Flow cytometric analysis of DNA ploidy in primary non-small cell carcinoma of the lung in Korea

Flow cytometrically determined nuclear DNA content has been measured on 74 formalin-fixed, paraffin embedded specimens of non-small cell carcinoma of the lung. Of the 60 tumors that were successfully analyzed, 32 (53%) were diploid and 28 (47%) were aneuploid. The mean DNA index of aneuploid tumor was 1.5 +/- 0.25, ranging from 1.1 to 2.0. There was no significant correlation between DNA ploidy and the patient's clinical characteristics, histology of tumor, nodal status or tumor stage. Tumor ploidy was not found as a prognostic determinant in non-small cell carcinoma of the lung in this study.

Dietary fat and fiber alter rat colonic mucosal lipid mediators and cell proliferation

To better understand the biochemical mechanisms by which dietary fat and fiber modulate colonic cell proliferation, we determined the effect of dietary fats and fibers on rat colonic epithelial cell phospholipid mass and composition and on two metabolic products of phospholipids, prostaglandins and diacylglycerol (DAG). In a 3 x 3 factorial design, groups of 10 male Sprague-Dawley rats were fed one of nine experimental diets for 3 wk: three types of fat at 15 g/100 g (beef tallow, corn oil or fish oil) x two types of fiber (pectin or cellulose) or fiber-free as a control group. Dietary treatment did not alter phospholipid or DAG mass, although the fatty acid compositions of membrane phospholipids and DAG were altered by dietary treatment. Arachidonic acid [20:4(n-6)] and eicosapentaenoic acid [20:5(n-3)] in colonic mucosal phospholipid and DAG were associated with higher and lower indices of cell proliferation, respectively. These correlations were specific for the distal colon, which was the principle site of dietary fat effects on cell proliferation. Prostaglandin E and prostacyclin synthesis in colonic mucosa and muscle was significantly lower in fish oil-fed compared with beef tallow- and corn oil-fed animals (by 46-90%, P < 0.001), in both the proximal and distal colon. Correlations between prostaglandin production and cell proliferation, however, were significant only in the distal colon. These data raise the possibility that dietary fat and fiber may modulate intracellular events related to cell proliferation via their effects on epithelial cell phospholipid fatty acid composition, and subsequently on prostaglandin production and DAG composition.

Longitudinal growth of the rabbit tibia after callotasis

We investigated the effect of bone lengthening by callotasis on longitudinal growth of the tibia in rabbits. Ninety-nine five-week-old immature rabbits were divided into five groups according to the percentage of lengthening: group I, 10%; group II, 20%; group III, 30%; group IV, 40%; and group V, sham operation without lengthening. Corticotomy was performed at the proximal metaphysis of the left tibia and the right tibia was used as a control. The lengthening rate was 0.25 mm twice daily. Radiological, histomorphometric, and immunohistochemical studies were done on animals killed at the time of corticotomy, at the completion of lengthening, and thereafter every two weeks until 12 weeks. Tibial lengthening did not cause retardation of growth when the bone was lengthened by up to 20%. When the bone was lengthened by 30% or more, growth retardation was evident, and persisted until skeletal maturity.

Homeostasis of zinc in marginal human zinc deficiency: role of absorption and endogenous excretion of zinc

Although biochemical and immunologic aspects of mild or marginal human zinc deficiency have been well characterized, there is a paucity of data regarding the effects of prolonged marginal zinc deficiency on zinc homeostasis. It appears that human beings are able to maintain zinc homeostasis by increasing efficiency of zinc absorption and decreasing endogenous excretion of zinc when they are subjected to short-term dietary zinc restriction. However, a mild deficiency of zinc in human beings under usual circumstances is an outcome of chronic exposure to diets low in zinc lasting for many months and years. Therefore, it is important to determine whether or not the adapted zinc homeostasis during the short duration of dietary zinc deprivation is also maintained during a prolonged period of dietary zinc restriction. We assessed the efficiency of zinc absorption as well as endogenous zinc excretion during a 6-month period of dietary zinc restriction (63.1 mumol/day) in human volunteers by using a stable zinc (70Zn). Prolonged marginal zinc deficiency did not impair the functional role of endogenous zinc excretion in zinc homeostasis, but efficiency of zinc absorption was not sustained and decreased in the majority of our volunteers when the zinc-restricted diet was continued for 6 months. Such altered mechanisms of zinc homeostasis suggest that chronic human zinc deficiency warrants reassessment of dietary zinc requirement to preserve normal zinc status in the subsets of population that are vulnerable to zinc deficiency.

