Terminal deletion of chromosome 10q at band 26.1: follow-up in an adolescent male with high-output renal failure from congenital obstructive uropathy

We report on the clinical findings in an adolescent male with a de novo terminal deletion of chromosome 10 del(10)(q26.1). This young man is one of the oldest known patients reported with this condition. His condition is compared with that of 11 reported cases of de novo terminal deletion of 10q at band 26. Individuals with chromosome 10q26 deletion have some findings and medical complications in common. Our patient has chronic renal failure due to urinary tract obstruction from posterior urethral valves. Similar anomalies have been reported in cases of 10q26 deletion, suggesting a careful renal/urinary tract evaluation should be completed in individuals with this condition.

Mechanisms underlying the inhibitory effect of propofol on the contraction of canine airway smooth muscle

BACKGROUND

Propofol has been shown to produce relaxation of preconstricted airway smooth muscle. Although the inhibition of calcium mobilization is supposed to be the major mechanism of action, the whole picture of the mechanisms is not completely clear.

METHODS

Contractile response was performed using canine tracheal rings. The effects of propofol on carbachol-induced mobilization of intracellular Ca2+ and phosphoinositide hydrolysis were measured using cultured canine tracheal smooth muscle cells by monitoring fura-2 signal and assessing the accumulation of [3H]-inositol phosphates. To detect the effect of propofol on muscarinic receptor density and affinity, [3H]N-methyl-scopolamine was used as a radioligand for receptor binding assay.

RESULTS

Pretreatment with propofol shifts the concentration-response curves of carbachol-induced smooth muscle contraction to the right in a concentration-dependent manner without changing the maximal response. Propofol not only decreased the release of Ca2+ from internal stores but also inhibited the calcium influx induced by carbachol. In addition, carbachol-induced inositol phosphate accumulation was attenuated by propofol; the inhibitory pattern was similar to the contractile response. Moreover, propofol did not alter the density of muscarinic receptors. The dissociation constant value was not altered by pretreatment with 100 microM propofol but was significantly increased by 300 microM (propofol, 952+/-229 pM; control, 588+/-98 pM; P<0.05).

CONCLUSIONS

Propofol attenuates the muscarinic receptor-mediated airway muscle contraction. The mechanism underlying these effects was attenuation of inositol phosphate generation and inhibition of Ca2+ mobilization through the inhibition of the receptor-coupled signal-transduction pathway.

The anti-inflammatory and hepatoprotective effects of fractions from Cudrania cochinchinensis var. gerontogea

Various fractions of the ethanol extract from the root wood of Cudrania cochinchinensis var. gerontogea (Moraceae) were evaluated for their anti-inflammatory effects on carrageenan-induced edema and hepatoprotective activities on carbon tetrachloride (CCl4)-induced and D-galactosamine-(D-GalN) induced acute hepatotoxicity in rats. The fractions (n-hexane, CHCl3, EtOAc, n-BuOH, and H2O) displayed significant inhibitory activity against carrageenan-induced edema, and the active anti-inflammatory components were further localized in the n-BuOH fraction, which exhibited the greatest anti-inflammatory effect, an effect 5% greater than indomethacin (which was used as a standard reference substance). Each fraction exerted a significant hepatoprotective effect by reducing enzymatic alteration (sGOT and sGPT) and by improving hepatic lesions, including liver centrilobular inflammation, cell necrosis, fatty change, ballooning degeneration in CCl4-induced acute hepatitis; and necrosis of the portal area in D-GalN-induced acute liver injury. The n-BuOH and EtOAc fractions had the greatest hepatoprotective effects on CCl4-induced liver injury; in contrast, the CHCl3 fraction was most potent against D-GalN intoxication, which is comparable to silymarin, as a recognized hepatoprotective drug.

