Toxic Effects of Copper on Photosystem II of Spinach Chloroplasts

The room temperature fluorescence induction of chloroplasts was utilized as a probe to locate the site of inhibition on PSII by copper. It was found that, while the initial fluorescence yield was hardly affected, the variable fluorescence yield was lowered without significant change in its kinetics. Addition of DCMU, or abolishing oxygen evolution capability by Tris treatment, did not alter this basic inhibition pattern. Copper was also found to lower the fluorescence yield of chloroplasts treated with linolenic acid which inhibited the secondary electron transport on both oxidizing and reducing sides of PSII. The data indicate that copper adversely affects the primary charge separation at the PSII reaction center. We suggest that the inhibition is due to creation of a lesion close to the reaction center, leading to increased dissipation of incoming excitation energy to heat.

Pseudocarcinomatous hyperplasia

Pseudocarcinomatous hyperplasia is not fundamentally a hyperplasia of epidermal epithelium, but rather a hyperplasia of adnexal epithelia, namely, of follicular infundibula and eccrine ducts. All examples of pseudocarcinomatous hyperplasia are responses to an underlying inflammatory or neoplastic process. That process can usually be discerned beneath the pseudocarcinomatous hyperplasia in the biopsy specimen. Application of criteria that pertain mostly to architectural pattern (silhouette) enables pseudocarcinomatous hyperplasia to be differentiated histopathologically from squamous cell carcinoma.

The structure of the gene for cecropin B, an antibacterial immune protein from Hyalophora cecropia

Pupae of the moth Hyalophora cecropia respond to an injection of live bacteria by the production of a potent antibacterial activity. The broad-spectrum property of this activity is due chiefly to two small proteins, cecropins A and B. Sequences of the proteins showed them to be homologous and to contain 37 and 35 amino acid residues respectively. The subsequent isolation of two cDNA clones for cecropin B showed that this protein is made as a prepro molecule composed of 62 amino acid residues. We have now prepared a genomic bank and studied four genomic clones for cecropin B. The coding regions were found in two neighbouring BglII fragments, one 0.79 kb and another varying in size from 3.1 kb to 4.9 kb for different clones. One transcriptional unit for preprocecropin B was sequenced and found to be 1035 bp long with a single intron, 514 bp in size. A conserved, insect specific cap site, ATCATTC, was identified by S1 mapping and primer extension experiments. Indications were found for the presence of multigene families and multicopy genes.

Ganglioneuromatous tumor of the skin: a combined heterotopia of ganglion cells and hamartomatous neuroma: report of a case

We report the histologic and ultrastructural findings of a solitary, unusual cutaneous tumor in a 69-year-old woman. The tumor is characterized by many mature ganglion cells in the papillary dermis and fascicles of unmyelinated axons in the lower dermis. The lesion is ganglioneuromatous but differs from the other ganglioneuromas histologically in that the ganglion cells do not intermingle with the neuromatous elements. It may represent a combined heterotopia of ganglion cells and hamartomatous neuroma. The histologic differential diagnosis and the possible pathogenesis are discussed.

Effects of exposing rat embryos in utero to physical or chemical teratogens are expressed later as enhanced induction of heat-shock proteins when embryonic hearts are cultured in vitro

In order to get more insight into the effects of teratogens on developing embryos, we investigated the protein synthesis patterns of the target organs isolated from teratogen-treated embryos. Rat embryos were either irradiated in utero with either 252Cf fission neutrons or 60Co gamma rays on day 8 of gestation or treated in utero with a bis(dichloroacetyl)diamine (a chemical teratogen) on days 9 and 10. Hearts were removed from the embryos on day 12 and were incubated in vitro at 37 degrees C in the presence of [35S]methionine for up to 8 hr. The newly synthesized labeled proteins were then analyzed qualitatively by two-dimensional polyacrylamide gel electrophoresis. Enhanced and prolonged induction of a family of heat-shock (stress) proteins with a molecular weight of about 70,000 (SP70s) was observed as compared with those of controls. Among the teratogen-treated hearts, those with gross malformations already detectable at this early stage showed especially higher inductions of SP70s than did the others. The abnormal expression of SP70s observed in the present study appears to be a reflection of persisting cellular (tissue) damage inflicted by the teratogens, and the extent of the induction may be indicative of the degree and/or type of the damage. Such persisting defects in surviving cells, manifested by abnormal induction of SP70s in the present study, might be related to malformation of embryonic hearts.

