The anti-inflammatory and hepatoprotective effects of fractions from Cudrania cochinchinensis var. gerontogea

Various fractions of the ethanol extract from the root wood of Cudrania cochinchinensis var. gerontogea (Moraceae) were evaluated for their anti-inflammatory effects on carrageenan-induced edema and hepatoprotective activities on carbon tetrachloride (CCl4)-induced and D-galactosamine-(D-GalN) induced acute hepatotoxicity in rats. The fractions (n-hexane, CHCl3, EtOAc, n-BuOH, and H2O) displayed significant inhibitory activity against carrageenan-induced edema, and the active anti-inflammatory components were further localized in the n-BuOH fraction, which exhibited the greatest anti-inflammatory effect, an effect 5% greater than indomethacin (which was used as a standard reference substance). Each fraction exerted a significant hepatoprotective effect by reducing enzymatic alteration (sGOT and sGPT) and by improving hepatic lesions, including liver centrilobular inflammation, cell necrosis, fatty change, ballooning degeneration in CCl4-induced acute hepatitis; and necrosis of the portal area in D-GalN-induced acute liver injury. The n-BuOH and EtOAc fractions had the greatest hepatoprotective effects on CCl4-induced liver injury; in contrast, the CHCl3 fraction was most potent against D-GalN intoxication, which is comparable to silymarin, as a recognized hepatoprotective drug.

Heart failure in Korean elderly patients — clinical features, prognosis and prognostic factors

Heart failure (HF) is very common in the elderly but there are not sufficient data about the clinical characteristics and prognostic factors of HF among the Asian elderly patients. The aim of the study was to find out the clinical characteristics, survival, and prognostic factors of HF in Korean elderly patients. Among elderly patients admitted from February 1995 to February 1998, the patients with a discharge diagnosis of HF were enrolled. Through the medical record review, the diagnosis was confirmed and clinical parameters to affect survival were identified. Total number of the subjects was 104 [age: 77+/-7 years (65-96), male:female=36:68, follow-up duration: 20+/-14 months, LVEF: 46+/-16%]. Ischemic heart disease (IHD) was the most common cause of HF (42%) followed by valvular heart disease (28%), and hypertension (20%). The 1-year survival rate was 71.3%. Advanced age [risk ratio (RR): 1.41 per 5 years of age; 95% CI: 1.11-1.80] and reduced left ventricular ejection fraction (0.69 per 10%, 0.52-0.93), poor initial functional class (2.40, 1.15-5.00), diabetes (2.79, 1.30-5.97) and past history of HF (2.37, 1.10-5.10) badly affected the survival rates. When the Cox proportional hazard model was applied for multivariate analysis, only aging (1.64 per 5 years of age, 1.19-2.28) and diabetes (4.92, 1.83-13.23) predicted poor prognosis. Twenty-seven percent of the patients had diastolic HF (LVEF>45%, LVEDD<55 mm) who had higher survival rates with marginal significance (0.35, 0.10-1.17, P=0.09).

Association between apolipoprotein E polymorphism and macroalbuminuria in patients with non-insulin dependent diabetes mellitus

OBJECTIVES

Apolipoprotein E (apo E) is known to play an important role in lipoprotein metabolism through its ability to bind to the receptors as a ligand. Three different apo E alleles (epsilon2, epsilon3 and epsilon4) produce six apo E genotypes (epsilon2/2, epsilon2/3, epsilon2/4, epsilon3/3, epsilon3/4 and epsilon4/4). The objective of this study was to investigate an association between apo E gene polymorphism and macroalbuminuria in 167 Korean patients with non-insulin dependent diabetes mellitus (NIDDM).

METHODS

The patients in the macroalbuminuria group (n = 74) represent those in whom 24 h urinary albumin excretion was above 300 mg. The patients in the normoalbuminuria group (n = 93) represent those in whom 24 h urinary albumin excretion was below 30 mg and serum creatinine levels were less than 1.2 mg/dl. The duration of diabetes in all patients was at least 8 years.

