Ruminal methane emission and lactational performance of cows fed rapeseed cake and oats on a grass silage-based diet.

The objective of this experiment was to investigate the effect of lipid from rapeseed cake and oats on ruminal CH4 emission and lactational performance of dairy cows. Twelve lactating Nordic Red cows, of which 4 primiparous, and averaging (±SD) 48 ± 22.9 DIM, 37.8 ± 7.14 kg/d milk yield were enrolled in a switch-back design experiment with 3 periods of 4 wk each. The cows were assigned into 6 pairs based on parity and days-in-milk, milk yield, and body weight at the beginning of the experiment. The experimental treatments were 1) rapeseed cake and oats (RSC+O), and 2) rapeseed meal and barley (RSM+B) as the concentrate feeds. Cows in each pair were randomly assigned to one of the 2 groups, which received the treatments in 2 different sequences, i.e., group 1 received RSC+O in period 1 and 3, and RSM+B in period 2, whereas group 2 was fed RSM+B in period 1 and 3, and RSC+O in period 2. The diets consisted of a partially mixed ration with grass silage mixed with either oats or barley, according to the treatment sequence, and the rapeseed cake or meal being mixed into a pellet with either oats or barley according to the treatments, and a mineral mix. The pellet was delivered at a fixed amount (i.e., 6 kg/d for multiparous and 5 kg/d for the primiparous cows) from the milking robot. The actual forage to concentrate ratios for RSC+O and RSM+B were 51:49 and 52:48, respectively, with NDF concentrations of 41.5 and 36.0% and CP concentrations of 17.0 and 16.7% of diet DM. Dry matter intake, milk yield, and gas exchange (with a GreenFeed system attached to the milking robot) were recorded daily, and milk composition and spot fecal samples were collected during the last wk of each period. Based on feed analysis, and dry matter intake of the cows during the experiment, the total fat content of the experimental diets was 4.1 and 2.7% of DM for RSC+O and RSM+B diets, respectively. Dry matter intake was 1.5 kg/d lower, and milk yield tended to be 1.0 kg/d greater for RSC+O vs. RSM+B. There were no differences in energy-corrected milk yield and milk composition between the treatments, while milk metabolizable energy efficiency was greater for cows fed RSC+O than RSM+B. Methane yield (g/kg dry matter intake) did not differ between treatments, but CH4 production (g/d) was 9.4% and CH4 intensity as g/kg energy-corrected milk was 11.7% lower for RSC+O vs. RSM+B. The lower CH4 production was likely caused by the lower DMI and fiber digestibility, observed with the RSC+O diet. In addition, the greater lipid intake also contributed to lower rate of fermentation and subsequent decrease in CH4 production. Overall, feeding rapeseed cake with oats in a grass silage-based diet increased feed efficiency while decreasing CH4 emission intensity in lactating cows. This provides a practical way of mitigating ruminal CH4 emission from dairy operations while maintaining milk production with commonly utilized feed stuffs in Nordic conditions.

Processed fava bean as a substitute for rapeseed meal with or without rumen-protected methionine supplement in grass silage-based dairy cow diets.

