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Background The purpose of this study was to assess whether increased body mass index (BMI) negatively affects assisted reproductive technology (ART) outcomes among gestational carriers. Methods A retrospective matched case-control cohort, including all gestational carrier (GC) cycles performed at CReATe Fertility Centre (Toronto, ON, Canada) between 2003 and 2016. Setting A Canadian fertility clinic, with a large surrogacy program. Patients All gestational carriers that had undergone a cycle completed to a transfer at our clinic, and had BMI and outcome data available, were matched by BMI to infertile patients treated at our clinic during the same years provided they had undergone a cycle completed to a transfer, and had outcomes data available. Interventions None. Main outcome measures Clinical pregnancies rates, miscarriage rates and live birth rates. Results BMI was not a reliable prediction factor of any of the measured outcomes. Importantly, the gestational carrier population had better outcomes and a significantly lower overall incidence of maternal, fetal and neonatal complications when compared with infertile patients, treated at our clinic during the same years. Conclusion BMI is not a reliable predictor of outcomes among gestational carriers.

OBJECTIVES Healthcare systems worldwide have been overburdened by the coronavirus disease 2019 (COVID-19) outbreak. Accordingly, hospitals had to implement strategies to profoundly reshape both non-COVID-19 medical care and surgical activities. Knowledge about the impact of the COVID-19 pandemic on cardiac surgery practice is pivotal. The goal of the present study was to describe the changes in cardiac surgery practices during the health emergency at the national level. METHODS A 26-question web-enabled survey including all adult cardiac surgery units in Italy was conducted to assess how their clinical practice changed during the national lockdown. Data were compared to data from the corresponding period in 2019. RESULTS All but 2 centres (94.9%) adopted specific protocols to screen patients and personnel. A significant reduction in the number of dedicated cardiac intensive care unit beds (−35.4%) and operating rooms (−29.2%), along with healthcare personnel reallocation to COVID departments (nurses −15.4%, anaesthesiologists −7.7%), was noted. Overall adult cardiac surgery volumes were dramatically reduced (1734 procedures vs 3447; P, The coronavirus disease 2019 (COVID-19) pandemic is the world’s largest infectious disease crisis in the last 100 years.

IN BRIEF Several contraindications limit the use of metformin, most notably the risk of lactic acidosis. This article reports on an examination of a population of patients with diabetes with preserved renal function to evaluate provider compliance with guidelines on metformin use and to identify factors that contributed when practice diverged from recommendations. It found that metformin was withheld from approximately one-third of these patients because of 1) an existent contraindication to metformin, 2) patient behavior or preference, or 3) provider preference or bias based on patient or personal factors. Although providers generally follow current recommendations for the use of metformin, deviations from guidelines in practice are common.

A total of 476 European isolates (310 Cryptococcus neoformans var. grubii, 150 C. neoformans var. neoformans, and 16 C. gattii species complex) from both clinical and environmental sources were analyzed by multi-locus sequence typing. Phylogenetic and population genetic analyses were performed. Sequence analysis identified 74 sequence types among C. neoformans var. neoformans (VNIV), 65 among C. neoformans var. grubii (56 VNI, 8 VNII, 1 VNB), and 5 among the C. gattii species complex (4 VGI and 1 VGIV) isolates. ST23 was the most frequent genotype (22%) among VNI isolates which were mostly grouped in a large clonal cluster including 50% of isolates. Among VNIV isolates, a predominant genotype was not identified. A high percentage of autochthonous STs were identified in both VNI (71%) and VNIV (96%) group of isolates. The 16 European C. gattii species complex isolates analyzed in the present study originated all from the environment and all belonged to a large cluster endemic in the Mediterranean area. Population genetic analysis confirmed that VNI group of isolates were characterized by low variability and clonal expansion while VNIV by a higher variability and a number of recombination events. However, when VNI and VNIV environmental isolates were compared, they showed a similar population structure with a high percentage of shared mutations and the absence of fixed mutations. Also linkage disequilibrium analysis reveals differences between clinical and environmental isolates showing a key role of PLB1 allele combinations in host infection as well as the key role of LAC1 allele combinations for survival of the fungus in the environment. The present study shows that genetic comparison of clinical and environmental isolates represents a first step to understand the genetic characteristics that cause the shift of some genotypes from a saprophytic to a parasitic life style. © 2019 Elsevier Inc.

