Interaction of beta-L-2',3'-dideoxy-2',3'-didehydro-5-fluoro-CTP with human immunodeficiency virus-1 reverse transcriptase and human DNA polymerases: implications for human immunodeficiency virus drug design

The work reported in this article has evaluated the relative molecular activity of the 5'-triphosphate of a novel beta-L-nucleoside with an unsaturated ribose residue, beta-L-2', 3'-dideoxy-2',3'-didehydro-5-fluorocytidine (beta-L-Fd4CTP), with that of beta-L-2',3'-dideoxy-5-fluorocytidine (beta-L-FddCTP) and 2', 3'-dideoxycytidine (ddCTP), on DNA strand elongation by human immunodeficiency virus-1 reverse transcriptase (HIV RT) and human DNA polymerases alpha (pol alpha), beta (pol beta), gamma (pol gamma), and epsilon (pol epsilon). The concentrations of beta-L-Fd4CTP that inhibited the yield of products by 50% were 0.20 micro M, 1.8 micro M, and 4.0 micro M for HIV RT, pol gamma, and pol beta, respectively. The beta-L-Fd4CTP at a concentration as high as 40 micro M had no inhibitory effect on pol epsilon, but could inhibit pol alpha by 10-20% at 20 micro M. The Km and relative Vmax values of beta-L-Fd4CTP, beta-L-FddCTP, and ddCTP for incorporation into the standing start point of 5'-[32P]-oligonucleotide primer annealed with M13mp19 phage DNA by HIV RT and human DNA polymerases were evaluated. The efficiency of incorporation (Vmax/Km) of beta-L-Fd4CTP by HIV RT was about 4-fold and 12-fold higher than that of ddCTP and beta-L-FddCTP, respectively. In contrast, the Vmax/Km ratio of beta-L-Fd4CTP for pol gamma was 7-fold lower than that of ddCTP, but 4-fold higher than that of beta-L-FddCTP. Pol alpha could use beta-L-Fd4CTP as a substrate, but only at a high concentration (>20 micro M). Incorporation of beta-L-Fd4CTP by pol epsilon could not be detected. A hypothesis about the preferable recognition of the 2',3'-dideoxy-2',3'-didehydro- structure of beta-L-Fd4CTP to that of the 2',3'-dideoxy-structure of beta-L-FddCTP by HIV RT is discussed.

High-dose cytarabine-containing chemotherapy with or without granulocyte colony-stimulating factor for children with acute leukemia

We sought to determine the role of granulocyte colony-stimulating factor (G-CSF) as an adjunct therapy in high-dose cytarabine-containing chemotherapy (HD C/T) for children with acute leukemia. Seventeen patients, aged 9 months to 18 years old, 8 ALL and 9 AML, were treated with cytarabine (Ara-C) 1 g/m2 q12h for 8 doses with mitoxantrone, idarubicin, VP-16, or asparaginase. A total of 71 courses of HD C/T was given. G-CSF was not used in 14 courses (Group A). Prophylactic G-CSF was given in 57 courses (Group B) as 200 microg/m2/d SC started one day after the completion of HD C/T and continued until the neutrophil recovery was maintained. The incidences of sepsis per course in Group A and Group B were 35.7% (5/14) and 40.4% (23/57), respectively. While 2 patients in Group A died of sepsis or pneumonia, none in Group B died. The mortality and delay in chemotherapy were fewer in Group B (P = 0.037 and 0.0006, respectively, Fisher exact test). There was a shorter average number of days of neutrophil <500/cumm, antibiotic usage, fever, and hospital stay in Group B (11, 8, 5, 17 days in Group B vs. 21, 17, 10, 37 days in Group A; P = 0.0001, log-rank test; 0.0006, 0.0023, 0.0001, Wilcoxon rank sum test, respectively). The incidence of neutropenic fever was lower in Group B, but the difference did not reach statistical significance (P = 0.06, Fisher exact test). We conclude that G-CSF as an adjunct therapy in HD C/T is effective in reducing mortality, days of neutropenia, antibiotic usage, fever, hospital stay, and frequency of delay in chemotherapy. The efficacy of this treatment approach requires further testing in a randomized, controlled trial.

The stage I yolk sac tumor of testis in children younger than 2 years, chemotherapy or not?

