Lack of effect of high-dose antioestrogen on the maturation and in-vitro fertilization of human oocytes

Thirty-four women requesting laparoscopic sterilization underwenta fixed schedule regimen for multiple follicular developmentwhich included norethisterone and clomiphene citrate. Follicleaspiration for oocyte recovery was attempted laparoscopically34 h after administration of 5000 IU human chononic gonadotrophin(HCG). Nineteen women were given 80 mg tamoxifen orally 4 hprior to HCG injection, while 15 acted as controls. There wasno statistical difference in fertilization rates in vitro betweentamoxifen-treated patients and controls (80 and 68% respectively).In addition, the morphological characteristics of the oocytes,the rates of cleavage, and the concentrations of oestradiol,progesterone and androstenedione in follicular fluid were similarin the two groups. Tamoxifen was detected in substantial amountsin follicular fluids of patients given tamoxifen. These resultssuggest that high-dose tamoxifeii, in clinically used doses,does not adversely affect the final stages of maturation orthe fertilization and early cleavage of human oocytes.     

Numerical simulation of aerosol particle transport by oscillating flow in respiratory airways

Particle transport by oscillating flow in a tapered channel or in a tapered tube was computed from the complete equations of motion. These geometries represent a simplified model of the divergent flow field of the mammalian bronchial tree. The computed deformation profile of a line of particles, transported by the oscillatory motion, was compared with prior experimental results and analytical calculations. All three methods agree that there is transport in the divergent direction of the tube by an axial stream of steady drift in the core for moderately high frequency of oscillation (Womersley parameter in the range of 1 to 10). Bidirectional flow is established by an annular stream in the convergent direction, with no net flow on integral cycles of the oscillating fluid. At higher frequency, however, the steady stream transforms to a different shape in the tapered tube, with transport in the divergent direction nearer the walls of the tube, rather than in the core. Transport by the continuing streams with oscillatory ventilation of the respiratory tract should deliver medicinal aerosols of low intrinsic particle mobility to the peripheral regions of the lungs.     

The use of proteomics in biomarker discovery in neurodegenerative diseases

Biomarkers for neurodegenerative diseases should reflect the central pathogenic processes of the diseases. The field of clinical proteomics is especially well suited for discovery of biomarkers in cerebrospinal fluid (CSF), which reflects the proteins in the brain under healthy conditions as well as in several neurodegenerative diseases. Known proteins involved in the pathology of neurodegenerative diseases are, respectively, normal tau protein, beta-amyloid (1-42), synaptic proteins, amyloid precursor protein (APP), apolipoprotein E (apoE), which previously have been studied by protein immunoassays. The objective of this paper was to summarize results from proteomic studies of differential protein patterns in neurodegenerative diseases with focus on Alzheimer's disease (AD). Today, discrimination of AD from controls and from other neurological diseases has been improved by simultaneous analysis of both beta-amyloid (1-42), total-tau, and phosphorylated tau, where a combination of low levels of CSF-beta-amyloid 1-42 and high levels of CSF-tau and CSF-phospho-tau is associated with an AD diagnosis. Detection of new biomarkers will further strengthen diagnosis and provide useful information in drug trials. The combination of immunoassays and proteomic methods show that the CSF proteins express differential protein patterns in AD, FTD, and PD patients, which reflect divergent underlying pathophysiological mechanisms and neuropathological changes in these diseases.     

Intracerebroventricular vasopressin reduces CSF absorption rate in the conscious goat

Summary Cerebrospinal fluid (CSF) levels of vasopressin (AVP) are elevated in some disorders associated with raised intracranial pressure. We have previously demonstrated that intracerebroventricular infusion of AVP in the conscious goat leads to elevation of intracranial pressure by a mechanism independent of changes in arterial blood pressure or circulating neurohypophysial peptide concentrations. We have now examined the effect of increasing CSF AVP levels on CSF dynamics using the technique of ventriculo-cisternal perfusion in the conscious goat. Intracerebroventricular perfusion with 5 pmol/min AVP in artificial CSF did not alter CSF formation rate but significantly reduced CSF absorption rate (24% decrease; p < 0.01), when compared with perfusion using artificial CSF alone. This AVP-mediated reduction in CSF absorption rate may represent increased resistance to resorption of CSF or may reflect the effect of raised intracranial pressure.     

