Under-three minute PCR: probing the limits of fast amplification.

Nucleic acid amplification is enormously useful to the biotechnology and clinical diagnostic communities; however, to date point-of-use PCR has been hindered by thermal cycling architectures and protocols that do not allow for near-instantaneous results. In this work we demonstrate PCR amplification of synthetic SARS respiratory pathogenic targets and bacterial genomic DNA in less than three minutes in a hardware configuration utilizing convenient sample loading and disposal. Instead of sample miniaturization techniques, near-instantaneous heating and cooling of 5 µL reaction volumes is enabled by convective heat transfer of a thermal fluid through porous media combined with an integrated electrical heater. This method of rapid heat transfer has enabled 30 cycles of PCR amplification to be completed in as little as two minutes and eighteen seconds. Surprisingly, multiple enzymes have been shown to work at these breakthrough speeds on our system. A tool for measuring enzyme kinetics now exists and can allow polymerase optimization through directed evolution studies. Pairing this instrument technology with modified polymerases should result in a new paradigm for high-throughput, ultra-fast PCR and will hopefully improve our ability to quickly respond to the next viral pandemic.

Dilated intercellular spaces and lymphocytes on biopsy relate to symptoms in erosive GERD but not NERD.

BACKGROUND: Mechanisms of symptom perception among patients with gastro-oesophageal reflux disease (GERD) remain to be fully elucidated. AIM: To correlate quantitative reflux symptom scores with microscopic oesophageal histopathology. METHODS: Prior to endoscopy, patients with reflux symptoms completed a validated reflux disease questionnaire (score 0-36). Erosive oesophagitis (EO) was graded using the LA classification. Oesophageal biopsies were graded 0-2 for basal cell hyperplasia, papillary elongation, dilated intercellular spaces (DIS), necrosis or erosion, eosinophils and neutrophils by a blinded gastrointestinal pathologist as previously described. Additionally, lymphocyte density was also evaluated. Pearson's correlation coefficients were computed. RESULTS: Thirty-two EO and 21 non-erosive reflux disease (NERD) patients were prospectively enrolled. For EO vs. NERD, mean reflux symptom scores (10.7 vs. 8.8, P=0.35) and histology scores were similar (4.29 vs. 4.25; P=0.9). However, when symptom scores were compared with histology scores, a correlation was found in the EO group, but not in the NERD group (r=0.34, P=0.05 vs. r=0.22, P=0.36). On further analysis, DIS was associated with symptom scores in the EO group (P≤0.001), but not in the NERD group (P=N.S.). Similarly, lymphocyte density was associated with symptom scores in the EO group (r=0.56, P=0.0009), but not in the NERD group (r=0.002, P=0.9). CONCLUSIONS: Although mean symptom and histology scores were similar in the EO and NERD groups, a significant correlation of symptom scores with histology scores, DIS and lymphocytes was found in the former, but not in the latter. EO and NERD patients may have different symptom perception mechanisms and thus, dissimilar symptom resolution rates with acid suppression.

The impact of pre-endoscopy proton pump inhibitor use on the classification of non-erosive reflux disease and erosive oesophagitis.

BACKGROUND: Factors associated with non-erosive reflux disease (NERD) and erosive oesophagitis (EO) are incompletely understood and the overlap between the two entities is debated. AIM: To compare clinical, demographic, and endoscopic findings in a large cohort of NERD and EO patients. METHODS: After they completed a validated GERD questionnaire, patients who presented for index endoscopy were enrolled and categorized as NERD or EO. Analysis was performed using Chi-square, Mann-Whitney U-test and multivariate logistic regression. RESULTS: A total of 696 GERD patients [455 (65.4%) NERD; 241 (34.6%) EO]; mean age 57 years; 92% men and 82% Caucasian were prospectively enrolled. Using logistic regression, patients on PPI were more likely to be classified as NERD (OR: 3.2; P < 0.001). NERD patients were older (OR: 1.50; P = 0.05), less likely to have nocturnal symptoms (OR: 0.63; P = 0.04) and hiatal hernia (OR: 0.32; P < 0.001). Compared with PPI-naïve NERD patients, those on PPI were more likely to have nocturnal symptoms (69% vs. 29%, P = 0.048) and less likely to have mild-moderate symptoms (63% vs. 79%, P < 0.001) - similar to the EO group. CONCLUSIONS: Pre-endoscopy PPI usage contributes significantly to the classification of GERD patients into the NERD-phenotype. NERD patients on PPI therapy demonstrate some features that are significantly different from PPI-naïve patients, but similar to EO patients. This observation supports the notion that some PPI NERD patients are actually healed EO patients, and that an overlap does exist between the GERD phenotypes.