Thin films containing aromatic pyridine moieties bonded to boron, in the partially dehydrogenated boron-rich icosahedra (B10C2HX), prove to be an effective material for neutron detection applications when deposited on n-doped (100) silicon substrates. The characteristic I–V curves for the heterojunction diodes exhibit strong rectification and largely unperturbed normalized reverse bias leakage currents with increasing pyridine content. The neutron capture generated pulses from these heterojunction diodes were obtained at zero bias voltage although without the signatures of complete electron-hole collection. These results suggest that modifications to boron carbide may result in better neutron voltaic materials.

Dementia, an age-associated clinical syndrome characterized by irreversible loss or decline in memory and other cognitive abilities, is a growing health problem due primarily to the steady aging of the population. In 2013, an estimated 5.2 million Americans were diagnosed with Alzheimer’s disease (AD), the most common cause of dementia. This figure is projected to reach 7.1 million Americans 65 and older with AD by 2025, and 13.8 million by 2050 (Alzheimer’s Association, 2013). AD accounts for an estimated 60% to 80% of all dementia; therefore, projected figures for the number of Americans with all types of dementia combined are even higher (Alzheimer’s Association, 2013). Pharmacotherapy is only modestly effective in addressing cognitive and behavioral symptoms of dementia; therefore, active management of dementia involves careful monitoring of symptoms, treatment of comorbidities, medication monitoring, nonpharmacological management strategies, and linkage to community support services (Brodaty & Arasaratnam, 2012; Gitlin, 2012). Moreover, it has long been known that family members caring for individuals with dementia often experience adverse health consequences due to stresses associated with dementia symptoms and uncertainties about how to find information and help to support their care responsibilities (Schulz & Beach, 1999; Schulz, O’Brien, Bookwala, & Fleissner, 1995). Therefore, family members must be included in active management of patients with dementia to maximize health-related outcomes for patients and their family caregivers. Many studies have demonstrated gaps in care provided by primary care physicians (PCPs) to older adults with dementia in the United States and elsewhere (Callahan, Hendrie, & Tierney, 1995; Fortinsky, 1998; Fortinsky, Leighton, & Wasson, 1995; Koch & Iliffe, 2010). Considering the current U.S. health policy climate focused on improving health care quality while reducing costs to Medicare and other health insurers, primary care enhancements that could effectively address PCP gaps in care for patients with dementia hold great potential for significant cost savings and improved health-related outcomes. A limited number of published trials of nonpharmacological interventions to enhance primary care for people with dementia and/or their family caregivers by augmenting the care provided by PCPs have yielded positive results (Bass, Clark, Looman, McCarthy, & Eckert, 2003; Callahan et al., 2006; Fortinsky, Kulldorff, Kleppinger, & Kenyon-Pesce, 2009; Maslow, 2012; Vickrey et al., 2006). However, none have been successfully sustained beyond the study period or replicated in community-based primary care settings. Tested interventions either required unsustainable linkages between PCPs and community organizations, involved multidisciplinary teams whose services are not presently reimbursable by Medicare or other health insurers, or occurred solely at academic health centers where only a fraction of all patients seek primary care. Therefore, models based on evidence-based care protocols still need to be tested in community-based settings where most primary care is delivered in the United States. Nurse practitioners (NPs) working collaboratively with PCPs successfully implemented dementia care protocols in two published trials based at academic health centers (Callahan et al., 2006; Vickrey et al., 2006). Although the scope of practice of NPs varies across the United States, all NPs can diagnose, treat, and prescribe medications with physician involvement (Iglehart, 2013). NP services provided in primary care settings, or in home settings when approved by PCPs, are reimbursable by Medicare and many private health insurance plans. Using NPs as primary care–based dementia care specialists is a timely innovation given the growing recognition of roles NPs can play to address primary care workforce shortages (Cassidy, 2012; Donelan, DesRoches, Dittus, & Buerhaus, 2013; Iglehart, 2013) and the growing movement within the nursing profession to teach geropsychiatry core competencies to new and established nurses and NPs due to the growing older population living with dementia and other mental health–related challenges (Buckwalter, 2005; Evans, Beck, & Buckwalter, 2012). Employing NPs as dementia care experts in primary care settings is also consistent with many goals and strategies included in the 2013 update to the National Alzheimer’s Project Act of 2011 (U.S. Department of Health and Human Services [USDHHS], 2013) and with collaborative care and comanagement principles that have been successfully tested to treat depression and other geriatric conditions in the primary care setting (Reuben et al., 2013; Unutzer, et al, 2002). Accordingly, the current study implemented and evaluated an evidence-based NP-guided dementia care intervention, where the NP received referrals from and worked collaboratively with three community-based PCP group practice sites. Important differences between this intervention and collaborative care models tested elsewhere are the home-based location of NP-guided dementia care and the equal focus on the patient and family caregiver. Targeted groups were individuals with newly or recently diagnosed AD or other dementia (patients) and their family caregivers. This 12-month dementia care intervention, featuring monthly in-home visits by the NP, used medication management and nonpharmacological treatment protocols developed in a published randomized controlled trial that was tested at an academic health center (Callahan et al., 2006). The intervention tested in this study was called Proactive Primary Dementia Care (PPDC). The following two objectives, as well as major hypotheses for Objective 1, formed the scope of this study: Objective 1: Determine the preliminary efficacy of PPDC on health-related outcomes in patients and their family caregivers. Patient-specific hypotheses: Patients receiving PPDC will show reduced or more stabilized neuropsychiatric symptoms, as well as improved or more stabilized self-reported quality of life, as compared to control group patients. Family caregiver-specific hypotheses: Caregivers receiving PPDC will show reduced or more stabilized depressive symptoms and burden, as well as increased or more stabilized self-efficacy for managing dementia, as compared to control group caregivers. Objective 2: Determine the acceptability of PPDC based on satisfaction expressed by physicians, patients, and caregivers.

