Nitric oxide, erectile dysfunction and beta-blocker treatment (MR NOED study): benefit of nebivolol versus metoprolol in hypertensive men.

1. Hypertensive men treated with beta-blockers frequently complain of erectile dysfunction. The present study investigated the effects of two beta(1)-adrenoceptor-selective antagonists, namely nebivolol and metoprolol, on erectile function in hypertensive men. 2. Male out-patients (age range 40-55 years) with newly diagnosed or existing stage 1 essential hypertension (mean seated systolic blood pressure 140-159 mmHg; diastolic blood pressure 90-99 mmHg) were enrolled in the study. All patients lived in a stable, heterosexual partnership and had no history of sexual dysfunction. After a 2-week placebo run-in period, patients were randomized double-blind to either Treatment group A (comprising nebivolol 5 mg once daily for 12 weeks, followed by placebo for 2 weeks and then metoprolol succinate 95 mg once daily for 12 weeks) or Treatment group B (comprising metoprolol succinate 95 mg for 12 weeks, placebo for 2 weeks and then nebivolol 5 mg for 12 weeks). An international index of erectile function (IIEF) questionnaire and a diary documented patients' sexual function and activity. 3. Nebivolol and metoprolol lowered blood pressure to a similar extent. Metoprolol, but not nebivolol, significantly decreased the IIEF erectile function subscore by 0.92 in the first 8 weeks after onset of beta-blocker treatment. In contrast with metoprolol, nebivolol improved secondary sexual activity scores and other IIEF subscores. 4. Despite similar antihypertensive efficacy of the cardioselective beta(1)-adrenoceptor antagonists nebivolol and metoprolol, nebivolol may offer additional benefits by avoiding erectile dysfunction in male hypertensive patients on long-term beta-adrenoceptor antagonist therapy.

Rapid diagnosis of pulmonary tuberculosis with the LCx Mycobacterium tuberculosis assay and comparison with conventional diagnostic techniques.

The LCx MTB amplification assay is a nucleic acid amplification test intended for the direct detection of Mycobacterium tuberculosis complex in respiratory specimens. We evaluated its performance on 2,001 consecutive respiratory specimens; 78 were culture positive for M. tuberculosis. Sensitivity, specificity, and positive and negative predictive values of this assay for all specimens compared to culture results were 88.5, 97.7, 60.5, and 99.5%, respectively. When referred to resolved clinical diagnosis of active tuberculosis, these values improved to 90.2, 98.4, 72.8, and 99.5%, respectively.

Diagnostic performance of amplified Mycobacterium tuberculosis direct test with cerebrospinal fluid, other nonrespiratory, and respiratory specimens.

The Gen-Probe Amplified Mycobacterium tuberculosis Direct Test (MTD) was adapted to be used for cerebrospinal fluid (CSF) and a large variety of other nonrespiratory specimens. Standardized with artificially spiked dilution series of CSF, the modified MTD procedure consists of (i) increasing the amount of sample 10-fold, (ii) pretreating the specimen with a detergent, and (iii) increasing the amplification time from 2 to 3 h. Performance of MTD in a clinical mycobacteriology laboratory was tested over an extended period of time, involving a total of 322 nonrespiratory as well as 1,117 respiratory specimens from 998 patients. Results from MTD were compared with those from microscopy, culture, analysis of tuberculostearic acid by gas-liquid chromatography-mass spectrometry (CSF only), and the final clinical diagnosis. When MTD results were compared with resolved data, the sensitivity, specificity, and positive and negative predictive values for MTD were 93.1, 97.7, 90.0, and 98.5%, respectively, for nonrespiratory specimens and 86.6, 96.4, 76.8, and 98.1%, respectively, for respiratory specimens. Our data demonstrate that (i) MTD is a robust, highly sensitive and specific technique for the rapid detection of M. tuberculosis complex in all types of clinical specimens, (ii) there was no statistically significant difference (P > 0.005) in sensitivity and specificity for nonrespiratory compared with respiratory specimens, and (iii) repeating all MTDs which yield a result between 30,000 and 200,000 relative light units would help prevent a large number of false positives and, thus, enhance test specificity.

Expression of gap junction connexins in the human endometrium throughout the menstrual cycle.