Prevalence of multiple sclerosis in a residential area bordering an oil refinery.

BACKGROUND: Community concerns about a potential excess of multiple sclerosis (MS) prompted this study. OBJECTIVE: To determine the period prevalence of MS in a community bordering a closed oil refinery and a control community. METHODS: Cases seen by a neurologist during 1998 to 2001 were obtained from area neurologists and hospital discharge data. Population data were obtained from the year 2000 US Census. Patient data were abstracted by a trained abstractor onto a standardized report form. A consulting neurologist reviewed the form and made a final diagnosis using the Poser criteria plus the category of presumed. Age-adjusted prevalence rates and rates of agreement were calculated. RESULTS: The direct age-adjusted period prevalence for both sexes and all races for the entire study area was 113 per 100,000 (95% CI = 93 to 136). For white subjects only, the prevalence was 123 per 100,000 (95% CI = 102 to 147). With use of an indirect method of age adjustment, the number of observed cases in the community bordering the refinery was similar to the number of cases expected (standardized morbidity ratio = 130.8, 95% CI = 62.3 to 199.3), based on rates from the comparison area. The agreement between the treating neurologist (for definite plus probable cases) and the consulting neurologist (for definite plus probable plus presumed cases) was good (kappa = 0.5733). CONCLUSIONS: The prevalence of multiple sclerosis (MS) for this area was generally consistent with prevalence estimates calculated in previous studies in other areas. No significant excess was seen in the exposed area. MS was more prevalent in females than in males. The overall agreement between the consulting and treating neurologist was good.

Discrepancy between phase behavior of lung surfactant phospholipids and the classical model of surfactant function.

The studies reported here used fluorescence microscopy and Brewster angle microscopy to test the classical model of how pulmonary surfactant forms films that are metastable at high surface pressures in the lungs. The model predicts that the functional film is liquid-condensed (LC) and greatly enriched in dipalmitoyl phosphatidylcholine (DPPC). Both microscopic methods show that, in monolayers containing the complete set of phospholipids from calf surfactant, an expanded phase persists in coexistence with condensed domains at surface pressures approaching 70 mN/m. Constituents collapsed from the interface above 45 mN/m, but the relative area of the two phases changed little, and the LC phase never occupied more than 30% of the interface. Calculations based on these findings and on isotherms obtained on the continuous interface of a captive bubble estimated that collapse of other constituents increased the mol fraction of DPPC to no higher than 0.37. We conclude that monolayers containing the complete set of phospholipids achieve high surface pressures without forming a homogeneous LC film and with a mixed composition that falls far short of the nearly pure DPPC predicted previously. These findings contradict the classical model.

Thermodynamic effects of the hydrophobic surfactant proteins on the early adsorption of pulmonary surfactant.

We determined the influence of the two hydrophobic proteins, SP-B and SP-C, on the thermodynamic barriers that limit adsorption of pulmonary surfactant to the air-water interface. We compared the temperature and concentration dependence of adsorption, measured by monitoring surface tension, between calf lung surfactant extract (CLSE) and the complete set of neutral and phospholipids (N&PL) without the proteins. Three stages generally characterized the various adsorption isotherms: an initial delay during which surface tension remained constant, a fall in surface tension at decreasing rates, and, for experiments that reached approximately 40 mN/m, a late acceleration of the fall in surface tension to approximately 25 mN/m. For the initial change in surface tension, the surfactant proteins accelerated adsorption for CLSE relative to N&PL by more than ten-fold, reducing the Gibbs free energy of transition (DeltaG(O)) from 119 to 112 kJ/mole. For the lipids alone in N&PL, the enthalpy of transition (DeltaH(O), 54 kJ/mole) and entropy (-T. DeltaS, 65 kJ/mole at 37 degrees C) made roughly equal contributions to DeltaG(O). The proteins in CLSE had little effect on -T. DeltaS(O) (68 kJ/mole), but lowered DeltaG(O) for CLSE by reducing DeltaH(O) (44 kJ/mole). Models of the detailed mechanisms by which the proteins facilitate adsorption must meet these thermodynamic constraints.