Il contrasto di quantità ha origine dal rapporto quantitativo di due o più colori e nessun colore risalta più di un altro se tale rapporto è equilibrato. Considerando come parametro l’intensità, inteso come la luminosità riferita ad uno sfondo grigio di luminosità media, i valori dei rapporti reciproci tra colori primari e secondari della sintesi sottrattiva, giallo:arancio:rosso:viola:blu:verde riferiti da Itten che li attribuisce a Goethe sono, nell’ordine: 9:8:6:3:4:6 [1]. È da sottolineare in questo contesto che una dettagliata ricerca su tale argomento lascia piuttosto supporre che la paternità di tali valori sia da attribuire a Schopenhauer [2-6]. Egli però non basa le sue considerazioni sull’intensità ma sulla quantità di energia che raggiunge la retina dell’osservatore. Lo studio realizzato ha avuto come obiettivo principale la verifica di tale enunciato riguardante i rapporti esistenti tra i tre primari ed i tre secondari della sintesi sottrattiva mediante la specificazione del colore con il metodo spettrofotometrico [7]. La valutazione dell’intensità considerata da Itten è stata effettuata, con lo stesso protocollo di misura [8-9] sugli stessi campioni in due Centri di Ricerca, BENECON SCaRL e PH3DRA labs, sulla base dei valori di E* (CIELAB1976) considerando come target i valori misurati sul riferimento per il minimo di luminosità (standard utilizzato per l’adjustment del nero). I risultati ottenuti hanno confermato quanto atteso in termini di andamento qualitativo dei valori dei rapporti reciproci dei sei.