Triple innominate osteotomy for hip stabilisation and transiliac leg lengthening after poliomyelitis

We reviewed our experience with a modified triple innominate osteotomy for hip instability and limb shortening due to poliomyelitis in 62 adolescent and adult patients, treated from 1973 to 1990. Their ages at surgery ranged from 12 years to 35 years (average 22.3). At a mean follow-up of 4 years (2 to 18) 59 of the patients (95.2%) had substantial improvement in hip stability, and all but one had radiological improvement as determined by the acetabular angle, centre-edge angle and acetabulum-head quotient. In 59 cases in which transiliac limb lengthening was attempted, the mean gain was 1.7 cm (0.6 to 3.0). When the abductor muscles had been partially paralysed, the operation produced an appreciable increase in power in 12 of the 39 hips examined.

Insulin-like growth factor binding protein-3 protease activity in the urine of children with chronic renal failure

The insulin-like growth factors, IGF-1 and IGF-II, are polypeptides that potentiate cellular growth. In addition to binding to specific cell surface receptors, the IGFs bind with high affinity to a family of proteins, the insulin-like growth factor binding proteins (IGFBPs). Serum and urine IGFBP patterns are altered in individuals with chronic renal failure (CRF). We recently reported that the urinary IGFBP pattern of CRF patients is unique for increased insulin-like growth factor binding protein-1 (U-IGFBP-1) levels. In this study, we used western ligand blotting (WLB), western immunoblotting (WIB), and radioimmunoassay (RIA) to further evaluate serum and urine IGFBP profiles of children with CRF (n = 14). Five patients with CRF displayed decreased serum IGFBP-3 profiles by WLB. Serum IGFBP-3 WIB profiles were remarkable for 30- and 20-kDa fragments of IGFBP-3 not seen in control serum. Serum IGFBP-3 levels, as determined by RIA, were slightly elevated. Serum levels of IGFBP-2 also were increased, although not at a level reaching statistical significance. WLB of CRF urine revealed a large increase in U-IGFBP-1 and a complete absence of urinary IGFBP-3. Recent studies of serum from pregnant women and seminal plasma have demonstrated a similar absence of intact IGFBP-3, due to the presence of a specific IGFBP-3 protease. To evaluate whether an IGFBP-3 protease accounts for the absence of intact U-IGFBP-3 in children with CRF, urine and serum samples from individuals with CRF and controls were tested.(ABSTRACT TRUNCATED AT 250 WORDS)

A modified Wagner technique for femoral lengthening in skeletally mature patients with poliomyelitis

A modified Wagner technique using an Orthofix was employed for femoral lengthening in 62 skeletally mature patients with residual poliomyelitis. The first stage was similar to that of the original Wagner technique. However, distraction was started after 5 to 7 days at a rate of 1.5 mm per day. At the second stage, a neutralization plate was applied and a corticocancellous iliac strut graft inserted in the distracted site, preferably under compression. Cast immobilisation was not used and a long leg brace with a thigh corset allowed early knee movement and weightbearing. The average age at operation was 26 years and 6 months. The period of follow-up averaged 3 years and 2 months, and the average amount of lengthening was 4.2 cm. The overall rate of complication was 34%.

