Search

We describe the case of a woman with congenital rubella who presented with backache. Plain abdominal X-ray revealed calcification of a superior mesenteric artery aneurysm. Intra-arterial digital subtraction angiography demonstrated multiple aneurysms of the arteries to the upper and lower limbs and the viscera. We have not found another report in the literature of the association of congenital rubella with multiple aneurysms.

Purpose: Organization, recanalization, and contraction are common to wound healing and thrombus resolution. Monocytes are essential to wound healing and are also found in venous thrombi. We measured endogenous levels of the monocyte chemotactic protein-1 (MCP-1) in naturally resolving venous thrombi and determined the effect of injecting MCP-1 into newly formed thrombus., Methods: Endogenous MCP-1 levels were estimated in rat blood, thrombi, and the adjacent vessel wall after thrombus formation, in cohorts of eight animals at 1, 7, and 14 days. In another group (n = 10), 1 microgram of MCP-1 was injected into newly formed thrombi. Carrier was injected into the thrombi of control animals (n = 10). Thrombi and adjacent vein walls were obtained for histology at 7 days. Thrombi were given an arbitrary organization score based on erythrocyte and extracellular matrix content, which was assessed by means of computerized and observer analysis. Specimen weight, thrombus area, and cellular and monocyte content were measured., Results: Endogenous MCP-1 increased between days 1 and 7 in the thrombus (1-day median, 1.1 ng/g wet wt; 1-day range, 0.8 to 1.4 ng/g wet wt; 7-day median, 5.4 ng/g wet wt; 7-day range, 1.5 to 7.4 ng/g wet wt; P <.0001) and vein wall (1-day median, 1.5 ng/g wet wt; 1-day range, 0.8 to 4.3 ng/g wet wt; 7-day median, 3.3 ng/g wet wt; 7-day range, 2.7 to 8.3 ng/g wet wt; P <. 05). At 14 days, thrombus was incorporated in the vein wall, and total MCP-1 levels remained high (median, 3.9 ng/g wet wt; range, 1.1 to 7.4 ng/g wet wt). Less MCP-1 was found in the thrombus than the adjacent vessel wall at day 1 (P <.05), but there was no difference at day 7. MCP-1 could not be detected in the blood. MCP-1 injection into thrombus increased the computer (P =.016) and observer (P =.004) organization scores, reduced the thrombus area (from median, 3. 4 mm(2), and range, 1.5 to 5.7 mm(2), to median, 0.2 mm(2), and range, 0.02 to 2.6 mm(2); P =.048), and increased the surrounding vessel wall monocyte content (P =.008). Specimen weights of treated animals were lower than those of control animals (P <.02)., Conclusion: Venous thrombus MCP-1 levels increase during natural resolution. MCP-1 treatment increased the organization and resolution of thrombi. MCP-1 may therefore be of therapeutic use.

Intramural thrombosis is a consistent finding in the arteries of patients who die following coronary angioplasty. This thrombosis is thought to have a role in restenosis, which is a common complication of coronary angioplasty. It has been hypothesised that antithrombotics such as hirudin or tissue-type plasminogen activator (tPA), may be therapeutically useful following angioplasty. This report describes the bioavailability of both agents following subcutaneous (sc) injection in cholesterol-fed rabbits. Intravenously delivered tPA has a half-life of 3-5 minutes. The half-life of intravenously administered hirudin is less than one hour in many species. In order to prolong the duration of action recombinant hirudin was conjugated to polyethylene glycol (PEG). Polyethylene glycol conjugated recombinant hirudin (PEG-rH) (0.7 mg/kg) antigen and activity were measurable after just 1 hr, reaching a maximum (663 and 884 ng/ml respectively) at 12 hours. Significant levels were present in rabbit plasma 24 hours after injection. Subcutaneously delivered recombinant (r-tPA) (1 mg/kg) was present in significant amounts 1 hr after injection, reaching a maximum (92 IU/ml) at 2 hours. Levels of tPA at 9 hours were approximately 80x normal circulating levels. High and constant levels of functional activity of both PEG-rH and r-tPA in rabbit plasma are achieved by subcutaneous delivery.

