A new antithrombotic agent, aspalatone, attenuated cardiotoxicity induced by doxorubicin in the mouse; possible involvement of antioxidant mechanism

A new antithrombotic agent, aspalatone (APT; acetyl salicylic acid maltol ester), was synthesized by esterification of acetyl salicylic acid (ASP) and maltol (MAL). It was suggested that APT possessed an antioxidant effect in in vitro. To evaluate the putative antioxidant effect of APT in in vivo, we developed doxorubicin (DOX)-related cardiac damage, which might be implicated by oxidative stress. Vitamin E (Vit E) was included in the present study as an example of an antioxidant. Prolonged treatments with APT, MAL and Vit E significantly reduced the mortality in animals receiving multiple dose of DOX (3 mg/kg x 4). The potential role of APT, MAL and Vit E against DOX insult may be explained by the induction of glutathione peroxidase activity accompanied by the inhibition of lipid peroxidation. Prolonged treatments of APT, MAL and Vit E also ablated histopathological evidence of DOX cardiomyopathy. ASP challenge, however, did not affect the mortality, myocardial lesion and antioxidant deficit induced by DOX treatments. In conclusion, the protective effect of APT was equipotent to that of Vit E against DOX cardiotoxicity. The results also suggest that the antiperoxidative effect of APT plays a protective role in DOX-related cardiotoxic side effect.

Pre-emptive ganciclovir treatment can play a role in restoration of hematopoiesis after allogeneic bone marrow transplantation

We performed pre-emptive ganciclovir therapy on two allogeneic bone marrow transplant (BMT) recipients with myelosuppression associated with cytomegalovirus (CMV) antigenemia after successful engraftment. During the hypoplastic phase, the nucleated cells in the bone marrow and peripheral blood were revealed to be of donor origin by DNA fingerprinting. These two patients had CMV antigen in their peripheral leukocytes. Following the pre-emptive ganciclovir treatment, both of them showed gradual recovery of granulocytes and platelets. They are still alive with stable bone marrow function. From these results, we suppose that infection or reactivation of CMV can suppress bone marrow function after bone marrow transplantation, and the pre-emptive ganciclovir therapy based on the CMV antigenemia may be beneficial if bone marrow function deteriorates after engraftment.

Activation of ribosomal protein S6 kinase in psoriatic lesions and cultured human keratinocytes by epidermal growth factor receptor ligands

p70 Ribosomal protein S6 kinase is a critical down-stream effector of a mitogen-stimulated signaling pathway that is selectively inhibited by the immunosuppressant rapamycin. The purpose of this study was to quantify S6 kinase expression in psoriatic involved, uninvolved, and normal epidermis and to characterize regulation of S6 kinase activity in cultured normal human keratinocytes. S6 kinase activity was increased 4-fold in psoriatic lesions (1.63 +/- 0.25 pmol per min per mg, n = 6), compared to nonlesional (0.44 +/- 0.12 pmol per min per mg, n = 6, p < 0.01), and normal (0.35 +/- 0.14 pmol per min per mg, n = 7, p < 0.01) epidermis. In contrast, S6 kinase mRNA and protein levels were not significantly different among psoriatic lesional, nonlesional, and normal epidermis. In keratinocytes, S6 kinase activity was stimulated 3-fold by mitogenic epidermal growth factor (EGF) receptor ligands, EGF and transforming growth factor-alpha (TGF-alpha), but not by cytokines interleukin-1alpha, tumor necrosis factor-alpha, interferon-gamma, or transforming growth factor-beta1. TGF-alpha stimulation of S6 kinase activity was inhibited in a concentration-dependent manner by rapamycin (IC50 < 0.2 nM) and the specific EGF receptor antagonist PD153035 (IC50 = 20 nM). Rapamycin also inhibited EGF-stimulated proliferation of keratinocytes (IC50 = 0.2 ng per ml) with a potency similar to that reported for inhibition of T-cell proliferation. We conclude: (i) the mitogenic signaling pathway(s) regulating S6 kinase is activated in psoriatic lesions, thus accounting for increased S6 kinase activity in the absence of increased S6 kinase gene or protein expression; (ii) S6 kinase activation in lesional keratinocytes likely occurs in response to EGF receptor stimulation by TGF-alpha and/or amphiregulin, which are known to be elevated in psoriatic lesions; and (iii) keratinocyte as well as T-cell mitogenic signaling pathways are susceptible to inhibition by rapamycin, suggesting that rapamycin may be of therapeutic benefit in the treatment of psoriasis.

