthesized fibronectin was predominantly incorporated into the extracellular matrix deposit of the cells. These findings indicate that Ang II and ET-1 may exert disparate effects on smooth muscle cell phenotype and migration.

Preincubation of rat skeletal muscle derived L6 myoblasts with 10 mM NaF increased, the activity of Na+/H+ exchanger, and the uptake of 45Ca by 2 and 5 folds, respectively. In cultured vascular smooth muscle cells (CVSMC) of rat aorta, NaF increased the activity of Na+ ,K+-pump, Na+/H+ exchanger, passive permeability for Na+, and 45Ca uptake by 1.6, 9, 2, and 9 folds, respectively. Both, in CVSMC and L6 cells, the effect of NaF on the Na+/H+ exchanger and 45Ca uptake were significantly augmented by 20 μM AlCl3. No effect of AlCl3 on the NaF dependent changes in ion flux was seen in rat erythrocytes. The results suggest that in L6 and CVSMC cells, the Na+/H+ exchanger and Ca++ uptake pathway(s) are activated by GTP-binding proteins.

This study examined 45Ca uptake, 45Ca efflux, and the distribution of exchangeable 45Ca in confluent, quiescent cultures of aortic smooth muscle cells (VSMCs) from normotensive Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHRs). These parameters were investigated under basal conditions and after addition of angiotensin II (Ang II) and low (LDL) and high (HDL) density lipoproteins. Basal 45Ca uptake was approximately 50% greater in VSMCs from SHRs (p < 0.005 versus WKY). Calcium antagonists (diltiazem or nifedipine) abolished this difference. The 45Ca uptake response to Ang II was approximately twofold greater in SHR than in WKY VSMCs (p < 0.05), and Ang II-induced increments of 45Ca uptake were weakly inhibited (by approximately 15-25%) by calcium antagonists. Lipoproteins also stimulated 45Ca uptake in VSMCs, and the apparent affinity of this process was approximately fivefold greater for LDL than for HDL. Calcium antagonists did not inhibit either LDL- or HDL-induced 45Ca uptake. SHR and WKY VSMCs did not differ with respect to 45Ca uptake induced by either LDL or HDL. The initial size of the slowly exchangeable pool of intracellular Ca2+ was approximately 35% greater in SHR VSMCs (p < 0.05 versus WKY). Ang II-induced mobilization of intracellular calcium (measured as the decrease in 45Ca content of the slowly exchangeable pool) was threefold greater in SHR VSMCs (p < 0.005 versus WKY). LDL and HDL marginally stimulated 45Ca efflux from this pool (< or = 20% above control) and to comparable extents in both SHR and WKY VSMCs.(ABSTRACT TRUNCATED AT 250 WORDS)

Highly energetic, variable and distant sources such as Active Galactic Nuclei provide a good means to evaluate effects due to the emission and the propagation of high energy photons. In this work, studies of possible energy‐dependent time‐lags with PKS 2155‐304 light curve as measured by H.E.S.S. on 28 July 2006 (MJD 52944) are presented. The time‐lags could come from the emission processes and also sign a Lorentz Symmetry breaking as predicted in some Quantum Gravity models. After a brief description of the methods in use, the latest results from two different analyses of the flare will be given.

