Particle therapy using carbon ions or protons as a definitive therapy for patients with primary sacral chordoma

OBJECTIVE

This study retrospectively evaluated the efficacy and toxicity of particle therapy using carbon ions or protons for primary sacral chordomas.

METHODS

We evaluated 23 patients with primary sacral chordoma treated with carbon ion therapy (CIT) or proton therapy (PT) between July 2005 and June 2011 at the Hyogo Ion Beam Medical Center, Hyogo, Japan. The median patient age was 72 years. 14 patients were treated with 70.4 Gy equivalents (GyE) in 16 fractions and 9 were treated with 70.4 GyE in 32 fractions. CIT was used for 16 patients, and PT was used for 7 patients.

RESULTS

The median follow-up period was 38 months. At 3 years, local control (LC), overall survival (OS) and progression-free survival (PFS) for all patients were 94%, 83% and 68%, respectively. The log-rank test revealed that male sex was significantly related to better PFS (p=0.029). No other factors, including dose fractionation and ion type, were significant for LC, OS or PFS. In nine patients, ≥ Grade 3 acute dermatitis was observed, and ≥ Grade 3 late toxicities were observed in nine patients. The 32-fraction protocol reduced severe toxicities in both the acute and late phases compared with the 16-fraction protocol.

CONCLUSION

Particle therapy for patients with sacral chordoma showed favourable LC and OS. Severe toxicities were successfully reduced by modifying the dose fractionation and treatment planning in the later treatment era. Thus, this therapeutic modality should be considered useful and safe.

ADVANCES IN KNOWLEDGE

This is the first study including both CIT and PT for sacral chordomas.

Chymase inhibition attenuates monocrotaline-induced sinusoidal obstruction syndrome in hamsters

Chymase stored in mast cells activates matrix metalloproteinase (MMP)-9, which may relate to the progression of sinusoidal obstruction syndrome (SOS). We investigated the preventive effect of a chymase inhibitor, TY-51469, on monocrotaline-induced SOS in hamsters. Hamsters were orally administrated with a single dose of monocrotaline (120 mg/kg) to induce SOS. Treatment with TY-51469 (1 mg/kg per day) or placebo had started 3 days before the monocrotaline administration. Two days after the monocrotaline administration, significant increases in aspartate aminotransferase, alanine aminotransferase and total bilirubin and a significant reduction of albumin were observed in plasma, but their changes were significantly attenuated by treatment with TY-51469. The numerous hepatic necrosis areas were observed in the placebo-treated group, but the ratio of necrotic area to total area in liver had been significantly reduced by treatment with TY-51469. Both chymase activity and MMP-9 level in liver were significantly augmented in the placebo-treated group. Furthermore, tumor necrosis factor (TNF)-α level in liver was also augmented in the placebo-treated group. However, the chymase activity and levels of MMP-9 and TNF-α were significantly attenuated in the TY-51469-treated group. Until 14 days after monocrotaline administration, survival rates in the placebo- and TY-51469-treated groups were 25% and 70%, respectively, and a significant difference was observed. In conclusion, chymase inhibition by TY-51469 may prevent the accelerating of severity in monocrotaline-induced SOS in hamsters.

Different patterns of cytokines and chemokines combined with IFN-γ production reflect Mycobacterium tuberculosis infection and disease

BACKGROUND

IFN-γ is presently the only soluble immunological marker used to help diagnose latent Mycobacterium tuberculosis (M.tb) infection. However, IFN-γ is not available to distinguish latent from active TB infection. Moreover, extrapulmonary tuberculosis, such as tuberculous pleurisy, cannot be properly diagnosed by IFN-γ release assay. As a result, other disease- or infection-related immunological biomarkers that would be more effective need to be screened and identified.

METHODOLOGY

A panel of 41 soluble immunological molecules (17 cytokines and 24 chemokines) was tested using Luminex liquid array-based multiplexed immunoassays. Samples, including plasma and pleural effusions, from healthy donors (HD, n = 12) or patients with latent tuberculosis infection (LTBI, n = 20), pulmonary tuberculosis (TB, n = 12), tuberculous pleurisy (TP, n = 15) or lung cancer (LC, n = 15) were collected and screened for soluble markers. Peripheral blood mononuclear cells (PBMCs) and pleural fluid mononuclear cells (PFMCs) were also isolated to investigate antigen-specific immune factors.

PRINCIPAL FINDINGS

For the 41 examined factors, our results indicated that three patterns were closely associated with infection and disease. (1) Significantly elevated plasma levels of IL-2, IP-10, CXCL11 and CXCL12 were present in both patients with tuberculosis and in a sub-group participant with latent tuberculosis infection who showed a higher level of IFN-γ producing cells by ELISPOT assay compared with other latently infected individuals. (2) IL-6 and IL-9 were only significantly increased in plasma from active TB patients, and the two factors were consistently highly secreted after M.tb antigen stimulation. (3) When patients developed tuberculous pleurisy, CCL1, CCL21 and IL-6 were specifically increased in the pleural effusions. In particular, these three factors were consistently highly secreted by pleural fluid mononuclear cells following M.tb-specific antigen stimulation. In conclusion, our data imply that the specific secretion of soluble immunological factors, in addition to IFN-γ, may be used to evaluate M.tb infection and tuberculosis disease.

Profile of gastrointestinal involvement in patients with systemic sclerosis

Systemic sclerosis (SSc) is a chronic autoimmune connective tissue disease. Of the numerous organ manifestations, involvement of the upper and lower gastrointestinal tract (GIT) appears to be the most frequent with regard to the clinical symptoms. However, as the frequency and clinical relevance of GI involvement in patients with SSc are not known in detail, the German network of the systemic sclerosis (DNSS) has developed a detailed questionnaire to evaluate the extent and profile of gastrointestinal involvement in SSc patients. The multi-symptom questionnaire was used at baseline and after 1 year in registered patients of the DNSS. In addition, the results were compared with gastrointestinal disorders in patients with SSc and other rheumatic diseases, as well as with the medical history of the patients. In total, 90 patients were included in the study. The results of the study show that in reality, a much higher (nearly all) percentage of (98,9%) patients than expected suffer from GI-symptoms, regardless of the stage of their disease. Of these, meteorism (87,8%) was the most common followed by coughing/sore voice (77,8%), heartburn (daytime 68,9%, nighttime 53,3%), diarrhea (67,8%), stomach ache (68,9%) and nausea (61,1%). Although SSc patients were treated according to the respective recommendations, only limited improvements with regard to GI-symptoms could be achieved after 1 year of follow-up. In addition, the study revealed that the multi-symptom questionnaire is a useful tool to contribute to identify the gastrointestinal sequelae in systemic sclerosis.

