Military implications of atropine hypersensitivity

Atropine hypersensitivity is a rarely reported condition. However, in the military environment, such reactions are of significant concern given the threat of chemical warfare and the use of atropine as a nerve agent antidote. Upon deployment to regions where chemical attacks are a threat, each service member is issued three 2-mg intramuscular autoinjectors of atropine for self-treatment. In the case presented here, an active duty service member presented to his Aid Station to request red dog tags for a previously identified allergy to atropine. Sensitivity testing revealed a significant reaction to <0.03 mg of intradermal atropine. This rarely reported reaction, in the military environment, poses a unique question regarding the suitability of deploying military members to areas where exposure to chemical warfare agents is possible.     

Recurrent excitation of granule cells with basal dendrites and low interneuron density and inhibitory postsynaptic current frequency in the dentate gyrus of macaque monkeys

Temporal lobe epilepsy is often associated with pathological changes in the dentate gyrus, and such changes may be more common in humans than in some nonprimate species. To examine species-specific characteristics that might predispose the dentate gyrus to epileptogenic damage, we evaluated recurrent excitation of granule cells with and without basal dendrites in macaque monkeys, measured miniature inhibitory postsynaptic currents (mIPSCs) of granule cells in macaque monkeys and compared them to rats, and estimated the granule cell-to-interneuron ratio in macaque monkeys and rats. In hippocampal slices from monkeys, whole-cell patch recording revealed antidromically evoked excitatory PSCs that were four times larger and inhibitory PSCs that were over two times larger in granule cells with basal dendrites than without. These findings suggest that granule cells with basal dendrites receive more recurrent excitation and, to a lesser degree, more recurrent inhibition. Miniature IPSC amplitude was slightly larger in monkey granule cells with basal dendrites than in those without, but mIPSC frequency was similar and only 26% of that reported for rats. In situ hybridization for glutamic acid decarboxylase and immunocytochemistry for somatostatin, parvalbumin, and neuronal nuclei revealed interneuron proportions and distributions in monkeys that were similar to those reported for rats. However, the interneuron-to-granule cell ratio was lower in monkeys (1:28) than in rats (1:11). These findings suggest that in the primate dentate gyrus, recurrent excitation is enhanced and inhibition is reduced compared with rodents. These primate characteristics may contribute to the susceptibility of the human dentate gyrus to epileptogenic injuries.     

Chinchilla models of selective cochlear hair cell loss

Although it is well known that ethacrynic acid (EA) can enhance gentamicin (GM) ototoxicity, there has been no systematic study of the relationship between dosing parameters and inner ear pathology. We examined the effects of two parameters, GM dose and time delay between GM and EA administration, on cochlear and vestibular hair cell loss in chinchillas. 'No delay' groups received one injection of GM (125, 40, 20, or 10 mg/kg i.m.) followed immediately by EA (40 mg/kg i.v.); 'delay' groups received GM (10 mg/kg i.m.) followed by EA 1 or 1.5 h later. Animals were sacrificed 7 days later for evaluation of hair cell loss in the cochlea and vestibular end organs (cristae, saccule and utricle). Vestibular function was assessed prior to sacrifice by measuring the duration of nystagmus induced by cold caloric stimulation. No delay groups had approximately 100% loss of outer hair cells and dose-dependent losses of inner hair cells, ranging from approximately 100% to 58%. In 1 and 1.5 h delay groups, inner hair cell losses were approximately 19% and 0%, outer hair cell losses were approximately 74% and 47%, and outer hair cell loss followed a typical base to apex gradient. Two results were remarkable. First, the three groups with partial inner hair cell loss showed an atypical lesion pattern in which losses were substantially greater in the apical half than in the basal half of the cochlea. Second, there was no vestibular pathology in any group. The results establish dosing parameters that can be used to produce animal models with defined patterns and magnitudes of cochlear hair cell damage, but normal vestibular function and morphology.     

Mitochondrial dysfunction in autistic patients with 15q inverted duplication

Two autistic children with a chromosome 15q11-q13 inverted duplication are presented. Both had uneventful perinatal courses, normal electroencephalogram and magnetic resonance imaging scans, moderate motor delay, lethargy, severe hypotonia, and modest lactic acidosis. Both had muscle mitochondrial enzyme assays that showed a pronounced mitochondrial hyperproliferation and a partial respiratory chain block most parsimoniously placed at the level of complex III, suggesting candidate gene loci for autism within the critical region may affect pathways influencing mitochondrial function.     

The effects of autologous platelet gel on wound healing

Laser resurfacing techniques have become a popular means of achieving rejuvenation of damaged skin. Interest is great in attempting to speed re-epithelialization and healing so that patients can return to their normal activities as quickly as possible. Previous studies have demonstrated that wounds heal more quickly when they are covered and kept moist than when they are left open to the air. Until now, no study has been conducted to investigate whether the healing process of a superficial skin burn might be accelerated by the use of an autologous platelet gel as a biologic dressing. Our study of five pigs showed that autologous platelet gel can influence wound healing by stimulating an intense inflammatory process that leads to highly significant increases in the production of extracellular matrices and granulation tissue. The platelet gel accelerated vascular ingrowth, increased fibroblastic proliferation, and accelerated collagen production. However, the gel did not appear to accelerate re-epithelialization. The aggressive production of granulation tissue and the acceleration of collagen production might mean that autologous platelet gel will have a future role in the treatment of burns because the highly vascularized bed it helps create should promote the success of skin grafting in patients with deep partial-thickness and full-thickness burns.