This time-course study investigates the early uptake and passage of microparticles across the intestinal mucosa. Single intraoral doses of fluorescent latex particles, 1.82 microns in diameter, were administered to young adult male, nonfasted rats at a dose of 1.88 x 10(9) particles. Peyer's patch regions and mesenteric lymph nodes were collected at 5, 15 and 30 min time points for both bulk tissue and morphological analyses. Particles were found at all experimental time points in macerated intestinal and nodal specimens: particle numbers were higher in proximal than in distal intestine at all time points despite the fact that particle numbers in distal Peyer's patch regions increased with time. Particle numbers in mesenteric lymph nodes also increased with time after administration. Detailed morphological data for several intestinal and nodal tissue compartments showed substantial early uptake of particles by villous epithelium, including goblet cells, but low involvement of follicle-associated cells. The distribution of particles in the lymph nodes confirmed that translocation occurred to all nodal compartments. These studies give confirmatory evidence that uptake and translocation of microparticles may take place as early as 5 min after administration and suggest that intestinal region may influence uptake.

This paper reviews compression therapy of the lower extremities and lays down guidelines for the levels of compression that are required to counteract different degrees of increased tissue pressure.

Studies were designed to find out how much of the plasma hemoglobin ( Hb) in whole blood was in microvesicles and how much was free Hb after 21 days of storage in citrate-phosphate-dextrose anticoagulant and to determine the effect of the plasticizer, di-(2-ethylhexyl)phthalate (DEHP). The total plasma Hb in polyolefin (PO) containers without DEHP was much higher than in polyvinyl chloride (PVC) with the plasticizer (p = 0.004). Less than 30% of the Hb was in free solution in either type of container. The addition of 300 micrograms/ml of DEHP to the plasma in the PO containers resulted in marked reduction in the microvesiculation (p less than 0.01) but did not affect the level of free Hb. RBC hypotonic fragility and morphology scores were significantly improved. It is concluded that microvesiculation contributes more to plasma Hb concentration than free Hb during storage. Some hemolysis of red blood cells (RBC) is expected during blood bank storage. It has been shown that part of the hemoglobin (Hb) in the suspending medium is free and part is encapsulated in microvescicles shed by the RBC [1]. The amount of hemolysis and microvesiculation that occurs has been noted to be less when blood is stored in polyvinyl chloride (PVC) containers in which di-(2-ethylhexyl)phthalate (DEHP) is used as the plasticizer [1]. The DEHP that leaches into the plasma has been shown to decrease hemolysis, microvesiculation, and the increase in osmotic fragility which RBC undergo during refrigerated storage [2-9].(ABSTRACT TRUNCATED AT 250 WORDS)

The maintenance of adenosine triphosphate (ATP) in red blood cells (RBC) during storage is largely dependent on the integrity of glycolytic metabolism in the Embden-Meyerhof pathway. Meryman et al. [Transfusion 1986; 26:500-505] hypothesized that a solution that increased the surface tension of the corpuscles through hypotonic swelling might retard the development of echinocytosis and membrane loss by the shedding of exocytic vesicles. Unexpectedly, maintenance of good ATP levels and satisfactory RBC survivals were found for a long as 18 weeks. The purpose of our study was to test their observations and to explore the possible mechanisms. Equal parts of units of packed RBC were stored in the experimental preservative and, for comparison, in ADSOL. The most notable findings were ATP values at 4 weeks averaging 5.2 mumol/g Hb (130% of initial) and at 12 weeks 2.9 mumol/g Hb (73% of initial), whereas these values declined as expected in ADSOL. Mean RBC diameters and surface areas by morphometric analysis were not significantly different in the two preservatives indicating the absence of any hypotonic swelling. The morphology scores of the RBC were significantly better throughout (p less than 0.05) than in ADSOL. The shedding of exocytic hemoglobin-containing vesicles was essentially the same in both preservatives. Our data confirm the observation that ATP levels are well maintained for at least 12 weeks, but do not show any evidence that hypotonic swelling was a part of the mechanism.