RESULTS

There were no significant differences in terms of age, sex, body mass index, HbA1c, total cholesterol, triglyceride, HDL-cholesterol and LDL-cholesterol between the two groups. In the macroalbuminuria group, the distribution of apo E genotypes revealed epsilon2/2 2 (2.7%), epsilon2/3 14 (18.9%), epsilon2/4 0 (0%), epsilon3/3 47 (63.5%), epsilon3/4 11 (14.9%) and epsilon4/4 0 (0%). In the normoalbuminuria group, the distribution of apo E genotypes revealed epsilon2/2 0 (0%), epsilon2/3 7 (7.5%), epsilon2/4 1 (1.1%), epsilon3/3 72 (77.4%), epsilon3/4 12 (12.9%) and epsilon4/4 1 (1.1%). There was no significant difference in the distribution of apo E genotypes between the two groups. However, there was a significant difference in the allele frequencies, epsilon2 frequency was significantly higher in macroalbuminuria group compared to normoalbuminuria group (12.2% vs 4.3%, P<0.05). Also, we compared apo E carrier frequencies between the two groups. Epsilon2 carrier frequency was significantly higher in macroalbuminuria group compared to normoalbuminuria group (21.6% vs 7.6%, P<0.05). In each group, there was no significant difference in the degree of lipid abnormalities between apo epsilon2 carrier (epsilon2/2, epsilon2/3 genotypes), epsilon3 carrier (epsilon3/3 genotype) and epsilon4 carrier (epsilon3/4, epsilon4/4 genotype).

CONCLUSION

Apo epsilon2 allele and epsilon2 carrier frequencies were significantly higher in macroalbuminuria group. These results suggest that epsilon2 allele may be associated with the development of clinical albuminuria in Korean patients with NIDDM.

Current status of peritoneal dialysis in Korea: efforts to achieve optimal outcome

Since its introduction in 1981, peritoneal dialysis (PD) has become firmly established as an effective mode of renal replacement therapy and serves an increasing patient population in Korea. The latest registry data indicate that about 3700 end-stage renal disease patients are maintained on chronic PD, representing 24.1% of the country's dialysis population. The majority (93.3%) of these patients are on continuous ambulatory peritoneal dialysis (CAPD) using the two-bag disconnect system, while only 3.3% are on automated PD. Under current renal reimbursement policies, most dialysis patients have to pay 20% of dialysis fees. Thus CAPD patients on 4 x 2-L daily exchanges pay about US$200 per month, not including medication and travel costs. Traditionally, most PD centers in Korea have used the "standard" prescription of 4 exchanges of 2 L of solution for most of their patients. A recent survey of 1467 patients who commenced CAPD in 1997 revealed that 84% of these patients were initially prescribed 4 x 2-L exchanges, while 12% were given a daily volume of 6 L. With this standard prescription, the percentages of Korean CAPD patients initially achieving the adequacy target of Kt/V urea > or = 2.0 and standardized creatinine clearance (SCCr) > or = 60 L/week/1.73 m2, were 74.4% and 82.1%, respectively. It is likely that, among current Korean CAPD patients, a much lower percentage will achieve the clearance targets compared to this initial outcome, but the precise data are not available. However, it is not clear whether the levels of small-solute clearance recommended for optimal PD outcomes, and proposed by the NKF-DOQI guidelines, will bring the expected benefits to Korean patients. Overall survival of Korean PD patients appears to be as good as, or even better than, that in most other countries. Recently, a single large PD center reported patient survival of 92.1%, 85.6%, 81.4%, and 67.6% at 1, 2, 3, and 5 years respectively. Other centers also reported similar outcomes. As in other countries, cardiovascular deaths predominate among Korean patients: death was due to cardiac causes in 29%, to vascular causes in 21%, and to infectious causes in 24%. Peritonitis is the most important barrier to prolonged use of CAPD in Korea, and more PD patients transfer to hemodialysis because of peritonitis than in other countries. To further reduce the morbidity and mortality of Korean PD patients, various control measures need to be implemented that can reduce or prevent peritonitis and other infectious complications. Also, to further improve long-term patient outcome, Korean nephrologists need to establish and practice optimal clearance targets in the chronic care of these patients.

Posttranslational mechanisms contribute to the suppression of specific cyclin:CDK complexes by all-trans retinoic acid in human bronchial epithelial cells

Retinoids have demonstrated activity in the chemoprevention of aerodigestive tract cancer. Potentially contributing to their lung cancer chemopreventive effects, retinoids inhibit the growth of human bronchial epithelial (HBE) cells. We observed previously that all-trans retinoic acid (t-RA) arrests the growth of HBE cells in the G0 phase of the cell cycle through activation of retinoic acid receptor-dependent pathways, which enhances the association of E2F-4 with retinoblastoma protein family members, converting E2F into a transcriptional suppressor. In this study, we examined the mechanism by which t-RA blocks cell cycle progression in HBE cells and the possibility that this signaling event is blocked in non-small cell lung cancer (NSCLC) cells that are refractory to the growth inhibitory effects of t-RA. t-RA suppressed the expression and activity of cyclin D1, cyclin E, and cyclin-dependent kinases (CDK)-2 and CDK-4, increased expression of the CDK inhibitor p27, and shifted the retinoblastoma protein to a hypophosphorylated form. Posttranslational mechanisms contributed to the changes in CDK-2, CDK-4, and p27 levels, which, in the case of CDK-4, involved the ubiquitin-proteasome pathway. In contrast, despite retinoic acid receptor transcriptional activation, these signaling events did not occur in a NSCLC cell line that is refractory to growth inhibition by t-RA. These findings provide the first evidence that t-RA activates degradation of CDK-4 through the ubiquitin-proteasome pathway, a novel mechanism by which t-RA causes HBE cells to exit the cell cycle, and blockade of these signaling events may contribute to the development of retinoid resistance in NSCLC cells.