Dietary fibers and fats alter rat colon protein kinase C activity: correlation to cell proliferation

Protein kinase C activity and cell proliferation in rat proximal colonic mucosa were determined following diet modification with select fibers and fats for 3 wk. Rats were assigned to one of nine dietary groups: three fibers (cellulose or pectin at 6 g/100 g diet or fiber free) x three fats (beef tallow, corn oil, fish oil at 15 g/100 g diet). Protein kinase C activity was determined by measuring the phosphorylation of a highly selective synthetic peptide derived from myelin basic protein. In vivo cell proliferation was measured by bromodeoxyuridine incorporation into DNA. There was a significant main effect of fat (P = 0.0008) but not fiber (P = 0.375) on the ratio of membrane to cytosolic protein kinase C with diets containing fish oils resulting in the highest ratios, corn oils in the lowest ratios and beef tallow producing an intermediate ratio. There was an interactive effect of fat and fiber on the proliferative zone (P = 0.04). Pectin resulted in a significantly greater proliferative zone than did cellulose and the fiber-free diet but only when the fat source was corn oil. There was a positive correlation between proliferative zone and both membrane protein kinase C activity (r = 0.76, P = 0.02) and protein kinase C membrane:cytosol ratio (r = 0.64, P = 0.06). Although the positive relationship between proliferative zone and protein kinase C activity has been reported previously, the high membrane protein kinase C activity found with fish oil supplementation compared to the low activity found with corn oil supplementation was unexpected.(ABSTRACT TRUNCATED AT 250 WORDS)

Characterization of the affinities of insulin-like growth factor (IGF)-binding proteins 1-4 for IGF-I, IGF-II, IGF-I/insulin hybrid, and IGF-I analogs

Insulin-like growth factor (IGF)-binding proteins (BPs) bind IGF-I and IGF-II with high affinity and modify the activity of IGF peptides in a complex manner. We have characterized the affinities of IGFBP-1-4 for IGF-I and -II by employing 1) purified IGFBP preparations, 2) both [125I]IGF-I and [125I]IGF-II as radioligands, and 3) multiple IGF analogs designed to have altered affinities for IGFBPs. To this end, human (h) IGFBP-1, hIGFBP-2, and rat (r) IGFBP-4 have been purified to homogeneity from human amniotic fluid, human prostate epithelial cell culture, and B104 rat neuroblastoma cells; for human IGFBP-3, the glycosylated recombinant form (rec-hIGFBP-3), produced in Chinese hamster ovary cells, was employed. The IC50 values of IGF-I for hIGFBP-1, hIGFBP-2, rec-hIGFBP-3, rIGFBP-4, and human serum IGFBPs were 0.05 +/- 0.01, 5.0 +/- 0.01, 0.25 +/- 0.20, 0.6 +/- 0.4, and 0.1 +/- 0.01 ng/ml, respectively. While hIGFBP-1 and rIGFBP-4 had virtually equivalent affinities for IGF-I and IGF-II, hIGFBP-2 and rec-hIGFBP-3 demonstrated 2- to 5-fold higher affinities for IGF-II than for IGF-I. Studies with [Gln3,Ala4,Tyr15,Leu16]IGF-I and Des-(1-3)-IGF-I indicate that specific residues in the first 16 amino acids of the B domain of IGF-I appear to be critical for binding to all of the IGFBPs tested, but not to IGF receptors. However, severe modifications in the B domain disrupt binding affinity, not only for IGFBPs, but also for receptors (IGF-I/insulin hybrid and B-chain mutant). Interestingly, modifications in the A domain of IGF-I, which is believed to contain residues critical for binding to IGF-I and insulin receptors, show differential effects on binding affinity to BPs. [Thr49,Ser50,Ile51]IGF-I, which has normal affinity for the type I IGF receptor, shows at least a 500-fold decreased affinity for hIGFBP-1 and recombinant hIGFBP-3, in contrast to 50- to 100-fold reduced affinity for hIGFBP-2 and rIGFBP-4, and 5- to 10-fold reduced affinity for purified human serum IGFBP-3. More significantly, [1-27,Gly4,38-70]IGF-I shows a 30-fold decreased affinity for the type I IGF receptor and 10- and 2.5-fold reduced affinities for hIGFBP-1 and rec-hIGFBP-3, respectively, but no reduction in affinity for hIGFBP-2 or rIGFBP-4.(ABSTRACT TRUNCATED AT 400 WORDS)