Natural variation in passive sodium permeability in human erythrocytes

The rate of influx of 22Na+ into human erythrocytes (RBC) varies greatly depending upon the donor. A high rate of influx may be related to a congenital predisposition to essential hypertension. In Northern Europeans, we find a threefold difference in the rate of 22Na+ influx between those with the least (LP) and most highly permeable (HP) RBC (from less than 0.15 to greater than 0.60 mmol Na+/liter RBC/hr). In order to further define determinants of these apparently hereditary differences in passive membrane Na+ transport, we identified two groups of normal laboratory and hospital personnel differing markedly (greater than twofold) in RBC 22Na+ influx rate. We find that the loop diuretics furosemide and bumetanide decrease by about 50% the influx of 22Na+ into HP RBC, but have a lesser influence on LP RBC. Impermeant polyanions such as citrate and pyrophosphate also specifically diminish 22Na+ influx into HP, but not LP, RBC. Therefore, the exaggerated 22Na+ influx into HP RBC probably occurs through a discrete pathway (perhaps via "Na/K/Cl cotransport"), which appears to be almost absent in LP RBC. The differences between HP and LP RBC most likely do not involve polymorphisms of RBC anion transport per se. The rate of RBC anion (35SO4(2-)) transport is the same in HP and LP RBC and is equally inhibited by furosemide and (to a lesser extent) bumetanide. Furthermore, the potent inhibitor of RBC anion transport, DIDS (diisothiocyanostilbene disulfonate) does not affect RBC Na+ permeability in either group. Nonetheless, the preferential reduction of Na+ permeation of HP RBC by loop diuretics may be of help in experimentally distinguishing HP from LP phenotypes. This information may be crucial in unraveling the structural basis of intrinsic differences in cell membrane Na+ permeability and their possible relationship to essential hypertension.

Overexpression and purification of a biologically active rifampicin-resistant beta subunit of Escherichia coli RNA polymerase

The gene rpoB (rifD 18), which encodes rifampicin-resistant beta subunit of Escherichia coli RNA polymerase, has been placed on an overexpression plasmid under the control of bacteriophage T7 promoter. Induction of the T7 RNA polymerase gene in the host cells resulted in extensive overproduction of the beta polypeptide. Most of the overproduced material was recovered from cell lysates in insoluble form and was solubilized by extraction with 6 M urea. Purified overproduced beta subunit was added, in molar excess, to urea-denatured rifampicin-sensitive RNA polymerase. Upon removal of urea by dialysis, the reconstituted enzyme became rifampicin-resistant, indicating that overproduced beta subunit can be efficiently assembled into functional holoenzyme.

Effects of a mild and prolonged restriction in sodium or food intake on the circadian rhythm of aldosterone and related variables

The effect of a mild reduction in dietary sodium intake (-30 mEq/24 hr) and body weight (-2 kg/2 months) on circadian rhythms of urinary aldosterone (UA), sodium (UNa), potassium (UK), creatinine (UC) and volume (UV) have been investigated in nine clinically healthy subjects. The mild reduction in dietary sodium is associated with: (1) a decrease in the 24-hr excretion rate of UNa, UK and UV, and an increased mesor of UA and UC; (2) a lowered extent of the circadian variation for UNa, UK, UV and a greater amplitude for UA and UC (3) a later crest in the temporal phase for UK, UA, UC, an earlier phasic wave for UNa. The mild reduction in calorie intake resulting in a body weight loss is associated with a more pronounced decrease in the 24-hr excretion rate of UNa and UK, and in the extent of circadian fluctuation for UNa. Peculiar events are: (1) the decreased 24-hr excretion rate for UA, and the increased mesor for UV; (2) the extent variability increased for UV, decreased for UC. Such effect may have a practical resonance for heuristic physiology since the role of dietary sodium and food intake has been better clarified. Dietary sodium and food can be regarded as 'chronomodulatory agents' for the adrenal cortex since their adrenotropic influence is extended to the tonic as well as phasic secretion of aldosterone.