Establishment and biological characteristics of a Jingning chicken embryonic fibroblast bank

Using tissue explantation and cryopreservation biotechniques, a Jingning chicken embryonic fibroblast bank was successfully established, which includes 43 embryo samples and a stock of 178 cryovials, each one containing 3.0×10⁶ cells. Most of the cells were apparently fibroblasts in their morphology, and the population doubling time (PDT) was about 48 h. The total chromosome number of a diploid cell was 78. According to karyotyping and G-banding, the diploid rate in the cell bank was 97.62±2.12%. The cells were tested for microbial contamination and found free of infections from bacteria, fungi, viruses and mycoplasms. There was no cross-contamination from other cell lines as revealed by lactate dehydrogenase (LDH) and malate dehydrogenase (MDH) isoenzyme polymorphisms. Six fluorescent proteins were transfected into the Jingning chicken embryonic fibroblasts, and the transfection efficiencies of these genes were between 10.1 and 41.9%. All the tests showed that the quality of the cell line conforms to the quality criteria of the ATCC (American type culture collection). This work succeeded not only in preserving the genetic resources of Jingning chicken, but it also established a new protocol to preserve endangered animal breeds.

Chymase as an important target for preventing complications of metabolic syndrome

Chymase plays a crucial role in angiotensin II formation in various tissues. Angiotensin II induces gene expressions of transforming growth factor (TGF)-β and matrix metalloproteinase (MMP)-9, and chymase also converts precursors of TGF-β and MMP-9 to their active forms. All of angiotensin II, TGF-β and MMP-9 are considered to be closely involved in the development and progression of metabolic syndrome and its complications. In a diabetic animal model, chymase induced pancreatic disorganization via attack of oxidative stress induced by augmentation of chymase-forming angiotensin II. In atherosclerotic lesions in patients, accumulation of chymase-positive cells was observed, and chymase inhibition prevented the development of atherosclerosis in an animal model. In Apo E-deficient mice, chymase inhibition prevents the development of angiotensin II-induced abdominal aneurysmal aorta (AAA). In this model, the AAA development on an increase in MMP-9 activities induced by angiotensin II, but the inhibition of MMP-9 activation by chymase inhibitor resulted in attenuation of the AAA development. Cardiac dysfunction after myocardial infarction was also attenuated by chymase inhibition. Steatosis and fiblosis in liver were strongly prevented by chymase inhibition in an animal model with nonalcoholic steatohepatitis which is involved in metabolic syndrome. Therefore, chymase inhibition may be useful for attenuating MMP-9 and TGF-β levels, in addition to reducing angiotensin II formation, and this function may provide powerful preventions of organ damages. In this review, we propose the significance of chymase as a target to prevent complications of metabolic syndrome.

Effect of sperminated pullulans on drug permeation through isolated rabbit cornea and determination of ocular irritation

The aim of this study was to investigate the effect of two sperminated pullulans (SP) with a different number of amino groups (SP-L, amino group content 0.124 mmol/g polymer; and SP-H, amino group content 0.578 mmol/g polymer) on the permeation of drugs through isolated rabbit corneas. Determination of corneal hydration levels and Draize eye tests were performed to assess the safety of SP both in vitro and in vivo. For 0.2% (w/v) SP-L and 0.2% (w/v) SP-H, the enhancement ratios (ERs) with dexamethasone of 1.34 and 1.42, respectively, were not statistically significant. For ofloxacin, tobramycin and sodium fluorescein, the ERs with 0.2% SP-L were 1.37, 2.02 and 2.12, respectively, and with 0.2% SP-H the ERs were 1.84, 4.69 and 6.87, respectively; these ERs were all statistically significant. Enhancement increased with increasing amino group content of the SP. The improved transcorneal drug absorption via the paracellular route indicated opening of the tight junctions in the corneal epithelium. Irritation tests indicated that 0.2% SP-L and 0.2% SP-H did not damage the corneal tissues.

Molecular characterization of suppression of hepatitis B virus transcription by hepatitis C virus core protein

To further elucidate the molecular mechanisms underlying the suppression of hepatitis B virus (HBV) expression by the hepatitis C virus (HCV) core protein, five molecular clones of HCV cDNA sequence containing the 5' noncoding (5'NC) and the core regions have been isolated from Chinese HBV- and HCV-coinfected patients. Sequence comparison and phylogenetic analysis showed that the HCV sequence cloned from coinfected individuals is indistinguishable from that identified in other patients. Cotransfection assay confirmed that the core protein expressed from one of the cloned sequence is capable of suppressing the expression of hepatitis B surface and e antigens (HBsAg and HBeAg, respectively). Deletion mapping revealed that the C-terminal hydrophobic region of the HCV. core is necessary for the suppression. Results from reporter assays demonstrated that HCV core protein interacts with the HBV C promoter and enhancer II elements and down-regulates the transcription of HBV as well as other cellular and heterologous viral genes in both hepatic and non-hepatic cell lines. Taken together, the findings suggest HCV core protein as a multifunctional negative regulator of transcription critically involved in the molecular interactions between HBV and HCV, and between HCV and the cell.