Fundamental niche prediction of Cryptococcus neoformans and Cryptococcus gattii in Europe is an important tool to understand where these pathogenic yeasts have a high probability to survive in the environment and therefore to identify the areas with high risk of infection. In this study, occurrence data for C. neoformans and C. gattii were compared by MaxEnt software with several bioclimatic conditions as well as with soil characteristics and land use. The results showed that C. gattii distribution can be predicted with high probability along the Mediterranean coast. The analysis of variables showed that its distribution is limited by low temperatures during the coldest season, and by heavy precipitations in the driest season. C. neoformans var. grubii is able to colonize the same areas of C. gattii but is more tolerant to cold winter temperatures and summer precipitations. In contrast, the C. neoformans var. neoformans map was completely different. The best conditions for its survival were displayed in sub-continental areas and not along the Mediterranean coasts. In conclusion, we produced for the first time detailed prediction maps of the species and varieties of the C. neoformans and C. gattii species complex in Europe and Mediterranean area. © 2017 Society for Applied Microbiology and John Wiley & Sons Ltd

Heart allograft outcome is unpredictable and acute rejection episodes still occur despite the improvement of immunosuppressive regimens. We therefore investigated whether the immunopathological profile of endomyocardial biopsies might underlie the variations in the clinical course of a graft. Biopsies from transplanted patients were analysed by histology, immunohistochemistry (associated with digital image analysis), confocal and electron microscopy to determine the type and the functional state of leukocytes infiltrating the myocardium, together with their ultrastructural features and those of the graft itself. In comparison with biopsies with grade 0R or grade 1R rejection, those from patients with grade 2R rejection displayed significant infiltration of macrophages, T lymphocytes, and CD83+ and DC-SIGN+ dendritic cells. Fifty-seven per cent were invaded by CD20+B lymphocytes, most of which expressed CD69 activation marker and cooperated in interleukin-12 production, and by CD69+CD94+NK cells expressing interferon-γ. Ultrastructural signs of myocyte degeneration and microvessel rupture by NK cells were frequent. These patients developed recurrent episodes of acute allograft rejection. Endomyocardial B and NK infiltrates are involved in the dynamics of allograft rejection and are associated with a high risk of its recurrence. Immunopathological assessment of endomyocardial biopsies may thus serve to forecast the probable outcome of a heart allograft. Copyright © 2006 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Vortex oscillations induced by dc currents (Idc) through a metallic nanocontact subject to in-plane magnetic fields (Hext) are studied by measuring voltage power spectra. Two oscillations modes exist: at large Idc the oscillation frequency (fosc) is substantially insensitive to Hext, whereas at low Idc, fosc decreases with Hext increasing. At intermediate Idc the two modes coexist. This behavior is ascribed to the magnetic states of the device ferromagnetic layers: in the first mode vortices are formed in both layers while in the second mode one layer is in a vortex state while the other is in a quasiuniform state.

Free fatty acids in isolated pancreatic islets have been quantified by gas chromatography-mass spectrometry after stimulation with insulin secretagogues. The fuel secretagogue D-glucose has been found to induce little change in islet palmitate levels but does induce the accumulation of sufficient unesterified arachidonate by mass to achieve an increment in cellular levels of 38-75 microM. Little of this free arachidonate is released into the perifusion medium, and most remains associated with the islets. Glucose-induced hydrolysis of arachidonate from islet cell phospholipids is reflected by release of the arachidonate metabolite prostaglandin E2 (PGE2) from perifused islets. Both the depolarizing insulin secretagogue tolbutamide (which is thought to act by inducing closure of beta-cell ATP-sensitive K+ channels and the influx of extracellular Ca2+ through voltage-dependent channels) and the calcium ionophore A23187 have also been found to induce free arachidonate accumulation within and PGE2 release from islets. Surprisingly, a major fraction of glucose-induced eicosanoid release was found not to require Ca2+ influx and occurred even in Ca(2+)-free medium, in the presence of the Ca(2+)-chelating agent EGTA, and in the presence of the Ca2+ channel blockers verapamil and nifedipine. Exogenous arachidonic acid was found to amplify the insulin secretory response of perifused islets to submaximally depolarizing concentrations of KCl, and the maximally effective concentration of arachidonate was 30-40 microM. These observations suggest that glucose-induced phospholipid hydrolysis and free arachidonate accumulation in pancreatic islets are not simply epiphenomena associated with Ca2+ influx and that arachidonate accumulation may play a role in the signaling process which leads to insulin secretion.

Suzanne Romaine is Merton Professor of English at the University of Oxford. She is a leading scholar in the areas of sociolinguistics, bilingualism, and the state of language diversity and maintenance.