In situ localization of neuronal nitric oxide synthase (nNOS) mRNA in the rat retina

We performed a comparative study on the distribution of neuronal nitric oxide synthase (nNOS) immunoreactivity and mRNA in a normal rat retina using immunocytochemistry and in situ hybridization technique. As in previous studies, we found NOS immunoreactive (NOS-IR) cells and fibers in inner and outer plexiform layers (IPL and OPL), inner nuclear layer (INL) and inner photoreceptor segment (IPS). However, very little nNOS-IR could be detected in groups of amacrine cells and ganglion cells localized in ganglion cell layer (GCL). However, in situ hybridization showed that intense NOS mRNA signals were mainly found in the GCL and INL while weak or no mRNA signals were detected in IPL, OPL, outer nuclear layer (ONL) and IPS. This difference suggests that nNOS proteins may be transported through axons into the terminals in the IPL and OPL after they were synthesized with nNOS mRNA templates in the INL. In the case of nNOS mRNA in GCL, synthesizing nNOS proteins may move outside the eyeball and carry out tasks in central nervous system. The difference of nNOS mRNA and nNOS IR means that the complete concurrence of nNOS IR and in situ hybridization results may not always occur in the rat retina.

In situ localization of p53, bcl-2 and bax mRNAs in rat ocular tissue

We mapped p53, bcl-2 and bax mRNAs, which are known to have correlation with apoptotic cell death, in the rat ocular tissue. p53 mRNA signals were present in several layers of retina, optic nerve, corneal epithelium, ciliary process and posterior surface of the iris. While almost the same pattern as p53 was recognized in the case of bcl-2 mRNA, bax signals were not found in ocular tissue except for ganglion cell layer (GCL). These results suggest that in the normal ocular tissue, p53 and bcl-2 genes play opposing parts in the physiological control of cell survival and death. A p53 mediated tumor-suppressing action might occur through the induction of transcriptional targets other than bax because only in GCL were p53 and bax mRNA expression co-localized.

Relationship of peritoneal membrane transport characteristics to the nutritional status in CAPD patients

BACKGROUND

The study was carried out to evaluate the role of individual peritoneal membrane transport characteristics in the nutritional status expressed as the composite nutritional index (CNI) METHODS: Cross-sectional analyses of the overall nutritional status of 147 continuous ambulatory peritoneal dialysis (CAPD) patients were performed using the CNI. CNIs based on a scoring system of 10 nutritional indices including subjective global assessment, biochemical parameters and anthropometry were compared according to the results of a standard peritoneal equilibration test (PET) RESULTS: Patients were classified as low (n = 16, 10.9%), low average (n=59, 40.2%), high average (n=54, 36.7%) and high (n=18, 12.2%) transporters based on the D/P(Cr) after 4 h dwells. The mean 4 h D/P(Cr) was 0.65 +/- 0.12 (0.34-0.95), and there was no significant correlation between D/P(Cr) and other demographic parameters such as age, duration of peritoneal dialysis and body surface area. D/P(Cr) was correlated with dialytic albumin loss (r=0.47, P<0.001), serum albumin (r=-0.46, P<0.001), serum creatinine (r= -0.38, P<0.001), serum TGF-1 (r=-0.37, P<0.01) and LBM(Cr) (r= -0.26, P<0.05). In high transporters, the serum albumin was significantly lower while dialysate protein and albumin losses were significantly greater compared with low transporters. Serum creatinine and IGF-1 concentrations as well as LBM(Cr) were also decreased in higher transporters. The mean CNI score was 8.1 +/- 4.9, with a range of 0-24. CNI was positively correlated with age, duration of peritoneal dialysis, incidence of peritonitis, CRP and dialytic protein loss, whereas it was inversely correlated with ultrafiltration volume, haemoglobin and NPNA. The CNI score was significantly higher in high transporters compared with low transporters (11.7 +/- 4.3 vs. 5.9 +/- 1.6, P < 0.01). There was also a significant correlation between D/P(Cr) and CNI (r = 0.29, P < 0.05). Multiple regression analysis revealed that the incidence of peritonitis, duration of CAPD, CRP and D/P(Cr) were the independent factors affecting the CNI.