Spinal nitric oxide participates in the control of the blood pressure during graded hemorrhage in the conscious rat

We sought to evaluate the role of spinal nitric oxide (NO) in the control of blood pressure in the conscious animal and determine its possible participation in the progression of hemorrhagic shock. Adult, male Sprague-Dawley rats were chronically prepared with intrathecal, intravenous, and intra-arterial catheters. We first investigated the role of spinal NO on blood pressure control by intrathecal administration of N(G)-nitro-L-arginine methyl ester hydrochloride (L-NAME) at 0.37 micromol, 0.74 micromol. or 1.48 micromol. A dose-related increase in blood pressure was observed. We next pretreated animals with intrathecal or intravenous L-NAME at 0.37 micromol and induced the animal to shock by graded hemorrhage. Animals that received vehicle control or intravenous L-NAME had a decrease in blood pressure after 12% of the total circulatory blood volume (TBV) had been removed and developed severe hypotension after 24% TBV was bled. On the other hand, intrathecal pretreatment of L-NAME significantly attenuated the decrease in blood pressure. The blood pressure was maintained until 40% TBV had been withdrawn. We concluded that inhibition of NO synthase, in the spinal cord, increased blood pressure in a dose-dependent manner, and hemorrhagic shock induced by graded hemorrhage may involve an upregulation mechanism of spinal NO synthase in producing severe hypotension in conscious rats.

Porphyromonas gingivalis bacteremia and subhepatic abscess after renal transplantation: a case report

A uremic patient developed subhepatic abscess, Porphyromonas gingivalis bacteremia and cytomegalovirus viremia after a renal transplantation in mainland China. P. gingivalis infection has been reported to cause gingivitis and periodontitis. Bacteremia due to P. gingivalis, however, has not been reported in the literature. We report herein a case of subhepatic abscess and bacteremia due to P. gingivalis in a renal transplant recepient who was treated successfully with the well functioning renal graft.

Interleukin-1 beta in oral submucous fibrosis, verrucous hyperplasia and squamous cell carcinoma tissues

Interleukin-1 beta (IL-1 beta) has been proven to be a multi-effect mediator of inflammation including in the promotion of inflammatory cells to move from blood to inflamed tissues, the regulation of the synthesis and decomposition of extra-cellular matrix, and indirectly in causing bone resorption and inhibition of bone growth. In this study, the amounts of IL-1 beta in the biopsied specimens of normal oral mucosa, oral submucous fibrosis (OSF), oral squamous cell carcinoma (OSCC), and verrucous hyperplasia (VerH) were quantified by ELISA. The results showed that the amounts of IL-1 beta (pg per mg tissue, mean +/- SD) in normal oral mucosa, OSF, OSCC, and VerH were 1.07 +/- 0.53, 0.76 +/- 0.56, 4.37 +/- 0.87 and 3.97 +/- 1.93 respectively. There were no significant differences (p > 0.05, Mann-Whitney U Test) between the amounts of IL-1 beta in normal oral mucosa and OSF, and between VerH and OSCC. However, a significant difference in IL-1 beta level was found (p < 0.001) between normal oral mucosa and OSCC or VerH. Immunohistochemistry staining technique using antibody against IL-1 beta showed positive staining in hyperplastic epithelium (VerH) and tumor cells of OSCC. These results might suggest a correlation between the amounts of IL-1 beta in oral precancerous and cancerous lesions and cell transformation. On the other hand, the amount of IL-1 beta did not change significantly as OSF progressed. Thus, IL-1 beta levels may not be useful to gauge the seriousness of fibrosis, but the gradual increase in IL-1 beta level from normal oral mucosa through VerH to OSCC suggests that IL-1 beta may play an important role in oral carcinogenesis.

The relation of white blood cell count and atherogenic index ratio of LDL-cholesterol to HDL-cholesterol in Taiwan school children

White blood cell (WBC) count is an independent coronary risk factor in adults. To clarify the relation of WBC count and atherogenesity in children, we conducted a cross-sectional study in Taiwan from February to June 1996. A total of 3818 subjects were eligible in the final analyses. The ratio of low to high density lipoprotein cholesterol was calculated as atherogenic index. The 75th percentile of atherogenic index was calculated and used as cut-off point for high and low levels. The mean WBC count in children with high atherogenic index (6.82 x 10(9) cells/L) was significantly (p < 0.001) higher than those with low atherogenic index (6.58 x 10(9) cells/L). By multiple logistic regression analysis, higher WBC count (> or = 7.8 x 10(9) cells/L) was found to be an independent risk indicator of atherogenesity (odds ratio: 1.70, 95% confidence interval: 1.20-2.41) among obese children. Other significant factors associated with atherogenesity were gender, obesity, age, triglyceride and total cholesterol level. Our results indicate that obese children with higher WBC count have higher atherogenic index.

