Cytokines in the central nervous system: expression of macrophage colony stimulating factor and its receptor during development

To investigate the potential role of cytokines in the development of the central nervous system, we analyzed the production of cytokine mRNA transcripts by S1-nuclease protection analysis in the brains of Swiss-Webster mice during fetal development and after birth. Cytokines studied were interleukin (IL)-1 alpha, IL-2, IL-3, IL-4, IL-5, IL-6, IL-7, macrophage-colony stimulating factor (M-CSF), granulocyte-colony stimulating factor (G-CSF), granulocyte macrophage-colony stimulating factor (GM-CSF), and leukemia inhibitory factor (LIF). Only mRNA transcripts for M-CSF were found to be produced constitutively in normal brain tissue. These transcripts were detected continuously from embryonic day (ED) 13 through adulthood. Transcripts encoding the M-CSF receptor (c-fms) were also detected at all of these time points. Despite identification of M-CSF transcripts in the brains of normal mice during development and M-CSF protein in cell cultures, neuropathological examination of the brains of op/op mice, a naturally occurring mouse mutant defective in the production of functional M-CSF, showed no cytoarchitectural abnormalities.

The nutritional status of pre-school children in poor rural areas of China

Described are the main findings of the first large-scale nutrition monitoring project carried out over a 4-year period in China. The nutritional status of nearly 10 000 preschool children in 18 comparatively poor rural areas in seven provinces was followed each year over the period 198S89 in order to identify their major nutritional problems and improve their growth and development. Physical measurements were made and dietary surveys and biochemical tests were performed on a subsample of the children. The proportion of stunted and underweight children was far higher than the national average. Based on the possibilities offered by local circumstances, the prevalences of stunting and underweight were lowered and anemia greatly reduced. Along with the progress in nutrition monitoring, major efforts were made to train health workers, as well as to encourage increased production of green vegetables, poultry, and small livestock. The wealth of information collected and the experience gained may serve as a baseline record, the project currently being expanded to cover 100 counties throughout China.

Propofol modifies recovery from isoflurane-nitrous oxide anesthesia

A randomized, prospective study was performed to evaluate the hemodynamic changes and recovery characteristics in 60 ASA physical status class I-II unpremedicated patients undergoing gynecological laparotomies with either isoflurane anesthesia only (ISO group) or isoflurane anesthesia followed by propofol infusion (ISO-PRO group). All patients received isoflurane 0.5-1.5% and nitrous oxide (N2O) 66% in oxygen after tracheal intubation. ISO-PRO group (n = 30) received 6 mg kg-1 hr-1 propofol infusion in substitution for isoflurane 25 minutes before the end of surgery. Propofol in ISO-PRO group and isoflurane in ISO group (n = 30) were discontinued 5 minutes before the end of surgery. In both groups, N2O was administered throughout the operation until skin was closed. Hemodynamic measurements were similar between the two groups except at extubation when heart rate and blood pressure were lower in ISO-PRO group. The maximal blood pressure was also lower in ISO-PRO group. In ISO-PRO group, the time required to responsiveness to verbal commands and to orientation were significantly shorter. ISO-PRO group had better Steward's score on arrival at the recovery room and was earlier to get a full score of six. The two groups experienced similar rates of emesis and excitement either two hours or 24 hours postoperatively. We conclude that in relatively long intra-abdominal operations, replacement of isoflurane by propofol infusion 25 minutes before the end of surgery may provide stable maintenance of anesthesia and a faster recovery.

Precipitation profile of the intravenous induction agents

To investigate the formation of precipitation between various intravenous agents, we cross-matched the anesthetic agents commonly used in the induction phase. Thiopentone and thiamylal precipitated in combination with non-depolarizing muscle relaxants, lidocaine, morphine, and meperidine. Ketamine and etomidate were naive to these agents. Crystalloidal solutions, such as lactated Ringer, normal saline, and dextrose solution did not contribute to the formation of precipitate. In conclusion, our study indicates that intravenous line must be irrigated before and after thiopentone and/or thiamylal. In order to prevent precipitate formation, mixtures of various drugs should be avoided until in vitro assay is done.

