STEAP: a prostate-specific cell-surface antigen highly expressed in human prostate tumors

In search of novel genes expressed in metastatic prostate cancer, we subtracted cDNA isolated from benign prostatic hypertrophic tissue from cDNA isolated from a prostate cancer xenograft model that mimics advanced disease. One novel gene that is highly expressed in advanced prostate cancer encodes a 339-amino acid protein with six potential membrane-spanning regions flanked by hydrophilic amino- and carboxyl-terminal domains. This structure suggests a potential function as a channel or transporter protein. This gene, named STEAP for six-transmembrane epithelial antigen of the prostate, is expressed predominantly in human prostate tissue and is up-regulated in multiple cancer cell lines, including prostate, bladder, colon, ovarian, and Ewing sarcoma. Immunohistochemical analysis of clinical specimens demonstrates significant STEAP expression at the cell-cell junctions of the secretory epithelium of prostate and prostate cancer cells. Little to no staining was detected at the plasma membranes of normal, nonprostate human tissues, except for bladder tissue, which expressed low levels of STEAP at the cell membrane. Protein analysis located STEAP at the cell surface of prostate-cancer cell lines. Our results support STEAP as a cell-surface tumor-antigen target for prostate cancer therapy and diagnostic imaging.

Estrogen receptor immunoreactivity within subregions of the rat forebrain: neuronal distribution and association with perikarya containing choline acetyltransferase

Administration of the neuroactive steroid hormone estrogen has been shown to effect cholinergic basal forebrain neuronal function. Antibodies directed against the estrogen receptor alpha (ERalpha) revealed dark (type 1) and light (type 2) nuclear positive neurons within the islands of Calleja, endopiriform nucleus, lateral septum, subfields of the cholinergic basal forebrain, bed nucleus of the stria terminalis, striohypothalamic region, medial preoptic region, periventricular, ventromedial, arcuate and tuberal mammillary nuclei of the hypothalamus, reuniens and anterior medial thalamic nuclei, amygdaloid complex, piriform cortex and subfornical organ. In contrast, only a few scattered ERalpha labeled neurons were found in cortex and hippocampus. ERalpha stained cell bodies were not seen in the striatum. Counts of ERalpha labeled neurons in intact female rats revealed significantly more type 2 neurons within the basal forebrain subfields. Quantitation of ERalpha immunoreactive neurons revealed a significant decrease in the relative number of type 1 neurons within the medial septum (MS), horizontal limb of the diagonal band (HDB) and substantia innominata/nucleus basalis (SI/NB) following ovariectomy. Quantitation following choline acetyltransferease (ChAT) immunohistochemistry revealed a significant decrease in the number of ChAT positive neurons within the MS, HDB and SI/NB, but not VDB following ovariectomy. Following ovx, the percentage of double labeled cholinergic basal forebrain neurons also declined significantly within the MS, VDB, HDB and SI/NB. These observations suggest that estrogen effects a subpopulation of cholinergic basal forebrain neurons and may provide insight into the biologic actions of this steroid in Alzheimer's disease.

Comparison of some antineoplastic drugs on inhibiting thrombin catalizing fibrinogen clotting in vitro

OBJECTIVE

To classify the effect of thrombin, the key enzyme which enables fibrinogen to form fibrin (fibrinogen clotting) on the formation of metastasis by comparing the inhibition of some antineoplastic drugs on fibrinogen clotting in vitro.

METHODS

Time intervals of different drugs to reach a maximum OD (340 nm) data in fibrinogen solution added with thrombin were used in this work.

RESULTS

It was found that L-4-oxalysine (8-40 micrograms/ml) and arabinosyl cytosine (10-50 micrograms/ml) could inhibit the effect of thrombin by extending the fibrinogen clotting time to 100%-150% (P < 0.001) and 61%-100% (P < 0.001) while the other antimetastatic drugs razoxane, probimane, adriamycin, harringtonine homoharringtonine and alpha-anordrin at the treatment concentrations showed no such activity. The positive rate of drugs to thrombin activity was approximately 25%.

CONCLUSION

It suggests that L-4-oxalysine and arabinosyl cytosine may even exhibit antimetastatic effect through thrombin-fibrinogen pathway, and thrombin might operate in tumor metastasis for only limited step but crucial to fibrin formation in tumor nodules.

Expression of the mutant thyroid hormone receptor PV in the pituitary of transgenic mice leads to weight reduction

Resistance to thyroid hormone (RTH) is a genetic disease caused by mutations of the thyroid hormone receptor beta gene (TRbeta). One of the symptoms in some affected individuals is growth retardation. To understand the molecular basis of growth retardation in these patients with RTH, a transgenic mouse was prepared in which the expression of the TRbeta1 mutant PV was targeted to the pituitary using the promoter of the glycoprotein hormone alpha-subunit. The PV mutant was originally identified in a patient with severe growth impairment. The PV mutation is a C-insertion at codon 448 of the TRbeta gene and leads to a frame-shift of the carboxyl-terminal 14 amino acids of TRbeta1, resulting in total loss of triiodothyronine (T3) binding and transcriptional activation. PV was selectively expressed in the pituitary of the transgenic mouse and not in other tissues examined. The transgenic mice showed a significant impairment in weight gain. However, no changes in the serum level of thyroid-stimulating hormone were seen, and no elevation of thyroid hormones was detected in the transgenic mice. The circulating levels of growth hormone and insulin-like growth factor I were not affected in the transgenic mice, suggesting that the growth impairment in RTH is complex and is mediated by pathways that are yet to be elucidated.

Failure of ascorbate to protect against broadband blue light-induced retinal damage in rat

BACKGROUND

Excessive generation of free radicals due to light absorption is proposed as the most likely mechanism for photochemical retinal damage. The observed reduction of green light-induced retinal injury after ascorbate treatment is believed to be an antioxidative effect. The aim of the present study was to evaluate the possible protection of ascorbate against blue light-induced photoreceptor damage.

METHODS

Cyclic light-reared albino rats were injected intraperitoneally with either ascorbate (1 mg/g body weight) or, as placebo, physiological saline 24 h before and just prior to exposure to blue light. After 20-22 h of dark adaptation, two groups of the rats were exposed in pairs to the blue light (400-480 nm) for 6 h at an average irradiance of 0.7 W/m(2) in the cage. Six days after light exposure, all rats were killed and retinal samples were analyzed.

RESULTS

Diffuse blue light irradiation resulted in an uneven distribution of damage in the retina. As judged from the pathological changes in the retina irradiated, no microscopic difference was observed between the two groups. The preserved thickness of the outer nuclear layer was on average 61.3% in the ascorbate-treated and 66.4% in the placebo-treated group. The photoreceptor loss was not significantly different between the two groups.

CONCLUSION

The ascorbate did not protect the retina from blue-light induced damage. This favors the assumption that the mechanisms for blue light-induced retinal damage might differ from that for green light.

