Effects of HI-6 on muscle acetylcholine receptor: analysis on minimal reaction model

AIM

To study the action of 1-(2-hydroxyiminomethyl-1-pyridino)-3-(4-carbamoyl-1-pyridino)-2-oxapropane dichloride (HI-6) on skeletal muscle acetylcholine receptor (N2-ChR).

METHODS

N2-ChR was expressed in Xenopus laevis oocyte after injection with mRNA extracted from denervated rat leg muscles. The inward membrane currents induced by various concentrations of carbamylcholine and effects of HI-6 or d-tubocurarine on the currents were measured with voltage clamp technique by fast cell flow of agents. The actions of HI-6 and d-tubocurarine on N2-ChR were analyzed by using the minimal reaction model.

RESULTS

K of 40.05, 156.00, and 334.67 mumol.L-1 for HI-6, K of 0.02, 0.10, and 0.18 mumol.L-1 for d-tubocurarine were obtained by using the competing for single acetylcholine (ACh)-binding site model, the competing for two ACh-binding sites model, and the noncompetitive inhibition model, respectively.

CONCLUSION

HI-6 and d-tubocurarine competed for two ACh-binding sites of N2-ChR with equal affinity to antagonize the effects of the agonist on N2-ChR. The N2-ChR inhibition by HI-6 is much weaker than that by d-tubocurarine.

Chronic osteomyelitis of the spine managed with a free flap of latissimus dorsi. A case report

STUDY DESIGN

A patient with intractable spinal osteomyelitis who underwent surgery 12 times with persistent exposed bone is presented.

OBJECTIVES

To demonstrate the effectiveness of free-flap grafting for managing difficult spinal osteomyelitis wounds.

SUMMARY OF BACKGROUND DATA

Conventional procedures can usually achieve wound closure, but they may not work for advanced cases.

METHODS

A free latissimus dorsi flap was transferred for reconstruction. The muscle component was used to obliterate the dead space and cover the exposed bone, and the skin component was used for tension-free closure of the wound.

RESULTS

The wound healed dramatically. There was no recurrence of infection at 2-year follow-up evaluation.

CONCLUSIONS

For an intractable spinal osteomyelitis wound, a free flap should be considered, although the surgery is difficult. Technical precautions in performing this operation are given.

Aesthetic refinements in toe-to-hand transfer surgery

Techniques for aesthetic refinement are as important as those for functional improvement in toe-to-hand transfer. The appearance of the thumb reconstructed using various types of great toe transfer can be improved by reduction of the soft tissue, bone, interphalangeal joint, and nail and by secondary pulp reduction and contouring procedures. Finger and thumb reconstructions using lesser toes can be improved aesthetically by minimal inclusion of adipofibrous tissue under the plantar skin flap especially at the metatarsophalangeal joint region, thus decreasing the anterior-posterior bulkiness. Tight extensor repair, temporary K-pin fixation of the proximal and distal interphalangeal joint in extension, followed by prolonged use of a nighttime extension splint and secondary pulp reduction help to avoid the claw and drumstick appearances of the transferred lesser toe. Adequate soft-tissue coverage, cruciate skin incisions, extensive mobilization, and thinning and trimming of the skin flaps of the digital amputation stump lead to a smooth junction between the amputated digit and the transferred toe. In the distal digital reconstruction, skeletonization of medial and lateral neurovascular bundles of the harvested toe helps primary closure of the digital wound, thus avoiding the unsightly skin graft on the sides of the reconstructed digit. Regarding the donor foot, preservation of the proximal 0.5 to 1 cm of the proximal phalangeal stump of the great toe maintains the span of the foot, thus improving donor site appearance. In single lesser toe or combined second and third toe transfer, the proximal phalanx should not be preserved but an optimal web space should be reconstructed. Primary closure without skin graft is essential for aesthetic appearance of the donor foot.