A positive role for histone acetylation in transcription factor access to nucleosomal DNA

Acetylation of the N-terminal tails of the core histones directly facilitates the recognition by TFIIIA of the 5S RNA gene within model chromatin templates. This effect is independent of a reduction in the extent of histone-DNA interactions or a change in DNA helical repeat; it is also independent of whether a histone tetramer or octamer inhibits TFIIIA binding. Removal of the N-terminal tails from the core histones also facilitates the association of TFIIIA with nucleosomal templates. We suggest that the histone tails have a major role in restricting transcription factor access to DNA and that their acetylation releases this restriction by directing dissociation of the tails from DNA and/or inducing a change in DNA configuration on the histone core to allow transcription factor binding. Acetylation of core histones might be expected to exert a major influence on the accessibility of chromatin to regulatory molecules.

Developmental changes in rat adrenal enkephalin precursor: peptide ratio

Developmental changes in rat adrenal [Met5]enkephalin (ME) immunoreactivity and [Met5]enkephalinargininephenylalanine (MERF) immunoreactivity (which presumably reflects proenkephalin) were examined. The concentration of MERF appeared highest at the end of the first week postnatally and decreased fourfold to near adult values by day 21, while ME levels decreased only about twofold. This indicates a fall in the adrenal proenkephalin:ME ratio during the transition from the suckling to the weanling period in the rat. The elevated MERF levels during the suckling period may result from deficient processing of proenkephalin to free ME. An increase in the activity of the processing enzyme carboxypeptidase E was observed at day 15, which may contribute to the developmental fall in the adrenal proenkephalin to free ME ratio. Mimicking sympathetic activity by nicotine treatment (3 mg/kg i.p. twice daily from birth) produced a precocious decrease in the MERF:ME ratio at day 8, and also increased the activity of the processing enzyme. Denervation at day 10 markedly decreased adrenal ME and produced a three-fold increase in MERF:ME ratio when measured at day 30. Adrenal carboxypeptidase E activity was also decreased after denervation. In summary, these results suggest that increasing preganglionic sympathetic nerve activity during the third week postnatally stimulates proenkephalin processing and leads to the developmental decrease in MERF:ME ratio in the rat adrenal.

Dietary fat and fiber modulate colonic cell proliferation in an interactive site-specific manner

A 3 x 3 factorial experiment was conducted to examine how dietary fiber and fat interactively affect cell proliferation in the colon in rats. Groups of 10 male Sprague-Dawley rats were fed one of nine experimental diets for three weeks: three types of fat at 15% by weight (beef tallow, corn oil, and fish oil) x 2 types of fiber (pectin and cellulose) plus a fiber-free diet as a control. Cell proliferation was measured by in vivo incorporation of bromodeoxyuridine into DNA. The main effect of dietary fiber on cell proliferation was found in the proximal colon, where the pectin diet stimulated cell proliferation compared with the cellulose and fiber-free diets (p < 0.05). In comparison, the main effect of dietary fat was in the distal colon, where the beef tallow diet was more promotive with respect to cell proliferation than the fish oil diet and the corn oil diet had an intermediate effect (p < 0.05). In the proximal colon, however, the effect of fiber on cell proliferation was highly dependent on the source of fat in the diet. Pectin exerted a hyperproliferative effect when the source of fat in the diet was corn oil, but not when beef tallow or fish oil was the fat source. These data indicate that dietary fiber and fat modulate cell proliferation of the colon in an interactive site-specific manner.