Genomic sequence, structural organization, molecular evolution, and aberrant rearrangement of promyelocytic leukemia zinc finger gene

The promyelocytic leukemia zinc finger gene (PLZF) is involved in chromosomal translocation t(11;17) associated with acute promyelocytic leukemia. In this work, a 201-kilobase genomic DNA region containing the entire PLZF gene was sequenced. Repeated elements account for 19.83%, and no obvious coding information other than PLZF is present over this region. PLZF contains six exons and five introns, and the exon organization corresponds well with protein domains. There are at least four alternative splicings (AS-I, -II, -III, and -IV) within exon 1. AS-I could be detected in most tissues tested whereas AS-II, -III, and -IV were present in the stomach, testis, and heart, respectively. Although splicing donor and acceptor signals at exon-intron boundaries for AS-I and exons 1-6 were classical (gt-ag), AS-II, -III, and -IV had atypical splicing sites. These alternative splicings, nevertheless, maintained the ORF and may encode isoforms with absence of important functional domains. In mRNA species without AS-I, there is a relatively long 5' UTR of 6.0 kilobases. A TATA box and several transcription factor binding sites were found in the putative promoter region upstream of the transcription start site. PLZF is a well conserved gene from Caenorhabditis elegans to human. PLZF paralogous sequences are found in human genome. The presence of two MLL/PLZF-like alignments on human chromosome 11q23 and 19 suggests a syntenic replication during evolution. The chromosomal breakpoints and joining sites in the index acute promyelocytic leukemia case with t(11;17) also were characterized, which suggests the involvement of DNA damage-repair mechanism.

Alteration of memory in the reduction of children's distress during repeated aversive medical procedures

The present study sought to reduce children's distress during aversive medical procedures using a brief, cost-effective intervention aimed at reframing memory. Fifty children diagnosed with leukemia (25 treatment, 25 attention control, aged 3-18) were observed as they underwent 3 consecutive lumbar punctures (LPs; baseline, postintervention, and follow-up). Self-report, physiological, and observable distress measures were collected before and after each LP. At posttreatment, children in the intervention group showed reductions in anticipatory physiological and self-report ratings relative to the control group. At follow-up, these effects generalized to reductions in procedural distress. These results suggest that (a) a simple memory-based intervention is efficacious at reducing children's distress and (b) benefits from this intervention are maintained over 1 week even without continued intervention.

Alteration of memory in the reduction of children's distress during repeated aversive medical procedures

The present study sought to reduce children's distress during aversive medical procedures using a brief, cost-effective intervention aimed at reframing memory. Fifty children diagnosed with leukemia (25 treatment, 25 attention control, aged 3-18) were observed as they underwent 3 consecutive lumbar punctures (LPs; baseline, postintervention, and follow-up). Self-report, physiological, and observable distress measures were collected before and after each LP. At posttreatment, children in the intervention group showed reductions in anticipatory physiological and self-report ratings relative to the control group. At follow-up, these effects generalized to reductions in procedural distress. These results suggest that (a) a simple memory-based intervention is efficacious at reducing children's distress and (b) benefits from this intervention are maintained over 1 week even without continued intervention.

Reliability of the drop test for the lacrimal drainage function

PURPOSE

The purpose of this study was to investigate the reliability of the drop test.

METHODS

The repeatability of the test was studied with the same and three different examiners. The influence of the blink rate was investigated by recording the blink frequency in 63 subjects. The degree of reflex lacrimation during the test was assessed in ten patients. The effect of different test solutions was investigated in ten test subjects.

RESULTS

There was no significant difference when the test was repeated either by the same or different examiners. The reflex lacrimation during the drop test was not significant. There was no correlation between drop test result and blink rate. A moderate increase in the viscosity of the test solution affected the lacrimal drainage.

CONCLUSION

The drop test is a reliable test for the lacrimal drainage function.

[Cost-benefit analysis for hepatitis A vaccine]

OBJECTIVE

To improve economic benefits of hepatitis A (HA) vaccination and to lay a foundation for formulating an immunization strategy for it.

METHODS

Health economics methods were used for analyzing the cost-benefit ratio, balance point of cost-benefit and balance point of antibody level after HA vaccination.

RESULTS

The benefit-cost ratio (BCR) for HA vaccine was 2.53 in Jiangxing City of Zhejiang Province with an HA-specific incidence rate of 41.15 per ten thousand. Incidence rate of HA was 16.26 per ten thousand at balance point of cost-benefit of HA vaccine. Cost would be reduced if serum HA antibody was screened before vaccination in the population with more than 50% of seropositive HA antibody.

CONCLUSION

It indicated that more economic benefits would be gained if mass HA vaccination strategy was used. Vaccinee of choice was those at ages of 15 to 29 years. HA vaccination after antibody screening in the population aged over 25 years would be more economic than the direct use.

[Applying combination of ultrasound and CT to diagnose paralaryngeal space tumor]

OBJECTIVE

To explore an effective way to diagnose parapharyngeal space tumor.

METHODS

The clinical data of 25 cases of this type of tumor, diagnosed by combinating ultrasound examination and CT scan, were analysed.

RESULTS

The diagnosis correspondence rate by the combinating way of ultrasound and CT is 92%. The combination of the two methods is likely able to reveal the overall shape, extend and feature of tumor, and to assist us in decision of the entrance of operation.

CONCLUSION

The combination of ultrasound diagaosis and CT scan is of satisfactory clinical value in diagnosis of parapharyngeal space tumor.

Blue light induced apoptosis in rat retina

PURPOSE

To explore cell death in blue light induced retinal damage.

METHODS

Sprague-Dawley rats reared under cyclic light were exposed continuously to diffuse blue light (400-480 nm) at 0.64 W/m2 for 3 or 6 h after 22 h of dark adaptation. The rats were kept in darkness and killed immediately, 8, 16 and 24 h following light exposure. The retinal damage by the blue light was examined with a transmission electron microscope. The cell death was characterised by in situ terminal dUTP nick end labelling (TUNEL) and gel electrophoresis.

RESULTS

During the 24 h following light exposure, photoreceptor cell death was characterised by progressive condensation and margination of the chromatin, shrinkage or convolution and fragmentation of the nucleus, condensation of the cytoplasm, and formation of apoptotic bodies along with rapid removal of dying cells from damaged areas in the absence of inflammatory response. The TUNEL-positive nuclei were scattered individually in the outer nuclear layer just after light exposure. A wave of massive TUNEL labelling of photoreceptor nuclei peaked at 8-16 h and dropped at 24 h following light exposure. The distribution of TUNEL-positive nuclei was located predominantly at the upper temporal region of the retina, which was the most sensitive area to the damage caused by blue light. Furthermore, the multiples of internucleosomal cleavage of 180-200 base pairs were demonstrated at corresponding time points.

CONCLUSION

Photoreceptor cell apoptosis is seen early after the retina is damaged by blue light.

[The role of breathing control disorder in the development of carbon dioxide retention in patients with obesity hypoventilation syndrome]

OBJECTIVE

To define the role of breathing control in the pathogenesis of carbon dioxide (CO(2)) retention in patients with obesity hypoventilation syndrome.

METHODS

10 obese obstructive sleep apnea syndrome (OSAS) patients were studied. They were separated according to their waking arterial partial pressure of CO(2) (PaCO(2)), 5 being eucapnic and 5 hypercapnic. Both groups had similar body mass index, apnea hypopnea index and normal lung function. The hypoxic (Delta P(0.1)/Delta SaO(2), Delta V(E)/Delta SaO(2)) and the hypercapnic response (Delta P(0.1)/Delta PaCO(2), Delta V(E)/Delta PaCO(2)) were tested before and during continuous positive airway pressure (CPAP) treatment (at 2, 4, 6 weeks).

