Transient myeloproliferative disorder and acute myeloid leukemia: study of six neonatal cases with long-term follow-up

Six neonates with hematological and clinical pictures indistinguishable from acute myeloid leukemia were studied. Two patients had Down syndrome and three others had either +21 or i(21q) chromosomal abnormalities in their blood cells at presentation. Granulocyte-macrophage colony-forming unit assays performed in bone marrow and peripheral blood mononuclear cells revealed abnormal growth patterns in two patients; both died of progressive disease of acute myeloid leukemia. All the other four neonates with normal in vitro cell growth pattern had spontaneous remission within 7 months. Of these four patients, one remains well and in remission for 8 years and the other three developed acute myeloid leukemia at the ages of 15, 32 and 19 months, respectively. We conclude that the in vitro cell growth pattern is helpful to distinguish transient myeloproliferative disorder from congenital acute myeloid leukemia and that patients with the former condition are at risk to develop acute myeloid leukemia subsequently.

Health status of patients with childhood acute lymphoblastic leukemia in continuous complete remission for over five years. The Taiwan Children's Cancer Study Group

Ninety-seven patients with childhood acute lymphoblastic leukemia (ALL) have achieved complete continuous first remission for more than five years. They were treated by Taiwan Children's Cancer Study Group protocol 821 or protocol 842. Their present health status was evaluated using blood counts, immunology, a psychiatric analysis and growth parameters. Hemoglobin and platelet counts rose quickly to the normal range after complete remission was achieved, then remained at low normal throughout the course. The leukocyte counts responded immediately to chemotherapy, usually recovering to about 5,000/uL, then gradually increasing after completion of chemotherapy. The absolute neutrophil counts were at a low normal level during chemotherapy, then gradually recovered to the normal level after chemotherapy was completed. Immunologic investigation after completion of chemotherapy showed that the subsets of lymphocytes were nearly all in the normal range for the 38 patients tested. On the other hand, in 17 patients tested for T-cell function, it was found that 29.4% had low natural killer (NK) cell cytotoxicity, 11.8% had an abnormal phytohemagglutinin (PHA) test and all had abnormally low IL-2 production (in vitro). There were 29 patients who had psychiatric analyses; the full IQ was borderline in 10.3%. The primary or middle school academic scores of 55 patients were reported; 15% of them belonged to the lower one-third of the class. Height was assessed by the standard deviation score from the mean for 58 patients. The differences were statistically insignificant; however, there were six patients whose growth curves crossed over their initial percentile line.(ABSTRACT TRUNCATED AT 250 WORDS)

Treatment of childhood acute lymphoblastic leukemia with protocol TCL-842 in Taiwan: the Taiwan Children's Cancer Study Group

From March 1984 to May 1988, 212 children with acute lymphoblastic leukemia were enrolled on Protocol TCL-842. In all, 68 patients were classified as standard risk (SR), 56 as intermediate risk (IR), and 88 as high risk (HR) groups. Remission induction for all three groups consisted of vincristine (VCR), prednisolone (PRED) and L-asparaginase (L-Asp). One consolidation course with cyclophosphamide (CP) and cytarabine (AraC) was used for the SR and IR groups, and two courses were given to patients in the HR group. Central nervous system prophylaxis was randomized using either cranial irradiation 18 Gy + 5 intrathecal methotrexate (IT MTX) or triple IT with maintenance. Reinforcement cycles were employed periodically during maintenance therapy (basically 6-mercaptopurine+MTX) and varied among the three groups. Four-week oral PRED every 16 weeks was the sole reinforcement agent for SR. Two-week VCR+dexamethasone (DEX)+adriamycin CP cycles were used to reinforce IR and HR at different intervals. Five third-form cycles with VCR+DEX+AraC were used only for HR. Treatment was discontinued after three years in patients who achieved continuous complete remissions (CCR). Eight patients died during the induction phase and eight failed to achieve complete remission (CR). The CR rate for SR was 97%, for IR was 98% and for HR was 83.3%; the overall rate was 91.8%. As of 30 June 1991, 33 patients had dropped out, 12 had died during remission, and 52 had relapsed. Twenty-eight SR, 26 IR, and 29 HR patients remained in CCR with a median follow-up duration of 66 months (38-88 months).(ABSTRACT TRUNCATED AT 250 WORDS)

Bacteremia in children with acute lymphoblastic leukemia

Bacteremia is one of the important complications of the treatment of hematological malignancy. In this report, we analyze bacteremias in 72 children with acute lymphoblastic leukemia who were admitted to our hospital from July 1, 1988 to October 31, 1991. Positive blood cultures were found in 26% (19/72) of the patients. There were 24 episodes of bacteremia; Gram-negative, Gram-positive and mixed bacteremia comprised 62.5% (15/24), 33.3% (8/24) and 4.2% (1/24), respectively. E. coli, klebsiella pneumoniae and Pseudomonas aeruginosa were the three most common pathogens. Eighty-three percent of the bacteremic episodes occurred during neutropenia (absolute neutrophil count below 500/mm3). Our data suggest that a Pseudomonas etiology, associated pneumonia, and shock accounted for a poor outcome. The over-all mortality for bacteremic events was 26.3% (5/19). Intensive supportive treatment and effective antibiotics are the most important factors in improving the outcome of bacteremia. The success in recent ALL treatment can be attributed in part to the improved outcome of bacteremia.

