Lack of ultrastructural detrusor changes following endoscopic injection of botulinum toxin type a in overactive neurogenic bladder

INTRODUCTION

Endoscopical injections of Botulinum toxin type A into the detrusor muscle are gaining clinical acceptance in the treatment of neurogenic detrusor overactivity. Structural effects of Botulinum toxin type A are only known from studies on striated muscles, where a widespread nerve sprouting occurs temporarily. The aim of this study was to evaluate the ultrastructural effects of Botulinum toxin type A injections on the human detrusor.

MATERIAL AND METHODS

30 detrusor biopsies were obtained from 24 patients with neurogenic detrusor overactivity. Patients were divided into two groups: Group I included 13 biopsies from patients before the first Botulinum toxin type A injection. Group II included 6 biopsies from patients within 3 months after the first injection and 11 biopsies at the time of decreasing efficacy of Botulinum toxin type A. The biopsies were processed by standard procedure for detailed electron microscopic study and evaluated by 2 examiners without prior knowledge of clinical/urodynamic data.

RESULTS

No statistically significant detrusor changes have been found concerning muscle cell fascicle structure (p = 0.445), width of intercellular space (p = 0.482) and number/kind of muscle cell junctions (p = 0.443). A median of 70% of intrinsic axon terminals presented with signs of degeneration in group I, a median of 66% in group II (p = 0.840). Out of 309 evaluated axon terminals in both groups, 1 sprouting axon was found in group I, 3 sprouting axons in group II (p = 0.864). Specimen from group I and group II showed only limited collagen deposits within the detrusor. No changes in the ultrastructure of the detrusor have been observed in those biopsies obtained before and after the Botulinum toxin type A injection of the same patient.

CONCLUSION

This study verifies our earlier report of severe intrinsic axon degeneration in the detrusor of patients with neurogenic detrusor overactivity. It also shows nearly no structural differences of the detrusor before and after Botulinum toxin type A injections. Contrary to reports of striated muscle, axonal sprouting within the detrusor was very limited after Botulinum toxin type A injections indicating pathophysiologically different reactions to the toxin either between striated muscle and smooth muscle or between different treated diseases.

Splanchnic oxygen transport, hepatic function and gastrointestinal barrier after normothermic cardiopulmonary bypass

BACKGROUND

The effect of non-pulsatile, normothermic cardiopulmonary-bypass (CPB) on the splanchnic blood-flow and oxygen-transport, the hepatic function and the gastrointestinal barrier were observed in a prospective observational study in 31 adults undergoing cardiac valve replacement surgery.

METHODS

The splanchnic (i.e. hepatic) blood-flow (HBF) was measured by the constant infusion of indocyanine-green (ICG) using a hepatic-venous catheter. Liver function was examined by calculation of lactate uptake, ICG extraction and the monoethylglycinexylidide (MEGX) test. A day before and after surgery the gastrioduodenal and intestinal permeability was measured by determination of sucrose and lactulose/mannitol excretion.

RESULTS

Splanchnic blood flow and oxygen delivery did not decrease during and after surgery while splanchnic oxygen consumption (P < 0.0125) and arterial lactate concentrations increased. The splanchnic lactate uptake paralleled the lactate concentration. After but not during CPB an increase of systemic oxygen consumption was observed. The MEGX test values decreased on the first day after surgery. The ICG extraction was attenuated during the operation. The gastroduodenal and the intestinal permeability increased significantly postoperatively (P < 0.002, respectively, P < 0.001). There was no correlation between these findings and the duration of CPB. There was a significant correlation of the intestinal permeability but not of the gastroduodenal permeability between the prior and after surgery values (P < 0.001).

CONCLUSION

Increased oxygen consumption during CPB may indicate an inflammatory reaction due to the pump beginning in the splanchnic area or a redistribution of the splanchinc blood flow during the CPB. Normothermic CPB does not lead to a significant or prolonged reduction of liver function. Normothermic CPB causes an increase of gastrointestinal permeability. The intestinal barrier function prior to surgery was accountable for the degree of loss of intestinal barrier function following surgery.

Synergistic interaction of two independent genetic loci causes extreme elevation of serum IgA in mice

Understanding the molecular regulation of immunoglobulin A (IgA) expression is important as it plays an essential role in the first-line defence through mucosal secretions. Using inbred mouse strains, we identified two independent and dominant acting genetic loci that synergistically cause a 40-fold upregulation in serum IgA levels when introduced into the murine strain C57Bl/6J (B6). The first locus on chromosome 12 appears to be mainly responsible for the natural four-fold higher IgA levels in C3HeB/FeJ (C3H) compared to B6 mice. A second independent, chemically induced mutation on chromosome 5 caused a two-fold elevation when transferred from C3H into B6 mice. Both loci in concert effect a 40-fold elevation against the B6 genetic background. We determined the chromosomal localization of the two loci simultaneously by a one-step mapping process. The chemically induced mutation was identified within the immunoglobulin joining chain (IgJ) gene on chromosome 5. The major serum IgA modifier between the C3H and B6 was located on chromosome 12. This modifier region was mapped to a 350 kb region containing several immunoglobulin heavy-chain genes and the Ig alpha germline switch gene. We speculate that by interfering with both IgA expression and distribution, synergistic regulation of IgA is achieved.

A mouse model for cystinuria type I

Cystinuria, one of the most common inborn errors of metabolism in humans, accounts for 1-2% of all cases of renal lithiasis. It is caused by defects in the heterodimeric transporter system rBAT/b0,+AT, which lead to reduced reabsorption of cystine and dibasic amino acids through the epithelial cells of the renal tubules and the intestine. In an N-ethyl-N-nitrosourea mutagenesis screen for recessive mutations we identified a mutant mouse with elevated concentrations of lysine, arginine and ornithine in urine, displaying the clinical syndrome of urolithiasis and its complications. Positional cloning of the causative mutation identified a missense mutation in the solute carrier family 3 member 1 gene (Slc3a1) leading to an amino acid exchange D140G in the extracellular domain of the rBAT protein. The mouse model mimics the aetiology and clinical manifestations of human cystinuria type I, and is suitable for the study of its pathophysiology as well as the evaluation of therapeutic and metaphylactic approaches.

Interleukin-12 inhibits apoptosis in chronic lymphatic leukemia (CLL) B cells

The purpose of the present study was to investigate the effect of interleukin-12 on apoptosis of chronic lymphatic leukemia (CLL) B cells. Apoptotic indices were determined in highly purified CD5(+) B lymphocytes isolated from peripheral blood of seven patients with histologically confirmed CLL. Interleukin-4 as a known inhibitor of apoptosis was used as control. Quantitative analysis of apoptosis was determined by cell death detection ELISA. Our findings indicate that interleukin-12 inhibits ex vivo apoptosis in a large proportion of B-CLL patients and may be closely involved in the pathogenesis of disease. Therefore, our results may help identify potential new therapeutic targets in this malignancy.

Interferon-alpha resistance in renal carcinoma cells is associated with defective induction of signal transducer and activator of transcription 1 which can be restored by a supernatant of phorbol 12-myristate 13-acetate stimulated peripheral blood mononuclear cells

Therapy of selected human malignancies with interferon-alpha is widely accepted but often complicated by the emergence of interferon-alpha resistance. Interferon is a pleiotropic cytokine with antiproliferative, antitumour, antiviral and immunmodulatory effect; it signals through the Jak-STAT signal transduction pathway where signal transducer and activator of transcription 1 plays an important role. Here we report both, a lack of signal transducer and activator of transcription induction in interferon-alpha resistant renal cell carcinoma cells and signal transducer and activator of transcription 1 reinduction of phorbol 12-myristate 13-acetate-stimulated peripheral blood mononuclear cells supernatant. Preliminary experiments on the identification of the molecules that reinducing signal transducers and activators of transcription 1 indicate that interferon-gamma may be the responsible candidate cytokine, but several others may be involved as well. This work provides the basis for therapeutic strategies directed at the molecular modulation of interferon-alpha resistance in human neoplasms.