RESULTS

Compared with the eucapnic patients, all the hypercapnic patients had lower Delta P(0.1)/Delta SaO(2) [(-0.04 +/- 0.02) cmH(2)O% vs (-0.14 +/- 0.03) cmH(2)O%], Delta V(E)/Delta SaO(2) [(-0.17 +/- 0.04) L x min(-1)% vs (-0.34 +/- 0.04) L x min(-1)%], Delta P(0.1)/Delta PaCO(2) [(0.23 +/- 0.1) cmH(2)O/mm Hg vs (0.49 +/- 0.1) cmH(2)O/mm Hg], Delta V(E)/Delta PaCO(2) [(1.32 +/- 0.7) L x min(-1) x mm Hg(-1) vs (2.18 +/- 0.81) L x min(-1) x mm Hg(-1)] and the Delta P(0.1)/Delta SaO(2), Delta V(E)/Delta SaO(2) were also lower than the normal value. After treatment with CPAP, the hypercapnic and the hypoxic response of the hypercapnic patients increased gradually, at about 4 approximately 6 week, both of them increased to the normal range, PaCO(2) showed a complete return to eucapnia, their weight were unchanged.

CONCLUSION

The depressed breathing control play an important role in the development of CO(2) retention in OSAS patients, and the disorder in breathing control may be secondary to hypoxia, hypercapnia and sleep disorder related to the OSAS.

[Utility of nocturnal oximetry for case finding in patients with suspected sleep apnea syndrome]

OBJECTIVE

Pulse oximeter is a useful screening device for SAS. We studied whether measurement of SaO2 could identify patients with SAS and evaluate the severity of SAS.

METHODS

174 snorers were assessed clinically and then underwent formal PSG and oximetry test at the same time. From the oximetry data, the percentage of time spent at SaO2 below 90% (SIT90%), waking SaO2(H SaO2%), the lowest SaO2(L SaO2%) during sleep, the mean SaO2(M SaO2%) and the number of oxygen desaturation > or = 4% per hour (DI4) were calculated. We also divided 100 cases among them into four groups by AHI, which were G0(AHI < 5), G1(AHI 5-19), G2(AHI 20-39), G3(AHI > or = 40), and evaluated whether the SIT90, ISaO2, MSaO2 and DI4 are different among the four groups.

RESULTS

There was an statistically significant correlation (r = 0.91 P < 0.001) between DI4 and AHI. DI4 > or = 5 per hour identified patients with AHI > 5 with a sensitivity of 94%; DI4 > or = 15 per hour identified patients with AHI > 5 with a specificity of 98%, and for patients with AHI > or = 20, the sensitivity was 100%. The SIT90 and DI4 were significantly different among the four groups (P < 0.01).

CONCLUSIONS

Oximetry with DI4 < 5 practically excludes clinically significant SAS, and DI4 > or = 15 identified almost all of them. SIT90 and DI4 could be used as parameters in evaluating the severity of SAS.

Concentration-dependent effects of muscimol to enhance pulsatile GnRH release from GT1-7 neurons in vitro

Immortalized GT1-7 neurons were used to characterize the effect of muscimol, a GABAA receptor agonist, to enhance pulsatile gonadotropin-releasing hormone (GnRH) release. GT1-7 neurons were grown on Cytodex-3 beads and placed in special superfusion microchambers. The cells were superfused at a rate of 6.2 ml x h-1 with Media 199 (pH 7.35) using a commercially available perfusion system. After a pre-muscimol period of 120 min, the cells were exposed for 5 min to 0.35, 1, 5 or 10 microM muscimol or 5 microM muscimol+20 microM of the GABAA receptor antagonist, bicuculline. Following removal of the muscimol (and bicuculline, in the case of the latter experiment), the superfusion was continued for another 115 min. Sample fractions were collected at 5 min intervals throughout the perfusion. Basal GnRH release from the GT1-7 neurons was pulsatile with an average interpulse interval of 45.4+/-0.5 min and an average pulse amplitude of 191.5+/-22.6 pg x min x ml-1. Our results also demonstrated that the GABAA receptor agonist, muscimol, enhances pulsatile GnRH release from GT1-7 neurons in culture. The response to muscimol was saturable and concentration-dependent with an EC50 of 0.47 microM. The effects of 5 microM muscimol to increase GnRH pulsatility were blocked by co-exposure to the GABAA receptor antagonist, bicuculline. The average GnRH interpulse intervals were 41.7+/-1.8 min, 32.5+/-2.9 min, 30.6+/-0.7 min and 25.5+/-0.4 min in the period following exposure to 0.35, 1, 5 and 10 microM of muscimol, respectively (post-muscimol period). GnRH pulse amplitude (mean-area for each pulse) was increased during exposure to muscimol but not during the pre- or post-muscimol periods. The GABAA receptor antagonist, bicuculline, itself had no effect on pulsatile GnRH release. These results are consistent with previously published reports suggesting that activation of the GABAA receptor stimulates hypothalamic GnRH release in embryonic and neonatal animals.

Multiple pathways on a protein-folding energy landscape: kinetic evidence

The funnel landscape model predicts that protein folding proceeds through multiple kinetic pathways. Experimental evidence is presented for more than one such pathway in the folding dynamics of a globular protein, cytochrome c. After photodissociation of CO from the partially denatured ferrous protein, fast time-resolved CD spectroscopy shows a submillisecond folding process that is complete in approximately 10(-6) s, concomitant with heme binding of a methionine residue. Kinetic modeling of time-resolved magnetic circular dichroism data further provides strong evidence that a 50-microseconds heme-histidine binding process proceeds in parallel with the faster pathway, implying that Met and His binding occur in different conformational ensembles of the protein, i.e., along respective ultrafast (microseconds) and fast (milliseconds) folding pathways. This kinetic heterogeneity appears to be intrinsic to the diffusional nature of early folding dynamics on the energy landscape, as opposed to the late-time heterogeneity associated with nonnative heme ligation and proline isomers in cytochrome c.

Proteins of the exocytotic core complex mediate platelet alpha-granule secretion. Roles of vesicle-associated membrane protein, SNAP-23, and syntaxin 4

To understand the molecular basis of granule release from platelets, we examined the role of vesicle-associated membrane protein, SNAP-23, and syntaxin 4 in alpha-granule secretion. A vesicle-associated membrane protein, SNAP-23, and syntaxin 4 were detected in platelet lysate. These proteins form a SDS-resistant complex that disassembles upon platelet activation. To determine whether these proteins are involved in alpha-granule secretion, we developed a streptolysin O-permeabilized platelet model of alpha-granule secretion. Streptolysin O-permeabilized platelets released alpha-granules, as measured by surface expression of P-selectin, in response to Ca2+ up to 120 min after permeabilization. Incubation of streptolysin O-permeabilized platelets with an antibody directed against vesicle-associated membrane protein completely inhibited Ca2+-induced alpha-granule release. Tetanus toxin cleaved platelet vesicle-associated membrane protein and inhibited Ca2+-induced alpha-granule secretion from streptolysin O-permeabilized platelets. An antibody to syntaxin 4 also inhibited Ca2+-induced alpha-granule release by approximately 75% in this system. These results show that vesicle-associated membrane protein, SNAP-23, and syntaxin 4 form a heterotrimeric complex in platelets that disassembles with activation and demonstrate that alpha-granule release is dependent on vesicle SNAP receptor-target SNAP receptor (vSNARE-tSNARE) interactions.

