Rottlerin stimulates metallothionein gene expression but inhibits metal transport in Chinese hamster ovary cells

Metallothionein (MT) can be induced by various metals. We have shown previously that H7, a protein kinase C (PKC) inhibitor, inactivates metal-induced MT gene expression. To investigate whether a specific PKC isoform is involved in the induction process, inhibitors for various PKC isoforms were administered to cadmium-resistant Chinese hamster ovary (Cd(R)) cells. None of the inhibitors used can reduce metal-induced MT gene expression. However, a PKCdelta inhibitor, rottlerin, induced MT mRNA expression in Cd(R) cells in the presence or absence of Cd. Notably, the induction occurs through the activation of the MT transcriptional factor (MTF-1) and is not related to an increase of metal influx. Furthermore, metal accumulation is reduced in the presence of rottlerin. Pulse-labeling analysis indicated that MT protein synthesis increased in Cd(R) cells upon rottlerin treatment. These results suggest that rottlerin blocks metal transport but stimulates MT synthesis in Cd(R) cells. Since rottlerin is capable of reducing the cellular accumulation of Cd, it was expected that the cytotoxic effect of Cd would decrease in the presence of rottlerin. Treating the parental cell of Cd(R) with Cd and rottlerin together indeed showed a decline of cytotoxicity compared to cells treated with Cd alone. We further examined how MTF-1 was activated by rottlerin. Rottlerin-induced MTF-1 activity was not affected in Cd(R) cells by the addition of EDTA. It was, however, diminished by administering an intracellular Zn chelator, TPEN. The result implies a mobilization of intracellular Zn ions after rottlerin treatment in Cd(R) cells. To investigate whether the described results occur in all types of cells, another cell line (GH(3)) was used to study the effect of rottlerin on MT gene expression. The result revealed that rottlerin did not increase the amount of MT mRNA in GH(3) cells. This differential effect between cell lines may be useful for investigating the regulatory mechanism of MT gene expression.

Telomerase activity in human bladder tumors and bladder washing specimens

Telomerase appears to be an important factor for the control of cellular proliferation and tumorigenesis. Enzyme activity dramatically increases in almost all human tumors. The purpose of our study was to evaluate the role of telomerase activity as a marker for bladder cancer diagnosis and follow-up. By using the PCR-ELISA based on the TRAP (telomerase repeat amplification protocol) method, telomerase activity of bladder tumors (n = 77), normal-appearing adjacent tissues (n = 21) and bladder washings (n = 37) were analyzed. Telomerase activity was detected in 87% (67/77) of cancer tissues and in 38% (8/21) of normal-appearing adjacent tissues. However, the levels of enzyme activity were significantly higher in cancer tissues than in normal-appearing adjacent tissues (p < 0.05). Telomerase activity in bladder cancer tissues was not correlated to the tumor stage or grade. During a 26 months follow-up period, disease progression occurred in 66.7% of patients with invasive tumors where telomerase activity of the normal-appearing adjacent tissue was detectable, as compared to only 14.3% for patients who showed undetectable telomerase activity in adjacent, normal-appearing tissues (p = 0.094). When telomerase activity of bladder washing fluid was compared with its corresponding tumors, sensitivity of detection was 81% and specificity was 75%. In contrast, urine cytology only yielded a sensitivity of 31% in the detection of cancer. The detection ability between telomerase activity measurement in washing fluid and cytological examination had a trend toward the telomerase measurement identifying more cancer cases than the cytologic examination (p = 0.07). In conclusion, telomerase activity is present in early-stage bladder cancer and is a potential molecular marker for bladder tumors diagnosis. The expression of telomerase activity in normal-appearing mucosa adjacent to bladder tumor is probably an indicator of disease progression. Using the telomerase activity to detect exfoliated cells in bladder washing fluids could be a useful method in adjunct to urine cytology and cystoscopy in establishing the diagnosis and follow-up of bladder cancer.

Effects of verapamil on coronary vascular resistance in rabbits: measurement with pulsed Doppler velocimetry

BACKGROUND

Verapamil is an effective vasodilator. The purpose of this study was to investigate the in vivo effect of verapamil on coronary blood flow velocity and vascular resistance in anesthetized, open-chest rabbits.

METHODS

Twenty-one male New Zealand white rabbits were anesthetized, and a 3-mm suction-type pulsed Doppler velocimeter probe was applied to the proximal part of the left anterior descending coronary artery after median sternotomy. The rabbits received intravenous bolus infusion of 4 different doses of verapamil (0.01 mg/kg, n = 5; 0.1 mg/kg, n = 5; 1 mg/kg, n = 5, and 10 mg/kg, n = 6). The percent changes in coronary blood flow velocity and coronary vascular resistance were examined.

RESULTS

There was 10.0+/-1.6% increase in coronary blood flow (CBF) and 12.5+/-1.9% reduction in coronary vascular resistance (CVR) after infusion of 0.01 mg/kg of verapamil. The CBF increased 23.0+/-9.5% and CVR decreased 24.2+/-5.2% after infusion of 0.1 mg/kg of verapamil. Infusion of 1 mg/kg of verapamil induced 34.8+/-10.5% increase in CBF and 32.6+/-2.5% reduction in CVR. The CBF increased 41.1+/-14.8% and CVR decreased 45.1+/-5.4% after infusion of 10 mg/kg of verapamil.

CONCLUSIONS

Compared with baseline condition, all doses of verapamil increased coronary blood flow velocity and decreased coronary vascular resistance significantly in anesthetized, open-chest rabbits.

Comparison of hand-assisted laparoscopic nephroureterectomy with open surgery for upper urinary tract tumor

Herein we report on our initial experience in performing nephroureterectomy by hand-assisted laparoscopic surgery, and compare the results with those performed by traditional open methods. From December 2000 to September 2001, 10 patients with upper urinary tract tumors underwent hand-assisted laparoscopic nephroureterectomy. Except for one patient who required elective conversion to open surgery due to renal vein injury, this cohort of 9 patients was compared to a group of 35 patients who had received traditional open nephroureterectomy over the last 2 years. Demographic, intraoperative and postoperative data were compared retrospectively. These two groups were similar in age, body mass index, operation time and time to postoperative oral intake. However, the hand-assisted laparoscopy group was found to have significantly less blood loss, less need for parenteral narcotic and a shorter length of time needed for postoperative hospitalization than the open group. Thus, in this report we have demonstrated hand-assisted laparoscopic nephroureterectomy to be a safe and efficacious treatment of malignant urinary collecting tumors. We believe the benefits of this minimally invasive surgery make it a viable alternative technique for management of upper urinary tract tumor.

RT-PCR reveals muscarinic acetylcholine receptor mRNA in the pre-Bötzinger complex

Muscarinic receptors mediate the postsynaptic excitatory effects of acetylcholine (ACh) on inspiratory neurons in the pre-Bötzinger complex (pre-BötC), the hypothesized site for respiratory rhythm generation. Because pharmacological tools for identifying the subtypes of the muscarinic receptors that underlie these effects are limited, we probed for mRNA for these receptors in the pre-BötC. We used RT-PCR to determine the expression of muscarinic receptor subtypes in tissue punches of the pre-BötC taken from rat medullary slices. Cholinergic receptor subtype M(2) and M(3) mRNAs were observed in the first round of PCR amplification. All five subtypes, M(1)-M(5), were observed in the second round of amplification. Our results suggest that the majority of muscarinic receptor subtypes in the pre-BötC are M(2) and M(3), with minor expression of M(1), M(4), and M(5).

