Eltanolone as an alternative to propofol for ambulatory anesthesia

The intravenous (i.v.) steroid anesthetic, eltanolone, compares favorably to propofol with respect to its induction characteristics. This double-blind investigation was designed to compare the induction and recovery profile of eltanolone (versus propofol) when it was used for both induction and maintenance of ambulatory anesthesia. Eighty-three consenting ASA physical status I-III outpatients undergoing minor gynecologic or urologic procedures lasting 10-40 min were randomly assigned to one of three anesthetic treatment groups. All patients received midazolam, 2 mg i.v., and fentanyl, 50 micrograms i.v., before induction of anesthesia. The control group (Group 1) was induced with propofol, 2.4 mg/kg i.v. (18-60 yr or ASA physical status I or II) or 1.6 mg/kg i.v. (61-80 yr and/or ASA physical status III), followed by intermittent bolus doses of 0.6 mg/kg i.v. in combination with N2O 67% for maintenance of anesthesia. In Group 2, anesthesia was induced with eltanolone, 0.75 mg/kg i.v., (18-60 yr and/or ASA physical status I or II) or 0.5 mg/kg i.v. (61-80 yr and/or ASA physical status III), and maintained with intermittent bolus injections of 0.2 mg/kg i.v. and N2O 67%. Group 3 received eltanolone, 1.0 mg/kg i.v. (18-60 yr and/or ASA physical status I or II), or 0.75 mg/kg i.v. (61-80 yr and/or ASA physical status III), followed by intermittent bolus injections of 0.2 mg/kg i.v. and N2O 67%. In addition to recording the induction and recovery times and side effects, psychomotor testing was performed before and at 30-min intervals after anesthesia. Induction times (57 +/- 23, 67 +/- 26, and 61 +/- 22s, respectively) were similar in all three groups. Although eltanolone produced no pain on injection (versus 52% in the propofol group), 10% of the eltanolone-treated patients (versus none in the propofol group) developed transient cutaneous (rash-like) reactions. The total dose of study medication used during the anesthetic period was 9.2 +/- 3.7 mg.kg-1.h-1 in the propofol group compared with 3.3 +/- 1.4 mg.kg-1.h-1 and 3.3 +/- 1.9 mg.kg-1.h-1 in Groups 2 and 3, respectively. Early recovery times were significantly shorter after propofol anesthesia. However, times to ambulation, micturition, and being judged "fit for discharge," as well as recovery of cognitive function, were similar in all three groups. Although ethanolone seems to be a safe and effective i.v. anesthetic, these data suggest that it is unlikely to replace propofol in the ambulatory setting.

IMPLICATIONS

Eltanolone is an investigational steroid anesthetic that causes less pain on injection and less cardiovascular depression than propofol (the most widely used intravenous anesthetic in the outpatient setting). Unfortunately, emergence from anesthesia after ambulatory surgery is slower with eltanolone compared with propofol. Therefore, it is unlikely that eltanolone will replace propofol for outpatient anesthesia.

Two cytotoxic pathways of natural killer cells in human cord blood: implications in cord blood transplantation

Using K562 cells as a target we investigated cord blood (CB)-natural killer (NK) cytolytic pathways. The cytotoxicity of fresh CB-NK cells was significantly lower than that of peripheral blood mononuclear cells (PB MNCs). When CB was incubated with IL-2, the level of CB-NK cytotoxicity was increased and boosted to the level observed in PB-NK cells. Fresh CB-NK cells induced apoptosis in target cells. Activated CB cells induced apoptosis and necrosis in target cells, at the same level as PB MNCs. CB stem cell transplantation may also induce graft-versus-host disease (GVHD)/graft-versus-leukaemia (GVL), similar to bone marrow transplantation.

[Effects of antisense oligodeoxynucleotides targeting multidrug resistance gene on resistant cell line K562/ AO2]

OBJECTIVE

To investigate the reversal effect of antisense oligodeoxynucleotide on human multidrug-resistant leukemic cell line K562/AO2.

METHODS

Antisense oligodeoxynucleotides (AOD) targeting-6 approximately 9 sites of exon 2 in human multidrug resistance gene(mdr-1), one of which is sequence-strict-complied and linked with polyethyleneglycol (PEG) at 5' end (AP, 15 mer), the other lacks nucleotide complied site-1 (AP', 14mer), were synthesized. AP, AP' and verapamil were simultaneously added to human mdr-1-mRNA positive leukemia cell line K562/AO2 and, mdr-1-mRNA and p170 were detected. AS' and AP'were labelled by FITC and designated as ASF' and APF', respectively. In addition, the intracellular concentration of them was detected by FACS.

