Randomized clinical trial of remote ischaemic preconditioning versus no preconditioning in the prevention of perioperative myocardial infarction during open surgery for ruptured abdominal aortic aneurysm.

BACKGROUND: Remote ischaemic preconditioning (RIPC) has been suggested as a means of protecting vital organs from reperfusion injury during major vascular surgery. This study was designed to determine whether RIPC could reduce the incidence of perioperative myocardial infarction (MI) during open surgery for ruptured abdominal aortic aneurysm (AAA). Secondary aims were to see if RIPC could reduce 30-day mortality, multiple organ failure, acute intestinal ischaemia, acute kidney injury and ischaemic stroke. METHODS: This randomized, non-blinded clinical trial was undertaken at three vascular surgery centres in Denmark. Patients who had open surgery for ruptured AAA were randomized to intervention with RIPC or control in a 1 : 1 ratio. Postoperative complications and deaths were registered, and ECG and blood samples were obtained daily during the hospital stay. RESULTS: Of 200 patients randomized, 142 (72 RIPC, 70 controls) were included. There was no difference in rates of perioperative MI between the RIPC and control groups (36 versus 43 per cent respectively), or in rates of organ failure. However, in the per-protocol analysis 30-day mortality was significantly reduced in the RIPC group (odds ratio 0·46, 95 per cent c.i. 0·22 to 0·99; P = 0·048). CONCLUSION: RIPC did not reduce the incidence of perioperative MI in patients undergoing open surgery for ruptured AAA. Registration number: NCT00883363 ( http://www.clinicaltrials.gov).

Repellency of the Components of the Essential Oil, Citronella, to Triatoma rubida, Triatoma protracta, and Triatoma recurva (Hemiptera: Reduviidae: Triatominae).

The kissing bugs--Triatoma rubida (Uhler), Triatoma protracta (Uhler), and Triatoma recurva (Stal)--are common hematophagous bugs in southeastern Arizona and responsible for severe allergic reactions in some individuals who are bitten. They also possess the potential to transmit the blood parasite, Trypanosoma cruzi. We previously found the essential oil, citronella, to be an excellent deterrent of feeding of T. rubida on a restrained mouse. In this work, we tested major components--alcohols, aldehydes, and monoterpenes--of citronella oil for repellency against the three common triatome species endemic in southern Arizona. The following citronella oil components--geraniol, citronellol, limonene, and citronellal--in different concentrations and combinations were tested. All components of citronella oil demonstrated some inhibition of feeding, ranging from very weak inhibition (limonene) to significant inhibition (geraniol and citronellol). A mixture of geraniol and citronellol was found to be repellant at concentrations of .165 and .165 vol%, respectively, for all three triatome species. Citronellal and limonene had no significant repellent activity. The repellent activity of citronella oil appears to be acting through direct contact with the bugs rather than diffusion of vapors.

Repellency of DEET, picaridin, and three essential oils to Triatoma rubida (Hemiptera: Reduviidae: Triatominae).

The kissing bug, Triatoma rubida (Uhler) is a common hematophagous bug in Tucson, AZ, and is responsible for causing severe allergic reactions in some bitten individuals. DEET, picaridin, tea tree oil, peppermint oil, and citronella oil were tested for repellency to T. rubida and its ability to probe and feed on a small restrained rat. No long range repellency was observed with any of the test materials. The lowest repellent concentrations observed were: 10% DEET, 7% picaridin; 30% tea tree oil, 3.3% peppermint oil, and 0.165% citronella oil. Only citronella oil was able to stop all probing and feeding by T. rubida. Citronella oil appears to be a promising potential repellent to prevent sleeping people from being bitten by kissing bugs.

The haemoflagellate Trypanoplasma borreli induces the production of nitric oxide, which is associated with modulation of carp (Cyprinus carpio L.) leucocyte functions.