Distribution of pathogenic Yersinia enterocolitica in China

Yersinia enterocolitica (1,295 strains) was isolated from diarrhea patients, livestock, poultry, wild animals, insect vectors, food, and the environment. They were studied for epidemiology distribution using bacterial biochemical metabolism tests, their virulence genes, and pulsed-field gel electrophoresis (PFGE) sub-typing. The data showed that 416 of the 1,295 strains were pathogenic, where the pathogenic Chinese isolates were of serotypes O:3 and O:9. These two serotypes were found in livestock and poultry, with swine serving as the major reservoir. The geographic distribution of pathogenic isolates was significantly different, where most of the strains were isolated from the cold northern areas, whereas some serotype O:3 strains were recovered from the warm southern areas. By the analysis of the data of the Ningxia Hui Autonomous Region, we find the phenomenon of 'concentric circle distribution' around animal reservoirs and human habitation. The clustering of PFGE showed that the patterns of the pathogenic strains isolated from diarrhea patients were identical compared to those from the animals in the same area, thus, suggesting that the human infection originated from the animals.

Therapeutic vaccination against advanced pancreatic cancer by autologous dendritic cells pulsed with a MUC1 peptide: Preclinical results of a clinical phase I trial

e15652

Background: Pancreatic ductal adenocarcinoma has a particularly poor prognosis. Therefore, novel therapeutic strategies such as immunotherapy are required. The aim of the present phase I study was to evaluate the safety, immune responses and clinical activity of a vaccine based on autologous dendritic cells (DC) pulsed with a specific MUC1 peptide in advanced pancreatic cancer patients. Methods: Five patients who had pancreatic cancer ductal adenocarcinoma expressing MUC1 in stage of III/IV were enrolled to the clinical trial. Patients underwent leukapheresis to generate dendritic cells by culture in vitro with granulocyte macrophage colony-stimulating factor and interleukin-4 for 5 days. Dendritic cells were then pulsed overnight with MUC1 peptide (GVTSAPDTRPAPGSTAPPAH) and harvested for vaccination. Dendritic cells (3×106-6×106) were injected intradermally every 2 weeks for 3–4 times. Results: All patients remained with progressive disease. Four patients developed strong T-cell IFN-γ and Granzyme B Elispot responses to the vaccine. Most interestingly, the patient who was treated with the highest number of DC(6×106) had more number of CTL than other patients and showed delayed-type hypersensitivity responses at injection sites and this patient stopped application of the analgetics. Another patient with relapsed pancreatic cancer who had finished the 4 times of vaccination and then followed 6 times of chemotherapy with Gemcitabine had a surprisingly long term of survival of 12 month. No evidence of significant treatment related toxicity or auto-immunity was observed. Conclusions: This study showed the safety and clinical response of MUC1 peptide-pulsed dendritic cell therapy for patients with advanced pancreatic cancer. It confirms the capability of this DC vaccine to stimulate an immune response in patients with pancreatic cancer even in the presence of a large tumor burden. Dendritic cell therapy is recommended for further clinical studies in pancreatic cancer patients.

No significant financial relationships to disclose.

A novel recombinant tandem repeat DNA vaccine targeting at MUC1

3066

Background: Tandem repeat (TR) is the key epitope of mucin 1 (MUC1) for inducing cytotoxic T lymphocytes (CTL) to kill the tumor cells specifically. A novel recombinant TR DNA vaccine was constructed to study its induced immune responses. Methods: A recombinant human TR (rhTR) gene encoding a single TR polypeptide of MUC1 was synthesized and cloned into the multiple cloning sites of plasmid pcDNA3.1/Myc-his (+) A to construct the recombinant plasmid pcDNA3.1-TR/Myc-his (+) A (pTR plasmid). Expression of pTR plasmid was confirmed by transfection assay and Western blot analysis. C57BL/6 (H-2b) mice were immunized with pTR plasmid (n=15) by tibial muscle injection. Mice inoculated with the empty vector (EV group, n=15) and 0.9% NaCl solution (NS group, n=15) were used as vector and blank control respectively. Four weeks later, all mice were immunized again. Specific antibody detection and cytotoxic assay were used to evaluate the vaccine-induced TR specific immune responses. Results: DNA sequencing confirmed that the pTR plasmid was exactly constructed. Transfection assay and Western blot analysis found that the transfected COS7 cells expressed TR polypeptide of MUC1 48 hours after transfection. Cytotoxic assay showed that immunization with pTR plasmid into C57BL/6 mice resulted in more efficient induction of CTL specific cytolysis against TR polypeptide than that of EV group and NS group (p<0.01). Vaccine immunized mice had a higher equivalent concentration of anti-TR specific antibodies (2324μg/ml±238μg/ml) than that of EV group (1896μg/ml±533μg/ml, p<0.01) and NS group (1736μg/ml±142μg/ml, p<0.01). Conclusions: The novel recombinant TR DNA vaccine targeting at MUC1 was exactly constructed, immunization with which could induce TR specific CTL response and antibodies response in mice.

No significant financial relationships to disclose.

Effect of V(2)O(5) on the sintering behavior, microstructure, and electrical properties of (Na(0.5)K(0.5))NbO(3) ceramics

Well-sintered (Na(0.5)K(0.5))NbO(3)-x mol% V(2)O(5) ceramics (abbreviated as NKN-V) with fine electrical properties were successfully prepared by conventional solid-state reaction through the careful control of processing conditions. The sintering behavior, phase structure, and electrical properties of the V(2)O(5)-doped NKN ceramics were investigated. Results show that when the V(2)O(5) content is 0.6 mol%, the NKN ceramics attained the maximum density of 4.46 g/cm(3) (about 98.9% of the theoretical density) at 1060 degrees C, and therefore possessed enhanced electrical properties. But when the V(2)O(5) content continued increasing, the density decreased. The secondary phase (Na(2)V (6)O(16)) could be detected by XRD analysis in all samples except x = 0 mol%. The Curie temperature of the NKN-based materials was found to decrease with the increase of V(2)O(5). The dielectric properties of NKN ceramics doped with 0.6 and 0.9 mol% V(2)O(5) were better than that of pure NKN ceramics. In addition, annealing treatment was proved to be an effective technique for improving dielectric properties and reducing the leakage current density.

