[Nonpalpable testicular masses incidentally discovered by ultrasound]

OBJECTIVE

To determine the diagnosis and management of impalpable testicular masses detected sonographically.

METHODS

We analyzed retrospectively the sonographic findings and pathologic results of such cases and reviewed related literature.

RESULTS

In over 600 patients receiving scrotal ultrasound, 14 aged on average 42.4 years (14 to 71 years) had 16 impalpable testicular masses, with a diameter of 5 to 30 mm (mean 12.1 mm). All masses were predominantly hypoechoic except for one appeared hyperechoic and calcified. Pathological examination showed 2 seminomas, 2 lymphomas, 2 testicular tuberculoses and cysts respectively. The other six were embryonal cell carcinoma, metastatic adenocarcinoma, testicular fibrosis, partial infarction, testis abscess, and hematoma. Malignant lesions accounted for 42.86% (6/14). In 13 of 14 patients, the affected testis was resected, while in 1 the testis spared for frozen sectioning revealed a benign cystic lesion.

CONCLUSIONS

Ultrasound findings can not differentiate malignant from benign in the impalpable lesions, and clinical history should be considered. All patients with indefinite diagnosis should undergo inguinal exploration and the testis can be spared if intraoperative frozen section diagnosis is negative. Ultrasound follow-up should be used only if there is a strong evidence of infection or trauma.

[New ellagic glycosides and known triterpenoids from Duchesnea indica Focke]

Two new ellagic glycosides, named ducheside A and ducheside B, have been isolated from Ducheside indica Focke. Their structures were established as 3'-O-methyl-ellagic acid-4-O-beta-D-xylopyranoside (I), 3'-O-methyl-ellagic acid-4-O-alpha-L-arabinofuranoside (II), respectively, on the basis of chemical method and spectral analysis. In addition, four known compounds were isolated and identified as 3 beta-hydroxylurs-12-en-28-oic acid (III), 2 alpha, 3 beta, 19 alpha-trihydroxylurs-12-en-28-oic acid (IV), 2 alpha, 3 beta, 19 alpha-trihydroxylurs-12-en-28-oic acid 28-O-beta-D-glucopyranoside (V), 2 alpha, 3 alpha, 19 alpha-trihydroxylurs-12-en-28-oic acid 28-O-beta-D-glucopyranoside (VI). Compounds IV, V, VI were isolated for the first time from Duchesnea genus.

Mitotic index and Alzheimer's disease

Alzheimer's disease (AD), a progressive neurodegenerative disorder, is diagnosed definitively by increased numbers of beta-amyloid plaques and neurofibrillary tangles in brain biopsy or autopsy specimens. There are no simple straightforward laboratory tests currently available for clinical diagnosis. We have found consistent reduction in mitotic index levels in skin fibroblast cultures from AD individuals compared with age- and sex-matched controls. These differences were enhanced by overnight exposure to colcemid (p = 0.04). Results suggest that mitotic index in skin fibroblasts cultures should be further investigated as a potential diagnostic indicator for AD.

Transcriptional activation by the Werner syndrome gene product in yeast

Werner syndrome (WS) is characterized by the premature occurrence of many age-related features. Before the cloning of the gene for WS (WRN), several reports suggested that transcriptional defects of genes may relate to the mechanisms of the occurrence of WS and natural aging. Because WRN, which encodes a helicase (WRN-H), has been cloned, we are attempting to clarify the mechanism of the transcriptional abnormalities found in WS cells, using WRN and WRN-H. In this article, we studied transcriptional activation of a promoter by WRN-H in a yeast assay system as a first step. The results showed that WRN-H functions as a transcriptional activator in the system. Furthermore, we performed additional transcriptional assays using various parts of WRN to define the critical region of WRN-H for transcriptional activation in yeast. The results revealed the critical region for the activation most likely mapped to the region of 315 to 403 aa. The region of 404 to 1309 aa may also effect activation in the presence of the critical region. The two regions contain an acidic domain, and the region of 404 to 1309 aa also contains a helicase domain. If this transcriptional activation by WRN-H occurs also in human cells in vivo, direct activation of the promoters by WRN-H could explain the results of somatic cell hybrid studies as well as the overexpressed genes detected in WS cells. However, our results should be interpreted with caution, because thus far, the transcriptional activation by WRN-H were only demonstrated using one promoter in a yeast system.