RESULTS

AP' significantly enhanced the sensitivity of K562/AO2 to DOX, down-regulated the expression of mdr-1 and MRP-mRNA and p170, elevated the intracellular concentration of the two AOD, while AP had no effect. The uptake of APF' was significantly higher than that of ASF' in K562/AO2, and the fluorescence was observed in the plasma and nuclear of K562/AO2 cells.

CONCLUSION

(AOD targeting mdr-1 promoted the drug sensitivity of drug-resistant tumor cells. 2 AOD had no cytotoxicity to tumor cells. 5 Low molecule PEG enhanced significantly the uptake of AOD by tumor cells.

Fibrin induction of tissue factor expression in human vascular endothelial cells

BACKGROUND

For the present study, we hypothesized that fibrin is an inducer of tissue factor (TF) expression in vascular endothelial cells in vitro and in vivo.

METHODS AND RESULTS

To test the in vitro aspect of this hypothesis, human umbilical vein endothelial cells (HUVECs) were cocultured with physiologically relevant concentrations of fibrin (0.03 to 1.0 mg fibrin/mL) for various times (0.5 to 24 hours), and TF expression was compared with that in unstimulated HUVECs (media control). Results demonstrated that fibrin induced a time- and dose-dependent increase in TF antigen expression, functional TF procoagulant activity, and TF mRNA in HUVECs.

CONCLUSIONS

These studies demonstrate that fibrin can directly regulate TF expression in HUVECs in vitro.

Cytotoxic T-lymphocytes recognizing P-glycoprotein in murine multidrug-resistant leukemias

A multidrug-resistant murine lymphoid leukemia P388/ADR overexpresses P-glycoprotein (P-gp), an active transporter that pumps cytotoxic drugs out of cells and a product of mdr1 gene. Cytotoxic T lymphocytes (CTL) that showed cytotoxicity against P388/ADR were generated from mixed lymphocyte tumor cell culture. CTL do not kill drugsensitive parental P388 (P388/parent) that does not express P-gp. Monoclonal antibody against P-gp inhibited cytotoxic activity. Similar results were obtained in another multidrug-resistant cell line P388/VP-16. Cytotoxic activity was mediated by Thy1+ CD4- CD8+ T-cells. When P388/ADR was treated with murine IL-4, expression of P-gp was downregulated. Monoclonal antibody against interleukin-4 (IL-4) abrogated the IL-4-induced suppression of P-gp. Cytolytic activity of CTL against IL-4-treated P388/ADR was dose dependently inhibited. These results suggest that P-gp is immunogenic and can be a target of CTL in this murine leukemia model.

[Discovery of a novel reassortant H1N2 influenza virus]

Three strains of influenza A virus were isolated from patients suffering from influenza like disease in Railway Hygiene and Anti-epidemic Station of Taiyuan in January 1996. The identification results by serological method indicated that the isolates were different from H1N2 subtype of influenza A virus isolated from men in 1989 and 1992 and that their HA antigenicity was similar to that of A/RP/8/34 (H1N1) virus, but distinguishable from that of influenza A (H1N1) virus circulating in mans recently. The comparison of migration patterns of the RNA among the isolates, the A/PR//34 (H1N1) and the A/Wuhan/359/95 (H3N2) viruses revealed that the migration patterns of RNA 1-4 segments of the isolates were similar to those of A/PR/8/34 (H1N1) virus, but those of RNA 5-6 segments were indistinguishable from those of A/Wuhan/359/95 (H3N2) strain. However, the migration patterns of RNA 7-8 segments of the isolates were not only different from those of A/PR/8/34 (H1N1) virus, but also distingrasgable from those of A/Wuhan/359/95 (H3N2) strain. Therefore, it could be considered that the isolates were a novel reassortant H1N2 influenza A virus.

[The plant regeneration of Salvia miltiorrhiza Bge. transformed by Agrobacterium]

The hairy roots and crown galls of Salvia miltiorrhiza were obtained by infecting plant with A. rhizogenes (strain 15834, LBA 9402) and A. tumefaciens (strain C58). The transformed plants were regenerated light and transplanted form cultural medium into soil successfully. The plants transformed by A. rhizogenes have characteristics of short stems and develop hairy roots, those and trans formed by A. tumefaciens grow vigorously featuring, longer stems and well developed roots. Both biomass production and tanshenone content are higher than the original plant.

