Gonadal dysfunction and changes in sex hormones in postnecrotic cirrhotic men: a matched study with alcoholic cirrhotic men

To investigate the gonadal dysfunction and changes in sex hormones in male patients with postnecrotic cirrhosis, and to compare them with those in alcoholic cirrhotic men, three age-matched groups of men (hepatitis B virus-related postnecrotic cirrhosis 27, alcoholic cirrhosis 21, normal controls 30) were studied. Twelve of the 21 (57%) alcoholic cirrhotics and 16 of the 27 (59%) postnecrotic cirrhotics had a history of impotence. Both alcoholic and postnecrotic cirrhotic patients had significantly lower basal testosterone, but higher estradiol and prolactin levels than the control group (p less than 0.05). However, no differences were noted between the two cirrhotic groups. The degree of reduced testosterone and increased prolactin levels correlated with the severity of the cirrhosis. Despite the low testosterone concentration, basal levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) were not increased in the cirrhotic patients. All the three groups studied had normal FSH and LH responses to the stimulation of exogenous gonadotropin releasing hormone. On the basis of these results, we conclude that: (1) impotence and low testosterone level are not infrequent findings in men with hepatitis B virus-related postnecrotic cirrhosis, especially in those with decompensated liver function. (2) The liver disease per se is important for the development of male sexual dysfunction. (3) The derangement of hypothalamic-pituitary function may play a role in the sexual dysfunction and changes in sex hormones in male patients with cirrhosis.

Acute hepatitis B viral infection in a patient with anti-HBs

We report a patient with antibody to hepatitis B surface antigen (anti-HBs) but no antibodies to other hepatitis B virus components, who developed acute symptomatic type B hepatitis. The possible explanations for this unusual serological pattern are 1) the antibody-positive status, which developed against only a subdeterminant of hepatitis B surface antigen (HBsAg), arose naturally or as the result of cross-reaction with a variety of antigens; and 2) seroconversion to anti-HBs occurred in response to surface antigen of a mutant strain of hepatitis B virus (HBV). This anti-HBs positivity, in the absence of antibody to hepatitis B core antigen, does not provide natural immunization against HBV infection, and so is not protective. Individuals who are positive to anti-HBs antibody alone which is not elicited by HBV vaccine, should be vaccinated against possible HBV infection.

Intranasal bioavailability of insulin powder formulations: effect of permeation enhancer-to-protein ratio

The intranasal administration of powder formulations containing insulin and the permeation enhancer sodium tauro-24,25-dihydrofusidate (STDHF) were investigated in the sheep model. Both the hypoglycemic response and the serum insulin levels increased as the mole ratio of STDHF to insulin was increased from 0 to 16.8. In vitro dissolution rates of the powders and the rapid tmax (approximately 5 min) observed after intranasal administration suggest that the absorption of insulin is not dissolution limited. The bioavailabilities (F) of the powder formulations ranged from 2.9 to 37.8%. In comparison, the F values for a solution formulation with a STDHF:insulin ratio of 8.4 administered as either drops or spray were 15.7 and 37.4%, respectively. The permeation enhancer STDHF increases mucosal permeability and reduces the average molecular weight of the insulin species.

Biomechanical evaluation of cervical spine instability after multiple level laminectomy

Four fresh human cervical spine specimens (C2-T1) were tested both intact and with C5-C6 laminectomies to evaluate the biomechanical effects of multiple level laminectomy. The loads applied to the specimens were physiological and clinically relevant motion patterns were simulated. The results showed that C5 vertical displacements increased by 83.33% in axial compression, 168.75% in flexion, 106.09% in extension, and 35.14% in left bending after C5-C6 laminectomies compared with intact specimens. The increased rates of C6 vertical displacements after laminectomy were slightly lower than C5. The anterior horizontal bulging of C5-6 discs increased by 29.69% in axial compression, 13.86% in flexion, 61.79% in extension, and 13.40% in left bending after laminectomy. The rotational angles of whole specimens had an increase of 15% after laminectomy. The strains in the anterior vertebral bodies and posterior laminae near the articular processes of C5 and C6 were increased significantly after laminectomy. The data indicated that multiple level laminectomy can lead to biomechanical instability of the cervical spine.