Bilateral primary renal non-Hodgkin's lymphoma presenting with acute renal failure: successful treatment with systemic chemotherapy

Primary renal non-Hodgkin's lymphoma (NHL) with acute renal failure is a very rare condition, which frequently occurs in bilateral renal involvement. We report a 26-year-old male with primary bilateral renal NHL presenting with acute renal failure. A CT scan of the abdomen showed markedly enlarged kidneys with multinodularity and para-aortic lymphadenopathy. A percutaneous renal biopsy demonstrated 'follicular center lymphoma, diffuse, small cell'. Thirteen cycles of systemic chemotherapy with cyclophosphamide-doxorubicin-vincristine-prednisolone (CHOP) and ifosfamide-methotrexate-etoposide-bleomycin (IMVP-Bleo) regimens were administered, which resulted in normalization of renal function with improvement of renal lymphoma. Since there was no further change of renal lesions after initial partial remission, a follow-up renal biopsy was performed 10 months after diagnosis, and no residual lymphoma was found.

Highly specific cytochrome P450-like enzymes for all-trans-retinoic acid in T47D human breast cancer cells

When human breast cancer T47D cells were treated with all-trans-retinoic acid (RA), the RA 4- and 18-hydroxylase activities were induced in microsomes in a time-dependent manner, indicating that these cells readily metabolized RA into more polar compounds, such as all-trans-4-hydroxy-RA and all-trans-18-hydroxy-RA. In contrast, T47D cells treated for 12 h with xenobiotics, such as phenobarbital, beta-naphthoflavone, 3-methylcholanthrene, and dimethylsulfoxide, showed lower levels of catalytic activities for 4- and 18-hydroxylases. The induction of 4- and 18-hydroxylase activities appears to be regulated at the level of transcriptional control (basal level). Competitive assays demonstrated that inhibitors and substrates for 1A, 2A, 3A, 2B, and 2C cytochrome P450 (P450 subfamilies), all-trans-retinol, and all-trans-retinal showed no inhibition of RA metabolism, but other retinoic acid derivatives competed highly with RA. The RA-inducible 4- and 18-hydroxylases showed high specificity for RA and high levels of catalytic activities, with Km and maximum velocity values for 4-hydroxylase equal to 99 nmol/L and 0.26 pmol/min.mg protein, respectively, and those for 18-hydroxylase equal to 65 nmol/L and 0.18 pmol/min.mg protein. Cell-free metabolism of RA required microsomes from RA-treated cells and NADPH, and was inhibited by liarozole, an inhibitor of P450. These data suggest that RA-inducible 4- and 18-hydroxylases may be novel P450 isozymes.

Overexpression of c-ErbB-2 protein in gastric cancer by immunohistochemical stain

An immunohistochemical stain to the c-ErbB-2 protein was performed in 225 paraffin-embedded tissue blocks from patients with locally advanced gastric cancer who underwent curative resection. The overexpression of the c-ErbB-2 protein was observed in 27.4% of the patients. The c-ErbB-2 positivity showed a statistically significant correlation with nodal status and stage. The patients with an overexpression of the c-ErbB-2 protein had a tendency to a shorter survival than those without, but it was not statistically significant (p = 0.08). The 5-year survival rate after surgery was 54% in the negative staining group to the c-ErbB-2 protein and 49% in the positive staining group. This suggests that the c-ErbB-2 protein has a possible role in lymph node metastasis. Therefore overexpression of the c-ErbB-2 protein is a useful indicator of disease progression in gastric carcinoma patients who received curative surgery.