Cranial computed tomography in children with acute lymphoblastic leukemia after prophylactic treatment with cranial radiation therapy and intrathecal methotrexate

BACKGROUND AND METHODS

Thirty-one children with acute lymphoblastic leukemia (ALL) who had received cranial radiation therapy (CrRT) and five concomitant doses of intrathecal methotrexate (IT MTX) for central nervous system prophylaxis (CNSP) and who had an event-free survival exceeding 5 years had cranial computed tomography (Cr CT) examination. The fractional dose for 21 of them was 1.5 Gy. The interval between the completion of CNSP and the time of Cr CT ranged from 5 to 8.5 years, with a median of 5 years 2 months.

RESULTS

Unlike the previous reports in the literature that 9-77% of children with ALL who had received Cr RT 18 Gy and IT MTX as CNSP had CT scan abnormalities, in this study no patient had CT scan abnormalities.

CONCLUSIONS

Our results might be attributable to the fractional dose of Cr RT being adequate, the IT chemotherapy being suitable, and the systemic chemotherapy not being intensive.

Studies on the crystal structure of [L-Met]B0 bovine insulin at 3.0A resolution

Based on the crystal symmetry of [L-Met]B0 bovine insulin (LMBBI) and the fundamental theory of the molecular packing method, the scheme for the determination of the position and orientation of the molecules by only using one-dimensional rotation and one-dimensional translation was chosen to be used, and therefore the calculation of the rotation function of the molecular replacement method and the refinement of the rotational and translational parameters by using the R-factor search method were simplified greatly. After the preliminary refinement by using the macromolecular rigid body refinement technique, the molecular model was further refined and adjusted by using the energy-minimizing stereochemical-restrained least squares refinement technique assisted by the manual revision on the difference Fourier maps. The L-Met residues on the N-terminus of the B-chain appeared clearly on the final electron density map.

Intravenous immunoglobulin prophylaxis in children with acute leukemia following exposure to varicella

The high risk of varicella in immunocompromised children has been well documented. With the aim of diminishing this risk, attempts have been made to modify or prevent varicella by passive immunization. From September 1985 to March 1991, five children with leukemia, having a total of seven episodes of intimate exposure to varicella, received a single dose (200 mg/kg) of intravenous immunoglobulin (IVIG) within 3 days of exposure. The patients included four children with acute lymphoblastic leukemia and one child with myelodysplastic syndrome in acute myeloblastic leukemic transformation. None of the five children developed varicella following IVIG infusion. No side effects were observed. IVIG appears to be an effective and safe alternative for preventing varicella in immunocompromised patients upon intimate exposure, when zoster immunoglobulin or varicella-zoster immunoglobulin is unavailable, as in Taiwan.

Molecular close-packing method and its application to crystal structure determination of deshexapeptide (B25-B30) insulin

Based on the molecule-packing theory, we defined a molecule-packing function expressing the compatibility of packing among the symmetry-related molecules in a unit cell. A computer program imitating the close-packing of molecules in the objective crystal lattice and giving the function value of each rotation and translation of the molecule in the unit cell was performed, and it therefore made the close-packing of molecules express quantitatively. This method not only could judge a correct solution from several peaks of the rotation or translation function but it may also independently, quantitatively and quickly solve some specific problems of rotation and translation. Using known structure of despentapeptide (B26-B30) insulin as an example, the effectiveness of this method and its program was inspected, and this method was successfully applied to solving the translation problem of the unknown structure of deshexapeptide (B25-B30) insulin. The molecular close-packing method proved by the results of R-search and electron density maps is relatively independent of the molecular replacement method, though an effective complement of it.

The possible mechanism of binding interaction of insulin molecule with its receptor

Detailed structural comparisons and investigation of DPI, 2 Zn insulin and some other derivatives of insulin were performed by the least-squares superimposition technique and the graphics technique. It is pointed out in this paper that the binding interaction with the receptor molecule should take place mainly on an amphipathic surface of the insulin molecule. In the middle, there is a hydrophobic surface with an area of about 150 A2 consisting of many hydrophobic residues; while the polar or charged groups distributing around the hydrophobic surface construct a hydrophilic zone. The hydrophobic surface is usually covered by the extended B-chain C-terminal peptides with great mobility and protected from the solvent molecules. The angle between the amphipathic surface and the surface of dimerization is about 20 degrees. The results from the detailed structural comparison between Al-(L-Trp) insulin and Al-(D-Trp) insulin have provided a very good explanation to their great difference in biological activity, and confirmed our proposed binding interaction model of the insulin molecule with its receptor as well.