Screening, confirmation and quantification of diuretics in urine for doping control analysis by high-performance liquid chromatography-atmospheric pressure ionisation tandem mass spectrometry

A sensitive, selective, robust and fast method to identify 32 diuretics and masking agents in urine is described. The analytical procedure is reduced to a single XAD extraction step for sample preparation, followed by reversed-phase liquid chromatography in combination with atmospheric pressure ionisation/tandem mass spectrometry. This technique is, after minor modifications, suitable for screening analyses and confirmation of identity as well as quantitation of diuretics. Considerations relating to the stability and metabolism of the compounds are given if relevant for routine screening analyses.

Risk factors for prolonged ventilation after cardiac surgery using APACHE II, SAPS II, and TISS: comparison of three different models

OBJECTIVE

To identify the risk for prolonged mechanical ventilation in cardiac surgical patients.

DESIGN

Prospective study with retrospective combination of a second database.

PATIENTS

Six hundred and eighty-seven patients after cardiac surgery over a period of 12 months.

MEASUREMENTS

Demographic data were recorded preoperatively, and surgical procedures intraoperatively using a surgical database designed for quality control. Length of ICU and hospital stay, and hospital outcome were recorded. Severity of illness was assessed daily using APACHE II, SAPS II, and Organ Failure Score. Intensity of treatment and nursing care was monitored by means of the Therapeutic Intervention Scoring System (TISS). Univariate and multivariate analyses were performed using logistic regression. The predictive value of the identified variables was tested by the Wilcoxon test using the receiver operating characteristic curve.

MAIN RESULTS

Sixty-two patients (9.0%) were ventilated for > 48 h and accounted for 42.8% of the total costs in the ICU. The pre- and intraoperatively collected data produced a model with weak predictive capacity for prolonged ventilation [area under curve (AUC) 73.22 and 71.08, respectively]. The use of TISS and SAPS postoperatively resulted in an effective model of prediction (AUC 93.76). Adding the occurrence of reoperation, reintubation, emergency transfusion, intraaortic balloon pumping, and need for total parenteral nutrition to the model further improved its predictive capacity (AUC 94.74).

CONCLUSIONS

The present results strongly suggest that data collected postoperatively using established scoring systems as well as documented events of high clinical impact for risk assessment and quality control are reliable predictors of prolonged ventilation.

Abnormalities of the photoreceptor-bipolar cell synapse in a substrain of C57BL/10 mice

PURPOSE

A preferential loss of ERG b-wave was detected in a substrain of C57BL/10 mice. Electroretinographic and histologic techniques were used to investigate this hitherto unknown retinopathy.

METHODS

ERGs were obtained from normal and affected C57BL/10. C57BL/6 mice served also as controls. a-Wave and c-wave analyses were performed. Microscopic investigations were done at two different ages.

RESULTS

In the scotopic ERG, a severe reduction of the b-wave amplitude could be observed, whereas the a-wave was only moderately attenuated ("negative ERG"). With age, the a-wave amplitude further decreased, but the rate of reduction was comparable to normals. Oscillatory potentials were severely altered, and the photopic ERG was absent. The ERG c-wave was comparable to normal. ERG a-wave analysis also revealed a reduced maximum amplitude, but no significant difference of receptor sensitivity. Light microscopy revealed a thinning of all retinal layers but mostly of the outer plexiform layer. The number of photoreceptor nuclei was reduced by one third. Electron microscopy revealed a profound loss of ribbon-shaped synapses between rod and rod-bipolar cells and severely abnormal ribbons in the case of cones.

CONCLUSIONS

The so-called negative ERG was associated with alterations in the synaptic layer between rods and rod bipolars. The absent cone ERG may be due to the altered cone-on-bipolar synapses. The overall thinning of the retina as well as the moderately reduced scotopic a-wave amplitude remain unexplained.

Tumour microdissemination and survival in metastatic melanoma

The value of tyrosinase messenger RNA (mRNA) detection by reverse-transcriptase polymerase chain reaction (RT-PCR) as a marker for circulating melanoma cells remains controversial. However, it has been suggested that detection of melanoma cell mRNA may be used to evaluate prognosis and disease progression in patients with advanced malignant melanoma. We used a highly sensitive tyrosinase RT-PCR detection assay to test peripheral blood specimens of 80 patients with metastatic malignant melanoma. Moreover, we developed a multiple marker RT-PCR assay detecting a variety of additional melanocyte/tumour specific markers addressing the potential heterogeneity of gene expression of circulating melanoma cells. Thus subgroups of 32 and 12 out of all the 80 patients were also analysed for multimarker gene expression in their peripheral blood and bone marrow specimens, respectively. Altogether, 15 out of 80 patients tested positive for one or more molecular markers with heterogeneous melanocyte/tumour gene expression patterns. All RT-PCR positive patients presented with progressive and widely disseminated disease. We concluded that the detection of melanoma cell mRNA occurs in a stage of massive tumour progression and may predict poor clinical outcome in advanced malignant melanoma patients (p < 0.001). In addition, the multiple marker RT-PCR analysis was more reliable and sensitive than a single molecular marker assay for the detection of melanoma cells.

Synaptosome-associated protein of 25 kilodaltons in oocytes and steroid-producing cells of rat and human ovary: molecular analysis and regulation by gonadotropins

The synaptosome-associated protein of 25 kDa (SNAP-25) is crucially involved in exocytosis in neurons. The aim of this study was to investigate whether it is present in the ovary. We found SNAP-25 to be expressed in nonneuronal cells of the rat and human ovary, namely in all oocytes and in steroidogenic cells, including granulosa cells (GC) of large antral follicles and luteal cells. Both isoforms, SNAP-25a and b, were found in the ovary. Oocytes obtained by laser capture microdissection were shown to express SNAP-25b, whereas SNAP-25a was found in rat GC and human luteinized GC. Immunohistochemical observations of strong SNAP-25 staining in GC of large growing antral follicles compared with absent or weak staining in small follicles suggested a role in folliculogenesis. To study a presumed regulation of SNAP-25, we used a rat GC line (GFSHR-17), which expresses FSH receptors, and luteinizing human GC, which express LH receptors. FSH elevated SNAP-25 mRNA and protein levels about fivefold within 24 h in GFSHR-17 cells. The cAMP analogue dibutyryl-cAMP (db-cAMP) mimicked this action of FSH. The effects of both db-cAMP and FSH were inhibited by the protein kinase A (PKA) inhibitor H89. In contrast, SNAP-25 protein and mRNA-levels were not altered by LH/hCG in luteinized human GC. Our results for the first time identify SNAP-25b in oocytes and SNAP-25a in steroidogenic cells of the mammalian ovary. SNAP-25a and b may be involved in different exocytotic processes in these cell types.

