Cardiovascular effects of anti-G suit and cooling garment during space shuttle re-entry and landing.

BACKGROUND: Many cardiovascular changes associated with spaceflight reduce the ability of the cardiovascular system to oppose gravity on return to Earth, leaving astronauts susceptible to orthostatic hypotension during re-entry and landing. Consequently, an anti-G suit was developed to protect arterial pressure during re-entry. A liquid cooling garment (LCG) was then needed to alleviate the thermal stress resulting from use of the launch and entry suit. METHODS: We studied 34 astronauts on 22 flights (4-16 d). Subjects were studied 10 d before launch and on landing day. Preflight, crewmembers were suited with their anti-G suits set to the intended inflation for re-entry. Three consecutive measurements of heart rate and arterial pressure were obtained while seated and then again while standing. Three subjects who inflated the anti-G suits also donned the LCG for landing. Arterial pressure and heart rate were measured every 5 min during the de-orbit maneuver, through maximum G-loading (max-G) and touch down (TD). After TD, crew-members again initiated three seated measurements followed by three standing measurements. RESULTS: Astronauts with inflated anti-G suits had higher arterial pressure than those who did not have inflated anti-G suits during re-entry and landing (133.1 +/- 2.5/76.1 +/- 2.1 vs. 128.3 +/- 4.2/79.3 +/- 2.9, de-orbit; 157.3 +/- 4.5/102.1 +/- 3.6 vs. 145.2 +/- 10.5/95.7 + 5.5, max-G; 159.6 +/- 3.9/103.7 +/- 3.3 vs. 134.1 +/- 5.1/85.7 +/- 3.1, TD). In the group with inflated anti-G suits, those who also wore the LCG exhibited significantly lower heart rates than those who did not (75.7 +/- 11.5 vs. 86.5 +/- 6.2, de-orbit; 79.5 +/- 24.8 vs. 112.1 +/- 8.7, max-G; 84.7 +/- 8.0 vs. 110.5 +/- 7.9, TD). CONCLUSIONS: The anti-G suit is effective in supporting arterial pressure. The addition of the LCG lowers heart rate during re-entry.

Use of monoclonal antibodies specific for the a determinant of K88 pili for detection of enterotoxigenic Escherichia coli in pigs.

Monoclonal antibodies directed against the a determinant of K88 pili from porcine enterotoxigenic Escherichia coli which react with all three K88 variants have been produced. These antibodies have been used for diagnosis of porcine enterotoxigenic E. coli in a direct enzyme-linked immunosorbent assay with sensitivity to 50 ng of pilus protein per ml.

Induction of tumor cytotoxic immune cells using a protein from the bitter melon (Momordica charantia).

The fruit and seeds of the bitter melon (Momordica charantia) have been reported to have anti-leukemic and antiviral activities. This anti-leukemic and antiviral action was associated with an activation of murine lymphocytes. A partially purified protein factor from the bitter melon caused an infiltration and activation of peritoneal exudate cells in C57B1/6J, C3H/HeJ, and C3H/HeN mice. When the extract was injected twice a week at 8 micrograms of protein per ip injection for 0-4 weeks, the peritoneal exudate cells from the treated mice were cytotoxic in a long-term (18-hr) 51Cr-release assay against a range of labeled targets: L1210, P388, and MOLT-4 tumor cells. Cytotoxicity was also observed against YAC-1 targets in a short-term (4-hr) assay. Fractionation of the cytotoxic immune cells implicated a nonadherent cell population which was capable of killing an NK-sensitive cell line in a 4-hr 51Cr-release assay. Unit gravity sedimentation studies indicated that the cytotoxicity was due to either a neutrophil or a large lymphocyte. Antibody depletion experiments using antibody to asialo GM1, an NK cell-specific antibody, depleted cytotoxicity observed in nonadherent, Ficoll/Hypaque-separated PEC. This suggests that at least part of the anti-leukemic activity of the bitter melon extract is due to the activation of NK cells in the host mouse.

Immune response to ultraviolet-induced tumors. III. Analysis of cloned lymphocyte populations exhibiting antitumor activity.