Human responses to propionic acid. II. Quantification of breathing responses and their relationship to perception.

In 20 normal and four anosmic participants, instantaneous inhalation and exhalation flow rates were recorded in response to 15 s stimulations with clean air or propionic acid concentrations (0.16, 1.14, 8.22 and 59.15 p.p.m., v/v) that ranged from peri-threshold for normals to clearly supra-threshold for anosmics. Each odorant/irritant delivery to the face-mask began with an exhalation. This allowed concentration to reach full value before stimulus onset, defined as the point where the participant began to bring the stimulus into the nose by inhalation. Two seconds after this stimulus onset, normals exhibited cumulative inhaled volume (CIV) declines of 39 and 14%, and latencies of 500 and 710 ms, with presentations of 59.15 and 8.22 p.p.m., respectively. With anosmics, 59.15 p.p.m. caused a 19% decline in CIV that began at 730 ms. Examination of the first inhalation after stimulus onset shows that the CIV declines in normals were achieved by a progressive decline in volume (InVol), beginning with a slight drop at 1.14 p.p.m., and a marked decline in duration (InDur) with only the highest concentration. Anosmics exhibited declines in InDur and InVol with only the 59.15 p.p.m. stimulus, and these declines were much more modest than the changes seen in normals. Comparison of these breathing results with perceptual responses from this same experiment demonstrates that: (i) in normals, odor perception rises slightly, but breathing does not change, with the lowest concentration; (ii) the higher breathing sensitivity (declines in InVol) of normals is paralleled by both the higher nasal irritation of these individuals and the presence of odor sensation; (iii) InDur declines in normals only with a stimulus concentration sufficient to cause marked nasal irritation in anosmics; and iv) in anosmics, modest but reliable declines in both InDur and InVol mirror the marked elevation in nasal irritation magnitude seen with only the highest concentration. In view of the failure of prior work to provide evidence that olfactory activation alone can cause any of the breathing changes we observed, we conclude that some breathing parameters are quite useful as rapid and sensitive measures of nasal irritation that arises from activation of nasal trigeminal afferents alone or in combination with the olfactory nerve.

Rapid compression transforms interfacial monolayers of pulmonary surfactant.

Films of pulmonary surfactant in the lung are metastable at surface pressures well above the equilibrium spreading pressure of 45 mN/m but commonly collapse at that pressure when compressed in vitro. The studies reported here determined the effect of compression rate on the ability of monolayers containing extracted calf surfactant at 37 degrees C to maintain very high surface pressures on the continuous interface of a captive bubble. Increasing the rate from 2 A(2)/phospholipid/min (i.e., 3% of (initial area at 40 mN/m)/min) to 23%/s produced only transient increases to 48 mN/m. Above a threshold rate of 32%/s, however, surface pressures reached > 68 mN/m. After the rapid compression, static films maintained surface pressures within +/- 1 mN/m both at these maximum values and at lower pressures following expansion at < 5%/min to > or = 45 mN/m. Experiments with dimyristoyl phosphatidylcholine at 37 degrees C produced similar results. These findings indicate that compression at rates comparable to values in the lungs can transform at least some phospholipid monolayers from a form that collapses readily at the equilibrium spreading pressure to one that is metastable for prolonged periods at higher pressures. Our results also suggest that transformation of surfactant films can occur without refinement of their composition.

Distinct steps in the adsorption of pulmonary surfactant to an air-liquid interface.