The characteristics and motion model of insulin monomer

The extensive conformational comparisons among the determined structures of the different species and crystal forms of insulin and the varied insulin derivatives were performed by using the least-squares superimposition technique and the graphics technique. The results of the investigation showed that the structure of molecule I in 2Zn insulin was closer to that of the natural monomer; the conformational difference between two molecules of a dimer came out during dimerization and it was further improved and stabilized during the hexamerization and packing of hexamers in crystal; through the hinge peptides, such as A10, B4, B8, B24, B20 and B23, there was a flexible relative motion among the structural segments in the insulin molecule, and the residues at the B-chain C-terminal might have a shift of more than 10A; the mobility for each residue side-chain was very different due to the different surroundings.

Varicella vaccine in children with acute lymphoblastic leukemia and non-Hodgkin lymphoma

To determine the safety and efficacy of varicella vaccine, 17 children with acute lymphoblastic leukemia (ALL) and 2 children with non-Hodgkin lymphoma (NHL) receiving chemotherapy in remission were immunized with live attenuated varicella vaccine (Oka strain). Rash occurred in 7 children 7-53 days (median 24 days) after vaccination. There were 10-80 (median 20) erythematous vesicles and low-grade fever. All children required no specific treatment. There was no spread of varicella to their susceptible siblings. The control group comprised 92 ALL and 25 NHL patients receiving chemotherapy in remission who were nonvaccinated and susceptible to varicella. Over a risk duration of 80 person-years, one child of the vaccinated group developed varicella of mild degree, whereas in a risk duration of 120 person-years, 14 of the control group developed varicella. One patient died, though prompt antiviral therapy, especially acyclovir, was given to all of them. Herpes zoster of mild degree was observed in one child of the vaccinated group 65 days after vaccination. Two children of the control group developed disseminated herpes zoster. With acyclovir therapy, there was no mortality. The incidence of varicella in the vaccinated group was less than that of the control group. The difference is statistically significant (p = .0222), and the side effects of the vaccine were acceptable. Thus we conclude that the vaccine can be safely used in children with ALL or NHL under chemotherapy and can effectively protect such children from varicella.

Epirubicin and cytosine arabinoside for the induction therapy of childhood acute nonlymphocytic leukemia

Epirubicin, a new anthracycline, was used in combination with cytosine arabinoside for the induction therapy of de novo acute nonlymphocytic leukemia in childhood. The treatment consisted of epirubicin 20 mg/m2/day for 3 days and cytosine arabinoside 100 mg/m2/day for 7 days. The treatment could be repeated every 3 weeks. Remission induction rate was 80% (20/25). Moreover, in 13 patients, the remissions were obtained after a single course. In general, the side effects of epirubicin and cytosine arabinoside were tolerable. However, the main causes of all the three deaths were infections. Our study suggests that epirubicin is acceptable and effective for the induction therapy for de novo acute nonlymphocytic leukemia in childhood.

Non-Hodgkin's lymphomas in Asia

The relative frequencies of the various histopathologic types of lymphomas are generally similar among Asian countries. Hodgkin's disease and follicular lymphomas are relatively rare in Asia. Among NHL, the Asians have a higher rate of aggressive NHL, as compared with the NCI data. Immunologic analysis revealed that PTCL is common in Asia. The relative frequency of PTCL is comparable among Chinese in Taiwan, the east coast of China, and Hong Kong, as well as in adult T-cell leukemia/lymphoma (ATLL) nonendemic areas in Japan. The increased rate of T-cell lymphomas in Asia is attributed to the low incidence of follicular lymphomas. The similar patterns of distribution in histopathologic and immunologic subtypes of NHL in Asia suggest that a common ethnic or geographic factor exists. To elucidate it, further detailed epidemiologic studies are needed. Primary extranodal NHL is slightly more prevalent in Asia than in the United States; the most frequent primary site is Waldeyer's ring in Japanese patients and the GI tract in Chinese patients. Primary small intestinal lymphoma in Asia showed the pattern of the Western type. Primary cutaneous lymphomas are rare in Asia. The clinical features of PTCL in Asia are comparable with those described in the United States, except for a predilection for the nasal/paranasal region. In Asia, outside Japan, ATLL has been reported only in Taiwan. The seroepidemiologic survey of carriers of ATLL showed the rate of seropositivity for HTLV-I in Taiwan was similar to that in nonendemic areas in Japan. The clinicopathologic features of ATLL in Taiwan and Japan are essentially identical. In children in Japan and Taiwan, Hodgkin's disease is much less frequent than in the West. However, the relative frequencies of the histopathologic and immunologic subtypes of childhood NHL in Japan and Taiwan do not differ significantly from those of the West. Although Burkitt's lymphoma in Japan and Taiwan is of nonendemic type, in India it may comprise both endemic and nonendemic types in almost equal number.