Modulation of retinoic Acid receptor-alpha, growth-factors and protooncogenes in retinoic Acid-induced apoptosis of ki-1 lymphoma cell-line

We have previously reported the successful salvage by retinoid acid (RA) of patients with refractory Ki-1 lymphoma. In this study, we have further investigated the effect of all-trans RA on a Ki-1 lymphoma cell line SR786. Similar to the clinical observation, SR786 cells were sensitive to RA treatment (ID50=0.6 mu m). RA-treated SR786 cells were transformed to a more differentiated morphology at 24 h, and subsequently died via apoptosis at 48-72 h. This process was associated with a decreased expression of the proliferation markers and c-myc proto-oncogene. The RA receptor alpha (RAR-alpha), however, showed an immediate enhanced expression at 1/2 h, and followed by an increase of transforming growth factor-beta 1 (TGF-beta 1) gene expression. The apoptosis and increased expression of TGF-beta 1 could be completely blocked;by the addition of cycloheximide given within 12 h of RA treatment. It appears that the RA-induced apoptosis of SR-786 is the result of an RA-induced upregulation of RAR-alpha and a subsequent activation of TGF-beta 1, which in turn leads to a cascade of the suppression of growth-related genes. Our observations strongly support the use of retinoids in Ki-1 lymphoma and invite further studies to test the potential of RA in other specific type T-cell lymphomas.

Effects of nerve segment supernatants on cultured Schwann cell proliferation and laminin production

Mouse sciatic nerves were transected and 3 hr to 16 days later proximal segments were removed and homogenized. Supernatants of these segments or of normal sciatic nerves were added to Schwann cells maintained in Dulbecco's modified Eagle's medium (DMEM) + 15% fetal calf serum (FCS). After 6 days, Schwann cells were solubilized and the protein content was measured using a Bio-Rad (Melville, NY) protein assay. Samples containing the same amounts of protein were then applied to microtiter plates and the laminin content was determined by enzyme-linked immunosorbent assay (ELISA). Lysates of cultures treated with 24 hr proximal segment supernatants contained significantly higher levels of laminin than those prepared from other intervals, from distal segments, or from control nerves. Increased surface and cytoplasmic anti-laminin immunoreactivity also was found in Schwann cells treated with 24 hr supernatants. To identify the source(s) of this effect, proximal segments removed 24 hr after transection were bisected; supernatants were prepared from each half and tested. Significant increases in laminin production were produced by supernatants from both halves. When supernatants from proximal and distal halves were compared, the latter produced significantly higher laminin levels. Electron microscopic examination of both halves showed that distal halves contained sprouting neurites and growth cones ensheathed by Schwann cells which had a basal lamina and resembled those seen during development and regeneration. Proximal halves appeared normal. Schwann cell proliferation also was compared in supernatant-treated cultures by using a bromodeoxy-uridine (BrdU) ELISA. The 24 hr and 2 day supernatants increased Schwann cell proliferation significantly; 12 hr, 4 day, and 8 day supernatants produced smaller increases. Our observations suggest that axons undergoing early regenerative changes are one of several possible sources of substance(s) in our proximal segment supernatants which increased Schwann cell proliferation and laminin production.

Overusage of mouse DH gene segment, DFL16.1, is strain-dependent and determined by cis-acting elements

The DJH structure is of particular importance for diversity in the immunoglobulin heavy chain because it encodes most of CDR3. Here, we investigate mechanisms responsible for generating the DJH structure. We found DFL16.1 was used at a high frequency in normal and transformed pre-B cells (fetal liver > 50%, A-MuLV lines approximately equal to 25%). One DFL16.1JH1 structure was found repeatedly and was also present in DJH and VDJH databases, suggesting this structure may be conserved in the primary repertoire. Genetic analysis demonstrated that C57BL/6 mice use DFL16.1 in DJH structures more frequently than BALB/c. Examination of individual alleles in (C57BL/6 x BALB/c)F1 A-MuLV cell lines revealed that the C57BL/6-derived allele used DFL16.1 twice as often as the BALB/c. This result indicates that part of the mechanism ensuring overusage of DFL16.1 gene segments is cis-acting.