Retroperitoneal laparoscopic nephrectomy in the treatment of incontinence from ectopic ureter with renal hypoplasia in the child--a case report

Unilateral single vaginal ectopic ureteral opening with ipsilateral hypoplastic kidney is a rare disease. It is classically presented with continuous urinary incontinence, but a normal voiding pattern after successful toilet training. The kidneys associated with this condition are usually nonfunctional and nephrectomy is the treatment of choice to cure the incontinence. We present a 7-year old girl with such a problem successfully treated by retroperitoneal laparoscopy. The patient resumed her normal unrestricted activity level on postoperative day 3. She was free of symptoms related to the operation during a 6-year follow-up period. It is suggested from this case that despite the reduced working space in children, retroperitoneal laparoscopic nephrectomy in the treatment of small kidney with complications is a feasible procedure.

Emergence of reduced susceptibility and resistance to fluoroquinolones in Escherichia coli in Taiwan and contributions of distinct selective pressures

A survey of 1,203 Escherichia coli isolates from 44 hospitals in Taiwan revealed that 136 (11.3%) isolates were resistant to fluoroquinolones and that another 261 (21.7%) isolates had reduced susceptibility. Resistance was more common in isolates responsible for hospital-acquired (mostly in intensive care units) infections (17.5%) than in other adult inpatient (11.4%; P = 0.08) and outpatient isolates (11.9%; P > 0.1). Similarly, reduced susceptibility was more common in isolates responsible for hospital-acquired infections (30.9%) than in other adult inpatient (21.0%; P = 0.04) and outpatient (21.4%; P = 0.06) isolates. Isolates from pediatric patients were less likely to be resistant (1.3 versus 12.0%; P < 0.01) but were nearly as likely to have reduced susceptibility (17.7 versus 21.9%; P > 0.1) as nonpediatric isolates. There was an inverse relationship in the proportion of isolates that were resistant versus the proportion that had reduced susceptibility among isolates from individual hospitals (R = 0.031; P < 0.05). In an analysis of isolates from two hospitals, all 9 resistant strains possessed double point mutations in gyrA and all 19 strains with reduced susceptibility strains had single point mutations; no mutations were found among fully susceptible strains. Risk factors for resistance included underlying cancer (odds ratio [OR], 83; 95% confidence interval [CI(95)], 7.3 to 2,241; P < 0.001), exposure to a quinolone (OR, undefined; P = 0.02), and exposure to a nonquinolone antibiotic (OR, 20; CI(95), 2.2 to 482; P < 0.001); underlying cancer was the only independent risk factor (OR, 83; CI(95), 8.6 to 807; P < 0.001). There were no significant associations between any of these factors and reduced susceptibility. Whereas acute and chronic quinolone use in cancer patients is a major selective pressure for resistance, other undetermined but distinct selective pressures appear to be more responsible for reduced susceptibility to fluoroquinolones in E. coli.

Real-time PCR for rapid genotyping of angiotensin-converting enzyme insertion/deletion polymorphism

OBJECTIVE

To develop a real-time PCR technique for detection of the insertion/deletion (I/D) polymorphism of angiotensin-converting enzyme (ACE) gene.

DESIGN AND METHODS

Three primers were designed for performing real-time PCR in the presence of SYBR Green I as flurochrome followed by melting curve analysis. Forty human genomic DNA that have been genotyped by two-rounds of conventional PCR were used for evaluation of this technique.

RESULTS

Melting curve analysis indicated the melting peak at 73.9 degrees C and 76.2 degrees C corresponding to the presence of I and D alleles, respectively. Comparable genotyping results were obtained by both conventional and real-time PCR. Besides, the mistyping of ID allele individuals by the first run of conventional PCR were accurately genotyped by single-tube real time PCR.

CONCLUSIONS

The real-time PCR method presented in this study provides a rapid and sensitive way for genotyping of ACE gene that may be suitable for large-scale clinical and epidemiologic study.

[Clinical study on treatment of chronic bronchitis by tracheitis plaster]

OBJECTIVE

To study the clinical effect and mechanism of Tracheitis Plaster (TP) in treating chronic bronchitis.

METHODS

TP is consisted of ephedra, almond, pinellia tuber, earthworm and white mustard seed. Patients were randomly divided into two groups, 59 patients in the treated group were treated with TP sticking on acupoints Dingchuan, Dashu, Fengmen, Feishu and Xinshu at back along both sides of thoracic vertebrae 1-6 and the 25 patients in the control group were treated with intramuscular injection of Siqikang. The times of treatment for both groups were 20. Clinical symptoms, X-ray chest film, level of immunoglobulin and T-lymphocyte subsets were recorded before and after treatment, and follow-up were carried out 0.5-1 year later.

RESULTS

The clinical total effective rate was 93.2% and the X-ray improvement rate was 40.7% in the treated group, while in the control group, 80.0% and 20.0% respectively. Half and 1 year follow-up studies showed the total effective rate in the treated group was 91.5% and 89.8% respectively, which was significantly higher than that in the control group (80.0% and 76.0%) respectively (P < 0.05). The improvement in levels of IgG and CD8 in the treated group was also superior to those in the control group (P < 0.05).

CONCLUSION

TP is a highly effective transcutaneous absorbent with promising long-term effect, it could regulate the immune function.

Role of intraventricular dispersion of early diastolic filling in indicating left ventricular diastolic dysfunction: assessment by color M-mode inflow propagation velocity

The intraventricular to mitral E velocity ratio (IvE/MvE) and the color M-mode Doppler inflow propagation velocity (LVIPV) were evaluated in 36 healthy controls and 33 patients with hypertension and/or ischemic heart disease. The intraventricular E velocity was significantly lower than the mitral E velocity in the control group (52 vs. 68 cm/s, p < 0.001), but they are similar in the disease group (59 vs. 63 cm/s, p = nonsignificant). Compared with the control group, the disease group had a higher IvE/MvE (0.95 +/- 0.28 vs. 0.78 +/- 0.23, p < 0.01). Nevertheless, the LVIPV was not significantly different between the disease and control groups (53 +/- 14 vs. 56 +/- 13 cm/s, p = nonsignificant). The LVIPV did not correlate with the IvE/MvE (r = 0.202, p = nonsignificant). Therefore, an intraventricular dispersion of early diastolic filling does not seem to indicate impaired left ventricular relaxation.

Mixed-chain phospholipids: structures and chain-melting behavior

It has long been established that diacyl phospholipids isolated from animal cell membranes are predominantly of a mixed-chain variety, meaning that the sn-1 and sn-2 acyl chains are saturated and unsaturated acyl chains, respectively. In general, monoenoic and dienoic acids are found in the sn-2 acyl chain of phosphatidylcholine (PtdCho), whereas polyenoic acids are in phosphatidylethanolamine (PtdEth). These unsaturated chains contain only cis-double bonds, which are always methylene-interrupted. In recent years, the structures and the chain-melting behavior of mixed-chain PtdCho and PtdEth have been systematically studied in this laboratory. Specifically, we have examined the effects of chain unsaturation of the sn-2 acyl chain on the phase transition temperature (Tm) of many PtdCho and PtdEth by high-resolution differential scanning calorimetry (DSC). The Tm values, for instance, obtained from all-unsaturated mixed-chain PtdEth derived from a common precursor can be grouped together according to their chemical formula to form a Tm-diagram. Hence, all the Tm values can be compared simply, systematically, and simultaneously using the Tm-diagram. In addition, the energy-minimized structures of mixed-chain phospholipids containing different numbers/positions of methylene-interrupted cis-double bonds have been simulated by molecular mechanics calculations (MM). In this review, the results of our MM and DSC studies carried out with various mixed-chain phospholipids are summarized. In addition, we emphasize that the combined approach of MM and DSC yields unique information that can correlate the various Tm-profiles seen in the Tm-diagram with the structural variation of mixed-chain lipids as caused by the introduction of different numbers/positions of methylene-interrupted cis-double bonds.