Interleukin-6 concentrations in umbilical cord plasma are elevated in neonates with white matter lesions associated with periventricular leukomalacia

OBJECTIVE

Periventricular leukomalacia, a common brain white matter lesion in preterm neonates, is a major risk factor for cerebral palsy. Recently, cytokines (i.e., tumor necrosis factor and interleukin-1(beta)) have been implicated as mediators for the development of periventricular leukomalacia. The purpose of this study was to examine the relationship between umbilical cord plasma levels of tumor necrosis factor-alpha, interleukin-1(beta), interleukin-6, and interleukin-1 receptor antagonist and the occurrence of periventricular leukomalacia in preterm neonates.

STUDY DESIGN

Umbilical cord blood was collected from 172 consecutive preterm births (25 to 36 weeks). Periventricular leukomalacia-associated lesions were diagnosed by brain ultrasonography within the first 3 days of life. Tumor necrosis factor-alpha, interleukin-1(beta) interleukin-6, and interleukin-1 receptor antagonist were measured by sensitive and specific enzyme-linked immunoassay methods. Umbilical cord arterial pH was measured at birth. Statistical analysis was performed with multiple logistic regression and receiver operating characteristic curve analysis.

RESULTS

Periventricular leukomalacia-associated lesions were present in 14.5% (25/172) of infants. Plasma concentrations of interleukin-6 but not of tumor necrosis factor-alpha, interleukin-1(beta), and interleukin-1 receptor antagonist were significantly higher in neonates with periventricular leukomalacia-associated lesions than in those without these lesions (median 718, range < 226 to 32,000 pg/ml vs median < 226, range < 226 to 43,670 pg/ml; p < 0.0001). An interleukin-6 value > or = 400 pg/ml had a sensitivity of 72% (18/25) and a specificity of 74% (108/147) in the identification of periventricular leukomalacia-associated lesions. Multivariate analysis showed that umbilical cord interleukin-6 was an independent risk factor for periventricular leukomalacia (odds ratio 6.2, p < 0.002) after correction for known confounding variables (i.e., gestational age at birth, umbilical artery pH, chorioamnionitis).

CONCLUSIONS

Interleukin-6 concentrations in umbilical cord plasma are elevated in neonates with periventricular leukomalacia-associated lesions. Our data support the hypothesis that periventricular leukomalacia may be the result of cytokine-mediated brain injury.

Gastric cancer in young patients who underwent curative resection. Comparative study with older patients

Although several studies demonstrated the poor prognosis of young patients with gastric cancer, there were few reports about the survival of young patients who underwent radical surgery. We retrospectively reviewed the hospital records of 697 patients with curatively resected locally advanced gastric cancer to compare the pathologic findings and prognosis of young patients (aged < 40 years; 91 patients) with those of older (aged > or = 40 years; 606 patients) patients. There were no significant differences in location of tumors, Borrmann types, tumor invasion, and pathologic stage between both age groups. Despite the male predominance in older patients, the male-to-female ratio was nearly equal in young patients (p = 0.022). A significantly higher percentage of young patients showed poorly differentiated histology including signet ring cell and undifferentiated carcinoma than older patients (p < 0.0001). Adjuvant chemotherapy was more frequently performed in the young patients with a variety of different regimens (85.7 vs. 72.3%; p = 0.009). The 5-year overall survival rate revealed no statistically significant differences between the young and older patients (53.1 vs. 56.6%; p = 0.820). In conclusion, the young patients with curatively resected locally advanced gastric cancer showed similar survival compared to that of older patients.