The two binding sites for DCMU in Photosystem II

Measurements on the fluorescence induction of Triton X-100 extracted Photosystem II (PSII) particles confirmed the existence of the two sites of inhibition in PSII for the herbicide DCMU. The two sites were located on the reducing and oxidizing sides of PSII, respectively. The inhibition on the oxidizing side, unlike that on the reducing side which was of the "none or all" type, was found only to slow down the electron donation at low concentrations of DCMU. The results also suggested that the inhibitions of DCMU at these two sites were mutually exclusive, i.e., the binding on one site prevented the binding on the other site.

Benign histiocytoma (xanthoma) of the rib

A 64-year-old man was found to have isolated focal rib lesion(s) by radiographs and radionuclide bone scan. A biopsy of one of the lesions located by imaging was done. The histologic diagnosis was sclerosing (ossifying) xanthoma. A literature search disclosed that xanthomatous lesions of bone are only one of the manifestations in hyperlipidemic patients. These benign lesions should be included among the causes of discrete hot rib abnormalities visualized on bone scan.

Radiation-induced chondrosarcoma of the clavicle complicating Hodgkin's disease. A case report

Review of the literature reveals that postradiation chondrosarcoma is a rare secondary malignant bone tumor. This case report demonstrates a Grade 1 chondrosarcoma of the proximal right clavicle in a 17-year-old boy, eight years after extensive chemotherapy and radiation therapy for a Stage IIB Hodgkin's disease.

Selective vasodilation produced by renal denervation in adult spontaneously hypertensive rats

The kidneys of adult male spontaneously hypertensive rats (SHR) were denervated, and systemic and regional blood flows were measured 3 to 5 hours or 5 days after denervation. Arterial pressure was reduced 20 to 27% in denervated SHR during both periods compared with that in sham-operated SHR (iliolumbar blood vessels painted with phenol). This hypotensive response was produced by a 32 to 35% reduction in total peripheral resistance. At 3 to 5 hours and at 5 days, a major decrease in total peripheral resistance was produced by vasodilation in the kidneys and splanchnic organs. Acute urine output, sodium excretion, and plasma renin activity in response to a saline load were not different between sham-operated and denervated SHR. The decreased total peripheral resistance in denervated SHR may have been secondary to a decreased central sympathetic nerve activity revealed by a decreased maximum response to ganglionic blockade. The results suggest that a pathophysiological link may exist between the kidneys and splanchnic organs in genetic hypertension and that specific efferent antiadrenergic or antiafferent nerve therapy, or both, in the kidney may lead to substantial specific decreases not only in renal vascular resistance but also in splanchnic vascular resistance and total peripheral resistance.

Anaplastic carcinoma of urinary bladder with oat cell features

Anaplastic carcinoma of the urinary bladder, with oat cell-like components, is rare. We report such a tumor in a fifty-nine-year-old man, who died of rapidly disseminated carcinoma in one year despite postoperative radiotherapy and chemotherapy.

Congenital giant craniopharyngioma

A case of a huge congenital craniopharyngioma in a male infant was reported with a review of five similar cases from the literature.

Effective multimodality treatment for advanced epidermoid carcinoma of the female genital tract

Fifteen patients with advanced or recurrent squamous-cell carcinoma of the cervix, vulva, vagina, and urethra were treated with simultaneous combination chemotherapy (5-fluorouracil infusion and mitomycin C) and radiotherapy (3,000 rad for a period of three weeks). Three to four weeks after completion of radiotherapy, 13 of 15 patients achieved partial or complete tumor shrinkage. Nine of 15 patients are alive, eight of whom (at a median follow-up time of 24 months) have no evidence of disease. The longest survival time was 45 + months. There was minimal toxicity associated with this therapy. The results of this pilot study suggest that the simultaneous administration of radiation and chemotherapy is an effective method of treatment of advanced female genital tract carcinoma.