Intraluminal pressure may affect vascular contractility in both normotension and hypertension. To test this hypothesis, we studied mesenteric resistance arteries from normotensive humans as well as normotensive (WKY) and spontaneously hypertensive (SHR) rats (internal diameter 214 +/- 27, 201 +/- 6, and 172 +/- 6 microns, mean +/- SEM at 10 mm Hg). Vessels were mounted on glass cannulas and perfused in organ chambers filled with buffer solution at intraluminal pressures of 10 to 120 mm Hg; vasomotion was measured using a video dimension analyzer. Under baseline conditions (10 mm Hg), wall thickness was 36 +/- 4 microns in humans, 32 +/- 4 microns in WKY, and 47 +/- 2 microns in SHR (P less than .001). With increasing pressure, the diameter of human vessels increased up to 25 mm Hg and remained constant at higher pressures. In contrast, resistance arteries of normotensive and hypertensive rats exhibited an almost linear increase in diameter over the whole pressure range. In SHR, the pressure-diameter relationship was much flatter than that of WKY, indicating reduced compliance. In human arteries, the contraction to KCl was maximal at 25 mm Hg and averaged 40 +/- 6%. Both above and below 25 mm Hg, the response declined to a minimum of 17 +/- 2% at 120 mm Hg (P less than .01). Similar results were obtained in WKY rats. In contrast, the contractile response in SHR remained maximal over the entire pressure range studied (65 +/- 5%).(ABSTRACT TRUNCATED AT 250 WORDS)

Endothelin-1 (ET-1) produced by vascular endothelial cells has been proposed to act in a paracrine manner on adjacent smooth muscle cells (SMCs) in vivo, exerting a variety of short- and long-term effects. Although some of the in vitro ET-1-mediated effects are related to growth-promoting events, the physiological significance of these observations remains to be clarified. Reported discrepancies of the mitogenic potential of ET-1 may relate to differences in culturing conditions (submitogenic levels of serum in combination with ET-1). Because ET-1 has been implicated in proliferation of vascular SMCs (VSMCs) at sites of vascular injury, as well as pathological events during atherogenesis, a clarification of the mitogenic effects of ET-1 is important. This study demonstrates the possible autocrine role for ET-1 in the regulation of the vasculature, its influence on VSMC cell cycle, and autocrine and phenotypic regulation of VSMCs. Stimulation of quiescent VSMCs with a variety of peptides resulted in the secretion of biologically active ET-1 by VSMCs. In contrast to previous reports, long-term exposure (12-15 days) of VSMCs to ET-1 in nonmitogenic medium did not promote cycling of cells. On the contrary, ET-1 attenuated the cycling of VSMCs in the S and G2/M phases and interrupted progression through the cell cycle at late G1/early S phase. Subsequent to ET-1 exposure, VSMCs expressed increased levels of smooth muscle-specific alpha-actin. Therefore, autocrine-produced ET-1 may contribute to phenotypic differentiation of VSMCs.

Atherogenesis is associated with alterations in the properties of different cell types, including monocytes/macrophages (foam cell formation), platelets (increased aggregation), endothelial cells (injury), and smooth muscle cells (SMCs) (lipid accumulation or foam cell formation). Oxidized low density lipoproteins (ox-LDL) play a key role in this vascular pathology. This study investigated the ability of ox-LDL to elicit chemical signaling events in cultured human vascular smooth muscle cells (VSMCs). Ox-LDL was found to stimulate phospholipase C-mediated phosphoinositide turnover in human VSMCs. This response occurred rapidly (within 1 minute) and at low concentrations of ox-LDL (half-maximal effective concentration, approximately 5 micrograms/ml). Ox-LDL-stimulated inositol phosphate accumulation in human VSMCs was inhibited by pretreatment of cells with phorbol 12-myristate 13-acetate and with compounds that elevate cyclic AMP or cyclic GMP. Ca2+ antagonists also blocked the effects of ox-LDL on phosphoinositide turnover. Inhibitors of receptor-endocytotic processes (including receptor clustering, cross-linking, and cytoskeleton-dependent internalization) effectively prevented ox-LDL-induced inositol phosphate generation. The data suggest that ox-LDL promotes phospholipase C-mediated phosphoinositide turnover in a manner analogous to that for other Ca(2+)-mobilizing hormones. The results also support an association between phosphoinositide turnover and receptor-mediated endocytosis. Prevention of the direct effects of ox-LDL on SMCs could prove an interesting therapeutic avenue for the prevention of atherosclerosis.