Effect of ionic and nonionic contrast media on fibrinolysis in patients undergoing angiocardiography

Very few investigators have studied the effect of contrast media on fibrinolysis. The results of those previous studies are contradictory and inconclusive. The purpose of this study was to evaluate the effect of ionic and nonionic contrast media on fibrinolysis in patients undergoing angiocardiography. Sixty-two patients randomly received either ionic contrast medium Hypaque-76 (n = 31) or nonionic contrast medium Ultravist-370 (n = 31). Plasma tissue plasminogen activator (t-PA), plasminogen activator inhibitor 1 (PAI-1), fibrinogen, and D-dimer were measured before and 20 minutes after the procedures. A significant increase of PAI-1 levels was seen in the Ultravist group but not in the Hypaque group. The t-PA and fibrinogen levels remained virtually unchanged in both groups. A significant increase of D-dimer concentrations was observed in the Hypaque group but not in the Ultravist group. The results of this study may in part explain the reason that the ionic contrast media produce fewer thromboembolic complications than the nonionic contrast media during the cardiac catheterization.

N-cyanoimidazole and diimidazole imine: water-soluble condensing agents for the formation of the phosphodiester bond

The reaction of BrCN with imidazole results in the formation of N-cyanoimidazole and diimidazole imine. These compounds were shown to be useful condensing agents for the formation of the phosphodiester bound in aqueous solution.

Characteristics of patients with Burkholderia cepacia bacteremia

Burkholderia cepacia has become an important pathogen of infections in immunocompromised and nosocomial patients. The characteristics of 42 episodes of B. cepacia bacteremia in 40 patients admitted to the Taipei Veterans General Hospital between January 1997 and December 1999 were retrospectively analyzed. Factors that adversely influenced the mortality rate included respiratory failure, an unknown infection source, a period in an intensive care unit, and shock. Most of the patients had serious underlying diseases, such as diabetes mellitus, malignancy, congestive heart failure, and chronic obstructive pulmonary disease. The mean time for a positive blood culture was 45 days after admission. The overall mortality rate was 28.6% (12/42), and 44.4% (12/27) of all deaths were directly related to B. cepacia bacteremia. Polymicrobial bacteremia was found in 5 patients. Ceftazidime was the most effective antimicrobial agent in vitro, whereas chloramphenicol, imipenem, and trimethoprim/sulfamethoxazole were less effective alternatives. Appropriate antibiotic therapy was given to 30 patients, most of whom responded to the therapy except for 5 who died despite receiving appropriate treatment. Although B. cepacia infection develops in a relatively small proportion of hospitalized individuals, it has a major impact on morbidity and mortality. In view of the fact that B. cepacia develops resistance to a wide range of antimicrobial agents, ceftazidime and/or trimethoprim/sulfamethoxazole should be the drug of choice for empiric therapy.

Ambulance utilization in metropolitan and rural areas in Taiwan

BACKGROUND AND PURPOSE

Emergency medical services (EMS) have expanded rapidly in the Asian developing countries recently. However, the patterns of ambulance utilization in the rural and urban areas of these countries have not been thoroughly described. This study investigated the patterns of ambulance utilization in two urban areas and the larger rural area of Taiwan formerly designated Taiwan Province.

METHODS

We studied a total of 304,368 ambulance missions during 1997 in Taiwan. We analyzed the differences in the characteristics of emergency calls and the interventions performed on the scene in two urban areas, Taipei City and Kaohsiung City, and in the rural area formerly designated Taiwan Province.

RESULTS

The call volume and percentage of non-transport calls were higher in the more developed of the two urban areas, Taipei City, than in Kaohsiung (p < 0.01). The incidence of calls with trauma-related causes was higher in both urban areas. However, the percentage of calls placed for trauma-related reasons was higher in the rural area (p < 0.01). More calls for acute medical illness were placed in Taipei City (p < 0.01) than in the rural area. The number of interventions performed by ambulance staff was higher in Taipei City and Kaohsiung City than in the rural area (p < 0.01). The availability of acute illness management was generally lower than needed in all areas.

CONCLUSIONS

Call volume and the number of interventions performed were higher in the urban area, whereas the percentage of trauma-related calls was higher in the rural area. These findings suggest that EMS use patterns in Taiwan are transitioning towards a pattern characteristic of a more developed country. The differences in ambulance utilization patterns must be considered in plans to further develop EMS services in these areas.

Induction of disabled-2 gene during megakaryocyte differentiation of k562 cells

Megakaryocyte differentiation is often accompanied by the changes of gene expression pattern. Here we reported that the expression of DAB2, a putative adaptor protein in cell signaling, was induced at the protein and mRNA levels upon 12-O-tetradecanoylphorbol-13-acetate-mediated megakaryocyte differentiation of human chronic myeloid leukemic K562 cells. On the other hand, the differentiation agents DMSO and retinoic acid had no effect on DAB2 expression. Analysis of promoter activity with the human DAB2 luciferase reporter constructs suggested that the regulation is partially at the transcriptional level. The responsive sequences located within an 80-bp DAB2 promoter region. To determine the involvement of MEK1-p42/p44 MAPK pathway in mediating DAB2 gene expression, we have performed the following experiments and found that (i) there was sustained activation of p42/p44 MAPK, but not p38 MAPK, upon K562 cells differentiation; (ii) application of MEK1 inhibitor U0126 reduced the expression of DAB2 protein, mRNA and promoter activity, as well as cell differentiation; (iii) constitutively active MEK1 increased DAB2 promoter activity; and (iv) dominant negative ERK2 abolished constitutively active MEK1-induced DAB2 promoter activity. Taken together, our results indicate that DAB2 gene is induced upon megakaryocyte differentiation by the MEK1-p42/p44 MAPK pathway and may define a new role of DAB2 in hematopoietic cell differentiation.

Statistical analysis of QT interval as a function of changes in RR interval in the conscious dog

INTRODUCTION

The duration of cardiac ventricular depolarization and repolarization is represented as the QT interval. QT prolongation has been associated with the occurrence of arrhythmias. Both cardiovascular as well as noncardiovascular agents have caused QT prolongation and sudden death in humans. Changes in heart rate (HR) play a major, though not exclusive, role in QT variation. Considerable debate has centered on how to normalize QT for variations in HR (QTc).

METHODS

The most common approaches use Bazett's (QTc = QT/(square root)RR) or Fridericia's (QTc = QT/(cube root)) formulas to fit the data and establish a single coefficient to analyze QT with respect to its relationship to RR, where RR= 60/HR. These single-coefficient models do not adequately describe the QT functional relationship with RR for the dog. Therefore, any calculation of QTc for the dog is misleading and can result in a false-positive indication or mask the potential hazards of a high QT. Other investigators have proposed multicoefficient exponential regression analyses to best fit the QT-RR relationship.

RESULTS AND DISCUSSION

Data presented here from dogs under resting conditions and during pharmacological maneuvers (E-4031 or cisapride intravenous infusion) support the use of such a model. In order to fully characterize drug-induced changes in the QT-RR relationship, our approach includes a statistical comparison of the regression curves for an overall effect, and quantitates the incidence and magnitude of points exceeding the upper 95% confidence interval ('outliers') to assess the degree of heterogeneity of ventricular repolarization.

Vibration characteristics of composite piezoceramic plates at resonant frequencies: experiments and numerical calculations

The experimental measurement of the resonant frequencies for the piezoceramic material is generally performed by impedance analysis. In this paper, we employ an optical interferometry method called the amplitude-fluctuation electronic speckle pattern interferometry (AF-ESPI) to investigate the vibration characteristics of piezoceramic/aluminum laminated plates. The AF-ESPI is a powerful tool for the full-field, noncontact, and real-time measurement method of surface displacement for vibrating bodies. As compared with the conventional film recording and optical reconstruction procedures used for holographic interferometry, the interferometric fringes of AF-ESPI are produced instantly by a video recording system. Because the clear fringe patterns measured by the AF-ESPI method will be shown only at resonant frequencies, both the resonant frequencies and corresponding vibration mode shapes are obtained experimentally at the same time. Excellent quality of the interferometric fringe patterns for both the in-plane and out-of-plane vibration mode shapes are demonstrated. Two different configurations of piezoceramic/aluminum laminated plates, which exhibit different vibration characteristics because of the polarization direction, are investigated in detail. From experimental results, we find that some of the out-of-plane vibration modes (Type A) with lower resonant frequencies cannot be measured by the impedance analysis; however, all of the vibration modes of piezoceramic/aluminum laminated plates can be obtained by the AF-ESPI method. Finally, the numerical finite element calculations are also performed, and the results are compared with the experimental measurements. Excellent agreements of the resonant frequencies and mode shapes are obtained for both results.