Yolk sac tumor is the most frequent germ cell tumor of testis in children. For stage I yolk sac tumor of testis in children younger than 2 years, high inguinal orchiectomy alone has been the standard treatment, with a cure rate of at least 75%. Here, we compare the treatment results of receiving chemotherapy or no chemotherapy after orchiectomy, to analyze the role of chemotherapy. From February 1987 to January 1997, 22 children younger than 2 years, with stage I yolk sac tumor of testis, were included in the study. All patients had high inguinal orchiectomy without retroperitoneal lymphadenectomy. Initial diagnostic imaging studies included computed tomographic scan of abdomen, chest radiography, and long bone survey. Clinical stage I was defined as a tumor completely resected with no evidence of local regional lymph node involvement or distant metastases. Serum alpha-fetoprotein (AFP) was assessed at diagnosis. After orchiectomy, diagnosis, and staging, patients were stratified into two treatment groups, with or without chemotherapy, according to the decision of the parents. Ten children received chemotherapy consisting of cisplatin, vinblastine, and bleomycin (PVB, modified "Einhorn regimen") for 12 weeks. The remaining 12 patients were followed up according to a "wait and see" policy. Determination of AFP was performed monthly during the first postoperative year, every other month during the second year, every 3 months during the third year, every 6 months during the fourth year, and yearly until the fifth postoperative year at least. The duration of follow-up ranged from 3 months to 119 months (median, 53 months). The Kaplan-Meier plot estimated an overall survival rate of 91.6% at 7 years after diagnosis. Among the 12 patients without chemotherapy, 2 children had relapses at 4 and 6 months after diagnosis, respectively. One was cured with PVB chemotherapy. The other patient died with refractory lung metastasis, in spite of intensive multimodality salvage therapy. The Kaplan-Meier plot showed a survival rate of 80% at 7 years and a relapse-free survival rate of 81.8% at 5 years after diagnosis. All children receiving chemotherapy were alive and free from relapse. There was no significant treatment-related toxicity. Our results may suggest that PVB chemotherapy after orchiectomy is an affective and safe regimen for stage I yolk sac tumor of testis in children younger than 2 years. Instead of four courses of PVB as used here, two or three courses could be enough. To elucidate the necessity for chemotherapy and to determine the number of courses of PVB needed (if chemotherapy is given), a randomized study of more cases is warranted.

Micellar electrokinetic chromatography of scopolamine-related anticholinergics

A simple micellar electrokinetic chromatography (MEKC) method is described for the separation of scopolamine N-oxide hydrobromide (SO), scopolamine hydrobromide (SH), scopolamine N-methylbromide (SM) and scopolamine N-butylbromide (SB), and for the quantitation of SH, SM and SB (using SO as an internal standard). The analysis of these drugs was performed in a phosphate buffer (30 mM; pH 7.00) with sodium dodecyl sulfate (SDS) (30 mM) as an anionic surfactant. Several parameters affecting the separation of the drugs were studied, including the concentrations of the buffer and SDS. The stability of the drugs in the phosphate buffer (pH 7.00) was also examined. Partial application of the method to the determination of scopolamine N-butylbromide in tablets proved to be feasible.

The development and use of respirator response functions as part of a workplace exposure monitoring program for control of potential respiratory hazards

The traditional hierarchy of measures for control of potential respiratory hazards in the workplace includes (in order of preference) engineering controls, workplace practices, and use of respiratory protection. Although third in this hierarchy, respirators can be an important component of the control mix-particularly for difficult-to-control jobs, as an interim measure (pending implementation of other controls), and in cases where exposure is intermittent. One of the problems associated with the use of respirators as a control measure is that valid and adequate data on respirator usage are often not available. Absent these data it is difficult to determine the practical effectiveness of respirators and exposure calculations which include the protective effect of respirators are speculative. This paper presents models (and appropriate statistical fitting techniques) suitable for quantification of respirator usage and defines three potentially useful measures of effectiveness for a respirator program. These models are illustrated with monitoring data on refractory ceramic fiber (RCF) developed as part of a Consent Agreement between the RCF industry and the U.S. Environmental Protection Agency. For this substance there are extensive and comprehensive monitoring data available. The models and methods of analysis may prove applicable for other potential respiratory hazards in the workplace.