Antioxidant activity of tannin components from Vaccinium vitis-idaea L

Reactive oxygen molecules have been implicated as important pathological mediators in many clinical disorders and periodontal disease. To provide possible alternative treatment of periodontal disease, six tannins isolated from Vaccinium vitis-idaea L. were evaluated for anti-lipid peroxidation, anti-superoxide formation and free radical scavenging activity. The results showed that cinnamtannin B1 displayed the strongest anti-lipid peroxidation activity, proanthocyanidin A-1 displayed the strongest superoxide scavenging activity, and epicatechin-(4beta--> 6)-epicatechin-(4beta-->8, 2beta-->O--> 7)-catechin had the strongest anti-superoxide formation effect. We conclude that tannins isolated from V. vitis-idaea L. exhibited multiple antioxidant activity, and could be used for the treatment of periodontal disease.

The penetration of ceftibuten into the respiratory tract

STUDY OBJECTIVE

To determine the penetration of ceftibuten into various respiratory tissues and fluids.

DESIGN

Single-dose, open-label, pharmacokinetic study.

SETTING

Veterans Administration Medical Center.

PATIENTS

Twelve hospitalized men aged 34 to 75 years with a variety of noninfectious pulmonary symptoms/diseases.

INTERVENTIONS

Patients received a single oral dose of ceftibuten, 200 mg, prior to undergoing diagnostic fiberoptic bronchoscopy. Plasma samples for the determination of ceftibuten concentrations were collected pretreatment and up to 12 h postdosing. Nasal secretions, tracheal secretions, BAL fluid, and lung tissue from a biopsy were obtained at bronchoscopy from 2 to 7 h postdosing.

MEASUREMENTS AND RESULTS

Mean pharmacokinetic parameters for ceftibuten in plasma were the following: maximum observed plasma concentration (Cmax), 8.77 microg/mL; time to reach Cmax, 2.2 h; area under the plasma concentration-time curve extraploated to infinity, 49.21 microg/h/mL; and terminal elimination half-life, 3.17 h. These parameters were similar to those obtained in studies using healthy volunteers. Mean penetration of ceftibuten into nasal, tracheal, and bronchial secretions was 47%, 50%, and 30%, respectively. Mean penetration into BAL fluid was 81%, whereas penetration into lung tissue was 39%. No patient experienced any adverse effects related to ceftibuten.

CONCLUSIONS

Ceftibuten penetrates well into various tissues and fluids of the upper and lower respiratory tracts. The results support the activity of ceftibuten in the treatment of upper and lower respiratory tract infections.

A retrospective study of clozapine and urinary incontinence in Chinese in-patients

OBJECTIVE

This study investigated the incidence of clozapine-associated urinary incontinence (UI) in schizophrenic patients, the percentage of these patients with persistent urinary incontinence (PUI), and the possible factors affecting the occurrence of UI.

METHOD

A total of 61 Chinese in-patients with schizophrenia (according to DSM-IV) treated with clozapine for more than 3 months were assessed retrospectively for the occurrence of UI. Patients who still had UI at the time of assessment were classified as having PUI. Patients whose UI had resolved at the time of assessment were classified as having self-limited urinary incontinence (SUI). We compared the characteristics of UI and non-UI cases and of PUI and SUI cases.

RESULTS

The results showed that urinary incontinence developed at some time in 27 of 61 patients (44.3%), and that it was persistent in 15 of 61 patients (25%). There were no statistically significant differences in age, sex, clozapine dose, duration of clozapine use, duration of index admission, duration of illness, age at onset of schizophrenia, or concurrent treatment with other psychiatric medications between the UI and non-UI groups and between the PUI and SUI groups.

CONCLUSION

Clozapine-associated urinary incontinence may be persistent in some patients, and it should be cautiously monitored in every patient taking clozapine.

