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Rectification and rapid activation at low Ca2+ of Ca2+-activated, voltage-dependent BK currents: consequences of rapid inactivation by a novel beta subunit.

A family of accessory beta subunits significantly contributes to the functional diversity of large-conductance, Ca(2+)- and voltage-dependent potassium (BK) channels in native cells. Here we describe the functional properties of one variant of the beta subunit family, which confers properties on BK channels totally unlike any that have as yet been observed. Coexpression of this subunit (termed beta3) with Slo alpha subunits results in rectifying outward currents and, at more positive potentials, rapidly inactivating ( approximately 1 msec) currents. The underlying rapid inactivation process results in an increase in the apparent activation rate of macroscopic currents, which is coupled with a shift in the activation range of the currents at low Ca(2+). As a consequence, the currents exhibit more rapid activation at low Ca(2+) relative to any other BK channel subunit combinations that have been examined. In part because of the rapid inactivation process, single channel openings are exceedingly brief. Although variance analysis suggests a conductance in excess of 160 pS, fully resolved single channel openings are not observed. The inactivation process results from a cytosolic N-terminal domain of the beta3 subunit, whereas an extended C-terminal domain does not participate in the inactivation process. Thus, the beta3 subunit appears to use a rapid inactivation mechanism to produce a current with a relatively rapid apparent activation time course at low Ca(2+). The beta3 subunit is a compelling example of how the beta subunit family can finely tune the gating properties of Ca(2+)- and voltage-dependent BK channels.

Amino Acid Sequence↗

Influence of repeated exposure to rapidly developing hypoxaemia on the arousal and cardiopulmonary response to rapidly developing hypoxaemia in lambs.

Experiments were done on four lambs to determine if repeated exposure to rapidly developing hypoxaemia influences the cardiopulmonary and arousal response from sleep. Each lamb was anaesthetized and instrumented for sleep staging and measurements of arterial haemoglobin oxygen saturation. No sooner than three days after surgery, measurements were made in quiet sleep and active sleep during control periods when the animal was breathing 21% oxygen and during experimental periods of rapidly developing hypoxaemia when the animal was breathing 5% oxygen for approximately 100 epochs of sleep. Arousal occurred from both sleep states during rapidly developing hypoxaemia but was delayed in active sleep compared to quiet sleep. The time to arousal and the decrease in arterial haemoglobin oxygen saturation were significantly increased with repeated exposure to rapidly developing hypoxaemia during both quiet sleep and active sleep. Thus, our data provide evidence that repeated exposure to rapidly developing hypoxaemia produces an arousal response decrement in lambs. Since it is possible that alterations in the arousal response to respiratory stimuli play a role in sudden infant death, studies to investigate the mechanism of the arousal response decrement following repeated exposure to rapidly developing hypoxaemia are warranted.

Animals↗

A rapid review of rapid HIV antibody tests.

Rapid HIV antibody tests recently approved by the Food and Drug Administration can help reduce unrecognized infections by improving access to testing in both clinical and nonclinical settings and increase the proportion of those tested who learn their results. Four rapid HIV antibody tests are now available in the United States; two are approved for use at point-of-care sites outside a traditional laboratory. All four tests are interpreted visually. Sites offering rapid HIV testing must periodically run external controls (known HIV-positive and HIV-negative specimens) and provide persons who undergo rapid testing a subject information sheet. This paper reviews the operating and performance characteristics, quality assurance and laboratory requirements, and HIV counseling implications of the currently available rapid HIV tests.

Journal Article↗

Field trials of a rapid test for G6PD deficiency in combination with a rapid diagnosis of malaria.

A rapid single-step screening method for detection of glucose-6-phosphate dehydrogenase (G6 PD) deficiency was evaluated on Halmahera Island, Maluku Province, Indonesia, and in Shan and Mon States, Myanmar, in combination with a rapid diagnosis of malaria by an acridine orange staining method. Severe deficiency was detected by the rapid test in 45 of 1126 volunteers in Indonesia and 54 of 1079 in Myanmar, but it was difficult to distinguish blood samples with mild deficiency from those with normal activity. 89 of 99 severely deficient cases were later confirmed by formazan ring method in the laboratory, but 5 with mild and 5 with no deficiency were misdiagnosed as severe. Of the samples diagnosed as mild and no deficiency on-site, none was found to be severely deficient by the formazan method. Malaria patients were simultaenously++ detected on-site in 273 samples on Halmahera island and 277 samples from Shan and Mon States. In Mon State, primaquine was prescribed safely to G6 PD-normal malaria patients infected with Plasmodium vivax and/or gametocytes of P. falciparum. The new rapid test for G6 PD deficiency may be useful for detecting severe cases under field conditions, and both rapid tests combined are can be useful in malaria-endemic areas, facilitating early diagnosis, prompt and radical treatment of malaria and suppression of malaria transmission.

