Morphologic grading of emphysema is useful in the selection of candidates for unilateral or bilateral reduction pneumoplasty

Objective: Radiologic morphology of emphysema proves useful in the selection of candidates for bilateral reduction pneumoplasty. We developed a simple morphologic grading system capable of identifying subsets of patients who had maximal functional improvement after unilateral or bilateral operation. Methods: Fifty-two patients who underwent unilateral (n = 34) or bilateral (n = 18) reduction pneumoplasty were evaluated. Emphysema morphology was visually scored by digital roentgenograms and high-resolution computed tomography. In each lung, severity of emphysema (ES), heterogeneity (DHT) and hyperinflation (DHF) degrees, were assessed. Asymmetric ratio of emphysema (ARE) between the lungs was expressed as: higher ES/lower ES scores. Morphometric data were correlated with absolute preoperative-postoperative FEV1 change (Delta FEV1). Results: No difference was found between the unilateral and the bilateral group for ES and DHT. DHF was greater in the bilateral group (3.1 vs. 2.7, P = 0.02) whereas ARE was greater in the unilateral group (1.29 vs. 1.05, P = 0.0001). Stepwise logistic regression extracted as best predictors of maximal Delta FEV1, ARE (odds ratio = 238, Wald test P = 0.04) in the unilateral group, and DHT (odds ratio = 24, P = 0.03) in the bilateral group. Unilateral group Delta FEV1 was greater in patients with ARE greater than or equal to 1.3 (0.44 vs. 0.241, P = 0.02). Bilateral group Delta FEV1 was greater in patients with DEET > 1 (0.50 vs. 0.31 1, P = 0.03). No difference was found when comparing Delta FEV1 resulting from unilateral RP and ARE greater than or equal to 1.3, and bilateral RP (0.44 vs. 0.41 1, not significant). Conclusions: This morphologic grading system identified subsets of patients who had maximal functional benefit from unilateral or bilateral reduction pneumoplasty and might be useful in the preoperative screening of candidates for either approach. (C) 2000 Published by Elsevier Science B.V

Cytotoxic activity of Hypericum perforatum L. on K562 erythroleukemic cells: differential effects between methanolic extract and hypericin

The influence of a methanolic extract of Hypericum perforatum L. and of purified hypericin has been comparatively tested on the growth of a human erythroleukemic cell line (K562). After 1 h exposure to increasing concentrations (as hypericin content) of both agents in the dark, leukemic cells were grown for 24 h and 48 h. The effects on cell growth were determined by viable cell count, flow cytometry analysis and fluorescence microscopy. Our data show that purified hypericin has only a weak inhibitory effect on cell growth and no effect in inducing apoptotic cell death. In contrast, the Hypericum flower extract shows a significant concentration-dependent and long-lasting inhibition of cell growth, and induces apoptotic cell death. This work con fi rms the interesting role of Hypericum perforatum L. in cancer therapy and strongly supports the hypothesis that agents, other than hypericin, present in the total extract can impair tumor cell growth acting separately or in a combined manner

Effect of different parameters on the binding of two anti-inflammatory drugs to human serum albumin

The binding to human serum albumin of two anti-inflammatory drugs, indomethacin and indoprofen, has been studied by chromatographic and spectroscopic techniques. The results shown indicate that the binding of both drugs--but more notably of indoprofen--is very sensitive to variations of the environmental conditions. The binding is also dependent upon limited modifications in the tertiary structure of the protein. The evidences shown tend to indicate that these two phenomena are related, and that the binding is permitted under conditions of a relatively open structure of the protein molecule

Neurosteroids in the brain of handling-habituated and naive rats: effect of CO2 inhalation.

In rats habituated to the manipulation that precedes killing (handling-habituated) the cerebral cortical concentrations of pregnenolone and progesterone were significantly lower (-57% and -69%, respectively) than in naive animals. An acute stress, induced by CO2 inhalation, elicited a marked increase in the concentrations of pregnenolone, progesterone and deoxycorticosterone in the brain cortex and hippocampus of handling-habituated rats. An accepted stress, such as foot shock, also enhanced the brain cortical levels of pregnenolone, progesterone and deoxycorticosterone in handling-habituated rats. These data show that the rat brain cortical and hippocampal steroid content is related to the 'emotional state' of the animal

Modulatory mechanisms of cyclic AMP-stimulated steroid content in rat brain cortex

The modulation of cyclic AMP dependent neurosteroidogenesis was studied in minces prepared from the cerebral cortex of adult rat. Forskolin or dibutyryl-cyclic AMP enhanced pregnenolone and progesterone production in a time and dose-dependent manner. The forskolin effect was mimicked by the cyclic AMP phosphodiesterase inhibitor isobutyl-methyl-xanthine, but not by the adenylate cyclase inactive forskolin analogue 1,9,dideoxy-forskolin. 4'-Chloro-diazepam, a high affinity ligand for the mitochondrial diazepam binding inhibitor (DBI) receptor, also elicited a time dependent increase in steroidogenesis. The forskolin and the 4'-chloro-diazepam stimulated pregnenolone increase was prevented by preexposing the rat brain cortical minces to 1-(2-chlorophenyl)-N-methyl-N-(1-methyl-propyl)-3-isoquinoline carboxamide (PK 11195), a high affinity ligand for the mitochondrial DBI receptor endowed with antagonistic properties. The protein synthesis inhibitor cycloheximide prevented the forskolin and 4'-chloro-diazepam stimulation of pregnenolone formation. In brain cortical minces of adrenalectomised/orchiectomised rats dibutyryl-cyclic AMP increased both pregnenolone and progesterone formation, while forskolin only increased progesterone. These data show that cyclic AMP enhances brain steroidogenesis by acting on a labile protein substrate which interacts with the mitochondrial DBI receptor

Cyclic AMP-dependent increase of steroidogenesis in brain cortical minces

Rat brain cortical minces were incubated with forskolin and dibutyryl-cyclic AMP for 60 and 30 min, respectively. The concentrations of pregnenolone, progesterone and desoxycorticosterone in this preparation were significantly increased by both substances. The results indicate that, in brain tissue, steroidogenesis appears to be regulated by receptor transduction mechanisms that operate through adenylate cyclase