Collection efficiency and capacity of three samplers for acidic and basic gases

This paper compares the collection efficiency and capacity of a coated porous metal disk with those of a silica gel tube and an impinger at the acid or basic aerosol concentration of two times the permissible exposure limitation (Taiwan IOSH, Institute of Occupational Safety and Health), relative humidity of 80 +/- 5%, and temperature of 30 +/- 3 degrees C in the laboratory. Using 5% sodium carbonate/glycerin coating, the collection efficiencies of the porous metal disk for nitric acid, hydrogen chloride, and hydrogen fluoride are found to be higher than those of the silica gel tube and the impinger when the sampling time is less than 3.0 h. The gas collection capacity of the porous metal disk coated with 5% sodium carbonate is calculated to be 3.9, 5.8, and >2.5 mg for nitric acid, hydrogen chloride, and hydrogen fluoride, respectively. For ammonia, the porous metal disk coated using 4% citric acid performs slightly better than the impinger, and the corresponding capacity is slightly greater than 33.6 mg.

Hand-assisted laparoscopic radical nephrectomy of renal cell carcinoma--a case report

A 62-year-old female patient with chronic medical history of DM and hypertension was admitted due to traffic accident. She was asymptomatic until 5 days before admission. She was referred to our medical center with an abdominal CT revealing left renal tumor. The diameter of the renal mass was 50 mm. On ultrasonographic examination, a heterogenous lesion over the left kidney was noted. Renal scanning showed a cold nodule in the left kidney. Hand-assisted laparoscopic transperitoneal radical nephrectomy was performed smoothly. The kidney was removed from the hand port in the supraumbilical skin incision with a volume of 14 x 7 x 6 cm3 and weight of 570 gm. The operation time was 5 hours, blood loss was 200 cc, and no significant change of blood pressure was noted during the surgery. The patient's postoperative course was uneventful. The pathological report of this mass was renal cell carcinoma.

Experimental and numerical investigations of resonant vibration characteristics for piezoceramic plates

Electronic speckle pattern interferometry (ESPI) is a full field, non-contact technique for measuring the surface displacement of a structure subjected to static loading or, especially, to dynamic vibration. In this article we employ an optical system called the amplitude-fluctuation ESPI with out-of-plane and in-plane measurements to investigate the vibration characteristics of piezoceramic plates. Two different configurations of piezoceramic plates, namely the rectangular and the circular plates, are discussed in detail. As compared with the film recording and optical reconstruction procedures used for holographic interferometry, the interferometric fringes of AF-ESPI are produced instantly by a video recording system. Because the clear fringe patterns will be shown only at resonant frequencies, both the resonant frequencies and the corresponding mode shapes are obtained experimentally at the same time by the proposed AF-ESPI method. Excellent quality of the interferometric fringe patterns for both the in-plane and out-of-plane vibration mode shapes is demonstrated. The resonant frequencies of the piezoceramic plates are also measured by the conventional impedance analysis. From experimental results, we find that the out-of-plane vibration modes (type A) with lower resonant frequencies cannot be measured by the impedance analysis and only the in-plane vibration modes (type B) will be shown. However, both the out-of-plane (bending) and in-plane (extensional) vibration modes of piezoceramic plates are obtained by the AF-ESPI method. Finally, the numerical finite element calculations are also performed, and the results are compared with the experimental measurements. It is shown that the numerical calculations and the experimental results agree fairly well for both the resonant frequencies and the mode shapes.

Structure activity studies on group C meningococcal polysaccharide-protein conjugate vaccines: effect of O-acetylation on the nature of the protective epitope

A series of group C meningococcal polysaccharide-tetanus toxoid (GCMP-TT) conjugates were prepared as vaccines with varying percentages of O-acetylation at the C-7 and C-8 positions of sialic acid residues in the polysaccharide (PS). The immune response in mice was highly dependent on the degree of O-acetylation. Less O-acetylation resulted in higher serum bactericidal activity (SBA) towards the O-acetylated (OA) meningococcal strain, C11. In addition, since an unconjugated de-O-acetylated (dOA) GCMP vaccine was previously shown to be highly immunogenic in humans, we had chosen this dOA form to couple with TT by reductive amination for clinical evaluation. This conjugate vaccine was shown to be well-tolerated and highly immunogenic in adults, children, and infants in the UK. To understand the nature of the GCMP protective epitope, a series of spectroscopic and serological studies were conducted, using high resolution H-NMR spectroscopy at 500 MHz and competitive inhibition SBA assays. The dOA GCMP was 10-1000 times better at inhibiting the SBA for an OA strain than the OA GCMP, suggesting that the GCMP-based protective epitope on the bacterium exists in a dOA form. In addition, SBA for an OA strain is highly correlated with dOA GCMP-specific IgG. NMR data on freshly isolated GCMP indicated that, on the surface of the organism, most of the O-acetylation exists at position C-8, with some regions containing dOA or OA C-7 sialic acid. After extraction of PS and storage in solution, most of the O-acetyl groups migrate to C-7, leaving an epitope that is conformationally related, but not quite identical (due to the presence of the O-acetyl group), to the one contained in the dOA PS. We speculate that the role of the O-acetyl group at the C-8 position of the PS on the organism is to form less immunogenic epitopes, or mask the protective epitope, and thus escape immune surveillance. The dOA form of the vaccine may therefore provide better protection against group C meningococcal disease than the OA form by eliciting a greater proportion of functional antibodies that are directly aimed at the protective epitope.

Bladder wall calcification after intravesical chemotherapy with mitomycin C--a case report

Bladder wall calcification has relatively few etiologies. We present such a case and review the literature to discuss it and the method for management. This case suffered from bladder wall calcification about 3 years after intravesical chemotherapy of mitomycin C. It was found accidentally during the transurethral resection of recurrent bladder tumor. The pathology confirmed the recurrence of transitional cell carcinoma combined with marked calcification. A repeat cystoscopy was done 3 months later. Massive calcified deposits in bladder wall especially in lesion of previous transurethral resection were still noted. Randomized biopsy showed dystrophic calcification without evidence of malignancy. We suggest that biopsy and/or resection (if possible) is a reasonable approach to eliminate the possibility of invasive bladder cancer.

Risk factors for mortality in primary isolated coronary artery bypass grafting surgery

BACKGROUND AND PURPOSE

Identifying the risk factors for mortality in coronary artery bypass grafting (CABG) surgery is important to improve surgical results. The purpose of this study was to identify the risk factors for mortality in primary isolated CABG in a series of Taiwanese patients.

METHODS

Medical records of 914 patients who underwent primary isolated CABG surgery in Veterans General Hospital-Taipei during the period from January 1, 1991, to December 31, 1995, were reviewed. Eighteen clinical and seven operative variables were included in the univariate and multivariate analyses to identify the determinants of mortality in CABG surgery.