Molecular and prognostic classification of advanced melanoma: a multi-marker microcontamination assay of peripheral blood stem cells

The presence or absence of melanoma cells in human peripheral blood has recently been shown to be associated with disease prognosis, including overall survival. The detection of tyrosinase mRNA-positive circulating melanoma cells by reverse transcription-polymerase chain reaction (RT-PCR) has been limited to disseminated tumours expressing measurable amounts of this melanocyte-specific enzyme. To biologically classify both melanotic and amelanotic melanomas and to evaluate the clinical and prognostic relevance of tumour cell microcontamination, we examined autologous peripheral blood stem cell (PBSC) harvests from patients with advanced malignant melanoma prior to dose-escalated chemotherapy. To assay heterogeneous melanoma cell antigen expression, we developed a highly sensitive RT-PCR using four melanoma- and one tumour-associated antigen as molecular markers. Expression of the melanocyte-associated transcripts of tyrosinase, MART1/Melan-A, tyrosinase-related protein-1 (TRP-1) and tyrosinase-related protein-2 (TRP-2) as well as the tumour-specific transcript of MAGE-3 was analysed by RT-PCR in PBSC harvests from 31 patients. Seven of the 31 PBSC harvests tested positive for one or more molecular markers: two patients for tyrosinase only, and one patient for MAGE-3 only, one patient for tyrosinase and MAGE-3, one for tyrosinase and MART1/Melan-A, and two patients for tyrosinase, MART1/Melan-A, TRP-2 and MAGE-3. mRNA-positive patients exhibited a significantly impaired overall survival (P = 0.0032), with a median survival of 3 months as opposed to 10 months in PBSC mRNA-negative patients. In conclusion, the use of this multiple-marker microcontamination assay allowed for molecular and prognostic classification of advanced malignant melanoma.

Analytical strategy for detecting doping agents in hair

Lists of banned classes of doping agents are released by the International Olympic Committee, adopted by other sports authorities and updated regularly, including the substance classes stimulants, narcotics, diuretics, anabolic agents, peptide hormones, beta-blockers etc. There are different classes of restriction: anabolic and masking agents (anabolic steroids, diuretics etc.) are always banned for athletes regardless of their topical activity (training or competition) several substances are permitted with certain restrictions (caffeine below a cut-off value, or inhalation of some beta 2 agonists) beta-blockers are prohibited in competitions of certain sports disciplines the majority of the substances (stimulants, narcotics etc.) is prohibited during competitions, so that they do not have to be analysed in out-of-competition samples. A differentiation between training and competition period is impossible by means of hair analysis due to the uncertainty of (especially short-term) kinetic considerations related to hair growth. Therefore, the analytical identification of doping relevant substances in hair is not always a sufficient criterion for a doping offence and the identification of stimulants, beta-blockers etc. in hair would be entirely irrelevant. The most interesting target substances are certainly the anabolic agents, because their desired action (enhanced muscle strength) lasts longer than the excretion, leading to sophisticated procedures to circumvent positive analytical results in competition control. Besides the analysis of out-of-competition control samples, the long term detection of steroids in hair could provide complementary information. An analytical approach to the identification of exogenous steroids in hair requires consideration of the presence of many other steroids in the hair matrix interfering the analysis at trace levels, and of a limited chemical stability. The analysis of endogenous steroids in hair appears to be even more complicated, because the possibility of many biotransformation reactions from (into) other precursors (metabolites) has to be taken into account. Precursor substances of anabolic steroids (especially esters as application forms) are very promising analytical targets of hair analysis, because they can only be detected after an exogenous intake. The quantitative evaluation of active parent compounds like testosterone (which is actively involved in physiological processes of hair growth) in hair is still controversial. Clinical applications under reproducible conditions can be useful, but the biovariability of these parameters will probably prevent the definition of acceptable cut-off levels as a criterion of abuse.

[Propane abuse. Extreme dose increase due to development of tolerance]

In spite of its serious sequelae, volatile substance abuse (VSA) attracts very little public attention in Germany. Our case report describes an adult male who inhaled propane for recreational purposes. Initially, he achieved short-lived euphoria and hallucinations. He compensated for the developing tolerance by increasing the dosage, finally consuming 5 litres of fluid propane daily. Getting such quantities was facilitated by his occupational access to propane. Since he abused the propane in an apartment house, he also exposed third parties to the danger of explosion. Clinical examination revealed disturbances in orientation, restricted perceptivity and concentration, reduced mnemonic performance, and psychomotor agitation. All these symptoms diminished during a 6-month follow-up. The relationship of his organic mental disorder to the abuse of propane was not clear, since he had also abused alcohol.

Bioavailability of trospium chloride after intravesical instillation in patients with neurogenic lower urinary tract dysfunction: A pilot study

Oral drug treatment of detrusor overactivity often causes undesirable side effects in other organs. For some patients, in particular those with neurogenically induced detrusor overactivity (detrusor hyperreflexia), the tolerance level for adverse effects is low and oral treatment may become ineffective. Intravesical administration of the drug can diminish the side effects or increase treatment effectivity in patients who are (partially) refractory to oral treatment because the relative concentration of the drug is increased in the target organ and decreased in the circulation. Six men (19-34 years old) with traumatic spinal cord lesions between C2 and Th11 were randomized to intravesical instillation with 15 or 30 mg trospium chloride in 40 ml saline into the empty bladder. Catheterization was postponed until at least 3 h after instillation, and fluid intake was not allowed during the first 4 h. Blood samples were taken before and 11 times after instillation; the last sample 12 h post instillation. Four positive samples were found in three patients: 0.10 ng/ml after 1 h and 0.13 ng/ml after 2(1/2) h in two patients with 15 mg, and 0.24 ng/ml after 30 min and 0.70 ng/ml after 6 h in one patient with 30 mg instilled trospium chloride. Three adverse effects were reported and were rated as probably not related to the drug. It is concluded that intravesically instilled trospium chloride is not absorbed into the circulation in significant amounts and, thus, it may be expected that this mode of administration will improve the efficacy of trospium chloride therapy by reducing the side effects. Neurourol. Urodynam. 18:447-453, 1999.

SNAP-25 requirement for dendritic growth of hippocampal neurons

Structure and dimension of the dendritic arbor are important determinants of information processing by the nerve cell, but mechanisms and molecules involved in dendritic growth are essentially unknown. We investigated early mechanisms of dendritic growth using mouse fetal hippocampal neurons in primary culture, which form processes during the first week in vitro. We detected a key component of regulated exocytosis, SNAP-25 (synaptosomal associated protein of 25 kDa), in axons and axonal terminals as well as in dendrites identified by the occurrence of the dendritic markers transferrin receptor and MAP2. Selective inactivation of SNAP-25 by botulinum neurotoxin A (BoNTA) resulted in inhibition of axonal growth and of vesicle recycling in axonal terminals. In addition, dendritic growth of hippocampal pyramidal and granule neurons was significantly inhibited by BoNTA. In contrast, cleavage of synaptobrevin by tetanus toxin had an effect on neither axonal nor dendritic growth. Our observations indicate that SNAP-25, but not synaptobrevin, is involved in constitutive axonal growth and dendrite formation by hippocampal neurons.

Introduction to the application of capillary gas chromatography of performance-enhancing drugs in doping control

Performance-enhancing drugs banned by antidoping rules are detected in doping control preferably by hyphenated chromatographic techniques, capillary gas chromatography in particular. Based on the prohibited classes of substances and on the general aspects of sample collection and preparation, a survey is given about the usual procedures of screening, identification and confirmation of the most important doping agents: stimulants, narcotics, anabolics, diuretics, beta-blockers. In addition to gas chromatography itself, the application of various MS techniques doping is outlined.

Altered expression of beta 1 integrins in renal carcinoma cell lines exposed to vinblastine

BACKGROUND

Cellular expression of P-glycoprotein (P-gp) which mediates a well characterized mechanism of multidrug resistance (MDR) has been reported previously to be associated with an enhanced tumor dissemination. Since adhesion receptors of the beta 1 integrin family play a substantial role in tumor spread, we studied expression of VLA-1 to -6 in a total of four renal carcinoma cell (RCC) lines prior to and after induction of MDR via exposure to vinblastine.

MATERIAL AND METHODS

Surface expression of P-gp and VLA-1 to -6 was determined immunocytochemically in untreated pre-established renal carcinoma cell lines (Caki-1, Caki-2, A498) and a cell line derived from a RCC patient who had received a vinblastine-containing therapy regimen prior to the resection of a local relapse of the tumor (EH). Resistant sublines were cultivated in the presence of 1 ng/ml and 10 ng/ml of vinblastine sulfate, respectively.