High-yield extraction and purification of glutathione reductase from baker's yeast

Glutathione reductase was extracted from toluene-treated baker's yeast cells by a two-stage buffer autolysis method. The yeast cells were treated with toluene for 1 h at 40 degrees C. After removal of the toluene, the cells were then allowed to autolysis in buffer for 72 h at 4 degrees C. The cells were collected and resuspended in buffer. A second stage autolysis was carried out for another 96 h at 4 degrees C. The enzyme was purified to 786-fold from the second stage cell autolysate by using two steps of affinity chromatography with triazine dyes (Yellow H-E4G and Yellow H-E6G) coupled to Sepharose CL-4B. By using this simplified method, 1.44 mg (165 units/mg) of glutathione reductase was obtained from 65 g (wet weight) of yeast cells, equivalent to 80% enzyme recovery.

Seroepidemiology of hepatitis C virus infection in Taiwan

The prevalence of antibody to hepatitis C virus among Chinese subjects in Taiwan was evaluated using a commercially available enzyme immunoassay. The overall prevalence of antibody to hepatitis C virus was 0.28% among 1,419 healthy subjects, 0.8% among 500 unselected paid blood donors and 0.4% among 793 pregnant women. The three offspring of the mothers positive for antibody to hepatitis C virus were all found to be positive for antibody to hepatitis C virus at birth but all became negative by the age of 6 mo. Among healthy subjects, none of 1,000 school children and young adolescents had antibody to hepatitis C virus. Among patients in selected "high-risk" groups, antibody to hepatitis C virus was detected in 100% of 9 hemophiliac patients who were positive for antibody to human immunodeficiency virus, in 53% of 115 intravenous drug abusers, in 34.4% of 96 hemodialysis patient and in 15.8% of 19 homosexual men who were positive for antibody to human immunodeficiency virus. Only 7.1% of 196 prostitutes, 5.9% of 34 spouses of patients positive for antibody to hepatitis C virus and 0.5% of 201 brothelgoers had antibody to hepatitis C virus. These findings suggest that hepatitis C virus is transmitted mainly by the parenteral route in Taiwan. Transmission from mother to infant is not an important mode of spread of hepatitis C virus.

Purification and Characterization of d -Aminoacylase from Alcaligenes faecalis DA1

A d -aminoacylase from Alcaligenes faecalis DA1 has been purified to homogeneity by a simple purification procedure with two columns, Fractogel DEAE-650 and HW-50. The specific activity of the purified enzyme was found to be 580 U/mg of protein with N -acetyl- dl -methionine as the reaction substrate. The apparent molecular weight and isoelectric point of this enzyme were determined to be 55,000 and 5.4, respectively.

Superinfection with hepatitis C virus in patients with symptomatic chronic hepatitis B

11/323 patients (3.4%) with symptomatic chronic hepatitis B were positive for antibody to hepatitis C virus (anti-HCV). The positive rate of anti-HCV in patients with serum alanine aminotransferase (ALT) levels greater than 200 U/l (n = 219) did not exceed that of the patients with ALT less than or equal to 200 U/l (n = 104) (2.7% vs. 4.8%). Of the 219 patients who were positive for hepatitis B e antigen (HBeAg) and/or hepatitis B virus-DNA (HBV-DNA), 5 (2.3%) had anti-HCV, while 6/104 patients (5.8%) who were positive for antibody to HBeAg (anti-HBe) had anti-HCV (p greater than 0.1). In contrast to the anti-HCV-negative patients, the patients with anti-HCV had a higher percentage of cirrhosis in their liver histological findings (36.4% vs 5.4%, p less than 0.005). In conclusion, the prevalence of HCV superinfection in symptomatic chronic hepatitis B patients is low and HCV superinfection is not an important factor in acute exacerbation of chronic hepatitis B. However, the superinfection with HCV may exacerbate the existing liver disease and accelerate its progression.