Pharmacokinetic study on acetaminophen: interaction with a Chinese medicine

To know the influences of a Chinese traditional medicine (KAKKONTO) on the metabolism of acetaminophen (APAP), we have carried out pharmacokinetic studies on APAP under KAKKONTO coadministration in humans and rats. In humans, the pharmacokinetic parameters were calculated from the blood APAP concentration-time curves of each volunteer. The parameters did not show any significant differences between the KAKKONTO-coadministration group (group K) and the APAP-administration group (group A). KAKKONTO, when given at two different doses, did not show any significant effects on blood APAP level. In rats, the blood APAP level was significantly higher than that of group A (p < 0.01) only in the 100 mg/kg of group K at 0.25 h after APAP administration. There were no other significant differences.

[In vitro reversal of homoharringtonine resistance by the combination of tamoxifen and verapamil]

OBJECTIVE

To investigate the reversal of homoharringtonine (HHT)-resistance by tamoxifen (TAM) or verapamil (VER) alone or in combination.

METHODS

The drug-sensitivity test was performed with semisolid agar culture.

RESULTS

The cytotoxicity of HHT to K562/S cells was not enhanced by TAM or VER alone or in combination,but HHT resistance in HHT resistant cells (K562/H20) was reversed by VER and TAM at nontoxic doses (4micromol/L or 8micromol/L). The IC50 of K562/H20 for HHT decreased from 446.8 +/- 0.08microg/L to 45.1 +/- 0.02microg/L in the presence of 4micromol/L of VER, to 22.4 +/- 0.03microg/L in 8micromol/L of VER, to 85.1 +/- 0.03microg/L in 4micromol/L of TAM and to 26.4 +/- 0.02microg/L in 8micromol/L of TAM. In the presence of combinations of 2micromol/L VER and 4micromol/L TAM and of 2micromol/L VER and 8micromol/L TAM, IC50 of K562/H20 decreased to 30.4 +/- 0.02microg/L and 4.3 +/- 0.04microg/L, respectively.

CONCLUSION

HHT-resistance could be reversed by VER or TAM alone, and the combination of the two drugs showed a synergistic effect.

Reciprocal regulation of the content of aromatic L-amino acid decarboxylase and tyrosine hydroxylase mRNA by NGF in PC12 cells

Aromatic L-amino acid decarboxylase (AADC) and tyrosine hydroxylase (TH) are involved in the synthesis of dopamine and other monoamine neurotransmitters, and their activities can be regulated by a number of physiological stimuli. An interesting finding has been that (-)-deprenyl and some other irreversible monoamine B oxidase inhibitors increase AADC gene expression and that these compounds can exert neuronal protection/rescue effects. In this study, we have investigated the effects of nerve growth factor (NGF), and of (-)-deprenyl on AADC and TH gene expression in PC12 cells. Cells were treated with different doses of NGF (0.2-50 ng/ml) for up to 3 days. Northern and blot hybridizations were performed to detect AADC and TH mRNA. The results show that NGF can down-regulate AADC gene expression while increasing TH gene expression in a time- and dose-dependent fashion. Treatment with (-)-deprenyl alone increases the gene expression of AADC, and (-)-deprenyl further counteracts the reductions induced by NGF. This study introduces novel results with regard to the regulation of the gene expression of AADC in PC12 cells, which is not paralleled by the other catecholamine biosynthetic enzymes. These findings support the existence of an interaction between NGF and AADC gene expression that may be associated with the process of neuronal degeneration or regeneration.

Fibrin induction of ICAM-1 expression in human vascular endothelial cells

In acute and chronic inflammatory processes, fibrin deposition, and leukocyte accumulation are classic histopathologic hallmarks. Previous studies have shown that fibrin and fibrin degradation products can have biologic effects on vascular endothelial cells and can induce the expression of several endothelial cell-derived factors that may be important in regulating inflammation and tissue repair. We now demonstrate that coculture of human vascular endothelial cells (EC) with fibrin results in the up-regulation of intercellular adhesion molecule-1 (ICAM-1), thus providing a first link between fibrin deposition and adhesion molecule expression, which may lead subsequently to leukocyte accumulation and extravasation. Increased ICAM-1 expression was demonstrated by ELISA, flow cytometry, and functional adhesion assays. EC ICAM-1 expression increased in a time and dose response fashion. Cell surface levels of ICAM-1 induced by fibrin were comparable to, or exceeded, levels induced by IL-1beta. ICAM-1 expression increased beginning at 4 h post-fibrin formation with sustained elevated expression at 48 h. Fibrin-stimulated EC also bound increased numbers of polymorphonuclear neutrophils in cellular adhesion assays. This increase in adhesion could be blocked by Ab to ICAM-1. Inhibition of fibrin polymerization also inhibited the up-regulation of ICAM-1. Culture medium from fibrin-stimulated EC contained elevated levels of soluble ICAM-1. These data suggest that fibrin deposition on vascular EC, in addition to other reported effects on EC metabolism, may also lead to leukocyte accumulation and extravasation through the induction of leukocyte adhesion molecules such as ICAM-1.