Cyclin E2, a novel G1 cyclin that binds Cdk2 and is aberrantly expressed in human cancers

A novel cyclin gene was discovered by searching an expressed sequence tag database with a cyclin box profile. The human cyclin E2 gene encodes a 404-amino-acid protein that is most closely related to cyclin E. Cyclin E2 associates with Cdk2 in a functional kinase complex that is inhibited by both p27(Kip1) and p21(Cip1). The catalytic activity associated with cyclin E2 complexes is cell cycle regulated and peaks at the G1/S transition. Overexpression of cyclin E2 in mammalian cells accelerates G1, demonstrating that cyclin E2 may be rate limiting for G1 progression. Unlike cyclin E1, which is expressed in most proliferating normal and tumor cells, cyclin E2 levels were low to undetectable in nontransformed cells and increased significantly in tumor-derived cells. The discovery of a novel second cyclin E family member suggests that multiple unique cyclin E-CDK complexes regulate cell cycle progression.

Glypican 3 and glypican 4 are juxtaposed in Xq26.1

Recently, we have shown that mutations in the X-linked glypican 3 (GPC3) gene cause the Simpson-Golabi-Behmel overgrowth syndrome (SGBS; ). The next centromeric gene detected is another glypican, glypican 4 (GPC4), with its 5' end 120763bp downstream of the 3' terminus of GPC3. One recovered GPC4 cDNA with an open reading frame of 1668nt encodes a putative protein containing three heparan sulfate glycosylation signals and the 14 signature cysteines of the glypican family. This protein is 94.3% identical to mouse GPC4 and 26% identical to human GPC3. In contrast to GPC3, which produces a single transcript of 2.3kb and is stringently restricted in expression to predominantly mesoderm-derived tissues, Northern analyses show that GPC4 produces two transcripts, 3.4 and 4.6kb, which are very widely expressed (though at a much higher level in fetal lung and kidney). Interestingly, of 20 SGBS patients who showed deletions in GPC3, one was also deleted for part of GPC4. Thus, GPC4 is not required for human viability, even in the absence of GPC3. This patient shows a complex phenotype, including the unusual feature of hydrocephalus; but because an uncle with SGBS is less affected, it remains unclear whether the GPC4 deletion itself contributes to the phenotype.

Degradation of proto-oncoprotein c-Rel by the ubiquitin-proteasome pathway

The c-rel proto-oncogene product, c-Rel, belongs to the Rel/NF-kappaB transcription factor family, which regulates a large variety of cellular functions. The activation of NF-kappaB involves the degradation of the inhibitor, IkappaB, through the ubiquitin-proteasome (Ub-Pr)-mediated pathway. Here we report that the turnover of c-Rel is also regulated by the Ub-Pr pathway, thus adding another level of complexity to the regulation of NF-kappaB. High molecular weight ubiquitinated c-Rel conjugates are detected in cells and accumulate in cells treated with proteasome inhibitors. In a cell-free in vitro degradation assay, c-Rel is degraded specifically through the Ub-Pr pathway. N-terminally truncated c-Rel is readily degraded, implying the dispensability of N-terminal sequence; in contrast, a series of deletion mutants missing C-terminal sequences display a reduced susceptibility to the degradation. Interestingly, the sequence between residues 118 and 171 of c-Rel, i.e. the region immediately following the c-Rel/v-Rel homology domain, appears to play an important role in mediating ubiquitin conjugation and the subsequent degradation. Together with our previous study showing an elevated tumorigenic potential for C-terminally truncated mutants, our data suggest that the C-terminal domain of c-Rel plays an important role in mediating c-Rel degradation and growth control.

Vitamin E up-regulates arachidonic acid release and phospholipase A2 in megakaryocytes

The release of arachidonic acid is the rate limiting step in eicosanoid synthesis. In mammalian cells, the release of arachidonic acid is catalyzed by several enzymes. The 85 kDa cytosolic phospholipase A2 (cPLA2) is the key enzyme for the release reaction because of its specific acyl selectivity in phospholipid substrates. We have previously reported that vitamin E enrichment potentiates the arachidonic acid release as well as the spontaneous prostacyclin release in human endothelial cells. In contrast, similar enrichment of diets caused a dose-dependent suppression of platelet thromboxane synthesis. Therefore, the present study was undertaken to determine the effect of vitamin E on arachidonate release and phospholipaseA2 activity in a platelet precursor cell, the MEG-01 megakaryocyte cell line. When these cells were incubated with different concentrations of vitamin E, cellular incorporation was linear with the dosages of this vitamin. Determination of arachidonate release after labeling cells with [3H]-arachidonate showed that vitamin E enrichment caused a dose-dependent increase in ionophore A23187-induced [3H]-arachidonic acid release. Analysis of PLA2 activity showed that activity was detected in the cytosol and this activity was completely abolished by the addition of anti-cPLA2, antibody. Determination of cPLA2 activity demonstrated that vitamin E enrichment caused an increase in enzyme activity. Analysis of cPLA2 protein by Western blot revealed that vitamin E caused an increase in enzyme protein. These data showed that the potentiation of arachidonic acid release and cPLA2, activity by vitamin E was mediated by the enhanced expression of cPLA2 protein.

Feline immunodeficiency virus associated myopathy in the adult cat

Human immunodeficiency virus (HIV-1) associated myopathy can be a debilitating disease in humans, leading to weakness, myalgia, and muscle wasting. Subclinical neuromuscular involvement is also common. A range of histologic lesions have been described in both forms that include both inflammatory and degenerative changes. The purpose of this study was to determine whether a myopathy was present in adult cats experimentally infected with feline immunodeficiency virus (FIV). Six specific pathogen-free, laboratory-housed cats were challenged intravenously with 1000 TCID50 of the Maryland isolate of FIV (FIV-MD) at 8 months of age. The highest serum creatine kinase values were seen at 18 months postinfection (mean 9838, SD 4805 U/L) compared to preinfection (mean 950, SD 374 U/L). Needle EMG studies revealed abnormal spontaneous activity in 2 cats. All FIV-MD infected cats exhibited at least one abnormality in muscle pathology. Of the 24 muscle samples, 15 (63%) had histopathologic lesions. The predominant histologic abnormalities consisted of perivascular and pericapillary lymphocytic infiltration, and myofiber necrosis, phagocytosis, and regeneration. Lymphocytic infiltration was graded 2+ or higher in 12 of 24 muscle samples (0 = negligible; 4+ = extensive). Immunohistochemical phenotypic lymphocyte labeling in all cats demonstrated only CD8+ lymphocyte staining. This report demonstrates the presence of a FIV associated inflammatory myopathy in the adult cat. Several similarities are apparent in comparison to HIV-1 associated polymyositis reported in humans. Future studies in the cat may thus prove useful in elucidating the pathogenesis of retrovirus related myopathy in humans.