RESULTS

Thirty-one patients (3.4%) died within 30 days after surgery; 41 (4.5%) died during hospitalization for the procedure. After univariate and multivariate analyses, emergency surgery, history of myocardial infarction, concomitant peripheral artery occlusive disease (PAOD), and prolonged cardiopulmonary bypass (CPB) were found to be significant determinants of mortality in primary isolated CABG. Other variables, including age, sex, angina class, NYHA class, diabetes mellitus, the number of anastomoses, aortic cross-clamp time, stenosis of the left main coronary artery, the number of stenotic coronary arteries, history of congestive heart failure, and a left ventricular ejection fraction less than 35%, were not significant determinants of mortality. Patients undergoing emergency surgery were found to be at highest risk of mortality.

CONCLUSIONS

Patients undergoing emergency surgery who had a history of myocardial infarction, concomitant PAOD, or prolonged CPB were at higher risk of mortality in CABG surgery. More comprehensive techniques in myocardial protection, surgical procedures, and postoperative care should be used in the treatment of high-risk patients to reduce mortality.

Glycophorin A dimerization and band 3 interaction during erythroid membrane biogenesis: in vivo studies in human glycophorin A transgenic mice

Band 3 and glycophorin A (GPA) are the 2 most abundant integral proteins in the human erythrocyte membrane. Earlier studies suggested that the 2 proteins may associate not only in the mature erythrocyte membrane, but also during their posttranslational processing and intracellular trafficking. The purpose of this study was to directly examine the GPA-band 3 interaction in vivo and determine the nature of this association during erythroid membrane biogenesis. Transgenic mice were generated expressing the human glycophorin A gene and were used to examine how the induction of human GPA expression affected the levels of murine GPA and band 3 expression in the red cell membrane. Murine GPA expression was reduced in erythrocytes expressing human GPA, whereas the level of band 3 expression remained constant, implying a tight coupling of band 3 and GPA expression in the membrane of mature red cells. In vivo GPA dimerization was not modulated solely by the GPA transmembrane motif, but the distance between this motif and the basic residues on the cytoplasmic side of the transmembrane domain may also be important. In addition, GPA monomers with varying degrees of glycosylation dimerized, providing clear evidence that carbohydrate structures on the extracellular domain do not affect dimerization. The association between the multiple transmembrane-spanning protein, band 3, and the single transmembrane-spanning sialoglycoprotein, GPA, may serve as a model for interactions of other multi-pass and single-pass polypeptides during membrane biogenesis.

The intrinsic stability of the noble gas-coordinated transition-metal complex ions

Density-functional-theory and high-level ab initio calculations have been performed on the [AuXe4]2+ ion and some other hypothetical xenon-, krypton-, and argon-coordinated transition-metal complex cations in the gas phase. Geometry optimization at the QCISD(T) level using a (6s7p4d2f1g) basis set for Au and a (4s4p2d1f) set for Xe predicted Au-Xe bond lengths in good agreement with the AuXe4(2+)(Sb2F11-)2 crystal structure. The ligand-binding energies of the [AuXe4]2+, [AuXe4]3+, and [PtXe4]2+ ions were predicted to be 229, 565, and 233 kcal/mol, respectively, at the CCSD(T) level. It is found that higher-level correlation effects are important to obtain accurate geometry parameters. The calculated results also indicated that various trivalent, tetravalent, and hexavalent transition-metal complexes of xenon or krypton might also be intrinsically stable.

The pressure waveform of coronary sinus in human hearts

BACKGROUND

The pressure waveform of coronary sinus in human hearts has never been well described. Retrograde cardioplegia perfusion has become a popular method of myocardial protection in recent years, and identification of the pressure waveform of the coronary sinus might help intubate the coronary sinus in retrograde cardioplegia perfusion by differentiating it from that of the right atrium. The purpose of this study is to identify the pressure waveform of the coronary sinus.

METHODS

We inserted a catheter into the coronary sinus under direct vision via a right atriotomy after completion of open heart operation in eight patients. The pressure waveforms of coronary sinus and central venous line, as well as the electrocardiogram (EKG), were recorded simultaneously after the patient was stable and weaned from the cardiopulmonary bypass. The recorded pressure waveforms of coronary sinus and central venous line were compared.

RESULTS

The pressure waveform of coronary sinus was found to have three peaks, more prominent than those of the central venous line waveform.

CONCLUSIONS

The pressure waveform of coronary sinus could be distinguished from that of the central venous line. The difference might help coronary sinus cannulation for retrograde cardioplegia perfusion.

Microarray profiling of gene expression patterns in bladder tumor cells treated with genistein

Microarray technology was used to gain an insight into the molecular events of tumor cell growth inhibition mediated by the soy isoflavone genistein. For this, a susceptible bladder tumor line TCCSUP was treated with the inhibitory dose (50 microM) of genistein for various periods of time, followed by mRNA isolations, cDNA probe preparations, and hybridization individually to cDNA chips containing 884 sequence-verified known human genes. After analyzing the hybridization signals with a simple quantitative method developed by this study, we detected that egr-1, whose expression has been associated with proliferation and differentiation, was transiently induced and this expression pattern was later confirmed by RT-PCR. Thus, microarray technology is a reliable and powerful tool for profiling gene expression patterns in many biological systems related to cancer. We further detected many groups of genes with distinct expression profiles and most of them encode for proteins that regulate the signal transduction or the cell cycle pathways. These genes warrant further investigation as regards their roles in the susceptibility of the tumor cell line to the antitumor drug.

Adrenal cyst--a case report

Adrenal cysts are rare and mostly silent clinically. Herein we report a case of adrenal cyst. A 55-year-old female was incidentally found to have a left suprarenal cystic lesion with a calcified wall by abdominal sonography during a work-up for her epigastralgia and left flank pain. Then, computed tomography (CT) revealed a left adrenal cystic mass with wall calcification, magnetic resonance imaging (MRI) showed left retroperitoneal cystic mass with fluid content, and angiography demonstrated an avascular lesion. Surgical exploration was performed via a flank incision and a calcified cystic adrenal mass was excised. The pathologic diagnosis was adrenal pseudocyst with calcified wall. We discuss the diagnosis and management of adrenal cyst and briefly review the literature.

Cystitis glandularis mimics bladder cancer--three case reports and literature review

Cystitis glandularis is an uncommon proliferative disorder of the mucus-producing glands within the mucosa and submucosa of urinary bladder epithelium. We report three cases with gross hematuria on first presentation. Both sonography and computer tomography revealing bladder tumor and transurethral resection was performed in all three cases. Cystitis glandularis was confirmed by pathology. Short-term follow-up of sonography and cystoscopy showed good results.

Corneal melt as the initial presentation of primary Sjögren's syndrome

Corneal melting is a rare complication of S ogren's syndrome (SS). Previously reported cases of corneal ulceration occurred in patients with established SS, usually secondary to RA. We describe the first case of corneal ulceration with stromal melting as the initial presentation of primary SS. A 79-year-old man without prior sicca symptoms developed a large sterile corneal ulcer that required extensive treatment over several months with ocular lubricants, systemic immunosuppressives, and surgical repair. Evaluation for an underlying connective tissue disease revealed positive antinuclear antibodies (1:640 speckled) and anti-SSA antibody. A lip biopsy established the diagnosis of SS. Ulceration later occurred in the contralateral eye. Two years after the last corneal ulcer and no longer taking prednisone, the patient's ocular disease remained quiescent taking azathioprine 175 mg and hydroxychloroquine 400 mg daily. This case highlights the potential for primary SS to present with serious ocular complications despite lack of a priori sicca symptoms, as well as the importance of immunosuppressive therapy in the treatment of this complication.

The influence of inserting a Fuji pressure sensitive film between the tibiofemoral joint of knee prosthesis on actual contact characteristics

OBJECTIVE

To investigate the influence of inserting a Fuji pressure sensitive film between the tibiofemoral joint of knee prosthesis on actual contact characteristics.

DESIGN

A finite element analysis was used to investigate the alteration of contact characteristics of the tibiofemoral joint due to inserting a pressure sensitive film between the contacting surfaces.