Effects of the sol-concentration on the structural and dielectric properties of Pb(0.3)Sr(0.7)TiO(3) thin films derived by the sol-gel method

Pb(0.3)Sr(0.7)TiO(3)(PST) thin films were deposited on Pt coated Si(100) substrates by sol-gel techniques using different sol-concentrations. The structural and dielectric characteristics of lead strontium titanate (PST) thin films as a function of the sol concentration were investigated. PST thin films reveal a columnar texture through the thickness when the sol-concentration is lower than 0.30 M. PST thin films derived from 0.35 M sol show better dielectric characteristics with the dielectric constant, dielectric loss, tunability, and field of motion (FOM) (tunability/ dissipation) of 200, 0.01, 47% and 47, respectively. The temperature dependence of the dielectric constant, dielectric loss and tunability of PST thin films were investigated in the temperature range of -140 to 120 degrees C exhibiting a dielectric peak of about -45 degrees C.

Renal differentiation of amniotic fluid stem cells

OBJECTIVES

The role of stem cells in regenerative medicine is evolving rapidly. Here, we describe the application, for kidney regeneration, of a novel non-genetically modified stem cell, derived from human amniotic fluid. We show that these pluripotent cells can develop and differentiate into de novo kidney structures during organogenesis in vitro.

MATERIALS AND METHODS

Human amniotic fluid-derived stem cells (hAFSCs) were isolated from human male amniotic fluid obtained between 12 and 18 weeks gestation. Green fluorescent protein and Lac-Z-transfected hAFSCs were microinjected into murine embryonic kidneys (12.5-18 days gestation) and were maintained in a special co-culture system in vitro for 10 days. Techniques of live microscopy, histology, chromogenic in situ hybridization and reverse transcriptase polymerase chain reaction were used to characterize the hAFSCs during their integration and differentiation in concert with the growing organ.

RESULTS

Green fluorescent protein and Lac-Z-transfected hAFSCs demonstrated long-term viability in organ culture. Histological analysis of injected kidneys revealed that hAFSCs were capable of contributing to the development of primordial kidney structures including renal vesicle, C- and S-shaped bodies. Reverse transcriptase polymerase chain reaction confirmed expression of early kidney markers for: zona occludens-1, glial-derived neurotrophic factor and claudin.

CONCLUSIONS

Human amniotic fluid-derived stem cells may represent a potentially limitless source of ethically neutral, unmodified pluripotential cells for kidney regeneration.

Hemangiogenic response after pre-operative COX2 inhibition predicts recurrence in esophageal cancer

15077

Background: Growth of esophageal cancer involves a proliferative hemangiogenic component. Biomarkers that predict this propensity in esophageal cancer and the impact of anti-angiogenic strategy on their levels as well as clinical response remain unknown. Methods: A multimodular approach was devised to assess hemangiogenic parameters in a cohort of chemotherapy naïve patients with locally advanced (T2-T3N0, T1-T3N1M0M1a) esophageal cancer pre- and 4 days post-celecoxib neoadjuvant treatment. Patients went on to receive neoadjuvant therapy with celecoxib, paclitaxel and carboplatin for 3 cycles, followed by surgical resection. This bioassay panel consists of 5 components: i) HUVEC-based angiogenic scale for functional plasma angiogenic activity, ii) flow cytometry to quantify CD133+VEGFR2+ circulating endothelial progenitors (CEPs), iii) hematopoietic colony-forming assay to quantify circulating hematopoietic progenitors (CHPs), iv) plasma SDF-1 level, and v) platelet VEGF-A level. Results: The cohort consists of 8 consecutive patients (6 men, 2 women) with median age of 58. After 18 months of followup, 6 patients remained alive and without evidence of recurrence, while 2 had tumor recurrence and metastasis. Analysis of the positive responders (pre-celecoxib baseline versus 4 days post treatment) revealed a global suppression of hemangiogenic parameters with reduction of the functional HUVEC-based angiogenic scale (mean score of 3.3 versus 1.8; p<0.05), 2.2-fold decrease in CEPs (p<0.05), and 3-fold decrease in CHPs (p<0.05). This trend also correlated with decreased plasma SDF-1 and platelet VEGF-A levels . However, in the 2 cases of tumor recurrence, the initial hemangiogenic response was blunted with no significant difference in all parameters tested during the celecoxib monotherapy period. Conclusion: Esophageal cancer development involved a hemangiogenic switch toward increased CEPs, CHPs, and functional plasma pro-angiogenic activity. COX2 inhibition with celecoxib normalized the hemangiogenic profile. Collective assessment of hemangiogenic biomarkers during neoadjuvant setting may be a promising tool in predicting clinical outcomes, recurrence, and for validating impact of anti-angiogenic therapy on esophageal cancer.

No significant financial relationships to disclose.

A Method of Recognizing Finger Motion Using Wavelet Transform of Surface EMG Signal

In this paper, an identification method of finger motions using the wavelet transform of multi-channel electromyography (EMG) signal is presented. The first step of this method is to analyze surface EMG signal detected from the subject's upper arm using the multi-resolution of wavelet transform, and extract features using the variance, maximum and mean absolute value of the wavelet coefficients. In this way, a new feature space is established by wavelet coefficients. The second step is to import the feature values into an Artificial Neural Network (ANN) to identify the finger motion. Based on the results of experiments, it is concluded that this method is effective in identification of finger motion. Thus, it provides an alternative approach to use the surface EMG in controlling the finger motion of a multi-fingered prosthetic hand.