Clinical effects of anterior cerebral artery infarction

Anterior cerebral artery infarction is uncommon. We studied the topographical distribution of the lesions and the resulting clinical effects for a better understanding of their relationship and the functional outcome. There were 17 patients; the mean age of the cohort was 71 years. There were 10 men and 7 women. Two clinical syndromes were identified in accordance to the two anatomic areas of distribution. The paracentral lobule syndrome (group 1) was characterized by contralateral motor weakness, the leg more than the arm. The second group involved mainly the motor and supplementary motor areas. Beside contralateral weakness, they had a clinical picture of extrapyramidal symptomatology, which was designated as pseudoparkinsonian syndrome (group 2). Sixty percent of the patients in group 2 had bilateral occlusive carotid artery disease compared with 14% in the group 1, and it is likely that the mechanism was artery-to-artery embolism or cardioembolism in this group. In group 1, the lesions were smaller but superficial and it is possible that small emboli from the heart or parent large artery caused the obstruction. The location of the occlusion may be indicative of the stroke mechanism. The pseudoparkinsonian group with extrapyramidal features attributable to involvement of the supplementary motor area had an unfavorable outcome. There was poor correlation between size of the infarct and functional outcome (P=.12) in both groups.

Knee injuries produced by recreational sports follow a different pattern than casual injuries

Data was collected on 208 Chinese males who underwent knee arthroscopy following trauma in the period from January 1993 through December 1994. For the purpose of comparison and analysis, the patients were classified according to their sporting habits as sedentary patients, recreational athletes, or competitive athletes. There were no significant differences in age between the three groups (average age: 25.82 +/- 10.6; range: 12 to 73 years). A hemarthrosis was present in 122 patients, and an effusion in 35. The most common mechanism of injury was direct impact (105 patients), followed by a twisting injury (58 patients). The most common arthroscopic finding was an anterior cruciate ligament (ACL) tear (partial in-37 patients and complete in 43 patients). In both sedentary and athletic patients, a hemarthrosis was significantly associated with ACL and meniscal tears (p = 0.02). When comparing the pattern of arthroscopic pathology between sports and casual injuries, a significantly greater number of ACL tears (both complete and partial) were caused during sports activity (p = 0.032). Sports injuries also resulted in a significantly greater number of meniscal injuries (p = 0.028). However, sedentary patients suffered from a greater prevalence of tibial osteochondral fractures (10%) than did those in the sports group (5%) (p = 0.04).

Multiple conformational states of a new hematopoietic cytokine (megakaryocyte growth and development factor): pH- and urea-induced denaturation

The effect of pH and urea on the conformation of recombinant human megakaryocyte growth and development factor (rHuMGDF) was determined by circular dichroism, intrinsic fluorescence spectroscopy, and equilibrium ultracentrifugation. The conformation of rHuMGDF was dependent on pH and urea concentration. Multiple folding forms were evidenced by multiple pH-induced transitions and urea-induced equilibrium transitions that deviated from a simple two-state process. In neutral to alkaline pH, rHuMGDF exists as a monomer, but an acid-induced conformational state self-associates to form a soluble aggregate. A folding intermediate(s) was observed with a more stable secondary structure than tertiary structure and was dependent on the pH of the urea-induced denaturation. The differences in the stabilities of the folding states were most distinct in the pH range of 4.5 to 6.5. The presence of intermediates in the folding pathway of rHuMGDF are similar to findings of previous studies of related growth factors that share a common three-dimensional structure.

Association of Cdk2/cyclin E and NF-kappa B complexes at G1/S phase

NF-kappa B/Rel family plays a pivotal role in a wide variety of cellular functions including growth, development, apoptosis and stress responses. Recent studies indicated that NF-kappa B is also involved in the cell cycle regulation, and high expression of c-Rel results in a cell cycle arrest at the G1/S-phase transition (Bash, J., Zong, W,-X., and Gelinas, C. (1997) Mol. Cell. Biol. 17, 6526-6536). Here we report the detection of Cdk2, a critical kinase responsible for the G1/S-phase transition, in immune complexes precipitated by the NF-kappa B antisera. Cdk2 and NF-kappa B association was detected by co-precipitation in the nuclear lysates of the G1/S-phase cells, and was found in cultured cell lines and in T cells purified from human peripheral blood. Using an affinity column containing the C-terminal peptide of human c-Rel, we isolated cyclin E, the regulatory subunit of the Cdk2 complex, as a c-Rel-binding protein. These findings support and provide physical basis for the involvement of NF-kappa B in the G1/S-phase cell cycle control, and suggest an important role played by the C-terminal sequence of c-Rel.

Comparison of upstream regions of X- and Y-chromosomal amelogenin genes

The amelogenin genes encode abundant enamel proteins that are required for the development of normal tooth enamel. These genes are active only in enamel-forming ameloblasts within the dental organ of the developing tooth, and are part of a small group of genes that are active on both sex chromosomes. The upstream regions of the bovine X- and Y-chromosomal and the sole murine X-chromosomal amelogenin genes have been cloned and sequenced, and conservation at nearly 60% is found in the 300 bp upstream of exon 1 for the 3 genes. A region of the bovine X-chromosomal gene that has inhibitory activity when assayed by gene transfer into heterologous cells includes motifs that have a silencing activity in other genes, and may be important to the mechanism that represses amelogenin expression in non-ameloblast cells in vivo. A comparison of sequences from three genes has led to the identification of several regions with conserved motifs that are strong candidates for having positive or negative regulatory functions, and these regions can now be tested further for interaction with nuclear proteins, and for their ability to regulate expression in vivo.

Dose-response function for lens forward light scattering after in vivo exposure to ultraviolet radiation

BACKGROUND

It is known that different types of radiation, as well as aging and metabolic disorders, can cause cataract. Several epidemiological investigations show a correlation between cataract development and the dose of ultraviolet radiation (UVR) received. It is well established experimentally that exposure of animal eyes to UVR induces cataract. The purpose of the present study was to determine the dose-response function for UVR-induced opacities in the rat lens after in vivo exposure.

METHODS

Sprague-Dawley rats received 0.1, 0.4, 1.3, 3, 5, 8 or 14 kJ/m2 UVR (lambda MAX = 300 nm, lambda 0.5 = 10 nm) unilaterally for 15 min. At 1 week after exposure both lenses were removed, photographs were taken and the intensity of forward-scattered light was measured.

RESULTS

One week after UVR exposure, opacities occurred on the lens surface, as observed with a microscope. With increased UVR dose the opacities became more intense and occurred also in the equatorial area of the lens, but not in the nucleus. The intensity of forward light scattering increased with increased UVR dose between 3 and 14 kJ/m2. No significant change in intensity of forward light scattering was observed for lower UVR doses.

CONCLUSION

The intensity of forward light scattering in the rat lens increase exponentially with increased UVR dose between 0.1 and 14 kJ/m2.

Detection of differentially expressed genes in primary tumor tissues using representational differences analysis coupled to microarray hybridization

The identification of differential gene expressionbetween cells is a frequent goal in modern biological research. Here we demonstrate the coupling of representational difference analysis (RDA) of cDNA with microarray analysis of the output for high throughput screening. Two primary Ewing's sarcoma tissue samples with different biological behavior in vivo were compared by RDA: one which was metastatic and progressed rapidly; the other localized and successfully treated. A modified RDA protocol that minimizes the necessary starting material was employed. After a reduced number of subtractive rounds, the output of RDA was shotgun cloned into a plasmid vector. Inserts from individual colonies from the subtracted library were amplified with vector-specific primers and arrayed at high density on glass slides. The arrays were then hybridized with differentially fluorescently labeled starting amplicons from the two tissues and fluorescent signals were measured at each DNA spot. We show that the relative amounts of fluorescent signal correlate well with the abundance of fragments in the RDA amplicon and in the starting mRNA. In our system, we analyzed 192 products and 173 (90%) were appropriately detected as being >2-fold differentially expressed. Fifty unique, differentially expressed clones were identified. Therefore, the use of RDA essentially provides an enriched library of differentially expressed genes, while analysis of this library with microarrays allows rapid and reproducible screening of thousands of DNA molecules simultaneously. The coupling of these two techniques in this system resulted in a large pool of differentially expressed genes.