Previously, we hypothesized that natural killer lymphocytes could function as effector cells in the rejection of UV-induced tumors in tumor-immune animals. Immunization with progressor UV-tumor 2237 induced lymphocytes exhibiting natural cell-mediated cytotoxicity but failed to elicit tumor-specific cytolytic T lymphocytes. In the present investigation, T lymphocyte cloning technology provided a means of isolating homogeneous lymphocyte populations exhibiting CTL and NK activities. Clones with both CTL and NK activity were isolated from regressor-1316-immune mice, but NK-like clones only were isolated from progressor-2237-immune mice. An evaluation of the in situ anti-UV-tumor action of a representative NK lymphocyte clone revealed that these cells could in fact prevent tumor outgrowth, supporting our hypothesis that these cells could function as effector cells in UV-tumor rejection responses in tumor-immune animals.

Immune response to ultraviolet-induced tumors. II. Effector cells in tumor immunity.

Skin tumors induced in mice by chronic ultraviolet irradiation are highly antigenic and can induce a state of transplantation immunity in syngeneic hosts. In the present study, we compared the in vitro cytolytic activity of splenic lymphocytes from mice immunized with either a regressor or a progressor UV-tumor. The results of this comparison supported previous work implicating a role for tumor-specific cytolytic T lymphocytes in the rejection of regressor UV-tumors. The results also revealed that immunization with the progressor UV-tumor 2237 failed to elicit detectable levels of progressor tumor-specific CTL in animals capable of rejecting the immunizing tumor. Interestingly, following in vitro resensitization of both regressor and progressor immune spleen cells, we found a previously undetected lymphocyte population with anti-UV-tumor activity. Besides lysing UV-tumors in vitro, these lymphocytes also lysed a wide variety of additional tumor targets. This effector activity along with the analysis of cell surface markers indicated that these lymphocytes belong to that category of effector cells mediating natural-cell-mediated cytotoxicity (NCMC). As we had not detected cells with this activity in splenic lymphocyte preparations prior to in vitro resensitization, we examined lymphocytes from the local tumor environment during the course of progressor 2237 tumor rejection for either NCMC activity or tumor-specific CTL activity. This in situ analysis revealed lymphocytes exhibiting significant levels of cytolytic activity against several UV-tumors, thus implicating NK cells as effector cells in the rejection of progressor UV-tumors by immune animals. The mechanisms whereby NK cells with NCMC activity could be induced in immune animals are discussed in the context of class-II-restricted immune responses by helper/inducer T lymphocytes.

Predominance of the ac variant in K88-positive Escherichia coli isolates from swine.

Monoclonal antibodies to K88ac and K88ab were used in enzyme-linked immunosorbent assays on Escherichia coli cultures known to produce K88 pili. A total of 415 K88-positive E. coli isolates from nine states were all found to be the K88ac variant. The cultures tested were isolated during the years 1976 to 1985.

Cutaneous vascular sensitivity to lower aliphatic alcohols and aldehydes in Orientals.

An ethnic predisposition to ethanol-provoked flushing among diverse Mongoloid populations may be the consequence of a delayed oxidation and accumulation of acetaldehyde. Orientals who flush after oral alcohol are more likely to have cutaneous erythema after topical ethanol or propanol, and the cutaneous vascular reaction to primary alcohols is actually provoked by the corresponding aldehyde. The cutaneous reaction to primary alcohols can be totally blocked by pretreatment with 4-methylpyrazole, a potent inhibitor of alcohol dehydrogenase.

Prostaglandins and nicotinate-provoked increase in cutaneous blood flow.

The mechanism of topically applied methyl nicotinate-induced local cutaneous erythema was studied in normal human subjects. Aqueous methyl nicotinate (0, 0.1, 1.0, 10.0, and 100 mmol/L) was applied to the volar forearms in quadruplicate after oral pretreatments with 25 mg doxepin hydrochloride, 600 mg ibuprofen, 50 mg indomethacin, 975 mg aspirin, and lactose placebo. The cutaneous vascular response was monitored by laser Doppler velocimetry. Although doxepin did not affect the cutaneous vascular response to methyl nicotinate, indomethacin, ibuprofen, and aspirin significantly suppressed the response. Because indomethacin, ibuprofen, and aspirin have different chemical structures, the common property of inhibition of the response to methyl nicotinate may be assigned to their common pharmacologic action, i.e., inhibition of prostaglandin bioformation.

The significance of hydronephrosis after aortofemoral reconstruction.