Duodenal somatostatin-containing tumor with psammoma bodies

A duodenal tumor was found in a 68-year-old woman undergoing routine cholecystectomy for chronic cholecystitis associated with cholelithiasis. Microscopically, the tumor contained glandular structures and psammoma bodies. Electron microscopic examination demonstrated numerous intracytoplasmic neurosecretory granules consistent with endocrine D cells. Immunoperoxidase staining for somatostatin was positive in the tumor cells. The tumor appeared to be different from the somatostatinomas reported in the literature in that it was nonfunctional, located in the duodenum, and associated with psammoma bodies.

The high affinity binding site for calcium on the oxidizing side of photosystem II

Preparations of photosystem II complex from spinach chloroplasts with Triton X-100 were treated with 1 M KCl to release 17 KDa and 23 KDa polypeptides. The inhibited oxygen evolution activity could be reactivated by adding high concentration (mM) of Ca++ or by reconstituting 17 KDa and 23 KDa polypeptides which were found to promote high affinity binding of Ca++ to the reconstituted membranes (Ghanotakis et al. FEBS (1984) 170, 169-173). Inclusion of 50 mM Ca++ during KCl treatment did not prevent the release of 17 KDa and 23 KDa polypeptides but protected oxygen evolution from being inactivated. It is explained by preservation of the high affinity binding site for Ca++ if, Ca++ is present during the salt treatment even though depletion of 17 KDa and 23 KDa polypeptides usually results in replacement by a low affinity (mM) binding site for Ca++. It also implies that the high affinity binding site is not located on 17 KDa and 23 KDa polypeptides.

Molecular cloning, cDNA sequencing, and chemical synthesis of cecropin B from Hyalophora cecropia

Two cDNA clones containing coding information for cecropin B from the Cecropia moth (Hyalophora cecropia) were identified by means of a synthetic probe. Sequencing of the two inserts showed that cecropin B is processed from a 62-amino acid residue precursor molecule including a 26-residue leader peptide and a COOH-terminal glycine residue. The latter presumably donates the nitrogen of the amide group present on the COOH-terminal leucine residue of the mature cecropin B. The sequence deduced for the mature cecropin B differed in the COOH-terminal region from the tentative structure previously determined by carboxypeptidase digestion. To settle the discrepancy, cecropin B was synthesized according to the cDNA sequence with an amidated COOH-terminal leucine. Natural and synthetic cecropin B were found to be indistinguishable with respect to electrophoretic mobility and antibacterial activity against seven different bacteria. The COOH-terminal tetrapeptides were isolated from both natural and synthetic cecropin B and found to be indistinguishable. The correct sequence for cecropin B is (formula; see text).

An efficient medical database system implementation with its tool and data structure consideration

The development of a new system for medical database application running on minicomputer under MUMPS system is described. Two kinds of data representation in global structure are briefly reviewed. The use of a subject oriented multi-dimensional data structure greatly simplifies database design and facilitates data manipulation, organization, selective retrieval and software development. It is concluded that the program generator approach can provide the flexibility necessary for various applications and future growth of computerized medical record system. The final system has been proven effective in practical operation. The future extension concerns the introduction of multi-microprocessor structure and logic representation is presented.