Fava bean offers a sustainable home-grown protein source for dairy cows, but fava bean protein is extensively degraded in the rumen and has low Met concentration. We studied the effects of protein supplementation and source on milk production, rumen fermentation, N use, and mammary AA utilization. The treatments were unsupplemented control diet, and isonitrogenously given rapeseed meal (RSM), processed (dehulled, flaked, and heated) fava bean without (TFB) or with rumen-protected (RP) Met (TFB+). All diets consisted of 50% grass silage and 50% cereal-based concentrate including studied protein supplement. The control diet had 15% of crude protein and protein-supplemented diets 18%. Rumen-protected Met in TFB+ corresponded to 15 g/d of Met absorbed in the small intestine. Experimental design was a replicated 4 × 4 Latin square with 3-wk periods. The experiment was conducted using 12 multiparous mid-lactation Nordic Red cows, of which 4 were rumen cannulated. Protein supplementation increased dry matter intake (DMI), and milk (31.9 vs. 30.7 kg/d) and milk component yields. Substituting RSM with TFB or TFB+ decreased DMI and AA intake but increased starch intake. There were no differences in milk yield or composition between RSM diet and TFB diets. Rumen-protected Met did not affect DMI, or milk or milk component yields but increased milk protein concentration in comparison to TFB. There were no differences in rumen fermentation except for increased ammonium-N concentration with the protein-supplemented diets. Nitrogen-use efficiency for milk production was lower for the supplemented diets versus control diet but tended to be greater for TFB and TFB+ versus RSM. Protein supplementation increased plasma essential AA concentration but there were no differences between TFB diets and RSM. Rumen-protected Met clearly increased plasma Met concentration (30.8 vs. 18.2 µmol/L) but did not affect other AA. Absence of differences between RSM and TFB in milk production together with limited effects of RP Met suggest that TFB is a potential alternative protein source for dairy cattle.

On-chip integrated vertically aligned carbon nanotube based super- and pseudocapacitors.

On-chip energy storage and management will have transformative impacts in developing advanced electronic platforms with built-in energy needs for operation of integrated circuits driving a microprocessor. Though success in growing stand-alone energy storage elements such as electrochemical capacitors (super and pseusocapacitors) on a variety of substrates is a promising step towards this direction. In this work, on-chip energy storage is demonstrated using architectures of highly aligned vertical carbon nanotubes (CNTs) acting as supercapacitors, capable of providing large device capacitances. The efficiency of these structures is further increased by incorporating electrochemically active nanoparticles such as MnOx to form pseudocapacitive architectures thus enhancing device capacitance areal specific capacitance of 37 mF/cm2. The demonstrated on-chip integration is up and down-scalable, compatible with standard CMOS processes, and offers lightweight energy storage what is vital for portable and autonomous device operation with numerous advantages as compared to electronics built from discrete components.

The effect of two different doses of remifentanil on postoperative pain and opioid consumption after cardiac surgery--a randomized controlled trial.

BACKGROUND: Remifentanil, an ultra-short-acting opioid, provides intensive analgesia without prolonged respiratory depression and is widely used in cardiac surgery. Diminished dosing may also offer stable hemodynamics, even during sternotomy and sternal retraction. However, increased postoperative pain and induced opioid tolerance after remifentanil dosing during abdominal surgery was reported. We tested whether remifentanil 0.3 µg/kg/min infusion increased postoperative opioid consumption and pain compared to 0.1 µg/kg/min dosing. METHODS: Ninety coronary artery bypass grafting or heart valve surgery patients were randomized to remifentanil 0.1 µg/kg/min or 0.3 µg/kg/min infusions during surgery. All patients received oxycodone bolus 0.15 µg/kg postoperatively, and patient-controlled analgesia (PCA) with oxycodone thereafter. Postoperative pain was estimated thrice daily by visual analogue scale, and 48-h opioid consumption was recorded from the PCA-device. RESULTS: Total remifentanil dosing was 64 µg/kg in the higher and 22 µg/kg in the lower dosing group during the 3-h cardiac operations. Mean postoperative opioid consumption was 107 (SD 36) mg in the lower and 104 (SD 33) mg in the higher dose remifentanil groups. Postoperative pain did not differ between groups, at rest or during deep breathing, at any time (P = 0.110 and 0.941, respectively). CONCLUSIONS: Remifentanil 0.3 µg/kg/min infusion did not increase postoperative pain or opioid consumption after cardiac surgery compared to the 0.1 µg/kg/min infusion. Remifentanil infusion 0.1-0.3 µg/kg/min during cardiac surgery was safe, with no exaggerated postoperative pain or opioid consumption.

Impact of coronary artery bypass surgery on ischemic mitral regurgitation.