RESULTS

In all cell lines examined, an increased number of P-gp expressing cells was observed upon exposure to vinblastine. Significant changes of beta 1 integrin expression were observed in three of four RCC cell lines. A de novo expression of VLA-1, VLA-2, and VLA-4 as detected by immunocytochemistry occurred in resistant Caki-1 cells. A498 cells showed an increasing number of VLA-2 positive cells in drug resistant sublines. In contrast, a decrease of VLA-2 and VLA-5 expression was found in EH cells, the only cell line exhibiting P-gp expression prior to vinblastine exposure. Caki-2 cells showed no significant changes of surface integrin expression upon treatment with vinblastine.

CONCLUSIONS

Our results demonstrate that induction of drug resistance can be associated with substantial changes of the integrin phenotype in renal carcinoma cell lines. In our experiments, among all VLAs studied, VLA-2 was most frequently altered in expression by RCC cell lines. The significance of these observations for aberrant metastatic properties of multidrug resistant tumor cells will be the subject of further studies.

Transient entrainment of a circadian pacemaker during development by dopaminergic activation in Syrian hamsters

Maternal cues entrain a circadian pacemaker in fetal Syrian hamsters. These cues may act through dopaminergic activation of the fetal suprachiasmatic nucleus (SCN); injection of the dopamine D1 agonist SKF38393 to pregnant hamsters entrains activity rhythms of their pups and induces expression of c-fos in the fetal SCN. The aim of this study was to examine the ability of SKF38393 to entrain neonatal Syrian hamsters and to determine the age at which this effect is lost. SKF38393 injections given to two groups of pups at opposite times of day on postnatal days (PN) 1-5 entrained the pups' activity rhythms to average phases that differed by 9.25 h. SKF38393 failed to establish different average phases when given on PN 6-10. Injection of SKF38393 on PN 1, but not PN 6, induced expression of Fos. These results demonstrate that dopaminergic activation is a potent entraining stimulus in neonatal hamsters and that its entraining effects, as well as its ability to induce Fos, are lost by PN 6. The phase established by dopaminergic activation was approximately opposite to that previously shown to be established by melatonin injections. Dopaminergic activation and melatonin may mimic separate but complementary maternal entraining signals which represent day and night.

Melatonin entrains the restored circadian activity rhythms of syrian hamsters bearing fetal suprachiasmatic nucleus grafts

A circadian pacemaker consists of at least three essential features: the ability to generate circadian oscillations, an output signal, and the ability to be entrained by external signals. In rodents, ablation of the suprachiasmatic nucleus (SCN) results in the loss of circadian rhythms in activity. Rhythmicity can be restored by transplanting fetal SCN into the brain of the lesioned animal, demonstrating the first two of the essential pacemaker features within the grafts. External signals, such as the light/dark cycle, have not, however, been shown to entrain the restored rhythms. Melatonin injections are an effective entraining stimulus in fetal and neonatal Syrian hamsters of the same developmental ages used to provide donor tissue for transplantation. Therefore, melatonin was used to test the hypothesis that SCN grafts contain an entrainable pacemaker. Daily injections of melatonin were given to SCN-lesioned hosts beginning on the day after transplantation of fetal SCN. Two groups that received melatonin at different times of day 12 hr apart each showed significantly clustered phases but with average phases that differed by 8.67 hr. Thus melatonin was able to entrain the restored circadian activity rhythms. In contrast to these initial injections, injections given 6 weeks after transplantation were unable to entrain or phase shift the rhythms. The results demonstrate that SCN grafts contain an entrainable circadian pacemaker. In addition, the results also indicate that the fetal SCN is directly sensitive to melatonin and, as with intact hamsters, sensitivity to melatonin is lost during SCN development.

Elevated plasma levels of interleukin-1 receptor antagonist are associated with decreased cellular BCL-2 oncoprotein expression in B-chronic lymphocytic leukemia

Plasma IL-1Ra levels and cellular BCL-2 oncoprotein expression were measured in a total of forty blood samples obtained from twenty-eight B-CLL patients and four healthy subjects. High IL-1Ra plasma levels (as defined by mean + three times standard deviation of normal controls) were observed in eleven samples (ten patients) which showed a significantly decreased cellular expression of BCL-2 protein (14.7 +/- 16.3% of cells as determined by immunofluorescence) when compared to B-CLL samples with no elevated IL-1Ra (BCL-2, 31.0 +/- 18.6%; p < or = 0.0115). Albeit correlational only, our results may encourage further experiments to elucidate potential regulatory effects of IL-1Ra for cellular BCL-2 oncoprotein expression.

Loss of VLA-3 (CD49c/CD29) expression in two multidrug resistant Burkitt's lymphoma cell lines

Expression of P-glycoprotein (P-gp) mediated multidrug resistance (MDR) has been suggested to be associated with an impaired clinical outcome in several malignancies. In contrast to P-gp itself, further phenotypical and functional alterations related to MDR are poorly characterized. In this in vitro study, we analyzed two Burkitt's lymphoma cell lines (Raji and Daudi) for the beta 1 integrin phenotype prior to and after induction of MDR via co-cultivation with vincristine. A significant loss of the VLA-3 (CD49c/CD29) adhesion receptor was observed whereas all other intergins analyzed lacked considerable changes. We conclude that induction of P-gp mediated MDR does not only affect resistance to cytotoxic drugs but also induces cellular changes with potential relevance for migratory and/or adhesive properties of malignant cells.

Prenatal hippocampal granule cells in primary cell culture form mossy fiber boutons at pyramidal cell dendrites

Mossy fiber boutons are the sites of synaptic signalling between hippocampal granule and pyramidal neurons. We studied the formation and localization of these terminals during development of prenatal hippocampal neurons in primary culture. Using the synaptic vesicle membrane proteins synaptophysin and synaptoporin as markers we observed that both proteins were mainly localized in perikarya and processes of fetal hippocampal neurons during the first days in vitro (DIV). Following DIV 6 synaptophysin was present in small terminals. After DIV 20 in addition large terminals immunoreactive for synaptophysin and synaptoporin were found, which were identified by electron microscopy as mossy fiber boutons impinging on pyramidal neuron dendrites. Synaptic vesicles and endosomes in the mossy fiber boutons were labeled when incubated with exogenous horseradish peroxidase, indicating that they were competent for exo-endocytosis. Taken together, our data show that hippocampal granule neurons grown in dissociated primary cultures form mossy fiber boutons containing synaptophysin and synaptoporin at pyramidal cell dendrites. Since the composition and the characteristic morphology of mossy fiber boutons formed in vitro is the same as observed in vivo we conclude that their development follows an intrinsic program.

Detection of melanoma cells in peripheral blood stem cell harvests of patients with progressive metastatic malignant melanoma

The detection of melanocyte-specific messenger RNA in patients with malignant melanoma suggests the potential contamination of peripheral blood stem cell (PBSC) harvests by neoplastic cells. In this study, the melanocyte-specific transcripts of tyrosinase and Melan-A/MART-1 were used to detect neoplastic cells in PBSC harvests of nine metastatic malignant melanoma patients. Only one patient's PBSC harvest tested positive for tyrosinase. All harvests were negative for Melan-A/MART-1. Our results suggest that contamination of PBSC harvests with neoplastic cells may not contribute to disease progression following high-dose chemotherapy in advanced malignant melanoma.

