Centipede envenomation.

Five episodes of envenomation by centipedes in 2 patients are reported. These arthropods are fast-moving, frightening in appearance to some, and may display aggressive behavior. However, stings from these centipedes, like most found worldwide, caused no serious morbidity or mortality. Common effects included intense local pain, erythema, induration, and necrosis, as well as mild constitutional symptoms. All resolved without sequelae. Treatment included pain control, wound care, and tetanus immunization.

Tirofiban administration attenuates platelet and platelet-neutrophil conjugation but not neutrophil degranulation during in vitro VAD circulation.

Ventricular Assist Devices (VADs) have been used as bridges to heart transplantation. However, VAD circulation is complicated by the incidence of thromboembolism, prolonged bleeding, and activation of the inflammatory cascade. We hypothesize that platelet and neutrophil activation are interrelated and linked to the activation of the glycoprotein (GP) IIb/IIIa platelet receptor. The purpose of this study is to evaluate the effects of Tirofiban, a platelet GP IIb/IIIa receptor inhibitor, on platelet and neutrophil activation during simulated VAD circulation. Two groups of five in vitro VAD circuits were simulated with and without Tirofiban using 450 cc of human blood. Blood samples were drawn at specific time intervals up to 72 hours, measuring leukotriene C4 (LTC4), platelet factor four (PF4), and neutrophil elastase. Tirofiban decreased serum levels of PF4 and LTC4 during VAD circulation. Neutrophil elastase secretion was not affected by Tirofiban administration. Preconditioning of VAD circulation with Tirofiban attenuated platelet activation as demonstrated by a decrease in serum PF4 levels. Tirofiban administration ameliorates the inflammatory response by altering platelet-neutrophil interaction as demonstrated by a decrease in LTC4 production. Continued elastase secretion indicates that the inflammatory response is not completely inhibited by Tirofiban administration. These results suggest that neutrophils may be activated by alternative mechanisms. Early complement activation has been demonstrated during in vivo and in vitro VAD circulation and may play a role in mediating inflammatory and thromboembolic reactions during VAD use.

Protection of platelet glycoprotein IIb/IIIa receptor complex preserves platelet function during in vitro ventricular assisted circulation.

Platelet dysfunction probably contributes to bleeding associated with ventricular assist devices (VADs). Previous evidence suggests that VAD associated platelet dysfunction may be due to dysfunction of the platelet fibrinogen receptor. The purpose of this investigation was to test the hypothesis that selective protection of platelet fibrinogen receptor preserves platelet aggregating ability during in vitro ventricular assisted circulation. Eight in vitro nonpulsatile centrifugal VAD circuits were simulated for four days using 450 ml of fresh human whole blood. Temperature, activated clotting time, pH, PCO2, PO2, Ca2+, and glucose were maintained at physiologic values. Flow was maintained at a constant 2.0 L/min/m2. We examined whole blood platelet aggregation induced by ristocetin, collagen, and adenosine diphosphate (ADP). We added a highly specific reversible inhibitor (MK-383) of the glycoprotein (GP) IIb/IIIa receptor complex before start of circulation to the final four VAD experiments. ADP induced aggregation decreased within the first hour of circulation. Ristocetin and collagen induced aggregation decreased to negligible levels after 10 hours of circulation. With MK-383, ristocetin induced aggregation was preserved. Addition of MK-383 did not alter the decrease of ADP and collagen induced aggregation. These results suggest platelet aggregating ability is maintained with protection of the platelet fibrinogen receptor during in vitro ventricular assisted circulation.

Evidence for selective degradation of platelet GP IIb/IIIa complex after prolonged in vitro ventricular assist.