Acridine Orange↗

Insulin glulisine, a new rapid-acting insulin analogue, displays a rapid time-action profile in obese non-diabetic subjects.

AIMS/HYPOTHESIS: This study compared the pharmacokinetics and pharmacodynamics of insulin glulisine, insulin lispro, and regular human insulin in obese subjects. METHODS: In this single-dose, randomized, double-blind, crossover euglycaemic clamp study, 18 non-diabetic subjects (mean body mass index [BMI] 34.7 kg . m (-2)) were randomized to receive subcutaneous injections of each insulin (0.3 U . kg (-1)) in pre-determined sequences. RESULTS: Insulin glulisine and insulin lispro had more rapid-acting profiles than regular human insulin. Fractional glucose infusion rate (GIR)-area under curves (AUC) of the GIR curve and maximum GIR were greater for insulin glulisine and insulin lispro versus regular human insulin. Total glucose disposal was slightly greater with insulin glulisine than with regular human insulin, and was comparable to insulin lispro, although it decreased with increasing insulin resistance (HOMA index) with all insulins. Time to 20 % (early glucose disposal) and 80 % (bulk of activity) of total GIR-AUC were shorter for insulin glulisine and insulin lispro versus regular human insulin. This was corroborated by more rapid and shorter residing pharmacokinetic profiles of insulin glulisine and insulin lispro versus regular human insulin, evidenced by shorter times to 20 % of total INS-AUC, INS-C (max) (INS-t (max)), and mean residence time. Moreover, time to 20 % of total GIR-AUC demonstrated a less rapid-acting profile for insulin lispro versus insulin glulisine, which was consistent with the slightly less rapid pharmacokinetic profile of insulin lispro. There was no significant correlation between BMI or subcutaneous fat thickness and pharmacokinetic or pharmacodynamic profiles for insulin glulisine, unlike insulin lispro and regular human insulin. CONCLUSIONS/INTERPRETATION: Insulin glulisine and insulin lispro demonstrated substantially more rapid time-action profiles than regular human insulin in obese non-diabetic subjects, which prevailed with insulin glulisine irrespective of BMI and subcutaneous fat thickness.

Adult↗

Comparative evaluation of the Rapid ID 32A kit system, miniaturized standard procedure and a rapid fermentation procedure for the identification of anaerobic bacteria.

The RAPID ID 32A and a rapid fermentation procedure were compared with a miniaturized standard procedure for the identification of 102 isolates of anaerobic bacteria belonging to 11 genera. The miniaturized standard procedure identified all 102 isolates at the genus level and 90 at the species level. The rapid fermentation procedure failed to identify 12 and 24 isolates at the genus and species levels respectively and is unsatisfactory. The RAPID ID 32A system misidentified 4 isolates (4%) at the genus level, 3 of which could have been avoided if the results of the Gram stain, the fundamental procedure in medical microbiology, had been taken into account. The system correctly identified 89 isolates at the species level. Since it does not produce species identifications within the genera Mobiluncus and Veillonella of which 7 and 2 isolates respectively were included in the study, the percentage of correct identifications at the species level is 96.7% (90/93). The RAPID ID 32A system is about 25 times more expensive than the miniaturized standard procedure if the investment for a gas chromatograph is not taken into account.

Bacteria, Anaerobic↗

Pulmonary vascular pressures of thoroughbreds increase rapidly and to a higher level with rapid onset of high-intensity exercise than slow onset.

Previous studies of pulmonary vascular pressures have utilised gradual incremental step exercise protocols, but in competitive racing at the track, horses perform rapid acceleration high-intensity exercise. The rate of rise in pulmonary vascular pressures under conditions of quick onset high-intensity exercise is unknown. Catheter mounted manometers, whose in vivo signals were matched with pressure signals obtained via transducers connected to fluid-filled lumens from same cardiovascular sites, were used to compare right heart and pulmonary vascular pressures in 8 healthy Thoroughbreds performing 2 separate exercise protocols on a high speed treadmill (gradually incremental vs. rapid acceleration exercise protocol where the belt speed was raised from 8 m/s to 15 m/s in 8 s). Heart rate, right atrial and pulmonary vascular pressures at rest were similar for the 2 protocols. Rapid acceleration of horses from 8 to 15 m/s was attended by an equally rapid escalation in the right heart and pulmonary vascular pressures such that these pressures reached their zenith as belt speed approached 15 m/s. Although exercise at 15 m/s resulted in similar heart rate in the 2 protocols, the mean +/- s.e. values of mean right atrial pressure, mean pulmonary artery pressure, mean pulmonary artery wedge pressure and mean pulmonary capillary pressure (91.5 +/- 3.9 mmHg) in the rapid acceleration exercise were significantly (P < 0.05) higher than respective values at 15 m/s in the gradual incremental step exercise protocol.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Rapidly progressive sensorineural hearing loss (rapid deafness).