Trace determination of methanol in water-ethanol solution by derivatization and high-performance liquid chromatography

A simple and sensitive high-performance liquid chromatographic method has been established for the determination of methanol in water-ethanol solution. The method is based on the transfer of the methoxide anion, which is formed from methanol under strong alkaline treatment in aqueous solution, by benzalkonium chloride into the dichloromethane organic phase for derivatization with 3-bromomethyl-7-methoxy-1,4-benzoxazin-2-one. The derivative obtained was separated on a LiChrospher diol column with n-hexane-dichloromethane (9:1, v/v) as the mobile phase. Several parameters affecting the partition/derivatization of methanol were investigated. The linear range for the determination of methanol was 2-20 mumol/ml; the detection limit (signal-to-noise ratio = 5; sample size, 10 microliters) of methanol was about 0.10 mumol/ml (R.S.D. = 16%, n = 3). The method has been satisfactorily applied to the assay of methanol in spiked commercial liquors.

A novel calcium-independent enzyme capable of incorporating putrescine into proteins

A Ca(++)-independent enzyme capable of incorporating [3H]-putrescine into proteins was detected in the rat intestine mucosa. The Ca(++)-independent incorporation of [3H]-putrescine into proteins was temperature-, pH-, time-, and dose-dependent. However, this enzyme was absent in the gastric mucosa. Similar to testicular Ca(++)-dependent transglutaminase, the optimal pH of intestinal Ca(++)-independent enzyme was 9.0. At 10(-5) M or less putrescine concentrations, the Ca(++)-independent enzyme in an intestinal cytosol preparation showed a greater activity than did the Ca(++)-dependent transglutaminase. However, at higher putrescine concentrations, the latter showed a greater activity than did the former. Both the intestinal Ca(++)-dependent and independent enzymes were inhibited by cystamine, thermal labile at 50 degrees C and precipitated by 30 to 50% saturation of ammonium sulfate. The fact that these two enzymes shared many similar characteristics, with the exceptions of Ca(++)-requirement, suggests that they may have similar active site and intrinsic molecular function(s).

Transcriptional regulation of the human UDP-GlcNAc:alpha-6-D-mannoside beta-1-2-N-acetylglucosaminyltransferase II gene (MGAT2) which controls complex N-glycan synthesis

UDP-GlcNAc:alpha-6-D-mannoside beta-1,2-N-acetylglucosaminyltransferase II (GnT II; EC 2.4.1.143) is essential for the normal assembly of complex Asn-linked glycans. Northern analysis showed a major transcript at 2.0 kb and a minor band at approximately 2.9 kb in five different human cell lines. The gene (MGAT2) has three AATAAA polyadenylation sites at 68, 688 and 846 bp downstream of the translation stop codon. 3'-RACE (rapid amplification of cDNA ends) using RNA from the human cell line LS-180 indicated that all three sites were utilized for transcription termination. 5'-RACE and RNase protection analyses showed multiple transcription initiation sites at -440 to -489 bp relative to the ATG translation start codon (+1). The data show that the entire GnT II gene is on a single exon. The gene has a CCAAT box at -587 bp but lacks a TATA box and the 5'-untranslated region is GC-rich and contains consensus sequences suggestive of multiple binding sites for Sp1; these properties are typical for housekeeping genes. A series of chimeric constructs containing different lengths of the 5'-untranslated region fused to the chloramphenicol acetyltransferase (CAT) reporter gene were tested in transient transfection experiments using HeLa cells. The CAT activity of the construct containing the longest insert (-1076 bp relative to the ATG start codon) showed a approximately 38-fold increase as compared to that of the control. Removal of the region between -636 and -553 bp caused a dramatic decrease in CAT activity indicating this to be the main promoter region of the gene.