Chronic volar dislocation of the metacarpophalangeal joint of the thumb: a case report and review of the literature

A 61-year-old man sustained a chronic volar dislocation of the metacarpophalangeal joint of the thumb. He did not present for treatment until he experienced recently progressive joint pain 2 year after injury. Arthrodesis of the metacarpophalangeal joint was performed to correct the deformity of the thumb because of its extensive tissue scarring and erosion of the articular cartilage of the metacarpal head. Six weeks of splint immobilization followed by a physiotherapy program allowed the patient to resume his daily activities with his right hand.

The salvage of a degloved hand skin flap by arteriovenous shunting

Nine cases of hand degloving injuries were treated successfully with arteriovenous shunting technique. Of these nine cases, four were degloved from the wrist level and one from the forearm, three were degloved at the palm and one at the dorsum of the hand. All injuries resulted in distally based skin flaps, which were either superficial to the palmar fascia or within the subcutaneous layer. Lack of active bleeding from the periphery of the avulsed flaps substantiated circulatory compromise before revascularization. Survival of the avulsed flaps was achieved by directing the proximal arterial flow into the venous channel within the avulsed skin flaps. The post-operative care and rehabilitation were straightforward, and functional results were satisfactory.

Time course of discriminative stimulus effects of bretazenil and chlordiazepoxide in rats

The time course of the discriminative stimulus effects of a benzodiazepine partial agonist, bretazenil, and a benzodiazepine full agonist, chlordiazepoxide, were determined in rats after administration of two doses of either drug. As in man, bretazenil was considerably shorter-acting than chlordiazepoxide, with 0% drug-appropriate responding at the 2-h time point after the training dose of 7 mg/kg and < 20% drug-appropriate responding at 9 h after the 14 mg/kg dose. With chlordiazepoxide, responding on the water-appropriate lever did not occur in all rats until 7 h after administration of the training dose of 7 mg/kg, compared to 17 h after administration of 14 mg/kg. Although there was considerable individual variability with both drugs, it would appear that the drug discrimination procedure can be a valuable tool for studying the time course of the interoceptive effects of psychoactive drugs.

Surgical management of the buried penis

BACKGROUND

Buried penis is a congenital abnormality in which the phallus is concealed within the surface of prepubic skin. It is probably more common than is generally recognized. The objective was to describe the pathophysiology, and search for the best management of this disease.

METHODS

Over a period of 6 years, a total of 31 cases receiving surgery for buried penis at this hospital were analyzed. According to their major pathophysiology, patients were divided into three groups: in the first, the major mechanism was poor skin suspension; in the second, prominent suprapubic fat pad was the major cause. In the third group, the dartos fascia was abnormally thickened and attached to the penile shaft. Different surgical techniques were applied in the different groups.

RESULTS

All 15 children in the first group had satisfactory results after penile skin fixation. In the second group, nine children underwent adjunctive lipectomy but only five had satisfactory results. Seven patients in the third group needed degloving of the penis and the three cases who underwent preputial unfurling had severe lymphedema of the inner preputial layer. One of them received revision. The end results were good in the other six patients after long-term follow up.

CONCLUSIONS

The buried penis occurs in a spectrum. Although, there are three major pathophysiology mechanisms, most of the patients had a combination. Surgical management should be individualized, and results are usually satisfactory. For the obese patient, weight loss is important. Preputial unfurling and using inner preputial layer to cover the defect should be avoided because of severe postoperative lymphedema.