The afferent projections of nucleus centrum medianum (CM) of the thalamus were studied, in the cat, by means of retrograde transport of electrophoretically ejected horseradish peroxidase. Several variations of method--survival time, fixatives, substrates, etc.--were tried to improve the amount of visible reaction product. Labeled neurons were localized primarily in two categories of nuclei in the brain. The first consisted of structures making up or closely related to the basal ganglia: the entopeduncular nucleus, the pars reticulata of the substantia nigra, and motor cortex. The second category was made up of nuclei closely related to postural and orienting functions: the deep layers of the superior colliculus ipsilaterally, and the medial and lateral vestibular nuclei bilaterally. Other nuclei containing retrogradely labeled neurons were the periaqueductal gray and locus coeruleus. Brain stem reticular projections were sparse and widely scattered. These results identify CM as an important element in the loop system linking medial thalamus and neostriatrum; the probable attention and orientation related functions of this system are discussed.

A comparison of the analgesic efficacy of enflurane 1% in air with Entonox (50% nitrous oxide in oxygen) was performed in 20 consenting women during the first stage of labour. The two drugs were given in a random sequence to each woman, who also acted as her own control. Pain scores were significantly lower with enflurane than Entonox, although drowsiness scores were higher. No untoward effects were reported with either agent. The use of enflurane as an analgesic in the first stage of labour warrants further investigation.

The responses of rat and goldfish retinal ganglion cells to axotomy were examined by a quantitative cytochemical method for RNA and by morphometric measurement 1-60 (rat) and 3-90 (goldfish) days after interruption of one optic nerve or tract intracranially. Unoperated control animals were studied also. The RNA content of axotomized neurons of rat fell 7-60 days postoperatively. Additionally, atrophy of the axotomized somas occurred. Over time, neuronal atrophy approximately paralleled the loss of RNA, and mean cell area and RNA content were reduced by about 25% 60 days after axotomy. Incorporation of 3H-uridine by axotomized neurons declined also. Axotomized retinal ganglion cells of goldfish behaved differently from those of the rat and showed increases in RNA content, most conspicuously 14-60 days postoperatively. Enlargement of axotomized fish neurons occurred but was less proportionately than concomitant increases in RNA content. The nonaxotomized ganglion cells of goldfish displayed statistically significant increases in size and RNA content 14-49 days after unilateral optic nerve or tract lesions. In contrast, alterations in rat retinal ganglion cells contralateral to interruption of one optic nerve were of limited and questionable significance. The contrasting reactions to axotomy by the retinal ganglion cells of these two vertebrates, one of which regenerates optic axons and one of which does not, may support the proposition that the somal response to axon injury has an important bearing upon the success or failure of CNS regeneration.(ABSTRACT TRUNCATED AT 250 WORDS)

The reaction of the goldfish retinal ganglion cells to optic nerve crush, as indicated by an increase in nucleolar incidence 4 to 5 days after this lesion, was not significantly affected if a second nerve crush was made within 3 days after the first. This appears to rule out axon sprouting as the initiating event for the cell body reaction to axotomy.

Under light to moderate sodium pentobarbital anesthesia one half of the thalamic neurons displaying place and modality specific responses to low intensity mechanical stimulation of contralateral receptive fields also responded, by excitation or by inhibition, to bradykinin injections into somatic and visceral arteries. Partial or complete somatovisceral convergence was commonly seen in neurons with otherwise typical lemniscal properties. The response intensities varied considerably for different neurons; the responses to somatic bradykinin were always stronger than to visceral injections. The time course of the response was comparable to that seen in peripheral nerves, other central sites, and the behavioral reaction to bradykinin. Control experiments indicated the independence of the bradykinin responses from variations in blood pressure or general arousal effects. It is suggested that modulation of ventrobasal thalamic activity may be an important factor in central nociceptive processing.