Trunk muscle use during pulling tasks: effects of a lifting belt and footing conditions

Pulling tasks require the torso to act as a rigid link in order to facilitate the force transmission between the ground and the hands. In this study, we tested the hypothesis that a lifting belt increases the rigidity of the torso, thereby increasing pulling strength or reducing trunk muscle forces, or both, as pulling tasks are performed. Twelve volunteers performed maximal and submaximal isometric pulling exertions; the latter were performed on nonslippery and slippery surfaces. Electromyographic data from 8 trunk muscles, trunk kinematic data, and ground reaction forces were sampled during each exertion. Results indicated that the lifting belt had no effect during maximal exertions on the maximal pull forces generated or the muscle recruitment levels, irrespective of the pulling posture. The lifting belt did not affect the EMG data obtained during the submaximal (40% of maximum) exertions, even when participants pulled on a slippery surface. However, the slippery surface increased the coactivation within the trunk musculature, perhaps stiffening the torso in the event of a slip. The absence of a statistical interaction effect between the lifting belt and the footing condition (slipperiness) indicates that the belt did not alter the coactivation pattern and hence was not relied upon by the participants as a protective mechanism. The data presented here will assist those who must make decisions regarding lifting-belt use and those who train individuals in manual materials handling techniques.

Importance of the herpes simplex virus UL24 gene for productive ganglionic infection in mice

The UL24 gene of herpes simplex virus overlaps the viral thymidine kinase (tk) gene. Most previous studies of UL24 have examined UL24 mutants that have also contained tk and sometimes other mutations. To address the importance of UL24 for viral replication in cell culture and in infections of a mammalian host, we constructed a mutant virus containing a UL24 nonsense mutation that does not affect TK activity and a second mutant that contains clustered point mutations in UL24 and a mutation in tk that does not by itself affect the ability of the virus to replicate acutely in mouse ganglia or to reactivate from latent infection following corneal inoculation of mice. Both mutant viruses replicated in cells in culture and in the mouse eye, albeit less efficiently than wild type or control viruses. Both mutants were much more severely impaired for acute replication in trigeminal ganglia and for reactivation from latency following explant of these ganglia. Viral DNA and latency-associated transcripts were present, albeit at lower levels in ganglia infected with the nonsense mutant. These results indicate that UL24 is especially important for productive infection of mouse sensory ganglia and may have implications for the behaviors of certain tk mutants in pathogenesis.

Accumulation of viral transcripts and DNA during establishment of latency by herpes simplex virus

Latent infection of mice with wild-type herpes simplex virus is established during an acute phase of ganglionic infection in which there is abundant viral replication and productive-cycle gene expression. Thymidine kinase-negative mutants establish latent infections but are severely impaired for acute ganglionic replication and productive-cycle gene expression. Indeed, by in situ hybridization assays, acute infection by these mutants resembles latency. To assess events during establishment of latency by wild-type and thymidine kinase-negative viruses, we quantified specific viral nucleic acid sequences in mouse trigeminal ganglia during acute ganglionic infection by using sensitive PCR-based assays. Through 32 h postinfection, viral DNA and transcripts representative of the three kinetic classes of productive-cycle genes accumulated to comparable levels in wild-type- and mutant-infected ganglia. At 48 and 72 h, although latency-associated transcripts accumulated to comparable levels in ganglia infected with wild-type or mutant virus, levels of DNA accumulating in wild-type-infected ganglia exceeded those in mutant-infected ganglia by 2 to 3 orders of magnitude. Coincident with this increase in DNA, wild-type-infected ganglia exhibited abundant expression of productive-cycle genes and high titers of infectious progeny. Nevertheless, the levels of productive-cycle RNAs expressed by mutant virus during acute infection greatly exceeded those expressed by wild-type virus during latency. The results thus distinguish acute infection of ganglia by a replication-compromised mutant from latent infection and may have implications for mechanisms of latency.

Sources of superoxide radicals involved in the pathogenesis of diethyldithiocarbamate-induced gastric antral ulcer in rats

The production of superoxide radicals as a result of decreased Cu,Zn-superoxide dismutase activity is considered to be the most important factor in the pathogenesis of diethyldithiocarbamate (DDC)-induced gastric antral ulcers in rats. The aim of the present study was to identify possible sources of superoxide radicals and the role of platelet-activating factor (PAF) in DDC-induced ulcer formation. Groups of rats were pretreated with a drug or antiserum before DDC (800 mg/kg) administration. The size of the DDC-induced gastric antral ulcers was measured. Pretreatment with anti-rat polymorphonuclear leukocyte serum or CV-3988 (a specific antagonist of PAF) 20 mg/kg significantly reduced the size of DDC-induced gastric antral ulcers. The results confirmed that superoxide radicals play an important role in the pathogenesis of DDC-induced gastric ulcer in rats and suggested that NADPH (reduced nicotinamide-adenine dinucleotide phosphate) oxidase in PAF-activated polymorphonuclear leukocytes may be involved in the generation of these radicals.

