High levels of lung resident CD4+CD28null cells in COPD: implications of autoimmunity.

Chronic obstructive pulmonary disease (COPD) is a worldwide burden and a major cause of death. Pathogenetic mechanisms underlying the disease are still largely unknown. However, a continuous toxic injury due to tobacco smoking leading to a self-maintaining inflammatory process is considered a key factor in the pathophysiology of the disease. Evidence that autoimmunity might be involved in the maintenance of COPD has been recently noticed with great interest.During the chronic phase of an autoimmune response, lymphocytes lose their costimulatory signals. Previously, CD4+CD28null cells were reported to be systemically heightened in COPD patients. However, a direct role of CD4+CD28null cells in the pathogenesis of COPD is still under discussion, since there is no evidence that CD4+CD28null cells originate from the lungs of diseased patients. Therefore, we evaluated lungs from end-stage COPD patients and compared the levels of tissue infiltrating CD4+CD28null cells to systemic levels. We could show that CD4+CD28null cells are present in high amounts in lung tissue obtained from COPD GOLD IV patients suggesting a direct involvement of those cells in the pathophysiology of COPD. Furthermore, purified lung-resident CD4+ cells showed a stable proliferative response to lung specific elastin and collagen.These results further corroborate the role of autoreactive CD4+ cells in the maintenance of the inflammatory destruction in COPD. Modulating CD4+ cell function might be a new promising tool for future therapeutic approaches.

Sevoflurane versus isoflurane--anaesthesia for lower abdominal surgery. Effects on perioperative glucose metabolism.

BACKGROUND: The aim of this study was to determine the impact of sevoflurane anaesthesia on metabolic and endocrine responses to lower abdominal surgery. METHODS: A prospective randomized controlled study in 20 patients undergoing abdominal hysterectomy. Patients were randomly assigned to receive either sevoflurane (S) or isoflurane anaesthesia (I). Using a stable isotope dilution technique, endogenous glucose production (EGP) and plasma glucose clearance (GC) were determined pre- and postoperatively (6,6-2H2-glucose). Plasma concentrations of glucose, insulin, cortisol, epinephrine and norepinephrine were measured preoperatively, 5 min after induction of anaesthesia, during surgery and 2 h after the operation. RESULTS: EGP increased in both groups with no intergroup differences (preop. S 12.2 +/- 1.6, I 12.4 +/- 1.6; postop. S 16.3 +/- 1.9*, I 19.0 +/- 3.1* micromol kg(-1) min(-1), all values are means +/- SD, *P < 0.05 vs. preop.). Plasma glucose concentration increased and GC decreased in both groups. There were no differences between groups. (Glucose conc. mmol l(-1) preop.: S 4.1 +/- 0.3, I 3.9 +/- 0.5; 5 AI S 5.1 +/- 0.6*, I 5.1 +/- 1.0*, postop. S 7.0 +/- 1.0*, I 7.1 +/- 1.4*; * = P < 0.05 vs. preop.; GC ml kg(-1)min(-1) preop. S 3.0 +/- 0.4, I 3.2 +/- 0.4; postop. S 2.4 +/- 0.3*, I 2.7 +/- 0.3*; *=P < 0.05 vs. preop.) Insulin plasma concentrations were unchanged. Cortisol plasma concentrations increased intra- and postoperatively with no changes between the groups. Norepinephrine plasma concentration increased in the S group after induction of anaesthesia. I group norepinephrine was increased 2 h after operation and showed no intergroup differences. CONCLUSION: Sevoflurane, as well as isoflurane, does not prevent the metabolic endocrine responses to surgery.

Biomass steam gasification--an extensive parametric modeling study.

A model for steam gasification of biomass was developed by applying thermodynamic equilibrium calculations. With this model, the simulation of a decentralized combined heat and power station based on a dual fluidized-bed steam gasifier was carried out. Fuel composition (ultimate analysis and moisture content) and the operating parameters, temperature and amount of gasification agent, were varied over a wide range. Their influences on amount, composition, and heating value of product gas and process efficiencies were evaluated. It was shown that the accuracy of an equilibrium model for the gas composition is sufficient for thermodynamic considerations. Net electric efficiency of about 20% can be expected with a rather simple process. Sensitivity analysis showed that gasification temperature and fuel oxygen content were the most significant parameters determining the chemical efficiency of the gasification.

Multiplexed continuous-wave diode-laser cavity ringdown measurements of multiple species.

Rapid cavity ringdown measurements of multiple broadband absorbing species (methanol and isopropanol) in gas mixtures have been recorded with two multiplexed continuous-wave distributed-feedback diode lasers operating near 1.4 mum. A measurement sensitivity of 2.4 x 10(-9) cm(-1) for a 4.3-s averaging time was achieved in a 39.5-cm-long static cell with 99.94% reflectivity mirrors. This corresponds to a water-vapor detection limit of less than 2 ppb (parts in 10(9)) for the strong H(2)O lines near 1.4 mum. The shot-to-shot noise of the decay time constant tau was approximately 0.3-0.7%, and ringdown acquisition rates as great as 900 Hz were achieved.