INTRODUCTION: To determine the course of ischemic mitral regurgitation (IMR) after coronary artery bypass grafting (CABG), and evaluate preoperative factors which predict the development of the severity of IMR after CABG. METHODS: Between 1992-2005, 1995 patients underwent CABG and 170 of them had IMR. Data of 131 patients were retrospectively analyzed and living patients (n = 112) had a clinical follow-up visit. The mean follow-up time was 6.5 years. RESULTS: At the time of CABG, 66% of the 131 cases analyzed had mild, 31% had moderate, and 3% had severe IMR. At the time of follow-up, 52% of patients had either no IMR or mild IMR, 27% had moderate IMR, 6% had severe IMR and 15% suffered from cardiac related death. During follow-up IMR grade reduced in 25% of study patients. None of the patient had re-operation due to the mitral regurgitation. Multivariate analysis showed that left ventricular ejection fraction (LVEF) was an independent predictor of good prognosis (O.R. 1.4, 95% C.I. 1.15-1.83/ 10% increase of LVEF, p = 0.02). CONCLUSION: Half of the patients, who have IMR at the time of CABG, have no IMR or only mild IMR postoperatively. Good LVEF adds to the probability that CABG only can reduce IMR.

Liquid phase deposition of polymers on arbitrary shaped surfaces and their suitability for e-beam patterning.

We present a straightforward low cost liquid phase deposition method to coat arbitrary-shaped dielectric substrates with uniform electron beam sensitive polymer films. Furthermore, we investigate the use of electron beam lithography to pattern the coated pre-form substrates. The polymers studied are poly-methyl-methacrylate with different molecular weights, poly(methyl methacrylate-co-ethyl acrylate) and methyl methacrylate. The polymer coverage over the whole surface area is shown to be uniform and the thickness of the film dependent on the concentration of the polymer liquid used. As the uniform polymer layer is deposited on non-flat surfaces, we show that with an electron beam various surfaces, e.g. microlens arrays, can be re-patterned accurately with nanoscale features. Furthermore, we show the required dose for electron beam exposure to be dependent on the concentration and on the molecular weight of the polymer used.

Auditory-evoked potentials in bispectral index-guided anaesthesia for cardiac surgery.

BACKGROUND AND OBJECTIVE: Midlatency auditory-evoked potentials, as measures of the anaesthetic state, were evaluated at similar levels of bispectral index in cardiac surgical patients maintained with either propofol or isoflurane anaesthesia. METHODS: Twenty-four patients were randomly allocated to anaesthesia with propofol (n = 12) or isoflurane (n = 12). Bispectral index was maintained below 60 during surgery. Auditory-evoked potentials were collected before induction of anaesthesia, 10 min after intubation, 30 min after sternotomy, during cardiopulmonary bypass at the time of cross-clamping of the aorta and during stable mild hypothermia, after de-clamping of the aorta, and after the operation. RESULTS: At the pre-determined time points, bispectral index values showed comparable depth of hypnosis in both groups. The latency of the Nb component of midlatency auditory-evoked potentials was significantly increased in the isoflurane group after intubation (P < 0.001) and that of both the Nb and the Pa components after sternotomy (P < 0.001) compared with the propofol group. No differences between the groups were detected with respect to haemodynamic variables. No patient reported recall of intraoperative events. CONCLUSION: After intubation and surgical stimulation, when bispectral index was at a constant level, there was a difference in the Nb and Pa components of the midlatency auditory-evoked potentials between the two anaesthetic regimens, indicating a distinction in the state of anaesthesia. Our results suggest that the parallel use of these two electrophysiological methods can show differences in the components of anaesthesia between various anaesthesia methods in cardiac surgical patients.

Parenteral lipids and the preterm infant: between Scylla and Charybdis.

Intravenous lipid infusions are a valid option for a dense source of energy and essential fatty acids when the enteral route is unavailable. However, the use of these preparations in neonatal patients has been associated with metabolic concerns such as oxidative stress, and complications such as abnormal vascular tone, intravascular fat deposition and even fat embolism. Metabolic issues related to nutrient accretion and noxious biological reactions should be considered when prescribing parenteral lipids with high PUFA content to the critically ill newborn infant.

Right atrial isomerism in four siblings.