Erythrocyte metallothionein response to dietary zinc in humans

The response of erythrocyte metallothionein to dietary zinc in human subjects was evaluated in a controlled metabolic protocol including standard indices of zinc status. Fifteen male subjects, age 27 +/- 3.6 y, participated in a 90-d, four-phase study consisting of acclimation (7 d; 15 mg Zn/d), treatment (6 wk; either 3.2, 7.2 or 15.2 mg Zn/d), depletion (12 d; 0.55 mg Zn/d) and supplementation (30 d; self-selected diet plus 50 mg Zn/d) phases. During the treatment phase erythrocyte metallothionein decreased in the group fed 3.2 mg Zn/d. Erythrocyte metallothionein decreased during the depletion phase (46 +/- 10%) to below the normal concentration in all groups and increased in the supplementation phase. Plasma zinc concentration decreased in the group fed 3.2 mg Zn/d during the treatment phase relative to the acclimation phase. Erythrocyte zinc decreased in all groups during the depletion phase relative to the treatment phase, and then increased during the supplementation phase. These data suggest that erythrocyte metallothionein can be used as a measure of status in severe zinc depletion and that comparing the change in erythrocyte metallothionein over a 6-wk period can differentiate between low and adequate levels of dietary zinc intake.

Changes in somatosensory-evoked potentials in limb lengthening. An experimental study on rabbits' tibiae

To assess the influence of the rate and amount of distraction on the electrophysiologic function of the peripheral nerve during limb lengthening, somatosensory-evoked potential (SSEP) studies were performed on the hindlimbs of 96 rabbits. In Group I, the tibiae were lengthened 0.35 mm per day; in Group II, 0.7 mm per day; in Group III, 1.05 mm per day; and in Group IV, 1.4 mm per day. The studies were done preoperatively and then postoperatively, until six weeks in Group I, five weeks in Group II, four weeks in Group III, and three weeks in Group IV. As lengthening proceeded, the P1 (the first major positive peak) latency gradually increased, whereas the amplitude decreased. Significant amplitude changes were observed at six-weeks postsurgery in Group I, three weeks in Group II, two weeks in Group III, and one week in Group IV. Significant changes in P1 latency were observed at four weeks postsurgery in Group II, three weeks in Group III, and two weeks in Group IV. Greater percentage increases in tibial length corresponded to more marked changes in P1 latency and amplitude. The SSEP monitoring may serve as an effective tool for early detection of neurologic dysfunction during limb lengthening.

Altered zinc metabolism occurs in murine lethal milk syndrome

The lethal milk (lm) mutation in mice causes Zn deficiency in pups nursed by lm dams. To examine tissue Zn distribution and Zn transport to milk and pups, 65Zn was administered to lactating normal and lm dams. Transport of 65Zn to milk of lm dams was approximately 50% of that transported to milk of normal dams. The lower milk 65Zn resulted in significantly less 65Zn uptake by tissues of the nursing pups. The decrease in 65Zn transport to the milk was accompanied by a significant increase in 65Zn uptake and metallothionein mRNA levels in kidney of the lm dams. The elevated Zn uptake and metallothionein expression was tissue specific and could be a reflection of altered zinc transport from mammary gland to milk. Polyacrylamide gel electrophoresis and Western transfer of mammary gland proteins from lm dams showed that a 30-kDa protein bound more 65Zn in vitro compared with proteins from normal mammary gland. Normal pups nursed by dams of the lm genotype had down-regulated metallothionein expression due to Zn deficiency. The genetic defect in lm mice decreases Zn transport to milk, thus explaining the neonatal Zn deficiency seen in normal mice fostered by lm dams. The greater metallothionein expression in dams of the lm genotype could be a secondary manifestation of altered tissue zinc distribution or a primary effect on a metallothionein regulatory mechanism.

Changes of blood flow of the femoral head after subtrochanteric osteotomy in Legg-Perthes' disease: a serial scintigraphic study

Serial quantitative scintigraphic studies using 99mTc-methylene diphosphonate were performed on 25 hips with Legg-Perthes' disease to evaluate changes in local blood flow of the femoral head after subtrochanteric varizational and/or derotational osteotomy. Studies were made preoperatively and were repeated postoperatively at 2, 4, 6, and 8 weeks at 3 and 6 months, at 1 year, and finally at 2 years after osteotomy. The relative vascularity of the affected femoral head at 2 weeks after osteotomy was significantly decreased as compared with the preoperative value. Thereafter, it increased steadily, reaching the preoperative level by 6 months with no further statistically significant increase at < or = 2 years. Our scintigraphic study showed that local blood flow of the femoral head does not increase significantly after subtrochanteric femoral osteotomy in Legg-Perthes' disease.