Bis-S-acyl-2-thioethyl (SATE)-bearing monophosphate prodrug of beta-L-FD4C as potent anti-HBV agent

The S-acyl-2-thioethyl (SATE)-bearing 5'-monophosphate prodrug of beta-L-FD4C (8) was synthesized and evaluated for its activity against HBV in the 2.2.15 cell line. This pronucleotide (8) exhibited an excellent inhibitory effect against HBV with an EC50 value that is more than eight fold lower than that of the parent nucleoside (4) under some assay conditions. It is also important to note that pronucleotide (8) was capable of inhibiting HBV replication by 90%; whereas its parent, beta-L-FD4C (4), could only inhibit virus replication no greater than 70% in the same assay. When evaluated in the standard cytotoxicity assay in CEM cell line, pronucleotide (8) exhibited an IC50 value of 52 microM, which was four times less toxic than parent beta-L-FD4C (4) (IC50 = 13 microM).

Management of lactose maldigestion by consuming milk containing lactobacilli

The influence of nonfermented milk containing L. acidophilus or L. bulgaricus on lactose utilization by lactose maldigesters was investigated. Nonfermented milks containing L. acidophilus or L. bulgaricus at 10(8) and 10(9) CFU/ml were prepared using 2% low-fat milk. Lactose maldigestion was monitored by measuring breath hydrogen at hourly intervals for 8 hr following consumption of 400 ml of each diet. Nonfermented milk containing L. acidophilus B at 10(8) CFU/ml were not effective in reducing breath hydrogen and symptoms. Nonfermented milk containing L. acidophilus B at 10(9) CFU/ml only slightly decreased breath hydrogen production; however, the symptoms were significantly improved. Nonfermented milks containing L. bulgaricus 449 at 10(8) and 10(9) CFU/ml were effective in reducing breath hydrogen and symptoms. The results for bulgaricus milk were all significant. In this study, L. acidophilus B and L. bulgaricus 449 were chosen because of their similar beta-galactosidase activity and bile sensitivity. L. acidophilus and L. bulgaricus are both thermophilic lactobacilli and an active transport (permease) system is found in both species for lactose transport. The major factor affecting in vivo lactose digestion in this study appears to be the bacterial cell wall/membrane structures. That the cell wall/membrane structures of L. acidophilus are different from those of L. bulgaricus can be indirectly proven by the results of sonication time for maximum beta-galactosidase activity measurement. The results of this study indicate that L. bulgaricus is usually a better choice than L. acidophilus for manufacturing nonfermented milks for lactose maldigesters.

SH3 domain of Bruton's tyrosine kinase can bind to proline-rich peptides of TH domain of the kinase and p120cbl

X-linked agammaglobulinemia (XLA), an inherited disease, is caused by mutations in the Bruton's tyrosine kinase (BTK). The absence of functional BTK leads to failure of B-cell differentiation; this incapacitates antibody production in XLA patients, who suffer from recurrent, sometimes lethal, bacterial infections. BTK plays an important role in B-cell development; it interacts with several proteins in the context of signal transduction. Point mutation in the BTK gene that leads to deletion of C-terminal 14 aa residues of BTK SH3 domain was found in a patient family. To understand the role of BTK, we studied binding of BTK SH3 domain (aa 216-273, 58 residues) and truncated SH3 domain (216-259, 44 residues) with proline-rich peptides; the first peptide constitutes the SH3 domain of BTK, while the latter peptide lacks 14 amino acid residues of the C terminal. Proline-rich peptides selected from TH domain of BTK and p120cbl were studied. It is known that BTK TH domain binds to SH3 domains of various proteins. We found that BTK SH3 domain binds to peptides of BTK TH domain. This suggests that BTK SH3 and TH domains may associate in inter- or intramolecular fashion, which raises the possibility that the kinase may be regulating its own activity by restricting the availability of both its ligand-binding modules. We also found that truncated SH3 domain binds to BTK TH domain peptide less avidly than does normal SH3 domain. Also, we show that the SH3 and truncated SH3 domains bind to peptide of p120cbl, but the latter domain binds weakly. It is likely that the truncated SH3 domain fails to present to the ligand the crucial residues in the correct context, hence the weaker binding. These results delineate the importance of C-terminal in binding of SH3 domains and indicate also that improper folding and the altered binding behavior of mutant BTK SH3 domain likely leads to XLA.

