Lipids and lipoproteins in patients undergoing coronary-artery surgery

Fasting blood samples were obtained from 290 patients who were undergoing elective coronary-artery graft procedures, and cholesterol, triglyceride and high-density lipoprotein cholesterol levels were measured. The 1983 National Heart Foundation of Australia's Risk Factor Prevalence Study was used as a source of age- and sex-matched "control" data. Of these patients, 80% had cholesterol levels of greater than 5.5 mmol/L; in 55% of patients, the level exceeded 6.5 mmol/L. Only 4% of patients who received a graft showed hypertriglyceridaemia alone (triglyceride level, greater than 2 mmol/L). Combined hyperlipidaemia (cholesterol level, greater than 5.5 mmol/L and triglyceride level, greater than 2.0 mmol/L) was present in 52% of subjects. Low-density lipoprotein cholesterol levels exceeded 3.5 mmol/L in 69% of men and in 71% of women. In terms of five 10-year age intervals, mean plasma triglyceride and cholesterol levels were elevated significantly in patients who had undergone a coronary-artery grafting procedure compared with those of subjects in the National Heart Foundation study. The mean high-density lipoprotein cholesterol levels were markedly-lower compared with those of the subjects in the National Heart Foundation study. Of those patients whose plasma cholesterol levels were less than 5.5 mmol/L, 97% of patients had high-density lipoprotein cholesterol levels that were less than the mean level for subjects in the National Heart Foundation study. Thus, a very-high proportion of patients who underwent coronary-artery bypass surgery had lipid abnormalities which required intervention postoperatively.     

V-shaped pillows and unsafe infant sleeping

To investigate the possibility that adult size V-shaped pillows may be associated with accidental asphyxial deaths in infants.

Methodology:

Review was undertaken of all cases of sudden infant death presenting to the Women's and Children's Hospital in Adelaide involving infants who had been found on adult size V-shaped pillows.

Results:

Four cases of sudden infant death were found in which infants were found sleeping on V-shaped pillows. All of the deaths had occurred in 1995. In two of the cases the pillows were considered to be implicated in the cause of death as the potential for obstruction of the infants' airways could be demonstrated on death scene reconstruction.

Conclusion:

Adult size V-shaped pillows may be unsafe for use in small infants who may accidentally suffocate if trapped between the two arms, or under, the pillow. The use of such pillows to maintain the body position of sleeping infants should be discouraged.     

Studies on the regenerative recovery of long-term denervated muscle in rats

Denervated extensor digitorum longus (EDL) muscles in rats rapidly lose mass and contractile force. After two months of denervation, mass and maximum tetanic force have fallen to 31% and 2% of the values of contralateral control muscles. Our purpose was to determine if grafting a long-term denervated muscle into an innervated site provides an effective means of restoring its structure and function. EDL muscles that had been denervated for periods of 2-12 months were freely grafted into innervated sites of EDL muscles in 4-month inbred host animals. Contralateral normally innervated EDL muscles from the same donors were implanted into the opposite legs of the same hosts. Two months after grafting, the muscles were removed and measurements were made in vitro of isometric contractile properties. The grafts were then prepared for morphological analysts. In all cases, the maximum forces generated by innervated grafts of denervated muscles were greater than those generated by denervated muscles. However, when compared with grafts of control muscles in the contralateral limb, grafts of previously denervated muscles showed a steady decline in structural and functional recovery corresponding to the time of previous denervation. The decline was especially pronounced for muscles denervated between 2 and 7 months prior to grafting. Grafts of 7-month denervated muscles were restored to only 17% of the maximum tetanic force of contralateral control grafts compared with 83% for grafts of 2-month denervated muscles. The longer a muscle had been denervated prior to grafting, the higher proportion of thin atrophic muscle fibers it contained. We conclude that grafting into an innervated site improves the mass and maximum force of a muscle over the denervated state, but the longer the period of prior denervation the poorer the recovery of the grafted muscles.     

Separation of bovine plasma lipoproteins by a rapid ultracentrifugation method

The recently described method of centrifugation with iodixanol for the rapid separation of human plasma lipoproteins was adapted to separate bovine plasma lipoproteins. Density gradients were generated by mixing plasma with iodixanol 12% (w/v), followed by centrifugation at 350,000 g and 16 degrees C for 3 h 10 min in a vertical rotor. Gradients were unloaded dense-end first into 10 fractions. Human very low density lipoprotein (VLDL; density < 1.011 g/ml), low density lipoprotein (LDL; density = 1.016-1.039 g/ml) and high density lipoprotein (HDL; density = 1.039-1.090 g/ml) were resolved well at densities considerably lower than those traditionally reported in salt gradients. In gradients generated from 12% iodixanol, bovine LDL and HDL exhibited even lower densities (1.016-1.028 and 1.016-1.048 g/ml, respectively) with all lipoproteins occurring at the lower density region of the gradient. In contrast, density gradients generated from layers of equal volumes of 6% and 12% iodixanol readily separated bovine HDL from VLDL, whilst LDL still overlapped with HDL. The latter accounts for >80% of all bovine lipoproteins and exists as two populations, namely light and heavy HDL. Gradients generated from two layers of iodixanol recovered bovine HDL in five fractions. The hypercholesterolaemia associated with lactation resulted in a modest shift in the profile of HDL cholesterol towards lipoprotein particles of lower density (light HDL). Significant between-farm differences were also detected in the density profiles of bovine plasma cholesterol. This new method is suitable for use in research and diagnosis in relation to lipoprotein metabolism disorders in cows.     