A role for the circadian clock of the suprachiasmatic nuclei in the interpretation of serial melatonin signals in the Syrian hamster

Seasonal rhythms of reproduction in the Syrian hamster are triggered by the pineal hormone melatonin. By varying the parameters of systemic infusions of exogenous melatonin delivered to pinealectomized hamsters, it has been shown that the hypothalamus is sensitive to the duration of individual signals, which serve as an inverse coding of day length. It also has been shown that animals are sensitive to the temporal structure of a series of signals insofar as a series of melatonin infusions of appropriate number and duration may fail to invoke a gonadal response if they are presented at inappropriate frequencies. Although the endogenous circadian pacemaker of the suprachiasmatic nucleus (SCN) is not thought to be involved in the measurement of or response to melatonin signal duration, its contribution to the interpretation of a series of melatonin signals remains to be determined. Syrian hamsters are able to show a short-day-like gonadal response to a series of melatonin signals delivered on a variety of noncircadian schedules, including one in which a "random" pattern of infusions is employed. This study investigated the role of the SCN in the interpretation of such infusion paradigms. Adult male Syrian hamsters received electrolytic lesions of the SCN. Pinealectomized, lesioned, and intact hamsters then were infused with melatonin or saline at one of three different phases of the day in a random pattern such that no signal was predictive of the timing of the next. Other lesioned and intact animals received melatonin or saline at the same time daily. After 6 weeks, control saline-infused animals in both lesioned and intact groups had large testes. However, sham animals receiving melatonin in the random infusion pattern had regressed testes, as did the lesioned animals receiving melatonin at the same phase every day. By contrast, lesioned animals that received melatonin in the random pattern of infusion did not show a short-day gonadal response. These results suggest that although the SCN is not necessary for measurement of the duration of individual signals, it may play a role in the interpretation of a series of melatonin signals in which the number of melatonin signals and the period of time over which they are encountered need to be compared.

Peripheral blood tyrosinase messenger RNA detection and survival in malignant melanoma

BACKGROUND

The most widely accepted criteria for the evaluation of prognosis of malignant melanoma are histopathologic and clinical presentation. No currently available laboratory tests provide additional prognostic information. It has recently been suggested that reverse transcription and polymerase chain reaction (RT-PCR)-based detection of tyrosinase messenger RNA (mRNA) in peripheral blood might be useful in the early detection of circulating tumor cells, since tyrosinase is thought to be a melanocyte-specific marker.

PURPOSE

To further evaluate the clinical relevance of this potential marker, we examined peripheral blood samples from patients with malignant melanoma in different stages of disease for the presence of tyrosinase mRNA.

METHODS

Total cellular RNA was extracted from heparinized peripheral blood cells from 64 patients with malignant melanoma, from five healthy control subjects, and from four patients with other cancers using the RNAzol A method. For analysis of tyrosinase mRNA, RT-PCR was performed as previously described by Smith et al.; the sensitivity of this assay was tested using RNA extracted from human melanoma cells (SK-mel 1 and SK-mel 3 cell lines) serially diluted with peripheral blood obtained from healthy control subjects. Two additional human melanoma cell lines (SK-mel 30 and RPMI-7951) served as positive controls for RT-PCR detection of tyrosinase mRNA. Overall patient survival curves were constructed using Kaplan-Meier estimates.

RESULTS

Tyrosinase mRNA was detected by RT-PCR assay of all four of the established melanoma cell lines tested. Nine of the 64 patients with malignant melanoma were found to have detectable tyrosinase mRNA in their peripheral blood cells (tyrosinase-positive patients). The 16 patients with localized primary melanoma did not have detectable tyrosinase mRNA in their peripheral blood cells. Among the 48 patients with metastatic disease, all 27 patients who exhibited no evidence of disease progression were tyrosinase negative. Notably, all nine tyrosinase-positive patients had visceral metastases and were found to exhibit disease progression at the time of the sampling. Four of the nine tyrosinase-positive patients were also found to test negative at times without evidence of progressive disease; one patient became negative after achieving stable disease and three became positive for tyrosinase transcripts on disease progression. The probability of survival from time of sampling was significantly lower in the nine tyrosinase-positive patients when tested versus the 23 patients with comparable disease but without detectable tyrosinase mRNA (two-sided; P < or = .05).

CONCLUSIONS

The results of this study demonstrate that the detection of tyrosinase mRNA in cells in the peripheral blood by RT-PCR may be a useful prognostic marker for predicting tumor progression and poor clinical outcome in patients with malignant melanoma.

Entrainment of Syrian hamster circadian activity rhythms by neonatal melatonin injections

The circadian rhythms of fetal and neonatal rodents are entrained by their mother. This entrainment is dependent upon the maternal suprachiasmatic nucleus (SCN), but the mechanism of entrainment is unknown. Administration of the pineal hormone melatonin to pregnant, SCN-lesioned female Syrian hamsters entrains the activity rhythms of their hamster pups. The aim of this study was to determine whether melatonin injected directly in neonatal Syrian hamsters is able to entrain circadian rhythms and, if so, for how long this effect persists during development. Injection of melatonin in two groups of hamster pups at opposite phases on postnatal days 1-5 entrained the onset of activity rhythms on the day of weaning to two phases 10.67 h apart. Melatonin injection did not entrain activity rhythms to opposite phases on either postnatal days 6-10 or 21-25. Vehicle injection did not entrain animals to opposite phases at any of the ages studied. These results demonstrate that melatonin is able to act directly on the neonate to cause entrainment and that this effect disappears after postnatal day 6.

Platelet endothelial cell adhesion molecule-1 (PECAM-1): a potential prognostic marker involved in leukocyte infiltration of renal cell carcinoma

We investigated immunohistochemically the leukocyte infiltrate [CD3, CD4, CD8, CD11a, CD11b, CD14, CD56, VLA-4 and platelet endothelial cell adhesion molecule-1 (PECAM-1)] and the endothelial expression of cell adhesion molecules (PECAM-1, VCAM-1, ICAM-1 and ICAM-2) in 23 renal cell carcinoma tumor tissues. Tumors with a moderate or high density of PECAM-1 positive endothelia showed a stronger infiltration with PECAM-1-positive leukocytes as compared to tumors with a low density of positive endothelia (p<0.0085). Additionally, overall survival of patients who presented with tumors exhibiting a moderate or high density of PECAM-1 endothelia alone or in combination with a PECAM-1-positive infiltrate was extended (median survival: 23.5 months) as compared to patients without these tumor characteristics (median survival: 6.5 months). These results suggest an involvement of PECAM-1 in the process of leukocyte migration and a potential role as a prognostic marker in renal cell carcinoma.

Exposure to vinblastine modulates beta 1 integrin expression and in vitro binding to extracellular matrix molecules in a human renal carcinoma cell line

Solitary stroma-invading tumor cells expressing the ATP-binding cassette transporter P-glycoprotein have been reported to be associated with a significantly higher incidence of vessel invasion and lymph node metastases. In contrast to P-gp-mediated multidrug resistance (MDR) which has become well characterized over the last decade, little is known about further morphological and functional alterations in drug-resistant tumor cells. Binding of malignant cells to components of the extracellular matrix mediated by beta 1 integrins has been suggested to play a substantial role in the metastatic cascade. We studied alterations of beta 1 integrin expression and in vitro adhesiveness to extracellular matrix proteins of the human renal carcinoma line Caki-1 in comparison to the vinblastine resistant sublines Caki-1/V1 and Caki-1/V10 (cultured in the presence of 1 ng/ml and 10 ng/ml vinblastine, respectively). Both VLA-1 and VLA-2 receptors were acquired by the Caki-1/V10 subline, whereas untreated and Caki-1/VI cells lacked surface expression of these antigens. VLA-6 was found to be decreased in the vinblastine-resistant sublines. Attachment of drug-resistant Caki-1/V1 and Caki-1/V10 cells to collagen type I was significantly increased when compared to parental cells (p < or = 0.005). Significant differences in the attachment to type IV collagen were observed between Caki-1/V10 and untreated cells (p < or = 0.045). Both Caki-1/V1 and Caki-1/ V10 cells exhibited increased adhesion to fibronectin when compared to cells of the untreated line (p < or = 0.04). Whether an aberrant expression of beta 1 integrin receptors in resistant cells in combination with altered tumor cell adhesiveness is caused by MDR induction or whether it is an epiphenomenon of cytotoxic stress is unknown. Future studies will be needed to characterize the clinical relevance of MDR-associated changes in tumor cells.