Circulating endothelial progenitor cells correlate to stage in patients with invasive breast cancer

616

Background: Tumor growth and metastasis is dependent on neo-angiogenesis. Both pre-existing and circulating vascular cells have been shown to contribute to the assembly of tumor neo-vessels in specific tumors. Mobilization of endothelial progenitor cells (EPCs) from the bone marrow constitutes a crucial step in the formation of de novo blood vessels, and levels of peripheral blood EPCs have been shown to be increased in certain malignant states. However, the role of circulating EPCs in breast cancer is largely unknown. Methods: We recruited twenty-five patients with biopsy-proven invasive breast cancer (BC) at Weill Cornell Breast Center to participate in a pilot study investigating the correlation of circulating EPCs to extent of disease and initiation of chemotherapy. For each patient, a baseline sample was drawn before systemic treatment, and for seventeen of those patients, a second sample was taken after the first round of chemotherapy. Levels of peripheral blood EPCs, as defined by co-expression of CD133 and VEGFR2, were quantified by flow cytometry. Results: BC patients with stage III & IV disease had statistically higher levels of circulating EPCs than did patients with stage I & II disease (median=165,000 EPCs/5×106MNCs vs. median=6,920 EPCs/5x106MNCs, respectively, p < 0.0001 by Wilcoxon rank-sum test). In addition, in late-stage patients, levels of EPCs demonstrated a statistically significant drop after initiation of chemotherapy (median=162,500 EPCs/5x106MNCs [pre] vs. median=117,500 EPCs/5x106MNCs [post], p = 0.01 by Wilcoxon signed-rank test). Conclusion: These results suggest that circulating EPCs may serve as a potential tumor biomarker in breast cancer and that EPCs may represent a plausible target for future therapeutic intervention. Supported in part by the Mentored Medical Student in Clinical Research Program (General Clinical Research Center/National Institutes of Health Grant M01RR00047), Madeline & Stephen Anbinder Clinical Scholar Award, and Anne Moore Breast Cancer Research Fund

No significant financial relationships to disclose.

[The relationship between angiotensin converting enzyme gene polymorphism and risk factors for cerebral infarct]

OBJECTIVE

To explore the relationship between angiotensin converting enzyme (ACE) gene polymorphism and risk factors of cerebral infarct (CI) in Chinese Han nationality.

METHODS

One hundred and sixty-five cases with cerebral infarct, 101 cases of essential hypertension patients with 106 normal persons in Chinese Han serving as controls were detected using polymorase chain reaction (PCR) and genetic methods. ACE contents in serum were measured by colorimetric method. Risk factors of cerebral infarct were assessed by standard questionnaire, physical examination and blood tests.

RESULTS

ACE DD genotype appeared more common in patients of cerebral infarct when comparing with essential hypertension groups (0.43 versus 0.31, chi 2 = 4.03, P < 0.05) and normal controls (0.43 versus 0.17, chi 2 = 19.86, P < 0.01). D:I allele frequency appeared to be 0.66:0.34 in cerebral infarct patients and 0.41:0.59 in controls (chi 2 = 32.85, P < 0.01). In basal ganglia infarct and thalamus infarct groups, ACE DD genotype and allele ratio distribution were remarkably different to that in normal subjects (chi 2 = 18.30, 12.41, P < 0.01). The mean levels of serum in cerebral and hypertension were higher than in normal controls (F = 2,240.06, P < 0.01), and serum ACE activity in ACE DD genotype was significantly higher than that in ACE DI and II genotype in cerebral group (F = 8.83, P < 0.01).

CONCLUSIONS

The ACE gene deletion polymorphism might serve as an independent risk factor for cerebral infarct in Chinese Han nationality while circulation ACE activity might be related to gene deletion polymorphism.

Significance of chymase-dependent angiotensin II-forming pathway in the development of vascular proliferation

BACKGROUND

Vascular tissues of humans and dogs contain chymase as an angiotensin II-forming enzyme. In this study, we investigated whether chymase-dependent angiotensin II formation plays a crucial role in the development of vascular proliferation in dog grafted veins.

METHODS AND RESULTS

The right external jugular vein of dogs was grafted to the ipsilateral carotid artery. As a control group, the right external jugular veins in dogs that had not received grafts were used. In the chymase inhibitor-treated group, the vein was infiltrated with 10 micromol/L Suc-Val-Pro-Phe(P)(OPh)(2) and was grafted to the carotid artery. In the placebo-treated group, ACE activity in the grafted veins was significantly lower than that in the control veins up to 7 days after the operation, whereas chymase activity was increased significantly. After 7 days, the mRNA levels of collagen I, collagen III, and fibronectin, all of which are induced by an increase of angiotensin II action, were significantly increased in the grafted veins, and the intima-media ratio of the grafted veins was also increased. In the chymase inhibitor-treated group, the chymase activity in the grafted veins 7 days after the operation was suppressed to 12.1%. The elevated mRNA levels of fibronectin, collagen I, and collagen III in the grafted veins were significantly suppressed by treatment with the chymase inhibitor, and the intima-media ratio was also decreased significantly.

CONCLUSIONS

We demonstrate for the first time that chymase-dependent angiotensin II formation plays an important role in the development of vascular proliferation in the grafted veins.

[Anterior thoracolumbar K-plate fixation system: design and clinical application]

OBJECTIVES

To develop an anterior thoracolumbar K-plate fixation system and to report its preliminary clinical application.

METHODS

The K-plate system was developed with titanium alloy(TC4, Ti6A14V) and self-locking screw design was used. In 23 cases treated with this system, 13 had thoracolumbar fracture, 9 tuberculosis, and back syndrome after lumbar TFC operation.

RESULTS

All the 23 cases were followed up for one to ten months, averaging 4.5 months. In the 13 cases of fracture, body height of injured vertebra were regained completely, and neurologic deficits improved 2.1 grades in Frankel scale. In the 9 cases of tuberculosis, neurologic functions recovered and no local recurrence was noted. In one case of back syndrome, symptoms and signs did not occur after anterior TFC removal, interbody fusion, and K-plate fixation. This patient received second operation to remove K-plate 3 months after solid osseous fusion, and no electric erosion or obvious tissue reaction was found. 18 of the 23 cases were followed up for four months or more, and solid fusion was found in these patients in three to four months after surgery. No early complications related to implant were noted during the follow-up.

CONCLUSION

This K-plate system is suitable for reconstruction of thoracolumbar stability after anterior decompression in indicated patients.