In an attempt to characterise the role of nitric oxide (NO) in immune responses of carp, carp leucocytes obtained during an acute T. borreli infection were examined, for their capacity to generate NO. In a second set of experiments the impact NO on viability of the parasite and on the modulation of functional carp leucocyte responses were tested in vitro. Both in carp head-kidneys and in the peripheral blood, the fractions of lymphoblasts among separated leucocytes were increased. However, the relative proportions of granulocytes among head-kidney leucocytes (HKL) significantly decreased during infection, whereas granulocytes appeared among peripheral blood leucocytes (PBL). The cellular dynamics of HKL and PBL of infected carp were paralleled by an enhanced spontaneous NO release in vitro. NO production was further increased after addition of viable parasites to these cultures. The hypothesis that NO had a possible role in granulocyte activation and lymphocyte proliferation in carp was supported by the reduction of mitogen-induced proliferative responses of PBL from healthy carp in the presence of NO donor substances. The negative effects of NO on lymphocyte proliferation were contrasted by enhancing effects on granulocyte functions: the inhibition of NO generation in T. borreli-stimulated HKL cultures by the l-arginine analogue L-NMMA reduced the viability of granulocytes and their phagocytic activity. Even massive amounts of nitric oxide produced by donor substances (up to 600 micromol l(-1) NO(-)(2)) caused no reduction in the numbers of viable T. borreli flagellates in vitro. Thus, in carp, T. borreli seems to induce high amounts of NO in vivo which are apparently not harmful for the parasite but which may interfere with co-ordinated interactions of activated cells aiming at the defence of the parasite.

Head kidney neutrophils of carp (Cyprinus carpio L.) are functionally modulated by the haemoflagellateTrypanoplasma borreli.

In the present work responses of carp (Cyprinus carpio) head kidney-derived neutrophils to the blood parasite T. borreli, and the consequences of these responses for parasite survival and other host response mechanisms, were studied. In co-cultures of head kidney leucocytes (HKL) with viable and lysed T. borreli a prominent shape change of neutrophilic granulocytes towards increased size and complexity was observed. In addition, the longevity of neutrophils in vitro was prolonged in the presence of T. borreli antigens. In these cultures, neutrophils also exhibited an increased phagocytosis activity. An up regulation of the production of nitric oxide (NO) and reactive oxygen species (ROS) was observed in T. borreli- and mitogen-stimulated HKL cultures. However, addition of live, fluorescence-labelledT. borreli to previously stimulated HKL cultures, revealed neither killing nor phagocytosis of the parasite by activated neutrophils. Moreover, viable T. borreli, when added to HKL cultures of infected carp, reduced their phagocytosis activity and NO production. Supernatants of co-cultures between T. borreli and HKL also contained mediators, which suppressed a mitogen-induced proliferative response of peripheral blood leucocytes (PBL) in vitro. Thus, while T. borreli itself appeared not to be sensitive to responses of activated neutrophils, the flagellates interferes with the production of immunomodulatory signals of these cells, probably resulting in a partial immunosuppression, which may favour the parasite development in vivo.

(Z)-3-hexenyl (R)-3-hydroxybutanoate: a male specific compound in three North American decorator wasps Eucerceris rubripes, E. conata and E. tricolor.

The males of the decorator wasps Eucerceris have been observed to display abdomen-dragging behavior on plants surrounding their nest. It is thought that this applies a territorial-marking sex pheromone that serves to alert females to the males' territory for courtship and mating. The extracts of three species E. rubripes, E. conata, and E. tricolor have been analyzed by GC-MS. The gas chromatograms revealed the presence, in large quantities, of one common volatile compound in the male head extracts. By analogy with the closely related bee wolves Philanthus, we believe the pheromone is produced in the mandibular glands. Utilizing mass spectrometry, microreactions, FT-IR, and 1H and 13C NMR spectroscopy the structure of the pheromone was proposed to be (Z)-3-hexenyl 3-hydroxybutanoate, which was confirmed by synthesis. The absolute configuration of the chiral center was determined to be R for the three species by preparing the Mosher esters of the insect samples and comparing their GC retention times with a synthetic sample of known absolute configuration. In addition 2- and 3-hexenoic acid and some aromatic compounds were also found in varying quantities in both males and females along with hydrocarbons and fatty acids, although no species-specific profiles emerged.

Chemistry, ontogeny, and role of pygidial gland secretions of the vinegaroon Mastigoproctus giganteus (Arachnida: Uropygi).