BACKGROUND The participation of the renin-angiotensin system in the control of blood pressure in normal, sodium-replete subjects is not clear. The use of a specific inhibitor of human renin should allow a better delineation of the importance of this system. METHODS AND RESULTS Blood pressure responses were measured 1 hour after randomized, double-blind administration of the renin inhibitor Ro 42-5892 (600 mg p.o.) or the angiotensin converting enzyme inhibitor captopril (50 mg p.o.) in 20 healthy men on an ad libitum sodium diet. Effective inhibition of the renin-angiotensin system by either compound was indicated by increases of immunoreactive renin associated with an increase of angiotensin I production rate of 67.8 +/- 33.6% after captopril and a decrease of 79.5 +/- 16.4% after Ro 42-5892. Furthermore, Ro 42-5892 decreased plasma renin activity by 64%. Whereas intra-arterial diastolic (60 +/- 5.1 to 51.4 +/- 7.2 mm Hg, p less than 0.01) and mean arterial (77.7 +/- 6.0 to 71.4 +/- 8.5 mm Hg, p less than 0.001) pressures decreased after captopril, they remained unchanged after Ro 42-5892. Captopril, but not Ro 42-5892, increased forearm blood flow (2.4 +/- 0.8 versus 1.9 +/- 0.8 ml/min/100 ml, p less than 0.01) and significantly enhanced the increase of forearm blood flow to brachial artery infusions of bradykinin (0.15, 1.5, 5, 15, and 50 ng/min/100 ml; 5 minutes each) from 744 +/- 632% to 1,383 +/- 514% (p less than 0.01). Furthermore, repeat bradykinin infusions resulted in further decreases of blood pressure (from mean pressure of 71.4 +/- 8.5 to 63.2 +/- 7.6 mm Hg, p less than 0.01) only after captopril. Changes of blood pressure after captopril were unrelated to baseline plasma renin activity but correlated with captopril-induced enhancement of vasodilation to bradykinin (r = 0.68, p less than 0.05). CONCLUSIONS The lack of blood pressure effects of renin inhibition in contrast to angiotensin converting enzyme inhibition suggests that the renin-angiotensin system does not contribute significantly to blood pressure control in normotensive, sodium-replete subjects. The hypotensive activity of angiotensin converting enzyme inhibitors may result from additional hormonal effects, for example, inhibition of bradykinin degradation and/or subsequent increases of vasodilating prostaglandins or endothelium-derived relaxing factor(s).

Smooth muscle cells from spontaneously hypertensive rats (SHR) proliferate in culture faster than those isolated from sex- and age-matched Wistar- Kyoto (WKY) animals. There was no difference in the kinetics of S6 kinase activation in the two cultures, but later metabolic events associated with proliferation were stimulated earlier in SHR cells than in WKY, eg, activation of ornithine decarboxylase. Both cell types elaborated an extensive extracellular matrix in culture composed of a different blend of connective tissue macromolecules. Matrix material from SHR cells was more stimulatory to growth of WKY cultures than their own matrices. Angiotensin stimulated the growth and synthesis of extra-cellular matrix material in SHR more than in WKY derived vascular smooth muscle cell cul-tures. Am J Hypertens 1991;4:183-188

Intracellular calcium transients play a major role in the control of cellular contraction and act through binding to target proteins and inducing subsequent conformational changes and activation of enzymes. Abnormalities of intracellular calcium handling are involved in the pathophysiology of essential hypertension and cardiac hypertrophy. In this study we report on the isolation, purification and calcium binding of a 33 kDa protein from human platelets and of a 38 kDa protein from cardiac tissue, both of which are identified as tropomyosin. The calcium binding properties of these human tropomyosin isoforms indicate a putative role for these proteins in the fine tuning of the cellular contraction. Elevated tropomyosin level is demonstrated in platelets from untreated essential hypertensive patients with left ventricular hypertrophy (tropomyosin/actin: 45.1 +/- 3.5, n = 12) relative to essential hypertensive patients without cardiac hypertrophy (tropomyosin/actin: 33.8 +/- 2.3). These findings suggest an association between the enhanced expression of tropomyosin in platelets and the development of cardiac hypertrophy which may relate to the cellular calcium overload of this disease.