Interleukin-1beta and rhinovirus sensitize adenylyl cyclase in human airway smooth-muscle cells

Rhinovirus (RV) is a major cause of wheezing in asthmatics and has been reported to cause beta2 adrenergic receptor hyporesponsiveness in human airway smooth muscle (HASM) via cellular secretion of interleukin (IL)-1beta. We studied the effects of IL-1beta and RV on cyclic adenosine monophosphate (cAMP) production in HASM cells. Chronic incubation with IL-1beta or RV caused a significant increase (approximately 3- and approximately 2-fold, respectively) in forskolin (FSK)-stimulated cAMP production, suggesting a sensitization of adenylyl cyclase (AC). The observed augmentation of FSK-stimulated cAMP formation by IL-1beta was completely abrogated by pretreatment with an IL-1 receptor antagonist or cycloheximide, demonstrating that the effect is mediated via the IL-1 receptor 1 (IL-1R1) and that de novo protein synthesis is required. In contrast, RV-induced AC sensitization was not mediated via the IL-1R1 but was observed to be protein kinase C-dependent. We suggest that the sensitization of AC observed after exposure to IL-1beta or RV infection is a cellular defense mechanism to promote pathways that induce relaxation in the inflamed airway.     

Demonstration of homology between IS6110 of Mycobacterium tuberculosis and DNAs of other Mycobacterium spp.?

The insertion sequence IS6110 has an important role in diagnostic PCR and typing of Mycobacterium tuberculosis. We have evaluated a one-tube nested PCR which detects IS6110. Positive results were obtained with DNAs from four of four M. tuberculosis isolates, seven of eight M. fortuitum isolates, seven of seven M. avium-M. intracellulare complex isolates, four of five M. kansasii isolates, four of five M. xenopi isolates, two of four M. malmoense isolates, and one of two M. chelonei isolates. These results were confirmed by hybridization of genomic DNA from bp 505 to 685 of the IS6110 from M. tuberculosis H37Rv. Dot blot hybridization of genomic DNAs from these isolates with the same probe cinfirmed the presence of a homologous sequence in these mycobacterial species. These data suggest that false-positive results may be obtained for clinical samples when some methods based on IS6110 are used [corrected].     

Balloon dilatation of excised aortic coarctations

Seven children 1-6 years of age underwent aortic resection and re-anastomosis for coarctation of the thoracic aorta. The excised segments were 1-2 cm long and were dilated in vitro with a Grüntzig balloon catheter less than two hours after resection. A pressure of 4-8 atmospheres was used, and the inflated diameter of the balloon was twice the luminal diameter of the undilated coarctation. The diameter of each specimen was increased by an average of 85%, largely because of an increase in the external diameter of the coarctation. However, extremely high pressures were required for successful dilatation, producing transmedial tears in the "normal" aorta distal to the coarctation in three specimens. These results indicate that although balloon dilatation appears feasible as palliation for aortic coarctation, further studies of its safety are necessary before instituting clinical trials.     

Phenotypic and functional translation of IL33 genetics in asthma

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Effect of monovalent ions in glass ionomer on their uptake and re-release

AIMS: The study aims to directly measure uptake of Na and F ions by glass ionomer cement from dilute NaF solution and compare this with the subsequent re-release of these ions into water. In addition, the effect of the presence or absence of Na and/or F as a component of the glass is evaluated. MATERIALS AND METHODS: The four glass ionomers used differed only in glass composition; AH2 contained both Na and F, LG26 contained F, MP4 contained Na and LG30 contained neither Na nor F. Discs of cement were set in moulds at 37 degrees C for 1 h and matured in water at 37 degrees C for 3 days. Test discs were immersed in 0.2% NaF solution for 24 h, control discs in water. Discs were subsequently immersed in water which was changed regularly. Ion-selective electrode measurements (F and Na) and atomic absorption spectrometry (Na) were used to determine uptake (change in immersion solution concentration) and re-release into water. RESULTS: All cements took up large quantities of Na and F ions (range 95-336 mumol g-1). This resulted in internal ion concentrations from 16 to 56 times higher than the immersing solution. All re-release was complete within 97 days. No cement re-released more ion than taken up. Glass ionomers containing fluoride took up more Na and F than fluoride-free ones and then re-released a lower percentage of these ions. The cements all took up Na and F ions in equimolar proportions, but initially re-released more F than Na with F-free cement results tending to unity by 97 days. CONCLUSIONS: Glass ionomer cements take up Na and F ions from NaF solution in large quantities and in equimolar proportion. This is re-released either wholly or in part in 97 days by which time the release does not differ from the controls. The presence or absence of F in the cement composition markedly influences both uptake and re-release. Fluoride/hydroxyl interchange does not appear to play an important role in uptake.