Chromatographic techniques--the basis of doping control

The principal definition of doping, the groups of banned compounds and the basic analytical problems and strategy of doping analysis are outlined, and the position of chromatography in doping analysis is explained. Examples of the application of GC-MS, especially high-resolution MS. and of LC-thermospray MS to doping problems are given. A practical case is presented briefly, showing the post-analytical problem of evaluating even unequivocal results.

Increased serum levels of basic fibroblast growth factor (bFGF) are associated with progressive lung metastases in advanced renal cell carcinoma patients

Basic fibroblast growth factor (bFGF) has been detected in body fluids of patients with various malignancies including renal cancer. Cytoplasmatic expression of bFGF in primary renal cell carcinoma cells has been reported recently to correlate with an impaired patient survival. In the present study, we analysed the statistical association of spontaneous serum bFGF levels in 23 patients with advanced renal cell carcinoma and progressive metastasis in different organ sites. Increased bFGF serum levels (>90% percentile for healthy donors i.e., > 14 pg/ml) were found in eight patients (35%) with a mean of 24.1 pg/ml. All patients in this subgroup presented with progressive pulmonary metastases at the time of sample collection (p < or = 0.007). In a total of fifteen patients exhibiting progressive pulmonary metastasis, bFGF serum levels were found to be significantly higher when compared to patients lacking progressive lung lesions (p < or = 0.0006). Of fifteen patients with bFGF levels lower than 14 pg/ml, six showed bone metastases at the time of sample collection (p < or = 0.04). Our results suggest that increased serum bFGF levels may be associated with a higher frequency of progressive pulmonary metastases. Interactions between soluble angiogenic factors and components of the extracellular matrix or basement membranes in remote sites of metastasis will be subject to further experiments.

Gonadal responses of the male tau mutant Syrian hamster to short-day-like programmed infusions of melatonin

Changes in the duration of the nocturnal peak of the circadian rhythm of melatonin secretion by the pineal gland mediate pohotoperiodic control of reproductive cycles in mammals. The present study examined whether the tau mutation of the circadian clock of the Syrian hamster altered the ability of the animals to exhibit photoperiodic, gonadal responses to timed infusions of exogenous melatonin. Pinealectomized tau mutant and wild-type hamsters received s.c. infusions of vehicle or melatonin solution (50 ng/h) for either 8 h or 6.67 h (i.e., 83% of 8 h, a reduction by the same proportion as circadian period is shortened by the mutation, 20 h vs. 24 h) once every 20 h for 6 wk. Testicular weight and serum levels of LH and prolactin were measured to assess the effects of the infusions on the reproductive axis. Both genotypes exhibited significant gonadal regression to the 8 h and 6.67 h melatonin signals, versus saline controls, although in taus the magnitude of the response to 6.67 h melatonin was significantly greater and more consistent than in wild-types. Compared to saline-infused hamsters, animals that received infusions of melatonin of either duration showed significantly reduced serum levels of LH and prolactin. There was no significant difference between the two genotypes in the observed endocrine responses to melatonin infusions. These preliminary data demonstrate that tau mutant hamsters can respond to programmed systemic infusions of melatonin in a manner comparable to that observed in wild-type hamsters, and therefore, that the tau mutation of the circadian clock has not impaired the ability of the hamster to measure photoperiodic time, as represented by melatonin.

Methohexital impairs osmoregulation. Studies in conscious and anesthetized volume-expanded dogs

BACKGROUND

Anesthetic agents influence central regulations. This study investigated the effects of methohexital anesthesia on renal and hormonal responses to acute sodium and water loading in dogs in the absence of surgical stress.

METHODS

Fourteen experiments (two in each dog) were performed in seven well-trained, chronically tracheotomized beagle dogs kept in highly standardized environmental and dietary conditions (2.5 mmol sodium and 91 ml water/kg body weight daily). Experiments lasted 3 h, while the dogs were conscious (7 experiments) or, after 1 h control, while they were anesthetized (7 experiments) with methohexital (initial dose 6.6 mg/kg body weight and maintenance infusion 0.34 mg.min-1.kg-1 body weight) over a period of 2 h. In both experiments, extracellular volume expansion was performed by intravenous infusion of a balanced isoosmolar electrolyte solution (0.5 ml.min-1.kg-1 body weight). Normal arterial blood gases were maintained by controlled mechanical ventilation. In another five dogs the same protocol was used, and vasopressin (0.05 mU.min-1.kg-1 body weight) was infused intravenously during methohexital anesthesia.

RESULTS

Values are given as means. During methohexital anesthesia, mean arterial pressure decreased from 108 to 101 mmHg, and heart rate increased from 95 to 146 beats/min. Renal sodium excretion decreased; urine volume increased; and urine osmolarity decreased from 233 to 155 mosm/l, whereas plasma osmolarity increased from 301 to 312 mosm/l because of an increase in plasma sodium concentration from 148 to 154 mmol/l. Plasma renin activity, plasma aldosterone concentration, plasma atrial natriuretic peptide, and plasma antidiuretic hormone concentrations (range 1.8-2.8 pg/ml) did not change in either protocol. In the presence of exogenous vasopressin (antidiuretic hormone 3.3 pg/ml), water diuresis did not occur, and neither plasma osmolarity nor the plasma concentration of sodium changed.

CONCLUSIONS

Methohexital may impair osmoregulation by inhibiting adequate pituitary antidiuretic hormone release in response to an osmotic challenge.

Lymphocyte-conditioned medium in combination with interleukin-2 effectively induces antitumour autoimmunity by adoptive transfer of short activated killer (SHAK) cells

In this study, effective antitumour immunity was transferred by autologous short activated killer (SHAK) cells induced over four hours with lymphocyte conditioned medium (LCM) and recombinant interleukin-2 (rIL-2). Among eight patients with progressive metastatic renal cell carcinoma refractory to standard therapy, there were six objective tumour responses to SHAKs. Progression-free survival ranged from 0 to 8+ months, and overall survival ranged from 2 to 14+ months, with a median of 9+ months. Systemic toxicity of SHAKs was limited to flulike symptoms. Patient SHAKs provided a tumour-specific immunity, both cellular and humoral (expression and secretion of secondary cytokines, including IL-2, GM-CSF, INF-gamma and TNF-alpha), far superior to rIL-2 activated killer cells.