Fibrin induction of ICAM-1 expression in human vascular endothelial cells

In acute and chronic inflammatory processes, fibrin deposition, and leukocyte accumulation are classic histopathologic hallmarks. Previous studies have shown that fibrin and fibrin degradation products can have biologic effects on vascular endothelial cells and can induce the expression of several endothelial cell-derived factors that may be important in regulating inflammation and tissue repair. We now demonstrate that coculture of human vascular endothelial cells (EC) with fibrin results in the up-regulation of intercellular adhesion molecule-1 (ICAM-1), thus providing a first link between fibrin deposition and adhesion molecule expression, which may lead subsequently to leukocyte accumulation and extravasation. Increased ICAM-1 expression was demonstrated by ELISA, flow cytometry, and functional adhesion assays. EC ICAM-1 expression increased in a time and dose response fashion. Cell surface levels of ICAM-1 induced by fibrin were comparable to, or exceeded, levels induced by IL-1beta. ICAM-1 expression increased beginning at 4 h post-fibrin formation with sustained elevated expression at 48 h. Fibrin-stimulated EC also bound increased numbers of polymorphonuclear neutrophils in cellular adhesion assays. This increase in adhesion could be blocked by Ab to ICAM-1. Inhibition of fibrin polymerization also inhibited the up-regulation of ICAM-1. Culture medium from fibrin-stimulated EC contained elevated levels of soluble ICAM-1. These data suggest that fibrin deposition on vascular EC, in addition to other reported effects on EC metabolism, may also lead to leukocyte accumulation and extravasation through the induction of leukocyte adhesion molecules such as ICAM-1.

Approximate maximum likelihood hyperparameter estimation for Gibbs priors

The parameters of the prior, the hyperparameters, play an important role in Bayesian image estimation. Of particular importance for the case of Gibbs priors is the global hyperparameter, beta, which multiplies the Hamiltonian. Here we consider maximum likelihood (ML) estimation of beta from incomplete data, i.e., problems in which the image, which is drawn from a Gibbs prior, is observed indirectly through some degradation or blurring process. Important applications include image restoration and image reconstruction from projections. Exact ML estimation of beta from incomplete data is intractable for most image processing. Here we present an approximate ML estimator that is computed simultaneously with a maximum a posteriori (MAP) image estimate. The algorithm is based on a mean field approximation technique through which multidimensional Gibbs distributions are approximated by a separable function equal to a product of one-dimensional (1-D) densities. We show how this approach can be used to simplify the ML estimation problem. We also show how the Gibbs-Bogoliubov-Feynman (GBF) bound can be used to optimize the approximation for a restricted class of problems. We present the results of a Monte Carlo study that examines the bias and variance of this estimator when applied to image restoration.

[Establishment of human amnion cell mutagenesis system by using a shuttle vector pS189]

Using transient shuttle vector pS189, we established a subclone human amnion cell (FL) mutagenesis detection system, and we detected the mutation specificity of N-methy-N'-nitro-N-nitrosoguanidine (MNNG) in this system. The spontaneous mutant frequency of target gene supF was 1.7 x 10(-5) and MNNG-induced mutant frequency was increased with dosage. The results from 0.8% agarose gel electrophoresis, PCR, PCR-single strand conformation polymorphism (PCR-SSCP) analysis showed that MNNG-induced 89% mutants were point mutants. These results indicated that this system can be used to detect and study the mutagenesis mechanism of potential mutagens.

Polymorphism of angiotensin I converting enzyme gene in the older Chinese: linked to ambulatory blood pressure levels and circadian blood pressure rhythm

This study was undertaken to evaluate the association of polymorphism of angiotensin I converting enzyme (ACE) gene with causal and ambulatory blood pressure in the Chinese population. Genomic DNA was amplified by polymerase chain reaction (PCR) using primers flanking the polymorphic region in intron 16 of the ACE gene. Alleles were detected on agarose gels stained with ethidium bromide. Causal blood pressure was measured in the 133 normotensive and 122 essential hypertensive subjects; of the essential hypertensive subjects, 65 patients underwent non-invasive ambulatory blood pressure. There was no significant difference of ACE genotype and allele frequencies between the hypertensive and normotensive subjects. Non-significant differences were demonstrated in gender, age, causal blood pressure according to the ACE gene genotypes in the 65 patients who underwent non-invasive ambulatory blood pressure; however, effects of the ACE gene genotypes were observed on the derivatives of ambulatory blood pressure, including sleeping blood pressure levels and circadian blood pressure rhythm (p < 0.05). We suggest that insertion/deletion polymorphism of the ACE gene should be associated with blood pressure and ambulatory blood pressure might be superior to causal blood pressure at the molecular level.