Minimally differentiated acute myelogenous leukemia presented with multiple cervical lymphadenopathy

Lymphadenopathy is a relatively uncommon finding of minimally differentiated acute myelogenous leukemia (AML-MO). We experienced a case of AML-MO in a 57-year-old man initially presented with multiple cervical lymphadenopathy. Bone marrow aspiration revealed myeloblasts, which were negative for myeloperoxidase, Sudan black B, Periodic acid-Schiff, non-specific esterase and double esterase reaction. In cell surface marker studies, CD13, CD14, CD33, CD34, CD45 and HLA-DR were present. CT scan of neck demonstrated multiple lymphadenopathy at both internal jugular chains, spinal accessory chains and submandibular area. He died about two weeks after diagnosis without specific treatment.

A case of rectal cancer with sternal metastasis as initial presentation

Colorectal cancer with bone metastasis as initial manifestation is a very rare event. We have reported a case of rectal cancer presenting with sternal metastasis. A 30 year-old man was evaluated due to pain in the sternal area with a bulging mass. History and physical examination did not suggest any specific disease. A radionuclide bone scan revealed increased uptake in the sternal area, right 6th rib, and sacrum. Microscopic examination of a biopsy specimen from the sternum showed metastatic adenocarcinoma. A barium enema and CT scan of the pelvis suggested carcinoma of the upper rectum. Adenocarcinoma of the rectosigmoid junction area was demonstrated by colonoscopic examination with biopsy. He received palliative transverse colostomy for obstruction without further treatment.

A carrot cDNA encoding an atypical protein kinase homologous to plant calcium-dependent protein kinases

Calcium-dependent protein kinases (CDPKs) in plants typically contain a C-terminal calmodulin-like domain with four EF-hand calcium-binding motifs. We have isolated a carrot somatic embryo cDNA clone which encodes a new, divergent isoform of this family, designated CRK (CDPK-related kinase). The catalytic domain of CRK shares a high degree of homology with the catalytic domains of plant CDPKs (53.5% average identity with its two closest phylogenetic relatives, CDPK431 (carrot) and AK1 (Arabidopsis). However, the C-terminal domain of CRK bears significantly less homology to calmodulin (22.0% identity to barley calmodulin) than other plant CDPKs (38.0% average identity between barley calmodulin and the C-terminal domains of CDPK431 and AK1). This degeneracy also involves the EF-hand motifs of CRK, which have diverged to varying extents. The predicted structure of CRK also contains an extended N-terminal domain 145 amino acids in length possessing a consensus N-myristoylation signal. CRK transcripts are most abundant in somatic embryos, with lesser accumulations in flowers and leaves and lowest levels in roots. Homologous genomic DNA sequences that hybridize with CRK cDNA but not with a carrot CDPK probe have been detected in a variety of higher plant taxa, including monocotyledonous species, suggesting that this CDPK-related kinase is widely conserved among angiosperms.

Bleomycin sclerotherapy in patients with congenital lymphatic malformation in the head and neck

Congenital lymphatic malformations of the head and neck often present challenging problems to the otolaryngologist-head and neck surgeon. Although surgical excision was agreed to be the treatment of choice for this disease, the infiltrating nature of lymphatic channels often increases the frequency of operative complications and recurrences of this lesion.

PURPOSE

Bleomycin sclerotherapy was attempted to avoid surgical risk and to cure this lesion.

MATERIALS AND METHODS

Clinical findings and treatment results were reviewed for patients with congenital lymphatic malformation and treated by bleomycin sclerotherapy.

RESULTS

Bleomycin sclerotherapy was a very effective therapeutic alternative. The best results were seen in cystic type 1 lesions in younger patients.

CONCLUSIONS

Bleomycin sclerotherapy is a useful medical alternative, and we believe that it should be attempted before excision of the lesion.

