Interleukin-10 induces interleukin-11 responsiveness in human myeloma cell lines

Interleukin (IL)-6-dependent human myeloma cell lines (HMCL) can be reproducibly obtained from patients with multiple myeloma and terminal disease. The growth of some of these HMCL can also be supported by IL-11. We show that IL-11-responsive, but not -unresponsive, HMCL expressed the gene of human IL-11 receptor (IL-11R) and produced an autocrine IL-10. All HMCL expressed the IL-10 receptor. In addition, IL-10 induced IL-11R gene expression and conferred IL-11 responsiveness on unresponsive HMCL. The ability of HMCL to produce IL-10 was strictly correlated with the capacity of the original patient's myeloma cells to produce IL-10 or not, and with the presence or absence of IL-10 in the patient's plasma.

Effect of captopril on membrane currents of ventricular myocytes

Using whole-cell patch-clamp technique, the present study examined the effects of captopril on membrane currents of ventricular myocytes. The results were as follow: when the concentration of captopril was 6 x 10(-4)mol, the fast inward sodium current and slow inward calcium current were all decreased significantly (P < 0.05). Besides, when the concentration exceeds 10(-3)mol, the delayed rectifier potassium current was increased (P < 0.05) as well. But if the experimental concentration was under 6 x 10(-4)mol, these three kinds of currents was not affected. These findings suggested that captopril has no direct antiarrhythmic effect at the average therapeutic serum level.

Measurement of whole body interleukin-6 (IL-6) production: prediction of the efficacy of anti-IL-6 treatments

A major limitation on the therapeutic use of cytokine antagonists is that the amount of cytokine to be neutralized in vivo is not presently known. We previously reported that anti-interleukin-6 (IL-6) monoclonal antibody (MoAb) administered to a patient with multiple myeloma (MM) induced high amounts of IL-6 to circulate in the form of monomeric immune complexes. Based on this observation, the present study developed a new methodology to estimate daily IL-6 production in 13 patients with MM or renal cancer who received anti-IL-6 MoAb. Treatment was considered effective when the production of C-reactive protein (CRP) was inhibited. The production of this acute-phase protein by hepatocytes is dependent on the activation of IL-6 gp130 transducer. Inhibition of tumor proliferation was also evaluated in patients with MM. In 7 of 13 patients whose CRP production was completely inhibited (> 96%) and who showed some antitumoral effects, whole-body IL-6 production in vivo was less than 18 micrograms/d (median, 5.7 micrograms/d; range, 0.5 to 17.5 micrograms/d). In the other 6 patients, subtotal inhibition of CRP production and a lack of antitumoral response were associated with high IL-6 production (median, 180 micrograms/d; range, 18 to 358 micrograms/d). These in vivo observations were consistent with mathematical modeling that predicted that anti-IL-6 MoAb treatment would be efficient only in low IL-6 producers. These data indicate the difficulty of neutralizing IL-6 with a single anti-IL-6 MoAb in vivo and call for new strategies to avoid accumulation of IL-6 in the form of stable immune complexes.

[Arrhythmogenic right ventricular disease on a young peasant]

This article, together with literatures, discusses one case of arrhythmia right ventricular dysplasia (ARVD) we treated. This disease should be taken into account in some arrhythmias from right ventricle, especially refractory arrhythmias in youths. Some non-invasive techniques such as echocardiography, cardial single photon emission computed tomography (SPECT), and magnetic resonance imaging (MRI) play more and more important role in the diagnosis of ARVD. These techniques can provide specific data for the early diagnosis.

An interleukin 1 receptor antagonist blocks the IL-1-induced IL-6 paracrine production through a prostaglandin E2-related mechanism in multiple myeloma

By analogy with the model of pristane-induced mouse plasmacytomas, we have wondered about the putative role of prostaglandin E2 (PGE2) in the human multiple myeloma (MM) cytokine network, involving interleukin 6 (IL-6) and interleukin 1 (IL-1) as essential myeloma cell growth factors and inducing cofactors respectively. We show that PGE2 is produced in short-term cultures of bone marrow cells of patients with MM, concomitantly with both IL-6 and IL-1. Indomethacin, a potent inhibitor of cyclo-oxygenase and of PGE2 synthesis, significantly inhibits IL-6 production (but not IL-1 production) by 35% to 90% depending on the different MM patients studied and concurrently to that of PGE2. Exogenous PGE2 reverses this inhibition or even stimulates IL-6 production. An IL-1 receptor antagonist (IL-1RA) also significantly inhibits PGE2, IL-6 production and myeloma cell growth. The inhibition of IL-6 production is reversed by adding exogenous PGE2. These results show that induction of IL-6 by IL-1 is related to PGE2 in the bone marrow of patients with MM. Inhibition of PGE2 synthesis (as obtained with indomethacin and the IL-1RA) might be helpful to inhibit myeloma cell proliferation by reducing IL-1-induced endogenous IL-6 production not only in vitro (as demonstrated here) but also in vivo.