Selection of trypsin inhibitors in phage peptide library

The newly developed techniques of peptide libraries have become a conventional and efficient method in screening ligands of proteins of interest. We present here the successful results of selection of trypsin inhibitors in a phage hexapeptide library. After affinity selection and activity assay, peptide sequences, deduced from DNA sequencing of the phage peptides with the most striking trypsin activity, share some common features with trypsin inhibitors reported. All of the phage peptides selected out and those native and synthetic trypsin inhibitors reported are composed of three parts: (a) positively charged part (Arg, Lys or their analogs); (b) polar part that may form hydrogen bonds with Ser in the active site of trypsin; (c) hydrophobic part that interacts with the nonpolar region of trypsin active site.

Fibrin activation of vascular endothelial cells. Induction of IL-8 expression

Fibrin deposition and leukocyte accumulation are classic histopathologic hallmarks of acute and chronic inflammation. Although both of these processes are common to inflammatory processes, surprisingly little is known about the interrelationship between fibrin deposition and leukocyte accumulation. We hypothesized that: 1) fibrin can regulate inflammation by directly inducing leukocyte chemotactic factor (LCF) expression from vascular endothelial cells (VEC), and 2) this fibrin-induced VEC expression of LCF would enhance leukocyte recruitment seen in acute and chronic inflammation. To test this hypothesis, we developed an in vitro model system of in situ polymerization of fibrin on isolated bovine pulmonary artery endothelial cells in culture. In the initial phase of our studies, we found that fibrin induced a time- and dose-dependent expression of leukocyte migration activity from VEC. Checkerboard analysis demonstrated that the leukocyte migration activity present in the fibrin-stimulated VEC culture supernatant was truly chemotactic in nature. In an effort to begin to characterize this chemotactic activity, we demonstrated that this fibrin-induced LCF activity was 1) protein dependent, 2) not derived from fibrin(ogen), and 3) had an apparent m.w. of 6 to 12 kDa. Our further studies demonstrated that fibrin was a potent stimulus for IL-8 Ag expression from the VEC. Thus, these studies clearly demonstrate that fibrin has the capability to induce leukocyte chemotactic activity in general, and IL-8 activity specifically, from VEC. These studies support our hypothesis that fibrin is an important activator of vascular endothelial cells in vivo.

Fibrin activation of vascular endothelial cells. Induction of IL-8 expression

Fibrin deposition and leukocyte accumulation are classic histopathologic hallmarks of acute and chronic inflammation. Although both of these processes are common to inflammatory processes, surprisingly little is known about the interrelationship between fibrin deposition and leukocyte accumulation. We hypothesized that: 1) fibrin can regulate inflammation by directly inducing leukocyte chemotactic factor (LCF) expression from vascular endothelial cells (VEC), and 2) this fibrin-induced VEC expression of LCF would enhance leukocyte recruitment seen in acute and chronic inflammation. To test this hypothesis, we developed an in vitro model system of in situ polymerization of fibrin on isolated bovine pulmonary artery endothelial cells in culture. In the initial phase of our studies, we found that fibrin induced a time- and dose-dependent expression of leukocyte migration activity from VEC. Checkerboard analysis demonstrated that the leukocyte migration activity present in the fibrin-stimulated VEC culture supernatant was truly chemotactic in nature. In an effort to begin to characterize this chemotactic activity, we demonstrated that this fibrin-induced LCF activity was 1) protein dependent, 2) not derived from fibrin(ogen), and 3) had an apparent m.w. of 6 to 12 kDa. Our further studies demonstrated that fibrin was a potent stimulus for IL-8 Ag expression from the VEC. Thus, these studies clearly demonstrate that fibrin has the capability to induce leukocyte chemotactic activity in general, and IL-8 activity specifically, from VEC. These studies support our hypothesis that fibrin is an important activator of vascular endothelial cells in vivo.

A region-specific microdissection library for human chromosome 2p23-->p21 and the analysis of an interstitial deletion of 2p21

A region-specific library of human chromosome 2p23-->p21 was constructed using microdissection and microcloning techniques. Analysis of 94 single-copy microclones from the library showed that 64% were derived from the dissected region. Ten microclones were further mapped to the 2p21 region using a patient with an interstitial deletion of 2p21 and displaying holoprosencephaly, an abnormal embryonic development in midbrain and midface.