Morphological analysis of cell subpopulations within carotid atherosclerotic plaques.

Atherosclerosis is considered a chronic inflammatory process, prompted by lipid accumulation and propagated by cell-mediated mechanisms. The present work was undertaken to clarify this process by characterizing cellular components of inflammatory infiltrate localized within atheroma. Cryostat sections of atherosclerotic lesions obtained from human carotid endarterectomy were analysed immunohistochemically by using monoclonal and polyclonal antibody directed against T cell subpopulations (CD3, CD4, CD8), B cells (CD20), plasma cells (CD138), macrophages (CD14), mast cells (anti-tryptase). Our results assess that T cells are the predominant cell type among plaque infiltrating inflammatory cells. B cells were detected near the lipid core of atheroma and clusters of plasma cells were observed within cellular infiltrates in most plaques. Numerous tryptase positive mast cells were noticed in many areas of complicated lesions. Our results indicate the presence of many inflammatory cells within type V and VI atherosclerotic plaques, suggesting the involvement of those cells in plaque progression. In fact it was previously shown that stability of atherosclerotic lesions is influenced by mast cell-released matrix metalloproteinases which induce plaque rupture and by cytokines and chemokines which increase local inflammatory response and are produced by lymphocytes and macrophages.

Closing and inactivation potentiate the cocaethylene inhibition of cardiac sodium channels by distinct mechanisms.

Cocaethylene, a metabolite of cocaine and alcohol, is a potent inhibitor of the cardiac (Nav1.5) sodium channel heterologously expressed in Xenopus laevis oocytes. Cocaethylene produces minimal tonic block under resting conditions but causes a potent use-dependent inhibition during repetitive depolarization and a hyperpolarizing shift in the steady-state inactivation. The data are consistent with a state-dependent binding mechanism, which has high affinity for inactivated channels (KI = 17 microM) and low affinity for resting channels (KR = 185 micro). Mutations of the interdomain D3-D4 linker eliminated rapid inactivation and weakened the cocaethylene inhibition, consistent with an important role for fast inactivation in cocaethylene binding. A rapid component of cocaethylene inhibition was observed in a noninactivating mutant of Nav1.5 that was tightly linked to channel opening and displayed properties consistent with a pore blocking mechanism. Hyperpolarization caused the noninactivating mutant channel to close, trapping cocaethylene and slowing the recovery. Mutation of a conserved isoleucine (I1756C) located near the extracellular end of the D4S6 segment accelerated the recovery of the noninactivating channel, suggesting that this mutation facilitates cocaethylene untrapping, which seems to be the rate-limiting step in the recovery when the channel is closed. This contrasts with the rapidly inactivating channel, where the I1756C mutation did not alter the recovery from cocaethylene inhibition. The data suggest that additional mechanisms, such as more stable cocaethylene binding, may be a more important determinant of recovery kinetics when the channels are inactivated. The data indicate that deactivation and inactivation slow the recovery and potentiate the cocaethylene inhibition of the Nav1.5 channel by distinct mechanisms.

Trigeminal and polyradiculoneuritis in a dog presenting with masticatory muscle atrophy and Horner's syndrome.

A 9-year-old, spayed female, Airedale Terrier was euthanatized and necropsied after a progressive clinical course that included Horner's syndrome of the left eye and unilateral atrophy of the masticatory muscles. Although gross lesions were limited, a polyradiculoneuritis and ganglionitis that was most severe in the trigeminal nerves and ganglia were confirmed histologically. The inflammatory infiltrate consisted predominantly of macrophages and B and T lymphocytes that were phenotypically confirmed by immunostaining. Horner's syndrome was the result of damage to postganglionic sympathetic fibers that were incorporated in segments of the inflamed trigeminal nerve and its ophthalmic branch. Histologically, the character and distribution of the inflammation was similar to previously described syndromes of suspected immune-mediated etiology in humans and animals.

Multiple sites and synergism in the binding of inhibitors to microsomal aminopeptidase.

The active site of microsomal aminopeptidase has been probed by studying the inhibition of the enzyme in the simultaneous presence of two ligands. The results have been analyzed with the Yonetani-Theorell plot to quantitate the degree of interaction between the two inhibitors. As expected, the enzyme contains a strong binding site for the alpha-amino group and the hydrophobic side chain of specific substrates. In addition, however, the enzyme can interact with another amine and a second hydrophobic group. Evidence suggests that this extra amine may bind to the zinc in an unprotonated form and that one of the hydrophobic sites is located in the vicinity. Another unexpected finding in this work is a strong synergism between the binding of ammonia and that of zinc ligands such as hydroxamates. This synergism may reflect an induced-fit mechanism that brings the catalytically important zinc atom into the optimal state only in the presence of specific substrates.

The use of patient instructors to teach interviewing skills.

A program which utilizes patient instructors (PI) to teach and evaluate interviewing skills of pharmacy students is described. The PIs were programmed with a history of either hypertension, chronic pulmonary disease, or congestive heart failure. Content areas within each history included past and present drug therapy, adverse drug reactions, drug interactions, as well as socioeconomic and other factors affecting therapy. The interviews were done with small groups of students and followed by PI evaluation of interview content and process. The majority of students felt the experience helped them assess and improve their interviewing skills and agreed the program should continue. The advantages of utilizing PIs to teach interviewing skills are discussed.