CONCLUSION

Peritoneal membrane transport characteristics correlate with the overall nutritional status of peritoneal dialysis patients assessed by the scoring system of the CNI, although it is associated with a different impact on the individual nutritional indices. The results of this cross-sectional study also suggest that a high permeability state is a risk factor for malnutrition in CAPD patients. Prospective studies evaluating the changes in nutritional parameters among patients with different membrane transport rates are needed to understand better the relationship of peritoneal membrane characteristics to the nutritional status of CAPD patients.

Combined ischemic preconditioning and laser Doppler measurement for early division of pedicled groin flap

OBJECTIVES

The main disadvantage of the pedicled groin flap for hand reconstruction is the long period of immobilization required. Early division of the pedicled groin flap is desirable for both patients and surgeons. The aims of this study were to investigate whether ischemic preconditioning can effectively accelerate the neovascularization of the junction between the donor and recipient sites in the pedicled flap, and the most objective method of judging the timing of early division of the pedicled groin flap. This report is the first prospective study to use ischemic preconditioning for early division of pedicled cutaneous flap combined with laser Doppler measurement.

METHODS

The severe hand injuries of 12 patients were reconstructed by using the pedicled groin flap method. The ischemic preconditioning program was prospectively performed as scheduled for 5 to 7 days postoperatively. The pedicled groin flap was monitored with laser Doppler when the flap was elevated, inset, with clamping and nonclamping postoperatively.

RESULTS

Eleven of the 12 pedicled groin flaps were divided safely and survived completely. Only one pedicled groin flap with a simultaneous harvest of iliac bone graft had partial flap loss, giving a success rate of 90.1%.

CONCLUSION

With ischemic preconditioning, the pedicled groin flap can be safely divided postoperatively at a mean period of 8.4 days according to the laser Doppler measurement, especially when the perfusion unit ratio of clamping over nonclamping reaches more than 36.6%.

Prognostic significance of CD44 and nm23 expression in patients with stage II and stage IIIA gastric carcinoma

BACKGROUND AND OBJECTIVES

Predicting the prognosis in gastric carcinoma patients with intermediate stages is difficult. We investigated the prognostic impacts of CD44 and nm23 expression in a homogeneous group of patients with stage II and IIIA gastric carcinoma who had undergone curative resections.

METHODS

A total of 261 paraffin-embedded gastric carcinomas were stained with the monoclonal antibodies CD44 and nm23 using the labeled streptovidin biotin method.

RESULTS

The expression of CD44 and nm23 was detected, respectively, in 31.0% (81/261) and 70.1% (183/261) of all tumors. There was no correlation between CD44 expression and clinicopathological variables. However, nm23 was more frequently expressed in older patients with differentiated adenocarcinoma. A significant difference in 5-year survival rates was found between patients with CD44-positive (43.2%) and CD44-negative tumors (63.4%), (P = 0.0018). However, there was no significant difference in 5-year survival rates between patients with nm23-positive (54.7%) and nm23-negative tumors (62.7%) (P = 0.2734).

CONCLUSIONS

CD44 expression was a significant adverse prognostic factor in gastric carcinoma and may be a predictor of metastatic potential of the primary tumor. By contrast, immunohistochemical detection of nm23 expression was not a predictor of outcome of patients with gastric carcinoma.

Regulation of thyroid hormones on the production of testosterone in rats

The effects of a thyroidectomy and thyroxine (T4) replacement on the spontaneous and human chorionic gonadotropin (hCG)-stimulated secretion of testosterone and the production of adenosine 3',5'-cyclic monophosphate (cAMP) in rat testes were studied. Thyroidectomy decreased the basal levels of plasma luteinizing hormone (LH) and testosterone, which delayed the maximal response of testosterone to gonadotropin-releasing hormone (GnRH) and hCG in male rats. T4 replacement in thyroparathyroidectomized (Tx) rats restored the concentrations of plasma LH and testosterone to euthyroid levels. Thyroidectomy decreased the basal release of hypothalamic GnRH, pituitary LH, and testicular testosterone as well as the LH response to GnRH and testosterone response to hCG in vitro. T4 replacement in Tx rats restored the in vitro release of GnRH, GnRH-stimulated LH release as well as hCG-stimulated testosterone release. Administration of T4 in vitro restored the release of testosterone by rat testicular interstitial cells (TICs). The increase of testosterone release in response to forskolin and androstenedione was less in TICs from Tx rats than in that from sham Tx rats. Administration of nifedipine in vitro resulted in a decrease of testosterone release by TICs from sham Tx but not from Tx rats. The basal level of cAMP in TICs was decreased by thyroidectomy. The increased accumulation of cAMP in TICs following administration of forskolin was eliminated in Tx rats. T4 replacement in Tx restored the testosterone response to forskolin. But the testosterone response to androstenedione and the cAMP response to forskolin in TICs was not restored by T4 in Tx rats. These results suggest that the inhibitory effect of a thyroidectomy on the production of testosterone in rat TICs is in part due to: 1) the decreased basal secretion of pituitary LH and its response to GnRH; 2) the decreased response of TICs to gonadotropin; and 3) the diminished production of cAMP, influx of calcium, and activity of 17beta-HSD. T4 may enhance testosterone production by acting directly at the testicular interstitial cells of Tx rats.