Pygidial gland secretions of the vinegaroon, Mastigoproctus giganteus, consist of 26% water and 74% short-chained fatty acids, with acetic acid and octanoic acids the dominant acids. The organic composition of the secretion consists of 83% acetic acid, 15% octanoic acid, 1% (Z)-5-octenoic acid, 0.0002% of the corresponding (E)-isomer, 0.11% heptanoic acid, 0.02% hexanoic acid, 0.007% decanoic acid, and in some individuals a trace of 2-nonanone. Formic acid is absent from the secretion. Glandular composition, especially in the concentrations of the minor components, varies dramatically among individuals and shows no age pattern differences among the four free-living subadult instars, or sex differences between adult males and females. Each individual exhibits its own specific blend of components which is identical in the two separate and different sized glands. The secretions act solely as allomones against potential predators, and do not act as pheromones, or elicit a communicative or behavioral response. Behavioral tests using live animals or a synthetic blend of vinegaroon secretion revealed that the secretion is maximally effective on sensitive respiratory, visual, or sensory systems of potential predators and is ineffective, or nearly so, when contact is restricted to inside the predator's mouth. Thus, the effectiveness of the secretion apparently results from its delivery as a spray of fine droplets, rather than as an exudate or vapor.

Labial gland chemistry of three species of bumblebees (Hymenoptera: Apidae) from North America.

The volatile secretion emanating from the cephalic part of the paired labial gland in male bumblebees of three North American species, viz. Bombus sonorus Say, Bombus huntii Greene and Psithyrus insularis (F. Smith) has been analysed by GC-MS and GC-FTIR. The secretion, which is deposited as a marking secretion on various objects along a repetitive flight path, is composed of isoprenoids, (acyclic sesqui- and diterpenes) and straight-chain fatty acid derivatives (alcohols containing 14, 16 and 18 carbon atoms, and odd numbered hydrocarbons ranging from 23 to 27 carbons). The secretions are species-specific with just a few major components. In B. sonorus (Z)-11-octadecen-1-ol is the main compound accompanied by geranylgeraniol and tetradecan-1-ol; in B. huntii the dominating compound is trans-2,3-dihydrofarnesol and it also contains (Z)-11-octadecen-1-ol and hexadecan-1-ol; P. insularis is characterized by geranylcitronellol, together with the (Z)-11-octadecen-1-ol and hexadecan-1-ol. These results agree with analyses of 36 species and two forms of Scandinavian bumblebees analysed previously.

Toxinology of venoms from the honeybee genus Apis.

The venoms of Apis dorsata, A. cerana, A. florea, and three different populations of A. mellifera were compared for lethal activity toward mice. All venoms exhibited identical activities, a finding consistent with recent evolutionary history within the genus. Young queen honeybees use their venoms only for stinging other queens and possess a venom only half as lethal to mice as worker venom, and by the time queens are 1-2 years of age their venom has become essentially inactive. Phospholipase A2 is the most lethal of the honeybee venom peptides, whereas melittin, which is only slightly less lethal, is the most abundant. Concurrent analyses of melittin, phospholipase, and the combination of the two at their natural 3:1 mixture in bee venom revealed that the lethal activity of the mixture was about the same as native honeybee venom. This value was less than that for either melittin or phospholipase alone and indicates that synergism of the two peptides is not occurring. The results are consistent with independent lethal activities for the venom components, and show that melittin is not only the dominant, but also the main lethal component in honeybee venom.

Attraction of reproductive honey bee swarms to artificial nests by Nasonov pheromone.

A crossover experimental design was established to test the attractancy of Nasonov pheromone to reproductive swarms of honey bees. Nineteen swarms were attracted to artificial nest cavities containing a slow-release blend of the Nasonov components citral, geraniol, and nerolic + geranic acids, and only four swarms were attracted to pheromone-free artificial nests. The results indicate that Nasonov pheromone plays a key role in the attraction of honey bee swarms to nest cavities.

Serine proteinase inhibitor profiles in the hemolymph of a wide range of insect species.

1. The inhibition of trypsin, chymotrypsin, neutrophil elastase and cathepsin G, and pancreatic elastase by the hemolymph of 14 insect species in six orders has been investigated. 2. All samples showed great diversity in terms of both total proteinase inhibitory capacity and specificity. 3. The highest total inhibitory capacity was found in the larval hemolymph of species in the beetle family Tenebrionidae and the lowest in that of an adult coreid bug, Acanthocephala femorata.

Biochemical variability of venoms from individual European and Africanized honeybees (Apis mellifera).