To investigate the mechanisms by which vesicles of pulmonary surfactant adsorb to an air-liquid interface, we measured the effect of different phospholipids and of their concentration both in the subphase and at the interface on this process. Adsorbing vesicles contained the hydrophobic surfactant proteins mixed with the following four sets of surfactant phospholipids that varied the content of anionic headgroups and mixed acyl chains independently: the complete set of purified phospholipids (PPL) from calf surfactant; modified PPL (mPPL) from which the anionic phospholipids were removed; a mixture of dipalmitoyl phosphatidylcholine (DPPC) and dipalmitoyl phosphatidylglycerol (DPPG) (9:1, mol:mol); and DPPC alone. The initial reduction in surface tension depended strongly on the anionic phospholipids and the subphase concentration. The acyl groups had no effect. Adsorption beyond the initial stage depended more on the mixed acyl groups, became increasingly independent of subphase concentration, and was determined instead by the interfacial concentration of the surface film. The different constituents produced the same effects in vesicles adsorbing to a clean interface or in a preexisting film to which vesicles of SP:DPPC adsorbed. Adsorption for vesicles of SP:PPL adsorbing to DPPC or of SP:DPPC to PPL above a certain threshold surface concentration followed exactly the same isotherm. Our results fit best with a two-step model for adsorption. The anionic phospholipids first promote the initial juxtaposition of vesicles to the interface. Compounds with mixed acyl constituents at the point of contact between vesicle and interface then facilitate fusion with the surface.

Persistence of phase coexistence in disaturated phosphatidylcholine monolayers at high surface pressures.

Prior reports that the coexistence of the liquid-expanded (LE) and liquid-condensed (LC) phases in phospholipid monolayers terminates in a critical point have been compromised by experimental difficulties with Langmuir troughs at high surface pressures and temperatures. The studies reported here used the continuous interface of a captive bubble to minimize these problems during measurements of the phase behavior for monolayers containing the phosphatidylcholines with the four different possible combinations of palmitoyl and/or myristoyl acyl residues. Isothermal compression produced surface pressure-area curves for dipalmitoyl phosphatidylcholine (DPPC) that were indistinguishable from previously published data obtained with Langmuir troughs. During isobaric heating, a steep increase in molecular area corresponding to the main LC-LE phase transition persisted for all four compounds to 45 mN/m, at which collapse of the LE phase first occurred. No other discontinuities to suggest other phase transitions were apparent. Isobars for DPPC at higher pressures were complicated by collapse of the monolayer, but continued to show evidence up to 65 mN/m for at least the onset of the LC-LE transition. The persistence of the main phase transition to high surface pressures suggests that a critical point for these monolayers of disaturated phospholipids is either nonexistent or inaccessible at an air-water interface.

Phase separation in monolayers of pulmonary surfactant phospholipids at the air-water interface: composition and structure.

The phase behavior of monolayers containing the complete set of purified phospholipids (PPL) obtained from calf surfactant was investigated as a model for understanding the phase transitions that precede compression of pulmonary surfactant to high surface pressure. During compression, both fluorescence microscopy and Brewster angle microscopy (BAM) distinguished domains that separated from the surrounding film. Quantitative analysis of BAM grayscales indicated optical thicknesses for the PPL domains that were similar to the liquid condensed phase for dipalmitoyl phosphatidylcholine (DPPC), the most abundant component of pulmonary surfactant, and higher and less variable with surface pressure than for the surrounding film. BAM also showed the optical anisotropy that indicates long-range orientational order of tilted lipid chains for the domains, but not for the surrounding film. Fluorescence microscopy shows that addition of DPPC to the PPL increased the area of the domains. At fixed surface pressures from 20-40 mN/m, the total area of each phase grew in proportion with the mol fraction of DPPC. This constant variation allowed analysis of the DPPC mol fraction in each phase, construction of a simple phase diagram, and calculation of the molecular area for each phase. Our results indicate that the phase surrounding the domains is more expanded and compressible, and contains reduced amounts of DPPC in addition to the other phospholipids. The domains contain a mol fraction for DPPC of at least 96%.

Neutral lipids induce critical behavior in interfacial monolayers of pulmonary surfactant.