[Simulated experiment of hemodynamics changes in aorta during high energetic trauma through abdomen]

In order to study the mechanism of remote effect of missile wound, we designed and carried out a simulated experiment. The change of hemodynamics in aorta was examined with a pressure transducer during gunshot and then calculated. The results revealed superhigh pressure, high speed of pressure rising, accelerated velocity of blood flow, substantial pressure difference and profuse blood flow in aorta during gunshot.

Myc activation reduces fibroblast clonogenicity via an apoptotic mechanism that can be suppressed by a soluble paracrine factor

The c-Myc transcription factor is involved in the regulation of cellular proliferation and differentiation and is one of the most frequently deregulated genes in human cancers. While c-Myc is known to enhance the proliferative potential of cells, its activation in immortalized fibroblasts has been found to result in apoptosis following gamma-irradiation or under adverse growth conditions, including serum deprivation and hypoxia. When plating Rat-1 fibroblasts at low cell densities (100 cells/100 mm plate), we observed a substantial reduction in the clonogenicity of cells with deregulated c-Myc activity compared to cells with normal c-Myc activity. This difference in clonogenicity was apparent despite the fact that cells were plated in media containing sufficient serum and oxygen concentrations known to suppress apoptosis of exponentially growing Rat-1 fibroblasts with activated c-Myc. Therefore, we hypothesized that the observed reduction in plating efficiency in cells with activated c-Myc occurred via an apoptotic mechanism and that a fibroblast-derived factor was required for suppression of apoptosis. Overexpression of the anti-apoptotic oncogene, Bcl-2, in cells with activated c-Myc restored the plating efficiency to normal levels in cells plated at low cell densities. This strongly suggested that the decreased clonogenicity of fibroblasts with altered c-Myc activity resulted from enhanced apoptosis of the cells under these conditions. Furthermore, plating cells on a feeder layer of lethally-irradiated fibroblasts or in Rat-1 conditioned media increased the plating efficiencies of sparsely plated cells in a dose-dependent fashion. These results suggest that in addition to previously reported requirements for serum-derived growth factors and normal oxygen conditions, a paracrine factor liberated by Rat-1 fibroblasts is required to suppress c-Myc-induced apoptosis in these cells.

Time-resolved circular dichroism studies of protein folding intermediates of cytochrome c

The circular dichroism spectra of cytochrome c (cytc) in 4.6 M guanidine hydrochloride (pH 6.5) indicate that the secondary structure in reduced cytc is near-native, whereas in the CO-bound species (COCytc) it is substantially unfolded. Photolysis of COCytc should thus induce large changes in the secondary structure, which can be probed with time-resolved circular dichroism (TRCD) spectroscopy in the far-UV region. Time-resolved absorption (TROA) and TRCD methods were used to study the photolysis reaction of COCytc in efforts to identify structural intermediates in cytc folding on time scales from nanoseconds to seconds. TROA data from the Soret region, similar to previous studies, showed four intermediates with lifetimes of 2, 50, 225, and 880 micros. The 2-micros process is proposed to involve Fe(II)-Met80 coordination. Approximately 7% of the native CD signal was observed in the TRCD signal at 220 nm within 500 ns, with no significant additional secondary structure formation observed. Further folding after 2 micros may be inhibited by ligation of His26/His33 with Fe(II), which is suggested to be associated with the 50-micros phase. The two slowest components, tau = 225 and 880 micros, are attributed to CO rebinding on the basis of mixed-gas experiments. CO rebinding is expected to compete with protein folding and favor the unfolded state. However, when the two CO rebinding lifetimes are extended into milliseconds by reducing the CO concentration, there is still no significant increase in CD signal at 220 nm.

Cerebral ptosis revisited

We studied nine patients with cerebral ptosis and gaze deviation following an acute stroke. The brains of all nine showed an extensive lesion in the fronto-parieto-temporal regions. In five the stroke was left hemispheric. The assumption is that cerebral ptosis may have a bihemispheric representation and results from damage to the connections rather than to a specific area.

[A modified laryngectomy combined with radical neck dissection for late-staged supraglottic carcinoma]

8 cases of supraglottic or transglottic carcinoma with neck lymphatic metastasis received a modified laryngectomy or subtotal laryngectomy combined with radical neck dissection. Laryngeal function was reconstructed in 3 of them. No postoperative complication occurred. All cases survived uneventfully through a five-year following up, except one who died of neck lymphatic and lung metastasis. The indication, procedure and advantage of this operation are discussed in this article.

[The virtual printing technology of micro-controller and its application in a ECG Holter system]

This paper introduced the virtual printing technology based 80c196 system including PSD and DRAM and its application of text and image printing in a long-term large capacity ECG system with real time recording and analysing.

Involvement of valosin-containing protein, an ATPase Co-purified with IkappaBalpha and 26 S proteasome, in ubiquitin-proteasome-mediated degradation of IkappaBalpha

The inactivation of the prototype NF-kappaB inhibitor, IkappaBalpha, occurs through a series of ordered processes including phosphorylation, ubiquitin conjugation, and proteasome-mediated degradation. We identify valosin-containing protein (VCP), an AAA (ATPases associated with a variety of cellular activities) family member, that co-precipitates with IkappaBalpha immune complexes. The ubiquitinated IkappaBalpha conjugates readily associate with VCP both in vivo and in vitro, and this complex appears dissociated from NF-kappaB. In ultracentrifugation analysis, physically associated VCP and ubiquitinated IkappaBalpha complexes sediment in the 19 S fractions, while the unmodified IkappaBalpha sediments in the 4.5 S fractions deficient in VCP. Phosphorylation and ubiquitination of IkappaBalpha are critical for VCP binding, which in turn is necessary but not sufficient for IkappaBalpha degradation; while the N-terminal domain of IkappaBalpha is required in all three reactions, both N- and C-terminal domains are required in degradation. Further, VCP co-purifies with the 26 S proteasome on two-dimensional gels and co-immunoprecipitates with subunits of the 26 S proteasome. Our results suggest that VCP may provide a physical and functional link between IkappaBalpha and the 26 S proteasome and play an important role in the proteasome-mediated degradation of IkappaBalpha.

Self-perceived health status of women three to five years after the diagnosis of gestational diabetes: a survey of cases and matched controls

OBJECTIVE

Our purpose was to determine the long-term effect on self-perceived health status and maternal perceptions of the offspring's health status after women had been labeled with a diagnosis of gestational diabetes.