Oral administration of a specific chymase inhibitor, NK3201, inhibits vascular proliferation in grafted vein

Chymase may play an important role in vascular proliferation, as shown by in-vitro experiments, but the role of chymase in vivo has been unclear. In this study, we investigated the effect of a novel chymase inhibitor, NK3201, on this proliferation in dog grafted veins. NK3201 inhibited human and dog chymases, but not rabbit ACE. NK3201 suppressed the Ang I-induced vascular contraction in isolated dog arteries in the presence of an ACE inhibitor, and the IC50 value of chymostatin and NK3201 in dog artery was 320 nM. In dog, the concentration of NK3201 in blood was about 10 microM at 24 h after oral administration of the drug (5 mg/kg). In the group treated with NK3201, each dog was administered orally 5 mg/kg per day from 5 days before to the day before the removal of the grafted veins. Each dog underwent right common carotid artery bypass grafting with the ipsilaterial external jugular vein. By 28 days after grafting, a significant vascular proliferation was observed in the grafted veins and the chymase activity was also increased significantly. Treatment with chymase inhibitor significantly suppressed the proliferation of the grafted veins and the increased chymase activity. In this study, we demonstrate for the first time that oral administration of a specific chymase inhibitor, NK3201, appears useful for preventing vascular proliferation.

A simple flow-injection on-line clean-up system for microwave plasma-torch atomic emission spectrometry

A simple flow injection (FI) on-line clean-up system has been developed for microwave plasma-torch atomic emission spectrometry (MPT-AES). A non-selective strongly acidic cation-exchange resin was used to achieve the goal of "on-line clean-up". Ag and Zr, which form halogen-complex anions in halide acid media, and Cr, Mo, and P, which exist as acid group anions or acids (neutral) in acidic solution, were determined and the interfering matrix cations were removed on-line. Satisfactory analytical results were obtained from some practical samples by use of this procedure.

[Development and clinical application of posterior STBtrade mark thoracolumbar transpedicular screw-plate fixation system]

OBJECTIVE

To develop a posterior STBTM thoracolumbar transpedicular screw-plate system and to apply it clinically.

METHODS

A posterior STBTM thoracolumbar transpedicular screw-plate system was developed with titanium alloy (TC4, Ti64A14V) and was used, from December 1999 to July 2000, to treat 63 cases with thoracolumbar or lumbar injuries or diseases, including thoracolumbar fracture/dislocation (33 cases), lumbar spondylosis and spondylolisthesis (16 cases), lumbar spondylosis and disk protrusion (6 cases), degenerative lumbar instability (4 cases), kyphosis due to ankylosing spondylitis (2 cases), and tuberculosis of spine (2 cases).

RESULTS

The 33 cases with thoracolumbar fracture/dislocation showed perfect reduction and fixation after the operation. The height of injured vertebral bodies returned to normal. One month later, all patients with neurological deficits, except the 6 cases with neurological deficits of Frankel grade A, showed improvement by 1 approximately 3 Frankel grades. The radicular symptoms in the 26 patients with lumbar spondylolisthesis, lumbar spondylosis and disk protrusion, and degenerative lumbar instability disappeared after operation. Among those cases, complete reduction was achieved in the 7 cases with grade I spondylolisthesis and 7 out of the 9 cases with grade II spondylolisthesis, and incomplete reduction (grade I) was seen in the remaining 2 cases with grade II spondylolisthesis. Forty cases were followed up for 5 months or over in out-patient department, no complication was found.

CONCLUSION

The posterior STBTM thoracolumbar transpedicular screw-plate system has the advantages of biological stability, excellent reduction capacity, easiness of operation, and positive clinical effectiveness.

Multiple pathways of angiotensin I conversion and their functional role in the canine penile corpus cavernosum

Multiple pathways of angiotensin (Ang) I conversion and their functional role in the canine penile corpus cavernosum were investigated. Biochemical analysis revealed high activities of angiotensin-converting enzyme (ACE) (6.9 +/- 1.7 mU/mg of protein, mean +/- S.E.M., n = 8) and chymase-like enzyme (4.0 +/- 1.4 mU/mg of protein). Functional recording of isometric tension showed that Ang I (3 x 10(-7) M) induced a tension of 0.17 +/- 0.05 g (n = 5), which was reduced to about 60% by pretreatment with an ACE inhibitor, lisinopril (10(-6) M), and almost completely blocked by lisinopril in combination with a chymase inhibitor, chymostatin (10(-4) M). Binding sites for ACE and Ang II receptors were studied by in vitro autoradiography using 125I-351A and 125I-[Sar1, Ile8]Ang II as ligands, respectively. Dense binding of ACE appeared in the endothelial layer of the corpus cavernosum penis, and Ang II receptors were localized in the trabecular smooth muscle layer. An AT1 receptor antagonist, CV-11974 (10(-6) M), markedly displaced 125I-[Sar1, Ile8]Ang II bindings, indicating that the corpus cavernosum penis contains AT1 receptors exclusively. Immunohistochemical studies demonstrated ACE in the endothelium of the corpus cavernosum penis. Mast cells that produce chymase were present mainly in the cavernosal area. These results demonstrate that chymase, in addition to ACE, is involved in the contraction of canine penile corpus cavernosum through local Ang II formation.

Possible roles of cardiac chymase after myocardial infarction in hamster hearts

The significance of cardiac chymase after myocardial infarction (MI) was evaluated using a hamster model of MI. At 1, 3, 7, 14, 28 and 56 days after MI, tissues were removed for measurements of angiotensin-converting enzyme (ACE) and chymase activities. The mean infarct size 3 days after left coronary artery ligation was 47.3 +/- 5.9% of the left ventricle circumference. The ratio of left ventricle weight to body weight was significantly increased from 3 days after MI. The level of plasma renin activity in the MI hamsters was significantly increased at the early phase of MI (1-3 days), while no significant changes in plasma ACE activity were observed. The ACE activity in the infarcted left ventricle was significantly increased starting from 3 days after MI and this increase was sustained up to 28 days. The chymase activity in the infarcted left ventricle was significantly increased starting from 1 day after MI and this increase was sustained up to 56 days. The number of chymase-positive mast cells in the infarcted left ventricle was significantly higher than in the sham group 3 and 7 days after operation. Treatment with an angiotensin (Ang) II type 1 receptor antagonist (candesartan cilexetil, 10 mg/kg per day) starting 3 days before the induction of MI significantly reduced the mortality rate during 14 days of observation following MI, whereas treatment with an ACE inhibitor (lisinopril, 20 mg/kg per day) did not. A significant improvement in hemodynamics (maximal negative and positive rates of pressure development, left ventricular systolic pressure and end-diastolic pressure, mean arterial blood pressure) was observed by the treatment with candesartan cilexetil, but not with lisinopril, 3 and 14 days after MI. These results suggested that Ang II produced by chymase may participate in the pathophysiologic state after MI in hamsters.