We have shown previously that lateral compression of pulmonary surfactant monolayers initially induces separation of two phases but that these remix when the films become more dense (1). In the studies reported here, we used fluorescence microscopy to examine the role of the different surfactant constituents in the remixing of the separated phases. Subfractions containing only the purified phospholipids (PPL), the surfactant proteins and phospholipids (SP&PL), and the neutral and phospholipids (N&PL) were obtained by chromatographic separation of the components in extracted calf surfactant (calf lung surfactant extract, CLSE). Compression of the different monolayers produced nonfluorescent domains that emerged for temperatures between 20 and 41 degreesC at similar surface pressures 6-8 mN/m higher than values observed for dipalmitoyl phosphatidylcholine (DPPC), the most prevalent component of pulmonary surfactant. Comparison of the different preparations showed that the neutral lipid increased the total nonfluorescent area at surface pressures up to 25 mN/m but dispersed that total area among a larger number of smaller domains. The surfactant proteins also produced smaller domains, but they had the opposite effect of decreasing the total nonfluorescent area. Only the neutral lipids caused remixing. In images from static monolayers, the domains for N&PL dropped from a maximum of 26 +/- 3% of the interface at 25 mN/m to 4 +/- 2% at 30 mN/m, similar to the previously reported behavior for CLSE. During continuous compression through a narrow range of pressure and molecular area, in N&PL, CLSE, and mixtures of PPL with 10% cholesterol, domains became highly distorted immediately prior to remixing. The characteristic transition in shape and abrupt termination of phase coexistence indicate that the remixing caused by the neutral lipids occurs at or close to a critical point.

Stabilization of lung surfactant particles against conversion by a cycling interface.

The large active particles of pulmonary surfactant are depleted in patients with acute respiratory distress syndrome and in animal models of this disorder. We studied in vitro conversion of large to small particles, separated by differential sedimentation, to determine how factors lavaged from rabbits injured by intravenous oleic acid would affect conversion. In half-filled test tubes rotated end over end, samples from injured animals increased the recovery of large particles from 40 +/- 6% of uncycled samples for controls to 62 +/- 21%. We hypothesized that proteins in the injured samples, and perhaps also the proteinase inhibitors used previously to block conversion (N. J. Gross and R. M. Schultz. Biochim. Biophys. Acta 1044: 222-230, 1990), stabilized surfactant particles by limiting access to the cycling interface. Hemoglobin, neutrophil elastase, and alpha1-antiproteinase (alpha1-PI) oxidized to eliminate its antiproteinase activity all stabilized large particles against conversion. Hemoglobin was most effective, increasing recovery from 18 +/- 5% for controls to 86 +/- 5% with 0.4 mg/ml hemoglobin. Native alpha1-PI had no effect on conversion. Our results suggest that acceleration of normal conversion is unlikely to explain the depletion of large particles in injured lungs. They also suggest that conversion of surfactant particles separated by differential sedimentation requires no proteinase susceptible to inhibition by alpha1-PI. They provide an alternate hypothesis related to interfacial effects rather than proteinase inhibition for the previously reported effect of alpha1-PI on conversion of particles separated according to density.

Lateral phase separation in interfacial films of pulmonary surfactant.

To determine if lateral phase separation occurs in films of pulmonary surfactant, we used epifluorescence microscopy and Brewster angle microscopy (BAM) to study spread films of calf lung surfactant extract (CLSE). Both microscopic methods demonstrated that compression produced domains of liquid-condensed lipids surrounded by a liquid-expanded film. The temperature dependence of the pressure at which domains first emerged for CLSE paralleled the behavior of its most prevalent component, dipalmitoyl phosphatidylcholine (DPPC), although the domains appeared at pressures 8-10 mN/m higher than for DPPC over the range of 20-37 degrees C. The total area occupied by the domains at room temperature increased to a maximum value at 35 mN/m during compression. The area of domains reached 25 +/- 5% of the interface, which corresponds to the predicted area of DPPC in the monolayer. At pressures above 35 mN/m, however, both epifluorescence and BAM showed that the area of the domains decreased dramatically. These studies therefore demonstrate a pressure-dependent gap in the miscibility of surfactant constituents. The monolayers separate into two phases during compression but remain largely miscible at higher and lower surface pressures.

Roles of different hydrophobic constituents in the adsorption of pulmonary surfactant.