Imerslund-Gräsbeck syndrome in two brothers: renal biopsy and ultrastructural findings

In two Chinese siblings with Imerslund-Gräsbeck syndrome, light microscopy of renal biopsies showed no remarkable change. Ultrastructurally, there were small possible focal defects in the glomerular basement membrane. Neither podocytes nor tubular cells showed evident change. No electron dense deposit was found. Our observations on renal ultrastructure differ from the previous five reports. The literature on renal pathology of this syndrome is reviewed.

A subset of acute lymphoblastic leukemia with co-expression of myeloid antigens: prevalence and clinical significance

In order to evaluate the biological features and clinical significance of myeloid antigen expression in acute lymphoblastic leukemia (ALL), immunophenotype analysis was performed on leukemic cells from 160 patients diagnosed as ALL by the French, American and British (FAB) criteria using a comprehensive panel of monoclonal antibodies to lymphoid and myeloid associated antigens. Expression of myeloid antigens was found in 32 cases (20%), including 11 out of 49 adults (22.4%) and 21 out of 111 children (18.9%). CD33 was positive in 18 patients (11.3% of the total cases), CD13 in 15 patients (9.4%), CD 11b in 12 patients (7.5%) and CD14 in 1 patient (0.6%). Nine patients expressed two or more myeloid antigens. There were no significant differences in clinical manifestations and hematological pictures between the ALL patients with myeloid antigen expression (My+ ALL) and those without (My- ALL). No consistent chromosomal abnormality was found in My+ ALL. Eighty percent of the childhood and 44.4% of the adult My+ ALL patients achieved complete remission, compared with 87% and 80%, respectively, for childhood and adult My- ALL, but the differences were not statistically significant. After a median follow-up of 2.1 years, there were also no statistically significant associations between myeloid antigen expression and shorter duration of remission or poorer survival rate for patients with both adult and childhood ALL.

Oxygen tension is a major determinant of hepatotoxicity due to 2-ethylhexanol in isolated tissue cylinders from periportal and pericentral regions of the liver lobule from phenobarbital-treated rats

2-Ethylhexanol, a metabolite of the commonly used plasticizer di(ethylhexyl)phthalate, was shown to cause toxicity exclusively to periportal regions of the perfused liver (Keller et al., 1990, J. Pharmacol. Exp. Ther. 252, 1355-1360.) To determine whether this toxicity was due to local oxygen tension or to drug delivery, isolated cylinders (plugs) of periportal and pericentral regions of the liver lobule from rats pretreated with phenobarbital were collected with a micropunch following brief perfusion of the organ. Plugs were 0.2 mm wide and 0.5 mm long and weighed between 0.5 and 1 mg each. Following incubation for at least 2 hr in Eagle's medium, they were judged viable based on production of urea at high rates and minimal leakage of lactate dehydrogenase (LDH). Plugs could be cultured for up to 24 hr with minimal loss of activity. Urea synthesis from ammonium chloride (3 mM) by plugs incubated in Krebs-Henseleit buffer equilibrated with 95% O2:5% CO2 was proportional to protein concentration and was linear with time for up to one hour at rates around 75 mumol/g/hr. Incubation of plugs with 2-ethylhexanol (0.1 to 3 mM) diminished urea synthesis in a dose-related manner (half-maximal effect = 0.5 mM). Ethylhexanol also caused extensive cell damage assessed from LDH leakage in incubations at 800 microM O2 but significantly less injury at 200 microM O2. Concomitantly, urea synthesis was inhibited by ethylhexanol by over 80% at 800 microM O2 but less than 50% at 200 microM O2. Plugs isolated from both regions of the liver lobule were affected similarly by ethylhexanol and O2. Taken together, these data indicate that ethylhexanol toxicity is dependent on oxygen tension in isolated sublobular regions of the liver lobule, and therefore it is unlikely that drug delivery can explain the selective injury to periportal regions in studies with the perfused liver.

Extralobar pulmonary sequestration of the left retroperitoneum

This paper presents an extralobar pulmonary sequestration in the left retroperitoneum in an eight year old girl. The clinical and diagnostic features included abdominal pain, an abdominal mass, elevated VMA, and radiological manifestations simulating a left adrenal mass. A laparatomy was performed. Extralobar pulmonary sequestration of the left retroperitoneum is fairly uncommon. An eight year old girl was admitted with abdominal pain, elevated urinary VMA and an abdominal mass. The radiological manifestations simulated a left adrenal mass. At surgery an extralobar pulmonary sequestration was detected.

Preliminary crystallographic analysis of deshexapeptide (B25-B30) insulin

Satisfactory single crystals of deshexapeptide (B25-B30) insulin for X-ray crystal structure analysis have been grown in citrate buffer by the method of hanging-drop gas phase diffusion. The crystal belongs to the monoclinic system with space group C2. The unit cell constants are a = 42.6 A, b = 37.9 A, c = 27.2 A, beta = 125.4 degrees and there is only one molecule of deshexapeptide insulin in an asymmetric unit.

