Long-term neuropsychological effects and MRI findings in patients with CS2 poisoning

OBJECTIVES: To evaluate the long-term neuropsychological effects and magnetic resonance imaging (MRI) findings among retired patients with a history of exposure to carbon disulfide (CS2). MATERIAL AND METHODS: Seventy-four patients with a history of exposure to CS2 were divided into two equal groups according to their level of exposure, and they completed a questionnaire and were evaluated for neuropsychological symptoms using the Korean version of the revised Wechsler Adult Intelligence Scale. Thirty-one MRI images were reviewed retrospectively. RESULTS: There were no statistically significant differences in total, verbal and performance IQs between high- and low-exposure groups. MRI findings revealed a significantly larger number of cerebral lacunae (five of 12 subjects) in the high-exposure group. Periventricular hyperintensities were mostly located in frontal and occipital areas, and white-matter hyperintensities were mostly in frontal and parietal areas. CONCLUSION: The higher prevalence of lacunae in the high-exposure group as revealed by MRI suggests that further MRI studies are needed into long-term neuropsychological effects induced by CS2.     

Lack of association between glutathione S-transferase P1 polymorphism and COPD in Koreans

The fact that only 10-20% of chronic heavy cigarette smokers develop symptomatic COPD and correlations of pulmonary function among twins and families suggests the presence of genetic susceptibility in the development of COPD. Genetic susceptibility to COPD might depend on the variations in enzyme activities that detoxify cigarette smoke products, such as microsomal epoxide hydrolase (mEPHX) and glutathione-S transferase (GST). The purpose of this study was to determine whether polymorphism of GSTP1 gene is linked to a genetic susceptibility to COPD. The hypothesis we tested here was that the polymorphism supposed to decrease GSTP1 activity would be the genetic risk for the development of COPD. Using PCR followed by restriction fragment length polymorphism (PCR-RFLP), genotypes of Ile105Val polymorphism in exon 5 of glutathione S-transferase P1 (GSTP1) gene were determined in 89 patients with COPD and 94 healthy smoking control subjects at the Seoul National University Hospital. Although the frequency of homozygous wild allele in exon 5 of GSTP1 gene in patients with COPD was higher than that observed in healthy controls (71% vs. 61%), the difference was not considered statistically significant. Neither the heterozygous nor homozygous mutant allele differed in frequency between the two groups. In conclusion, the genetic polymorphisms of exon 5 of GSTP1 gene may not be associated with development of COPD in Koreans.     

Effects of potassium channel opener aprikalim on the receptor-mediated vasoconstriction in the human internal mammary artery

BACKGROUND: Arterial grafts for coronary artery bypass grafting such as the internal mammary artery (IMA) may develop spasm perioperatively. The purpose of this study was to investigate the effects of the potassium channel opener, aprikalim, on the receptor-mediated vasoconstriction in the human IMA in vitro. METHODS: We studied 160 IMA rings taken from coronary artery surgery in organ baths. The interaction between aprikalim and four vasoconstrictors 5-hydroxytryptamine (5-HT), norepinephrine (NE), endothelin-1 (ET-1), and angiotensin II (AII) was investigated in two ways. RESULTS: Aprikalim relaxed IMA rings precontracted by the vasoconstrictors to 66.40 +/- 5.9% for 5-HT (EC50: -6.78 +/- 0.26 LogM), 57.40 +/- 5.5% for NE (-6.54 +/- 0.39 LogM), 81.00 +/- 6.7% for ET-1 (-6.58 +/- 0.26 LogM), and 93.90 +/- 2.5% for AII (-7.80 +/- 0.23 LogM). The relaxation in endothelium-denuded rings contracted by AII was similar to that in the endothelium-intact rings. The relaxation was attenuated by glibenclamide (3 microM) in 5-HT or NE-precontracted IMA. Pretreatment with aprikalim at 1 microM depressed AII-induced contraction (33.20 +/- 7.5% versus 59.70 +/- 7.3%, p < 0.01) but only shifted the curves rightward for 5-HT or NE (EC50 3.1 or 4.3-folds higher, p < 0.05), whereas at 30 microM it also significantly depressed the maximal contraction for 5-HT (35.70 +/- 4.9% versus 103.30 +/- 9.8%, p < 0.001) and NE (90.60 +/- 15.6% versus 125.60 +/- 7.9%, p < 0.05). In contrast, aprikalim did not significantly depress the contraction induced by ET-1 (p > 0.05). CONCLUSIONS: We conclude that aprikalim has vasorelaxant effects on IMA and the effect is vasoconstrictor-selective and endothelium-independent. Aprikalim may provide clinically useful vasorelaxant effects in coronary bypass surgery.     