Symptomatic radiation-induced pericarditis in Hodgkin's disease

This is a retrospective review of 193 evaluable patients treated with radiation therapy to the mediastinum for Stages I, II and III-A Hodgkin's disease. Eligible patients were those receiving 3000 rad or more to the mediastinum and no chemotherapy prior to the radiation. During the study period, 13 patients developed symptomatic pericarditis. The interval post treatment to the development of symptoms was six to 34 months. The incidence of pericarditis was studied as a function of: (1) the dose of radiation at a depth of 2 cm, 5 cm and the midplane of the mediastinum; (2) the ratio of anterior to posterior weighting of dose; (3) the presence or absence of intrathoracic tumor; (4) the size of the tumor when present; and (5) the fraction of the heart exposed to the radiation beam. There was a significant increase in the incidence of pericarditis with an increased dose of radiation at 2 cm, 5 cm and midplane depths and also with the presence of a large intrathoracic tumor. A reduction in mediastinal dose is recommended.

Altered regional vasodilator responses to glossopharyngeal nerve stimulation in spontaneously hypertensive rats

The hindlimb and renal vasodilator responses produced by electrical stimulation of the glossopharyngeal nerve were examined in adult (six to eight months) male spontaneously hypertensive rats (SHR) and Wistar-Kyoto (WKY) normotensive rats to ascertain whether central neurogenically activated vasodilator capacity of these regional vascular beds is altered in SHR. Changes in systemic blood pressure and regional blood flow were simultaneously measured, and vascular resistance was calculated. Glossopharyngeal nerve stimulation (3.0 volts, 0.3 ms) at the frequency of 10 Hz resulted in a significantly greater vasodilation (% decrease in resistance) in SHR than in WKY control for both the hindlimb (SHR - 13.0 +/- 1.5% versus WKY - 3.4 +/- 1.6%, P less than 0.01) and renal (SHR - 7.6 +/- 0.6% versus WKY - 1.3 +/- 0.4%, P less than 0.01) vascular beds. The linear portion of the frequency-response curves of hindlimb or renal vasodilation of SHR was shifted parallel to the left of the WKY curve. Stimulus frequencies required to produce a 20% reduction in hindlimb resistance and a 10% reduction in renal resistance were lower in SHR (hindlimb 17.0 +/- 1.8 Hz; renal 19.9 +/- 1.4 Hz) than in WKY control (hindlimb 24.6 +/- 1.1 Hz; renal 39.3 +/- 4.8 Hz; P less than 0.01). The maximal vasodilator response to glossopharyngeal nerve stimulation in the hindlimb vascular bed was similar in SHR and WKY control, but in the renal vascular bed SHR showed a greater maximal response compared to WKY normotensives (SHR - 16.3 +/- 0.9% versus WKY - 12.7 +/- 1.6%, P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

CT analysis of lung density changes in patients undergoing total body irradiation prior to bone marrow transplantation

Sequential changes in lung density measured by CT are potentially sensitive and convenient monitors of lung abnormalities following total body irradiation (TBI). Methods have been developed to compare pre- and post-TBI CT of lung. The average local features of a cross-sectional lung slice are extracted from three peripheral regions of interest in the anterior, posterior, and lateral portions of the CT image. Also, density profiles across a specific region may be obtained. These may be compared first for verification of patient position and breathing status and then for changes between pre- and post-TBI. These may also be compared with radiation dose profiles through the lung. A preliminary study on 21 leukemia patients undergoing total body irradiation indicates the following: (a) Density gradients of patients' lungs in the antero-posterior direction show a marked heterogeneity before and after transplantation compared with normal lungs. The patients with departures from normal density gradients pre-TBI correlate with later pulmonary complications. (b) Measurements of average peripheral lung densities have demonstrated that the average lung density in the younger age group is substantially higher: pre-TBI, the average CT number (1,000 scale) is -638 +/- 39 Hounsfield unit (HU) for 0-10 years old and -739 +/- 53 HU for 21-40 years old. (c) Density profiles showed no post-TBI regional changes in lung density corresponding to the dose profile across the lung, so no differentiation of a radiation-specific effect has yet been possible. Computed tomographic density profiles in the antero-posterior direction are successfully used to verify positioning of the CT slice and the breathing level of the lung.