A new method for measurement of femoral anteversion. A comparative study with other radiographic methods

A new biplanar method of measuring femoral anteversion, which may be considered a modified Magilligan's method, is described. In addition to the true antero-posterior radiograph, a true translateral radiograph is taken, instead of a transcervical lateral radiograph as in the Magilligan method. The acute angles (alpha and gamma) between the long axes of the shaft and neck of the femur on both the antero-lateral and lateral radiographs are measured. The angle (gamma') of anteversion is obtained by the trigonometric formula; tan gamma' = tan/tan alpha. The femoral anteversion in 20 adult dried femora and 40 femora in 20 children was measured by the Magilligan method, the authors' method and the conventional CT method. Compared with direct measurement in the dried femora, it was found that both the Magilligan and the authors' methods tended to overestimate and the CT method tended to underestimate (p < 0.05) the anteversion. In children's femora, a similar trend was observed among the three methods and the measurements by each method differed significantly from the other (p < 0.05). We feed that our method of biplanar measurement of femoral anteversion is more accurate, although probably marginally, than the conventional Magilligan method. It also has some relative advantages in clinical application in that positioning is easier, rotation is better controlled, and less time is consumed.

Pericardiocentesis: a 20 patients study

Emergency pericardiocentesis, guided by a two-dimensional echocardiography, was performed on twenty patients with symptomatic pericardial effusion of various types and causes. There were fourteen men and six women. The underlying causes were: primary lung cancer (6 cases), metastatic cardiac tumors (3 cases), tuberculosis (4 cases), complicated interventional procedures with cardiac chamber or vessel perforations (2 cases), dissecting aortic aneurysm (1 case), systemic lupus erythematous (1 case), idiopathic pericarditis (1 case), bacterial pericarditis (1 case), and myxedema heart disease (1 case). Seventeen cases were performed through the left xipho-sternal approach and 3 cases through the apical approach. None of the patients died as a result of these procedures. A two-dimensional echocardiogram is useful in diagnosing cardiac tamponade as well as in guiding pericardiocentesis, and obtaines highly positive results (20/20). The positive rate of pericardial fluid cytology for malignant cells was 89% (8/9), however, pericardial fluid cultures or direct smear for tuberculosis were negative (0/4). In cancer patients, the mean survival time following pericardiocentesis was 4.2 months (range, 1-7.8 months). We concluded that neoplastic involvement of the pericardium is the most frequent cause of symptomatic pericardial effusion. Pericardiocentesis assisted by a two-dimensional echocardiogram is safe and easy. In addition, pericarditis caused by TB is still significant and must be considered in every case in our nation.

Prostaglandin profile and synthetic capacity of the colon: comparison of tissue sources and subcellular fractions

Although there has been intense interest in the physiology and pathophysiology of prostaglandins (PGs) synthesized in the colon, little is known about the PG profile and synthetic capacity of different tissue sources and subcellular fractions as enzyme sources. Subcellular fractions prepared from the mucosa and muscle layer of rat colon were incubated with or without exogenous arachidonic acid ([3H]20:4n-6) for 30 min. In experiments with exogenous [3H]20:4n-6, the prostaglandin synthetic capacity of the colonic muscle layer was significantly higher than that of the mucosa. Among the subcellular fractions, microsomes had the highest PG synthetic capacity in both mucosa and muscle. The major PG product was PGI2 and PGD2 in the mucosal microsomes and PGI2 and PGE2 in the muscularis microsomes. However, production of PGI2 in the mucosa and PGE2 in the muscle was significantly reduced in the fractions containing both cytosol and microsome, resulting in an alteration of the PG profile. Substrate availability (exogenous vs endogenous supply) appears to influence the PG profile of the colon. In the colonic mucosa with exogenous [3H]20:4n-6, the production of PGI2 was 5 times higher than that of PGE2, whereas the production of PGE2 was twice higher than that of PGI2 in experiments with endogenous 20:4n-6. These observations indicate: 1) different PG profile and synthetic capacity of tissue sources and subcellular fractions; 2) alteration of PG profile due to the variation of 20:4n-6 availability. Thus, the outcome of experiments on the physiological role of PG in the colon may be determined, in part, by the tissue source and subcellular fraction selected for analysis. The present study also suggests that the variation of substrate availability in physiological and pathophysiological processes may affect the PG profile of the colon.