Infant leukemia: an analysis of nine Chinese patients

A study was made of the cellular and molecular characteristics of nine Chinese infants, consecutively presenting with acute leukemia. Five cases were acute lymphoblastic leukemia (ALL); four were acute nonlymphoblastic leukemia (ANLL). Hyperleukocytosis, hepatosplenomegaly, and poor response to conventional therapy were common features, and CNS involvement was detected at diagnosis in three cases. The blast cells from all five cases with ALL expressed early B-cell markers, i.e., HLA-DR+, CD19+, but CD10-. Terminal deoxynucleotidyl transferase (TdT) was present in blasts from four of the five cases and periodic acid-Schiff staining in blasts from two patients only. The leukemic cells of one patient also showed positive nonspecific esterase activity and expressed myeloid-associated antigens CD33 (My9), CD11 (OkM1), and CD14 (My4 and Mo2). Molecular analysis of leukemic cell DNA from this and two other patients showed rearrangement of the immunoglobulin (Ig) heavy-chain genes, but without any evidence of kappa light-chain gene rearrangement. T-cell receptor (TCR) genes remained in the germline configuration in these cases. Cytogenetic analysis showed translocation t(4;11) (q21;q23) in all four cases studied. In the group of ANLL, three cases belonged to the M4 and one to the M2 subtype. Chromosomal abnormality involving 11q23 was also detected in two patients: t(11;17)(q23;q11) and del(11)(q14q23) in each case respectively. Neither Ig nor TCR gene rearrangement was present in blast cells from patients with ANLL. The data indicate that chromosomal rearrangement of band 11q23 was quite common in Chinese infants with either form of leukemia, a finding that may have pathogenetic implications.

Studies on the crystal structure of A1-(D-Tryptophan) insulin

We have determined the crystal structure of A1-(D-Trp) insulin and discovered that it belongs to the trigonal system with space group R3. The parameters of the unit cell are a = b = 78.6 A, c = 50.0 A. A set of data for half a sphere reciprocal space to a spacing of 2.2 A were collected. The model was adjusted and refined by using a step-by-step approach and a stereochemically-restrained least squares program, assisted by manual revision based on the difference Fourier maps, to a final R-factor of 0.218. The main and side chains of both A1-D-Trp residues in the asymmetric unit are well ordered. The packing of A1-(D-Trp) insulin in the unit cell, the conformational differences with other insulin structures and its structure and function relationship have also been discussed.

Hepatotoxicity due to clofibrate is oxygen-dependent in the perfused rat liver

Toxicity of clofibrate, a hypolipidemic drug, was assessed in livers from fasted rats perfused in both the anterograde and the retrograde directions. Oxygen uptake decreased steadily following infusion of clofibrate (15 mM) and was diminished by about 40% in 15 min. Cell damage, assessed by the appearance of lactate dehydrogenase (LDH) in the effluent perfusate, began within 20 min. Maximal values for LDH release into perfusate were around 250 U/g/hr after perfusion with clofibrate for 40 min. Inhibition of oxygen uptake and release of LDH into the perfusate was dose-dependent (half-maximal effect = ca. 12 mM clofibrate). Nearly 90% of hepatocytes in oxygen-rich, periportal regions but only about 30% in oxygen-poor, pericentral areas took up trypan blue, an indicator of irreversible cell death, following perfusion with clofibrate in the anterograde direction. In contrast, when livers were perfused in the retrograde direction, 85% of cells in upstream, oxygen-rich pericentral regions were damaged whereas only about 30% in downstream areas were stained. When local oxygen tension was lowered by reducing the flow rate to one-quarter of normal, trypan blue uptake in periportal areas was diminished nearly completely (ca. 5% of cells were stained). Incubation in vitro of isolated cylinders of periportal and pericentral tissue with clofibrate at 800 or 200 microM oxygen led to about three times greater LDH release in incubations carried out at high than at low oxygen tension. This experiment led us to rule out the involvement of clofibrate delivery in the mechanism of zone-specific toxicity. Subsequently, local rates of oxygen uptake were measured using miniature oxygen electrodes placed on the liver surface. Clofibrate decreased oxygen uptake about 30% in oxygen-rich, periportal regions of the liver lobule, yet had no effect on respiration in downstream, pericentral areas. These phenomena can best be explained by a direct effect of clofibrate on active mitochondria in periportal regions of the liver lobule where oxygen uptake predominates, since state 3 but not state 4 rates of respiration were inhibited by clofibrate in isolated mitochondria (half-maximal effect = ca. 1.8 mM clofibrate). Thus, toxicity of clofibrate in upstream, periportal areas of the liver lobule is dependent on local oxygen tension and affects actively respiring mitochondria. This may lead to local cell death and be responsible for initiating a sequence of events leading to the well-known carcinogenic effects of this compound.