Phosphorylation of transcription factor cyclic-AMP response element binding protein mediates c-fos induction elicited by sustained hypertension in rat nucleus tractus solitarii

We investigated the role of cyclic-AMP response element binding protein signaling in the induction of the immediate-early gene c-fos by baroreceptor activation in neurons of the nucleus tractus solitarii of anesthetized rats. Activation of the arterial baroreceptors with sustained hypertension significantly increased the number of neurons in the caudal nucleus tractus solitarii that were immunoreactive to an antiserum that detects Ser133-phosphorylated cyclic-AMP response element binding protein. This implied increase in phosphorylation of cyclic-AMP response element binding protein was subsequently followed by an elevation in the expression of Fos protein in neurons of the nucleus tractus solitarii. Microinjection bilaterally into the nucleus tractus solitarii of a phosphorothioated antisense oligonucleotide directed against the initiation site of cyclic-AMP response element binding protein messenger RNA discernibly reduced the manifested immunoreactivity of phosphorylated cyclic-AMP response element binding protein in response to baroreceptor activation. This was accompanied by a decline in the transcription of c-fos messenger RNA and the expression of Fos protein, along with an appreciable potentiation of the baroreceptor reflex response. Control injections of the sense oligonucleotide or artificial cerebrospinal fluid were ineffective. These findings suggest that phosphorylation of cyclic-AMP response element binding protein is crucial to Fos expression in the nucleus tractus solitarii elicited by sustained hypertension. As such, phosphorylation of cyclic-AMP response element binding protein may be an important early nuclear event that mediates the long-term inhibitory modulation of the baroreceptor reflex response by Fos protein at the nucleus tractus solitarii.

MRI of tuberculous pyomyositis

PURPOSE

The purpose of this article is to describe the findings of MRI in tuberculous pyomyositis (PM).

METHOD

The MR images of four proven cases of tuberculous PM were retrospectively reviewed and analyzed with clinical and laboratory findings. The location, signal intensity on T1- and T2-weighted spin echo images, presence of abscess, signal intensity of peripheral rim, patterns of contrast enhancement, and associated findings were evaluated.

RESULTS

On MR images, all cases demonstrated low signal intensity on T1-weighted images and high signal intensity on T2-weighted images in a single muscle. Abscess was seen in all cases. Peripheral rim showed subtle hyperintensity on T1-weighted images and hypointensity on T2-weighted images. After gadolinium infusion, peripheral rim enhancement was observed in all cases. Cellulitis was associated in one case. The patients clinically presented with a palpable mass of long duration.

CONCLUSION

Tuberculous PM shows characteristic findings of a well demarcated abscess with rim enhancement at MRI and can be distinguished from other soft tissue masses.

Prognostic significance of CD44 and nm23 expression in patients with stage II and stage IIIA gastric carcinoma

BACKGROUND AND OBJECTIVES

Predicting the prognosis in gastric carcinoma patients with intermediate stages is difficult. We investigated the prognostic impacts of CD44 and nm23 expression in a homogeneous group of patients with stage II and IIIA gastric carcinoma who had undergone curative resections.

METHODS

A total of 261 paraffin-embedded gastric carcinomas were stained with the monoclonal antibodies CD44 and nm23 using the labeled streptovidin biotin method.

RESULTS

The expression of CD44 and nm23 was detected, respectively, in 31.0% (81/261) and 70.1% (183/261) of all tumors. There was no correlation between CD44 expression and clinicopathological variables. However, nm23 was more frequently expressed in older patients with differentiated adenocarcinoma. A significant difference in 5-year survival rates was found between patients with CD44-positive (43.2%) and CD44-negative tumors (63.4%), (P = 0.0018). However, there was no significant difference in 5-year survival rates between patients with nm23-positive (54.7%) and nm23-negative tumors (62.7%) (P = 0.2734).

CONCLUSIONS

CD44 expression was a significant adverse prognostic factor in gastric carcinoma and may be a predictor of metastatic potential of the primary tumor. By contrast, immunohistochemical detection of nm23 expression was not a predictor of outcome of patients with gastric carcinoma.