28 ears of 28 patients, aged 15 to 60 years, whose sensorineural hearing loss had developed over a period of a few hours to 3 days, were defined as having rapidly progressing sensorineural hearing loss (rapid deafness), in comparison with so-called sudden deafness with instantaneous onset. For other criteria, their hearing loss was idiopathic and the rate of hearing loss was confirmed by reliable means. The rate was greatest within the first 1-3 days. Of the 28 patients, 12 (43%) recovered completely, while another 12 improved markedly. The prognosis in rapid deafness was relatively good, but the recovery time was longer than in spontaneously healing sudden deafness. Sensorineural hearing loss in contralateral ears more often preceded rapid deafness (9 cases, 32%). No clear-cut difference could be found between rapid deafness and sudden deafness.

Adolescent↗

Rapid antimicrobial susceptibility testing of gram-negative bacilli using Baxter MicroScan rapid fluorogenic panels and autoSCAN-W/A.

The MicroScan Rapid Neg MIC/Combo panels and autoSCAN-W/A (Walk Away) system utilize automated fluorescence technology for rapid antimicrobial susceptibility testing of Gram-negative bacilli. In a three site clinical study eleven antimicrobial agents were evaluated by comparing results obtained with 741 clinical isolates, using rapid fluorogenic expanded dilution MIC panels and corresponding frozen microdilution reference panels determined visually. Results for 31%, 40%, 12% and 9% of the isolates were available within 3.5, 4.5, 5.5 and 7.0 hours respectively. Results for 7.3% were not available within that time period. For the seven drugs analyzed using a Minimum Inhibitory Concentration range of dilutions, overall agreement (+/- 1 dilution) was 94%, with 1.5% very major, 0.9% major and 2.5% minor errors. For the four drugs analyzed using a Breakpoint range of dilutions, overall agreement (+/- 1 dilution) was 97%, with two percent very major, and one percent major errors. The MicroScan Rapid Neg MIC system is an accurate and rapid method for same day determination of susceptibility of Gram-negative bacilli.

Anti-Bacterial Agents↗

Rapid antimicrobial susceptibility testing of gram-positive cocci using Baxter MicroScan rapid fluorogenic panels and autoSCAN-W/A.

The Microscan Rapid Pos MIC/Combo panels and autoSCAN-W/A (Walk Away) system utilize automated fluorescence technology for rapid antimicrobial susceptibility testing of staphylococci, streptococci, and Listeria. In a three site clinical study, panels containing 26 antimicrobial agents were evaluated by comparing results obtained with 605 clinically significant isolates, using rapid fluorogenic expanded dilution MIC panels and corresponding frozen microdilution reference panels. Results for 16%, 40%, 13%, 9%, 8%, 11% and 1% of the isolates were available within 3.5, 4.5, 5.5, 7.0, 8, 11 and 15 h respectively. Results for 2% were not available within that time period. Overall agreement (+/- 1 dilution) for the 14,609 efficacy comparisons was 96%, with 1% each for very major, major and minor errors. Interlaboratory reproducibility testing of 25 isolates in triplicate in each site, showed an overall essential agreement of 97%. The MicroScan Rapid Pos MIC System is an accurate, reproducible and rapid method for same-day determination of susceptibility of Gram-positive cocci.

Anti-Bacterial Agents↗

Use of the RAPID ID 32 A system for rapid identification of Clostridium species important in food hygiene.

The identification of Clostridium species using conventional biochemical reactions or commercially available miniaturized ready-to-use test kits often yields uncertain results. One of these test kits, the RAPID ID 32 A identification system for anaerobes (bioMérieux, Marcy-l'Etoile, France), is based on the evaluation of the action of preformed bacterial enzymes and allows classification to the species level within 4 h. This study intended to assess the suitability and reliability of this system for the rapid identification of Clostridium species relevant to food hygiene. For this purpose, 122 test strains of 18 different Clostridium species were examined via RAPID ID 32 A. Of these, 110 (90.2%) were correctly identified to the species level within 4 h. In addition, six strains were successfully classified after examination with supplementary biochemical reactions suggested by the manufacturer, which required an overall examination time of 72 h. The identity of five Clostridium strains could not be determined and in one case the test kit yielded a wrong species classification. Altogether, a correct identification was possible for 116 (95.1%) of the isolates, the total error rate was 4.9%. Using the RAPID ID 32 A system a great number of Clostridium species which are relevant to food hygiene and are often difficult to identify can be correctly and reliably classified within 4 h. Nevertheless, the test system has to be regarded as not yet completely satisfactory, e.g., because C. tyrobutyricum isolates were only insufficiently identified. Further improvements of the system are desirable in order to make it universally applicable in food microbiology.