Overexpression of protein kinase FA/GSK-3 alpha (a proline-directed protein kinase) correlates with human hepatoma dedifferentiation/progression

Computer analysis of protein phosphorylation sites sequence revealed that transcriptional factors and viral oncoproteins are prime targets for regulation of proline-directed protein phosphorylation, suggesting an association of the proline-directed protein kinase (PDPK) family with neoplastic transformation and tumorigenesis. In this report, an immunoprecipitate activity assay of protein kinase FA/glycogen synthase kinase-3 alpha (kinase F(A)/GSK-3 alpha) (a member of PDPK family) has been optimized for human hepatoma and used to demonstrate for the first time significantly increased (P < 0.01) activity in poorly differentiated SK-Hep-1 hepatoma (24.2 +/- 2.8 units/mg) and moderately differentiated Mahlavu hepatoma (14.5 +/- 2.2 units/mg) when compared to well differentiated Hep 3B hepatoma (8.0 +/- 2.4 units/mg). Immunoblotting analysis revealed that increased activity of kinase FA/GSK-3 alpha is due to overexpression of the protein. Elevated kinase FA/GSK-3 alpha expression in human hepatoma biopsies relative to normal liver tissue was found to be even more profound. This kinase appeared to be fivefold overexpressed in well differentiated hepatoma and 13-fold overexpressed in poorly differentiated hepatoma when compared to normal liver tissue. Taken together, the results provide initial evidence that overexpression of kinase FA/GSK-3 alpha is involved in human hepatoma dedifferentiation/progression. Since kinase FA/GSK-3 alpha is a PDPK, the results further support a potential role of this kinase in human liver tumorigenesis, especially in its dedifferentiation/progression.

Regional retinal blood flow and vascular autoregulation

The temporal retina is larger than the nasal retina and contains the metabolically active fovea. The variation in the distribution of blood between the temporal and nasal retinal circulations was investigated in 15 healthy volunteers, and the autoregulatory capacity of the temporal and nasal circulations was quantitated using 60% oxygen in the inspired air. Retinal blood flow was determined from red cell velocity using laser Doppler velocimetry and retinal vessel diameter from retinal photographs using a digital image analysis system. Volume flow was lower in the nasal than the temporal circulation by 52.49% (p < 0.001). This is a consequence of both significantly smaller vessels (20.4%, p < 0.001) and slower blood velocity in the nasal circulation (24.64%, p = 0.003) compared with the temporal vessels. After breathing 60% oxygen for 10 minutes, there was significant vasoconstriction (temporal, 10.42 +/- 1.24%, p < 0.001; nasal, 7.66 +/- 1.48%, p < 0.001), slower red cell velocity (temporal, 27.10 +/- 3.92%, p < 0.001; nasal, 27.36 +/- 5.51%, p < 0.001) and a significant reduction in the volumetric flow rate (temporal, 41.16 +/- 3.64%, p < 0.001; nasal, 37.99 +/- 5.07%, p < 0.001). The reduction in the haemodynamic parameters was comparable in the temporal and nasal circulations, indicating similar autoregulatory capacity. Retinal vascular conductance was calculated from volume flow and retinal perfusion pressure. It was 53% larger in the temporal than the nasal circulations. This provides an index of the metabolic needs of the different regions of the retina.

Stepping over obstacles: dividing attention impairs performance of old more than young adults

BACKGROUND

Tripping over an obstacle is a common cause of falls in the elderly. An earlier study of abilities to avoid stepping on suddenly appearing obstacles found that, although healthy old adults had a lower rate-of-success than young adults, the magnitude of that difference was not large. The present study inquired whether dividing attention during such a task would differentially affect young and old healthy adults.

METHODS

Rates-of-success were observed in 16 young and 16 old healthy adults (mean ages 24 and 72 years) in avoiding stepping on a band of light that was suddenly projected across their gait path while they walked at their comfortable gait speed. This virtual obstacle was placed at predicted next-footfall locations to give 350 or 450 msec available response times before footfall. During most of the trials the subjects were asked, in addition to trying not to step on the obstacle, simultaneously to respond vocally as quickly as possible when red lights near the end of the walkway turned on. These attention-dividing reaction time tests were of two types: synchronized, when only red lights lit at intervals synchronized with the appearance of the obstacle, and unsynchronized, when green or yellow lights lit in addition to the red lights, with lighting intervals not synchronized with the appearance of the obstacle.