Combination therapy with suicide and cytokine genes for hepatic metastases of lung cancer

Metastases of lung cancer are a major cause of treatment failure. To evaluate the therapeutic efficacy of gene therapy in metastatic lung cancer, we used adenoviral (ADV) mediated transfer of the herpes simplex virus thymidine kinase (HSV-tk) gene and the cytokine gene interleukin-2 (IL-2) to treat a murine model of metastatic lung cancer in the liver. Hepatic metastases were established by intrahepatic implantation of LL2 cells in syngeneic recipient mice. One week after tumor implantation, various replication defective ADV vectors were injected intratumorally. Treatment with a vector expressing the HSV-tk followed by ganciclovir administration with ADV.tk resulted in significant regression of tumor (p<0.01) as well as prolongation of survival (p<0.001). While a vector expressing mouse IL-2 ADV.IL-2 alone was ineffective, combination therapy with HSV-tk resulted in further tumor regression and improvement of animal survival (p<0.05). These results demonstrate that suicide and cytokine genes can be utilized in combination to treat metastatic lung cancer in vivo.

Macrodactyly of the feet and hands

We reviewed the records of 16 patients with true macrodactyly and analyzed the typical clinical features and methods of treatment. Fourteen feet were involved in 13 patients (one was bilaterally affected). Three hands were involved in three patients. Clinically, all lesions in the hands and lesions in 11 of 14 feet involved the preaxial side. There was multiple digit involvement in two hands and 11 feet. Progressive macrodactyly (10 feet and two hands) was more common than the static type (four feet and one hand). Proximal involvement of the sole or palm occurred in seven feet and one hand; all cases were of progressive macrodactyly. Enlargement of the metatarsals or the metacarpals was frequent (11 feet and two hands). The growth behavior and extent of bony involvement were similar in patients with hand involvement and those with foot involvement. Fourteen patients had additional clinodactyly, either medial or lateral. The toes of eight feet had angular deformities in the sagittal plane; most were angulated dorsally. Nine patients underwent surgery and two had repeated surgery. The reduction procedures included debulking, ray resection, toe resection, phalangeal resection, and phalangeal epiphysiodesis; the corrective procedures included wedge osteotomy, interdigitalization, and split thickness skin graft. Of the nine patients surgically treated, five had good results and four had fair results. Of the seven patients without surgical repair, three had fair results and four had poor results. Surgical debulking, phalangeal resection, ray resection, and phalangeal epiphysiodesis produced significant improvement in macrodactyly of the feet and hands. Toe resection was not as beneficial.

[Effect of jiangtangkang on blood glucose, sensitivity of insulin and blood viscosity in non-insulin dependent diabetes mellitus]

OBJECTIVE

To study the hypoglycemic effect of Jiangtangkang (JTK), a Chrysanthemum product and its influence on sensitivity of insulin in non-insulin dependant diabetes mellitus (NIDDM).

METHODS

Newly discovered (71 cases) and poorly controlled (117 cases) NIDDM were divided to JTK, 8 g each time, 3 times per day, and the control (Glibenclazide in newly discovered, no treatment in poorly controlled) group respectively.

RESULTS

After 2 months of treatment, the fasting blood glucose (FBG), postprandial blood glucose (PBG), glucosylated hemoglobin (GHb) improved remarkably and insulin of plasma remained unchanged in JTK group, their blood viscosity and triglyceride decreased after 6-month reatment, the FBG, PBG lowered in the control group while their viscosity and lipids were unaffected. Insulin tolerance test on newly discovered NIDDMs showed an increased sensitivity to insulin, their serum chromium elevated, and the urinary albumin in poorly controlled persons lowered significantly.

CONCLUSIONS

JTK might improve the sensitivity to insulin and decrease the blood viscosity in NIDDM.