BACKGROUND

The discrepancy between actual contact behaviors of tibiofemoral joint of knee prosthesis and the measurement using Fuji pressure sensitive film was not discussed extensively. The change of direct contact circumstance of the tibiofemoral joint due to inserting a pressure sensitive film was not well reported.

METHOD

A two-dimensional finite element model of the tibiofemoral joint of knee prosthesis in the sagittal plane was constructed. Four different radii of the femoral component were used to investigate the conformity effect. Two-layers of plane strain element were used to model the pressure sensitive film. The influence of inserting a pressure sensitive film on the actual contact characteristics was analyzed by comparing the results of the change in contact radius.

RESULTS

Inserting a pressure sensitive film between contacting surfaces would disturb the original contact behaviors, especially in the lowest conformity design. The maximum difference of contact radius between the model simulating actual contact circumstance and the model with inserting a pressure sensitive film between contacting surface was 77% in the lowest conformity condition at the smallest load.

CONCLUSIONS

This study proposes a quantitative analysis of contact characteristics in the tibiofemoral joint of knee prosthesis between the models with and without inserting a pressure sensitive film into the contact surface. The measurement of contact area in artificial tibiofemoral joints by using Fuji pressure sensitive film is always overestimated its true contact area by 14-77%.

RELEVANCE

This study revealed the measurement of contact characteristics of artificial tibiofemoral joints by using Fuji pressure sensitive film which depends on not only the applied load, but also the conformity and material properties of the contact surface. Therefore, the information of the conformity and material properties of the contact surface should be provided as well as the applied load wherever a measurement of contact characteristics using Fuji pressure sensitive film is analyzed and interpreted.

Adult Wilms' tumor associated with polycythemia--a case report

Both Wilms' tumor (nephroblastoma) in adults and polycythemia in Wilms' tumor are rare. Herein we report an extremely rare case of adult Wilms' tumor associated with polycythemia. A 41-year-old female was incidentally found to have right renal mass by abdominal sonography in a routine health examination. Laboratory examination revealed polycythemia (hemoglobin 20.2 g/dL). Although physical examination was unremarkable, CT scan revealed an homogeneous mass at the middle pole of right kidney, and chest x-ray revealed no metastatic lesions. Right radical nephrectomy was performed smoothly. Grossly, the tumor of 5 x 4.5 x 4.5 cm in size was well circumscribed, and had no vascular structure or collecting system involvement. Microscopic features were consistent with adult nephroblastoma. The post-operative course was uneventful. At follow-up, the patient was well, showed no evidence of recurrence and her hemoglobin level had returned to normal (hemoglobin 14.5 g/dl). We suggest that the relationship between polycythemia and Wilms' tumor should be carefully evaluated before surgical treatment.

Rh type B glycoprotein is a new member of the Rh superfamily and a putative ammonia transporter in mammals

Ammonium transporters play a key functional role in nitrogen uptake and assimilation in microorganisms and plants; however, little is known about their structural counterpart in mammals. Here, we report the molecular cloning and biochemical characterization of Rh type B glycoproteins, human RhBG and mouse Rhbg, two new members of the Rh family with distinct tissue specificities. The RhBG orthologues possess a conserved 12-transmembrane topology and most resemble bacterial and archaeal ammonium transporters. Human RHBG resides at chromosome 1q21.3, which harbors candidate genes for medullary cystic kidney disease, whereas mouse Rhbg is syntenic on chromosome 3. Northern blot and in situ hybridization revealed that RHBG and Rhbg are predominantly expressed in liver, kidney, and skin, the specialized organs involving ammonia genesis, excretion, or secretion. Confocal microscopy showed that RhBG is located in the plasma membrane and in some intracellular granules. Western blots of membrane proteins from stable HEK293 cells and from mouse kidney and liver confirmed this distribution. N-Glycanase digestion showed that RhBG/Rhbg has a carbohydrate moiety probably attached at the NHS motif on exoloop 1. Phylogenetic clustering, tissue-specific expression, and plasma membrane location suggest that RhBG homologous proteins are the long sought major ammonium transporters in mammalians.

Analysis of estrogenic hormones in municipal wastewater effluent and surface water using enzyme-linked immunosorbent assay and gas chromatography/tandem mass spectrometry

Although the estrogenic hormones 17 beta-estradiol and 17 alpha-ethinyl estradiol can be quantified in polluted waters by gas chromatography/mass spectrometry (GC/MS) and gas chromatography/tandem mass spectrometry (GC/MS/MS), the compounds often are present at concentrations below detection limits. Enzyme-linked immunosorbent assays (ELISAs) provide a sensitive and robust means of quantifying estrogenic hormones in wastewater effluents and surface waters. Results from ELISA analysis of estrogenic hormones in secondary wastewater effluent indicate concentrations comparable to those that cause vitellogenesis in fish. Confirmatory analyses by GC/MS/MS are consistent with ELISA results. Effluent filtration, using sand filtration or microfiltration, removes approx. 70% of the hormones from secondary effluent, while advanced treatment, using reverse osmosis, removes more than 95% of hormones. The detection limits for estrogenic hormones are approx. 0.1 ng/L in wastewater effluent and 0.05 ng/L in surface water. The ELISA technique provides a relatively simple and practical method of assessing the fate of estrogenic hormones in engineered and natural systems.

Morphometric identification of luminal narrowing of myocardial capillaries after cardioplegic arrest

BACKGROUND

Because there is no smooth muscle cell surrounding the capillary endothelial cells, the effect of coronary microcirculation at the capillary level following cardioplegic arrest and reperfusion would be much different from that of resistant arterioles. We therefore studied the effect of hypothermic blood cardioplegic arrest and subsequent reperfusion on the myocardial capillaries in cardiac operation patients.

METHODS

Twenty-seven patients who underwent cardiac operations were included in this study. Three sequential biopsies (preischemia, ischemia, and reperfusion) were obtained from the right atrium. This study was restricted to blood vessels with a diameter of less than 8 microns. Ten randomly selected capillaries from each biopsy were measured for luminal surface area, endothelial cytoplasmic surface area, and total cross-sectional surface area of capillaries.

RESULTS

From stereologic morphometric studies, the serial changes in total cross-sectional surface area were not statistically significant (p = 0.152). However, there was a significant swelling of endothelial cytoplasm following ischemia and reperfusion (p = 0.0007). Meanwhile, changes in luminal surface area of capillaries following ischemia and reperfusion were also remarkable (p = 0.0008).

CONCLUSIONS

The most striking finding of this study was the progressive decrease in capillary lumen during ischemia and after reperfusion. The swelling of endothelial cells is a major determinant of luminal narrowing of capillaries in patients receiving cardioplegic arrest.

Molecular Mechanics and Calorimetric Studies of Phosphatidylethanols

Phosphatidylethanols (PEths) are negatively charged diacyl phospholipids that are ubiquitously present in humans under the condition of alcohol intoxication. These lipids, derived in vivo from other naturally occurring phospholipids such as phosphatidylcholines (PC) via transphosphatidylation reaction as catalyzed by phospholipase D in the presence of ethanol, are well known to affect many biochemical properties of the cell membranes in humans. In this communication, we applied the combined approach of molecular mechanics (MM) simulations and high-sensitivity differential scanning calorimetry (DSC) to investigate the structure and phase transition behavior of PEth. We first determined the energy-minimized structures of tetrameric C(15):C(15)PEth arranged in two types of packing motif by the MM approach. An inwardly bent orientation of the lipid headgroup was observed; specifically, the methyl terminus of PEth's headgroup was juxtaposed intramolecularly to the C(2) atom of the sn-2 acyl chain. Clearly, this headgroup conformation was rather unique among all naturally occurring phospholipids. Subsequently, the phase transition behavior of the fully hydrated lipid bilayers prepared individually from 11 species of saturated C(X):C(Y)PEth with the same MW was studied by DSC, and the resulting Tm values were codified in terms of the normalized acyl chain asymmetry (deltaC/CL). A V-shaped Tm profile was observed in the plot of Tm versus deltaC/CL for each subclass of these lipids, suggesting two types of packing motif for C(X):C(Y)PEth at T < Tm. Moreover, it was observed that within each packing motif these Tm values were, on average, 2.0 +/- 0.9 degrees C smaller than the Tm values of the corresponding saturated PC. However, based on the unique headgroup conformation of PEth, we were able to predict that monounsaturated PEth with a cis double bond near the H2O/hydrocarbon interface would exhibit a higher Tm than the corresponding PC. Most interestingly, this prediction was indeed borne out by DSC results obtained with C(18):C(20:1delta5)PC and C(18):C(20:1delta5)PEth.