Expression of connexins, the proteins which comprise gap junction channels, is regulated by ovarian hormones in the female reproductive tract of rodents. In order to determine if these hormones also affect connexin expression in the human uterus, the distribution patterns of different connexins (cx26, cx32, cx43) were investigated by immunohistochemistry in human endometrial tissue collected throughout the menstrual cycle. During the early proliferative phase of the cycle extremely low staining for connexin 43 was observed and connexin 26 antigens could not be detected. An increase in the amount of connexin 43 in stromal cells and of connexin 26 in glandular and luminal epithelial cells was seen from days 11-15 of the cycle. Following ovulation, the expression of both connexins was suppressed and was completely abolished in the late secretory phase. Weak staining for connexin 32 was found mainly in the late proliferative and the early secretory phase and was restricted to the basal membrane region of the glandular cells. These results suggest that the different connexins could represent cell biological markers for the proliferation and differentiation of the human endometrium throughout the menstrual cycle.

Spatial and temporal expression of connexin26 and connexin43 in rat endometrium during trophoblast invasion.

The expression of two different gap junction transcripts, connexin26 and connexin43, has been investigated in rat endometrium during implantation and early chorionic-allantoic placentation. An induction of connexin26 protein is detected locally in the epithelium of the implantation chamber prior to trophoblast invasion. At the same stage connexin43 is found exclusively in the primary decidual zone. By the sixth day of pregnancy the uterine epithelium of the implantation chamber has degenerated and the invading trophoblast is directly confronted with the developing decidua. Connexin26 is then detected in decidual cells accompanying the invading trophoblast, whereas connexin43 has spread through the decidual tissue up into the myometrial layers. This distribution pattern of connexin43 and connexin26 is maintained until at least Day 9 of pregnancy. In decidual cells adjacent to the trophoblast both connexins seem to be coexpressed in the same gap junctional plaque. In these early stages of pregnancy a clear correlation exists between levels of connexin43 mRNA and protein expression. In regard to connexin26 mRNA a similar correlation is found from Day 5 of pregnancy onward. The amount of mRNA on Day 4, however, does not correspond to the amount of connexin26 antigen in the endometrium at that stage. The spatial and temporal expression pattern of connexin26 accompanies the process of embryo implantation in the surrounding endometrium, pointing to a specialized function of these cells.

Localization and synthesis of monoamines in regions of Limax CNS controlling feeding behavior.

Localization and synthesis of dopamine and serotonin in the cerebral and buccal ganglia of Limax maximus were studied. A combination of fluorescence histochemistry, immunocytochemistry, and microchemical analysis showed that both amines were localized to particular cell groups and fiber tracts within and between the two sets of ganglia. Since these ganglia control feeding behavior, which is readily modified by associative learning, these studies have direct bearing on analysis of both motor control and learning mechanisms.

Identification and partial characterization of two proteinases from the cell envelope of Candida albicans blastospores.

As we have communicated previously, the fungal opportunist Candida albicans produces an angiotensin-1 liberating proteinase and a serine proteinase that acts as a converter of the coagulation factor X in vitro (25). Both enzymes are attached to delipidated cell fragments of fungal blastospores. They copurify upon ion exchange chromatography and gel filtration. The enzymes could be separated by hydrophobic chromatography on Phenylsepharose. According to their substrate and inhibition pattern, the enzymes have been classified as an aspartyl proteinase and a chymotrypsin-like proteinase. Their partial characterization includes estimates of the molecular weight and isoelectric points.

[Connective tissue suspension in blade implantations. Preliminary report]. / Bindegewebige Aufhängung bei Blattimplantaten. Vorläufige Mitteilung

An investigation on blade implants is in process. These implants represent endstanding abutments of fixed bridgework. It was found that the implants, adapting to heavy masticatory stresses, show a response in the bone representing a connective tissue suspension.

Feeding value and nutrient preservation of high moisture corn ensiled in conventional silos forlactating dairy cows.

Sixty-one Holstein cows were used at varying stages of lactation to evaluate the feeding value of high moisture shelled corn ensiled in conventional silos. Control rations consisted of comparable amounts of conventional shelled corn dried in commercial drying facilities. Cows fed high moisture corn produced milk of higher fat content (3.09 versus 2.64%) and greater quantities of fat (.73 versus .64 kg) while they consumed less concentrate (9.28 versus 9.84 kg), resulting in the crude fiber content of the dry matter being 14.60% compared to 13.82% for control cows. Covariate adjustment of treatment means to equal intake of crude fiber eliminated differences above. Milk, 4% fat corrected milk, silage, total dry matter intake, and rumen volatile fatty acids were not significantly different between groups. Dry matter recovery following the ensiling process was 96.0 plus or minus 1.9% with 3.0 plus or minus 1.1% classified as spoiled corn, resulting in a total of 7% loss. Recoveries of all proximate constituents were similar to dry matter with the exception of ash (82.4%). Costs of the two systems were evaluated for varying corn prices and moisture.