Biologic effects of anti-interleukin-6 murine monoclonal antibody in advanced multiple myeloma

In patients with advanced multiple myeloma (MM) there is an excess of production of interleukin-6 (IL-6) in vivo, and elevated serum levels are associated with plasmablastic proliferative activity and short survival. These data prompted us to perform a clinical trial with a murine anti-IL-6 monoclonal antibody (MoAb) to neutralize the excess of this putatively deleterious factor in these patients. Ten MM patients with extramedullary involvement frequently were treated with anti-IL-6 MoAb. The MoAb was administered intravenously to 9 patients; 1 patient with malignant pleural effusion received intrapleural therapy. Of the 3 patients who succumbed to progressive MM after less than 1 week of treatment (including the only 1 treated locally), 2 with evaluable data exhibited marked inhibition of plasmablastic proliferation. Among the 7 patients remaining more homogeneous receiving the anti-IL-6 MoAb for more than 1 week, 3 had objective antiproliferative effect marked by a significant reduction of the myeloma cell labelling index within the bone marrow. One of these 3 patients achieved a 30% regression of tumor mass. However, none of the patients studied achieved remission or improved outcome as judged by standard clinical criteria. Of major interest, objective antiproliferative effects were associated with complete inhibition of C-reactive protein (CRP) synthesis and low daily IL-6 production in vivo. On the other hand, the lack of effect in 4 patients was associated with a higher IL-6 production and inability of the MoAb to neutralize it. Anti-IL-6 was also associated with resolution of low-grade fever in all the patients and with worsening thrombocytopenia and mild neutropenia. The generation of human antibodies to Fc fragment of the murine anti-IL-6 MoAb observed in 1 patient was associated with dramatic progression. These data show that anti-IL-6 MoAb can suppress the proliferation of myeloma cells and underscore the biologic role of IL-6 for myeloma growth in vivo. Furthermore, suppression of CRP and worsening of neutropenia/thrombocytopenia both indicate that IL-6 is critically involved in acute-phase responses and granulopoiesis/thrombopoiesis.

A comparative study of radiofrequency ablation in unipolar and bipolar fashion

In this study we compared the effects of radiofrequency (RF) energy applied to the swine endocardium in a unipolar fashion and in a bipolar one with two different interelectrode distances (5 mm, 10 mm). RF energy (500 kHz) delivered to the swine endocardium was divided into eight categories: 100 J, 101-200 J, 201-300 J, 301-400 J, 401-500 J, 501-600 J, 601-1000 J, and > 1000 J. The results showed that when RF energy was applied in a bipolar fashion, the lesions involved the catheter/tissue interface and partly the interelectrode spacing, while in a unipolar fashion. They were found in the catheter/tissue interface only. At any energy level, there were no statistically significant differences in lesion depths among all the three fashions, and the lesion surface areas produced by the bipolar fashion (with 5 mm or 10 mm interelectrode spacing) were all greater than those by the unipolar fashion (P < 0.05). When the delivered energy was under 500 joules, a greater lesion surface area was found in 5 mm bipolar fashion than in 10mm bipolar fashion (P < 0.05), while energy exceeded 500 joules, the differences in the lesion surface areas were no longer significant between these two bipolar fashions.