Inhibitory Mechanism of Daphnodorins for Human Chymase

We investigated the inhibitory mechanisms of daphnodorins for human chymase using three-dimensional molecular modeling. In daphnodorin A-human chymase complex, daphnodorin A was fixed to the active site via hydrogen bonds with Ala177, Phe29, and Gly199 in human chymase, and it formed hydrogen bonds with Ser182 and Gly180, and this complex was formed stably. In daphnodorin B-human chymase complex, daphnodorin B formed hydrogen bonds with Lys28 and Phe29 in human chymase, but it could not form hydrogen bonds with Gly199, Ala177, and Lys179. The phenyl group of daphnodorin B shifted from the P1 hole in human chymase in comparison with that of daphnodorin A. For the inhibition of human chymase by daphnodorins, we indicated that it was significant whether daphnodorins formed hydrogen bonds with Ala177 located in the P1 hole, Ser182 located in the active site, Gly180 located in the anion hole, and with Gly199, Phe29, and Lys28 in human chymase.

An orally active chymase inhibitor, BCEAB, suppresses heart chymase activity in the hamster

We investigated the effects of a novel chymase inhibitor, BCEAB (4-[1-[[bis-(4-methyl-phenyl)-methyl]-carbamoyl]-3-(2-ethoxy-benzyl)-4-oxo-azetidine-2-yloxy]-benzoic acid). The IC50 value of BCEAB for purified human chymase was 5.4 nM, whereas BCEAB did not inhibit the angiotensin-converting enzyme, elastase and tryptase. In isolated dog arteries, the IC50 value of BCEAB for the angiotensin I-induced contraction in the presence of 1 microM lisinopril was 2.8 microM. In the hamster, the heart chymase activities were significantly suppressed to 42.0% and 26.9% 3 h after oral administration of 100 and 300 mg of BCEAB/kg of body weight, respectively. In conclusion, BCEAB is a useful chymase inhibitor for studying the role of chymase in vivo.

12-Hydroxyeicosatetraenoic acid potentiates angiotensin II-induced pressor response in rats

We studied whether 12-hydroxyeicosatetraenoic acid (HETE) affected the angiotensin II-induced pressor response in rats. After intravenous administration of 1 and 3 microg/kg 12-HETE, the angiotensin II-induced pressor response was not potentiated. However, 10, 20 and 30 min after the administration of 10 microg/kg 12-HETE, the angiotensin II-induced pressor responses were increased by 7.5, 6.8 and 4.8 mm Hg, respectively. The significant pressor response was observed at 10 and 20 min after the administration. In this study, we clearly demonstrated that 12-HETE potentiated the angiotensin II-induced pressor response.

[The biological function of platelet-derived growth factor-BB in the osteoblast-osteoclast co-culture system]

OBJECTIVE

To investigate the biological effects of platelet-derived growth factor (PDGF)-BB on the osteoclasts in the osteoblast-osteoclast co-culture system.

METHODS

The human osteoblasts and osteoclasts were isolated from the iliac crest of patients and co-cultured in the same system. The PDGF-BB or PDGF-BB + NO synthase inhibitor, N(G)-monomethyl-L-arginine (L-NMMA) was administered to the co-culture system. The tartrate-resistant acid phosphatase (TRAP) activities in the medium were measured by enzyme kinetics. The resorption pits were stained by toludine blue. The area and number of the resorption pits were determined with the Leica Quantimet 500 system.

RESULTS

Under the stimuli of PDGF-BB in the co-culture system, TRAP activities changed from 1.40 U/L +/- 0.12 U/L to 1.46 U/L +/- 0.08 U/L (P > 0.05) in the medium, and the area and number of resorption pits was changed from (427 +/- 149) micrometer(2) and (13.3 +/- 0.9) per slice to (436 +/- 147) micrometer(2) and (14.1 +/- 1.2) per slice respectively (P > 0.05). After the L-NMMA was applied to the system, the TRAP activities rose significantly from 1.46 U/L +/- 0.10 U/L to 2.47 U/L +/- 0.38 U/L along with the increase of dose of PDGF-BB, and the number and area of the resorption pits increased significantly from 436 micrometer(2) +/- 147 micrometer(2) and (14.1 +/- 1.2) per slice to 592 micrometer(2) +/- 171 micrometer(2) and (22.5 +/- 1.7) per slice. Both the TRAP activities and resorption pits rose significantly after the L-NMMA was administered. Comparisons of different treatment groups were made using analysis of variance (ANOVA) with multiple comparisons and a Student-Newman-Keuls test.

CONCLUSIONS

The nitric oxide (NO) was produced by osteoblasts stimulated by PDGF-BB in the osteoblast-osteoclast co-culture system. Therefore, the direct promotion effects of PDGF-BB on the osteoclasts were inhibited.

Chymase-dependent angiotensin II formation in the saphenous vein versus the internal thoracic artery

OBJECTIVES

The great saphenous vein graft is known to be less patent than the internal thoracic artery graft. Recently, we reported that chymase-dependent angiotensin II formation plays an important role in the development of intimal hyperplasia in dog grafted veins. In this study we investigated the levels of angiotensin II-forming enzymes, angiotensin-converting enzyme, and chymase in human saphenous veins and internal thoracic arteries.