Competitive immunoassay for cyclosporine using capillary electrophoresis with laser induced fluorescence polarization detection

Frequent monitoring of immunosuppressive drug cyclosporine A (CsA) in blood samples of tissue transplant patients is required in clinical practice because of the narrow therapeutic range between the immunosuppressive effect and the toxic effect of this drug. We describe a competitive immunoassay capillary electrophoresis (CE) with laser induced fluorescence polarization detection method, which is rapid and sensitive for the determination of CsA. The method is based on the competitive immunochemical reaction between the analyte and fluorescent hapten (CsA*) with the antibody, CE separation of the antibody bound and free fluorescent CsA*, followed by the laser induced fluorescence polarization detection (LIFP) of the fluorescent species. The method detection limit is governed by the stability of the antibody-CsA* complex rather than by the detector noise. The use of post-column sheath flow cuvette LIFP detection resulted in excellent detection limit, typically 0.9 nM (or 9.10(-19) mol for 1 nl injection) of CsA. CsA in whole blood samples from organ transplant patients were measured and results agreed well with those obtained by using a standard fluorescence polarization immunoassay. Each determination took less than 3 min. The CsA metabolites AM9 and AM19 were also determined by using this technique, and their cross-reactivities with the antibody were 13% and 2%, respectively.

Molecular and epidemiological studies of Werner syndrome in the Japanese population

Werner syndrome (WS) is an autosomal recessive genetic disease characterized by many age-related features. The gene responsible for WS (WRN) has been isolated and contains a helicase domain, but its function is unknown. Six different mutations throughout the WRN gene have been reported in the Japanese population. We have studied whether patients with a specific mutation exhibit distinct phenotypes from others. Fourteen patients with different mutations showed almost the same signs and symptoms and, therefore, the C terminal part of the product appears to be crucial for its functions, although other parts may be important as well. Haplotype analyses using 13 microsatellites covering the 2.8-3.0 cM WRN region showed that two out of six different mutations had founder chromosomes. These two founder chromosomes may be evenly distributed throughout the western part of Japan, suggesting that these mutations go back to a time earlier than 1400 years ago.

Growth factor and cytokine-regulated hyaluronan-binding protein TSG-6 is localized to the injury-induced rat neointima and confers enhanced growth in vascular smooth muscle cells

Hyaluronan (HA) and HA-binding proteins have been implicated in a diverse array of biological processes, including development, tissue repair, and tumor invasion. However, the role of HA and HA-binding proteins in atherosclerosis and restenosis is poorly understood. PS4 (TSG-6) is a HA-binding protein expressed by cultured vascular smooth muscle cells (SMCs) in response to serum and growth factor stimulation. To delineate a possible role for TSG-6 in vascular disease progression, we have characterized its expression in cultured SMCs and in a rat vascular injury model, and we have studied the effect of constitutive overexpression of TSG-6 on SMC behavior. We found that interleukin-1 (IL-1) but not tumor necrosis factor or interleukin-6 was able to stimulate TSG-6 expression in SMCs. The IL-1 pathway could be distinguished from the growth factor pathway by its insensitivity to protein synthesis inhibitors. Furthermore, epidermal growth factor, fibroblast growth factor-1, and transforming growth factor-beta1 were all capable of augmenting maximum IL-1-induced expression of TSG-6. To gain further insight into the function of TSG-6 in SMCs, we examined the effect of constitutive overexpression of TSG-6 on these cells. We found that TSG-6-overexpressing cells grew >50% faster than control cells. Furthermore, this growth advantage became more evident in the absence of serum growth factors, with an average increase in cell number of 118% over control cells after 6 days. Consistent with these in vitro data, we observed intense immunostaining for TSG-6 in proliferating SMCs in the rat neointima after injury, whereas only an occasional cell was positive for TSG-6 in the medial layer and in nonballooned arteries. We conclude that the expression of TSG-6 is tightly controlled by growth factors and cytokines via two distinct pathways in SMCs and that overexpression of TSG-6 confers a growth advantage to these cells.

BRCA1 is a component of the RNA polymerase II holoenzyme

The familial breast-ovarian tumor suppressor gene product BRCA1 was found to be a component of the RNA polymerase II holoenzyme by several criteria. BRCA1 was found to copurify with the holoenzyme over multiple chromatographic steps. Other tested transcription activators that could potentially contact the holoenzyme were not stably associated with the holoenzyme as determined by copurification. Antibody specific for the holoenzyme component hSRB7 specifically purifies BRCA1. Immunopurification of BRCA1 complexes also specifically purifies transcriptionally active RNA polymerase II and transcription factors TFIIF, TFIIE, and TFIIH. Moreover, a BRCA1 domain, which is deleted in about 90% of clinically relevant mutations, participates in binding to the holoenzyme complex in cells. These data are consistent with recent data identifying transcription activation domains in the BRCA1 protein and link the BRCA1 tumor suppressor protein with the transcription process as a holoenzyme-bound protein.