Characteristics of the epitope of leukotriene B4 recognized by a highly specific mouse monoclonal antibody

Mouse monoclonal IgG2b antibodies to leukotriene B4 bind [3H]leukotriene B4 with an affinity one-thirtieth to one-third that of different rabbit antibodies to leukotriene B4. The concentrations of related ligands required to inhibit by 50% the binding of [3H]leukotriene B4 define cross-reactivities of approximately 100% for carboxyl-derivatives of leukotriene B4, 10% for 12(S)-leukotriene B4 and 8 cis-leukotriene B4, which were not distinguished from leukotriene B4 by polyclonal antibodies, 3-5% for the two isomers of 6 trans-leukotriene B4, 5% for 20-OH-leukotriene B4 and 20-COOH-leukotriene B4, and less than 1% for other leukotrienes, mono-hydroxy-eicosatetraenoic acids, and the two leukotriene B4-like isomers of 8, 15-di-hydroxy-eicosatetraenoic acid. Thus the monoclonal combining site is highly specific for the di-hydroxy-triene portion of leukotriene B4.

Insect immunity. Isolation and sequence of two cDNA clones corresponding to acidic and basic attacins from Hyalophora cecropia

The Cecropia moth has three known classes of antibacterial immune proteins, attacins, lysozyme and cecropins (earlier referred to as P5, P7 and P9, respectively). Six attacins with different isoelectric points have been purified. The N-terminal sequences for five of these forms imply that only two different genes exist. We have now isolated and sequenced two cDNA clones, one for the basic attacin and one for the acidic form. The two mature proteins show 76% homology at the nucleotide level, while the regions beyond the stop codons are 36% homologous. The differences in the content of aspartic acid accounts for the difference in net charge between the acidic and basic attacin. Further differences in charge can be obtained by post-translational removal of a lysine-containing tetrapeptide at the C-terminal end of the two proteins. Evidence for a prepro form of the basic attacin is presented.

An analysis of neuroblastoma at a single institution

Between 1949 and 1978, 119 children with the diagnosis of neuroblastoma or ganglioneuroblastoma were treated at the Washington University Medical Center. Of these, 50 (41%) were alive and disease-free 3 or more years after diagnosis. Important prognostic variables included stage of tumor (Evans staging), histology, age at diagnosis, and site of primary tumor. A stepwise logistic regression analysis of these data has shown that, in order of significance, stage, histology and age at diagnosis are independent prognostic variables. Sex of the patient and nodal status at diagnosis (where known) were not significant prognostic variables. No effects of individual treatment modalities could be detected. This study confirms the overwhelming influence of factors unrelated to treatment in determining the prognosis of neuroblastoma.

Differential blocking effects of prazosin and yohimbine on vasopressor responses to sympathetic nerve stimulation and intravenous norepinephrine in the pithed rat

The effects of prazosin and yohimbine on the vasopressor response to sympathetic nerve stimulation, and to i.v. administration of norepinephrine were studied in the pithed rat to ascertain whether prazosin and yohimbine would preferentially block pressure responses due to exogenous versus endogenous alpha-adrenergic receptor activation. Prazosin (3 and 10 micrograms/kg, i.v.) was more effective in blocking the response due to sympathetic nerve stimulation than that due to i.v. norepinephrine. On the other hand, yohimbine (0.3 and 1 mg/kg, i.v.) produced greater inhibition of the i.v. norepinephrine response than the sympathetic nerve stimulation response. Yohimbine at the 0.1 mg/kg dose enhanced the nerve stimulation response while at higher doses the response was either unchanged (at 0.3 mg/kg) or substantially reduced (at 1 mg/kg). In this model, prazosin and yohimbine showed dose-related blocking effects on the pressor response of phenylephrine and clonidine, respectively. The results suggest that prazosin and yohimbine preferentially block the pressor responses of postsynaptic alpha-adrenergic receptor activation due to endogenous and exogenous norepinephrine, respectively. The diverse effects of yohimbine on the sympathetic nerve stimulation response may be due to an action on both the presynaptic (low dose) and postsynaptic (high dose) alpha-2 adrenergic receptors in vascular smooth muscle.