Adaptive changes of juxtamedullary glomerular filtration in the remnant kidney

The participation of surviving juxtamedullary nephrons in the adaptive changes of glomerular filtration that occur in response to loss of functioning nephron mass was examined by direct micropuncture of the rat renal papilla. The solitary remnant kidney (RK) in rats with an 85% reduction of renal mass demonstrated strikingly elevated values for single nephron glomerular filtration rate (SNGFR) in both superficial (46.1±3.2 nl/min) and juxtamedullary (73.5±6.1 nl/min) nephrons in comparison to respective values observed in normal hydrophenic rats (superficial SNGFR=15.0±1.9nl/min,P<0.001, and juxtamedullary SNGFR=30.2±3.2 nl/min,P<0.001). In RK rats, the proximal portions of both superficial and juxtamedullary nephrons exhibited a marked increase in absolute fluid reabsorption as well as a markedly enhanced delivery of fluid to more distal portions of the nephron. These observations indicate that similar, not preferential, functional adaptations in glomerular filtration occur concommitantly in both superficial and juxtamedullary nephrons consequent to reduction of renal mass.     

The relationship of free and conjugated catecholamines in plasma and cerebrospinal fluid in cerebral and meningeal disease

Summary The concentration of free and conjugated norepinephrine (NE), epinephrine (E) and dopamine (DA) were measured by a modified radioenzymatic assay in the plasma and in the cerebrospinal fluid (CSF) of 45 patients with normal and in 21 patients with disturbed blood-CSF barriers. In patients with an undisturbed blood-CSF barrier the free NE and E in CSF were 128±45 ng/l and 27±20 ng/l (mean values±S.E.), respectively, and represented about 50 % of the average plasma values. Mean DA was not different in plasma (47±22 ng/l) and in CSF (41±19 ng/l). Both in plasma and in CSF, considerable higher free catecholamine (CA) levels were measured in patients with dysfunction of the blood-CSF barrier. In one patient with bacterial meningitis twofold higher concentrations of free NE and DA in CSF as compared with plasma were detectable. Sulfate conjugates of catecholamines are predominant in plasma and CSF.The contribution of conjugated CA to total CA in plasma from patients with normal blood-CSF barrier averaged 69.7 %, 63.1 % and 98.1 % for NE, E and DA, respectively and was significantly lower in the CSF (p<0.001). In patients with disturbed blood-CSF barrier, the increases of conjugated CA were more pronounced in CSF than in plasma. Further, the contribution of conjugated NE and E to total NE and E in CSF was not only increased in patients with bacterial meningitis, but also in patients with renal insufficiency compared to the control patients (p<0.02 and p<0.001 resp.). Free and conjugated NE, E and DA in the plasma and CSF were related significantly (p<0.01 resp.) with stronger correlation for conjugated CA (p<0.001 resp.). These results together with findings in the literature, suggest that there is little or no rostral-caudal gradient in CSF CA conjugate concentrations and that even in patients with intact blood-CSF barrier plasma conjugated CA concentrations influence those in CSF. Thus only free CA levels in CSF may reflect the central adrenergic activity.     