STUDY DESIGN

We designed a mail survey of women who had participated in a large cohort study 3 to 5 years earlier. A tentative address list was developed for 139 women diagnosed with gestational diabetes and 406 matched controls; 33 and 89 questionnaires, respectively, were returned as "wrong address," but 106 case and 317 control addresses were potentially valid. The primary analysis compared cases and controls on the general health scale of the SF-36. Secondary outcomes included comparisons of the groups' mean results on a worry scale, ratings of the health of the child born in the index pregnancy, disability days, physician visits, diabetes preventive behaviors, and diabetes risk appraisal.

RESULTS

The usable response rates were 65 of 106 (61.3%) and 197 of 317 (62.1%), with no meaningful demographic differences found between respondents and nonrespondents. For general health, the mean score for cases was 68.9 (SD 22.34) vs 73.8 (SD 19.86) for controls, p = 0.05 (prespecified, one-tailed). After factors found to be independently related to health perception (age, race, birth place, and comorbidity) were controlled, the differences narrowed, with a mean score for cases of 70.09 versus 73.38 for controls, p = 0.11, two-tailed. Compared with controls, cases were more worried about their own health (p = 0.02, two-tailed), rated their children as less healthy (p = 0.005, two-tailed), and perceived themselves as more likely to have diabetes (p < 0.0001, two-tailed).

CONCLUSION

The diagnosis of gestational diabetes may lead to long-term changes in how women view their own health status and that of the child born during the affected pregnancy.

Subcongenic analysis of the Idd13 locus in NOD/Lt mice: evidence for several susceptibility genes including a possible diabetogenic role for beta 2-microglobulin

Although they share approximately 88% of their genome with NOD mice including the H2g7 haplotype, NOR mice remain free of T cell-mediated autoimmune diabetes (IDDM), due to non-MHC genes of C57BLKS/J (BKS) origin. NOR IDDM resistance was previously found to be largely controlled by the Idd13 locus within an approximately 24 cM segment on Chromosome 2 encompassing BKS-derived alleles for H3a, B2m, Il1, and Pcna. NOD stocks carrying subcongenic intervals of NOR Chromosome 2 were utilized to more finely map and determine possible functions of Idd13. NOR- derived H3a-Il1 (approximately 6.0 cM) and Il1-Pcna (approximately 1.2 cM) intervals both contribute components of IDDM resistance. Hence, the Idd13 locus is more complex than originally thought, since it consists of at least two genes. B2m variants within the H3a-Il1 interval may represent one of these. Monoclonal Ab binding demonstrated that dimerizing with the beta 2m(a) (NOD type) vs beta 2m(b) isoform (NOR type) alters the structural conformation, but not total expression levels of H2g7 class I molecules (e.g. Kd, Db). Beta 2m-induced alterations in H2g7 class I conformation may partially explain findings from bone marrow chimera analyses that Idd13 modulates IDDM development at the level of non-hematopoietically derived cell types controlling selection of diabetogenic T cells and/or pancreatic beta cells targeted by these effectors. Since trans-interactions between relatively common and functionally normal allelic variants may contribute to IDDM in NOD mice, the search for Idd genes in humans should not be limited to functionally defective variants.

DNA sequences of amelogenin genes provide clues to regulation of expression

The amelogenins are a heterogeneous group of enamel proteins, which have an important function in enamel formation, as mutations in the amelogenin gene result in the enamel defect amelogenesis imperfecta. The cDNAs that encode murine, bovine, human, porcine, rat and opossum amelogenins have been cloned, and as many as nine alternatively spliced messages can be produced from a single primary transcript, explaining some of the protein heterogeneity. Bovine and human amelogenin genes are found on both X and Y chromosomes, and the sexually dimorphic proteins would have 87-93% identity. A comparison of genes from human, bovine and mouse indicates that they are organized into seven exons, and sequences are highly homologous among species. Bovine, murine and human upstream regions also have similarities, with consensus sequences for potential binding of transcription factors, such as AP1 and CTF/NF1. Transgenic mouse studies have shown that 2300-3500 bp of upstream region are sufficient for expression, while 900 bp are insufficient. Analysis of DNA sequence has identified (a) major homology between species for coding exons with the exception of exon 4, (b) similarities in upstream regions likely involved in tissue specific regulation of expression, and (c) sequences at the RNA splice sites which may determine exon inclusion or skipping.

Gravity, blink rate, and lacrimal drainage capacity

PURPOSE

To investigate the influence of gravity and blink rate on lacrimal drainage capacity and to learn whether lacrimal pump function can be measured with the drop test.

METHODS

The drop test for lacrimal drainage capacity was performed in 20 test subjects, aged 12 to 30 years. Drops of a known volume of lukewarm saline solution were repeatedly instilled in the tear film for 3 minutes. Excessive saline solution was then removed, and the volume drained by the lacrimal passages was calculated. The drop test was performed both with the nasolacrimal duct in a 45-degree position and with the nasolacrimal duct in a horizontal position. The drop test was performed two times in each position, with the individual reading and not reading. A lower blink rate was induced by reading.

RESULTS

There was a high correlation between blink rate and lacrimal drainage when the nasolacrimal duct was in a horizontal position. The volume drained with each blink was approximately 2 microliters. However, when gravity acted upon the fluid in the lacrimal sac-nasolacrimal duct in the direction of the tear flow, the lacrimal drainage capacity showed a significant but variable increase, and there was no significant correlation between blink rate and lacrimal drainage capacity.

CONCLUSIONS

Lacrimal drainage capacity in young individuals was significantly affected by both blink rate and gravity. Lacrimal pump function can be measured quantitatively with the drop test.

Nebulized wet aerosol treatment in emergency department--is it essential? Comparison with large spacer device for metered-dose inhaler

OBJECTIVE

To determine the efficacy of a metered-dose inhaler (MDI) with a large spacer device as compared to nebulized wet aerosols in the treatment of an unselected population with severe airflow limitation.

DESIGN

Randomized, double blind, placebo-controlled trial.

SETTING

University Hospital Department of Emergency Medicine (DEM).

PATIENTS

Fifty patients, referred to the DEM between October 1, 1994 and March 31, 1995 with a severe, acute obstructive pulmonary event. Thirteen patients were diagnosed as having COPD; 37 patients were diagnosed as having asthma.

INTERVENTION AND RESULTS

Patients received either placebo MDI through a 750-mL cone-shaped spacer (Glaxo) [2 puffs] and nebulized salbutamol aerosol 0.5 mL in 1.5 mL saline solution (group 1, n=25) or salbutamol MDI and 0.5 mL saline solution in 1.5 mL saline solution administered in the same manner as above (group 2, n=25). The above treatment was repeated three times every 15 min, unless side effects appeared. Upon enrollment into the study, the FEV1 in group 1 was 0.78+/-0.7 L (mean+/-SD), 32% of predicted, and in group 2, 0.74+/-0.51 L, 29% of predicted (p=0.83). The FEV1 values after the first, second, and third interventions were as follows: in group 1, 1.18+/-0.99 L, 1.40+/-0.8, and 1.47+/-0.79, respectively, and in group 2, 1.17+/-0.99 L, 1.46+/-1.01, and 1.54+/-0.79 (p=0.83, 0.36, and 0.48, respectively). We observed no difference in spirometric measurements between the two groups at any time.

CONCLUSION

Even in the setting of the unselected group of patient referrals to the DEM for episodes of severe airflow limitation, the clinical and the objective bronchodilator responses to the administration of salbutamol are independent of the method of delivery: MDI with a large spacer vs aerosol nebulization.