Systemic and regional haemodynamic effects of renal denervation in spontaneously hypertensive rats

Systemic and regional haemodynamic effects of renal denervation were evaluated in adult (six-month-old) male spontaneously hypertensive rats (SHR) using the Fick procedure and electromagnetic flowmetry technique. Renal denervation (bilateral, 10% phenol in ethanol), performed five to eight days before the experiment, resulted in a significant decrease (-12%) in arterial pressure in conscious SHR (denervated = 182 +/- 4 versus sham = 207 +/- 8 mmHg, P less than 0.05) that was associated with a reduction in total peripheral resistance (TPR: denervated = 1.83 +/- 0.19 versus sham = 2.78 +/- 0.29 mmHg/ml/min, P less than 0.05) and an increase in cardiac output (denervated = 106 +/- 10 versus sham = 80 +/- 9 ml/min, P less than 0.05). Heart rate was not different between the two groups. Renal, hindquarter and superior mesenteric blood flows, determined under pentobarbital anaesthesia, of denervated SHR were not significantly different from sham values. Renal vascular resistance (mmHg/ml/min) was substantially reduced (-39%) in the denervated SHR (denervated = 25.1 +/- 1.86 versus sham = 41.1 +/- 3.48, P less than 0.01), but vascular resistances in the hindquarter and superior mesenteric beds were not reduced significantly. In this preparation TPR was reduced 32% in denervated SHR. The data demonstrate that renal denervation in adult SHR proves an antihypertensive vasodilator-like effect related to a decrease in TPR with increased cardiac output. The reduction in renal vascular resistance in denervated SHR may produce a major contribution to decreased TPR. Other beds may also contribute to the decrease in TPR, although to a lesser extent, since the decrease in TPR cannot be fully accounted for by decreased renal vascular resistance.

Accrual of radiotherapy patients to clinical trials

Recruitment of patients to clinical trials is a multi-stage process. To participate in a protocol, a patient must meet all the eligibility requirements; the physicians managing the patient must be amenable to enrolling the patient on protocol; and finally, the patient must consent to participate. In 1979, 64 clinical trials were open to patient accrual in the Division of Radiation Oncology, Mallinckrodt Institute of Radiology, St. Louis, Missouri. A total of 1103 cases were reviewed. Two hundred sixty-three patients were eligible for one of the protocols, of whom 124 were successfully recruited. The reasons for ineligibility and nonparticipation are discussed.

Characterization of cell surface antigens of human mammary epithelial cells with monoclonal antibodies prepared against human milk fat globule

Hybridomas have been prepared that secrete monoclonal antibodies against three different surface antigens of normal human mammary epithelial cells by fusion of mouse myeloma cells with spleen cells from mice and rats immunized with delipidated human milk fat globules. Using a novel method for molecular weight determination, the three different monoclonal antibodies, BLMRL-HMFG-Mc3, BLMRL-HMFG-McR2, and BLMRL-HMFG-Mc5, were found to identify molecules with apparent molecular weights of 46,000, 70,000, and 400,000 daltons, respectively. The latter is a mucin-like glycoprotein with a high sugar content and has not previously been described as a component of the human milk fat globule or of human mammary epithelial cell membranes. Single-cell quantitation of binding of monoclonal BLMRL-HMFG-Mc5 to three breast tumor cell lines using a Microscope Spectrum Analyzer and indirect immunofluorescence revealed a heterogeneous expression. Further, using a competitive radioimmunoassay, it was found that breast tumor cell lines differed by at least 10-fold in the 400,000-molecular-weight antigen content. None of the three antigens are detectable on several nonbreast cell lines, including normal breast fibroblasts.