It has recently been shown that nitric oxide (NO) or a labile NO-releasing compound is produced in endothelial cells. In the present study we measured the NO-release from human vascular smooth muscle cells in culture. The cells released an average 2.2 x 10(-9) moles nitric oxide per 10(8) cells in ten minutes with a large variation between different cell lines and passages without stimulators. The NO-release was markedly reduced by the inhibitor of NO-formation NG-momomethyl-L-arginine (L-NMMA, 10(-5) M) to 3% of the control levels (p less than 0.02, n = 4), but unaffected by acetylcholine, bradykinin or endothelin -1, -2 or -3. In a microperfusion system the compound released from human vascular smooth muscle cells caused profound relaxation of isolated rat mesenteric resistance arteries. Thus, human vascular smooth muscle cells in culture produce and release biologically active NO from L-arginine.

We have investigated the interrelationship between growth factors and vasoconstrictor peptides in terms of their possible paracrine/autocrine regulation of vascular smooth muscle cell differentiation/proliferation. Responses of quiescent cells from spontaneously hypertensive and Wistar-Kyoto rats to stimulation with a selected number of growth factors- and vasoconstrictor peptides were established (induction of mRNA as well as secretion of immunoreactive peptides). A single exposure of quiescent vascular smooth muscle cells to the vasoconstrictor peptides Angiotensin II and Endothelin-1 (10−8 M each) resulted in a prolonged induction of platelet- derived growth factor A-chain and transforming growth factor β transcripts (maximal at 5–6 hrs poststimulatory). The interrelationship between platelet- derived growth factor AA and transforming growth factor β was investigated in experiments using the pure peptides individually for stimulation of mRNA and peptide secretion. Both growth factors enhanced their own and one anothers transcript expression. The results demonstrated that in spontaneously hypertensive rats, an established animal model of hypertension, the steady state balance of this set of growth factors may be disturbed. Defects involved may be attributable to alterations in the secretory machinery and/or amount of autocrine growth factor produced.

Low density lipoprotein and its oxidized form has been implicated in the process of arteriosclerosis which involves growth-related events in the smooth muscle cells of the arterial wall. The induction of so-called early-growth response genes e.g. c-myc and c-fos can serve as an indicator for these growth-related events. In cultured human vascular smooth muscle cells, both LDL and HDL3 were individually capable of stimulating c-myc and c-fos expression in a concentration dependent manner. However, when they were used in combination, depending on the proportion of HDL3 to LDL, c-fos but not c-myc expression was less pronounced than with the single components. In contrast to HDL3 and LDL alone, a combination of the two lipoproteins also blunted both the expression of autoinduced transforming growth factor beta transcripts and the transforming growth factor beta-induced increase of c-fos mRNA. It is concluded that a) the inhibition of transforming growth factor beta autostimulation by HDL3 plus LDL may involve reduced AP-1 activity via a reduction of c-fos expression by the lipoprotein combination and b) the ratio HDL3:LDL might influence the pathogenesis of arteriosclerosis via growth-related events in the arterial wall.

Predictors for early development of essential hypertension were identified in a prospective study of 98 normotensive and 23 borderline hypertensive subjects of both sexes aged 18-24 years. Baseline examination included psychological tests as well as resting and stress-induced cardiovascular and neurohormonal measurements. During the 30 (+/- 4 s.d.)-month follow up, 14 out of 98 (14%) initially normotensive subjects developed borderline hypertension, while of 23 borderline hypertensive subjects, 11 (48%) remained in the borderline group (141-159/91-94 mmHg), another five (22%) increased to greater than 160/95 mmHg and seven (30%) normalized blood pressure to less than 140/90 mmHg. In the 98 normotensive subjects, the height of casual systolic blood pressure at entry was the best predictor of subsequent borderline hypertension, correctly classifying 75% of the subjects in a stepwise discriminant analysis. Stress-induced blood pressure responses, together with measures of sympathetic nervous system activity (11%) and psychological factors (6%), were relatively weak predictors of subsequent pressure classification. In the 23 borderline hypertensives, the height of systolic blood pressure induced by mental stress was the single best predictor for sustained borderline or subsequent established hypertension, classifying 74%. When all 121 subjects were taken together, the greatest increases in blood pressure were found in those subjects who had suppressed aggression, particularly those who also had normal-high or borderline blood pressure at entry. Thus, suppressed aggression emerged as a superimposed permissive factor for a steeper trajectory or acceleration of early development of hypertension. Language: en