Regulation of leukotriene and platelet-activating factor synthesis in human alveolar macrophages

It has been suggested that phospholipase A2 (PLA2) contributes to the regulation of leukotriene (LT) and platelet-activating factor (PAF) synthesis by controlling the release of their precursors, arachidonic acid (AA) and lysophosphatidylcholine (lysoPC), from membrane phospholipids. In rat alveolar macrophages (AMs), PLA2 appears to have a major role in LT synthesis but a more limited role in PAF synthesis. The present study was designed to define the role of PLA2 in LT and PAF synthesis in human AMs and determine whether differences exist between AMs obtained from normal subjects and those from patients with asthma. In the normal subjects, the calcium ionophore A23187 (Cal) increased AM PAF synthesis (percent incorporation of tritiated acetate) by 135% (p < 0.01) and LTB4 synthesis 88-fold (p < 0.001). Phorbol myristate acetate (PMA) had little effect alone, but it had a synergistic effect with Cal, increasing PAF synthesis by 466% and LTB4 synthesis to 229-fold above the control values (p < 0.001 for both). Ro 25-4331, a combined cytosolic (c) and secretory (s) PLA2 inhibitor, had little effect on the Cal-stimulated PAF synthesis, but it completely blocked the effect of PMA. It also blocked the Cal- and Cal+PMA-stimulated LTB4 synthesis. AACOCF3, a cPLA2 inhibitor, had no effect on either Cal or Cal+PMA-stimulated PAF synthesis. It reduced LTB4 synthesis, but it did so less effectively than Ro 25-4331. CoA-independent transacylase (CoAI-TA) activity in the AMs increased after stimulation and exposure to Ro 25-4331. SK&F 45905, a CoAI-TA inhibitor, reduced stimulated PAF synthesis by 30% to 40%. Patients with asthma had similar results except that cPLA2 had a greater role in stimulated LTB4 synthesis. These data indicate that PLA2 plays a direct role in human AM LT synthesis; both the cytosolic and secretory forms contribute to LT synthesis; PLA2 appears to have a more limited role in PAF synthesis, although it mediates the synergistic effect of PMA, probably via sPLA2; and CoAI-TA contributes to PAF synthesis during PLA2 inhibition. With the exception of the greater role for cPLA2 in stimulated LTB4 synthesis in the patients with asthma, the contributions of PLA2 and CoAI-TA to AM LT and PAF synthesis appear to be similar in normal subjects and patients with asthma.

Selective screening for gestational diabetes mellitus. Toronto Trihospital Gestational Diabetes Project Investigators

BACKGROUND

The usual approach to detecting gestational diabetes mellitus is to screen all pregnant women by measuring their plasma glucose after a 50-g oral glucose load at 24 to 28 weeks' gestation. Women are referred for an oral glucose-tolerance test if the plasma glucose concentration one hour later is > or = 140 mg per deciliter (7.8 mmol per liter). We hypothesized that the efficiency of screening could be enhanced by considering women's risks of gestational diabetes on the basis of their clinical characteristics.

METHODS

We studied 3131 pregnant women who underwent both the screening and the diagnostic tests. We randomly selected data on half the women and used them to derive new screening strategies. We categorized each woman's risk of gestational diabetes mellitus on the basis of her age, body-mass index before pregnancy, and race. We developed strategies that entailed no screening for low-risk women, usual care for intermediate-risk women, and universal screening with lower thresholds -- plasma glucose values of 130 mg per deciliter (7.2 mmol per liter) or 128 mg per deciliter (7.1 mmol per liter) -- for high-risk women. The strategies were validated with data on the other half of the women.

RESULTS

The new strategies allowed a 34.6 percent reduction in the number of screening tests performed (95 percent confidence interval, 32.3 to 37.0) and detected 81.2 to 82.6 percent of the women with gestational diabetes as compared with the 78.3 percent detected through usual care. The percentage of false positive screening tests was significantly reduced, from 17.9 percent with usual care to 16.0 per cent (P=0.02) or 15.4 percent (P<0.001) with the new strategies, depending on the threshold values for high-risk women.

CONCLUSIONS

Consideration of women's clinical characteristics allows efficient selective screening for gestational diabetes.

True trisomy 2 mosaicism in amniocytes and newborn liver associated with multiple system abnormalities

Among 58,000 amniocenteses completed, our laboratories found one case of true cytogenetic trisomy 2 mosaicism in a fetus with multiple abnormalities. In contrast, 11 fetuses phenotypically normal at birth were found to have true trisomy 2 mosaicism in their chorionic villus cells among the 10,500 fetuses tested by chorionic villus sampling (CVS). In our single abnormal case, amniocentesis performed at 19 weeks after finding an elevated maternal serum AFP found two independent cultures with trisomy 2 karyotypes in 8 of 25 and 7 of 31 amniocytes, respectively. Although oligohydramnios was noted by ultrasound, the mother elected to continue the pregnancy. At 26 weeks the fetus had intrauterine growth retardation (IUGR), hydronephrosis, and cardiac abnormalities. When delivered by Cesarean section at 30 weeks, the infant had multiple anomalies and developed necrotizing enterocolitis and severe cholestasis. At 5 months coronal magnetic resonance imaging (MRI) displayed delayed myelination and abnormal brain morphology. The patient also exhibited significant growth failure and developmental delay. Although chromosomes were normal in blood, skin fibroblasts, and ascites fluid cells, 4 of 100 hepatic biopsy fibroblasts were 47,XY,+2. Molecular analysis excluded uniparental disomy (UPD) of chromosome 2 in the 46,XY cell line. This and other reports of rare phenotypically abnormal trisomy 2 mosaic fetuses identified by karyotyping amniocytes emphasizes the substantially higher fetal risk of abnormal development than when trisomy 2 is found only in chorionic villus cells.

p53 influences mice skeletal development

The p53 tumor suppressor gene encodes a transcriptional activator whose targets include genes that regulate cell cycle progression and apoptosis. Since we have shown that a critical event in the life history of the chondrocyte is programmed cell death, we asked the question: does loss of the p53 gene influence skeletogenesis? Female p53(+/-) mice were mated with p53(+/-) male mice and 17-day-old fetal mice were studied. Exencephaly was the most profound skeletal defect of the p53 null mutation. This defect was due to failure of formation of the bones that comprise the mouse calvarium. There was also loss of the hyoid bone, and defective mineralization of the manubrium sternum and the terminal phalanges. In the homozygous state (-/-), in the absence of exencephaly, the number of skeletal deformities was markedly reduced. Aside from the gross changes associated with null status, the mutants exhibited alterations in bone length and width. Small differences in the size and orientation of the mineral crystals in embryonic bone, as evaluated by small-angle X-ray scattering, were found to disappear after birth. To explain these observations, we evaluated the extent of apoptosis in the tibial growth plates using the TUNEL stain. In the growth plate of the p53(-/-) homozygote, there was minimal labeling of the hypertrophic layer. Since the p53(-/-) TUNEL stain pattern at 17 days was very similar to the pattern of labeling of the p53(+/+) at 15 days, we concluded that the growth defect reflected a delay in cartilage maturation rather than a change in chondrocyte phenotype. On this basis, we predict that after birth, in mice that survive, differences in bone length would become minimal, and at maturity, the length of the long bones of (+/+) and (-/-) mice would be similar.