Dynamic states of a continuum traffic equation with on-ramp

We study the phase diagram of the continuum traffic flow model of a highway with an on-ramp. Using an open boundary condition, traffic states and metastabilities are investigated numerically for several representative values of the upstream boundary flux f(up) and for the whole range of the on-ramp flux f(rmp). An inhomogeneous but time-independent traffic state (standing localized cluster state) is found and related to a recently measured traffic state. Due to the density gradient near the on-ramp, a traffic jam can occur even when the downstream density is below the critical density of the usual traffic jam formation in homogeneous highways, and its structure varies qualitatively with f(rmp). The free flow, the recurring hump (RH) state, and the traffic jam can all coexist in a certain metastable region where the free flow can undergo phase transitions either to the RH state or to the traffic jam state. We also find two nontrivial analytic solutions. These solutions correspond to the standing localized cluster state and the homogeneous congested traffic state (one form of the traffic jam), which are observed in numerical simulations.

Variations in meniscofemoral ligaments at anatomical study and MR imaging

PURPOSE

To demonstrate variations in the meniscofemoral ligaments (ligaments of Wrisberg and Humphrey) at anatomical study and magnetic resonance (MR) imaging.

DESIGN

Twenty-eight cadaveric knees were partially dissected for the examination of the meniscofemoral ligaments. One hundred knee MR examinations were reviewed by two experienced musculoskeletal radiologists. Proximal variations in the meniscofemoral ligaments at MR imaging were classified into three types according to the attachment site: type I, medial femoral condyle; type II, proximal half of the posterior cruciate ligament (PCL); type III, distal half of the PCL. Distal variations were classified into vertical or oblique types according to the orientation of the intermediate signal at the interface of the ligament and lateral meniscus.

RESULTS

At anatomical study, six cases showed variations in the proximal insertion site of the meniscofemoral ligaments. At MR imaging 93 cases had one or more meniscofemoral ligaments, giving a total of 107 ligaments: 90 ligaments of Wrisberg and 17 ligaments of Humphrey. Forty-one ligaments of Wrisberg were type I, 28 type II, 19 type III, and with two indeterminate type, while 6 ligaments of Humphrey were type I and the remaining 11 were indeterminate. Seven cases showed no meniscofemoral ligament. Of the 107 meniscofemoral ligaments, the distal insertion orientation was of vertical type in 10 ligaments, oblique type in 70 and unidentified in 27.

CONCLUSION

An understanding of the high incidence of meniscofemoral ligament variations may help in the interpretation of knee MR studies.

All-trans-retinoic acid inhibits Jun N-terminal kinase by increasing dual-specificity phosphatase activity

Jun N-terminal kinases (JNKs) are serine-threonine kinases that play a critical role in the regulation of cell growth and differentiation. We previously observed that JNK activity is suppressed by all-trans-retinoic acid (t-RA), a ligand for retinoic acid nuclear receptors (RARs), in normal human bronchial epithelial cells, which are growth inhibited by t-RA. In this study, we investigated the mechanism by which t-RA inhibits JNK and the possibility that this signaling event is blocked in non-small cell lung cancer (NSCLC) cells. Virtually all NSCLC cell lines are resistant to the growth-inhibitory effects of t-RA, and a subset of them have a transcriptional defect specific to retinoid nuclear receptors. We found that in NSCLC cells expressing functional retinoid receptors, serum-induced JNK phosphorylation and activity were inhibited by t-RA in a bimodal pattern, transiently within 30 min and in a sustained fashion beginning at 12 h. Retinoid receptor transcriptional activation was required for the late, but not the early, suppression of JNK activity. t-RA inhibited serum-induced JNK activity by blocking mitogen-activated protein (MAP) kinase kinase 4-induced signaling events. This effect of t-RA was phosphatase dependent and involved an increase in the expression of the dual-specificity MAP kinase phosphatase 1 (MKP-1). t-RA did not activate MKP-1 expression or inhibit JNK activity in a NSCLC cell line with retinoid receptors that are refractory to ligand-induced transcriptional activation. These findings provide the first evidence that t-RA suppresses JNK activity by inhibiting JNK phosphorylation. Retinoid receptor transcriptional activation was necessary for the sustained inhibition of JNK activity by t-RA, and this signaling event was disrupted in NSCLC cells with retinoid receptors that are refractory to ligand-induced transcriptional activation.

Risk factors influencing the decline of residual renal function in continuous ambulatory peritoneal dialysis patients

OBJECTIVE

To assess the nature of the decline in residual renal function (RRF) after the initiation of peritoneal dialysis, and to identify risk factors influencing the preservation of RRF.

DESIGN

A retrospective single-center study.

SETTING

Tertiary medical center.

PATIENTS

Eighty patients who were clinically stable and had been on continuous ambulatory peritoneal dialysis (CAPD) for a minimum of 6 months.