Heterotaxy syndromes, right or left atrial isomerism, result from disruption of left-right axis determination and their manifestations include complicated heart defects. Recent studies in model organisms have revealed complex genetic pathways and several genes involved in this process. In affected humans, however, molecular studies have identified mutations in a small number of individuals, while in most the cause remains unknown. Furthermore, although family data suggest, autosomal recessive inheritance, such genes have not yet been identified. We have studied six members of a family, four children affected with right atrial isomerism (RAI) and their healthy parents, for disturbances of left-right axis development. The children, one female and three males who all had complicated heart defects, succumbed and had an autopsy. Their nonconsanguineous parents were examined by cardiac and abdominal ultrasound or MRI. In all four children the heart defects included single ventricle with dysplastic atrioventricular (AV) valve, total anomalous pulmonary venous drainage (TAPVD), and malposition of great arteries (MGA) with pulmonary stenosis (PS). All had asplenia; two also had dextrocardia and abdominal situs inversus. The diagnosis of RAI was made postnatally in the first child and prenatally in others. Two siblings had no surgery and died as a newborn, one with obstructed supracardiac TAPVD and the other with regurgitating AV valve. Two children underwent heart surgery. One had repair of obstructive infracardiac TAPVD but died in infancy. The other underwent both hemi-Fontan operation and heart transplantation but died at the age of 2 years. This is the first report describing four children with RAI in the same family. The occurrence of RAI in male and female siblings without any indication of left-right axis abnormalities in their parents suggests autosomal recessive inheritance of human isomerism.

Feasibility of predicting the risk of atrial fibrillation after coronary artery bypass surgery with logistic regression model.

BACKGROUND AND AIMS: The aim of this study was to determine the risk factors of postoperative atrial fibrillation (AF) after coronary artery bypass grafting and to create predictive model and to evaluate the effects of AF on patients outcome. MATERIAL AND METHODS: Data of 3,676 consecutive patients were analysed to identify the predictors of AF. Multivariate logistic regression model was validated prospectively in 1,107 patients. RESULTS: Increasing age (p < 0.001), preoperative use of digoxin (p = 003), need of intra-aortic balloon pump or inotropic medication in the weaning off cardiopulmonary by pass or during the first 24 hours postoperatively (p = 0.013), increasing body surface area (p = 0.006) and lower ejection fraction (p = 0.048) were independent risk factors for postoperative AF. The predictive model gave area under the receiver-operating characteristic (ROC) curve 0.682, 95% confidence interval 0.663-0.701, and p < 0.001. The patients with AF incidence had more postoperative stroke (p = 0.008), confusion (p < 0.001) severe gastrointestinal complications (p = 0.005), readmission to ICU (p < 0.001), longer ICU (p < 0.001) and hospital stay (p < 0.001) when compared with the patients who remained in sinus rhythm. CONCLUSION: Logistic regression model with the parameters used was not accurate enough for clinical purposes. Postoperative AF is associated with postoperative stroke, severe gastrointestinal complications, readmission to ICU, and longer ICU and hospital stay.

Lung epithelial ion transport in neonatal lung disease.

Lung epithelial ion transport promotes salt and water movement across the fetal and neonatal lung epithelium. The mechanism is dependent on basolateral membrane Na-K-ATPase and the apical membrane Cl(-) and Na(+) channels. During fetal life active secretion of Cl(-) and parallel movement of Na(+) across the epithelium into the developing lung lumen induce accumulation of liquid into the future airspaces. Postnatally, however, absorption of fluid from the airspaces must start. Present evidence suggests that activation of Na(+) transport from the lumen into the basolateral direction drives fluid absorption and results in an essentially dry air-filled alveolus. In laboratory animals amiloride, a Na(+) channel blocker, induces respiratory distress and impedes lung fluid clearance. One of the epithelial amiloride-sensitive Na(+) channels, ENaC, is composed of three homologous subunits that differentially respond to glucocorticoid hormone. In newborn infants an increase in pulmonary fluid and a defective Na(+) transport associate with respiratory distress. The ontogeny, subunit composition and function of ENaC along the respiratory tract are currently under investigation. It will be interesting to find out whether the subunit composition and function of lung ENaC respond to the therapy of the critically ill newborn infant.