Nutritional status of preschool children in poor rural areas of China

Described are the main findings of the first large-scale nutrition monitoring project carried out over a 4-year period in China. The nutritional status of nearly 10,000 preschool children in 18 comparatively poor rural areas in seven provinces was followed each year over the period 1986-89 in order to identify their major nutritional problems and improve their growth and development. Physical measurements were made and dietary surveys and biochemical tests were performed on a subsample of the children. The proportion of stunted and underweight children was far higher than the national average. Based on the possibilities offered by local circumstances, the prevalences of stunting and underweight were lowered and anaemia was greatly reduced. Along with the progress in nutrition monitoring, major efforts were made to train health workers, as well as to encourage increased production of green vegetables, poultry, and small livestock. The wealth of information collected and the experience gained may serve as a baseline record, the project currently being expanded to cover 100 counties throughout China.

Prevention of heterosexual transmission of human immunodeficiency virus through couple counseling

In the absence of an effective vaccine, behavior change remains the most effective means to prevent the spread of HIV. We examined behavior change over time and rates of HIV seroconversion in a cohort of HIV individuals and their heterosexual partners recruited since 1985. Participants were recruited from various HIV counseling and testing sources throughout California and were usually interviewed and tested in their own homes. Couple counseling and risk assessments were conducted at average intervals of six months. Data from 144 couples who were discordant for HIV serostatus are reported. Of the index cases, 78% were men. Most male index cases were bisexuals, and most female index cases were infected through heterosexual intercourse with a previous sexual partner. The mean duration of the relationship for the couple at intake was 5.6 years. Both condom use and sexual abstinence increased over time (p < 0.001 for both), and most behavior change occurred between intake and first follow-up visit. We observed no seroconversion after 193 couple-years of follow-up. Couple counseling in combination with social support appears to be an effective means to promote and sustain behavior change among HIV-infected individuals and their heterosexual partners.

High frequency of normal DJH joints in B cell progenitors in severe combined immunodeficiency mice

The severe combined immunodeficiency (scid) mouse has a defective V(D)J recombinase activity that results in arrested lymphoid development at the pro-B cell stage in the B lineage. The defect is not absolute and scid mice do attempt gene rearrangement. Indeed, approximately 15% of all scid mice develop detectable levels of oligoclonal serum immunoglobulin and T cell activity. To gain more insight into the scid defect and its effect on V(D)J rearrangement, we analyzed DJH recombination in scid bone marrow. We determined that DJH structures are present in scid bone marrow and occur at a frequency only 10-100 times less than C.B-17+/+. The scid DJH repertoire is limited and resembles fetal liver DJH junctions, with few N insertions and predominant usage of reading frame 1. Moreover, 70% of the DJH structures were potentially productive, indicating that normal V(D)J recombinants should be arising continually.

Inherited syndrome of infantile olivopontocerebellar atrophy, micronodular cirrhosis, and renal tubular microcysts: review of the literature and a report of an additional case

An 8-month-old male infant who presented in the neonatal period with failure to thrive, bilateral pleural and pericardial effusions, and hepatic insufficiency characterized by elevated liver functions tests and hypoalbuminemia was found at autopsy to have an unusual combination of olivopontocerebellar atrophy (OPCA), micronodular cirrhosis, and renal tubular microcysts. Metabolic evaluation was significant only for elevated urine dicarboxylic acids. In the brain, sections from the cerebellum showed marked atrophy of folia most severe in the vermal and paravermal regions. In addition, mild neuronal loss was present in the basis pontis and inferior olivary nuclei accompanied by gliosis. Residual Purkinje cells in the cerebellar hemispheres exhibited greatly expanded and swollen arbors, which ultrastructurally were found to contain densely packed membranous cytoplasmic body-like inclusions that had the appearance of unwinding, lamellar coils. Review of the literature shows that this constellation of findings has been associated with carbohydrate-deficient transferrin. This biochemical marker along with the distinctive clinical presentation and pathological features clearly delineates a unique subset of OPCA.