External (combination) rhinoplasty approach for trans-sphenoidal adenectomy

The external (combination) rhinoplasty approach and the sublabial approach to trans-sphenoidal adenomectomy have been used at this institution for seven years. A summary of experience with the external (combination) rhinoplasty technique in 10 patients is reported; and a comparison is made between this approach and the sublabial approach in 12 patients. Advantages unique to this approach are: the distance to the sphenoid sinus is decreased allowing greater ease of instrumentation, the Hardy speculum may be opened widely to increase exposure, uniquely this allows synchronous cosmetic or reconstructive septorhinoplasty, and this technique is also invaluable for revision surgery--especially when septal cartilage has been removed by a previous sublabial approach. Disadvantages of this technique are the external incision across the columella, which leaves an imperceptible scar of no clinical significance, and postoperative nasal tip edema, which resolves with time.     

Coordination environment of the active-site metal ion of liver alcohol dehydrogenase.

The coordination environment of the catalytically active metal ion of horse liver alcohol dehydrogenase (alcohol:NAD+ oxidoreductase, EC 1.1.1.1) has been investigated by electron paramagnetic resonance (EPR) methods with use of the active-site-specific Co2+-reconstituted enzyme. The EPR absorption spectrum of the metal-substituted enzyme is characteristic of a rhombically distorted environment. The spectrum of the enzyme--NAD+ complex shows approximate axial symmetry of the metal ion site, indicating that binding of the coenzyme induces a structural alteration in the active-site region. This environment is not significantly altered further by binding of the competitive inhibitor pyrazole. To assign the coordination number of the active-site metal ion, the zero-field splitting was determined on the basis of the temperature dependence of the spin--lattice relaxation of the Co2+ ion. The zero-field splitting energies are approximately 9 cm-1 for the free Co2+-reconstituted enzyme and approximately 46 and approximately 47 cm-1 for the enzyme--NAD+ and enzyme--NAD+--pyrazole complex, respectively. On the basis of studies of structurally defined small molecule complexes, these values are compatible with a tetracoordinate metal ion in the active site of the free enzyme but a pentacoordinate metal ion in the binary enzyme--NAD+ complex and in the ternary enzyme--NAD+--inhibitor complex and, therefore, presumably also in the catalytically active ternary enzyme--NAD+--alcohol complex formed in the course of alcohol oxidation.     

Temporal stability and precision of ventricular defibrillation threshold data.

Over 200 measurements of the minimum damped sinusoidal current and energy for transchest electrical ventricular defibrillation (ventricular defibrillation threshold) were made to determine the stability and precision of threshold data in 15 pentobarbital-anesthetized dogs. Threshold was determined by repeated trials of fibrillation and defibrillation with successive shocks of diminishing current, each 10% less than that of the preceding shock. The lowest shock intensity that defibrillated was defined as threshold. In three groups of five dogs each, threshold was measured at intervals of 60, 15, and 5 min over periods of 8, 5, and 1 h, respectively. Similar results were obtained for all groups. There was no significant change in mean threshold current with time. Owing to a decrease in transchest impedance, threshold delivered energy decreased by 10% during the first hour of testing. The standard deviations for threshold peak current and delivered energy in a given animal were 11% and 22% of their respective mean values. Arterial blood pH, Pco2, and Po2 averaged change of pH, PCO2 and PO2 were not significantly different from zero. The data demonstrate that ventricular defibrillation threshold is a stable physiological parameter that may be measured with reasonable precision.