To study biochemical differences between venom from individual honeybees, venom sacs from 103 European (EU) bees and 92 Africanized bees representing 12 different colonies were dissected, and the dry weight (DW) of venom from each bee was determined. Venom from each of these bees was studied with isoelectric focusing and functional assays for phospholipase A2 and melittin. Phospholipase concentrations in individual EU bee venoms varied between 1.8% and 27.4% (wt/wt). The melittin concentration in EU bee venom varied less and, on the average, was found to be much lower than previously reported. There was an eightfold to ninefold difference between lowest and highest venom sac DW contents, suggesting the possibility of highly variable venom delivery from bee stings. One EU bee contained greater than 300 micrograms of venom, three times the recommended maintenance dose for venom immunotherapy. Isoelectric focusing also demonstrated large differences between individual bees, with respect to major and minor components of their venoms. Africanized bees contained significantly less venom but more phospholipase than did EU bees. Bee venoms from different colonies differed in their DW content and in their concentrations of phospholipase and melittin. The results are relevant to the uncertainty of responses from sting challenges and field stings in allergic patients and massive stinging attacks on normal subjects.

Phenylalkenals in ponerine(Leptogenys sp.) and myrmicine (Pogonomyrmex sp.) ants.

Cephalic extracts of two unrelated species of ants,Leptogenys processionalis andPogonomyrmex rugosus, have been found to contain 2-phenylpropenal and 2-phenyl-2-butenal, while two other species related to the first,L. chinensis andL. kitteli, lacked either.L. kitteli also produced a tetrasubstituted pyrazine found previously only in two New Zealand ants in the genusMesoponera. The chemical reactivity of the phenylalkenals suggests their function in repelling attack by predators.

Mandibular gland secretions of the male beewolvesPhilanthus crabroniformis, P. barbatus, andP. pulcher (Hymenoptera: Sphecidae).

The composition of the territorial marking pheromones from mandibular glands of males of the beewolvesPhilanthus crabroniformis, P. barbatus, andP. pulcher have been determined. The structures of the components were elucidated by gas chromatography-mass spectrometry and gas chromatography-Fourier transform infrared spectroscopy. The major compound ofP. crabroniformis is isopropyl tetradecanoate, with somewhat lesser amounts of 2-tridecanone, 3-methyl-3-butenyl tetradecanoate, and 92∶8 (Z)∶(E)-11-eicosen-1-ol. The major compounds ofP. barbatus are ethyl tetradecanoate and hexadecanal, which are present in approximately a 60∶40 ratio. These two compounds comprise over 95% of the neutral lipids. Also present in lesser amounts are ethyl dodecanoate, tetradecanal, hexadecan-1-ol, a Δ (x) -octadecen-1-ol, and octadecan-1-ol. The major compounds ofP. pulcher are ethyl (Z)-7-hexadecenoate and geranylgeraniol acetate, which comprise nearly 90% of the neutral lipid fraction, with smaller amounts of tetradecanal, pentadecanal, and ethyl hexadecanoate; trace amounts of Δ (x) hexadecenal, hexadecanal, and octadecanal are also present.

Pharmacological characterization and chemical fractionation of the venom of the ponerine ant, Paraponera clavata (F.).

1. The neurotoxic action of the venom of the ponerine ant, Paraponera clavata, was studied using a cascade of mammalian smooth muscle preparations and a preparation for investigating transmission from fibres of the cercal nerve to a giant interneuron in the sixth abdominal ganglion of the cockroach. 2. The venom contains three toxic fractions that block synaptic transmission in the insect central nervous system. 3. Two of these fractions have agonistic action on mammalian smooth muscle preparations. 4. One of the later fractions was characterized pharmacologically as containing a kinin. 5. The other, and most active neurotoxic fraction, was rechromatographed, resulting in the purification of a peptide of 25 amino acids residues, called poneratoxin, PoTX: Phe-Leu-Pro-Leu-Leu-Ile-Leu-Gly-Ser-Leu-Leu-Met-Thr-Pro-Pro-Val-Ile-Gln- Ala-Ile-His-Asp-Ala-Gln-Arg-HN2.

Poneratoxin, a novel peptide neurotoxin from the venom of the ant, Paraponera clavata.

1. At concentrations varying from 10(-8) to 10(-6) M synthetic poneratoxin (PoTX) is a strong, but very slowly acting agonist for smooth muscles and its blocks synaptic transmission in the insect CNS in a concentration-dependent manner and depolarizes giant interneurons. 2. However, in isolated dorsal unpaired median cells 10(-6) M PoTX causes only a reversible hyperpolarization of about 5 mV. 3. At concentrations from 10(-8) to 10(-6) M PoTX affects the electrical activity of isolated cockroach axons, as well as isolated frog and rat skeletal muscle fibres. 4. PoTX prolongs action potentials and induces slow automatic activity, due to a slow Na(+)-current activation at very negative values of potential and due to slow deactivation.