MAIN OUTCOME MEASURES

All subjects had at least three measurements of RRF, which was calculated as the average of creatinine clearance (Ccr) and urea clearance from a 24-hour urine collection. All measurements of RRF were plotted on a logarithmic scale and a linear scale against the duration of CAPD. Covariables used in the correlation analyses were age, sex, the presence of diabetes mellitus, mean blood pressure, mean diastolic blood pressure, hematocrit and Ccr at the start of peritoneal dialysis, peritoneal membrane transport characteristics by peritoneal equilibration test (PET), and the rate of peritonitis.

RESULTS

A significant correlation was found between CAPD duration and RRF decline represented on a logarithmic scale with a correlation coefficient (r) of 0.355 (p < 0.001). In contrast, on a linear scale, the correlation coefficient was only 0.273 (p < 0.01). By linear multiple regression analysis, the only independent risk factor for the decline of RRF was the rate of peritonitis (r = -0.446, p < 0.001).

CONCLUSION

These results suggest that RRF declines exponentially rather than linearly with time, and that the rate of peritonitis is an independent risk factor for the decline of RRF in CAPD patients.

Antiangiogenesis treatment for gliomas: transfer of antisense-vascular endothelial growth factor inhibits tumor growth in vivo

Presently, there is no effective treatment for glioblastoma, the most malignant and common brain tumor. Angiogenic factors are potentially optimal targets for therapeutic strategies because they are essential for tumor growth and progression. In this study, we sought a strategy for efficiently delivering an antisense cDNA molecule of the vascular endothelial growth factor (VEGF) to glioma cells. The recombinant adenoviral vector Ad5CMV-alphaVEGF carried the coding sequence of wild-type VEGF165 cDNA in an antisense orientation. Infection of U-87 MG malignant glioma cells with the Ad5CMV-alphaVEGF resulted in reduction of the level of the endogenous VEGF mRNA and drastically decreased the production of the targeted secretory form of the VEGF protein. Treatment of s.c. human glioma tumors established in nude mice with intralesional injection of Ad5CMV-alphaVEGF inhibited tumor growth. Taken together, these findings indicate that the efficient down-regulation of the VEGF produced by tumoral cells using antisense strategies has an antitumor effect in vivo. This is the first time that an adenoviral vector is used to transfer antisense VEGF sequence into glioma cells in an animal model, and our results suggest that this system may have clinical and therapeutic utility.

Rat osteopontin antibody is cross-reactive to a novel myelin-associated protein in chick

Osteopontin (OPN) was initially identified as glycosylated phosphoprotein in bones of vertebrates. Recently, OPN is reported to express in the primitive neuroepithelia of early chick embryonic hindbrain. We have demonstrated that rat OPN is immunohistochemically localized in the white matter of chick CNS. We have further confirmed the specificity of OPN cross-immunoreaction in myelin using demyelinated optic nerve induced by lysophosphatidylcholine (LPC), where the intensity of immunoreaction was closely related to the degree of demyelination. Immunoblot analyses showed that rat OPN antibody recognized a protein with molecular weights of approximately 47 kDa from chick CNS. Our data suggest that the antigen recognized by rat OPN is a previously undescribed myelin-associated protein in the chick CNS.

Inhibition of lipopolysaccharide-induced inducible nitric oxide (iNOS) mRNA expression and nitric oxide production by higenamine in murine peritoneal macrophages

Nitric oxide synthesized by inducible nitric oxide synthase (iNOS) has been implicated as a mediator of inflammation in rheumatic and autoimmune diseases. The effects of higenamine, a tetrahydroisoquinoline compound, on induction of NOS by bacterial lipopolysaccharide (LPS) were examined in murine peritoneal macrophages. LPS-induced nitrite/nitrate production was markedly inhibited by higenamine which at 0.01 mM, decreased nitrite/nitrate levels by 48.7+/-4.4%. This was comparable to the inhibition of LPS-induced nitrite/nitrate production by tetrandrin (49.51+/-2.02%) at the same concentration. Northern and Western blot analysis of iNOS expression demonstrated that iNOS expression was significantly attenuated following co-incubation of peritoneal macrophages with LPS (10 microg/ml; 18 hrs) and higenamine (0.001, 0.01 mM; 18 hrs). These results suggest that higenamine can inhibit LPS-induced expression of iNOS mRNA in murine peritoneal macrophages. The clinical implications of these findings remain to be established.

Posterior capsule opacification in eyes with a silicone or poly(methyl methacrylate) intraocular lens

PURPOSE

To evaluate the effect of poly(methyl methacrylate) (PMMA) and silicone intraocular lenses (IOLs) on posterior capsule opacification (PCO) after cataract surgery.

SETTING

Kangnam St. Mary's Hospital, Seoul, Korea.