Insect immunity. Isolation of cDNA clones corresponding to attacins and immune protein P4 from Hyalophora cecropia

Diapausing pupae of the Cecropia moth (Hyalophora cecropia) respond to an injection of live bacteria by the selective synthesis of certain types of RNA and immune proteins (designated P1-P9). The in vitro translation products of RNA from both injured and infected pupae showed specific patterns with a defined number of extra bands. Some proteins characteristic of the normal RNA were reduced in the immune RNA translation products. Antibody reaction was used to show the selective synthesis of immune proteins P4 and P5 with mRNA from pupae subjected to injury or infection. The protein synthesized in vitro, which cross-reacted with P5 antibodies, is most likely a precursor of the attacins described in the preceding paper. A cDNA clone bank was prepared and two clones were isolated and shown to contain 750 bp corresponding to P4 and 250 bp of attacin information. These clones were used to estimate the sizes of the mRNAs by Northern blotting and to estimate, by RNA/DNA hybridization, the levels of P4 and P5 mRNA. In vivo incorporation of [35S]methionine into attacins and P4 during different conditions was compared with the levels of the corresponding mRNA.

Chronopsies assess the within-day variability of blood pressure and pulse

Blood pressure and pulse were monitored throughout 24 hours in 13 middle-aged men using a sphygmomanometer with an automatically inflatable cuff. These volunteers were in part mistakenly believed to have a "mildly elevated blood pressure" (in the light of a conventional non-chronobiologic approach, involving time-unspecified spot checks of blood pressure). Within about 24 hours, blood pressures and pulse varied remarkably: the coefficient of variation extended from 6.9 to 14.9% for systolic blood pressure (SBP), from 8.5 to 15.4% for diastolic blood pressure (DBP) and from 8.0 to 17.9% for pulse. By applying the single cosinor method (involving the least-squares fit of a 24-hour cosine curve), statistically significant circadian rhythms were observed in SBP, DBP, and pulse in all but 2 cases. In most cases, the timing of peak values was estimated to be in the evening for all 3 variables. Circadian rhythmicity accounted for up to 46, 30, and 42% of the total variability of SBP, DBP, and pulse, respectively. This marked circadian rhythmic variability is an important aspect of cardiovascular function.

Age as a criterion for eligibility in a lung cancer clinical trial

The results of a clinical trial can be generalized only if the study sample is representative of the population with the disease entity under study. A prerequisite for patient participation in a clinical trial is that all the eligibility criteria be met. In many cooperative group trials, it is common practice to use age as a criterion for eligibility on the premise that advanced age is an unfavorable prognostic factor. In this paper, we evaluate the bias introduced in a sample when this practice was followed in a lung cancer protocol. Of 653 lung cancer cases reviewed, 77 met the eligibility criteria; an additional 23 patients were ineligible for the trial solely on the basis of age. There was no significant difference in survival between these two groups of patients. This indicates that age is not an unfavorable prognostic factor for patients with lung cancer and should not be used as a criterion for eligibility in a clinical trial.

Alternative approaches to evaluating the impact of local control on survival

An important aspect of evaluating treatments aimed at local tumor control is to assess the effect of local control on survival. A common approach to this problem is to compare all patients who have failed locally with those who have not using a logrank test. However, this method of analysis does not take into account the effect of time on a patient's local disease status. Since patients in the local failure group must survive long enough to fail, this group may be biased in favor of longer survival times. The Mantel-Byar extension of the logrank test avoids this source of bias by utilizing the data on time to local failure in defining the local control and local failure groups. In this paper, the application of this technique is illustrated using data from recurrent breast cancer patients and contrasted with the results obtained using the standard logrank test.

The risk of second primaries subsequent to irradiation for cervix cancer

A review of 1048 patients with cancer of the cervix treated with radiation, either alone or combined with surgery, disclosed 32 cases of second primary malignancies occurring from 1 to 16 years subsequent to treatment. Using the person years approach, the incidence rate of second primaries was 5.49 per 1000 person years, which is not significantly different from population based rates. The anatomic locations of the new malignancies and the times from treatment of the cervix cancer to diagnosis of a new primary are presented; the possible carcinogenic effects of radiation are discussed. In this group of patients, it was concluded that under the period of observation irradiation administered at therapeutic doses did not increase the probability of second malignancy in the pelvis or at other sites.