Red-green flicker photometry and nonlinearities in the flicker electroretinogram

We investigated whether responses from different cone classes are combined before or after the nonlinearity that is responsible for generating nonlinear response components of the flicker electroretinogram (ERG). We measured the nonlinear response of the retina while systematically varying the modulation in the long-wavelength-sensitive and middle-wavelength-sensitive cones by changing the proportions of flickering 633- and 543-nm lights that compose a sum-of-sinusoids temporal waveform. We found that at high temporal frequencies the ERG responses are best accounted for by a model in which the principal retinal nonlinearity is located before the convergence of signals from the two cone classes. At low temporal frequencies the ERG signal is dominated by cone-antagonistic responses. At frequencies of 30 Hz and higher, the flicker ERG and psychophysical flicker photometry give similar estimates of the relative proportions of long- and middle-wavelength-sensitive cones. The ERG photometric null is frequency dependent, whereas the psychophysically determined ratio is much less sensitive to changes in frequency.

Intraventricular and subarachnoid hemorrhage resulting from necrotizing vasculitis of the choroid plexus in a patient with Churg-Strauss syndrome

Neurologic symptoms are common in patients with the Churg-Strauss syndrome and often manifest as a peripheral neuropathy of the mononeuritis multiplex type secondary to vasculitis. Reports of central nervous system involvement is less frequent and ranges from psychiatric disturbances to cerebral hemorrhage. We report the first case of pathologically documented vasculitis involving the choroid plexus causing massive and fatal intraventricular and subarachnoid hemorrhages in a 47-year-old patient with Churg-Strauss syndrome.

Localized hypertrophic mononeuropathy of the trigeminal nerve

We report a case of localized hypertrophic mononeuropathy that involved the trigeminal nerve in a 61-year-old woman with a 5-year history of progressive drooping of the left eyelid, double vision, and left-sided temporal and retro-orbital pain. A mass that occupied the patient's left cavernous sinus was found to display localized hypertrophic mononeuropathy characterized by "onion bulbs" that were formed of concentrically proliferating Schwann cell processes around intact axons. This contrasted to the majority of previously reported cases of localized hypertrophic mononeuropathy, predominantly found in peripheral nerves, where the proliferating cell processes have been shown to be of a perineurial cell origin. Differences in architectural arrangement and degree of cellularity between the perineurial and schwannian forms of localized hypertrophic mononeuropathy were noted. These findings suggest important fundamental differences in the pathogenesis of various forms of onion-bulb mononeuropathies.

Right gastroepiploic artery: an alternative arterial conduit for coronary artery bypass

From September 1990 to February 1991, 15 cases of myocardial revascularization with the right gastroepiploic artery (RGEA) combined with arterial or venous grafts were performed at VGH-Taipei. All were males, ranging in age from 49 to 64 years (mean age 61.2 +/- 4.6 years). The mean number of distal anastmoses including vein grafts was 3.6 +/- 0.7 and the mean number of graft was 3.1 +/- 0.3 per patient. The mean aortic clamp time was 123.6 +/- 24.0 minutes and the mean cardiopulmonary bypass time was 176 +/- 35 minutes. There was one mortality (6.7%). The other 14 patients are alive without angina. Studied within 3 postoperative months, graft early patency was 100% (6/6) in GEA graft. GEA graft should be a third available arterial conduit for coronary artery bypass.