METHODS

This retrospective study comprised 48 patients (54 eyes) who had neodymium:YAG (Nd:YAG) laser posterior capsulotomy from March 1995 to December 1997. All operations were performed by 1 surgeon using the same technique except for incision method.

RESULTS

Mean interval from cataract surgery to Nd:YAG capsulotomy was 31 months in the PMMA group and 15 months in the silicone group. The difference between groups was statistically significant (P = .0002). The ratio of Elschnig pearl to fibrosis type PCO was 16:6 in the PMMA group and 14:18 in the silicone group. Mean total Nd:YAG laser energy used was 256 mJ in the PMMA group and 309 mJ in silicone group. However, the damage caused by the laser was more severe and more common in the silicone group.

CONCLUSION

Silicone IOLs induced PCO faster than PMMA IOLs, with fibrosis the most common type in the silicone group. Precautions should be taken to prevent damage during Nd:YAG laser capsulotomy in eyes with a silicone IOL.

Results of kidney transplantation from 1979 to 1997 at Yonsei University

1. Long-term graft survival markedly improved after the introduction of CsA as the main immunosuppressant in living-donor kidney transplantation at our institution. 2. HLA-identical LRD kidney transplantation provided the best long-term graft survival rate, probably due to a decreased incidence of graft loss from rejection. 3. We could achieve good long-term graft survival in LURD kidney transplantation compared with that of HLA-haploidentical LRD kidney transplantation. 4. Because of the striking discrepancy between organ donation and the increasing demand for transplantation, distant relative donors and LURDs, including swap donors, should be considered as an alternative way to increase the number of available donors when accompanied by a careful evaluation process.

Bistage control of pH for improving exopolysaccharide production from mycelia of Ganoderma lucidum in an air-lift fermentor

It was found that pH control definitely affects mycelial cell growth and exopolysaccharide (EPS) production of the mycelial cultivation of Ganoderma lucidum. Compared to the case of uncontrolled pH cultivation, a culture system whose pH was kept constant at 3 and 6 exhibited improved mycelial cell growth and EPS production, respectively. The bistage pH control technique, that is, shifting the pH from 3 to 6 at the initial phase of the exponential growth, is introduced to improve cell growth and EPS production. This technique can greatly increase EPS production to 20.1 g/l from 4.1 g/l in the case of uncontrolled pH cultivation, without adverse effects on cell growth as in the case of constant maintenance of a high pH. It was also proved that bistage pH control retained the desirable morphologies of the mycelia during cultivation and resulted in low viscosity and yield stress of the culture broth. It will be useful for the application of the culture process to mycelial growth in a large-scale fermentor.

T cell subsets in chronic hepatitis B and the effect of prednisolone withdrawal and interferon alpha-2b

OBJECTIVES

The evaluations of the pathogenetic roles of cell mediated immunity and of the preventive effect for disease progression with interferon(IFN) treatment in patients with chronic active hepatitis-B(CAH-B) are the objectives of this study.

METHODS

Thirty-two patients with CAH-B were treated with interferon alpha-2b(IFN alpha-2b) with prednisolone withdrawal and 30 control patients were treated with conventional hepatotonics for 6 months. Peripheral total T cell fractions and T cell subsets of the patients with CAH-B, treated with IFN alpha-2b with prednisolone withdrawal, were examined 1 month before administration of prednisolone, and compared with 12 normal controls for assessing the potential role of cellular immunity in the development of CAH-B. To estimate the effectiveness of IFN therapy for the patients with CAH-B, levels of various liver function tests, HBsAg, anti-HBs, HBeAg, anti-HBe, HBV DNA, anti-HCV and others were assessed for the treatment group and compared with control patients at pre- and post-treatment period each.

RESULTS

The value of CD4 was significantly lower in patients with CAH-B than normal controls (36.3 +/- 7.7% vs 42.1 +/- 5.7%, p < 0.05) and the value of CD8 was significantly higher in patients with CAH-B than normal controls (30.6 +/- 10.3% vs 24.3 +/- 5.2%, p < 0.05) before prednisolone administration. The patients in responder group (n = 26) had significantly lower CD4 cells compared with normal controls, but non-responders (n = 6) did not have. The levels of liver function test(LFT) in the patients with IFN alpha-2b treatment with prednisolone withdrawal were not different from the control patient group at pretreatment, but significantly lower than control patient group's after treatment, regardless of response to IFN alpha-2b treatment with prednisolone withdrawal.

CONCLUSIONS

The cellular immunity of the host may have a potential role in the pathogenesis of chronicity of hepatitis B infection. IFN alpha-2b treatment with prednisolone withdrawal may be regarded as one of the effective treatment modalities for the inhibition of disease progression in patients with CAH-B.