Acinetobacter baumannii bloodstream infection: clinical features and antimicrobial susceptibilities of isolates

The number of nosocomial infections caused by Acinetobacter baumannii has increased in recent years. The purposes of this study are to discover the risk factors of transmission to prevent the nosocomial infection of A. baumannii. We retrospectively studied 36 patients with A. baumannii bacteremia at China Medical College Hospital from January 1996 to December 1997. There were 23 males and 13 females. All bacteremia were acquired nosocomially. Malignancy (n = 8) and intracranial hemorrhage (n = 6) were the most common underlying diseases. Only one patient on arterial line disclosed intraarterial catheter-related A. baumannii bacteremia and 3 patients had evidence of A. baumannii pneumonia. Twenty-one patients (58%) had central venous catheters in place at the onset of bacteremia, but none was proven to be catheter-related infection. There were 32 patients (89%) with unknown portal of entry. Multivariate logistic regression analysis revealed that potential risk factors related to A. baumannii bacteremia were prior antimicrobial therapy (P < 0.05). The most common clinical features of A. baumannii bacteremia were, in descending order, fever, leukocytosis, thrombocytopenia and hypotension. Eleven patients (30.6%) died directly from A. baumannii bacteremia. All isolates were resistant to ampicillin, cephalothin, cefonicid and moxalactam. The most alarming evidence was that 19% of isolates showed resistance to imipenem. Our findings emphasized that A. baumannii bacteremia had the following characteristics: usually acquired nosocomially, unknown portal of entry, and high multiresistance, especially the increasing resistance rate to imipenem. Imipenem must be reserved as a last-line agent to treat A. baumannii infections, so we want to suggest that the treatment of choice for A. baumannii is gentamicin, amikacin or ceftazidime.

Expression of nm23 in the primary tumor and the metastatic regional lymph nodes of patients with gastric cardiac cancer

Tumor recurrence and distant metastasis are major causes of treatment failure in gastric cardiac cancer (GCC). Rapid growth of tumor cells and reduced expression of nm23, a metastatic suppressor gene, in tumor cells have been suggested as two important mechanisms for disease progression of GCC. Therefore, to determine the prognostic value of nm23 expression in GCC, we used immunohistochemistry to examine the expression of nm23 in the pathological sections of both gastric cancer and metastatic lymph nodes from 24 stage III patients. Twenty-two patients had total gastrectomy, and two patients had proximal subtotal gastrectomy with a D2 dissection. Postoperative adjuvant therapy was provided, and the clinical responses were followed routinely. Clinical correlation was evaluated by chi2 with Fisher's exact test and survival by log-rank test. Our results show that the reduced nm23 expression in the primary tumor and in the nodal metastasis is the most useful marker for the poor prognosis of GCC following surgery.

Simple and sensitive high-performance liquid chromatographic method for the determination of an everninomycin, SCH 27899, in rat plasma

A simple and sensitive high-performance liquid chromatographic (HPLC) method was developed for the determination of SCH 27899, an everninomycin antibiotic, in rat plasma. The method involved plasma protein precipitation with acetonitrile, followed by reversed-phase HPLC analysis using a polymeric column and a mobile phase containing acetonitrile and ammonium phosphate, pH 7.8. The linear relationship between detector response and concentration was demonstrated with a correlation coefficient of larger than 0.996 at concentrations ranging from 0.2 to 100 microg/ml. The results showed that the HPLC method was accurate (bias < or = 6%) and precise (coefficient of variation, C.V. < or = 6%). The limit of quantitation was 0.2 microg/ml with a C.V. of 2.6% and bias of 5%. SCH 27899 was stable in rat plasma at -20 degrees C for at least 40 days. The HPLC method has been utilized for the determination of SCH 27899 in plasma samples from rats following single intravenous administration (3 mg/kg).