Roger Shuy is Distinguished Research Professor of Linguistics, Emeritus at Georgetown University (Washington, DC, USA) and is the President of Roger W. Shuy, Inc. in Missoula, Montana. Shuy is a leading figure in the field of forensic linguistics and has been an expert witness in hundreds of criminal and civil court cases over the last 30 years.

A novel broad-band telecom laser source is used to realize a lateral-shear scanning-wavelength interferometer for measuring the thickness of thin plates. We show that the wide tunability range allows to detect samples down to tens of microns with a relative uncertainty of less than 0.5% and a resolution of about 1 nm. A comparable accuracy in the thickness characterization of double-layer structures is also demonstrated. In turn, the wide tunability range needs the dispersion law of the materials to be taken into account in the model for correct thickness evaluation.

— As the greatest obstacle to the study of interstitial cystitis is the lack of agreement regarding its aetiology, we set up a diagnostic-therapeutic protocol based on clinical findings, physical examination, urodynamics, Parson's test, cystoscopic evaluation with hydrodistension and biopsy. 12 patients with interstitial cystitis and 10 controls were evaluated. 60% therapeutic success was obtained after only hydrodistension and antidepressant therapy.

We investigated the clinical value of serum prostate specific antigen in 35 patients with apparently localized prostate cancer who underwent retropubic radical prostatectomy at our Department. In this series preoperative prostate specific antigen levels tended to increase with the increasing severity of pathological stage. The positive and negative predictive values were 68.1% and 63.6% respectively, accuracy was 66.6%. In the case of lymph node involvment, PSA values were lower than 10 nanog./ml in 20% of cases. Prostate specific antigen values not useful to predict preoperatively the final pathological stage of the prostate cancer because of the wide range of values among patients within each stage.

The RIMA (Rimodellamento Infarto Miocardico Acuto) study was designed to assess the relative effects of angiotensin-converting enzyme (ACE) inhibition by captopril, beta-blocker therapy by metoprolol, and their combination in patients with a first acute myocardial infarction on: 1. echocardiographically detected left ventricular remodeling; 2. prognosis. The second goal will be the argument of the present paper. Two-hundred fiftyor = 75 years consecutive patients (mean age: 58 yrs, males = 203) with acute myocardial infarction were randomly allocated to receive foror = 3 months captopril (up to 75 mg/day, Group 1), metoprolol (up to 200 mg/day, Group 2) or captopril + metoprolol (Group 3) starting in the first 24 hours after the onset of symptoms. Intravenous beta-blockers in the acute phase of myocardial infarction and all other cardioactive drugs were allowed. The effect of the randomized therapy at six months from admission to the coronary care unit was considered in relation to: 1. recurrence of spontaneous cardiac events and of elective revascularization procedures; 2. adverse reactions (hypotension, atrioventricular block, cough, allergy, need of beta-blockers in Group 1, need for ACE inhibition in Group 2) requiring treatment modification based on physician's decision.Definite follow-up data were available in 226 patients and 195/226 patients (86%) had a complete treatment period. In these patients (per protocol analysis), 37 spontaneous cardiac events occurred: cardiac death = 6, non-fatal reinfarction = 9, unstable angina requiring hospitalization = 16, congestive heart failure = 6. Moreover, seven patients received a coronary revascularization procedure. Events occurred in 11/67 patients from Group 1, 16/63 patients from Group 2, 10/65 patients from Group 3 (16% vs 25% vs 15%, p = 0.28). The multiple logistic regression analysis demonstrated an increased odds ratio (OR) for spontaneous cardiac events in patients from Group 2 (OR = 2.82, 95% Cl: 1.16-6.87: p0.05). Elective revascularization procedures were statistically less frequent in patients treated with metoprolol (Group 1 = 9%, Group 2 = 1.6%, Group 3 = 0%; Group 1 vs Groups 2 and 3; p = 0.03). The intention-to-treat analysis on the overall population (226 patients) confirmed the presence of a trend towards a higher risk in patients from Group 2 (OR = 2.1, 95% Cl: 0.96-4.59; p = 0.06). Adverse reactions were observed in 16 patients from Group 1, 6 patients from Group 2 and 15 patients from Group 3 (22% vs 10% vs 23%; Group 2 vs Groups 1 and 3; p = 0.08). At the multivariate regression analysis, a trend towards less adverse reactions in patients assigned to the beta-blocker therapy alone was confirmed (OR = 0.41, 95% Cl: 0.15-1.13; p = 0.07).In a randomized early post-infarction treatment strategy, ACE inhibition with captopril alone or in combination with metoprolol demonstrated an increased protection against spontaneous cardiac events at six months in comparison with metoprolol alone. On the other hand, the beta-blocker treatment was associated with a lower number of elective revascularization procedures and appeared better tolerated than ACE inhibition.