Interleukin-10 is a proliferation factor but not a differentiation factor for human myeloma cells

Because interleukin-10 (IL-10) is a potent differentiation factor of human B cells into mature plasma cells, we investigated its effect on human malignant plasma cells. IL-10 did not induce any differentiation and increase in Ig synthesis in four human IL-6-dependent malignant plasma cell lines. However, it stimulated the proliferation of two of four cytokine-dependent cell lines in the absence of IL-6 and IL-10-dependent myeloma cell lines have been obtained. The myeloma cell growth activity of IL-10 was unaffected by anti-IL-6 and anti-IL-6R antibodies. Similarly, IL-10 stimulated (P = .001) the proliferation of freshly-explanted myeloma cells in IL-6-deprived cultures of tumor samples from patients with active multiple myeloma (MM) and produced twice as many myeloma cells in these cultures. Again, this cytokine was unable to induce further differentiation (assessed by rate of Ig production) of fresh myeloma cells. A very sensitive enzyme-linked immunosorbent assay (ELISA; 1 pg/mL) only rarely detected IL-10 in the sera of MM patients (3 of 89). On the contrary, serum IL-10 was detected in 60% of patients with plasma cell leukemia (12 of 20). These data show that IL-10 is an IL-6-unrelated growth factor for malignant plasmablastic cells. This cytokine could be involved in the late phase of MM in vivo.

Purification of deformin, an extracellular protein synthesized by Bartonella bacilliformis which causes deformation of erythrocyte membranes

A factor capable of deforming erythrocyte membranes, found in the culture supernatants of Bartonella bacilliformis, was purified 1840-fold using hydrophobic, ion exchange and gel exclusion chromatography. The final fractions contained a single detectable polypeptide species, referred to as deformin, having a molecular weight of 67000 by SDS-PAGE and a native molecular weight of 130,000 by gel exclusion chromatography or velocity sedimentation in a glycerol gradient. Erythrocytes treated with deformin acquire trenches, indentations, and invaginations which could be reversed by vanadate, dilauroylphosphatidylcholine (DLPC), or by raising the internal Ca2+ concentrations with the inophore A23187. Internal vacuoles also form. Erythrocytes treated with trypsin or neuraminidase are much more sensitive to deformin than untreated erythrocytes; erythrocytes treated with phospholipase D are less sensitive to deformin. This protein may play a role in causing the severe anemia which can result as a consequence of infection by B. bacilliformis.

Effect of radiofrequency catheter ablation on calcium channel of ventricular myocytes

Using whole-cell patch-clamp technique, the effect of radiofrequency catheter ablation (RFCA) on calcium current (Ica) of guinea pig ventricular myocytes was examined. The radiofrequency energy delivered was 20 W x 10 s. RF-CA decreased Ica apparently with the affected area reaching up to 1.2 cm from the ablation focus. In the meanwhile, the pathological lesion size resulted from RFCA was merely 0.41 +/- 0.11 cm. These findings indicate that RFCA, apart from causing tissue necrosis by heat, can affect myocyte membrane currents in a large area. This may explain why RFCA has a very high success rate with a small pathological lesion.

A highly sensitive quantitative bioassay for human interleukin-11

Human interleukin-11 (IL-11) is a cytokine with a broad spectrum of activity, similar to interleukin-6 (IL-6). However, its role in human disease is poorly understood, partly because of a lack of sensitive bioassays. A subclone (B9-11) obtained from the B9 hybridoma (which responds poorly to human IL-11) enabled us to develop a highly sensitive bioassay for human IL-11. B9-11 cells responded only to human IL-11 and IL-6 and not to other human cytokines using the same gp130 transducer chain (ciliary neurotrophic factor, leukemia inhibitory factor and oncostatin M) or to other human interleukins (interleukin-1 to interleukin-13), human hematopoietic cytokines (granulocyte colony stimulating factor, granulocyte-macrophage colony stimulating factor, colony stimulating factor-1) and various other human cytokines (interferon-alpha, tumor necrosis factor-alpha, tumor necrosis factor-beta, fibroblast growth factor and nerve growth factor). In addition, these cytokines did not interfere with the IL-11 response of B9-11 cells. IL-11-induced proliferation of B9-11 cells was unaffected by anti-murine IL-6 receptor mAb but inhibited by anti-gp130 mAb. Half-maximal proliferation of B9-11 cells was obtained with 30 pg/ml of recombinant IL-11, a concentration 300-fold lower than IL-11 concentrations known to be active on human cells. Finally, culturing of B9-11 cells with an anti-IL-6 mAb enabled us to measure the natural IL-11 produced by various cell lines. Thus, B9-11 cells should be useful for studies of IL-11 involvement in various human diseases as well as for a better understanding of the mechanisms of action of this cytokine.

