Successful surgical repair of aortic dissection presenting with complete heart block.

Acute dissection of the ascending aorta can present with complete heart block if the dissecting hematoma involves the interatrial septum near the atrioventricular node. We report a case of acute type A dissection presenting with complete heart block treated with emergency grafting of the ascending aorta, aortic valve replacement, and coronary artery bypass grafting. The patient survived, although complete heart block persisted requiring permanent pacemaker implantation.

Inhibition of central nervous system aromatase activity: a mechanism for fenarimol-induced infertility in the male rat.

Fenarimol (alpha-(2-chlorophenyl)-alpha(4-chlorophenyl)-5-pyrimidine-methanol), a pyrimidine carbinol agricultural fungicide, was previously reported to cause a dose-related decrease in fertility in rats (K. S. Hirsch, E. R. Adams, D. G. Hoffman, J. K. Markham, and N. V. Owen (1986), Toxicol. Appl. Pharmacol. 86, 391-399). Based on the results of a number of reproduction studies (K. S. Hirsch, E. R. Adams, D. G. Hoffman, J. K. Markham, and N. V. Owen (1986), Toxicol. Appl. Pharmacol. 86, 391-399), the infertility appeared to be associated with an impairment of male sexual behavior. When [14C]fenarimol was administered to the dam, high concentrations of radioactivity were observed in the neonatal hypothalamus, which functions in the development and subsequent expression of male sexual behavior. In the present studies fenarimol exhibited neither antiandrogenic nor antiestrogenic activities. The compound did, however, prevent the increase in nuclear estrogen receptors in the brain which normally occurs in the male during the early postnatal period. These results suggested that fenarimol might be acting to inhibit estrogen biosynthesis (via the aromatase enzyme complex) within the central nervous system. [3H]Testosterone was administered to neonatal rats, and the tritiated metabolites were isolated. Testosterone and dihydrotestosterone (17 beta-hydroxy-5 alpha-androstan-3-one) concentrations were similar in all treatment groups. Tritiated estrogens were detected in the brain cell nuclei from control neonates but not in neonates exposed to fenarimol. Fenarimol was also observed to inhibit rat ovarian aromatase activity in vitro. These data indicate that the decrease in male sexual behavior and the infertility associated with exposure to fenarimol were, most likely, due to inhibition of aromatase activity within the central nervous system.

Effects of in utero and in vitro incubation on the lipid-bound fatty acids and sterols of porcine spermatozoa.

Sperm-rich semen and washed porcine spermatozoa were incubated for up to 2 hr either in utero in the presence of oviduct fluid or in vitro at 37 degrees C. Sperm lipids were extracted and separated into phospholipid and neutral lipid fractions. Eleven phospholipid and five neutral lipid fatty acids were identified and quantified using GC and GC-MS. The percentage of 22:5n6, the major phospholipid fatty acid, decreased slightly but significantly during 1.5 hr of in utero incubation (41.2-38.0%), but after 2.0 hr of in utero incubation no significant difference was observed (40.0%). None of the phospholipid fatty acids changed in concentration during in vitro incubation. The mole ratio of phospholipid to phospholipid fatty acid (1.00:1.27) did not change during incubation. The levels of neutral lipid-bound 14:0 decreased (43.5% to 31.8%) and that of 18:0 increased (11.1% to 18.2%) during in utero incubation. Similar but less pronounced changes were observed during in vitro incubation. (43.5% to 36.0%; and 11.1% to 15.8%, respectively). Two major sterols, cholesterol (73%) and desmosterol (27%) were identified by gas chromatography-mass spectrometry. The mole ratio of phospholipid to sterol (2.47:1:00) did not change during incubation.

Discovery and development of a novel class of nonsteroidal aromatase inhibitors.

Efforts to develop a novel class of nonsteroidal aromatase inhibitors began with the discovery that the infertility in male rats exposed to high levels of the agricultural fungicide, fenarimol (alpha-(2-chlorophenyl)-alpha-(4-chlorophenyl)-5-pyrimidine-methanol), was attributable to the inhibition of aromatase activity within the central nervous system during the critical neonatal period. Although fenarimol was not particularly potent in inhibiting rat ovarian microsome aromatase activity in vitro (50% inhibition (IC50) = 4.1 microM). Subsequent testing of a number of analogues led to the identification of LY56110 (alpha,alpha-bis(4-chlorophenyl)-5-methylpyrimidine) which exhibited an IC50 of 29 nM. LY56110 was orally active, blocking the testosterone-induced increase of uterine weight and ovarian estrogen biosynthesis in immature female rats. In rats with established DMBA-induced mammary carcinoma, complete tumor regression was observed in 80% of the animals. Development of LY56110 was, however, stopped because of its effects on hepatic microsomal enzymes and an unacceptably long half-life. Structural modifications resulted in the development of the indenopyrimidines. LY113174 (8-chloro-5-(4-chlorophenyl)-5H-indeno less than 1, 2D greater than pyrimidine) was highly effective in vitro (IC50 = 24 nM) and in vivo but was far less potent than LY56110 with respect to induction of hepatic microsomal enzymes. LY113174 exhibited an acceptable biological half-life and had no effect on cholesterol side-chain cleavage. The indenopyrimidines appear to be a novel class of nonsteroidal aromatase inhibitors which may prove useful in the treatment of estrogen-dependent diseases.

