Neurological and histological outcomes after subarachnoid injection of a liposomal bupivacaine suspension in pigs: a pilot study.

BACKGROUND: An injectable liposomal bupivacaine suspension (EXPAREL™) is approved by the US Food and Drug Administration for analgesia by tissue infiltration and interscalene brachial plexus, but not for use in the neuraxial space. This pilot study describes neurological and histological outcomes of escalating doses of this extended-release formulation of bupivacaine after subarachnoid administration. METHODS: Twenty-five pigs (Sus scrofa domesticus) weighing 36.2 (4.4) kg were randomly assigned to one of five groups to receive a subarachnoid injection of sodium chloride 0.9%, 3 ml (negative control), preservative-free bupivacaine hydrochloride 0.5%, 3 ml (positive control), or one of three doses of liposomal bupivacaine suspension 1.33%: 1.5, 3, or 5 ml. After recovering from general anaesthesia, neurological outcomes were assessed by blinded observers. Three weeks later, the animals were sacrificed for histological evaluations of neurotoxicity. RESULTS: Animals that received sodium chloride 0.9%, bupivacaine hydrochloride, or liposomal bupivacaine 1.5 ml recovered within 2, 5, or 4 h, respectively. Animals that received liposomal bupivacaine 3 or 5 ml exhibited signs of neuraxial block (decreased nociception and proprioception) up to 32 h after injection. No histological evidence of neurotoxicity was found in any of the groups. CONCLUSIONS: Subarachnoid administration of liposomal bupivacaine in pigs exhibited a dose-response effect, and resulted in longer duration of neuraxial block than bupivacaine hydrochloride without histological evidence of neurotoxicity. Our study contributes preliminary data to inform further toxicological assessments and regulatory approval before subarachnoid administration in humans.

Step initiation interferes with working memory in nondisabled patients with the earliest multiple sclerosis-A dual-task study.

Balance and cognition are affected by multiple sclerosis (MS). Cognitive-motor interference (CMI) is important for balance impairment in MS, however little is known about CMI at the earliest stages of the disease. Step initiation (SI) with anticipatory postural adjustments (APAs) has been linked to postural instability and falls in subjects with MS, therefore we aimed to assess CMI between SI and the two storage systems of working memory in patients with clinically isolated syndrome (presented as optic neuritis-ON) suggestive of MS. Twenty patients with normal/near normal visual acuity and 20 age-, weight-, height-, sex- and education-matched control subjects were included. APAs were studied using center of pressure measures in three conditions: SI alone, SI+Brooks' spatial- and SI+2-back verbal working memory task. Decrements (% change) in performance on cognitive tasks and in APA parameters were calculated. CMI was assessed combining the two decrements scores. Performance on both cognitive tasks was more affected by dual-tasking in patients compared to healthy subjects. In both groups APA parameters were not influenced by dual-tasking. CMI was higher in patients compared to healthy subjects. Our results suggest that the disease affects CMI in its earliest stages. Since both cognitive tasks were similarly affected by dual-tasking in patients and controls central executive seems to play the major role in CMI between SI and working memory. Patients prioritizing motor over cognitive task for balance maintenance suggests reduced divided attention capacity as a cause of increased CMI in the earliest MS.

Discovery of a superconducting high-entropy alloy.

High-entropy alloys (HEAs) are multicomponent mixtures of elements in similar concentrations, where the high entropy of mixing can stabilize disordered solid-solution phases with simple structures like a body-centered cubic or a face-centered cubic, in competition with ordered crystalline intermetallic phases. We have synthesized an HEA with the composition Ta34Nb33Hf8Zr14Ti11 (in at. %), which possesses an average body-centered cubic structure of lattice parameter a=3.36 Å. The measurements of the electrical resistivity, the magnetization and magnetic susceptibility, and the specific heat revealed that the Ta34Nb33Hf8Zr14Ti11 HEA is a type II superconductor with a transition temperature Tc≈7.3 K, an upper critical field µ0H_c2≈8.2 T, a lower critical field µ0Hc1≈32 mT, and an energy gap in the electronic density of states (DOS) at the Fermi level of 2Δ≈2.2 meV. The investigated HEA is close to a BCS-type phonon-mediated superconductor in the weak electron-phonon coupling limit, classifying it as a "dirty" superconductor. We show that the lattice degrees of freedom obey Vegard's rule of mixtures, indicating completely random mixing of the elements on the HEA lattice, whereas the electronic degrees of freedom do not obey this rule even approximately so that the electronic properties of a HEA are not a "cocktail" of properties of the constituent elements. The formation of a superconducting gap contributes to the electronic stabilization of the HEA state at low temperatures, where the entropic stabilization is ineffective, but the electronic energy gain due to the superconducting transition is too small for the global stabilization of the disordered state, which remains metastable.