Measurement of 5-HIAA levels in ventricular CSF (by LCEC) and in striatum (byin vivo voltammetry) during pharmacological modifications of serotonin metabolism in the rat

Summary The relationship between the concentrations of 5-hydroxyindoleacetic acid (5-HIAA) in the CSF and in the striatum has been evaluated in the rat by measuring the levels of this metabolite in ventricular CSF (by liquid chromatography coupled with electrochemical detection) and in the striatal extracellular fluid (byin vivo voltammetry) after administration of inhibitors of serotonin synthesis or degradation. Pargyline, NSD 1015 and-propyldopacetamide all caused an exponential decline of 5-HIAA in both CSF and striatum. For a given drug, the rate constants for 5-HIAA disappearance were identical in the CSF and in the striatal extracellular fluid. These results confirm the view that CSF 5-HIAA may serve as a good index of brain serotonin turnover.     

Increased concentration of hypoxanthine in human central cerebrospinal fluid after subarachnoid haemorrhage

Summary The adenine nucleotide metabolites hypoxanthine, xanthine and uric acid were determined by high performance liquid chromatography in cerebrospinal fluid (CSF) from 25 patients with subarachnoid haemorrhage (SAH) and from 26 control subjects. In addition, the haemoglobin and protein levels in the CSF of the patients were determined.In 13 subjects, from which lumbar CSF was collected three, six and nine days after SAH, there was a gradual increase in 8 patients for hypoxanthine and in 3 of the 13 patients for xanthine and uric acid. The mean concentrations were not significantly higher than the controls. In 12 SAH patients, consecutive CSF fractions of 10 ml were collected peroperatively during surgical clipping of aneurysms. The hypoxanthine concentrations increased continously from lumbar to central CSF samples. Hypoxanthine levels were 6.5±1.0 M in lumbar CSF compared to 11.8±2.3 M in central CSF (p<0.001), while xanthine, uric acid, haemoglobin and protein levels were equally distributed. Furthermore, the SAH patients showed about 3 times higher concentrations of central CSF hypoxanthine (p<0.01) and xanthine (p<0.05) while that for uric acid was similar compared to all control subjects. Also, an in vitro study showed that the increased concentrations of the adenine nucleotide metabolites could not be caused by degradation of blood components in the subarachnoid space.It is presumed that the increased central CSF concentrations of hypoxanthine that were demonstrated in patients after SAH could be a sensitive marker for brain tissue ischaemia. However, since there was no correlation between the hypoxanthine levels, clinical condition or cerebral vascular diameter, other factors have to be excluded before ischaemia alone could explain the elevated central hypoxanthine levels in patients without major clinical dysfunction after SAH.This study was supported by grants from Karolinska Institutet, the Swedish National Society against Heart and Chest disease, The Swedish Society of Medical Sciences, Wibergs Foundation, Boehringer Ingelheim and the Swedish Medical Research Council (proj. no. 7485).     

The effects of verapamil on cerebrospinal fluid pressure in surgical patients

The effects of verapamil upon cerebrospinal fluid pressure (CSFP) were studied in twenty surgical patients without intracranial pathology who were divided into two groups of ten patients each: verapamil 0.075mg·kg^–1 was given in group 1 and 0.15mg·kg^–1 was given in group 2. A spinal needle was inserted into the subarachnoid space to permit continuous measurement of CSFP. Intravenous verapamil as a bolus produced a statistically significant increase in CSFP: from 6.0 ± 3.5 (mean ± SD) to 10.5 ± 4.3mmHg in group 1 (P < 0.01), and from 6.2 ± 3.1 to 12.6 ± 3.8mmHg in group 2 (P < 0.01). CSFP after verapamil attained its maximum in 0.5–1.5min, then gradually returned to control levels. Changes in CSFP were always associated with statistically significant decreases in arterial blood pressure and cerebral perfusion pressure, while the heart rate showed variable changes. It is concluded that a clinical dose of verapamil showed variable changes. It is concluded that a clinical dose of verapamil (0.075–0.15mg·kg^–1) has no neurological side effects in patients without intracranial hypertension. However, it must be emphasized that verapamil may increase CSFP to undesirable levels and should be avoided in patients with compromised intracranial compliance.(Nishikawa T, Namiki A: The effects of verapamil on cerebrospinal fluid pressure in surgical patients. J Anesth 1: 132–136, 1987)