BACKGROUND: Left ventricular assist devices (VAD) have improved survival in patients with end-stage heart failure. Past studies have shown that interactions between blood and synthetic surfaces promote initial bleeding and later thromboembolism. The exact mechanism of blood activation during VAD circulation remains unclear. The purpose of this study was to test the hypothesis that platelet glycoprotein (GP) IIb/IIIa receptor degradation occurs during clinical use of ventricular assist devices. METHODS: Five in vitro nonpulsatile centrifugal VAD circuits were simulated for 4 days using 450 mL of fresh human whole blood. Temperature, activated clotting time, pH, pCO2, pO2, Ca++, and glucose were maintained at physiologic values. Flow was maintained at a constant 2.0 L/min/m2. We examined whole blood platelet aggregation induced by ristocetin, collagen, and adenosine diphosphate (ATP). We also examined whole blood platelet degranulation induced by collagen and ADP. RESULTS: Platelet aggregation in response to ristocetin, collagen, and ADP irreversibly and progressively declined with prolonged circulation in the VAD. While ADP-induced aggregation declined within the first hour, ristocetin and collagen-induced aggregation declined after 10 hours. Collagen-induced platelet degranulation decreased similar to aggregation, whereas ADP-induced degranulation continued and was preserved throughout the experiment. CONCLUSIONS: These results suggest prolonged circulation of human blood in a VAD circuit irreversibly impair platelet aggregation. The response of circulating platelets to individual agonists suggests that this platelet degradation is partially receptor specific. In our VAD system, ADP-stimulated platelet aggregation is more rapidly degraded with circulation. These results offer preliminary evidence that circulation of human blood in a VAD circuit leads to early degradation of the platelet GP IIb/IIIa complex. GP IIb/IIIa complex degradation is likely to be the mechanism of early VAD associated bleeding.

Functional reconstruction of trans regulation of the Ultrabithorax promoter by the products of two antagonistic genes, trithorax and Polycomb.

Maintenance of the "on-off" state of Drosophila homeotic genes in Antennapedia and bithorax complexes requires activities of the trithorax and Polycomb groups of genes. To identify cis-acting sequences for functional reconstruction of regulation by both trithorax and Polycomb, we examined the expression patterns of several Ubx-lacZ transgenes that carry upstream fragments corresponding to a region of approximately 50 kb. A 14.5-kb fragment from the postbithorax/bithoraxoid region of Ultrabithorax exhibited proper regulation by both trithorax and Polycomb in the embryonic central nervous system. Using a Drosophila haploid cell line for transient expression, we found that trithorax or Polycomb can function independently through this upstream fragment to activate or repress the Ultrabithorax promoter, respectively. Studies of deletion mutants of trithorax and Polycomb demonstrated that trithorax-dependent activation requires the central zinc-binding domain, while Polycomb-dependent repression requires the intact chromodomain. In addition, trithorax-dependent activity can be abrogated by increasing the amount of Polycomb, suggesting a competitive interaction between the products of trithorax and Polycomb. Deletion analysis of this fragment demonstrated that a 440-bp fragment contains response elements for both trithorax and Polycomb. Furthermore, we showed that the integrity of the proximal promoter region is essential for trithorax-dependent activation, implicating a long-range interaction for promoter activation.

Xenopus 5S gene transcription factor, TFIIIA: characterization of a cDNA clone and measurement of RNA levels throughout development.

Initiation of 5S RNA gene transcription in Xenopus oocytes requires a 38,500 dalton polypeptide, TFIIIA. The levels of both 5S RNA and TFIIIA are regulated throughout oogenesis and embryonic development. To delineate the mechanisms by which the corresponding genes are regulated, as well as to determine the primary structure of TFIIIA, we have isolated a cDNA clone that encodes TFIIIA. Using the cDNA clone, we have determined that there is (are) one or a small number of TFIIIA gene(s) per Xenopus haploid genome, and we have estimated the size and levels of TFIIIA RNA throughout Xenopus development. We report sequence homologies between TFIIIA cDNA and regulatory regions of the Xenopus tmet and 5S RNA genes. Implications of these data for developmental regulation of the TFIIIA and 5S RNA genes are discussed.

Tandemly repeated hexanucleotide at Tetrahymena rDNA free end is generated from a single copy during development.

The linear extrachromosomal ribosomal DNA of Tetrahymena is generated from a single integrated copy during macronuclear development. The free ends of this extrachromosomal gene contain 20-70 tandem repeats of the hexanucleotide CCCCAA. We have determined the nucleotide sequence at the same (3') end of the single, integrated micronuclear gene. In contrast to the extrachromosomal gene, only a single CCCCAA sequence was found at this position. The same result was obtained from two independently isolated DNA clones, and was therefore not likely an artifact of cloning. Comparisons of the genomic DNA with the cloned fragment by Southern hybridization also supported this argument. Thus the tandemly repetitive hexanucleotide at the free ends of the extrachromosomal rDNA is not an inherited feature, and must be generated during the development of the macronucleus.