Reproducible obtaining of human myeloma cell lines as a model for tumor stem cell study in human multiple myeloma

We report a novel, reproducible methodology which enabled 10 human myeloma cell lines (HMCL) to be obtained from each of 10 tumor samples harvested from 9 patients with extramedullary proliferation. Fresh samples were cultured with interleukin 6 (IL-6) and granulocyte macrophage-colony stimulating factor (GM-CSF) at a high cell density and resulting HMCL growth became progressively dependent on IL-6 alone, no longer requiring GM-CSF. These HMCL, which had the same immunoglobulin gene rearrangements as the patients' original myeloma cells, were designated XG-1 to XG-9. XG HMCL had a plasma cell morphology, expressed plasma cell antigen (Ag), namely cytoplasmic immunoglobulins, CD38, B-B4 Ag, and CD77, and lacked the usual B-cell Ag. They also expressed activation antigens such as CD28 with coexpression of CD28 and its ligand, B7 Ag, in four HMCL. Six HMCL expressed CD40, 4 CD23, and 5 its ligand, CD21. The XG HMCL bore adhesion molecules VLA-4 and CD44 (all 10 HMCL), VLA-5 (7 HMCL), and CD56 (4 HMCL). Finally, cytogenetic study of 8 HMCL indicated a 14q+ chromosome, and t(11,14) translocation was found in 6 of 8 and 5 of 8 HMCL, respectively. The possibility of obtaining malignant plasma cell lines reproducibly from each patient with extramedullary proliferation offers a unique tool for studying the phenotype and abnormalities of the still unidentified tumor stem cell in this disease.

Epitope analysis of human IL-6 receptor gp80 molecule with monoclonal antibodies

Gp80 human IL-6R was studied using 7 murine mAb (M37, M91, M113, M139, M164, M182 and M195) obtained after fusion of splenocytes of Balb/c mice immunised with a mixture of recombinant IL-6 receptor (rIL-6R) and cells from 2 cell lines expressing IL-6R. These were U266, which is IL-6 independent and XG-1 which is IL-6-dependent. In ELISA the 7 mAb reacted against the rIL-6R and against the natural soluble form found in plasma (nIL-6R), which both lack transmembrane and cytoplasmic domains. However, M195 reacted less with the natural than with the recombinant soluble IL-6R. Using FACS analysis, the 7 mAb were shown to bind to U266 cells but not to the Namalva cell line which is deprived of IL-6R. This showed that they all recognised the membrane form of the IL-6R. Three of the anti-IL-6R mAb reacted with rIL-6R by Western blotting. Four different epitopes of the molecule were identified, either by cross-blocking experiments of mAb binding to IL6R in ELISA or by the biosensor Biacore technology. A group of 4 mAb (M37, M113, M139 and M164) and another mAb (M195) identified 2 different epitopes involved in IL-6 binding. These antibodies were able to inhibit the binding of IL-6 to IL-6R and the proliferation of the IL-6-dependent XG-1 cell line. M91 and M182 recognized 2 other epitopes that were not involved in IL-6 binding. As expected, M91 did not inhibit XG-1 proliferation; in contrast, M182 interfered with the proliferative response of the XG-1 cell line.(ABSTRACT TRUNCATED AT 250 WORDS)

Ciliary neurotropic factor, interleukin 11, leukemia inhibitory factor, and oncostatin M are growth factors for human myeloma cell lines using the interleukin 6 signal transducer gp130

Interleukin 6 (IL-6) is a major growth factor for tumor plasma cells involved in human multiple myeloma (MM). In particular, human myeloma cell lines (HMCL), whose growth is completely dependent on addition of exogenous IL-6, can be obtained reproducibly from every patient with terminal disease. Four cytokines, ciliary neurotropic factor (CNTF), IL-11, leukemia inhibitory factor (LIF), and oncostatin M (OM), use the same transducer chain (signal transducer gp130) as IL-6 and share numerous biological activities with this IL. We found that these four cytokines stimulated proliferation and supported the long-term growth of two out of four IL-6-dependent HMCL obtained in our laboratory. Half-maximal proliferation was obtained with cytokine concentrations ranging from 0.4 to 1.2 ng/ml for IL-11, LIF, and OM. CNTF worked at high concentrations only (90 ng/ml), but addition of soluble CNTF receptor increased sensitivity to CNTF 30-fold. The growth-promoting effect of these four cytokines was abrogated by anti-gp130 antibodies, contrary to results for anti-IL-6 receptor or anti-IL-6 antibodies. No detectable changes in the morphology and phenotype were found when myeloma cells were cultured with one of these four cytokines instead of IL-6. Concordant with their IL-6-dependent growth, the four HMCL expressed membrane IL-6R and gp130 detected by FACS analysis. LIF-binding chain gene (LIFR) was expressed only in the two HMCL responsive to LIF and OM.