METHODS

The saphenous vein and internal thoracic artery specimens were obtained from coronary artery bypass grafts of patients during surgical procedures (saphenous vein, n = 16; internal thoracic artery, n = 16). Activities of angiotensin-converting enzyme and chymase were determined by using the extract from the saphenous vein or internal thoracic artery. Sections of the saphenous vein or internal thoracic artery were stained with van Gieson's elastin stain and were immunostained with anti-human chymase antibody.

RESULTS

The activities of angiotensin-converting enzyme in the saphenous vein and internal thoracic artery were 0.34 +/- 0.12 and 0.32 +/- 0.17 mU/mg protein, respectively, and the difference was not significant. The chymase activity in the saphenous vein was significantly higher than that in the internal thoracic artery (saphenous vein, 10.1 +/- 0.81 mU/mg protein; internal thoracic artery, 6.21 +/- 1.86 mU/mg protein). Chymase-positive cells in the saphenous vein were located in both the media and adventitia, and those in the internal thoracic artery were located only in the adventitia. The number of chymase-positive cells in the saphenous vein was about 2.6 times that in the internal thoracic artery.

CONCLUSION

The chymase activity, but not the angiotensin-converting enzyme activity, was significantly higher in the saphenous vein, suggesting that the high levels of chymase activity may be related to the poorer performance of the saphenous vein for use as a bypass conduit.

Different angiotensin II-forming pathways in human and rat vascular tissues

We studied the angiotensin II-forming pathways in extracts from human and rat vascular tissues. In the extract from human artery, angiotensin I mainly converted to two products, angiotensin-(1-9) and angiotensin II, while in the extract from rat artery, the major angiotensin I products were angiotensin II and angiotensin-(5-10). The concentrations of angiotensin II and angiotensin-(1-9) generated in the human extract (1 mg protein/ml) after incubation for 30 min were 3.2 and 2.5 nmol, respectively, and that of angiotensin II and angiotensin-(5-10) generated in the rat extract (1 mg protein/ml) were 0.28 and 2.3 nmol, respectively. In the extract from human vascular tissues, the angiotensin II formation was inhibited by 8% with lisinopril and by 95% with chymostatin. The other product, angiotensin-(1-9) was inhibited completely by carboxypeptidase inhibitor. In the extract from rat vascular tissues, the angiotensin II formation was suppressed to 4% by lisinopril, but not by chymostatin. The angiotensin-(5-10) formation was completely inhibited by chymostatin. These findings suggest clearly that human vascular tissues contain two angiotensin II-forming enzymes, angiotensin-converting enzyme and chymase, but rat vascular tissues have no chymase-dependent angiotensin II-forming pathway.

R(-)-4-(3-Isothiocyanatopyrrolidin-1-yl)-7-(N,N-dimethylaminosulfonyl)-2,1,3-benzoxadiazole, a fluorescent chiral tagging reagent: sensitive resolution of chiral amines and amino acids by reversed-phase liquid chromatography

The usefulness of R(-)-4-(3-isothiocyanatopyrrolidin-1-yl)-7-(N,N-dimethylaminosulfonyl)-2,1,3-benzoxadiazole [R(-)-DBD-PyNCS], a fluorescent chiral tagging reagent, for the determination of racemic amines and amino acids, was studied. The reagent reacted with beta-blockers selected as representative secondary amines to produce corresponding fluorescent diastereomers (excitation at 460 nm and emission at 550 nm). The yields of the derivatization reaction were dependent on the stereostructure arround the NH group in beta-blockers. The resulting diastereomers were completely separated with single chromatographic run using linear gradient elutions by reversed-phase chromatography. R(-)-DBD-PyNCS was also applied to the determination of DL-amino acid, considered to be one of the primary amines, in human urine and foodstuffs. DL-amino acids tested equally reacted with the reagent, and the thiocarbamoyl derivatives were separated with an ODS column. The epimerization during the derivatization reaction was negligible judging from the resolution of opposite diastereomers on the chromatogram. The occurence of D-amino acids (D-Ala, D-Ser, D-Asp and/or D-Glu) was identified in the samples tested. The structures and the purities were elucidated with on-line HPLC-MS. The chiral reagent possessing an isothiocyanate group (-NCS) in the structure seems to be applicable to continuous sequential analysis of peptides containing D-amino acids. The thiocarbamoyl derivatives obtained from the reaction with DL-amino acids were converted to thiohydantoins via thiazolinones in acidic medium. The thiohydantoins produced from acidic, basic, neutral, hydroxyl and aromatic amino acids were completely separated with isocratic elutions using acidic mobile phase containing 0.1% TFA. The separations were sufficient for the identification of DL-amino acid in peptide sequences. Although the epimerization during the conversion reaction to thiohydantoins was not avoidable, the descrimination of D- and L-configuration was demonstrated with some commercially available peptides such as beta-lipotropin and [D-Ala2]-deltorphin II. The Edman degaradation method using R(-)-DBD-PyNCS was also adopted to autoanlaysis by gas-phase sequencer. The separation and the detection (UV 254 nm) conditions of the derivatives were used without any change from those for the Edman degradation method using PITC as the tagging reagent. The three DL-amino acid residues (Tyr, Ala and Gly) in [L-Ala2]-leucine-enkephalin and [D-Ala2]-leucine-enkephalin were perfectly identidied with the autoanalysis.

Cilostazol suppresses intimal formation in dog grafted veins with reduction of angiotensin II-forming enzymes

Cilostazol prevents neointimal formation, but its mechanism has remained unclear. We investigated whether intimal formation in dog grafted veins is suppressed by cilostazol, and studied the effect of cilostazol on angiotensin II-forming enzymes. The external jugular vein was grafted to the carotid artery, and cilostazol (60 mg/kg/day) was administered orally. By 28 days after the surgery, the intimal cross-sectional area of the grafted vein was reduced to 16.7% by treatment of cilostazol, and the activities of angiotensin II-forming enzymes were suppressed significantly. The inhibitory effect of cilostazol in intimal formation may be dependent on inhibition of angiotensin II-forming enzymes.