Sexual transmission of hepatitis D virus infection in Taiwan

Multivariate analysis of the risk factors for hepatitis D virus infection among 53 men with acute hepatitis D virus superinfection, 59 men with acute exacerbation of chronic hepatitis B and 54 asymptomatic male hepatitis B carriers revealed that sexual contact with prostitutes and use of nondisposable needles were the factors significantly associated with hepatitis D virus infection in Taiwan (odds ratio = 5.5, 95% confidence interval = 3.3 to 9.2; odds ratio = 2.4, 95% confidence interval = 1.3 to 4.4, respectively). The prevalence of antibody to hepatitis D virus antigen among hepatitis B virus carriers with histories of sexual exposure to prostitutes was 10.3% (14 of 136) and the prevalence of hepatitis D virus antigen among the female prostitutes who were hepatitis B virus carriers was 59% (24 of 51). Among those who admitted to sexual contact with prostitutes, testing for hepatitis D virus antigen revealed positive correlations with the frequency of such sexual contacts and with the frequency of history of venereal diseases. Among the female prostitutes, the prevalence of hepatitis D virus antigen had a positive correlation with the frequency of sexual contact and a negative correlation with age. Analysis of serum hepatitis D virus RNA among those with hepatitis D virus antigen revealed that 4 of the 9 with sexual exposure to prostitutes and 3 of the 24 prostitutes were positive. From these findings, we conclude that these two groups are not only at high risk for hepatitis D virus infection but also form a reservoir of this virus.

Enzyme loading in a solid support with nonuniform pore size distribution

The concept of pore size distribution is incorporated into the Clark model of enzyme immobilization in the present study. This refined model predicted that in the case of small harmonic pore radius with the same surface area and porosity of the support, more enzyme could be loaded in a support with nonuniform pores than that with uniform pores. In comparing the enzyme loading efficiency of the support with two different pore size distributions, the one with Gaussian distribution had the greater amount of enzyme immobilized than the other one with Rajagopalan's distribution. Furthermore, more enzyme could be loaded in a support with wider Gaussian pore size distribution than that with narrower distribution. The immobilized enzyme profile in the solid support with pore size distribution displayed a stepwise pattern which differed appreciably from the sigmoidal profile predicted for the support with uniform pore size. This stepwise enzyme distribution profile became sigmoidal with decreasing h(T) or increasing k. The new model could be used for designing protocols for an enzyme immobilization process.

Isoniazid-rifampin-induced hepatitis in hepatitis B carriers

From January 1984-December 1987, 1783 patients received combination therapy of isoniazid, rifampin, and ethambutol for the control of tuberculosis. Forty-two developed symptomatic hepatitis during the period of treatment. Fifteen were hepatitis B virus carriers, and the remaining 27 were noncarriers. The peak serum transaminase and bilirubin levels were higher in carriers. Seven carriers died of fulminant or subacute hepatic failure, and only 1 noncarrier died. Eleven carriers had detectable serum hepatitis B virus deoxyribonucleic acid during the acute stage of hepatitis. The roles of isoniazid-rifampin combination therapy and hepatitis B virus in the adverse outcomes of carriers were discussed.

Effects of phentolamine and propranolol on the changes of pain threshold and contents of MEK and LEK in rat brain after EA

The contents of Met-enkephalin (MEK) and Leu-enkephalin (LEK) in striatum and MEK in hypothalamus of rat increased markedly after electroacupuncture analgesia (EAA). Intraperitoneal injection of phentolamine, a blocker of alpha receptor, potentiated the EAA and abolished the effects of EA increasing MEK and LEK contents; while injection of propranolol, a blocker of beta receptor, partially inhibited the EAA, as well as abolished the effects of EA increasing MEK and LEK concentrations in the striatum and the hypothalamus, and also elevated the MEK and LEK contents in hippocampus and MEK level in cortex. The results indicate that EA regulates metabolism of MEK and LEK, as well as EAA partially via alpha and beta receptors.