Post-hepatitic aplastic anaemia in children in Taiwan, a hepatitis prevalent area

Aplastic anaemia is a rare but serious complication of hepatitis, and hepatitis is an unusual cause of aplastic anaemia in children in the West. However, the relative frequencies of acquired aplastic anaemia in children in Taiwan, a hepatitis prevalent area, differ from those in the West, in the very high frequency of post-hepatitic aplastic anaemia (23.9% of all cases of aplastic anaemia). This may account for the higher incidence of aplastic anaemia in children in Taiwan. Although the prognosis of post-hepatitic severe aplastic anaemia was very poor, the present study using bone marrow transplantation, antithymocyte (or antilymphocyte) globulin, high-dose methylprednisolone and cyclosporin, etc., has improved the response rate and the survival.

O2-dependent hepatotoxicity due to ethylhexanol in the perfused rat liver: mitochondria as a site of action

Toxicity of 2-ethylhexanol, a metabolite of diethylhexyl phthalate, was assessed in the perfused rat liver. Livers from starved rats were perfused with ethylhexanol (3 mM) dissolved in Krebs-Henseleit buffer (pH 7.4, 37 degrees C) saturated with 95% O2-5% CO2 in both the anterograde and retrograde direction. Following infusion of ethylhexanol, O2 uptake and ketone body formation were diminished by 50 and 80%, respectively, and cell damage, as assessed by the appearance of lactate dehydrogenase in the effluent perfusate, was apparent. Both inhibition of O2 uptake by ethylhexanol and the appearance of lactate dehydrogenase in the perfusate were dose-dependent. Only O2-rich upstream regions of the liver lobule were damaged as reflected by trypan blue uptake. Inhibition of O2 uptake by ethylhexanol was also reflected by a 60% decrease in the ATP/ADP ratio. Local rates of O2 uptake, measured using miniature electrodes placed on the liver surface, indicated that ethylhexanol only diminished O2 uptake in O2-rich upstream regions of the liver lobule regardless of the direction of flow. This phenomenon apparently can be explained by a direct effect of ethylhexanol on mitochondria in upstream regions since active state 3 rates of respiration were inhibited by ethylhexanol in isolated mitochondria. Ethylhexanol also caused a dose-dependent decrease in the mitochondrial membrane potential and an increase in the beta-hydroxybutyrate/acetoacetate (B/A) ratio. However, infusion of radical scavengers such as allopurinol, cianidanol and uric acid did not alter lactate dehydrogenase release due to ethylhexanol. Thus, the toxicity of ethylhexanol in the liver is dependent on local O2 tension and mitochondrial are primary targets.(ABSTRACT TRUNCATED AT 250 WORDS)

Intracranial hemorrhage in the hemophiliacs

Five of 34 hemophiliac children suffered from nine episodes of intracranial hemorrhage (ICH) from hemophilia A, and another 3 were B hemophiliacs. Diagnoses were confirmed by computed tomographic scan in all nine episodes. The ages of the patients with ICH ranged from 3 months to 4 1/2 years. The most frequent presenting symptoms were headache and vomiting, followed by focal neurological deficits. Eight of 9 episodes had bleeding in multiple regions. All the patients received immediate replacement therapy had recovered without surgical intervention. The duration of treatment was 10 +/- 2 days. All the patients survived and only one of them had neurological sequela as left hand paresis. From this observation we suggest that the treatment of suspected ICH in hemophiliacs should include prompt replacement therapy for either trauma or neurological symptoms in the absence of trauma history, documentation of ICH by computed tomographic scan, and prolonged replacement therapy and control of increased intracranial pressure in hemophiliacs with documented ICH.

Studies on the crystal structure of (D-Ala)-B0 porcine insulin at 1.9 A resolution

The crystal structure of (D-Ala)-B0 porcine insulin has been determined, using data to 1.9 A and atomic parameters of 2 Zn porcine insulin as a starting model, and through the use of the difference method and the restrained least square method, to a final R-factor of 0.211 and r.m.s. deviation of 0.057 A for the bond lengths. The electron densities of B0 residues were very clear. Introduction of B0 residues into the molecules had reduced the thermal vibration of the N-terminus of B-chain for both molecules I and II and made the molecules pack closer in the crystal. The obvious differences between the crystal structures of 2 Zn and (D-Ala)-B0 porcine insulin were the conformations of partial polar groups around the possible receptor binding surface and the assembly mode of two helixes of A-chain in molecule I. In the local environment of the N-terminus of B-chain there were great differences between the crystal structures of (D-Ala)-B0 porcine insulin, (Trp)-B1 porcine insulin and Des B1(Phe) bovine insulin. In this paper the structure-immunoactivity relationships of insulin molecule have also been discussed briefly.