Suppression of mouse lymphocyte proliferation in vitro by naturally-occurring biflavonoids

In a continuing effort to investigate biological activities of flavonoids, nine biflavonoids, isolated from three plant sources were evaluated for their suppressive effects on mouse lymphocyte proliferation. The biflavonoids tested were amentoflavone, bilobetin, ginkgetin, isoginkgetin, sciadopitysin, ochnaflavone, 4'-O-methylochnaflavone, cryptomerin B and isocryptomerin. At 10 uM, several biflavonoids such as ginkgetin, isoginkgetin, ochnaflavone, cryptomerin B and isocryptomerin showed the suppressive activity against lymphocyte proliferation induced by Con A or LPS. Apigenin (flavone) and quercetin (flavonol) were suppressive against Con A-induced lymphocyte proliferation, but not against LPS-induced lymphocyte proliferation at the same concentration range. Biflavonoids were found to be irreversible inhibitors of lymphocyte proliferation. This is the first report describing the suppressive effects of naturally-occurring biflavonoids against lymphocyte proliferation.

Amniotic fluid interleukin-6: a sensitive test for antenatal diagnosis of acute inflammatory lesions of preterm placenta and prediction of perinatal morbidity

OBJECTIVE

Our purpose was to determine whether amniotic fluid concentrations of interleukin-6 are of value in the antenatal diagnosis of acute inflammatory lesions (histologic chorioamnionitis) of preterm placenta and in the prediction of perinatal morbidity and mortality.

STUDY DESIGN

The relation among placental histologic findings, perinatal outcome, and amniotic fluid interleukin-6 concentrations was examined in 50 consecutive patients who delivered preterm neonates within 72 hours after amniocentesis. Interleukin-6 was determined by enzyme-linked immunosorbent assays. Receiver-operator characteristic curve was used for analysis.

RESULTS

Patients with acute histologic chorioamnionitis had significantly higher median amniotic fluid interleukin-6 concentrations than patients without histologic chorioamnionitis (median 70.8 ng/ml, range 0.7 to 499.2 ng/ml vs median 2.9 ng/ml, range 0.8 to 16.0 ng/ml, respectively; p < 0.00001). An amniotic fluid interleukin-6 concentration > 17 ng/ml had a sensitivity of 79% (23/29) and a specificity of 100% (21/21) in the diagnosis of acute histologic chorioamnionitis and a sensitivity of 69% (18/26) and a specificity of 79% (19/24) in the prediction of significant neonatal morbidity (defined as neonatal sepsis, respiratory distress syndrome, pneumonia, intraventricular hemorrhage, bronchopulmonary dysplasia, or necrotizing enterocolitis) and mortality. These sensitivities were significantly higher than those of amniotic fluid culture (79% vs 38%, p < 0.005; 69% vs 27%, p < 0.01, respectively).

CONCLUSIONS

Amniotic fluid interleukin-6 is a sensitive test for the prospective diagnosis of acute histologic chorioamnionitis and the identification of neonates at risk for significant morbidity and mortality.

Perioperative blood transfusions and prognosis in patients with curatively resected locally advanced gastric cancer

Several reports have demonstrated an adverse effect of perioperative blood transfusions on the survival of patients with various solid tumors treated surgically. We retrospectively investigated the relationship between perioperative blood transfusions and the survival of 501 patients who underwent radical subtotal gastrectomy for locally advanced gastric cancer (stage II-IIIB) from January 1984 to December 1989. Three hundred and fifty-two patients (70.3%) received blood transfusions within the perioperative period. The transfused group included patients with tumors of larger size (5.1 vs. 4.4 cm, p = 0.001) and more advanced stage (stage IIIB: 27.6 vs. 10.7%, p = 0.0001) than the nontransfused group. Although the 5-year overall survival rate was significantly lower (52.9 vs. 66.7%, p = 0.026) in the transfused patients than the nontransfused, subgroup analysis according to the pathologic stage showed no statistically significant difference in survival in each stage between the two groups. In conclusion, we could not find any causal relationships between transfusion and prognosis in patients with curatively resected locally advanced gastric cancer. Circumstances such as advanced stage necessitating transfusions may be more important prognostic factors.

