We have compared the incidence of CNS symptoms and changes in echocardiography and electrophysiology during i.v. infusions of ropivacaine, bupivacaine and placebo. Acute tolerance of i.v. infusion of 10 mg min-1 was studied in a crossover, randomized, double-blind study in 12 volunteers previously acquainted with the CNS effects of lignocaine. The maximum tolerated dose for CNS symptoms was higher after ropivacaine in nine of 12 subjects and higher after bupivacaine in three subjects. The 95% confidence limits for the difference in mean dose between ropivacaine and bupivacaine were -30 and 7 mg. The maximum tolerated unbound arterial plasma concentration was twice as high after ropivacaine (P < 0.001). Muscular twitching occurred more frequently after bupivacaine (P < 0.05). The time to disappearance of all symptoms was shorter after ropivacaine (P < 0.05). A threshold for CNS toxicity was apparent at a mean free plasma concentration of approximately 0.6 mg litre-1 for ropivacaine and 0.3 mg litre-1 for bupivacaine. Bupivacaine increased QRS width during sinus rhythm compared with placebo (P < 0.001) and ropivacaine (P < 0.01). Bupivacaine reduced both left ventricular systolic and diastolic function compared with placebo (P < 0.05 and P < 0.01, respectively), while ropivacaine reduced only systolic function (P < 0.01).

The retinoid X receptor (RXR) is a nuclear receptor that functions as a ligand-activated transcription factor. Little is known about the ligands that activate RXR in vivo. Here, we identified a factor in brain tissue from adult mice that activates RXR in cell-based assays. Purification and analysis of the factor by mass spectrometry revealed that it is docosahexaenoic acid (DHA), a long-chain polyunsaturated fatty acid that is highly enriched in the adult mammalian brain. Previous work has shown that DHA is essential for brain maturation, and deficiency of DHA in both rodents and humans leads to impaired spatial learning and other abnormalities. These data suggest that DHA may influence neural function through activation of an RXR signaling pathway.

Dehydroepiandrosterone (3f3-hydroxy-5-androsten-17-one, I) sulfate (Ia) has been characterized in the anterior and the posterior parts of the brain of adult male rats. Its level (1.58 ± 0.14 and 4.89 ± 1.06 ng/g, mean ± SD, in anterior and posterior brain, respectively) largely exceeded that of I in brain (0.42 ± 0.10 and 0.12 ± 0.03 ng/g in anterior and posterior brain, respectively) and of Ia in plasma (0.26 ± 0.13 ng/ml). Brain Ia level did not seem to depend on adrenal secretion; it was unchanged after administration of corticotropin or dexamethasone for 3 days, and no meaningful change occurred in brain 15 days after adrenalectomy plus orchiectomy, compared with sham-operated controls. In contrast, stress conditions prevailing 2 days after adrenalectomy plus orchiectomy or after the corresponding sham operation resulted in a significantly increased concentration of Ia in the brain. Changes of Ia level in brain occurred irrespective of changes in corresponding plasma samples. It is proposed that Ia formation or accumulation (or both) in the rat brain depends on in situ mechanisms unrelated to the peripheral endocrine gland system. Dehydroepiandrosterone (3,3hydroxy-5-androsten-17-one, I) sulfate (Ia) is below detection limit in the plasma of most adult mammals (1); the exceptions are man and the highest nonhuman primates (1-3). It is a major secretory product ofhuman adrenals (4-7), and its concentration in adult plasma is larger than that of any other steroid. Although Ia is the main precursor of placental estrogens (8-10) and is occasionally converted into active androgens in peripheral tissues (11,12) was added to 2 ml of plasma or <1 g of tissue, and then 5 ml ofacetone/ethanol (1:1) was added. Tissues were homogenized in acetone/ethanol (1:1) with a Teflon/glass homogenizer and sonicated with a Branson Jl sonifier equipped with a minitip at a 100-W setting for 10 sec. The suspensions were kept at 390C overnight and centrifuged at 1000 x g for 10 min. The supernatant was saved, and the pellet was extracted with 4 ml of methanol/chloroform (1:1) with continuous shaking at room temperature for 30 min. The extract was centrifuged, and the two supernatants were combined and taken to dryness. The residue was dissolved in 4 ml of methanol/chloroform (1:1)/10 mM NaCl and deposited on a Sephadex LH-20 column (10 X 445 mm) equilibrated and developed in the same solvent system (15). The first 50 ml to run off contained unconjugated I, Ia was eluted in the next 75 ml. It was completely separated from free I and from I conjugated to fatty acids (16) 4704The publication costs ofthis article were defrayed in part by page charge payment. This article must therefore be hereby marked "advertisement" in accordance with 18 U. S. C. §1734 solely to indicate this fact.

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Nuclear receptors (NRs) constitute a large and highly conserved family of ligand-activated transcription factors that regulate diverse biological processes such as development, metabolism, and reproduction. As such, NRs have become important drug targets, and the identification of novel NR ligands is a subject of much interest. The retinoid X receptor (RXR) belongs to a subfamily of NRs that bind vitamin A metabolites (i.e. retinoids), including 9-cis-retinoic acid (9-cis-RA). However, although 9-cis-RA has been described as the natural ligand for RXR, its endogenous occurrence has been difficult to confirm. Recently, evidence was provided for the existence of a different natural RXR ligand in mouse brain, the highly enriched polyunsaturated fatty acid (