Proteomic analysis of undiluted lung epithelial lining fluid

BACKGROUND: Proteomics is increasingly leading to biomarker discovery in human disease. Epithelial lining fluid (ELF), until now only recovered indirectly, diluted in BAL fluid, is an attractive sample for lung disease proteomics. The direct recovery of undiluted ELF is now possible using a bronchoscopic microsampling (BMS) probe. In this preliminary study of anesthetized ventilated rabbits, we applied this probe to recover ELF and to analyze the resulting samples with the aim of determining their potential in lung disease biomarker discovery. METHODS: In order to do so, a method was devised and evaluated in preliminary experiments both for nonbronchoscopic use of the probe and for recovering undiluted ELF from probe tips. To verify the proteomic potential of the sample, the recovered ELF was separated by one-dimensional polyacrylamide gel electrophoresis, and the resulting lane was cut into multiple fractions, each of which was digested and analyzed by liquid chromatography tandem mass spectrometry. The identified proteins were then searched against Medline for association with broad categories of lung disease. RESULTS: Nonbronchoscopic use of the probe allowed successful ELF sampling and the recovery of undiluted ELF from probe tips. Proteomic analysis showed that ELF contains many proteins that have already been reported as being associated with lung disease as well as proteins potentially correlated with lung disease. CONCLUSIONS: This preliminary study of undiluted ELF, as recovered by the BMS probe, shows that it may be an ideal sample for lung proteomics. The potential application of this sampling technique in various lung diseases will need to be confirmed by future studies.     

Usefulness of regional cerebral oxygen saturation monitoring in balloon test occlusion

PURPOSE: Recently, temporary balloon test occlusion (BTO) of the internal carotid artery (IC) has become a well accepted procedure for preoperative evaluation of patients with IC large aneurysms. However, it might be dangerous to move patients fitted with a balloon catheter to the room for single-photon emission computed tomography (SPECT). We attempted to clarify the usefulness of regional cerebral oxygen saturation (rSO2) monitoring during BTO, comparing cerebral blood flow (CBF) obtained from SPECT. MATERIALS AND METHODS: Eight patients with an IC large aneurysm underwent BTO with rSO2 monitoring. Regions of interest in the SPECT were defined in the area below the rSO2 sensor of each hemisphere. Correlations among rSO2, CBF, stump pressure and appearance of symptoms were discussed. RESULTS: The rSO2 significantly reduced during BTO (74.1 +/- 1.2 to 60.4 +/- 2.7%, p < 0.001). The individual decreases in rSO2 correlated with decreases of CBF from SPECT (r = 0.966, P < 0.001). Four patients with deltarSO2 (baseline rSO2 - rSO2 during IC occlusion) less than 12 points had no symptoms, but 4 patients with deltarSO2 more than 14 points had some symptoms. The stump pressure had no correlation with CBF and rSO2. CONCLUSIONS: The rSO2 significantly correlated with CBF from SPECT and related with appearance of symptoms. Our results revealed that rSO2 monitoring was useful in BTO, and SPECT could be skipped in some cases to determine the strategies for treatment of IC large aneurysms.     

Diagnostic value of perfusion-weighted MRI for evaluating postoperative alteration of cerebral hemodynamics following STA-MCA anastomosis in patients with moyamoya disease

OBJECTIVE: Surgical revascularization for moyamoya disease prevents cerebral ischemic attacks by improving cerebral blood flow (CBF). But little is known about the changes of CBF and its effect on neurological status during the acute stage after direct bypass for moyamoya disease. METHODS AND RESULTS: Perfusion-weighted magnetic resonance imaging (PWI) by the SE-EPI method was performed 4 and 10 days after superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis on 11 sides of 9 patients (male:female = 2:7, 24-61 years old) with moyamoya disease. All patients underwent single-photon emission computed tomography (SPECT) 1 and 7 days after surgery. The time-to-peak (TTP) by PWI showed focal decrease at the site of the anastomosis 4 days after STA-MCA anastomosis compared to preoperative TTP, and was further decreased in larger territory 10 days after surgery in all patients. Postoperative cerebral blood volume (CBV) by PWI showed significant increase compared to preoperative CBV in four patients who suffered symptomatic cerebral hyperperfusion after surgery. Postoperative SPECT revealed apparent increase of CBF in all patients and the patency of the STA-MCA bypass was confirmed by MRA. All patients were discharged without neurological deterioration compared to preoperative neurological status, and none of them suffered ischemic attack after surgery. CONCLUSION: Postoperative decrease in TTP by PWI could be a sensitive parameter for the normalization of CBF after STA-MCA anastomosis in patients with moyamoya disease. Postoperative increase in CBV may suggest cerebral hyperperfusion and could be the optimal predictor for hyperperfusion syndrome after STA-MCA anastomosis in patients with moyamoya disease.     

Penetrating atheroma in cervical carotid artery stenosis

A 61-year-old male presented with left hand motor weakness associated with cerebral infarction in the right frontal lobe. Right common carotid angiography demonstrated a 66% stenosis and carotid duplex scan demonstrated intermediate echogenic plaque, indicating typical carotid plaque. Carotid endarterectomy was performed 22 weeks after the ischemic onset. During exposure of the carotid artery, a soft and yellowish mass (5 x 5 mm) was observed in the lateral wall of the carotid bulbus, which was not covered with adventitia but with thin connective tissue. The mass was removed en-bloc with a small part of the surrounding arterial wall combined with ordinary endarterectomy. The artery was closed with a collagen-impregnated polyester patch graft (Hemashield patch) to maintain adequate arterial lumen. Histological examination of the removed plaque confirmed that atheroma had protruded from the intima through the media as well as the adventitia and formed an extra-arterial mass. Such a case requires great care to dissect the carotid artery to prevent premature disintegration of the atheroma.     

Mercury content in museum and recent specimens of chiroptera in Japan

Summary The mercury content of insectivorous Chiroptera caught in 1890, when mercurial pesticides had not yet been in use, and preserved in a museum in alcohol were compared with those caught in 1965–1967 or 1970–1975, during and after the use of mercurial pesticides, and kept frozen. The mercury content of the Chiroptera caught in 1890 was lower than that of those caught during or after the use of mercurial pesticides. Difference in mercury content between bats caught during and after use was not significant.     

Effects of ethanol on methyl mercury toxicity in rats

This study was designed to investigate the effect of different doses of ethanol on the morbidity, mortality, and distribution of mercury in the tissues of groups of rats treated orally once daily with methyl mercury chloride (MMC: 5 mg/kg . d) for 10 consecutive days. Ethanol potentiated the toxicity of methyl mercury in terms of neurological manifestations (hindleg crossings and abnormal gait) and mortality. The magnitude of effect depended on the concentration of ethanol administered. The concentration of mercury in the kidney and brain also increased with the dose of ethanol given. These findings indicate that epidemiologic studies designed to evaluate methyl mercury toxicity must take into account the multiple environmental burdens that can affect the population cumulatively and simultaneously.     

Disintegration of orthogonal arrays in perivascular astrocytic processes as an early event in acute global ischemia

A quantitative freeze-fracture study of perivascular astrocytic processes in rat cerebral cortex disclosed rapid disintegration of orthogonal arrays of the intramembrane particles in acute global ischemia. The process apparently preceded the development of astrocytic swelling.