Brain synaptosomal aging: free radicals and membrane fluidity

Dietary restriction was used in this study as a modulator of free radical reactions to examine the effects of age on the physico-biochemical property of synaptosomal membranes. Synaptosomal membranes were isolated from the frontal cortices of 6- and 24-month-old barrier-reared male Fischer 344 rats maintained on either an ad lib (AL) or a 40% diet restricted (DR) feeding schedule. The age-related production of reactive oxygen species (ROS) was only seen in the AL group, and dietary restriction suppressed the amount of the reactive species at both ages. Although membrane fluidity significantly decreased with age in AL fed rats, no change occurred in DR rats. Because age-related increases in cholesterol/phospholipid occurred in both AL and DR groups, fluidity loss may be influenced by factors other than cholesterol. We suggest that lipid peroxidation may be a major factor in the change in fluidity during the aging process.

The effect of eradication of Helicobacter pylori upon the duodenal ulcer recurrence--a 24 month follow-up study

OBJECTIVES

To evaluate the effect of eradication of Helicobacter pylori(H.pylori) in the patients with duodenal ulcer(Du) upon the DU recurrence.

METHODS

This study was performed for 190 patients with DU. Four different methods-microscopy of Gram stained mucosal smear, specific culture, biopsy urease test, histology of H &E staining-were taken for identifying colonization of H. pylori before treatment, and for finding the eradication of H. pylori 4 weeks after completion of therapy in each treatment group (cometidine, omeprazole, colloidal bismuth subcitrate(CBS), CBS and metronidazole double therapy, CBS, metronidazole and amoxicillin triple therapy). To detect DU recurrence, the gastroscopy was performed at 6, 12, 18, and 24 months after therapy.

RESULTS

The eradication rate of the cimetidine group the omeprazole group, and the CBS group were 0%, 7.7%, 0%, respectively, and that of the double therapy group and the triple therapy group were 44.4% and 89.3%, respectively. Seventy three patients who were followed up for 2 years were categorized into two groups according to the eradication of H. pylori. The recurrence rate was 3.2% both in 1 year and 2 years later in the former group-one consisting of 31 patients with H. pylori eradicated, while the recurrence rate was 57.1% in 1 year and 78.6% in 2 years later, in the latter group-the other of 42 patients with H. pylori not eradicated.

CONCLUSION

The eradication of H. pylori in patients with DU reduces the recurrence of DU.

Esophageal duplication cyst complicated with intramural hematoma--case report

Esophageal duplication cysts account for a very small percentage of benign esophageal tumors and are infrequently symptomatic. Esophageal duplication cysts result from aberrant alignment of the normal vacuolization process that produce the esophageal lumen in the 5th to 8th week of embryonic life. Complications most often are bleeding into or infection of cysts. Recently, we experienced a case of esophageal duplication cyst complicated with intramural huge hematoma and the cause of hematoma could not be identified. We report it with a review of literatures.

Penetration of piperacillin-tazobactam into cancellous and cortical bone tissues

The penetration characteristics of piperacillin-tazobactam into cortical and cancellous bone tissues were investigated in 10 patients undergoing total hip replacement. The concentration ratios of piperacillin/tazobactam were 9.4 +/- 1.8 in cancellous bone tissue and 8.0 +/- 2.2 in cortical bone tissue, which were close to the 8:1 ratio of drugs administered. The mean ratios of drug concentrations in bone and plasma for cancellous and cortical tissue were 23 and 18%, respectively, for piperacillin and 26 and 22%, respectively, for tazobactam. The concentrations of tazobactam achieved are sufficient to exert anti-beta-lactamase activity and supportive of clinical trials involving bone and joint infections, including those caused by beta-lactamase-producing pathogens.