RESULTS

When synchronized and unsynchronized reaction time tests were conducted concurrently with the obstacle avoidance tasks, mean rates-of-success in avoidance decreased significantly in both young and old adults. With available response times of 350 msec, mean success rates decreased from their no-division values in the young adults by 14.7% for synchronized reaction and by 19.9% for unsynchronized reaction, attention-dividing tests. Corresponding mean decreases for the old adults were 32.0 and 35.7%. This age difference in the effects of dividing attention was significant.

CONCLUSION

Both young and old adults had a significantly increased risk of obstacle contact while negotiating obstacles when their attention was divided, but dividing attention degraded obstacle avoidance abilities of the old significantly more than it did in the young. Diminished abilities to respond to physical hazards present in the environment when attention is directed elsewhere may partially account for high rates of falls among the elderly.

Microvascular free posterior interosseous flap and a comparison with the pedicled posterior interosseous flap

The posterior interosseous flap has been used as a pedicled flap for coverage of hand wounds. However, the pedicled flap is associated with partial or even complete loss when there is venous congestion. This happens because it depends on retrograde venous drainage. Another pitfall of the pedicled posterior interosseous flap is the undetected damage to the communicating vessels between the anterior and posterior interosseous arteries before surgery. This would result in failure if the flap is used as a distally based flap. Thirty-four patients had been reconstructed with the microvascular free posterior interosseous flap. The free flap has a large draining vein. Flap survival rate was 97%. There was no venous congestion and no partial loss of the flap. It is thin, sensate, and reliable. The free posterior interosseous flap is indicated for coverage of the following wounds: (1) first web space and thumb, (2) radial side of the index and ulnar side of the small finger if a cross-finger flap cannot be used, and (3) defects at the dorsum of multiple fingers. It can also be used as a free fascial flap. The free posterior interosseous flap provides a reliable option for coverage of hand wounds. Previously, another 14 patients with hand wounds had been reconstructed with a pedicled posterior interosseous flap. The results of pedicled and free posterior interosseous flaps are compared.

Risk factors of hepatitis C virus infection in a Taiwanese aboriginal community

The aim of this study is to identify the risk factors associated with anti-HCV positive status in a Bunun aboriginal community in Taiwan. In a door-to-door survey we collected 712 blood samples, and employed an enzyme immunoassay for anti-HCV to detect the recombinant antigen of viral genome including one structural and two nonstructural proteins. The prevalence of anti-HCV was 16.9% for the whole community covering an age range of five years to 84 years, but it was 48% in individuals older than 45 years. The calculated annual incidence rate was 1.25%. Information about possible risk factors was obtained from questionnaires completed in 1992. Age, sex, village of residence, educational level, and the extraneous factor of having been iatrogenic injected during a period one or two years before the survey, showed a significant association with positive anti-HCV status. A dose response relationship between the rate of positive anti-HCV status and frequency of injections was found statistically significant (P < 0.001). Accordingly, a second visit was made to find the possible infection source, and according to information obtained from the recall of 211 interviewees, an illegal medical service was suspected of spreading the recent infection.

Rapid detection of Vibrio parahaemolyticus in oysters by immunofluorescence microscopy

A method of indirect immunofluorescence microscopy was developed for the rapid detection of Vibrio parahaemolyticus in oysters. Affinity-purified antibodies against two outer membrane proteins (molecular mass 36 and 34 kDa, respectively) of V. parahaemolyticus were used as the primary antibodies to label the vibrio, and fluorescein isothiocyanate-conjugated goat anti-rabbit immunoglobulin G was used to reveal the antigen-antibody reaction. Of 85 strains of V. parahaemolyticus tested, all produced strong fluorescence under the fluorescence microscope. However, for 63 strains (including 27 vibrios) of other bacteria tested, 6 produced weak to moderate fluorescence. The sensitivity and specificity of the immunostaining technique were 100 and 90.5%, respectively. In the inoculation experiments, as low as 1.7 CFU/g of V. parahaemolyticus spiked in oysters could be detected by the immunostaining method after 18-h enrichment in alkaline peptone water containing 3% NaCl. The immunofluorescence microscopy is recommended for rapid screening of V. parahaemolyticus in oysters; a presumptive positive result could be obtained within 24 h.