Coupled beta-cyclodextrin and reverse-phase high-performance liquid chromatography for assessing biphenyl hydroxylase activity in hepatic 9000g supernatant.

Coupled beta-cyclodextrin bonded-phase and reverse-phase high-performance liquid chromatography with fluorescence detection has been employed to detect the major hydroxylated metabolites of biphenyl following in vitro incubation with hepatic 9000g supernatant. The method requires only 0.3 mg of protein and its sensitivity was as low as 0.36 nmol metabolite formed/mg protein/h (0.32 pmol injected) for 2-, 3-, and 4-hydroxybiphenyl. Microsomes need not be purified and no organic extraction or derivatization was required. The method was employed successfully with samples from rats and mice treated with Aroclor, beta-naphthoflavone, or phenobarbital; from monkeys dosed with Aroclor; and from untreated dogs.

Comparison of continuous positive airway pressure, incentive spirometry, and conservative therapy after cardiac operations.

Of 38 patients undergoing median sternotomy for cardiac operations all developed profound restrictive defects in pulmonary function during the first 72 h after tracheal extubation. Although decreased lung volumes were refractory to correction by vigorous, aggressive pulmonary therapy during this period, frequent and supervised treatment may prevent further deterioration in pulmonary function. The overall incidence of pneumonia was only 3% (1/38). Continuous positive airway pressure delivered by mask proved to be a nearly effortless form of postoperative respiratory therapy that was less painful than incentive spirometry or coughing and deep breathing, and therefore may be preferable.

Diacyl, alkenyl, and alkyl ether phospholipids in ejaculated, in utero-, and in vitro-incubated porcine spermatozoa.

The phospholipids of porcine spermatozoa were analyzed by a hydrolytic procedure directly after ejaculation, and after incubation for 120 min in vitro or in ligated uterine segments of females with induced estrus. Total phospholipid content of ejaculated sperm was 65.7 micro g lipid P per 10(9) sperm, of which 41% was alkyl ether and 23% was alkenyl ether glycerophospholipid. All of the ether phospholipids were choline and ethanolamine glycerophospholipids. In order of decreasing amount (% of total phospholipid), the phospholipids were choline and ethanolamine glycerophospholipids (49.9 and 28.2), sphingolipid (10.6), cardiolipin (5.5), phosphatidylinositol (2.3), phosphatidic acid (1.5), phosphatidylserine (1.2), and phosphatidylglycerol (0.8). Phosphorus-containing sphingolipid separated into two components during thin-layer chromatography. Sphingosine was the only long-chain base identified in either band. Major fatty acids in the band with lower R(f) were 16:0 (56%), 20:0 (23%), and 18:0 (11%) plus smaller amounts of 14:0, 18:1, and 22:0, while those in the band with higher R(f) were 14:0 (30%), 16:0 (45%), and 18:1 (12%) plus smaller amounts of 18:0, 20:0, and 22:0. Choline was the only water-soluble base present in the lower R(f) sphingomyelin while ethanolamine was prevalent in the higher R(f) component. Incubation of washed spermatozoa in Ca(2+)-free Ringer-fructose at 37 degrees C for 2 hr produced no significant change in the level of any of the phospholipids. Incubation of washed sperm in the uterus for 2 hr, in the presence of oviductal secretions, produced an increase in phosphatidylcholine from 7.2 to 10.2 micro g lipid P per 10(9) sperm.-Evans, R. W., D. E. Weaver, and E. D. Clegg. Diacyl, alkenyl, and alkyl ether phospholipids in ejaculated, in utero-, and in vitro-incubated porcine spermatozoa.

Tuberculosis in brood sows and pigs slaughtered in Iowa.

Mycobacterium avium was isolated from 21 of 23 lymph nodes with lesions collected from 23 brood sows and from 17 lymph nodes with lesions of 17 pigs slaughtered at an abattoir in north central Iowa. Mycobacterium avium serotype 2 accounted for more than 65% of the isolations in sows and in pigs. Granulomas with acid-fast bacilli were found in 15 of 23 tissues from brood sows and in 13 of 17 lymph nodes from pigs. Similar microscopic lesions were observed in the sows and pigs.