Crystal structure determination of desheptapeptide (B24--B30)-insulin

Desheptapeptide (B24--B30)-insulin (DHPI), an essentially inactive insulin analog, is crystallized in space group P212121 with two molecules in an asymmetric unit. The orientations of the molecules in the crystal cell have been determined by using Patterson search method at 6 A resolution and the positions of the molecules are deduced from translation function calculation and R search at 3 A resolution. After using the rigid body refinement (CORELS) further to refine the orientational and positional parameters as well as the initial energy restrained refinement (EREF) for the model, the crystallographic R value is reduced to 0.384 at 3 A resolution. The initial Fourier map shows that the B-chain N-terminal (B1-B8) and C-terminal (B20-B22) segments, compared with the native 2 zinc insulin, exhibit drastic conformational changes, but the three helices of B- and A-chains and their relative arrangement are essentially kept in DHPI.

Granulocyte/macrophage colony-forming units from cord blood of premature and full-term neonates: its role in ontogeny of human hemopoiesis

It is still uncertain whether the yolk sac is the only origin of hemopoietic stem cells during fetal development. We studied the level of circulating granulocyte/macrophage colony-forming unit (CFU-GM) from the 23rd week of gestation to fullterm, trying to delineate its role in the ontogeny of human hemopoiesis. Cord blood samples were collected from 45 healthy premature neonates and 91 healthy full-term neonates. CFU-GM assays were performed using a single agar layer system with human placental conditioned medium as a source of colony stimulating activity. The mean numbers of colonies produced from the cord blood samples of the premature and full-term neonates were 116 +/- 185 (SD) and 96 +/- 113/2 x 10(5) mononuclear cells, respectively. There was no statistical difference between the numbers of colonies of the two groups (Mann-Whitney test, p greater than 0.05). These results indicate that the level of circulating CFU-GM from the 23rd week of gestation to full term is constantly high and add credence to the assumption that CFU-GM are produced not only from the yolk sac but also from other hemopoietic sites.

Studies on the crystal structure of A1-(L-tryptophan) insulin at 2.1 A resolution

In order to study the biological effect of alterations to the N-terminus of the insulin A-chain, we have determined the crystal structure of A1-(L-Trp) insulin and discovered that it belongs to the trigonal system with space group R3. The parameters of the unit cell are a = b = 80.3A, c = 37.5A. The model was adjusted and refined by using a stereochemically-restrained least squares program, assisted by manual revision of the model based on the difference Fourier map, to a final R-factor of 0.195. The main and side chains of both A1-(L-Trp) residues in the asymmetric unit are well ordered. It was found that the A1-Trp residue of molecule I occupied two distinct positions. We have proposed from the results of the three-dimensional structure that the 4-zinc insulin hexameric form is a stored state of insulin molecules in a conformation of low activity. The structural details of the insulin molecule and its structure and function relationship have also been discussed.

A simple and rapid in situ staining method for granulocyte-macrophage colonies in agar culture

This report describes a very simple, quick and effective method for in situ staining of granulocyte-macrophage colonies in agar cultures and for classifying various colony types. The procedure takes only one minute to fix and a few minutes to stain; a few additional minutes are required for preparation of the permanent whole plate. In this process the Riu stain, a modified Romanowsky stain, is used. Besides the ease and rapidity of this procedure, the identification of colony types appears to be enhanced. Thus, the method seems to be very beneficial in routine observations of colony types.

Reactive histiocytosis in acute lymphoblastic leukemia and non-Hodgkin's lymphoma

An extensive hemophagocytic syndrome in the termination of one case of pre-T acute lymphoblastic leukemia (ALL) and another case of non-Hodgkin's lymphoma (NHL), are described. Since most of the proliferating cells were mature macrophages and these cells were limited in the mononuclear phagocytic system (MPS), it was determined to be a reactive histiocytosis rather than histiocytic medullary reticulosis (HMR) or malignant histiocytosis (MH). The pathogenesis of the HMR or MH-like syndrome in these patients is discussed, and it is considered that this might be a reaction of the bacterial sepsis related to their immunosuppressed state secondary to the pre-existing malignancies and/or the cytotoxic therapy. The literature was reviewed. Based on a proposal for differential diagnosis between reactive histiocytosis and MH (or HMR), the heterogeneity of HMR-like syndrome complicating the malignancies are clarified.

To early distinguish neonatal transient leukemoid proliferation from congenital leukemia by in vitro cell growth

To differentiate neonatal transient leukemoid proliferation from congenital leukemia at an early stage is often difficult. Bone marrow culture is found to be helpful in this aspect. A normal in vitro growth pattern suggests transient leukemoid proliferation, while an abnormal growth pattern indicates congenital leukemia. A neonate who manifested with pictures mimicking acute myeloblastic leukemia (M1), had a karyotype of 46, XY/46, XY, i(21 q). However, the in vitro growth pattern was normal and so only supportive treatment was given. All the leukemoid manifestations disappeared several months later and he is now a healthy 2 year old boy remaining in complete remission. A second neonate who also displayed features of acute myeloblastic leukemia (M2), had a karyotype of 46, XY/47, XY, + 21 and abnormal in vitro growth pattern. This neonate died at 18 days of age.