Topographic distribution of inguinal lymph nodes metastasis: significance in determination of treatment margin for elective inguinal lymph nodes irradiation of low pelvic tumors

PURPOSE

To study the distribution of gross inguinal lymph node metastasis and, in particular, its correlation with major pelvic bony structures on a simulation film.

METHODS AND MATERIALS

Thirty-seven cases of low pelvic tumors having gross inguinal lymph node metastasis that were treated with radiation therapy between November 1987 and December 1992 were segregated for study. The patient's nodes were palpated and marked with lead wire before the simulation film was assumed to be the origin of the previously uninfested node. A total of 84 such labeled nodes was taken. The geometric center of the usually round or elliptical node on the film was obtained from these 37 cases. These centers were transferred to and mapped collectively on a new simulation film showing major pelvic bony structures of left hemipelvis and upper femur.

RESULTS

Distribution of gross inguinal lymph nodes was found confined to the following area, as related to major pelvic bony structure: laterally, just abutting the tangential line that passes through lateral border of the femoral head; medially: 3 cm away from the body's midline axis; superiorly: 1 cm below the line that joins both upper borders of the femoral head; inferiorly: 2.5 cm below the low borders of ischial tuberosity. According to this rectangular boundary, three nodes were out of the field, nine nodes near the border less than 1 cm margin. This area adequately covered 86% (72 of 84) of the studied nodes.

CONCLUSION

Distribution study is important in determining the treatment margin. In general, an additional 1-2 cm beyond the area described above is the recommended treatment margin for elective inguinal lymph nodes irradiation with high confidence level of coverage.

Inhibition of hepatitis B surface antigen secretion on human hepatoma cells. Components from Rubia cordifolia

The antiviral activity in the roots of Rubia cordifolia was examined, and three naphthohydroquinones, furomollugin (1), mollugin (2), and rubilactone (3), were isolated from it. Compounds 1 and 2 strongly suppressed the secretion of hepatitis B surface antigen (HBsAg), both with IC50 = 2.0 micrograms/mL, in human hepatoma Hep3B cells while having little effect on the viability of the cells. Evaluation of structurally related derivatives of 1 and 2 revealed that a 6-hydroxy group and a pyran or furan ring contribute to this suppressive effect.

Spontaneous pulmonary squamous cell carcinoma in an aging CD rat

Naturally occurring squamous cell carcinomas of lung of laboratory rodents are rare, and few cases have been reported and illustrated. A solid peripheral lung mass was observed grossly in a untreated 573-day-old male Sprague Dawley CD (Crl:CD [SD] BR) rat. Microscopically, the mass was composed of neoplastic squamous epithelial cells arranged in nests, cords, nodules, or solid sheets. Epithelial pearls were present. The mitotic index was high, and intercellular bridging (prickles) was noted. In some areas, neoplastic cells rimmed large cystic areas containing neutrophils, cell debris, and laminated keratin masses. Neoplastic cells had both expansive and invasive growth with entrapment of bronchioles and marked fibroplasia.

Molecular cloning and characterization of a novel casein kinase II substrate, HASPP28, from rat brain