Stabilization mechanism of γ-Mg17Al12 and ß-Mg2Al3 complex metallic alloys.

Large-unit-cell complex metallic alloys (CMAs) frequently achieve stability by lowering the kinetic energy of the electron system through formation of a pseudogap in the electronic density of states (DOS) across the Fermi energy εF. By employing experimental techniques that are sensitive to the electronic DOS in the vicinity of εF, we have studied the stabilization mechanism of two binary CMA phases from the Al-Mg system: the γ-Mg17Al12 phase with 58 atoms in the unit cell and the ß-Mg2Al3 phase with 1178 atoms in the unit cell. Since the investigated alloys are free from transition metal elements, orbital hybridization effects must be small and we were able to test whether the alloys obey the Hume-Rothery stabilization mechanism, where a pseudogap in the DOS is produced by the Fermi surface-Brillouin zone interactions. The results have shown that the DOS of the γ-Mg17Al12 phase exhibits a pronounced pseudogap centered almost exactly at εF, which is compatible with the theoretical prediction that this phase is stabilized by the Hume-Rothery mechanism. The disordered cubic ß-Mg2Al3 phase is most likely entropically stabilized at high temperatures, whereas at lower temperatures stability is achieved by undergoing a structural phase transition to more ordered rhombohedral ß' phase at 214 ° C, where all atomic sites become fully occupied. No pseudogap in the vicinity of εF was detected for the ß' phase on the energy scale of a few 100 meV as determined by the 'thermal observation window' of the Fermi-Dirac function, so that the Hume-Rothery stabilization mechanism is not confirmed for this compound. However, the existence of a much broader shallow pseudogap due to several critical reciprocal lattice vectors [Formula: see text] that simultaneously satisfy the Hume-Rothery interference condition remains the most plausible stabilization mechanism of this phase. At Tc = 0.85 K, the ß' phase undergoes a superconducting transition, which slightly increases the cohesive energy and may contribute to relative stability of this phase against competing neighboring phases.

Geometric origin of magnetic frustration in the µ-Al4Mn giant-unit-cell complex intermetallic.

The structurally ordered µ-Al(4)Mn complex intermetallic phase with 563 atoms in the giant unit cell shows the typical broken-ergodicity phenomena of a magnetically frustrated spin system. The low-field zero-field-cooled and field-cooled magnetic susceptibilities show splitting below the spin freezing temperature T(f) = 2.7 K. The ac susceptibility exhibits a frequency-dependent cusp, associated with a frequency-dependent freezing temperature T(f)(ν). The decay of the thermoremnant magnetization is logarithmically slow in time and shows a dependence on the aging time t(w) and the cooling field H(fc) typical of an ultraslow out-of-equilibrium dynamics of a nonergodic spin system that approaches thermal equilibrium, but can never reach it on the experimentally accessible time scale. The above features classify the µ-Al(4)Mn complex intermettalic among spin glasses. The origin of frustration of magnetic interactions was found to be geometrical due to the distribution of a significant fraction of Mn spins on triangles with antiferromagnetic coupling. The µ-Al(4)Mn phase is a geometrically frustrated spin glass.

Pulmonary arterial hypertension associated with interferon beta treatment for multiple sclerosis: a case report.

A 23-year-old woman with multiple sclerosis developed respiratory symptoms 3 years after introduction of interferon beta-1b. The diagnosis of pulmonary arterial hypertension (PAH) was established. The patient partially responded to sildenafil and bosetan treatment. This is the first report of PAH, associated with interferon beta therapy. As shown in experimental models, interferon treatment can induce PAH by stimulation of thromboxane cascade and secretion of various inflammatory mediators.

Angiotensin-converting enzyme I/D gene polymorphism and risk of multiple sclerosis.

OBJECTIVES: Angiotensin-converting enzyme (ACE) activity is increased in blood and cerebrospinal fluid of patients with multiple sclerosis (MS). In addition, in experimental autoimmune encephalomyelitis (EAE), an animal model of MS, the blockade of ACE suppresses the disease itself. To analyze the genetic association of the ACE gene with MS, we examined ACE gene insertion/deletion (I/D) polymorphism in MS patients. MATERIALS AND METHODS: A total of 313 MS patients from Slovenia and Croatia and 376 healthy controls were genotyped by polymerase chain reaction method. RESULTS: We found statistically significant differences in the distribution of ACE I/D allele frequencies (P < 0.01) and genotypes (P < 0.04) in male patients. ACE DD genotype was associated with MS in men at an odds ratio of 1.86 (95% CI 1.09-3.19, P = 0.02). CONCLUSIONS: DD genotype of ACE gene might contribute to a higher risk of developing MS in men.