Hydronephrosis due to ureteral obstruction is a rarely reported complication of aortic bypass grafting. Patients who had undergone aortic reconstruction were screened using serial real-time ultrasound examination to detect ureteral obstruction. The clinical course and incidence of graft complications, renal impairment, amputation, and death were determined for hydronephrotic patients and compared with the incidence of similar complications in a control group. Hydronephrotic patients had an extremely high incidence of graft infection, anastomotic aneurysm, graft thrombosis, and amputation. Obstructed ureters were at high risk for intraoperative injury during removal of infected aortic grafts. A subgroup of hydronephrotic patients who developed multiple anastomotic aneurysms without graft infection was identified. Hydronephrosis was frequently silent, and detection required active investigation. After aortic reconstruction, routine screening with real-time ultrasound examination appears warranted to identify a high-risk subset of patients.

Immune response to ultraviolet-induced tumors. I. Transplantation immunity developing in syngeneic mice in response to progressor ultraviolet-induced tumors.

Ultraviolet-light-induced murine skin tumors were analyzed for the ability to induce transplantation immunity and cytotoxic lymphocytes in syngeneic mice. A correlation was found between tumor regression and the induction of cytotoxic T cells with specificity for a unique tumor-associated antigen. Processing tumors possessed tumor-associated transplantation antigens (TATA), which could be demonstrated by transplantation in hyperimmunized mice. Progression correlated with a lack of splenic cytotoxic T cell reactivity. High levels of in situ cytotoxic reactivity could be induced by presenting the tumor-specific antigen on nongrowing tumor cells. Tumor-bearer hosts were shown to be sensitized to TATA because cultured tumor-bearer T cells adoptively transferred protection against tumor outgrowth. Mechanisms of the in vivo suppression of antitumor immunity are discussed.

Giant cell arteritis involving the carotid artery.

A case of transient cerebral and retinal ischemia caused by giant cell arteritis is reported. Because of the distribution of the disease, the patient was treated with a subclavian to carotid reversed saphenous vein graft. The clinical features of giant cell arteritis affecting the branches of the aortic arch are reviewed, and the management of atypical carotid artery lesions is discussed.

Abdominal aortic aneurysms.

Aneurysms are common in our increasingly elderly population, and are a major threat to life and limb. Until the advent of vascular reconstructive techniques, aneurysm patients were subject to an overwhelming risk of death from exsanguination. The first successful repair of an abdominal aortic aneurysm using an interposed arterial homograft was reported by Dubost in 1952. A milestone in the evolution of vascular surgery, this event and subsequent diagnostic, operative and prosthetic graft refinements have permitted patients with an unruptured abdominal aortic aneurysm to enjoy a better prognosis than patients with almost any other form of major systemic illness.

In vivo antitumor activity of the bitter melon (Momordica charantia).

The in vivo antitumor activity of a crude extract from the bitter melon (Momordica charantia) was determined. The extract inhibited tumor formation in CBA/H mice which had been given i.p. injections of 1.0 X 10(5) CBA/Dl tumor cells (77% of the untreated mice with tumors versus 33% of the treated mice with tumors after 6 weeks). The extract also inhibited tumor formation in DBA/2 mice which had been given i.p. injections of either 1 X 10(5) P388 tumor cells (0% of untreated mice survived after 30 days versus 40% survival of the treated mice) or 1 X 10(5) L1210 tumor cells (0% survival of untreated mice versus 100% of treated mice after 30 days). The in vivo antitumor effect required both the prior exposure of tumor cells to the extract (2 hr) in vitro and i.p., biweekly injections of the extract into the mice. The optimum dose for tumor inhibition (8 micrograms protein, biweekly, i.p.) was not toxic to mice for at least 45 days of treatment. This same treatment caused a marked enhancement of C3H mouse thymic cell response to concanavalin A in vitro. When compared to the untreated control mice, the bitter melon-injected animals exhibited a 4-fold-higher incorporation of tritiated thymidine into trichloroacetic acid-precipitable material after 48 hr of exposure to 50 micrograms of concanavalin A. Nylon wool-purified spleen cells from these same bitter melon-treated mice exhibited an enhanced mixed lymphocyte reaction when exposed to irradiated P388 stimulator cells (186% of the untreated control mice). These data indicate that in vivo enhancement of immune functions may contribute to the antitumor effects of the bitter melon extract.