Transcutaneous ultrasonography of the avian urogenital tract.

The purpose of this article is to provide a survey of the diagnostic use of transcutaneous sonographic examination of the urogenital tract of pet birds. Possibilities and limitations in imaging normal and altered components of this organ system are discussed. Ultrasonographic examination of the avian urogenital tract was evaluated in 386 pet birds. Abnormal clinical signs were present in 289 birds; 97 birds were normal. Transcutaneous ultrasonography proved to be a useful, noninvasive, and fast diagnostic tool, especially in imaging laminated eggs and changes of the oviduct. Until now, these pathologic changes were not diagnosable in birds with other common noninvasive methods (e.g. radiography). The imaging of low-grade changes of the oviduct, disorders of the kidney without enlargement of the organ, as well as roughening of the egg shell proved to be difficult. Sonographic imaging of neither the normal kidney nor the inactive gonads was possible.

Observations on the significance of diagnostic findings in egg-binding of Psittaciformes.

Clinical examination of 2192 psittacine birds of both sexes revealed a prevalence of 2.74 per cent (60 birds) of egg-binding. Domesticated species easily bred in captivity were the most commonly affected; the prevalence in cockatiels (15.75 per cent), and in budgerigars (5.73 per cent). An accurate diagnosis was possible in all cases by means of an evaluation of the case history, a visual examination, palpation and radiographic and ultrasonographic examinations. The case history alone was typical in 60 per cent of the cases, and reliable diagnosis was reached with the help of a visual examination in 70 per cent of the cases. Radiographic examination provided a definitive diagnosis in 30 per cent of the cases, especially in those with shelled eggs. Medullary bone proved to be a radiographic indication of laminated and thin-shelled eggs. However, laminated and thin-shelled eggs could only be differentiated definitively from abdominal masses, salpingitis and cystic degeneration by means of ultrasonography.

Urine bactericidal activity of pefloxacin versus norfloxacin in healthy female volunteers after a single 800-mg oral dose.

In an open randomised crossover study the antibacterial activity of pefloxacin and norfloxacin was assessed in the urine after a single 800-mg oral dose in 14 healthy female volunteers. Pefloxacin demonstrated lower peak concentrations in the urine than norfloxacin (mean, 217.2 mg/l versus 492.9 mg/l as determined by the microbiological assay) but pefloxacin was present over a longer period of time in sufficient concentrations than norfloxacin. Mean urine levels of at least 2 mg/l were present for 7 days after pefloxacin administration and 2 days after norfloxacin administration as determined by the microbiological assay. Overall, the urinary recovery of pefloxacin and norfloxacin amounted to 49.3% and 25.1%, respectively, of the total administered dose. The average urine bactericidal activity against the five test organisms was as follows: against reference strain Escherichia coli ATCC 25922 susceptible to nalidixic acid (Nal-S) for 5 days with pefloxacin and 2 days with norfloxacin; against three clinical isolates, one strain each of E. coli resistant to nalidixic acid (Nal-R), Klebsiella pneumoniae Nal-R, and Staphylococcus saprophyticus, for 3 days with pefloxacin and 24 h with norfloxacin; and against a clinical isolate of Enterococcus faecalis for 2 days with pefloxacin and 12 h with norfloxacin. In conclusion, pefloxacin as a single dose proved to have sufficiently high and long-lasting urine bactericidal activity against urinary pathogens. These findings support the results of a meta-analysis of seven clinical trials in patients with uncomplicated lower UTI, demonstrating a single oral dose of 800 mg pefloxacin to be as effective as a conventional treatment with comparative drugs.

Polymyositis with tubular aggregates.

We report a patient with classic idiopathic polymyositis who had tubular aggregates on muscle biopsy. Tubular aggregates are distinctly rare in polymyositis although seen in a variety of other muscle disorders including myopathies associated with muscle cramping. Our patient did not have muscle cramps or severe myalgia. Moreover, the patient's disease responded to steroids, indicating that tubular aggregates were not a marker for steroid resistance. The function of the tubular aggregates in this disease is not clear.

Atrial natriuretic factor in acute and chronic cardiac failure.

Water, sodium, and potassium balance and urinary excretion of norepinephrine and aldosterone were investigated in rats with left ventricular failure due to left ventricular infarction, and measurements were obtained of plasma levels of atrial natriuretic factor (ANF). Increased plasma levels of ANF in relation to the size of the infarction and to the right atrial and left ventricular end-diastolic pressure were found. The augmented levels of ANF were not able to prevent an accumulation of sodium in the rats with myocardial infarction in which urinary excretion of norepinephrine and aldosterone was unchanged in comparison to control values. Plasma levels of ANF in the pulmonary artery, aorta, and renal vein of six conscious dogs were studied during the development of heart failure due to rapid right ventricular pacing. A threefold increase in ANF was found: ANF levels did not differ between the pulmonary artery and the aorta, but a reduction in ANF of about 30% was reported in the renal vein in comparison to the arteries. A close positive correlation between right atrial pressure and plasma levels of ANF was noted. No correlation could be demonstrated between mean pulmonary arterial pressure and ANF or between the stimulated plasma renin concentration and plasma ANF values.