HASPP28 (heat- and acid-stable phosphoprotein of 28 kDa) has been purified to near homogeneity from the acid-stable protein fraction of rat brain extract. Based on the N-terminal 40 amino acid sequence, a pair of highly degenerate primers was used to generate a 107-bp probe from rat brain RNA by RT-PCR. From the rat brain lambda gt11 library, this probe identified two positive clones that together provided a cDNA of 837 bp with an open reading frame of 546 bp. This cDNA was extended by 3'RACE to 1.2 kb that included a polyadenylation signal and a poly(A) tail. The 180-amino-acid sequence derived from the open reading frame, which did not correspond to any known protein, was predicted to have phosphorylation sites for protein kinase C, casein kinase II (CKII), and protein kinase A. Indeed, both the purified rat brain HASPP28 and the recombinant HASPP28 (rHASPP28) can be phosphorylated by these kinases. Northern blot analysis indicated that HASPP28 was present in all rat tissues tested, including those from the brain, lung, spleen, kidney, liver, heart, and muscle, in decreasing order of abundance. Phosphopeptide analysis of rHASPP28 phosphorylated in vitro by various kinases showed different tryptic patterns on two-dimensional mapping and isoelectric focusing gels. From [32P]PO4-labeled N1E115 neuroblastoma cells, HASPP28 can be immunoprecipitated with a polyclonal antiserum raised against rHASPP28. The immunoprecipitated protein showed a phosphopeptide pattern similar to that of rHASPP28 phosphorylated by CK II in vitro. Furthermore, the immunoprecipitates from cells treated with phorbol 12-myristate 13-acetate or 8-bromo-cAMP did not show any increased phosphorylation over those of untreated ones, and the phosphopeptide patterns of the immunoprecipitates again were similar to that of CK II phosphorylated protein. These results suggest that HASPP28 is a novel phosphoprotein that can be phosphorylated by several kinases in vitro. In intact cells, CK II seems to be solely responsible for the phosphorylation of HASPP28.

Specificity and kinetic studies on the cleavage of various prohormone mono- and paired-basic residue sites by yeast aspartic protease 3

The specificity and relative efficiency of cleavage of mono- and paired-basic residue processing sites by YAP3p was determined in vitro for a number of prohormone substrates: human ACTH1 39, bovine proinsulin, porcine cholecystokinin 33, cholecystokinin (CCK) 13-33, dynorphin A(1-11), dynorphin B(1-13), and amidorphin. YAP3p generated ACTH1-15 from ACTH1-39. It cleaved proinsulin at the paired-basic residue sites of the B-C junction as well as the C-A junction. Leu-enkephalin-Arg and Leu-enkephalin-Arg-Arg were generated from dynorphin A and dynorphin B, respectively. YAP3p generated Met-enkephalin-Lys-Lys from amidorphin showing that cleavage by this enzyme can occur at a lone pair of Lys residues. CCK33 was cleaved at Lys23 and Arg9, each containing an upstream Arg residue at the P6 and P5 position, respectively. Km values were between 10(-4) and 10(-5) M for the various substrates, with the highest affinity exhibited for the tetrabasic site of ACTH1-39 (1.8 x 10(-5) M). The tetrabasic residue site of ACTH1-39 was cleaved with the highest relative efficiency (kcat/Km = 3.1 x 10(6) m-1 s-1), while that of the monobasic site of CCK13-33 and the paired-basic site of proinsulin B-C junction, were cleaved less efficiently at 4.2 x 10(4) m-1 s-1 and 1.6 x 10(4) m-1 s-1, respectively.

The association of focal adhesion kinase with a 200-kDa protein that is tyrosine phosphorylated in response to platelet-derived growth factor

Focal adhesion kinase (FAK) is a cytoplasmic tyrosine kinase implicated in the signal transduction pathways initiated by integrins. However, we have previously found that platelet-derived growth factor (PDGF) could stimulate the association of FAK with phosphatidylinositol 3-kinase in NIH 3T3 cells [Chen, H.-C. & Guan, J.-L. (1994) J. Biol. Chem 269, 31229-31223], suggesting that FAK might participate in some of the cellular effects of the growth factors in modulating cell morphology and migration. In this report, we describe the association of FAK with a 200-kDa protein (pp200) that is tyrosine phosphorylated in response to PDGF stimulation in NIH 3T3 cells. Although the identity of pp200 is unknown at present, we have excluded the possibilities that it is the PDGF receptor beta, tension, talin, myosin or the guanosine-triophosphatase-activating-protein-associated p190 protein. Furthermore, we found that the tyrosine phosphorylation of FAK-associated pp200 upon PDGF stimulation is largely independent of cell adhesion or the integrity of the cytoskeleton. Therefore, pp200 and its interaction with FAK may also be involved in growth-factor-induced cellular effects such as the modulation of cell adhesion or cell migration via cytoskeletal reorganization or disruption of focal adhesions.