Serum inhibits tight junction formation in cultured pigment epithelial cells

PURPOSE

These experiments were designed to characterize tight junction formation by retinal pigment epithelial (RPE) cells in vitro and to compare the effects on this process of hormonally defined medium (HDM) and serum-containing medium.

METHODS

Formation of RPE tight junctions was analyzed in freshly isolated rat RPE cells maintained either in HDM or serum-containing medium. Junctions were evaluated functionally by measuring transepithelial electrical resistance (TER) and permeability and structurally by immunolocalization of the junction-associated actin microfilaments. Calcium dependency of the junctions was determined by reducing media calcium concentration.

RESULTS

RPE cells cultured in serum-free HDM developed calcium-dependent tight junctions, which exhibited TER levels > 150 omega cm2 and low paracellular permeability. Serum-containing media inhibited tight junction formation as indicated by significant reductions in TER and increases in permeability. Junction-associated actin microfilaments and cell density were unchanged.

CONCLUSIONS

Tight junction formation by RPE cells is inhibited by serum. This activity may play an important role in responses of the RPE layer to injury, contributing to the pathologic progression of blood-retinal barrier dysfunction.

Cloning and sequencing of a cDNA for firefly luciferase from Photuris pennsylvanica

The first cDNA from the Photurinae subfamily of the Lampyridae encoding a firefly luciferase from lantern mRNA of Photuris pennsylvanica has been cloned, sequenced, the amino-acid sequence predicted and the sequence reported to GenBank. The cDNA was about 1.8 kb in length with the largest open reading frame coding for a 545-residue protein. The 5' noncoding region is 61 bp long and the 3' noncoding region is 135 bp in length. There is a 24-nucleotide poly(A) tail. When the amino-acid residues are aligned, P. pennsylvanica contains 154 (about 28% of the total residues) that are conserved in all 16 of the deduced luciferase sequences that are presently available. In this P. pennsylvanica luciferase, the amino acids at 276 of the positions are the same at corresponding positions of at least one of the other enzymes. There are two amino-acid differences between this luciferase and the unpublished sequence obtained by Dr. Keith Wood for a putative larval Photuris firefly luciferase cloned from a Maryland firefly. Signature amino-acid sequences and domains found in the deduced sequence are for adenylate kinase, the putative AMP-binding domain, luciferin 4-monooxygenase, 4-coumarate CoA ligase, long-chain fatty acid CoA ligase, 2-acylglycerophosphoethanolamine acyltransferase, the microbody-directing sequence, peptide-synthesizing complexes, and acyladenylate-synthesizing enzymes.

Photon absorption coefficient and the Franz-Keldysh shift of cutoff wavelength for mercury cadmium telluride detectors

Based on the calculation of photon absorption coefficient alpha and width W of the depletion region of mercury cadmium telluride detectors, we derived the equation for alpha, W and the effective Franz-Keldysh shift Dlambda(ce). An interpretation of the substantial difference between Dlambda(ce) and the maximum Franz-Keldysh shift Dlambda(cm) of the cutoff wavelength is presented. We also propose a method to increase the Dlambda(ce) of mercury cadmium telluride detectors.

A high-density STS map based on a single contig of YAC and P1 clones in the chromosome 8p12-p21 region

We have constructed a yeast artificial chromosome (YAC) and P1 contig in the 8p12-p21 region. The contig comprises 16 overlapping YAC clones and 44 overlapping P1 clones. Twelve dinucleotide-repeat polymorphic sequence-tagged site (STS)-markers that were previously isolated mainly from these YAC and P1 clones were genetically mapped. A total of 46 nonpolymorphic STS markers were newly established mainly from the YAC and P1 clone end fragments, and 28 of the 46 nonpolymorphic STSs, as well as the 12 polymorphic STSs, were also mapped physically onto the contig based on STS content analysis of YAC pools and of the P1 and YAC clones. As a result, the YAC and P1 clones were assembled into a single contig covering a minimum of 1.5 Mb physically and 2.8 cM genetically with 12 polymorphic and 28 nonpolymorphic STSs within the 8p12-p21 region. Average STS spacing in the contig was estimated to be 40 kb/STS. In addition, further characterization of the contig suggested that this contig includes a region where genetic recombination occurs frequently. Thus, the resulting cloned region, together with densely mapped STS markers on the contig, should help to promote our understanding of this region.