Overall interleukin-6 production exceeds 7 mg/day in multiple myeloma complicated by sepsis

We previously reported that injection of anti-IL-6 monoclonal antibody (mAb) in a patient with multiple myeloma (MM) induced the circulation of high amounts of IL-6 in the form of IL-6/anti-IL-6 monomeric complexes. This made it possible to estimate overall daily IL-6 production in patients in vivo, which had not been achieved in animals or humans before. In this study, estimations are given for a patient with MM who developed Escherichia coli sepsis during anti-IL-6 mAb. During the first 12 days, the overall IL-6 production was estimated at 1.5 to 2.0 micrograms/day. On day 13, serum IL-6 concentration, in the form of IL-6/anti-IL-6 complexes, increased 1000-fold and was 1.7 x 10(6) pg/ml, in relation with the development of E. coli sepsis. Overall IL-6 production was estimated to be greater than 7 mg/day, i.e. 3500 times higher than before sepsis. Serum IL-6 levels in the form of monomeric immune complexes remained very high for 20 days after sepsis indicating the persistence of very high overall IL-6 production (100 to 3500-fold greater than pre-sepsis production). This study demonstrates a considerable and persistent potential for IL-6 production in this patient during and after sepsis.

Evaluation of exercise-induced QRS amplitude changes (Athens score) and their clinical value

The index of exercises-induced amplitude changes in a combination of Q, R and S waves, named Athens score, was tested in 213 patients, who underwent coronary angiography within 3 days of a maximal exercise test. Of the 155 cases with conclusive exercise test results, according to the coronary angiography document, 23 (14.8%) were diagnosed as having no significant coronary artery disease (CAD); 27 (17.4%) as 1-vessel disease; 28 (18.1%) as 2-vessel disease and 77 (49.7%) as 3-vessel disease. The Athens score for them was 4.87 +/- 2.89, 0.02 +/- 3.35, -1.70 +/- 3.68, -1.75 +/- 3.98 respectively, F = 19.65, P < 0.01. An Athens score of 2 mm predicted CAD with sensitivity of 84.9% and specificity of 78.3% both being higher than those of ST segment depression (75.0% and 60.9%). It was concluded that the Athens score was a promising index for improving the efficiency of exercise test to predict CAD.

gamma-Interferon in multiple myeloma: inhibition of interleukin-6 (IL-6)-dependent myeloma cell growth and downregulation of IL-6-receptor expression in vitro

In multiple myeloma, malignant plasma cells from most patients with active disease proliferate spontaneously when cultured for 5 days in vitro. This spontaneous proliferation is related to the endogenous production of interleukin-6 (IL-6), the major myeloma-cell growth factor. A 50% inhibitory dose (100 U/mL) of human recombinant gamma-interferon (hr gamma-IFN) blocked the proliferation of myeloma cells almost completely in all 19 patients analyzed. This inhibition was not caused by suppression of endogenous IL-6 production and was also observed in the presence of an excess of hrIL-6. hr gamma-IFN was also completely inhibitory in four human myeloma cell lines (HMCL) whose growth is totally dependent on the addition of exogenous hrIL-6. This inhibition was associated with a 47% to 73% decrease in membrane IL-6-binding gp80 protein as well as with a 90% decrease in the amount of gp80 mRNA in HMCL. These results are in line with recent reports indicating that gamma-IFN inhibited several IL-6-dependent biologic processes. They suggest a need to reconsider why previous preliminary clinical trials failed to demonstrate a beneficial effect of gamma-IFN in multiple myeloma.