In the first part of the paper, evidence has been presented that electrochromic styryl dyes, such as RH 421, incorporate into Na,K-ATPase membranes isolated from mammalian kidney and respond to changes of local electric field strength. In this second part of the paper, fluorescence studies with RH-421-labeled membranes are described, which were carried out to obtain information on the nature of charge-translocating reaction steps in the pumping cycle. Experiments with normal and chymotrypsin-modified membranes show that phosphorylation by ATP and occlusion of Na+ are electroneutral steps, and that release of Na+ from the occluded state to the extracellular side is associated with translocation of charge. Fluorescence signals observed in the presence of K+ indicate that binding and occlusion of K+ at the extracellular face of the pump is another major electrogenic reaction step. The finding that the fluorescence signals are insensitive to changes of ionic strength leads to the conclusion that the binding pocket accommodating Na+ or K+ is buried in the membrane dielectric. This corresponds to the notion that the binding sites are connected with the extracellular medium by a narrow access channel ("ion well"). This notion is further supported by experiments with lipophilic ions, such as tetraphenylphosphonium (TPP+) or tetraphenylborate (TPB-), which are known to bind to lipid bilayers and to change the electrostatic potential inside the membrane. Addition of TPP+ leads to a decrease of binding affinity for Na+ and K+, which is thought to result from the TPP(+)-induced change of electric field strength in the access channel.

Membrane fragments containing a high density of Na,K-ATPase can be noncovalently labeled with amphiphilic styryl dyes (e.g., RH 421). Phosphorylation of the Na,K-ATPase by ATP in the presence of Na+ and in the absence of K+ leads to a large increase of the fluorescence of RH 421 (up to 100%). In this paper evidence is presented that the styryl dye mainly responds to changes of the electric field strength in the membrane, resulting from charge movements during the pumping cycle: (i) The spectral characteristic of the ATP-induced dye response essentially agrees with the predictions for an electrochromic shift of the absorption peak. (ii) Adsorption of lipophilic anions to Na,K-ATPase membranes leads to an increase, adsorption of lipophilic cations to the decrease of dye fluorescence. These ions are known to bind to the hydrophobic interior of the membrane and to change the electric field strength in the boundary layer close to the interface. (iii) The fluorescence change that is normally observed upon phosphorylation by ATP is abolished at high concentrations of lipophilic ions. Lipophilic ions are thought to redistribute between the adsorption sites and water and to neutralize in this way the change of field strength caused by ion translocation in the pump protein. (iv) Changes of the fluorescence of RH 421 correlate with known electrogenic transitions in the pumping cycle, whereas transitions that are known to be electrically silent do not lead to fluorescence changes. The information obtained from experiments with amphiphilic styryl dyes is complementary to the results of electrophysiological investigations in which pump currents are measured as a function of transmembrane voltage. In particular, electrochromic dyes can be used for studying electrogenic processes in microsomal membrane preparations which are not amenable to electrophysiological techniques.