[Studies on protective monoclonal antibodies to Leishmania donovani]

Kala-azar is increasing in incidence in some endemic areas of China, such as provinces of Sichuan and Gansu. Monoclonal antibodies have been shown to interfere with the cutaneous leishmaniasis infection in the experimental animals. We have now raised McAb against membrane antigen of promastigotes of L. donovani canine isolate (the pathogen of visceral leishmaniasis). In this paper we report 3 McAb which inhibit the growth of promastigotes in vitro culture by incorporation of 3H-thymine deoxyriboside, such as McAb 2B12-A8, 2H6-E3, in the presence of complement, showing strong inhibiting effects with a decrease in incorporation of 3H-TdR, 94-99.3% rate of inhibition, whereas the inhibition rate induced by McAb 1B1-C2 fluctuated in a range of 68-95%, which is identical with the results of macrophage infection inhibition test by the same McAb, 61-87%. The results of ultrastructural localization of L. donovani antigen by protective McAb 2H6-E3 with immunogold technique showed the gold particles, in clumps, widely distributed on the outer side of promastigotes membrane. According to the high density of localized gold particles, it is suggested that this antigen is abundant on the plasma membrane.

Lymphocyte subset analysis to predict progression to AIDS in a cohort of homosexual men in San Francisco

A group of 10 leukocyte and lymphocyte subsets were measured by simultaneous dual immunofluorescence and flow cytometry in a group of homosexual men from the San Francisco General cohort. Absolute numbers and percentages of lymphocytes were determined in 30 individuals who progressed to AIDS and 29 who did not over a 44-month period at annual intervals. At entry into the study, all subjects were asymptomatic, HIV seropositive, and had multiple changes in lymphocyte subsets compared to HIV-negative controls. In progressors, large changes occurred from the first visit to the last visit before progression in both absolute numbers and percentages of CD4 cells. The percentage of HLA-DR-bearing CD8 cells also increased. We utilized a proportional hazards model to assign a predictive value for progression to AIDS to lymphocyte subsets in both univariate and multivariate tests. Increased DR-positive CD8 cells, decreased CD4 cells, and increased CD8-positive, Leu 7-positive cells independently predicted progression to AIDS at P less than 0.006 (relative hazard 5.8-4.0). In a multivariate model, the most useful tests were either increased numbers or percentages of DR-positive CD8 cells. These data suggest parsimonious approaches to following HIV-positive individuals and further support the possibility of autoreactive T cells in the pathogenesis of HIV-associated diseases.

Effect of electroacupuncture on brain enkephalins content at different times in rats

The basic level of methionin-enkephalin (MEK) in rat medulla oblongata plus pons was the highest at 05:00 o'clock and the lowest at 23:00. In both hypothalamus and striatum at 05:00 it was higher than at 11:00, 17:00 and 23:00. In both hippocampus and midbrain at 05:00 and 23:00 it was higher than those at 11:00 and 17:00. In the cortex it was higher at 05:00 than at 11:00 and 17:00. The basic level of leucine enkephalin (LEK) in the medulla oblongata plus pons was the highest at 11:00 and the lowest at 17:00 and 23:00. Electroacupuncture (EA) at 05:00 increased the MEK content in the medulla oblongata plus pons and the LEK level in the hypothalamus. It decreased the MEK content in the hypothalamus and the LEK level in the cortex; EA at 11:00 produced decreases of MEK concentrations in the medulla oblongata plus pons and the midbrain and increases of MEK content in the cortex, hypothalamus and striatum. At 17:00 it increased the MEK level in the hypothalamus and the LEK content in the hippocampus. At 23:00 it reduced the levels of MEK and LEK in the hippocampus. The results suggest that there are very marked circadian rhythms in the MEK basic levels of the six discrete brain regions observed and the LEK of the medulla oblongata plus pons; EA at different times produces different effects on brain MEK and LEK levels.