Changing trends in histologic types of lung cancer during the last decade (1981-1990) in Korea: a hospital-based study

A review of the histopathology and past history of 2229 patients with primary lung cancer diagnosed at the Yonsei University Medical Center from 1981 to 1990 was performed to investigate the changes in histologic types and the relationship to smoking history. The most frequent histologic type of lung cancer was squamous cell carcinoma (956 patients, 54.0%) followed by adenocarcinoma (311 patients, 17.6%) in males (1772 patients), and adenocarcinoma (206 patients, 45.1%) followed by squamous cell carcinoma (126 patients, 27.6%) in females (457 patients). In both sexes, the predominant type was adenocarcinoma under the age of 40, whereas squamous cell carcinoma was the most frequent type above the age of 40. While squamous cell carcinoma decreased over 10 years (54.3% in 1981, 44.3% in 1990), adenocarcinoma showed a gradually increased incidence (17.0% in 1981, 28.3% in 1990) in both sexes, and the proportion of small cell carcinoma and large cell carcinoma remained unchanged. These changes in histologic type were more prominent in non-smokers. In conclusion, the increasing incidence of adenocarcinoma in both sexes, especially in non-smokers, suggests the possible presence of etiologic factors other than smoking, such as environmental pollution.

Polymorphism of glucokinase gene in non-insulin dependent diabetes mellitus

Several lines of evidence suggest a strong genetic component to NIDDM. To clarify the role of glucokinase gene in the development of NIDDM, restriction fragment length polymorphism (RFLP) of glucokinase gene and 3' microsatellite polymorphism analyses by polymerase chain reaction-single strand conformational polymorphism (PCR-SSCP) were performed in NIDDM and control subjects. Compared to NIDDM with 1.3 kb allele/Pvu I digestion of glucokinase, 10% of NIDDM did not demonstrate 1.3 kb allele and these patients were characterized by increased insulin secretion. In 3' microsatellite polymorphism analysis, autoradiography of PCR products revealed three different alleles, including Z, Z + 2 and Z + 4. Z was the most common allele in both NIDDM and nondiabetic controls. There was no significant allele associated with NIDDM. Frequency of the homozygote Z/Z genotype was significantly lower in NIDDM subjects (16.7%) compared to normal control (46.7%)(p < 0.05). There was no difference in clinical findings according to 3' microsatellite genotypes in NIDDM. These data suggest that there does not appear to be a significant glucokinase allele associated with NIDDM but Z/Z genotype may play a suppressive role in the pathogenesis of a certain type of NIDDM in Korea. Further studies may be required to identify the molecular basis of this association.

Detection of Mycobacterium leprae DNA in formalin-fixed, paraffin-embedded samples from multibacillary and paucibacillary leprosy patients by polymerase chain reaction

BACKGROUND

Diagnosis of paucibacillary leprosy is often difficult. A method that could confirm the diagnosis is the polymerase chain reaction (PCR) of M. leprae DNA. This reaction was applied to biopsied tissues of leprotic patients to determine the suitability and sensitivity of the reaction.

METHODS

Biopsy samples were taken from previously untreated patients with multibacillary (5 patients) and paucibacillary (3 patients) leprosy, fixed in formalin, and embedded in paraffin. DNA was extracted from paraffin blocks and PCR applied. The sensitivity of the PCR method was tested by using the serially diluted DNA sample as the template.

RESULTS

All eight patients showed a positive PCR for M. leprae DNA. The sensitivity was such that a single organism of M. leprae, as counted by staining of the acid-fast bacilli was identified by the PCR.

CONCLUSIONS

The PCR method is simple, sensitive, specific, and does not require the use of radioisotopes. It can be applied to the unequivocal diagnosis of paucibacillary leprosy which is difficult by other means. The diagnosis can be obtained within 10 hours.