Evaluation of the antioxidant activities of Erycibe obtusifolia

Free radicals may be involved in various pathogenesis processes. Tissue damage and cellular toxicity of some chemicals mediated by oxygen free radicals can be monitored by studying the levels of lipid peroxidation in the tissues. The study reported here is to investigate the MDA concentrations in different tissues after various doses of Erycibe obtusifolia (EO) treatments. EO given at doses of 10, 20 and 30 mg/kg body weight is experimentally tested through oral administration. The antioxidant effect of EO extract is assessed by the measurements of hepatic, renal and splenic lipid peroxides (measured as malondialdehyde; MDA) after treatments. The results show no significant time-related and dose-dependent increase or decrease of MDA concentrations in the liver, kidney and spleen after EO administrations, respectively. The peak of antioxidant activities is found on the first day and the 6 hrs after treatments for liver and kidney, respectively. In contrast, the MDA concentrations in spleen after EO administrations remained above the normal values. This result suggests that a high dose of EO administration may contribute a little antioxidant activity in both liver and kidney.

Adenomatoid hyperplasia in the mandibular retromolar area. Case report

This paper reports a case of adenomatoid hyperplasia of minor salivary glands in the retromolar area, with a unique symptom of painful swelling. This appears to be the first reported case in the Chinese population. It would be useful for clinical dentists to be aware of this tumour.

Placental glutathione S-transferase isoenzyme expression during promotion of two-stage hamster cheek-pouch carcinogenesis

Glutathione S-transferases (GSTs) are the products of a multigene family. A well-established function of GSTs is to metabolize carcinogens by catalysing the conjugation of electrophilic substrates to glutathione. Whether placental GST (GST-P) is expressed during the promotion of two-stage hamster buccal-pouch mucosa (HBPM) carcinogenesis was investigated here, using 7,12-dimethylbenz[a]anthracene (DMBA) as the initiator and 12-O-tetradecanoylphorbol-13-acetate (TPA) as the promoter. Cytoplasmic and nuclear staining for GST-P was seen in pouches treated with DMBA for 4 or 16 weeks, as well as in those treated with DMBA for 4 weeks and then TPA for 12 weeks. No GST-P positivity was seen in any pouches treated with only TPA or with mineral oil for either 4 or 16 weeks. The average number of GST-P-stained foci in the groups treated with DMBA for 16 weeks (246 +/- 96; mean +/- SD) or DMBA for 4 weeks followed by TPA for 12 weeks (186 +/- 67) was significantly higher than in pouches treated with only DMBA for 4 weeks (97 +/- 24). These results demonstrate that TPA alone is not sufficient for GST-P expression in hamster buccal pouch mucosa. However, after being initiated with DMBA, then promoted with TPA, GST-P activity is induced in hamster buccal pouch mucosa during squamous-cell carcinogenesis. This underpins the suggestion that GST-P may play an important part during the promotion stage of oral carcinogenesis.

High-performance liquid chromatographic analysis of the anti-tumor agent SCH 66336 in cynomolgus monkey plasma and evaluation of its chiral inversion in animals

SCH 66336 is a novel non-cytotoxic anti-tumor agent that is in phase I/II clinical trials for the treatment of solid tumors. This compound is a single enantiomer with one chiral center. Prior to evaluation of this drug candidate in man, it was necessary to evaluate its pharmacokinetics and possible chiral inversion in animals. Thus, high-performance liquid chromatographic (HPLC) methods have been developed for its determination in cynomolgus monkey plasma and for the evaluation of its chiral inversion in rats and cynomolgus monkeys. The achiral HPLC analysis involved extraction with 30% methylene chloride in hexane followed by separation on a CN column and quantitation by UV absorbance at 280 nm. The method was linear over a concentration range of 0.1 to 20 microg/ml in monkey plasma. The chiral HPLC analysis involved the use of a Chiralpak AD column set at 39 degrees C with a mobile phase of hexane-ethanol-diethylamine mixture and a UV detector set at 280 nm. Plasma samples were subjected to solid-phase extraction on a C2 cartridge prior to HPLC analysis. The method was linear over a concentration range of 0.25 to 10 microg/ml in rat and cynomolgus monkey plasma for both enantiomers. Both methods showed good linearity (r2>0.99), accuracy (bias< 13%) and precision (CV<12%). Chiral HPLC analysis indicated that SCH 66336 was not subjected to chiral inversion in rats and cynomolgus monkeys.