Molecular structure and absolute configuration of suberogorgin

In the present paper it is reported that the molecular structure and absolute configuration of poisonous suberogorgin are determined by using X-ray diffraction method. The crystal of suberogorgin belongs to orthogonal system with space group D4(2)-P2(1)2(1)2(1). The crystallographic parameters are: a = 16.135A, b = 13.189A, c = 12.901A, Z = 8. The initial model of the crystal structure was solved by the direct method. The refinement of the structure parameters was carried out by using the least square method and led to a final R-factor of 0.056. In accordance with the molecular structure of suberogorgin mentioned above, the solvent effect of NMR has been further discussed and the relationship between the molecular structure of suberogorgin and its toxicity has also been preliminarily investigated.

The growth of single crystal and the determination of crystallographic parameters of (L-tryptophan)A1-insulin and (D-tryptophan)A1-insulin

The crystal-growing conditions and the results of preliminary X-ray crystallographic analysis of (L-Try)A1-insulin and (D-Try)A1-insulin are reported. The single crystals of this pair of insulin analogue suitable for X-ray diffraction analysis have been grown in the citrate buffer system by still-setting method. They both belong to the trigonal system with space group R3. The parameters of the unit cell (L-Trp)A1-insulin are aH = 80.31A, cH = 37.45A and those of (D-Trp)A1-insulin aH = 79.48A, cH = 43.81A. There are two molecules in an asymmetric unit. The obtained results are discussed.

Molecular structure and absolute configuration of the diterpene lactone, praelolide

Praelolide is a new compound which was isolated out from the gorgonian, Menella praelonga (Ridley), collected from the South Sea of China at Zhanjiang, Guangdong. The molecular formula is C28H35O12Cl. The research result by X-ray diffraction method on the crystal structure is presented. The compound is orthorhombic with space group P2(1)2(1)2, cell dimensions a = 16.936, b = 16.709, c = 10.333 A, and Z = 4. The structure has been solved by direct method and refined to R = 0.055 for 2257 unique observable reflexions by least-squares. The molecule is composed of the major conformational isomer in which the three main rings (a six-membered ring, an eight-membered ring, a six-membered ring) take separately the form of chair-chairboat-chair, a five-membered actone ring, a C1 substitution, 4 acetate groups, and a three-membered epoxide ring. The absolute configuration of the molecule has also been determined by statistics (R factor ratio R = 1.012) and Bijvoet pairs observation. For 30 pairs of the greatest anomalous contributions the residuals are R'(+) = 0.057 for the first enantiomorph and R'(-) = 0.005 for the second one, so the latter should unambiguously correspond to the absolute configuration of the molecule.

The growth of single crystals of (L-arginine)B0 bovine insulin and their preliminary X-ray crystallographic analysis

The crystals of (L-Arg)B0 bovine insulin large enough for X-ray structure analysis have been grown by vapour diffusion in a buffer containing citrate, acetone and zinc chloride. The X-ray diffraction of the crystals extends to 3.0 A spacing. The crystals belong to the trigonal system with unit cell dimension of a = b = 81.82 A, c = 35.05 A, alpha = beta = 90 degrees, gamma = 120 degrees, space group R3. There are two insulin molecules in the crystallographic asymmetric unit.

Subcellular site of antispermatogenic effect of gossypol and its possible molecular mechanism of action

This paper reports the results of gossypol effects on the testicular mitochondrial ultrastructures and functions. A hypothesis of mechanism of gossypol action based on our experimental data was postulated. Electron microscopic observations confirmed further our previous studies that the mitochondria of the target germ cells were the most sensitive and the most severely damaged among cellular organelles in response to gossypol. The damages included the swelling, vacuolation, crista depletion, lysis, granular accumulation in matrix and the process of intact mitochondria disintegration. The activity of the mitochondrial marker enzyme, the LDH-X of human spermatozoa, was markedly decreased or suppressed completely after gossypol treatment. The functions of isolated testicular mitochondria determined by Warburg manometric and oxygen electrode polarographic methods indicated that gossypol stimulated respiration but inhibited slightly the oxidative phosphorylation at low concentrations (20-40 microM) in vitro. With the increase in concentration of gossypol, the mitochondrial respiration and phosphorylation decreased obviously, they were completely inhibited at a concentration of 80 microM for oxidative phosphorylation and at about 300 microM for respiration. The degree of uncoupling of phosphorylation appears to be dose-dependent. Similar results were obtained for the testicular mitochondria isolated from rats that had been administered per os gossypol previously (6 mg, 10 mg and 15 mg/day X 21 respectively), in which the P/0 ratio decreased significantly (P less than 0.001) as compared with that of the control group. The distribution of 14C-gossypol in mitochondrial was found to be 2-3 times higher than that in other subcellular fractions. Similar pattern of distribution was shown in double labeling experiments with 14C-gossypol and 3H-ouabain.