Morphometric study of glycine-immunoreactive neurons and terminals in the rat cuneate nucleus

The distribution of glycine-immunoreactive (glycine-IR) neurons and their associated axon terminals in the rat cuneate nucleus was studied using antiglycine postembedding immunoperoxidase labelling and immunogold staining, respectively. The immunoperoxidase-labelled glycine-IR neurons were widely distributed in the entire rostrocaudal extent of the nucleus. They made up 30.8% (9671/31368) of the neurons surveyed. Quantitative evaluation showed that the percentage of glycine-IR neurons in the caudal level was significantly higher than that in the middle and rostral levels. The glycine-IR neurons were small cells (mean area = 198+/-1.9 microm2, n = 2862) with ovoid or spindle-shaped somata. Statistical analysis showed that the size of the glycine-IR neurons in the rostral level was significantly smaller than that in the middle and caudal levels. Immunogold labelled glycine-IR terminals which contained predominantly pleomorphic synaptic vesicles were mostly small (mean area = 1.24+/-0.03 microm2, n = 286) and they constituted 24.7% (286/1158) of the total terminals surveyed. They formed axodendritic, axosomatic and axoaxonic synapses with unlabelled elements. It is suggested from this study that glycine is one of the major neurotransmitters involved in the depression of synaptic transmission in the cuneate nucleus.

Granulopoiesis in newly diagnosed childhood solid tumors

Granulopoiesis at the diagnosis of solid tumors has not been previously reported. The purpose of this study is to detect the changes of granulopoiesis of patients with solid tumors in different clinical stages. Granulocyte-macrophage colony-forming unit (CFU-GM) assays and liquid suspension cultures of bone marrow and peripheral blood were studied in 90 children with newly diagnosed solid tumors, including 5 benign tumors and 85 malignant tumors. The malignant tumors were categorized into nonadvanced, advanced, or marrow-invaded ones. Bone marrow from children with immune thrombocytopenic purpura and peripheral blood from adult volunteers were used as controls. Granulocyte-macrophage colony formation from bone marrow in benign or nonadvanced malignant tumor was not significantly different from that of controls. However, granulocyte macrophage colony formation from bone marrow in advanced or marrow-invaded malignant tumor was significantly less than that of controls or nonadvanced malignant tumor. Furthermore, the bone marrow of patients with advanced malignant tumor occasionally had a defective proliferation pattern and the bone marrow of those with marrow-invaded malignant tumor often had a defective proliferation pattern. Peripheral blood in marrow-invaded malignant tumor had colony and cluster formations in very wide ranges. As a malignant tumor progresses into advanced stages, irrespective of marrow infiltration, bone marrow CFU-GM levels may decline and defective granulopoiesis may occur.

Toe-to-hand transfer for traumatic digital amputations in children and adolescents

In the period from July of 1990 to August of 1994, 45 toe or toe tissue transfers were performed in 28 children and adolescents with traumatic amputation of digits. The average age at the time of transfer was 12 years (range, 3 to 16 years), and the median age was 10 years. The methods of reconstruction included transfer of 6 trimmed great toes, 2 great toe pulps, 24 second toes, 1 vascularized metatarsophalangeal joint from the second toe, 2 third toes, 4 combined second and third toes. and 1 combined third and fourth toes. All of the transferred toes, except one second toe, ultimately survived. Exploration and reanastomosis were required in three cases owing to arterial insufficiency. Partial pulp loss occurred in two digits. Follow-up ranged from 1 to 5 years (average, 3 years). Bony union occurred uneventfully in all patients. Two-point discrimination averaged 5 mm (static) and 6 mm (moving). Active range of the motion averaged 69, 38, and 13 degrees at the metaphalangeal proximal interphalangeal and distal interphalangeal joints of the reconstructed fingers, respectively, and 15 degrees at the interphalangeal joint of the reconstructed thumbs. None of the children required subsequent tenolysis. Pulp plasty was performed in nine digits in seven patients. Radiologically, the transferred phalanges showed the some growth as the non-transferred ones. Trimming the great toe before transfer did not result in premature physeal closure or growth retardation. The donor foot maintained a satisfactory appearance. None of the patients complained of difficulty in running or jumping. Toe-to-hand transfer in children, performed meticulously, can provide a valuable option for reconstruction of traumatic digit loss.