Expression of alpha-, beta-, and gamma-hENaC mRNA in the human nasal, bronchial, and distal lung epithelium.

The amount of fluid covering the epithelium of the airways and alveolar space is modulated by active transport of Na+ from the lumen through the apical membrane Na+ permeant ion channels towards the interstitial space. We have measured the subunit expression of the amiloride-sensitive human Na+ channel (hENaC) by concomitant assessment of alpha-, beta-, and gamma-hENaC mRNA in the nasal, bronchial, and peripheral lung epithelia of adult patients undergoing lobectomy secondary to lung cancer. The study employed quantitative competitive reverse-transcriptase-polymerase chain reaction and qualitative in situ hybridization techniques. The hENaC mRNA content of each sample was normalized to the amount of epithelial cell-specific cytokeratin 18 (CK18) mRNA. Nasal epithelium contained significantly more (p < 0.05) alpha-hENaC mRNA (18 +/- 5 SD amol/fmol CK18), than bronchus (8 +/- 2 SD amol/fmol) and peripheral lung (9 +/- 2 SD amol/fmol). The ratio of gamma-hENaC/alpha-hENaC mRNA concentration was lowest in the nasal area, and it increased significantly towards the distal lung regions. The change in beta-hENaC mRNA was less profound. In situ hybridization studies of bronchial and peripheral lung sections selectively revealed expression of alpha-hENaC mRNA in superficial epithelium and submucosal glands of large airways, in bronchiolar epithelium, and in alveolar cells. We conclude that the relative expression of the hENaC subunit genes changes from the proximal to distal regions of the human respiratory tract.

Intra-institutional prediction of outcome after cardiac surgery: comparison between a locally derived model and the EuroSCORE.

OBJECTIVE: To construct models for predicting mortality, morbidity and length of intensive care unit (ICU) stay after cardiac surgery and to compare the performance of these models with that of the EuroSCORE in two independent validation databases. METHODS: Clinical data on 4592 cardiac surgery patients operated between 1992 and 1996 were retrospectively collected. In order to derive predictive models and to validate them, the patient population was randomly divided into a derivation database (n=3061) and a validation database (n=1531). Variables that were significant in univariate analyses were entered into a backward stepwise logistic regression model. The outcome was defined as mortality within 30 days after surgery, predefined morbidity, and the length of ICU stay lasting >2 days. In addition to the retrospective database, the models were validated also in a prospectively collected database of cardiac surgical patients operated in 1998-1999 (n=821). The EuroSCORE was tested in two validation databases, i.e. the retrospective and prospective one. Hosmer-Lemeshow goodness-of-fit was used to study the calibration of the predictive models. Area under the receiver operating characteristic (ROC) curve was used to study the discrimination ability of the models. RESULTS: The overall mortality in the retrospective and the prospective data was 2 and 1%, and morbidity 22 and 18%, respectively. The created predictive models fitted well in the validation databases. Our models and the EuroSCORE were equally good in discriminating patients. Thus, in the prospective validation database, the mean areas under the ROC curve for our models and for the EuroSCORE were similar, i.e. 0.84 and 0.77 for mortality, 0.74 and 0.74 for morbidity, and 0.81 and 0.79 for the length of intensive care unit stay lasting for 2 days or more, respectively. CONCLUSIONS: Our models and the EuroSCORE were equally good in discriminating the patients in respect to outcome. However, our model provided also well calibrated estimation of the probability of prolonged ICU stay for each patient. As was originally suggested, the EuroSCORE may be an appropriate tool in categorizing cardiac surgical patients into various subgroups in interinstitutional comparisons. Our models may have additive value especially in resource allocation and quality assurance purposes for local use.

Sodium nitroprusside increases human skeletal muscle blood flow, but does not change flow distribution or glucose uptake.