[Low-dose cytosine arabinoside in treatment of 17 patients with acute nonlymphocytic leukemia]

Low dose Ara-C (LDAra-C, Ara-C 10-15 mg/12 h, i.m. x 14-21 days) was used in the treatment of 17 patients with ANLL, and from 14 patients blast cells were isolated before chemotherapy and cultured in the presence of Ara-C (10(-8) and 10(-7) mol/L), no definite induction of differentiation of leukemic cells was found. Of the 17 cases, 5 obtained CR, only one of them with M4 entered CR without pancytopenia or bone marrow aplasia during the LDAra-C treatment. For the rest, 4 with M2 obtained PR, and 8 did not respond. Toxic effects, including pancytopenia and bone marrow aplasia, were observed in most of the patients. Laboratory results showed that differentiation was not induced by Ara-C in low concentration in in vitro culture. LDAra-C is thought to be effective in the treatment of ANLL, and the mechanism may involve both the cytotoxicity and the induction of differentiation of leukemic cells, but the former is far more important.

Intraoperative determination of thoracic duct injury with 131I-fat. An experimental study on dogs

The creation of an experimental animal model of traumatic chylothorax was verified by 131I labelled fat (peanut oil). 15 dogs of 3 groups were administered 131I labelled oil via a gastric tube. The results were compared between the two experimental groups and a control group with nonchylous pleural effusion. Dynamic radioactive studies on the blood and pleural fluid showed that the absorption curve of the dog's blood and chyle to 131I labelled oil was identical regardless of different attitudes, and was also similar to that of the human blood because the peak appeared 4 hours after the administration of 131I labelled oil, at which the radioactivity of chyle reached its maximum, more powerful than that of the blood collected at the same time (P less than 0.01). The 99% confidence limitation of radioactivity of the pleural fluid, and the radioactivity ratio of the pleural fluid to blood in the experimental groups were 1.8-10.5 and 493-2340 cpm respectively. The specific characteristics of chyle was then determined qualitatively according to the quantitative norms. We conclude that the technique is parallel with the normal physiological pattern and seems to be more simple and reliable than the conventional methods for detection of intraoperative injury of the thoracic duct and early diagnosis of postoperative chylothorax.

Development of a microsphere-based fluorescent immunoassay and its comparison to an enzyme immunoassay for the detection of antibodies to three antigen preparations from Candida albicans

A sensitive assay for the simultaneous detection of multiple serum antibodies by flow cytometry was developed. Polystyrene microspheres of 5, 7 and 9.3 micron in diameter were used as solid supports for the attachment of three different antigen preparations from Candida albicans. These antigens were a whole cell extract; a cytoplasmic protein extract and a cell wall polysaccharide. Microsphere-associated fluorescence was quantitated by flow cytometry, with the different sized microspheres analyzed separately using electronic volume gating. This procedure allowed for different antigen-coated microspheres with discrete sizes to be analyzed independently for immunofluorescence. The assay detected antibody levels in human serum at dilutions up to 10(-6) and provided complete discrimination, using all three antigen preparations, between antibody levels seen in healthy subjects and those seen in patients suspected of having a systemic Candida infection. A standard enzyme immunoassay (EIA) failed to provide complete discrimination between healthy subjects and patient samples: at least 17% of patient values fell within the healthy subject range using all three antigen preparations. The microsphere assay which allowed for the simultaneous detection of multiple antibodies, has increased dynamic range over EIA and provides for better discrimination of patients from healthy subjects in comparison to EIA. Precise quantitation of antibodies is possible and the rapid analysis of thousands of microspheres markedly enhances the statistical accuracy of the assay. We suggest this assay is likely to have many other important applications in immunologic testing.