Biopharmaceutical explanation for the topical activity of 6-hydroxyethoxy-2-benzothiazolesulfonamide in the rabbit eye

6-Hydroxyethoxy-2-benzothiazolesulfonamide (compound 1), 6-hydrogen-2-benzothiazolesulfonamide (compound 2) and ethoxzolamide (compound 3) are carbonic anhydrase inhibitors, of which only compound 1 is active in lowering intraocular pressure when administered to the rabbit eye. They were compared for potency by inhibiting carbonic anhydrase I (CAase I) using the pH stat procedure. No differences were detected. Binding affinity and number of binding sites were identical; only a single binding site was operative. 14C-labelled compound 1 was used to measure the presence of an ocular metabolite which ranged from 17 to 57% in cornea, iris/ciliary body and aqueous humor. By maintaining drug solutions on either the corneal or conjunctival/scleral surfaces of the eye of anesthetized rabbits for 120 minutes, steady state concentrations of compounds 1-3 were determined in cornea, aqueous humor and iris/ciliary body. It was concluded that compound 1 penetrated both routes equally well and also accumulated at the active site in considerably higher concentrations than compounds 2 and 3. Compounds 2 and 3 did not accumulate in the iris/ciliary body nor did compound 3 penetrate the conjunctival/scleral route very well, approximately 5-20 fold lower than from the corneal route.

Ecto 5' nucleotidase (5'NT) as a sensitive indicator of human zinc deficiency

Ecto 5' nucleotidase (5'NT) is an integral plasma membrane enzyme located on most mammalian cells, and it is zinc dependent. We assayed 5'NT activity in the lymphocytes of two groups of subjects. The first group of six subjects had a mild state of zinc deficiency, as measured on the basis of zinc levels in lymphocytes, granulocytes, and platelets, but were otherwise healthy. They received 50 mg zinc as acetate orally for 12 weeks. The second six subjects were normal human volunteers in whom a mild state of zinc deficiency was induced experimentally by dietary techniques (4.2 to 5.6 mg daily zinc intake). For the assay of 5'NT, intact lymphocytes were incubated with 8-14C-labeled inosine monophosphate as substrate. Product and substrate were separated by thin-layer chromatography. Zinc level in cells was measured by flameless atomic absorption technique. In the first group of subjects with zinc deficiency, the decreased activity of 5'NT was corrected and the cellular zinc levels were normalized by oral zinc supplementation (p less than 0.01). In the second group of subjects, the baseline data were compared with those in early zinc depletion (4 to 8 weeks) and late depletion periods (greater than 20 weeks). A decrease in the activity of 5'NT was observed during the early zinc depletion phase. Zinc levels in lymphocytes, granulocytes, and platelets decreased significantly only during the late zinc depletion phase (p less than 0.01). Plasma zinc level did not change even during the late zinc depletion phase. Our studies show that 5'NT activity may be a sensitive and useful indicator of mild deficiency of zinc in human subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

A case of intrapericardial extralobar pulmonary sequestration--first case in Korea

Extralobar pulmonary sequestration, known as accessory lung, is a rare congenital anomaly and intrapericardial lung sequestration is extremely rare. To the best of our knowledge, only four reported cases were intrapericardial. We report a case with intrapericardial extralobar pulmonary sequestration confirmed by operation and morphologic basis.