1. The role of blood flow as a determinant of skeletal muscle glucose uptake is at present controversial and results of previous studies are confounded by possible direct effects of vasoactive agents on glucose uptake. Since increase in muscle blood flow can be due to increased flow velocity or recruitment of new capillaries, or both, it would be ideal to determine whether the vasoactive agent affects flow distribution or only increases the mean flow. 2. In the present study blood flow, flow distribution and glucose uptake were measured simultaneously in both legs of 10 healthy men (aged 29 +/- 1 years, body mass index 24 +/- 1 kg m-2) using positron emission tomography (PET) combined with [15O]H2O and [18F]fluoro-2-deoxy-D-glucose (FDG). The role of blood flow in muscle glucose uptake was studied by increasing blood flow in one leg with sodium nitroprusside (SNP) and measuring glucose uptake simultaneously in both legs during euglycaemic hyperinsulinaemia (insulin infusion 6 pmol kg-1 min-1). 3. SNP infusion increased skeletal muscle blood flow by 86 % (P < 0.01), but skeletal muscle flow distribution and insulin-stimulated glucose uptake (61.4 +/- 7. 5 vs. 67.0 +/- 7.5 micromol kg-1 min-1, control vs. SNP infused leg, not significant), as well as flow distribution between different tissues of the femoral region, remained unchanged. The effect of SNP infusion on blood flow and distribution were unchanged during infusion of physiological levels of insulin (duration, 150 min). 4. Despite a significant increase in mean blood flow induced by an intra-arterial infusion of SNP, glucose uptake and flow distribution remained unchanged in resting muscles of healthy subjects. These findings suggest that SNP, an endothelium-independent vasodilator, increases non-nutritive, but not nutritive flow or capillary recruitment.

Coronary flow reserve in young men with familial combined hyperlipidemia.

BACKGROUND: Familial combined hyperlipidemia (FCHL) is a common hereditary disorder of lipoprotein metabolism estimated to cause 10% to 20% of premature coronary heart disease. We investigated whether functional abnormalities exist in coronary reactivity in asymptomatic patients with FCHL. METHODS AND RESULTS: We studied 21 male FCHL patients (age, 34.8+/-5.4 years) and a matched group of 21 healthy control subjects. Myocardial blood flow (MBF) was measured at baseline and during dipyridamole-induced hyperemia with PET and 15O-labeled water. The baseline MBF was similar in patients and control subjects (0.79+/-0.19 versus 0.88+/-0.20 mL. g-1. min-1, P=NS). An increase in MBF was seen in both groups after dipyridamole infusion, but MBF at maximal vasodilation was lower in FCHL patients (3.54+/-1.59 versus 4.54+/-1.17 mL. g-1. min-1, P=0.025). The difference in coronary flow reserve (CFR) was not statistically significant (4.7+/-2.2 versus 5.3+/-1.6, P=NS, patients versus control subjects). Considerable variability in CFR values was detected within the FCHL group. Patients with phenotype IIB (n=8) had lower flow during hyperemia (2.5+/-1.2 versus 4.2+/-1.5 mL. g-1. min-1, P<0.05) and lower CFR (3.4+/-2.1 versus 5.4+/-2.0, P<0.05) compared with phenotype IIA (n=13). CONCLUSIONS: Abnormalities in coronary flow regulation exist in young asymptomatic FCHL patients expressing phenotype IIB (characterized by abnormalities in both serum cholesterol and triglyceride concentrations). This is in line with previous observations suggesting that the metabolic abnormalities related to the pathophysiology of FCHL are associated with the phenotype IIB.

Decreased blood flow but unaltered insulin sensitivity of glucose uptake in skeletal muscle of chronic smokers.