The authors retrospectively analyzed the results of their experience with combined laparoscopic excisional and guided needle biopsy in the determination of chronic liver disease in children.Between January 1986 and January 1996, at the Division of Pediatric Surgery of the "Federico II" University of Naples, eighty patients underwent laparoscopic liver biopsy to evaluate a chronic liver disease. Patient ages ranged between 50 days and 16 years (mean 5.8 years). There were 41 girls and 39 boys. Fifteen of these children (18.7%) were addressed to a surgeon because the previously performed percutaneous blind needle biopsy was not sufficiently informative or because the specimens were too small to allow chemical or biochemical tissue studies. In these 15 patients, we performed a combination of laparoscopic guided needle biopsy using a 14-gauge tru-cut needle together with an excisional biopsy on the right lobe, using two additional 5-mm trocars.The post-operative course was uneventful for all the patients. All patients were discharged from hospital after 24 hours. A precise histological diagnosis was made and biochemical tissue studies were possible after laparoscopic biopsy in all 15 children. In our opinion, a combination of laparoscopic-guided needle biopsy and laparoscopic excisional biopsy is more reliable than simple biopsy alone for the diagnosis of cirrhosis in children with chronic liver disease.

Retrograde ejaculation is observed after surgical treatment of B.P.H. in the majority of patients; erectile failure may follow these procedures in 10-20% of cases. Post-prostatectomy impotence is not depending on surgical technique and probably occurs as a consequence of venous leakage due to traumatic injury of the nervi erigentes at the prostatic apex. Pathological factors also play an important role as it is shown by the efficacy of preoperative exploration in reducing the incidence of this complications. It is advisable to include potency problems in the informed consent to be signed by the patient before any kind of prostatic surgery.

Echocardiography is a highly useful diagnostic technique providing clinical information concerning cardiac anatomy, function, and hemodynamics at low patient cost and risk. Its various modalities of M-mode, 2-D, Doppler and Color Flow combine in complementary fashion to provide the physician with information important in the diagnosis, therapy, and prognosis of a wide range of cardiovascular disorders. The addition of the transesophageal approach has expanded our ability to obtain more detailed information in patients whose hearts were previously inaccessible from the transthoracic approach or who have prosthetic devices with acoustic shadows which obscure important echocardiographic information. An understanding of the wide array of applications of echocardiography is important in making the best use of this valuable diagnostic tool.

Cyclic AMP (cAMP) has been shown to be a primary signal of the agglutination-induced mating events of flagellar tip activation, cell wall loss, and mating structure activation in the unicellular alga Chlamydomonas reinhardtii (Pasquale and Goodenough, Cell Biol. 105 (1987), 2279–2293). The flagellar membrane adenylate cyclase of Chlamydomonas is here shown to be inhibited in vitro by EGTA, La3+, and trifluoperazine, and to be stimulated in the presence of calcium by incubation with exogenous calmodulin. Also, the motility of detergent-extracted models of Chlamydomonas is shown to be enhanced by cAMP. These observations suggest the hypothesis that the twitching motility characteristic of agglutinating Chlamydomonas gametes may be signaled by cAMP produced locally within the flagella by a calmodulin-sensitive adenylate cyclase.