New Insights into the Rh Superfamily of Genes and Proteins in Erythroid Cells and Nonerythroid Tissues

The past decade has seen extensive studies of the erythrocyte Rh30 polypeptides and Rh-associated glycoprotein, which specify the clinically important Rh blood group system. Here we consider recent advances on these and other Rh homologues in the context of gene organization, molecular evolution, tissue-specific expression, protein structure, and potential biological functions. The Rh family is now known to contain a large number of homologues that form a unique branch in the eucarya life domain. The ancient origin and broad distribution imply central roles for the various Rh proteins in maintaining normal cellular and organismal homeostatic conditions. Rh homologues occur in the form of multiple chromosomal loci in mice and humans, but as single-copy genes in unicellular organisms (e.g., green alga and slime mold). While primitive Rh genes vary largely in exon/intron design, the mammalian Rh homologues bear a similar genomic organization. Sequence comparisons have revealed the signatures and a consensus 12-transmembrane fold characteristic of the Rh family. Phylogenetic analysis has placed all Rh homologues as a related cluster that intercepts ammonium transporter (Amt) clusters, indicating an intimate evolutionary and structural relationship between the Rh and Amt families. The biochemical identification and epithelial expression of RhBG and RhCG orthologues in mammalian kidney, liver, skin, testis, and brain suggest that they serve as transporters likely participating in ammonia homeostasis. Further inquires into the structure, function, biosynthesis, and interaction of Rh proteins will shed new light on ammonia homeostasis in a wide range of human physiological and pathological states.

The investigation of three-dimensional vibration for piezoelectric rectangular parallelepipeds using the AF-ESPI method

Electronic speckle pattern interferometry (ESPI) is a powerful tool for the full-field measurement of a deformed body. In this paper, a three-dimensional vibrating block that couples the out-of-plane and in-plane motions is investigated using the amplitude-fluctuation ESPI (AF-ESPI). This method demonstrates the advantages of combining high processing speed, such as in the subtraction method, with high fringe sensitivity, such as in the time-averaged method. The optical system for AF-ESPI is then employed to analyze the volume vibration of piezoelectric material for a rectangular parallelepiped configuration. Based on the fact that fringe patterns measured by the AF-ESPI method appear as a clear picture only at the resonant frequency, both the natural frequencies and the out-of-plane and in-plane vibration mode shapes are successfully obtained in this study. Finally, the impedance analysis as well as the finite element method (FEM) with three-dimensional model are also conducted to compare with the result obtained by AF-ESPI. It is shown that the numerical calculation and the experimental result agree fairly well for both the resonant frequency and the mode shape in three-dimensional configurations.

Enhanced cAMP-induced nitric oxide-dependent coronary dilation during myocardial stunning in conscious pigs

The goal of the current study was to determine the effects of cAMP-mediated coronary reactivity in conscious pigs with stunned myocardium induced by 1.5 h coronary stenosis (CS) and 12 h coronary artery reperfusion (CAR). Domestic swine (n = 5) were chronically instrumented with a coronary artery blood flow (CBF) probe, hydraulic occluder, left ventricular pressure gauge, wall-thickening crystals in the ischemic and nonischemic zones, and a coronary sinus catheter. The hydraulic occluder was inflated to induce a CS with a stable 38 +/- 1% reduction in CBF for 1.5 h. Before flow reduction and during CAR, cAMP-induced coronary vasodilation was investigated by forskolin (20 nmol. kg(-1). min(-1)). Enhanced CBF responses [+62 +/- 9%, P < 0.05, compared with pre-CS (+37 +/- 3%)] were observed for forskolin at 12 h after CAR as well as for bradykinin and reactive hyperemia. With the use of a similar protocol during systemic nitric oxide (NO) synthase inhibition with N(omega)-nitro-L-arginine (30 mg. kg(-1). day(-1) for 3 days), the enhanced CBF responses to forskolin, bradykinin, and reactive hyperemia were not observed after CS. Isolated microvessel preparations from pigs (n = 8) also demonstrated enhanced NO production to direct stimulation of adenylyl cyclase with forskolin (+71 +/- 12%) or NKH-477 (+60 +/- 10%) and administration of 8-bromo-cAMP (+74 +/- 13%), which were abolished by protein kinase A or NO synthase inhibition. These data indicate that cAMP stimulation elicits direct coronary vasodilation and that this action is amplified in the presence of sustained myocardial stunning after recovery from CS. This enhanced cAMP coronary vasodilation is mediated by an NO mechanism that may be involved in myocardial protection from ischemic injury.

The effect of fluvastatin on fibrinolytic factors in patients with hypercholesterolemia

Several studies have shown cardiovascular benefit in treating hypercholesterolemia with HMG-CoA reductase inhibitor. However, in addition to the lowering of cholesterol, the beneficial effects of this inhibitor reflect other pharmacological activities. Whether these beneficial effects are partly mediated by changes in fibrinolytic factors remains to be proven, since clinical studies on the effects of HMG-CoA reductase inhibitors on fibrinolytic factors have not yielded consistent results. The purpose of this study was to evaluate the effects of fluvastatin on fibrinolytic factors in hypercholesterolemic patients. After 6 weeks on a low-fat, low-cholesterol diet, 23 outpatients known to have primary hypercholesterolemia with low density lipoprotein cholesterol (LDL-C) > or = 130 mg/dl with at least 2 risk factors or fasting LDL-C > or = 160 mg/dl were selected for the study. Venous blood samples were collected at baseline and at 8 weeks after fluvastatin therapy (40 mg/day) to measure of tissue plasminogen activator (t-PA), plasminogen activators inhibitor-1 (PAI-1), fibrinogen, D-dimer and lipid profile. After 8 weeks of therapy, fluvastatin reduced serum cholesterol by 11% (261.9 mg/dl vs 233.2 mg/dl, P < 0.01) and LDL-C by 22% (191.9 mg/dl vs 149.3 mg/dl, P < 0.01). D-dimer was significantly decreased (0.38 ng/L vs 0.28 ng/L, P = 0.02) and tPA, PAI-1 and fibrinogen tended to decrease after therapy. Fluvastatin therapy improved fibrinolytic profile; the result of this study may in part explain the benefit of HMG-CoA reductase inhibitor on cardiovascular system other than lipid lowering.

Characterization of an axonemal dynein heavy chain expressed early in airway epithelial ciliogenesis

The most conspicuous evidence of airway epithelial maturation and vitality is the presence of motile cilia. In an effort to generate genetic and antigenic markers of airway maturation, injury, and repair, we characterized airway epithelial expression of a gene identified by two human expressed sequence tags that encoded peptides with sequence similarity to an invertebrate ciliary dynein heavy chain (DHC). Molecular analyses showed that the gene has a very large RNA transcript that encodes a very high molecular weight polypeptide with biochemical properties that are characteristic of a dynein heavy chain. Expression of the gene transcript correlated with the presence of ciliated cells in tissues, and immunohistochemical localization of the gene product confirmed its presence in the cilia of mature airway epithelium. In epithelium undergoing ciliogenesis ex vivo, expression of the gene transcript preceded ciliation of the epithelium and the gene product was present in the cytoplasm and at the apical border of nonciliated cells. These data suggested that the gene encodes an axonemal DHC that is expressed early during ciliogenesis, before the appearance of cilia.