Chronic cigarette smoking is associated with dysfunction of the vascular endothelium. Smokers have also been shown to be insulin-resistant, at least in some studies. Since insulin-induced vasodilation is dependent on endothelial cell nitric oxide (NO) synthesis, we tested the hypothesis that decreased skeletal muscle blood flow causes insulin resistance in smokers. We studied 37 young normotensive normolipidemic nondiabetic men, of which 14 were smokers and 23 lifelong nonsmokers. The groups were similar with respect to age, body mass index (BMI), and maximal oxygen uptake (VO2max). Basal and insulin-stimulated femoral muscle blood flow was measured using [(15)O]H2O and insulin-stimulated muscle glucose uptake using [18F]fluoro-2-deoxy-D-glucose ([18F]FDG) and positron emission tomography (PET). Whole-body glucose uptake was measured using the hyperinsulinemic (insulin infusion 5 mU/kg x min)-euglycemic clamp technique. In the basal state, muscle blood flow was 51% lower in smokers (17 +/- 3 mL/kg muscle x min) versus nonsmokers (35 +/- 17 mL/kg x min, P < .0001). Insulin increased muscle blood flow comparably in both groups; the mean rate of insulin-stimulated blood flow was 30 +/- 10 and 55 +/- 38 mL/kg x min (P = .049), respectively. Whole-body and skeletal muscle glucose uptake were similar in both groups during insulin infusion. We conclude that muscle blood flow is lower in chronic smokers compared with nonsmokers under both fasting and hyperinsulinemic conditions. The insulin-induced increase in muscle blood flow and insulin-stimulated glucose uptake appear normal, suggesting that the vasodilatory and metabolic effects of insulin are intact in smokers and the reduced muscle blood flow per se does not cause insulin resistance in these subjects.

Metabolic syndrome is associated with changes in D-mannose metabolism.

Serum mannose concentration increases in diabetic patients and correlates closely with blood glucose. In patients with glomerulonephritis, serum mannose and mannose/glucose ratio positively correlate with dyslipidemia and the extent of urinary protein excretion. We investigated whether changes in serum mannose mark subjects with features of metabolic syndrome, including obesity, hypertension, glucose intolerance, and dyslipidemia. The study comprised 20 patients with mean age of 68 (SD 11) years, body mass index 27.2 (SD 5.1) kg/m2, blood glucose 6.2 (SD 1.6) mmol/L, serum total cholesterol 6.3 (SD 1.2) mmol/L, triglyceride 2.0 (SD 0.08) mmol/L, uric acid 320 (SD 109) micromol/L, mannose 60.0 (SD 17) micromol/L, and mannose/glucose ratio 9.7 (SD 1.8) micromol/mmol. Serum mannose correlated with blood glucose (r=0.758, p=0.012), triglyceride (r=0.478, p=0.023), and HDL-cholesterol (r = approximately 0.427, p=0.022). Mannose/glucose ratio correlated with BMI (r=0.581, p=0.033), mannose (r=0.491, p=0.035), and uric acid (r=0.608, p=0.027). The rate of VLDL lipoprotein turnover may be instrumental in the regulation of serum mannose concentration. We conclude that an altered mannose metabolism is a novel consideration among the metabolic abnormalities in the metabolic syndrome.

O2-induced ENaC expression is associated with NF-kappaB activation and blocked by superoxide scavenger.

Cultured rat fetal distal lung epithelial cells (FDLEs), when switched from fetal (3%) to postnatal (21%) O2 concentrations, have increased epithelial Na+ channel (ENaC) mRNA levels and amiloride-sensitive Na+ transport [O. Pitkänen, A. K. Tanswell, G. Downey, and H. O'Brodovich. Am. J. Physiol. 270 (Lung Cell. Mol. Physiol. 14): L1060-L1066, 1996]. The mechanisms by which O2 mediates these effects are unknown. After isolation, FDLEs were kept at 3% O2 overnight, then switched to 21% O2 (3-21% O2 group) or maintained at 3% O2 (3-3% O2 group) for 48 h. The amiloride-sensitive short-circuit current (Isc) in the 3-21% O2 group was double that in the 3-3% O2 group. Amiloride-sensitive Isc could not be induced by medium conditioned by 21% O2-exposed FDLEs but was reversed by returning the cells to 3% O2. Neither the cyclooxygenase inhibitor ibuprofen, liposome-encapsulated catalase, nor hydroperoxide scavengers (U-74389G or Trolox) blocked the O2-induced amiloride-sensitive Isc. In contrast, the cell-permeable superoxide scavenger tetramethylpiperidine-N-oxyl (TEMPO) eliminated the O2-induced increases in amiloride-sensitive Isc and ENaC mRNA levels. The switch from 3 to 21% O2 induced the transcription factor nuclear factor-kappaB, which could also be blocked by TEMPO. We conclude that 1) the O2-induced increase in amiloride-sensitive Isc is reversible and 2) the O2-induced increase in amiloride-sensitive Isc and ENaC mRNA levels is associated with activation of nuclear factor-kappaB and may be mediated, at least in part, by superoxide.