Clostridium↗

Rapid review in cervical cytology: a retrospective review of cases detected on rapid review within a DGH cytology department and subsequent outcome.

We retrospectively reviewed smears detected by rapid review within a district general hospital (DGH) laboratory over a period of 33 months and the subsequent histological or cytological outcome. Sixty-three cases had adequate follow-up data: 32 subsequently had two negative smears and 31 had a histological abnormality on subsequent biopsy. Twenty were high-grade lesions (CIN2, CIN3 or a glandular lesion) and eight of these were preceded by a low-grade smear abnormality. We reviewed and compared the pattern and distribution of smear abnormalities in these 63 cases. Abnormalities were often present within few cells (76%, n = 48 with 50 abnormal cells or less) or in micro-biopsies (27%, n = 17). There was no statistical difference in the pattern and distribution of smear abnormality between the rapid review-detected smears with a biopsy-proven abnormality and those with negative follow-up smears. Overall, the positive predictive value for high-grade CIN detected by rapid review (75%) was within NHSCSP achievable standards targets. This review of rapid review-detected abnormalities and the biopsy and cytological follow-up reiterates the importance of the method in cervical screening.

Diagnostic Errors↗

Comparison of API 20E, API rapid E, and API rapid NFT for identification of members of the family Vibrionaceae.

Sixty isolates, from nine species of the family Vibrionaceae, were tested by the API 20E, API Rapid E, and API Rapid NFT systems. Results were compared with those obtained with standard biochemicals. Included were 7 Aeromonas caviae isolates, 27 Aeromonas hydrophilia isolates, 10 Aeromonas sobria isolates, 3 Plesiomonas shigelloides isolates, 3 Vibrio alginolyticus isolates, 3 Vibrio cholerae isolates, 1 Vibrio fluvialis isolate, 5 Vibrio parahaemolyticus isolates, and 1 Vibrio vulnificus isolate. The API 20E correctly identified all the isolates within 24 h. The API Rapid E correctly identified only 77%, misidentified 8%, and failed to identify 2% of the isolates in 4 h. The remaining 13% of the isolates gave a low selectivity identification, with one of the choices being correct. The API Rapid NFT correctly identified 87%, misidentified 5%, gave a low selectivity identification for 8% of the isolates, and in some instances, required up to 48 h of incubation. The API 20E is a valid system for use in the identification of the more commonly occurring members of the family Vibrionaceae and the most accurate and efficient of the three systems tested.

Reagent Kits, Diagnostic↗

[Skin closure in inguinal hernia repair with rapidly absorbing Polyglactin 910/370 (Vicryl-Rapide) suture material].

OBJECTIVE: Results of fast absorbing Poliglactin 910/370 suture material were assessed in skin closure following invaginal hernia repairs. METHODS: Fifty consecutive patients undergoing invaginal hernia repair were prospectively and randomly assigned in two groups. In Group I, wounds were closed with conventional absorbable subcutaneous Polyglactin 910 (VICRYL, ETHICON) and non absorbable cutaneous Monofilament Nylon (ETHILON, ETHICON) stitches. In Group II, running subcutaneous and intradermic irradiated Polyglactin 910/370 (VICRYL-Rapide, ETHICON) sutures were used. The time of skin closure, the price of the suture material, short and middle term cosmetic results, complications in wound healing and the subjective comfort of patients were noted. RESULTS: The cost of skin closing was similar, while the need for further medical wistis was lower in the VICRYL-Rapide group. The wound healing process and it's cosmetic results were similar. Patients in Group II experienced less discomfort, due to the avoidance of suture removal. CONCLUSION: The rapidly resorbing suture material (VICRYL-Rapide) is a cost effective choice for closing the skin of invaginal hernia repairs and probably of other clean operations.

Absorption↗

Pulmonary edema and rapid transfusion: the comparison between rapid intravenous and intraarterial infusion in the severely hemorrhagic anesthesized pigs.