Behavioural and cellular responses to light of the circadian system of tau mutant and wild-type Syrian hamsters

The tau mutation shortens the free-running circadian period of the activity rhythm of the Syrian hamster from around 24 h in the wild-type, to 20 h in the homozygous mutant. The aim of this study was to examine the effects of light pulses on the activity rhythms and expression of c-fos in the suprachiasmatic nuclei of wild-type and mutant hamsters. This would make it possible to determine the relative durations of subjective day and night, and thereby characterize further the effect of the mutation upon the circadian cycle. Presentation of light pulses (15 min) to animals kept in dim red light for seven to 10 days induced phase-dependent shifts in the onset of activity. During subjective day (inactive phase) there was no effect of light upon the activity rhythm of either normal or mutant animals. Early in subjective night (i.e. after the start of the active phase), light pulses induced phase delays of approximately one circadian hour in both phenotypes. However, later in subjective night light pulses induced phase advances in activity rhythms. The magnitude of the advance phase shifts differed considerably between the two phenotypes, with the wild-types typically showing shifts of about one circadian hour, while the mutants showed much larger advances of up to 12 circadian hours. In both strains, advances were observed following light at circadian time 22 but not after light at circadian time 24. The relative duration of subjective night was therefore comparable in the mutants and wild-types i.e. around 11 circadian hours. In order to examine the light-induced expression of the immediate early gene c-fos at different circadian phases, animals received a second light pulse (15 min) or a control "dark pulse" at the same circadian time as they had received the first, but seven to 10 circadian days later. They were perfused 1 h after the start of the pulse and brains processed for the immunocytochemical detection of Fos, the protein product of c-fos. Animals receiving dark pulses showed minimal Fos immunoreactivity in the suprachiasmatic nucleus, regardless of the circadian time of presentation of the stimulus. During subjective day (circadian times 4-11), light induced very little Fos immunoreactivity. In contrast, light presented during subjective night (after circadian time 12) induced a dense pattern of Fos immunoreactivity in the ventrolateral, retino-recipient region of the suprachiasmatic nucleus of both wild-type and mutant animals.(ABSTRACT TRUNCATED AT 400 WORDS)

In vivo tumor necrosis factor-alpha as indicator of biologic and clinical response to low-dose SC recombinant interleukin 2

The effect of low-dose human recombinant interleukin-2 (rIL-2) on the induction of secondary tumor necrosis factor-alpha (TNF-alpha) in vivo was studied in 16 patients with metastatic renal cell carcinoma. In all patients s.c. rIL-2 resulted in a significant increase in TNF-alpha serum levels within 4 to 8 hours, as determined by enzyme-linked immunosorbent assay (ELISA). TNF-alpha serum concentrations remained elevated up to 24 hours following single s.c. administration of rIL-2. Total secondary TNF-alpha release, as assessed by the area under the curve (AUC), appeared to be independent of dose distribution of rIL-2 (10 million IU rIL-2 q12 hours versus 20 million IU rIL-2 q24 hours). rIL-2 induced TNF-alpha release was significantly higher in patients who had received prior rIL-2 immunotherapy, while steroids resulted in a significant suppression of TNF-alpha release. Secondary TNF-alpha release was statistically associated with progression-free survival of renal cell carcinoma patients and may be a prognostic factor in patients receiving rIL-2.

Platelet aggregation inhibiting and anticoagulant effects of oligoamines, XXIII: Influence of the oligoamine RE 1492 on the deformability of red blood cells

The influence of the oligoamine RE 1492 on the deformability of Red Blood Cells (RBCs) was measured with the micropipette aspiration technique and the capillary rigidometer. The maximal cell flow resistance (MCFR) and the apparent elastic membrane shear modulus mu were increased by 45% at RE 1492 concentrations > 10 mumol/L. There was a decrease of the surface/volume ratio of 6% at RE 1492 concentrations of 25 mumol/L. The qualitative analysis of the polypeptide pattern of membranes and extracted membranes of human RBCs suggests that the reduction of deformability is due to an increased affinity of skeletal proteins to the cytosolic part of the membrane. RE 1492 caused a decrease of osmotic hemolysis by 80% at concentrations of 8 mumol/L.

Immunocytochemical detection of P-glycoprotein: initial expression correlates with survival in renal cell carcinoma patients

We evaluated 28 patients with advanced renal cell carcinoma for the initial expression of P-glycoprotein (MDR1 gene product) employing immunocytochemistry. Tumor specimens were obtained upon primary tumor nephrectomy. In all patients, progression-free survival time following nephrectomy was evaluated and correlated statistically with the staining results. Progression-free survival of patients with no or very few (< 1%) P-glycoprotein-positive tumor cells (n = 8, median survival 27.0 months) was significantly extended (p < 0.04) as compared to patients with 1% or more P-glycoprotein-positive tumor cells (n = 20, median survival 4.0 months). Correlations with histopathological tumor characteristics were insignificant. These results suggest a potential role for P-glycoprotein as a biologic parameter predictive of tumor progression in renal cell carcinoma patients.

Soluble interleukin 2 receptors abrogate IL-2 induced activation of peripheral mononuclear cells

Soluble interleukin 2 receptors (sIL-2R) exert a potential role in immunoregulation. We investigated the in vitro effects of sIL-2R on several interleukin 2 (IL-2)-dependent cellular events. Cytotoxicity of human rIL-2-stimulated PBMC against K562 and Daudi was correlated inversely to the concentration of sIL-2R in the culture medium during rIL-2 stimulation. sIL-2R concentrations higher than 4.0 pM produced a significant loss of cytotoxicity (P < 0.01). The effect of different sIL-2R concentrations added to cultured human PBMC on secondary sIL-2R production was tested by ELISA. Secondary sIL-2R production was abrogated by high initial sIL-2R dosages whereas low initial dosages were followed by a continuing production of secondary sIL-2R after five days of culture. Proliferation of the IL-2-dependent mouse cell line CTLL-2-was suppressed by sIL-2R added to the culture medium in a dose-dependent way. The neutralizing capacity of sIL-2R strongly depended on the initial number of CTLL set in per proliferation assay. In contrast, variation of rIL-2-concentration had no significant effect on reduction of proliferation by sIL-2R. Furthermore, preincubation of sIL-2R with rIL-2 did not enhance growth suppression. These last findings indicate that there is at least no functional interaction between sIL-2R and free IL-2, whereas an interaction of sIL-2R with the membrane-bound receptor for IL-2 seems possible.

In vivo time and dose dependency of interleukin-6 secretion in response to low-dose subcutaneous recombinant interleukin-2

Serum concentrations of Interleukin-6 (IL-6) were determined in renal cell carcinoma patients treated with low-dose subcutaneous human recombinant interleukin-2 (rIL-2). In all patients, administration of rIL-2 resulted in a significant increase in IL-6 serum levels to peak values within 4 to 6 hours as measured by enzyme-linked immunosorbent assays (ELISA). Repetitive administration of rIL-2 induced significantly lower IL-6 serum peaks when compared to the initial administration of rIL-2. Cumulative IL-6 release, as expressed by the area under the concentration curve (AUC), appeared to be independent of rIL-2 dose distribution (10 million IU rIL-2/m2 versus 20 million IU rIL-2/m2), and IL-6 serum peaks showed no direct dose dependency. Prior rIL-2 immunotherapy had no measurable effect on rIL-2 induced IL-6 release, while steroids resulted in a significant suppression of secondary IL-6 did not correlate with response to rIL-2 therapy or survival of rIL-2 treated renal cell carcinoma patients.

Induction of cytokines and cytotoxicity against tumor cells by Newcastle disease virus

The use of NDV as biological adjuvant in vaccines against human cancer is still actual in several clinical treatment protocols. In this study, we have investigated in vitro-effects of Newcastle disease virus (NDV) strain 73-T on isolated mononuclear blood cells and cultured tumor cells. Cellular cytotoxicity of PBMC freshly isolated from healthy donors against tumor cells was enhanced significantly (p < 0.01) after coincubation of NDV with effector cells. NDV failed to enhance cytotoxicity of effector cells when PBMC were stimulated three days with 500 IU recombinant interleukin-2 (rIL-2) per ml prior to coincubation with the virus. No significant enhancement of cellular lysis was seen when only target cells were coincubated with NDV. As shown by depletion of various lymphocyte subsets, NK cells were the predominant mediator of lysis. Enhancement of cytotoxicity correlated with the induction of interferon-alpha (IFN-alpha) in PBMC by NDV. NDV also induced high amounts of tumor necrosis factor-alpha (TNF-alpha) in PBMC. Induction of interferon-gamma (IFN-gamma) was weak. A direct cytopathic effect (CPE) of NDV on different target cells was detected by colorimetric measurement of metabolic cell activity. The human tumor cell lines A-498, A-704, Caki-1, Caki-2, and K-562 and the fibroblast line MRC-5 showed progressive cellular destruction 48 h after infection with NDV, whereas PBMC and Daudi cells remained unaffected during the observation period. The nontransformed monkey kidney cell line CV-1 and the transformed monkey kidney cell line COS-1 were both lysed by NDV with marginal difference in time course of CPE. Our results indicate a reasonable potential of pleiotropic modifications of the immune response against tumors by NDV.