Significance of ion transport during lung development and in respiratory disease of the newborn.

Active ion transport plays a critical role in the liquid movement across the fetal and perinatal lung epithelium. The fetal lung liquid production is coupled with active secretion of Cl- into the luminal space. The potential for fluid absorbing mechanisms related to active Na+ transport from the apical to the basolateral side of the epithelium appears near the end of gestation. At birth there is a dramatic change of environment with commencement of air-breathing, sudden increase in oxygen partial pressure (PO2) and profound changes in the pulmonary circulation. A concurrent switch from fluid secretion to maintenance of low amounts of alveolar fluid is another major physiological adjustment taking place in the perinatal distal lung epithelium. The fluid-absorbing mechanism is a result of a well-synchronized co-operation between the basolateral membrane Na-K-ATPase and the apical membrane Na+ channels and it promotes salt and water movement from the airspace. Inability of the fetal lung epithelium to switch from fluid secretion to Na+ transport-dependent absorption seems to be an important factor adversely contributing to the respiratory distress of the newborn premature infant.

Early impairment of coronary flow reserve in young men with borderline hypertension.

OBJECTIVES: The purpose of this study was to investigate whether functional abnormalities in coronary vasomotion are present in young healthy asymptomatic men fulfilling the World Health Organization (WHO) criteria for borderline hypertension. BACKGROUND: Previous studies have reported reduced coronary flow reserve in middle-aged subjects with sustained hypertension and hypertension-induced microvascular heart disease or left ventricular hypertrophy. METHODS: Myocardial blood flow was measured at baseline and during dipyridamole-induced hyperemia by means of positron emission tomography and oxygen-15-labeled water in asymptomatic young men with borderline hypertension (group 1: n = 16, mean +/- SD age 37 +/- 4 years, 24-h ambulatory blood pressure 135 +/- 10/81 +/- 9 mm Hg) and matched healthy control subjects (group 2: n = 19, age 35 +/- 3 years, 24-h ambulatory blood pressure 119 +/- 8/69 +/- 8 mm Hg, p < 0.001). Left ventricular (LV) mass, dimensions and function were measured by echocardiography. RESULTS: LV mass, dimensions and diastolic function were similar in the study groups. Baseline myocardial blood flow was similar (0.83 +/- 0.21 vs. 0.80 +/- 0.22 ml/g per min, group 1 vs. group 2, respectively, p = NS), and a significant increase in flow was detected after dipyridamole infusion (0.56 mg/kg body weight in 4 min intravenously) in both groups. However, the flow response to dipyridamole was significantly lower in group 1, leading to lower hyperemic flow in group 1 than in group 2 (2.85 +/- 1.20 vs. 3.80 +/- 1.44 ml/g per min, respectively). Consequently, the coronary flow response was lower in hypertensive than in normotensive men (3.46 +/- 1.23 vs. 4.99 +/- 2.5 ml/g per min, group 1 vs. group 2, respectively, p < 0.05). CONCLUSIONS: These results demonstrate reduced coronary reactivity present in young asymptomatic men with borderline hypertension and no signs of hypertension-induced angina or left ventricular hypertrophy. Because baseline basal myocardial blood flow was unchanged, the reduction in coronary flow reserve depends on an impaired maximal vasodilator capacity.