In vivo labeling of Escherichia coli cell envelope proteins with N-hydroxysuccinimide esters of biotin

The primary amine coupling reagents succinimidyl-6-biotinamido-hexanoate (NHS-A-biotin) and sulfosuccinimidyl-6-biotinamido-hexanoate (NHS-LC-biotin) were tested for their ability to selectively label Escherichia coli cell envelope proteins in vivo. Probe localization was determined by examining membrane, periplasmic, and cytosolic protein fractions. Both hydrophobic NHS-A-biotin and hydrophilic NHS-LC-biotin were shown to preferentially label outer membrane, periplasmic, and inner membrane proteins. NHS-A- and NHS-LC-biotin were also shown to label a specific inner membrane marker protein (Tet-LacZ). Both probes, however, failed to label a cytosolic marker (the omega fragment of beta-galactosidase). The labeling procedure was also used to label E. coli cells grown in low-salt Luria broth medium supplemented with 0, 10, and 20% sucrose. Outer membrane protein A (OmpA) and OmpC were labeled by both NHS-A- and NHS-LC-biotin at all three sucrose concentrations. In contrast, OmpF was labeled by NHS-A-biotin but not by NHS-LC-biotin in media containing 0 and 10% sucrose. OmpF was not labeled by either NHS-A- or NHS-LC-biotin in E. coli cells grown in medium containing 20% sucrose. Coomassie-stained gels, however, revealed similar quantities of OmpF in E. coli cells grown at all three sucrose concentrations. These data indicate that there was a change in outer membrane structure due to increased osmolarity, which limits accessibility of NHS-A-biotin to OmpF.

Combined use of tamoxifen, cyclosporin A, and verapamil for modulating multidrug resistance in human hepatocellular carcinoma cell lines

The intensive use of chemotherapeutic agents for the treatment of cancer has resulted in the cure or improved survival of many patients. But unfortunately, many cancers including human hepatocellular carcinoma (HCC) don't respond to chemotherapy. One of the major mechanisms for the drug resistance in the HCC is an elevated MDR1 RNA expression which makes cells become multidrug resistant. To overcome the multidrug resistance (MDR) phenotype, a high dose of verapamil is required both clinically and experimentally. Accordingly we have examined the MDR modulating effects with combinations of tamoxifen, cyclosporin A, and verapamil in vitro with the physiologically achievable concentrations of each agent, i.e., 2.0 microM/L for tamoxifen, 1.6 microM/L for cyclosporin A, and 2.5 microM/L for verapamil respectively in HCC lines. As expected, verapamil alone with the physiologically achievable concentration at which we tested didn't enhance the doxorubicin cytotoxicity in the HCC lines. Furthermore, any verapamil combination with cyclosporin A or tamoxifen was not effective in overcoming the doxorubicin resistance in the high MDR1 expressor (Hep-G2) line. However tamoxifen reduced the IC50 of doxorubicin by a factor of 1.9 in the low MDR1 expressor (SK-Hep1) and 1.1 in the high MDR1 expressor line (p < 10(-5) respectively). Of interest, combinations of tamoxifen and cyclosporin A showed a significant reduction in the IC50 of doxorubicin in both HCC lines. The IC50 of doxorubicin was reduced by a factor of 3.9 and 1.3, i.e., from 0.023943 micrograms/ml to 0.006157 micrograms/ml (p < 10(-5)) in the SK-Hep1 cell line, and 0.068819 micrograms/ml to 0.052442 micrograms/ml (p < 10(-5)) in Hep-G2 respectively when tamoxifen and cyclosporin A were administered together. Both the estrogen and progesterone receptors in the SK-Hep1 and Hep-G2 lines were less than 0.01 fmol/mg of cytosol protein, respectively. It is therefore suggested that the reversal of doxorubicin resistance is unrelated to their anti-estrogenic activity in the HCC lines. Three modulator combinations of tamoxifen, cyclosporin A, and verapamil were not more effective than the combination of tamoxifen and cyclosporin A on the sensitivity to doxorubicin. MDR modulators of tamoxifen, cyclosporin A, and verapamil didn't reduce the IC50 of cisplatin to the clinically achievable concentration range in HCC lines. In summary, the combination of tamoxifen and cyclosporin A at the concentrations normally seen after clinical administration of these modulators showed significant synergism on the sensitivity to doxorubicin in both low and high MDR1 expressor HCC lines. These data indicate the need for in vivo trials.