Testicular regression in pinealectomized Syrian hamsters following infusions of melatonin delivered on non-circadian schedules

The aims of this study were to validate the use of a timed infusion protocol for restoring physiologically appropriate rhythms of melatonin in the circulation of pinealectomized hamsters and, using such infusions, to compare the relative importance of the parameters of the nocturnal melatonin signal--frequency, phase, and duration of the interval between signals--in the photoperiodic control of testicular function in male Syrian hamsters. Hamsters were pinealectomized and fitted with a chronic s.c. cannula enabling them to receive timed infusions of melatonin (50 ng/h) or saline vehicle (50 microliters/h). In experiment 1, RIA of serum samples confirmed that s.c. infusions produced a pattern of melatonin in the blood equivalent in amplitude and duration to that observed previously in pineal-intact animals exposed to a short photoperiod. In experiment 2, we investigated the relative importance of the frequency of the melatonin signal and the duration of the interval between signals. Pinealectomized animals that received infusions of saline for 6 wk had large testes and high concentrations of LH in the serum. Animals that received a series of short-day-like infusions of melatonin of 14-h duration, separated by an interval of either 10 h or 6 h, underwent gonadal regression and had low serum concentrations of LH. Animals that received infusions of melatonin of 8-h duration, separated by intervals of 12 h, also exhibited full gonadal collapse. However, animals that received the same 8-h infusions separated by intervals of 8 h (i.e., once every 16 h) did not undergo gonadal regression and their circulating levels of LH remained high.(ABSTRACT TRUNCATED AT 250 WORDS)

Pretreatment natural killer antigen density correlates to clinical response in tumor patients receiving long-term subcutaneous recombinant interleukin-2 and recombinant interferon-alpha

We evaluated density of the natural killer (NK) cell-associated CD56 antigen on circulating NK cells of 47 patients with advanced renal cell carcinoma. Patients received a combination of low-dose subcutaneous recombinant interleukin-2 (rIL-2) and recombinant interferon-alpha (rIFN-alpha) as home therapy. Antigen density of CD56 before therapy was 2.2-fold higher (P < 0.005) in patients who subsequently achieved a complete or partial remission when compared with patients who presented with progressive disease on therapy. After a 6-week treatment cycle, NK cells of treatment responders expressed significantly (2.1-fold; P < 0.005) more CD56 antigens than NK cells in nonresponding patients. These results suggested a potential role of both pre- and posttreatment NK antigen density levels as a biologic correlate to treatment response.

Non-photic phase shifting of the circadian activity rhythm of Syrian hamsters: the relative potency of arousal and melatonin

This study investigated the relative potency of melatonin and arousal as Zeitgebers in the non-photic phase shifting of circadian rhythmicity in the adult Syrian hamster. Animals held under dim red light (DD) exhibited robust free-running rhythms of wheel-running activity. Melatonin (1 mg/kg) or ethanolic saline vehicle, delivered manually by subcutaneous injection after removing the animal from its cage, resulted in phase advances of the activity rhythm. This effect was phase dependent, injections at CT 8 and 10 being effective (CT 12 = anticipated activity onset), whereas injection at CT 2, 6, 14 and 20 did not cause a shift. There was no significant difference between the magnitude or timing of phase shifts in response to injections of saline or melatonin. To determine whether the observed shifts were related to arousal of the animals induced by handling, a second group held under DD were fitted with chronic s.c. cannulae so that melatonin solution or vehicle could be delivered remotely at projected CT 10. Neither solution had any effect upon the free-running rhythm. However, when these animals received manual s.c. injection of saline or melatonin solution, they exhibited phase advances similar to those observed in Expt. 1. These results fail to support the hypothesis that melatonin can exert a chemically specific, acute phase-shifting action in the adult Syrian hamster. They do, however, demonstrate the potent effect of arousing stimuli upon the circadian clock in this species.

The effect of signal frequency on the gonadal response of male Syrian hamsters to programmed melatonin infusions

The aim of this study was to investigate which characteristics of the nocturnal melatonin signal, in addition to its duration, convey photoperiodic information to the reproductive axis. To achieve control over the pattern of circulating melatonin, male Syrian hamsters held under stimulatory long daylengths (16h light:8h dark) were pinealectomized to remove the principal source of circulating endogenous hormone and then fitted with chronic subcutaneous cannulae through which programmed infusions of melatonin solution or vehicle could be delivered. Experiment 1 tested whether long intervals between successive melatonin signals impaired the photoperiodic response. Animals which received a short day-like melatonin infusion of 10 h duration once every 24 h (T = 24) for 6 weeks underwent gonadal atrophy. When the same number of signals (42) was delivered at a frequency of once every 32 h (T = 32), they were ineffective and animals remained gonadally active. Two infusion patterns were used to determine if the loss of response to 10 h signals given at T = 32 h was a consequence of the frequency per se or the long interval between signals (22 h). In the first, a 'chimaeric' signal which combined a long duration i.e. short day-like 18 h melatonin signal with a short day-like melatonin-free interval of 14 h (combined signal T = 32 h) was able to induce significant, but only partial, gonadal atrophy. Second, when the 22-h interval between 10-h melatonin signals was interrupted by a short (2 h) melatonin pulse, significant but partial gonadal regression again occurred. Moreover, the response depended upon the timing of the 2 h pulse. When this fell early in the melatonin-free interval, leaving a large portion of it intact, it had no effect on gonadal condition. In contrast, a pulse delivered in the middle of the interval, which divided it up into two short day-like segments of 10 h each, was partially effective in restoring a short day response. The second experiment tested whether melatonin signals delivered at a high frequency would induce a photoperiodic response. A 10 h infusion delivered once every 24 h caused gonadal atrophy. The same melatonin infusion delivered at a periodicity of 20 h (T = 20) was also very potent as a short day stimulus. However, when 10-h signals were delivered at the higher frequencies of once every 18 or 16 h, they were less effective. Only a minority of animals exhibited gonadal atrophy and overall the group means were not significantly different from those of saline-infused controls, but were significantly greater than those of the 24 and 20 h groups. These data demonstrate that the photoperiodic response to the melatonin signal is sensitive to the frequency at which the signal is received. However, there is no evidence for a circadian basis to this sensitivity, nor a dependence upon the relationship between the endocrine stimulus and the light-dark cycle, insofar as signals encountered at a non-circadian period of 20 h are very effective. Moreover, the effectiveness of signals encountered at longer periodicities can be modified by manipulation of the uninterrupted duration of the interval free of melatonin, demonstrating a role in photoperiodic time measurement for the duration of the interval between signals.

[A uterine rupture during peridural anesthesia]

A 31 years old multiparous woman was delivered by caesarean section at her first pregnancy. For her third, spontaneous, full-term labour an epidural analgesia was realized with 0.125% epinephrined bupivacaine and fentanyl (1 mg per kg). In spite of its initial efficacy, pains appeared only localized at the caesarean scar. An uterine rupture was suspected, due probably to the use of oxytocin. The operating room was immediately prepared for an emergency caesarean section. As none other pejorative clinical manifestation was present, vaginal delivery was pursued and an healthy boy was taken out after application of forceps. The uterine revision and the secondary laparotomy, performed under epidural anesthesia, confirmed an uterine break, not very wide. The end result was satisfactory both for the mother and the child. The use of epidural analgesia and oxytocin are discussed from the literature and the clinical facts. The absence of internal tocography is an arguable point in this case report.