The vascular effects of endothelin-1 (ET) in humans were investigated by brachial artery infusions of ET into 25 healthy volunteers. Forearm blood flow increased from a mean +/- SD value of 2.3 +/- 1.5 to 2.5 +/- 1.5 ml/min/100 ml forearm tissue (n = 25, p less than 0.05) in response to low dose (0.5 ng/min/100 ml forearm tissue) ET infusion and decreased to 1.78 +/- 1.3 and 1.1 +/- 0.9 ml/min/100 ml forearm tissue (p less than 0.001) during higher dosages (25 and 50 ng/min/100 ml forearm tissue). Sodium nitroprusside (0.6 micrograms/min/100 ml forearm tissue, n = 6), acetylcholine (16 micrograms/min/100 ml forearm tissue, n = 7), nifedipine (6 micrograms/min/100 ml forearm tissue, n = 6), and verapamil (80 micrograms/min/100 ml forearm tissue, n = 6) were infused alone and in combination with ET to evaluate the interactions between ET-induced vasoconstriction and stimulation of vascular muscle cyclic GMP levels by sodium nitroprusside, release of endothelium-derived relaxing factor by acetylcholine, and blockade of voltage-operated calcium channels by nifedipine and verapamil. Neither the vasodilator nor the vasoconstrictor response to ET was influenced by sodium nitroprusside or acetylcholine. In contrast, both calcium antagonists converted ET-induced vasoconstriction (e.g., delta forearm vascular resistance to ET 50 ng/min/100 ml forearm tissue, 151 +/- 100% and 164 +/- 92% in verapamil and nifedipine groups, respectively) to vasodilation (-35 +/- 12% and -21 +/- 16%, p less than 0.05). Our results demonstrate both ET-induced vasodilation (at low dosages) and vasoconstriction (at high dosages) in resistance vessels of normal humans. Blockade of voltage-operated calcium channels prevented ET-induced vasoconstriction and unmasked the vasodilator effect of high ET dosages. In human resistance vessels, blockade of voltage-operated Ca2+ channels but not cyclic GMP-dependent vasodilation may be an effective tool to inhibit ET-induced vasoconstriction.

Vascular smooth muscle cells from spontaneously hypertensive rats (SHR) were growth stimulated when cocultured with bovine aortic endothelial cells whereas myocytes from normotensive, Wistar Kyoto rats (WKY) were growth inhibited. The responsiveness of cells from the two rat sources to the two homodimeric forms of platelet-derived growth factor (PDGF-AA or -BB) was different; SHR-derived cells responding equally well to both PDGF forms whereas cells from WKY responded to the B-chain homodimer only. The responses measured included S6 kinase activation, phospholipase C mediated phosphoinositide catabolism and cell growth. Saturation binding experiments using [125I]-labelled PDGF homodimers (AA or BB) indicated that smooth muscle cells from hypertensive rats possess similar numbers of cell-surface A-chain receptors (alpha subunits) as Swiss 3T3 cells which have been used to characterize the mitogenic effects of the two PDGF homodimeric forms. The differences in responsiveness of SHR vs WKY cells to PDGF-AA and to the influence of endothelial cells may reside in their differential expression of PDGF receptors.

The high‐frequency‐peaked BL Lac PKS 2155‐304 is one of the brightest and best‐studied VHE γ‐ray sources in the southern hemisphere. The High Energy Stereoscopic System (H.E.S.S.) has monitored PKS 2155‐304 in 2006 and a multi‐wavelength campaign involving X‐ray, optical and radio observatories was triggered by the detection of an active state in July 2006, followed by the detection of two extraordinary flares on July, 28th and 30th, with peak fluxes ∼100 times the usual values. We present results from the spectral and flux variability analysis of the VHE and simultaneous X‐ray observations with Chandra during the second flare, as well as the detailed evolution of the VHE flux of PKS 2155‐304 observed by H.E.S.S. in 2006. A study of flux correlations in the different frequency ranges during the second flare and the adjacent nights is discussed. We also present an interpretation of the active state of PKS 2155‐304 in the framework of synchrotron self‐Compton emission.

Several Quantum Gravity models predict small differences in the speed light between photons of different energies, leading to deviations from Lorentz Symmetry. This minute effect was predicted to add up to measurable time lags for photons which traveled cosmological distances. Here we present the search for such time lags during the H.E.S.S. observations of the exceptional VHE flares of the active galaxy PKS 2155‐304 in July 2006. Since no time lag is found, we derive a lower limit on the energy scale on which Lorentz violations can occur.