Comparison between laser and electrical ablation of ventricle in dogs: hemodynamic, pathologic and electrocardiographic observations

To characterize and compare the pathologic, hemodynamic and electrocardiographic changes of both transcatheter laser and electrical energy on ventricle, 36 subendocardial myocardium lesions were induced at energy 60, 120 and 240 Joules by either transcatheter laser irradiation or electrical shock in 7 anesthetized dogs. The following results were observed: 1) Both laser and electrical ablation on myocardium created nonhomogeneous myocardium injury, but laser ablation caused mainly focal tissue vaporization and necrosis, while electrical shock induced widespread tissue degenerations; 2) Both laser and electrical induced-lesion dimensions increased parallel to the total dosage of energy; 3) Laser ablation caused mainly (90%) single ventricular premature beats and 86% of them occurred within the first minute after energy discharged, while ventricular tachycardias were found in any electrical energy groups; ventricular fibrillations occurring during laser and electrical ablation were 5% and 13% respectively (P < 0.01); 4) A decrease in aortic blood pressure and an increase in central venous pressure induced by laser ablation were significantly less than that produced by the same amount of electrical energy (P < 0.01). Our preliminary results have shown that transcatheter laser ablation has great potential for becoming a practical method in the management of refractory tachycardias.

High amounts of circulating interleukin (IL)-6 in the form of monomeric immune complexes during anti-IL-6 therapy. Towards a new methodology for measuring overall cytokine production in human in vivo

A patient with plasma cell leukemia was treated with anti-interleukin (IL)-6 monoclonal antibodies (mAb) for 2 months. Using chromatography on protein A-Sepharose, anti-murine-IgG-Sepharose, anti-IL-6-mAb-Sepharose and gel filtration at pH 2.3, we have demonstrated that the anti-IL-6 mAb, by preventing the binding of IL-6 to its cell membrane receptor and its renal elimination, has induced huge amounts of IL-6 to circulate in the form of monomeric immune complexes. By using this observation, we have developed a mathematical modelling that allows the determination of the overall daily production of IL-6 in this patient, which was in the range of 15 micrograms per day. Overall in vivo production of cytokines has never been evaluated in animals or in humans before.

Association of vanadate-sensitive Mg(2+)-ATPase and shape change in intact red blood cells

Intact human erythrocytes, initially depleted of Mg2+ by EDTA incubation in the presence of A23187, exhibit Mg(2+)-dependent phosphate production of around 1.5 mmol per liter cells.h, half-maximally activated at around 0.4 mM added free Mg2+. This appears to correspond to Mg(2+)-stimulated adenosine triphosphatase (Mg(2+)-ATPase) activity found in isolated membranes, which is known to have a similar activity and affinity for Mg2+. Vanadate (up to 100 microM) inhibited Mg(2+)-dependent phosphate production and ATP breakdown in intact cells. Over a similar concentration range vanadate (3-100 microM) transformed intact cells from normal discocytes to echinocytes within 4-8 h at 37 degrees C, and more rapidly in Mg(2+)-depleted cells. The rate of Ca(2+)-induced echinocytosis was also enhanced in Mg(2+)-depleted cells. These results support previous studies in erythrocyte ghosts suggesting that vanadate-induced shape change is associated with inhibition of Mg(2+)-ATPase activity localized in the plasma membrane of the red blood cell.

Interleukin-6 is the central tumor growth factor in vitro and in vivo in multiple myeloma

When bone-marrow cells from patients with multiple myeloma (MM) were seeded in short-term cultures, a spontaneous proliferation of the myeloma cells occurred for most of the patients with active disease and proliferating myeloma cells in vivo. In all cases, this spontaneous proliferation was inhibited by anti-IL-6 monoclonal antibodies (mabs). Moreover, myeloma cell lines, completely dependent upon exogenous IL-6 for their growth, could be reproducibly established by initially stimulating the myeloma cells with both IL-6 and GM-CSF. These results demonstrate that IL-6 is a major paracrine myeloma-cell growth factor in vitro. High serum IL-6 levels were observed in MM patients with active disease, especially patients with terminal disease. High IL-6 mRNA levels were found in bone-marrow cells of MM patients, mainly in myeloid and monocytic cells, in vivo. The myeloma cells did not express IL-6 mRNA. Injection of anti-IL-6 mabs to MM patients with terminal disease and extramedullary proliferation, completely blocked the myeloma-cell proliferation in vivo and completely inhibited the serum IL-6 bioactivity and the serum CRP levels. One patient with plasma cell leukemia and hypercalcemia was treated for two months with anti-IL-6 mabs and maintain in remission for 2 months without major side effects. Interestingly, the serum calcium levels also decreased in these patients. All these results show that IL-6 is the main cytokine responsible not only for the myeloma-cell proliferation in vivo, but presumably also for the large bone resorption processes observed in human MM.(ABSTRACT TRUNCATED AT 250 WORDS)