Selective brain cooling during and after prolonged global ischemia reduces cortical damage in rats

BACKGROUND AND PURPOSE

Studies of the cerebroprotective effects of selective brain cooling have failed to show amelioration of ischemic injury in the cerebral cortex. This study was designed to test the hypothesis that mild-to-moderate selective brain cooling initiated after the onset of global brain ischemia in rats protects the cerebral cortex and improves neurological outcome.

METHODS

Global forebrain ischemia for 30 minutes in 27 fasted adult male Wistar rats was achieved by bilateral carotid occlusion and hypotension. In group 1, brain temperature, measured in the temporalis muscle, was maintained at 37-38 degrees C throughout the experiment. In group 2, brain temperature fell spontaneously during ischemia to 34.7 +/- 0.1 degrees C and rose spontaneously to 36-37 degrees C after 10 minutes of recirculation. In group 3, brain temperature was lowered with ice packs placed around the head after 15 minutes of ischemia to 24.1 +/- 0.9 degrees C by the end of ischemia, maintained at 30.0 +/- 1.0 degrees C for the first hour of recirculation, then allowed to rise to 36-37 degrees C.

RESULTS

Seven-day survival was 0% (0 of 6) in group 1, 73% (8 of 11) in group 2, and 100% (6 of 6) in group 3. Severity of neuronal damage was less in group 2 than in group 1 in the cortex (p < 0.05) and hippocampal CA1 (p < 0.05) and CA3 regions (p < 0.05). Group 3 had less neuronal damage than group 2 in both cortex (p < 0.02) and striatum (p < 0.02). Furthermore, postischemic weight loss was less and neurobehavioral scores were significantly higher in group 3.

CONCLUSIONS

This study shows that selective brain cooling increases survival from prolonged global ischemia and reduces neuronal injury in the cerebral cortex as well as the striatum and hippocampus.

Androgen receptor in cirrhotic liver, adenomatous hyperplastic nodule and hepatocellular carcinoma in the human

Androgen receptors (AR) were assayed for cirrhotic liver, adenomatous hyperplastic nodule (AHN), and hepatocellular carcinoma (HCC) which were removed by partial hepatic resection from five patients. There were three men and two women. Age ranged from 59 to 68 years. Underlying cirrhosis was macronodular in three and micronodular in two. AHN was present within HCC in two patients, but these two lesions were found in different lobes of the same liver in another two patients. Only AHN was seen in the last patient. ARs in the cytosol of cirrhotic liver ranged from nil to 12.8 fmol/mg of protein with the dissociation constant (Kd) of 3.2-20.3 x 10(-10) M. AHNs possessed ARs ranging from 4.0 to 27.6 fmol/mg of protein (Kd values, 7.4-21.0 x 10(-10) M. All HCC nodules had ARs ranging from 11.8 to 72.8 fml/mg of protein with Kd values of 5.3-27.1 x 10(-10) M. Thus, cytosolic AR concentrations were highest in HCC, lowest in cirrhotic liver, and intermediate in AHN. The present study seems to indicate that AHN may be a precancerous lesion and that androgen and its receptor play an important role in human hepatocarcinogenesis.

Successful management of perforating injury of right atrium by chest tube

Tube thoracostomy is an invasive procedure caring about 1% complication rate. Most confronted complications include diaphragm or lung laceration [1-3], damage to intrabdominal organ, intercostal artery bleeding and unilateral pulmonary edema. Here we present another rare complication of perforation of the right atrium which occurred in a patient with rheumatic heart disease (RHD) who had received mitral valve replacement (MVR) and tricuspid annuloplasty. Severe tricuspid regurgitation (TR) with huge right atrium was noted. Chest tube was inserted for pleural effusion drainage. The lesion was proved to be in the right atrium by echocardiography and computerized tomography three days later. The penetrated hole was repaired with bovine pericardium patch with minimal blood loss. This case attests to the extreme caution warranted when performing tube thoracostomy in patient with huge cardiomegaly.