Psychosomatic factors, sympathoneural and sympathoadrenal as well as cardiovascular mechanisms, were studied in 24 patients 18-24 years of age with borderline hypertension, 50 age-matched normotensive offspring of hypertensive parents, and 49 controls with no family history of hypertension. They were compared by projective and questionnaire-based psychological tests and their circulatory and neurohormonal reactivity to mental (Stroop color-word conflict test and arithmetic test) and physical stressors (orthostasis and bicycle ergometry test) were measured. Borderline hypertensive subjects externalized aggression less (p less than 0.05) but internalized it more (p less than 0.05) and were more submissive (p less than 0.05) when compared with controls. Offspring of hypertensive parents showed a similar but weaker pattern. Both risk groups reported more positive interactions with their parents (genetic risk subjects versus controls, p less than 0.05; borderline hypertensive patients versus controls, p = 0.08) and had higher state-anxiety levels (p less than 0.05). There were more subjective symptoms of beta-adrenergic receptor-mediated functions (e.g., tachycardia, tremor) in borderline hypertensive subjects and offspring of hypertensive parents, elevated heart rates (analysis of repeated measures, p less than 0.001), and enhanced plasma norepinephrine concentrations (p less than 0.05) when compared with controls. These findings in subjects at risk for the development of hypertension suggest that psychosomatic factors and sympathetic overactivity are involved in the early phase of hypertension.

In isolated blood vessels, acetylcholine releases endothelium-derived relaxing factor (EDRF). In vivo, the vasodilator action of acetylcholine may be mediated by EDRF, but prostacyclin or prejunctional inhibition of adrenergic neurotransmission may also be involved. Therefore, we investigated whether acetylcholine releases EDRF in humans in vivo and, if so, whether the response altered in essential hypertension. Acetylcholine was infused into the brachial artery, and forearm blood flow measured by venous occlusion plethysmography. In control subjects, acetylcholine (0.02-16 micrograms/min/100 ml tissue) increased flow from 2.4 +/- 5.0 to 20.6 +/- 5.2 ml/min/100 ml tissue (n = 14; p less than 0.05) and decreased forearm vascular resistance from 42.0 +/- 4.1 to 6.0 +/- 1.4 units (p less than 0.03), a response comparable to that of sodium nitroprusside (0.6 micrograms/min ml tissue). Acetylsalicylic acid (500 mg i.v.) given to block vascular prostacyclin production did not alter the response (n = 14). alpha-Adrenoceptor blockade by phentolamine (12 micrograms/min/100 ml tissue) did not prevent the increase in flow evoked by acetylcholine. In hypertensive patients, the decrease in forearm vascular resistance induced by acetylcholine but not evoked by sodium nitroprusside was reduced as compared with controls (14.5 +/- 3.1 and 6.1 +/- 1.6 units, respectively; n = 8; p less than 0.05). Thus, the vascular effects of acetylcholine in the human forearm circulation are independent of prostaglandins and adrenergic neurotransmission and therefore are most likely to be mediated by EDRF; the acetylcholine-induced release of EDRF is blunted in patients with essential hypertension.

This study demonstrates the induction of endothelin (ET) mRNA expression and synthesis of functional ET peptide in cultured human vascular smooth muscle cells (hVSMC). Compounds eliciting such responses in hVSMC include the vasoconstrictor hormones angiotensin II and arginine-vasopressin and the growth factors transforming growth factor beta, platelet derived growth factor AA and epidermal growth factor. Induction of ET mRNA expression in hVSMC exhibited transient kinetics (peak at 3-5 hrs. and return to basal within 7 hrs.) which differed from the more sustained ET transcript induction observed for porcine endothelial cells. ET peptide (determined by both radioimmuno- and radioreceptor assays) produced by stimulated hVSMC attained levels (approximately 120-160 pg/10(6) cells/4 hrs.; concentration approximately 3 x 10(-11) M) within the biologically effective concentration range of ET. Stimulated secretion of ET from hVSMC was abolished in the presence of the protein synthesis inhibitor cycloheximide. Sep-pak C18 extracts of medium from stimulated hVSMC elicited a concentration-dependent phosphoinositide catabolic response in myo-[2-3H]-inositol-prelabelled hVSMC. Our findings invoke a role for ET which extends beyond the paracrine regulation by peptide synthesized and secreted by endothelial cells. We propose that VSMC-synthesized ET may function in an autocrine manner to regulate both tone and structural modelling of vasculature.