BACKGROUND: Patients with shock often develop pulmonary edema (PE) after rapid and massive fluid supplement and intravenous infusion. Rapid intraarterial infusion (RIA) is often used for fluid supplement in cardiac surgery, but has not yet been applied to treatment of hemorrhagic shock. However, by perfusing the ischemic peripheral organs through RIA, the fluid should flow first through the venous system to the heart and lung in less volume at lower speed. Therefore, the probability of developing PE should be less than that in rapid intravenous infusion (RIV) to the heart and lung in the same condition regarding volume and speed. Accordingly, we compared RIV and RIA in the treatment of hemorrhagic shock (HS) to determine if RIA provides any beneficial effect in reducing the development of PE. METHODS: Eleven male mini-pigs weighing 17.5-32 kg were randomly divided into two groups to have RIV and RIA. Under general anesthesia, HS was induced by shedding blood (about 35 ml/kg) through the femoral artery until the mean arterial blood pressure (MAP) fell to 50 mm Hg. This condition was maintained for three hours. Then, lactated Ringer's solution (LRS) was infused thrice by force through a femoral artery (RIA) or an external jugular vein (RIV) at a speed of 25 ml/kg/min for 3 min. Data include hemodynamics, arterial blood gases, urine output, total extravascular lung water index (ETVI), and total amount of infused LRS used to induce gross PE (endotracheal release of pinkish foamy sputum). Serum concentrations of catecholamines, platelet activating factor (PAF) and thromboxane B2 (TxB2) were measured. RESULTS: The total amount of LRS needed to induce gross PE was significantly greater in RIA than in RIV group. ETVI after rapid transfusion with a total of 225 ml/kg LRS was significantly less in RIA than in RIV group. Also, TxB2 concentrations in serum were less in RIA group. However, there was no difference in changes of hemodynamics, blood gases, acid-base, pulmonary shunting, urine output, serum concentrations of PAF or catecholamines between these two groups. CONCLUSIONS: RIA may be a better choice for fluid replacement in HS in terms of decreasing the development of PE and lessening the release of ETVI and TxB2 in severely hemorrhagic anesthetized pigs. Further human investigation is warranted.

Animals↗

Coronary dissection resulting from angioplasty with slow oscillating vs. rapid inflation and slow vs. rapid deflation.

To determine if slow inflation or slow deflation (compared to standard rapid inflation/deflation) would minimize coronary arterial dissection, we randomized 162 lesions from 136 patients undergoing coronary angioplasty with polyolefin copolymer balloons to slow oscillating (1 atmosphere/20 sec) vs. rapid (over 30 sec) inflation and slow (over 15 sec) vs. rapid deflation. The incidence of any dissection was nearly identical in the four inflation/deflation groups. The incidence of severe dissection, however, was significantly higher for the slow inflation/slow deflation group compared to the other three groups (38% vs. 15%, P = .024). For angioplasty performed with polyolefin copolymer balloons, slow deflation combined with slow oscillating inflation is associated with more frequent severe dissections.

Adult↗

Efficacy and safety of Fenwal CS-3000 plateletpheresis performed at a rapid donor blood flow rate: rapid plateletpheresis with Fenwal CS-3000.

Results of 3,214 plateletpheresis procedures, using the Fenwal CS-3000 cell separator, were reviewed to determine the effects on performance when the donor blood flow rate was increased by 30% (i.e., to 65 ml/min instead of 50 ml/min). Ninety-two percent (2,962 of 3,214) of procedures completed the rapid flow protocol, and results were compared with those reported by others using the more conventional blood flow rates of 32-55 ml/min. When the rapid flow procedure was used, mean platelet yields (4.07 x 10(11)) and leukocyte contamination (2.65 x 10(8)) were satisfactory, and major donor reactions were infrequent (0.6% of procedures). Thus, CS-3000 plateletpheresis can be performed at a relatively rapid, donor blood flow rate of 65 ml/min to shorten the procedure and make it more appealing to donors.

Blood Flow Velocity↗

Rapid vessel prototyping: vascular modeling using 3t magnetic resonance angiography and rapid prototyping technology.

OBJECT: Conversion of thoracic aortic vasculature as measured by Magnetic Resonance Imaging into a real physical replica. MATERIALS AND METHODS: Several procedural steps including data acquisition with contrast enhanced MR Angiography at 3T, data visualization and 3D computer model generation, as well as rapid prototyping were used to construct an in-vitro model of the vessel geometry. RESULTS: A rapid vessel prototyping process was implemented and used to convert complex vascular geometry of the entire thoracic aorta and major branching arteries into a real physical replica with large anatomical coverage and high spatial resolution. CONCLUSION: Rapid vessel prototyping permits the creation of a concrete solid replica of a patient's vascular anatomy.

Aorta, Thoracic↗