The effects of prehospital trauma care on survival from a 50-meter fall.

One hundred eighty individuals are known to have jumped or fallen from Seattle's Aurora Bridge during the past 49 years. The survival rate has been increasing, as has been the severity of injury experienced by the survivors. Both prehospital resuscitative measures and advances in the overall care of the trauma patients in hospital may have contributed to this. The survival statistics and injury severity scores of this homogeneous group of patients before and after the institution of a sophisticated prehospital emergency medical care program (Medic I) provide historically controlled data on the role of this type of system in the care of trauma patients. More patients who were alive at the scene arrived at the hospital alive after the development of the Medic I program. Overall survival was tripled. Patients with more severe injuries survived. These data demonstrate that prehospital airway control, ventilation, initiation of fluid resuscitation and cardiovascular support by physician-supervised paramedical personnel can significantly benefit multiple trauma patients. In this context, the Medic I approach was superior to the previously existing 'load and go' system.

Identification of tumor-associated antigens on ultraviolet light-induced tumors using antitumor antibodies developed in ascites fluid.

A method is described which leads to the production of large amounts of ascites containing antitumor antibody in small numbers of mice. The antibody was then used to identify and characterize tumor-associated antigens on an ultraviolet light-induced murine skin fibrosarcoma. The antibody showed specific complement-dependent cytotoxicity to the homologous tumor and to an allogeneic tumor line which displayed a glycoprotein viral determinant with a molecular weight of 70,000 on its surface. Absorption of the immune ascites with other tumor cell lines removed the cytotoxicity in relation to the presence of the glycoprotein. Isolation of the tumor cell surface components binding antibody revealed two components with molecular weights of approximately 70,000 and 60,000. The Mr 70,000 component was identified as viral gp70 by peptide mapping.

Identification and cytotoxic reactivity of inflammatory cells recovered from progressing or regressing syngeneic UV-induced murine tumors.

Most tumors induced in C3H mice by ultraviolet (UV) light are immunologically rejected by normal syngeneic recipients, but will grow progressively in immunosuppressed mice and in mice treated with UV light. In this study we compared the composition and cytotoxic activity of the inflammatory cell infiltrate from tumors transplanted into syngeneic UV-irradiated or unirradiated mice. Tumor fragments were implanted in either normal (regressor) or UV-treated (progressor) mice, and removed on various days after implantation and mechanically dissociated. The cells were examined by immunofluorescence for theta and immunoglobulin markers, stained for morphologic examination, and tested for cytotoxicity against the tumor. No significant differences were noted in numbers of macrophages, granulocytes, or B cells recovered from progressing or regressing tumors on day 6, the time of greatest activity. However, the numbers of T cells recovered from tumor fragments implanted in normal mice was approximately 3-fold that recovered from tumor fragments implanted in UV-treated mice. Lymphocytes recovered from regressing tumor fragments were specifically cytotoxic for that tumor in a microcytotoxicity test; those from progressing tumor fragments were not cytotoxic.

In vitro reactivity of splenic lymphocytes from normal and UV-irradiated mice against syngeneic UV-induced tumors.

Skin tumors induced in mice by chronic ultraviolet (UV) irradiation are highly antigenic and are frequently immunologically rejected upon transplantation to normal syngeneic recipients. In this study we characterized this immune response with an in vitro microcytotoxicity test. Cytotoxic activity was present in the spleen cells of mice given a single injection of syngeneic UV-induced fibrosarcoma cells. After removal of adherent spleen cells, the remaining splenic lymphocytes were specifically cytotoxic for the immunizing tumor and showed no cross-reactivity with other syngeneic UV-induced or methylcholanthrene-induced tumors of similar histologic type. The level of cell-mediated reactivity against UV-induced tumors was quite high compared to that obtained with syngeneic tumors induced by methylcholanthrene, and the cytotoxicity was attributable to a population of theta antigen-bearing lymphocytes. With this in vitro test, we compared the response of normal mice, which reject a syngeneic tumor challenge, with that of UV-irradiated mice, in which the syngeneic UV-induced tumors grow progressively. After tumor cell inoculation, lymphocytes form the unirradiated (regressor) mice showed a high degree of cytotoxicity that reached a maximum level 8 days after injection. In contrast, no reactivity could be detected in the spleens of tumor-challenged UV-irradiated (progressor) mice.