Association of a polymorphic variant of the Werner helicase gene with myocardial infarction in a Japanese population

The Werner syndrome (WS) is a rare autosomal recessive progeroid syndrome characterized by the premature onset of multiple age-related disorders, including atherosclerosis, cancer, non-insulin-dependent diabetes mellitus (NIDDM), ocular cataracts and osteoporosis [Epstein et al., 1966]. The major cause of death (at a median age of 47) is myocardial infarction (MI) [Epstein et al., 1966]. The WS mutation involves a member (WRN) of the RecQ family of helicases and may perturb DNA replication, repair, recombination, transcription, or chromosomal segregation [Yu et al., 1996]. We now report data on 149 MI cases and age-matched controls suggesting that a polymorphic WRN variant is associated with increased risk for MI. Based on our data, homozygosity for a cysteine at amino acid 1367 (the most prevalent genotype) predicts a 2.78 times greater risk of MI (95% confidence intervals: 1.23 to 6.86). The variant was not significantly associated with NIDDM. The two alleles (cysteine vs. arginine) could influence helicase activity, turnover, macromolecular interactions or, alternatively, could be markers for haplotypes influencing WRN regulation or reflecting gene action at linked loci. However, given the caveats implicit in genetic association studies, it is imperative that the present results be replicated in independent populations.

A home electrocardiography and blood pressure telemonitoring system

A home electrocardiography (ECG) and blood pressure telemonitoring system for cardiac patients was installed in the Macau region. The monitoring centre was established in the emergency unit at the Government Hospital of Macau. The first users were 10 cardiovascular patients selected by a physician. The average age of these users was 61 years (range 30-78). The results of a three-month trial showed that the system was easy to operate and technically reliable. It was found to be helpful for cardiac patients. The most significant problem during the trial was electrical noise from the ECG electrodes.

Narrowing the position of the Werner syndrome locus by homozygosity analysis-extension of homozygosity analysis

Werner syndrome (WS) is an autosomal recessive disorder characterized by the premature occurrence of many age-related features. Previously, the WS gene (WRN) was mapped between D8S131 and D8S87, in an 8.3-cM interval. In this study, regions of homozygosity in 36 WS patients from inbred families were searched for by genotyping for 35 dinucleotide repeat polymorphic markers to narrow down the WRN critical region. The region most consistently homozygous in these patients was between the D8S1219/D8S1220 cluster and D8S278, within a 4.4-cM interval. For 16 markers mapped in this interval, 24 WS patients (22 Japanese patients and 2 Caucasian patients) in whom consanguinity failed to be proved were also genotyped, under the assumption that some of these patients might still be from consanguineous marriages. The data were analyzed by Fisher's exact test with a 2 x 2 contingency table for the 22 Japanese patients, excluding the 2 Caucasian patients. The frequencies of homozygosity in the 22 patients at 10 of 16 markers tested were significantly higher than those detected in the general population. Analysis of homozygosity patterns indicated that the region most consistently homozygous was between D8S1445 and D8S278. Thus the WRN locus is most likely between the two markers D8S1445 and D8S278, in a 1.6-cM interval.

Artificial antibodies to corticosteroids prepared by molecular imprinting

BACKGROUND

Molecular imprinting can be used to prepare antibody and receptor mimics. We have previously shown that acrylic acid polymers can be imprinted to recognize a variety of small molecules. Here, we show that molecularly imprinted polymers (MIPs) can selectively recognize steroid structures.

RESULTS

Artificial antibodies mimicking the binding performance of natural anti-corticosteroid antibodies have been prepared using a molecular imprinting protocol with either cortisol or corticosterone as a target molecule. The binding characteristics of a range of structurally related ligands were estimated using a form of radioimmunoassay. The antibody mimics were found to be highly selective for the ligands used in their preparation and the cross-reactivities with compounds of related structure resembled those obtained in studies with natural antibodies.

CONCLUSIONS

The binding properties of MIPs, prepared against corticosteroids, exhibit strong similarities to those of naturally raised antibodies. Such artificial antibodies may serve as a useful complement to their natural counterparts in studies of corticosteroid binding events.