Dieulafoy's lesion of the jejunum

Dieulafoy's lesion is a rare vascular anomaly but a potentially life-threatening disease. This lesion can also be found in the small intestine, which can be diagnosed only by angiography. However, the angiography may be normal when the bleeding is inactive. We report a case of jejunal Dieulafoy's lesion with a repeated attack of massive gastrointestinal bleeding with a normal initial angiography. The pathological examination found an unusual picture as a dilated submucosal vessel protruded like a submucosal tumor.

Spondyloepiphyseal dysplasia congenita: report of one case

Spondyloepiphyseal dysplasia (SED) congenita is a rare disorder with autosomal dominant inheritance which demonstrates short stature since birth and displays progressive involvement of the spine and the epiphyses of long bones. We present a case of SED congenita with short stature since birth, flat midface, short neck, barrel chest with pectus carinatum, lumbar lordosis, myopia without retinal detachment, and flat, avoid-shaped vertebral bodies. Neurological examination is normal. No specific biochemical change or intellectual impairment can be discerned.

Acetophenone glycosides from thyme (Thymus vulgaris L.)

Four acetophenone glycosides were isolated from the butanol-soluble fraction of thyme extracts. Their structures were determined by spectral methods (MS, NMR, and 2D-NMR). Among them, two new compounds, 4-hydroxyacetophenone 4-O-[5-O-(3, 5-dimethoxy-4-hydroxybenzoyl)-beta-D-apiofuranosyl]-(1-->2)-beta-D -gl ucopyranoside (1) and 4-hydroxyacetophenone 4-O-[5-O-(4-hydroxybenzoyl)-beta-D-apiofuranosyl]-(1-->2)-beta-D-+ ++gluc opyranoside (2), were determined. Compound 1 showed weak cytotoxicity, inhibiting DNA synthesis of human leukemia cells.

Conservation of human gamma-X centromeric satellite DNA among primates with an autosomal localization in certain Old World monkeys

Gamma-X satellite DNA is a 220-bp tandemly arranged repetitive DNA with specificity for the centromeric region of the human X chromosome. The conservation of this human X centromeric satellite DNA sequence in primate species was evaluated by comparative fluorescence in-situ hybridization to metaphase chromosome preparations of the great apes and three Old World monkeys. Homologous gamma-X DNA were detected at centromeric locations in all six primate species. For the great apes, gamma-X was exclusively localized to the centromeric regions of the X chromosomes. Among the Old World monkeys studied, only the golden monkey exhibited localization to the X chromosome. In the black-and-white colobus and the pig-tailed macaque, human gamma-X sequences were localized to the pericentromeric regions of autosomes 1 and 4, respectively.

Improved reliability of the rapid microtiter plate assay using recombinant enzyme in predicting CYP2D6 inhibition in human liver microsomes

A higher throughput method of screening for the inhibition of recombinant CYP2D6 using a microtiter plate (MTP) assay was evaluated using 62 new chemical entities and compared to data from the dextromethorphan O-demethylase assay in human liver microsomes (HLM). The IC50 values for the two assays closely matched for 53 compounds (85%). Six of the variant nine compounds had higher IC50 values with the recombinant enzyme, whereas three had lower IC50 values with the recombinant enzyme. When the inhibition with the recombinant enzyme was determined at various time points, the IC50 values increased as the duration of the incubation increased for the six compounds with higher IC50 values in the MTP assay. The IC50 values at 10 min matched more closely the IC50 values in HLM (95% compared with 85%). For three compounds that showed comparable IC50 values in the two assays, and the three compounds with lower IC50 values in the MTP assay, the IC50 values did not change over time. These results suggest that the six compounds that showed higher IC50 values in the MTP assay at 45 min are substrates for CYP2D6. Using known CYP2D6 substrates, a similar phenomenon was observed, i.e., inhibition curves shifted to higher IC50 values as incubation time increased. These results indicate that the higher throughput MTP assay is more comparable to HLM if the IC50 values are determined at 10 min rather than the recommended 45 min. Furthermore, data acquisition at multiple time points may indicate if a compound is a potential substrate or metabolism/mechanism-based inhibitor for the enzyme.

Recognition of functional pulmonary atresia by color Doppler echocardiography

Vigorous crying aids right ventricular ejection into the pulmonary artery. This phenomenon can differentiate functional pulmonary atresia from anatomic pulmonary atresia.