Surface tension-time adsorption isotherms were measured at 37 degrees C for calf lung surfactant extract (CLSE) and subfractions of its constituents: the complete mix of surfactant phospholipids (PPL), phospholipids depleted in anionic phospholipids (mPPL), hydrophobic surfactant proteins plus phospholipids (SP&PL, SP&mPL), and neutral lipids plus phospholipids (N&PL). Adsorption experiments were done using a static bubble surfactometer where diffusion resistance was present, and in a Teflon dish where diffusion was minimized by subphase stirring. The contribution of diffusion to bubble adsorption measurements decreased as phospholipid concentration increased, and was small at 0.25 mM phospholipid. At this phospholipid concentration, PPL, mPPL, and N&PL all adsorbed more rapidly and to lower final surface tensions than dipalmitoyl phosphatidylcholine (DPPC) on the bubble. However, none of these phospholipid mixtures adsorbed to surface tensions below 46 mN/m after 20 min, behavior that was significantly worse than CLSE, SP&PL, and SP&mPL which additionally contained hydrophobic SP. Both CLSE and SP&PL rapidly adsorbed to surface tensions below 25 mN/m at 0.25 mM phospholipid concentration on the bubble, as did SP&mPL at a somewhat reduced rate. Further experiments defining the influence of hydrophobic protein content showed that addition of even 0.13% SP (by wt) to PPL improved adsorption substantially, and that mixtures of PPL combined with 1% SP had adsorption very similar to CLSE. Mixtures of SP combined with mPPL had faster adsorption than corresponding mixtures of SP:DPPC, and neither fully matched the adsorption rates of CLSE and SP&PL even at high SP levels (4% in SP:mPPL and 5.2% in SP:DPPC). These results demonstrate that although the secondary zwitterionic and anionic phospholipids and neutral lipids in lung surfactant enhance adsorption relative to DPPC, the hydrophobic SP have a much more pronounced effect in promoting the rapid entry of pulmonary surfactant into the air-water interface.

Phosphatidylcholine molecular species of calf lung surfactant.

This paper reports the detailed composition of molecular species of the phosphatidylcholines (PCs) in pulmonary surfactant from calves. PC isolated by thin-layer chromatography (TLC) was converted to benzoylated diradyl glyceride derivatives, which were separated by TLC according to linkage group. Quantification of linkage groups by analysis of total fatty acid content demonstrated that surfactant PC contained 97.2% diacyl, 2.4% alkyl-acyl, and 0.4% alkenyl-acyl compounds. The diacyl and alkyl-acyl diglyceride derivatives were separated into individual molecular species by high-performance liquid chromatography. Four major species constituted 87% of the diacyl compounds. Dipalmitoyl phosphatidylcholine (DPPC) was the most abundant constituent, contributing 41% of the total PC. A second disaturated species, palmitoyl-myristoyl phosphatidylcholine (PMPC), also contributed an additional 12% of total PC. At least 65% of PMPC occurred as the 1-palmitoyl-2-myristoyl/isomer, which has a lower melting point than the 1-myristoyl-2-palmitoyl compound. These results show that most of pulmonary surfactant PC is a relatively simple mixture, that numerous minor compounds are present in small but possibly important amounts, and that in surfactant from calves, the widely reported estimate that DPPC constitutes 60% of surfactant PC is too large by 50%.

Dynamic surface activity of films of lung surfactant phospholipids, hydrophobic proteins, and neutral lipids.

Surface pressure-area (pi-A) isotherms during dynamic cycling were measured for films of dipalmitoyl phosphatidylcholine (DPPC) and column-separated fractions of calf lung surfactant extract (CLSE). Emphasis was on defining the relative importance of lung surfactant phospholipids (PPL), neutral lipids (N), and hydrophobic proteins (SP) in facilitating dynamic respreading and surface tension lowering within the interfacial film itself. Solvent-spread films in a Wilhelmy balance were studied at 23 degrees and 37 degrees C over a range of cycling rates for initial concentrations giving both monomolecular and surface-excess films. A striking finding was that PPL films containing the complete mix of surfactant phospholipids had greatly improved dynamic respreading compared to DPPC, particularly in surface excess films (30 and 15 Angstrum 2/molecule). Hydrophobic SP gave an additional increase in dynamic respreading in SP&PL compared to PPL films for initial concentrations of 60, 30, and 15 Anstrum 2/molecule. Neutral lipids also improved respreading slightly in N&PL versus PPL films, but maximum surface pressures in N&PL films at 37 degrees C were consistently the lowest of any surfactant subfraction. Spread films of SP&PL at 60 and 30 Angstrum 2/molecule had lower maximum pressures than PPL, but maximum pressures were slightly larger for SP&PL films at high initial concentration (15 Anstrum 2/molecule). Supplementary oscillating bubble studies involving both adsorption and film dynamics at rapid cycling rate (20 cycles/min) showed that dispersions of CLSE and SP&PL lowered surface tension to < 1 mN/m, while PPL and N&PL had elevated minimums of 21 mN/m. These results show that secondary surfactant phospholipids in addition to DPPC are important in the film behavior of pulmonary surfactant, giving improved respreading and overall pi-A isotherms very different from disaturated phospholipids. Hydrophobic SP also increase respreading in the interfacial film, in addition to their known action in increasing surfactant adsorption. SP may also improve film stability at high interfacial concentrations of phospholipid, although they were destabilizing in more dilute films. Neutral lipids contributed minor increases in surfactant respreading, but were consistently detrimental to surface tension lowering.