Salvage of a devascularized digit with free arterialized venous flap: a case report

Significant soft tissue and vascular loss is always encountered in salvage of a devascularized digit that has sustained crush or avulsion injury. Ideal reconstruction should include repair of the vascular defect and provision of stable soft tissue coverage simultaneously in a single operation to facilitate early recovery and early rehabilitation. A venous flap is a composite cutaneous flap that contains a segment of vein traversing it. A free venous flap is used in a devascularized digit to cover the soft tissue defect and restore the digital circulation by perfusion of arterial blood through the flap's venous network (i.e., free arterialized venous flap). Satisfactory result, both for the flap and for the digit, is obtained. The free arterialized venous flap is a useful, up-to-date option for such dual-purpose reconstruction.

Antenatal diagnosis and early surgery for choledochal cyst: a report of two cases

Since the advent of routine antenatal sonography to detect fetal abnormalities, two cases of choledochal cyst have been found prenatally in our hospital. The first presented when a choledochal cyst was demonstrated at 31 weeks of gestation, and a firm diagnosis established within 2 days of birth. Technetium 99m disofenin (DISIDA) cholescintigram revealed delayed visualization of the small bowel. The second case was found by ultrasound examination at 21 weeks of gestation to have a choledochal cyst, and diagnosis was confirmed within 3 days of birth. DISIDA scintigram demonstrated complete obstruction of the extrahepatic biliary tree. Both infants received early excision of the cyst at the ages of three and four days respectively. The postoperative course was quite smooth, and there were no abnormal symptoms after follow up of four and two years, respectively. Neonates with distal common bile duct obstruction in association with presumed choledochal cyst should have prompt surgical exploration, and early excision of the cyst is a safe procedure in the newborn.

Decreased urinary epidermal growth factor in children with acute renal failure: epidermal growth factor/creatinine ratio not a reliable parameter for urinary epidermal growth factor excretion

To verify some animal experimental results in humans, we have studied urinary epidermal growth factor (EGF) excretion in normal children as well as children with acute renal failure (ARF). Urinary EGF excretion was expressed as a ratio of urinary EGF to urinary creatinine concentration (EGF/Cr) for random and 24-h urine, and a daily total urinary EGF for 24-h urine. The highest urinary EGF/Cr in children was found at 1 mo to 3 y of age. There was a highly significant correlation between random urine EGF/Cr and 24-h urine EGF/Cr (r = 0.92, p < 0.001), whereas no correlation of urinary EGF/Cr with daily total urine EGF was found. During the course of ARF, a decline in urinary EGF/Cr from the period before peak serum creatinine to the period after the declination of serum creatinine was noted (p = 0.013, n = 13, by repeated measure analysis), with a constant low daily total urine EGF (p value not significant). However, a rise in both urinary EGF/Cr and daily total urine EGF was found between the period of serum creatinine decline and the period of completely normal serum creatinine (p < 0.001). Serum EGF remained unchanged throughout the course of ARF. These results suggest 1) the possible role of EGF in renal growth or maturation during the first 2 or 3 y of life, 2) the possible renal origin of human urinary EGF, and 3) decreased urinary EGF excretion in children with ARF. In particular, EGF/Cr is not a reliable indicator for the expression of actual urinary EGF excretion in ARF. Instead of urinary EGF/Cr, urinary EGF concentration may be used to predict the daily total urinary EGF excretion during ARF. These results provide the pattern of urinary EGF excretion during ARF in children and may be of help for further clinical studies.