Antiviral effect of mangiferin and isomangiferin on herpes simplex virus

Using tissue culture technique the present study for the first time indicated the antiviral effect of mangiferin and isomangiferin against type I herpes simplex virus (HSV-I). 4 methods were used for evaluating drug effectiveness (i.e., in vitro drug-on-virus direct action, simultaneous addition of drug-virus-inoculum to cell bottle, virus inoculation preceding drug addition, and drug addition followed by virus inoculation), it was readily found by log determination of HSV-I inhibition that isomangiferin somewhat exceeded such control drugs as acyclovir, idoxuridine, and cyclocytidine in log by 0.27-0.50, and that mangiferin was lower than isomangiferin in log by 0.53. The average plaque reduction rates of mangiferin and isomangiferin were 56.8% and 69.5% respectively. The antiviral effect of mangiferin and isomangiferin was presumably due to their capability of inhibiting virus replication within cells.

Ethnic differences in physiological responses associated with the Valsalva maneuver

Ethnic differences in cardiovascular indices at rest and across the Valsalva maneuver (VM) were studied in 30 Asian, 86 Caucasian, and 12 Black healthy men and women aged 30 to 55 years. Subjects simulated the VM by blowing into an aneroid pressure-gauge meter to 40 mmHg for 10 seconds. Resting systolic blood pressure (SBP) was significantly higher in Blacks than in Asians or Caucasians. During the strain phase of the VM, the fall in SBP from baseline was significantly greater in Asians and Blacks than in Caucasians. Further, Asians had the greatest overshoot of SBP above baseline. Although resting heart rate was significantly higher in Asians compared to Caucasians, there were no differences in heart rate responses to the VM. Reduction in carotid artery blood flow velocity during strain was significantly less in Blacks. We conclude that there are ethnic differences in cardiovascular indices at rest and across the VM.

Periodontal conditions in 35-44-year-old factory workers in Shanghai

A periodontal survey applying CPITN was carried out in almost 500 male and female factory workers, 35-44 yr of age, in Shanghai, P.R. China. Calculus and shallow pockets were most frequent. Deep pockets of 6 mm and over were seldom found. The mean number of missing teeth was only 2.7 (out of 32). Problems associated with third molars seem to provide the largest immediate oral health problem.

[Tubal anastomosis for reversal of sterilization with microsurgical technic in 246 women]

Tubal anastomosis for reversal of sterilization was performed with microsurgical technique in 246 women, from January 1985 to June 1987. The operation time after tubal sterilization averaged 43.5 months. The patients (99.6%) were followed-up for 3-33 months. Intrauterine pregnancies occurred in 178 cases, the rate being 72.4%. The factors which influence success rate are the tubal length after anastomosis and the mode of original tubal ligation. Postoperative instillation of fluids into fallopian tubes should be performed early to prevent adhesions and early intercourse should also be encouraged.

[Experiences with 184 cases of chronic hemodialysis]

From 14 years' experience of 184 cases of chronic hemodialysis for ESRD, we confirmed that dialysis should begin when Ccr is 5-10 ml/min, and in individualized treatment with dialysis, prevention and treatment of renal osteodystrophy is important in patients undergoing maintenance hemodialysis. Suitable dialysis and rational nutrition can improve renal anemia. Complications decreased significantly in the recent 4-5 years, and 1-year, 5-year and 10-year survival rates were 90.9%, 77.8% and 58.8% respectively.

[Antiviral effect of mangiferin and isomangiferin on herpes simplex virus]

Using tissue culture techniques the present study assured us of the merits of mangiferin and isomangiferin in the antiviral action against HSV-1. Utilizing 4 main patterns for evaluating drug effectiveness (ie intratube drug-on-virus direct action, simultaneous addition of drug-virus-inoculum to cell bottle, virus inoculation preceding drug addition, and drug addition followed by virus inoculation), it was readily found by logarithm determination of HSV-I inhibition that isomangiferin was superior to such control drugs as acyclovir, idoxuridine, and cyclocytidine in logarithm by 0.27-0.50, and that mangiferin was lower than isomangiferin in logarithm by 0.53. The average plaque reduction rates of mangiferin and isomangiferin were 69.5% and 56.8%, respectively. All in all, the antiviral effect of mangiferin and isomangiferin was attributed presumably to their capability to inhibit virus replication within cells.