Separation of subfractions of the hydrophobic components of calf lung surfactant.

This study reports the biochemical separation of the hydrophobic constituents of calf lung surfactant into separate fractions from which specific components are excluded. Gel permeation chromatography on LH-20 with acidified chloroform-methanol separated the constituents of calf lung surfactant extract (CLSE) into fractions containing purified phospholipids (PPL), the neutral lipids and phospholipids (N&PL), or the hydrophobic surfactant proteins (SP)-B and -C together with the phospholipids (SP&PL). Extraction of acid to prevent phospholipid degradation after separation reduced recovery of the apoproteins in SP&PL. This fraction was therefore supplemented with protein purified separately to attain the initial levels present in CLSE. Biochemical analyses confirmed that the resulting preparations had the expected composition not only of protein, neutral lipids and phospholipids, but also of the phospholipid head groups. In addition to these fractions obtained with acidified solvent, elution of CLSE with chloroform-methanol without acid yielded the zwitterionic phospholipids substantially depleted of anionic phosphatidylglycerol and phosphatidylinositol. Limited interfacial measurements also demonstrated that the process of separation did not alter the fundamental surface characteristics of the surfactant constituents. Recombined CLSE (rCLSE) reconstituted from all of the separated components had surface activity indistinguishable from the original CLSE. The individual fractions of surfactant components also had average molecular areas at the air-liquid interface which agreed with predictions based on their biochemical composition. These well defined preparations of the hydrophobic constituents of pulmonary surfactant provide the basis for future studies to establish the role of individual components in the function of this complex surface active material.

Changes in subphase aggregates in rabbits injured by free fatty acid.

Rabbits treated with intravenous free fatty acid suffer an acute lung injury. Material obtained from these lungs by bronchoalveolar lavage (BAL) has dramatically impaired ability to lower surface tension in vitro despite normal levels of surfactant phospholipids. Although large quantities of surface-active inhibitors are present in BAL, their effects are not sufficient to explain the magnitude of surfactant inactivation. This study determines if alterations in the surfactant aggregates can explain the loss of surfactant function in fatty acid lung injury. In injured animals, the larger, most active surfactant particles recovered by centrifugal pelleting were found to be decreased in amount. The remaining large particles had reduced surface activity compared with control aggregates. In addition, large particles in injured animals had a higher density than control animals on sucrose gradients following equilibrium centrifugation. Interaction with serum components present in the injured BAL could explain these higher densities. The ability of the injured BAL to lower surface tension was improved by supplementation with normal levels of particles from injured lungs. Supplementation of injured BAL with control large aggregates improved activity further and restored the ability to lower surface tension to < 1 mN/m. Therefore both the decreased amount and activity of large surfactant aggregates in injured animals contributed significantly to the observed inactivation of surfactant. Diminished surfactant function from alteration in surfactant aggregates is a mechanism common to other forms of acute lung injury, and the design of therapies with exogenous surfactants in injured lungs will need to consider strategies that restore surfactant function towards normal.

Human engineering for the space station.

NASA: Human factor engineering standards and considerations for the International Space Station are reviewed. Factors considered for laboratory and habitation modules, workstations, visual displays, and EVA worksites are discussed.^ieng