Cellular responses to the vasoconstrictor peptide, endothelin, have been investigated in quiescent cultured human vascular smooth muscle cells (hVSMC). Endothelin caused intracellular alkalinization and activation of the protein synthetic enzyme S6-kinase, but such responses were not associated with any mitogenic effects of endothelin on hVSMC. In myo-[3H]inositol-prelabelled hVSMC endothelin elicited a rapid increase in inositol bis- and tris-phosphates and concomitant hydrolysis of polyphosphoinositol lipids. In [3H]arachidonate-prelabelled hVSMC endothelin promoted production of diacylglycerol, the early kinetics of which parallelled polyphosphoinositol lipid hydrolysis. Such phospholipase C activation by endothelin was sustained in hVSMC with accumulation of inositol polyphosphates being markedly protracted and the decay of diacylglycerol slow. Endothelin promoted extracellular release of [3H]arachidonate-labelled material from hVSMC which derived via deacylation of both phosphatidylinositol and phosphatidylcholine. This process was inhibited by phospholipase A2 and lipoxygenase inhibitors, but insensitive to phospholipase C and cyclooxygenase inhibitors. Endothelin-induced activation of phospholipase C and phospholipase A2 signal transduction pathways (EC50 approximately 5-8 nM for both) in hVSMC apparently proceed in an independent parallel manner rather than a sequential one.

To investigate possible alterations in 5-hydroxytryptamine (5HT) kinetics and sensitivity of blood platelets in patients with essential hypertension, 45 essential hypertensive patients and 45 normotensive healthy subjects matched in pairs for age, sex, and smoking status were compared. There were 18 women and 27 men in each group, ranging from 30 to 73 years of age. Results of essential hypertensive patients differed in several ways from those of normotensive subjects. In essential hypertensive patients, maximal 5HT uptake velocity (Vmax) decreased with increasing blood pressure and age and was reduced the most in older men. Vmax was positively related to the EC50 of 5HT for inducing a shape change reaction. In essential hypertensive patients, both Vmax of 5HT uptake and the EC50 of 5HT for shape change showed positive correlations with the 5HT content in platelets; the former relation was different between the essential hypertensive and normotensive groups (F = 5.53; p = 0.02). These results indicate reduced uptake of 5HT by blood platelets and suggest enhanced 5HT plasma concentrations in local areas, especially vascular lesions in essential hypertensive patients. Increased periplatelet concentrations of 5HT may lead to preactivation of platelets and possibly stimulation of vascular smooth muscle via their 5HT2-receptors. These changes are likely to be involved in the pathogenesis of increased thromboembolic complications in essential hypertensive patients, particularly in older men.

Quantitative in vitro autoradiography was used to study beta-adrenergic and benzodiazepine receptor density in discrete regions from sagittal brain sections of 20 week old hypertensive (SHR) and normotensive (WKY) rats. The density of beta-adrenoceptors was increased by 68% in the granule cell layer of the cerebellum of the SHR without a change in receptor affinity; this increase was specific for receptors of the beta 2-subtype. On the other hand, benzodiazepine receptor density was unchanged in the cerebella of SHR. These results indicate that brain beta-adrenoceptors are differentially modulated by the hypertensive state which may be either a cause or a consequence of alterations in adrenergic nervous system activity found in the SHR.