Identification of the erythropoietin receptors of erythroleukemic cells

Erythropoietin (epo) is the physiologic regulator of red blood cell development. We have demonstrated the presence of epo receptors on two erythroleukemia cell lines, IW32 and IW201. IW32 produces epo constitutively while IW201 is a nonproducing cell line. Neither cell lines respond to epo to differentiate. In this study, we have shown that these cells bound 125I-epo specifically. Binding could be displaced by the presence of unlabeled epo but not by insulin or epidermal growth factor. In contrast to that found in epo responsive cells isolated from Friend virus infected mouse spleen, which were reported to contain both "high" and "low" affinity receptors, our finding indicated only a single class of "low" affinity receptors with apparent dissociation constants of 1.7 nM and 2.0 nM for IW32 and IW201 cell lines, respectively. It is suggested that the absence of "high" affinity receptors may account for the lack of responsiveness of these cells to epo.

The cobalt(II)-alkaline phosphatase system at alkaline pH

The uptake of cobalt(II) ions by apoalkaline phosphatase at pH 8 (the pH optimum for activity) has been investigated by the combined use of electronic and 1H NMR spectroscopies. The presence of fast-relaxing high spin cobalt(II) ions in the active site cavity of the protein induces sizable isotropic shifts of the 1H NMR signals of metal-coordinated protein residues, allowing us to propose a metal uptake pattern by the various metal binding sites both in the presence and in the absence of magnesium ions. In the absence of magnesium the active site is not organized in specific metal binding sites. The first equivalent of cobalt(II) ions per dimer binds in an essentially unspecific and possibly fluxional fashion, giving rise to a six-coordinated chromophore. The second and third equivalents induce the formation of increasing amounts of metal ions pairs, cooperatively arranged into the A and B sites of the same subunit with a five- and six-coordinated geometry, respectively. The fourth and fifth equivalents induce the formation of fully blocked A-B pairs in both subunits. Magnesium shows the property of organizing the metal binding sites, probably through coordination to the C sites. Electronic and 1H NMR titration with Co2+ ions show that the initial amount of fluxional cobalt is smaller than in the absence of magnesium and that A-B pairs are more readily formed. Titration of fully metalated Co4Mg2alkaline phosphatase samples with phosphate confirms binding of only one phosphate per dimer.

Identification of erythropoietin receptors in isolated membranes from Friend virus infected mice spleen cells

It has been shown that radiolabeled erythropoietin (epo) specifically binds to homogeneous epo-responsive spleen cells from mice infected with the anemic variant of the Friend virus. We now report that membranes isolated from these cells retain the ability to specifically bind epo. Spleen cells were swollen in ice-cold 10 mM Tris-Cl pH 7.4 containing 0.2 mM phenylmethyl sulfonylfluoride for 5 minutes, after which the cells were homogenized and centrifuged to remove nuclear fraction. Membranes were collected by centrifuging the supernatant at 75,000 g for 90 min. Utilizing 3H-epo labeled at the terminal sialic acids of the carbohydrate moieties or 125I-epo labeled at the tyrosine residues, it was shown that the isolated membranes contained specific epo binding sites. About 90% of the binding could be inhibited by the presence of unlabeled epo whereas no inhibition was seen with other glycoproteins and growth factors. Equilibrium could be reached in approximately 2.5 hr at 25 degrees C or 1.5 hr at 37 degrees C. Binding could be saturated at an epo concentration of about 3 nM, Scatchard analysis indicated a single class of receptors with a Kd of approximately 1.5 nM.

Interstitial microwave antennas for thermal therapy

This paper presents a new microwave antenna design with improved heating at the tip for interstitial hyperthermia and thermocoagulation. Temperature distribution patterns surrounding a conventional insulated antenna and the new sleeved coaxial slot radiator are measured in a saline phantom under transient and steady-state conditions. The new design provides an improved steady-state temperature distribution over the active region of the radiator. In contrast to the cold zone at the tip of a conventional insulated antenna the new sleeved coaxial slot antenna provides maximal (sixfold greater) power deposition at its tip.