Genetic aberration in primary hepatocellular carcinoma: correlation between p53 gene mutation and loss-of-heterozygosity on chromosome 16q21-q23 and 9p21-p23

To elucidate the molecular pathology underlying the development of hepatocellular carcinoma (HCC), we used 41 highly polymorphic microsatellite markers to examine 55 HCC and corresponding non-tumor liver tissues on chromosome 9, 16 and 17. Loss-of-heterozygosity (LOH) is observed with high frequency on chromosomal region 17p13 (36/55, 65%), 9p21-p23 (28/55, 51%), 16q21-q23 (27/55, 49%) in tumors. Meanwhile, microsatellite instability is rarely found in these microsatellite loci. Direct sequencing was performed to detect the tentative mutation of tumor suppressor genes in these regions: p53, MTS1/p16, and CDH1/E-cadherin. Within exon 5-9 of p53 gene, 14 out of 55 HCC specimens (24%) have somatic mutations, and nucleotide deletion of this gene is reported in HCC for the first time. Mutation in MTS1/p16 is found only in one tumor case. We do not find mutations in CDH1/E-cadherin. Furthermore, a statistically significant correlation is present between p53 gene mutation and loss of chromosome region 16q21-q23 and 9p21-p23, which indicates that synergism between p53 inactivation and deletion of 16q21-q23 and 9p21-p23 may play a role in the pathogenesis of HCC.

Functional implication of human serine/threonine kinase, hAIK, in cell cycle progression

Protein phosphorylation is involved in many biological activities and plays important roles in cell cycle progression. In the present study, we identified a serine/threonine kinase, hAIK, from human hepatic cells using degenerated polymerase chain reactions with a pair of primers derived from the highly conserved sequence in the catalytic domain of kinases. The full-length hAIK cDNA was then obtained, which contained 403 amino acids and was homologous to Drosophila Aurora2 and yeast Ipl1 proteins. Northern blotting analysis revealed that hAIK was highly expressed in the testis but not in other tissues. Expressions of hAIK drastically increased in cancer tissues/cell lines but not in fibroblasts or nontumorigenic cell lines. The recombinant hAIK protein phosphorylated itself and histone H1; this phosphorylation activity was totally abolished after a point mutation at the catalytic domain (hAIKm). During the interphase cell, hAIK was found mainly in the cytoplasm; during mitosis hAIK accumulated at the centrosomes. In addition, overexpression of hAIK in cancer cell lines (HEK293T and HeLa) appeared to inhibit cell cycle progression. None of these phenomena were observed in hAIKm whose kinase activity was rendered inactive. Our results suggest that hAIK protein/activity might modulate cell cycle progression by interacting with the centrosomes and/or proteins associated with these structures.

Photoelectrochemical Response of Langmuir-Blodgett Monolayer Films Containing Donor-pi-Acceptor Azomethine Dyes

Three amphiphilic azomethine dyes, (E)-N-octadecyl-2-[2-(4-N, N-dimethylaminophenyl)azomethinyl]quinolinium tiodide, (E)-N-octadecyl-4-[2-(4-N, N-dimethylaminophenyl)azomethinyl]quinolinium iodide, and (E)-N-octadecyl-6-[2-(4-N, N-dimethylaminophenyl)azomethinyl]quinolinium iodide, have been prepared by changing different relative positions of electron-accepting groups. They were successfully transferred onto indium-tin oxide slides by the Langmiur-Blodgett (LB) technique. Photoelectrochemical studies on these dyes' LB monolayer-modified ITO electrode were carried out. In 0.5 M KI solution containing 0.05 M I(2), the photocurrent generation quantum yield for these dyes varied from 7.2 to 15.9%, depending on the linking positions. Dependence of the photocurrent on the applied potential and the redox couple suggests that they undergo the photoinduced electron transfer mechanism of photoelectric conversion. Copyright 2000 Academic Press.

Effects of age and diabetes on blood flow rate and primary outcome of newly created hemodialysis arteriovenous fistulas

To study the feasibility of creating a radiocephalic hemodialysis fistula in elderly and diabetic patients, we prospectively studied 176 patients undergoing the first permanent vascular access creation and followed the outcome of fistula until primary failure or success was assessed. Color duplex ultrasonography was used to measure the blood flow rate. Fistula blood flow rate was significantly smaller in elderly patients, however, it was > 400 ml/min in over 78% of the elderly patients with successful fistulas. There was no difference in fistula blood flow rate between nondiabetics and diabetics. Dialysis adequacy (Kt/V) via fistula was the same between age groups and between diabetes mellitus status. Old age or diabetes per se did not significantly predispose a new fistula to primary failure, but concurrent old age and diabetes markedly increase the risk. In conclusion, a good primary outcome of newly created radiocephalic fistula and adequate dialysis via fistula were demonstrated for elderly and diabetic patients. However, the longevity of fistula in elderly and diabetic patients needs further study.

Assessment of the coronary artery disease and systolic dysfunction in hypertensive patients with the dobutamine-atropine stress echocardiography: effect of the left ventricular hypertrophy

This study was performed to evaluate whether left ventricular hypertrophy (LVH) can influence the diagnostic accuracy of coronary artery disease (CAD) using the dobutamine stress echocardiography (DSE) in hypertensive patients. In addition to the detection of CAD, the relationship between systolic dysfunction and the quantitation wall motion scoring system of DSE was studied also. DSE was performed in 101 patients. There were 45 (45%) patients with a history of acute myocardial infarction. Twenty-eight patients (28%) had electrocardiographic LVH and 59 patients (58%) had echocardiographic LVH. A total of 74 patients (73%) had angiographically documented CAD defined as > or = 50% diameter stenosis. For the 56 patients without history of myocardial infarction, the diagnostic sensitivity, specificity, and accuracy in detecting CAD were not influenced by LVH defined by either electrocardiography or echocardiography. For the total patients, the diagnostic sensitivity, specificity, and accuracy in detecting multivessel disease were also not influenced by LVH defined by either method. The resting global wall motion score was correlated well with the left ventricular ejection fraction in patients with and without LVH (r = -0.70, p < 0.001 vs. r = -0.70, p < 0.001). When using the resting wall motion score of 24 as a cutoff value, the diagnostic sensitivity, specificity, and accuracy of systolic dysfunction (defined by left ventricular ejection fraction <40%) were 79, 86 and 85%, respectively. In conclusion, the diagnostic accuracy of CAD using the DSE was not affected by LVH in hypertensive patients. In addition to detection of coronary artery disease, the resting wall motion score of DSE was able to detect systolic dysfunction in patients with and without LVH.

Surgical management of traumatic thoracic aortic rupture from falling

A 40-year-male was admitted to our hospital after falling from a four-story height. Thoracic aortic rupture was suspected based on chest roentgenography and helical computed tomography. The patient was in the operating room within 6 hours after admission to the hospital. A median sternotomy with a left thoracotomy in the fifth intercostal space was done after left femoral arterial cannulation. Profound hypothermic circulation arrest with retrograde cerebral perfusion was applied. The site of aortic rupture was the descending aorta, just distal to the origin of the left subclavian artery. There were two areas of rupture within 2 cm of each other. The ruptured aorta was grafted with a 20-mm woven double-velour Hemashield graft. The total circulatory arrest time was 80 minutes and the cardiopulmonary bypass time was 290 minutes. The postoperative course was complicated by prolonged mechanical ventilation support due to pulmonary contusion. The patient was discharged 30 days after surgery without neurologic deficit.