Antitumor effects of new-type recombinant interleukin-2

Two new human recombinant interleukin-2 (rIL-2), 125-Ser-rIL-2, and 125-Ala-rIL-2, were generated by protein engineering technique. Both of them maintained the proliferation of natural killer (NK) cells, CTLL-2 cells and their long-term propagations. The mutated new rIL-2 also enhanced the bioactivity of NK cells and the cytotoxicity of tumor-infiltrating lymphocytes (TIL) against the target tumor cells. The above results were all compared with that of the native rIL-2 and a similarity between them was found, which indicates that new type rIL-2 could be used for adoptive immunotherapy of malignant diseases.

A new autoperfusion technique for aortic reconstruction of suprarenal aortic aneurysm

Visceral ischemia is a serious factor in the postoperative morbidity and mortality of suprarenal aortic reconstruction. We reported two patients of suprarenal aortic aneurysm involving visceral arteries, who received successful Dacron graft replacement by using Pruitt-Inahara balloon catheters as an autoperfusion for preservation of the visceral organs. No visceral organ ischemia occurred postoperatively except in patient 2 who had preoperative chronic renal failure and persistent renal failure after the operation. The renal function recovered gradually during the follow-up period. Both patients are doing well at the present time. The new autoperfusion technique can directly deliver normothermic blood from the arterial cannula at proximal aorta to the individual visceral arteries by using the balloon perfusion catheters. It is simple, safe, easily instituted and the used products are readily obtainable. It allows the surgeon to provide an effective protection of visceral organs for the suprarenal aortic reconstruction.

Effects of tryptophan mutation on the deprotonation and reprotonation kinetics of the Schiff base during the photocycle of bacteriorhodopsin

The rates of deprotonation and reprotonation of the protonated Schiff base (PSB) are determined during the photocycle of nine bacteriorhodopsin mutants in which Trp-10, 12, 80, 86, 137, 138, 182 and 189 are individually substituted by either phenylalanine or cysteine. Of all the mutants, the replacement of Trp-86, Trp-182, and Trp-189 by phenylalanine and Trp-137 by cysteine is found to significantly alter the rate of the deprotonation, but not that of the reprotonation process. As compared with ebR, the Trp-86 mutation dramatically increases the rate of deprotonation of the PSB while the Trp-182 mutation greatly decreases this rate. Temperature dependence studies on the rate constants of the deprotonation demonstrate that the different energetic and entropic effects of the mutation are responsible for the observed different kinetic behavior of the Trp-86 and Trp-182 mutants as compared with that of ebR. In the case of Trp-86 mutant, a large decrease in both energy and entropy of activation suggests that the mutation of this tryptophan residue opens up the protein structure as a result of eliminating the hydrogen-bonding group on its side chain by a phenylalanine substitution. A correlation is observed between the proton pumping yield and the relative amplitudes of the slow deprotonation component but not with rate constants of the rise or decay process at constant pH. These results are best discussed in terms of the heterogeneity model (with parallel cycle) rather than back reaction model.

Enumeration and characterization of DJH structures in mouse fetal liver

The primary immunoglobulin (Ig) repertoire in the mouse develops during fetal life in the liver. The first Ig gene rearrangement--the joining of a DH to a JH gene segment--contributes largely to the diversity found in CDR3, as well as potentially encoding the D mu protein which is believed to function in the development of a B cell. In this report, the number of DJH joins in two mouse strains, C57BL/6 and BALB/c, were enumerated from days 12 to 16 of fetal development. It was found that the number of DJH structures increased from less than 300 per liver on day 12 to greater than 700,000 (C57BL/6) and 300,000 (BALB/c) on day 16. Each JH gene segment was used approximately equally on each day examined. When the DJH structures were examined by cloning and sequencing it was found that the DJH reading frame (RF) usage (with respect to JH) was not random--RF1 was used 70% of the time. Moreover, a single D gene segment, DFL16.1, was used in greater than 50% of all joins reinforcing the notion that the fetal repertoire is restricted in its antigen binding potential.