A survival study of surgically treated lung cancer in Korea. Lung Cancer Surgical Study Group

Survival rate over a 5-year period were studied in a series of 658 proven primary lung cancer patients treated by thoracic surgeons at 8 institutes during the period from 1976 to 1987 in Korea. The study was designed as a multi-center cooperative work for the statistical analysis of the followup result. Clinical data of age, sex, morbidity, and staging of the tumor were assessed in 540 patients to evaluate their 5-year survival rates. Eventually, 405 resectable patients were analyzed by stage, cell type, surgical procedure, and TNM status. The 5-year actuarial survival rates by stage in the resectable group were: stage I 39.7%, II 30.6% III A 16.3%, III B 6.7%, and IV 0%. The 5-year survival rates by cell type were: squamous cell 31.9%, adenocarcinoma 21.2%, large cell 11%, and small cell 6%. The survival rates by surgical procedures were: lobectomy 30.7% and pneumonectomy 25.7%. The survival rates by TNM status in the operable group were: T1 34.7%, T2 26.8%, T3 7.5%, T4 5%; N1 23%, N2 10%, N3 3%; MO 21%, and M1 0%, respectively. The overall actuarial 5-year survival rate in the group of 405 resectable patients was 25.9%.

Hemodynamic effects of hydralazine in mitral valve prolapse with regurgitation

Vasodilators cause the earlier occurrence of click and prolong the duration of regurgitation murmur in mitral valve prolapse (MVP), meanwhile, they also decrease the intensity of murmur. To investigate the net effects of vasodilators on mitral regurgitation (MR) caused by MVP, we studied the hemodynamic responses to intravenous hydralazine in 10 patients with MVP and associated MR. The results showed that hydralazine reduced systemic vascular resistance by 28% (1705 +/- 307 to 1223 +/- 227 dyne-sec-cm5 p less than 0.001) and produced a 30% increase in cardiac output (4.4 +/- 0.7 to 5.7 +/- 0.7 l/min, p less than 0.001). The forward stroke volume increased by 18% (56 +/- 12 to 66 +/- 11 ml, p less than 0.001), while regurgitant stroke volume fell by 14% (46 +/- 22 to 40 +/- 23 ml, p less than 0.05), with a resultant slight fall in pulmonary capillary wedge v wave (13 +/- 5 to 11 +/- 3 mmHg, p = 0.05). We thus suggest that hydralazine has beneficial hemodynamic effects on MVP with regurgitation, and may be effective in the treatment of these patients.

Use of zinc-copper metabolic interactions in the treatment of Wilson's disease

Zinc acetate is becoming a well-established therapy for the treatment of Wilson's disease. It is excellent for maintenance therapy and for the treatment of the presymptomatic patient. Current evidence suggests that it will also be excellent for the treatment of the pregnant patient. Zinc acts by inducing intestinal cell metallothionein, which binds copper with high affinity, blocking its absorption, and causing its excretion in the stool. We have shown that zinc, even in doses as low as 25 mg daily, negatively affects copper balance. Zinc in doses of 50 mg three times daily, with all doses separated from food, controls the abnormal positive copper balance, blocks uptake of orally administered 64Cu, controls urine and plasma copper, prevents the reaccumulation of hepatic copper, and prevents the development or progression of symptoms of copper toxicosis in Wilson's disease patients. Zinc acetate will probably be licensed in the near future for the treatment of Wilson's disease. We recommend that physicians use urine and plasma copper, and urine zinc, as primary monitoring tools. In contrast to the comfortable situation with maintenance therapy, the initial treatment of acutely ill Wilson's disease patients is not well worked out. Patients with neurological disease often get worse initially on penicillamine, and zinc acts more slowly than is ideal. We have initiated studies of tetrathiomolybdate for this purpose. Studies of biliary secretions of normal subjects suggest that they excrete regulatory (excess) copper packaged in a protease-resistant ceruloplasmin fragment. This fragment is missing in Wilson's disease bile. The gene for Wilson's disease is on chromosome 13, close to the retinoblastoma locus.(ABSTRACT TRUNCATED AT 250 WORDS)