Myocardial lactate (L) metabolism was tested in 27 stable angina patients during atrial pacing (AP) and in the recovery period (R) from AP-induced angina pectoris. The recovery period was assessed in order to evaluate the changes in the rate of L release and detect possible relationships with the severity of ischaemic damage. The following variables were assessed: coronary sinus blood flow (CSBF), left ventricular end-diastolic pressure (LVEDP), lactate extraction ratio (L%), lactate extraction or release rate (LR) and myocardial oxygen consumption (MVO2) at the onset of AP (AP1), during angina (AP2), and 30 s, 2 and 4 min (R1, R2 and R3) after AP ceased. At Ap2, negative L% and LR values (-39.37 +/- 43.3, -3.2 +/- 2.9) were found, in spite of a rise in CSBF (+86%, P less than 0.001). Furthermore, LVEDP showed its maximal increase in AP2 (+27%, P less than 0.001). Compared to AP2, L% resulted unchanged in R1, while LR showed a mild decrease (from -3.2 +/- 2.9 to +2.06 +/- 2.93). Lactate production was converted to extraction in R3 only. Since lactate production and release are progressively reduced with increasing severity of ischaemic damage, AP2 coronary sinus lactate release should largely arise from the less damaged areas (i.e. the outer myocardial layers) and the contribution of the more damaged areas (i.e. the inner myocardial layers) should be more limited. After AP ceases, the mild ischaemic areas should recover more rapidly than the severely ischaemic areas, where the damage only declines, leading to a temporary increase in lactate production and release.(ABSTRACT TRUNCATED AT 250 WORDS)

When Chlamydomonas reinhardtii gametes of opposite mating type are mixed together, they adhere by a flagella-mediated agglutination that triggers three rapid mating responses: flagellar tip activation, cell wall loss, and mating structure activation accompanied by actin polymerization. Here we show that a transient 10-fold elevation of intracellular cAMP levels is also triggered by sexual agglutination. We further show that gametes of a single mating type can be induced to undergo all three mating responses when presented with exogenous dibutyryl-cAMP (db-cAMP). These events are also induced by cyclic nucleotide phosphodiesterase inhibitors, which elevate endogenous cAMP levels and act synergistically with db-cAMP. Non-agglutinating mutants of opposite mating type will fuse efficiently in the presence of db-cAMP. No activation of mating events is induced by calcium plus ionophores, 8-bromo-cGMP, dibutyryl-cGMP, nigericin at alkaline pH, phorbol esters, or forskolin. H-8, an inhibitor of cyclic nucleotide-dependent protein kinase, inhibits mating events in agglutinating cells and antagonizes the effects of cAMP on non-agglutinating cells. Adenylate cyclase activity was detected in both the gamete cell body and flagella, with the highest specific activity displayed in flagellar membrane fractions. The flagellar membrane adenylate cyclase is preferentially stimulated by Mn++, unresponsive to NaF, GTP, GTP gamma S, AlF4-, and forskolin, and is inhibited by trifluoperazine. Cyclic nucleotide phosphodiesterase activity is also present in flagella. Our observations indicate that cAMP is a sufficient initial signal for all of the known mating reaction events in C. reinhardtii, and suggest that the flagellar cyclase and/or phosphodiesterase may be important loci of control for the agglutination-stimulated production of this signal.

The bone CO2 buffering system and bone calcium and phosphorus were studied in guinea pigs exposed to 1% CO2 for periods up to 8 wk and killed at weekly intervals together with control animals of the same age. Measurements were made of arterial CO2 tension, pH, standard bicarbonate, and bone Ca and P. Heat-stabile bone CO2 (carbonate) was determined as dry bone CO2 and heat-labile bone CO2 (bicarbonate) as delta wet-dry bone CO2. During the first 3-4 wk of exposure to 1% CO2, a systemic acidosis was found as indicated in a lowered pH, increased arterial CO2 tension, and decreased standard bicarbonate. The acidosis subsided during the last 4 wk of exposure. Phasic changes in bone bicarbonate were observed as shown in immediate rise lasting for 2 wk followed by a 2-wk decline and second rise after 6 and 8 wk. Bone carbonate exhibited the opposite change during the first 4 wk and thereafter remained stable at an elevated level. Bone Ca and P fell in association with increasing bone bicarbonate and rose with increasing bone carbonate.

In the present work the authors have tried to offer a vast and detailed summary of theories and questions concerning the role of the MDF in shock. One of the major problems that surrounds this molecule is the myocardial contractility depression, the solution of which could allow a more rationalistic therapeutic approach to that which remains one of the most complex and delicate clinical framework.