Umbilical cord blood transplantation from unrelated HLA-matched donor in an adult with severe aplastic anemia

A 23-year-old male suffering from severe aplastic anemia (SAA) weighing 60 kg was successfully treated by unrelated allo-CBSCT (cord blood stem cell transplantation). A six-loci HLA-identical umbilical cord blood (UCB) was infused after conditioning with low-dose cyclophosphamide (CTX) and antilymphocyte globulin (ALG). The prophylaxis of GVHD consisted of CsA and MTX. The infused cord blood provided 1.89 x 10(7) nucleated cells per kg, CD34-positive cells: 0.89%. Neutrophils >0.5 x 10(9)/l were reached 10 days after transplant, and platelets greater than 50.0 x 10(9)/l at day 26. RBC and platelet transfusion independence were reached on days 15 and 18. The patient developed grade 1 skin GVHD 10 months after engraftment of the donor cells. Microsatellite DNA fingerprinting indicated a stable and persistent donor-recipient mixed chimerism, whilst the circulating red cells remain of host origin.

[The potential role of growth factor in the airway wall remodeling of a chronic obstructive pulmonary disease rat model and the effects of drugs on them]

OBJECTIVE

To evaluate the expression and distribution of transforming growth factor-beta1 (TGF-beta1), epidermal growth factor (EGF) and basic fibroblast growth factor (bFGF) in the lung tissue of chronic obstructive pulmonary (COPD) rat models and the relationship between these growth factors and the airway wall remodeling. The effects of drugs on them were also investigated.

METHODS

The COPD rat model (model group) was established by intratracheal instillation of lipopolysaccharide twice and daily exposure to cigarette smoking. Drug intervention groups received daily inhalation of heparin since the second week and TGF-beta1 monoclonal antibody (TB21) 0.5 mg twice through the tail veins. At the end of four weeks, the thickness of the smooth muscle and collagen in bronchi and pulmonary arterioles were measured by computer image analyzer, also the protein and gene relative content of these growth factors as well as the effects of drugs on them were observed.

RESULTS

There was a significant increase in the smooth muscle and collagen thickness in the bronchi and pulmonary arterioles of the model group in comparison with that of the control group (P < 0.01), the relative contents for TGF-beta1, EGF and bFGF in the epithelial cells of the bronchi, endothelial cells of the pulmonary arterioles and alveolar macrophages of the model group were significantly higher than those of control group (P < 0.001 approximately 0.05). The relative content for TGF-beta1 in TB21 group was significantly lower than that of model group (P < 0.01). These were statistical positive relationships between the smooth muscle e thickness of bronchi and the relative contents for TGF-beta1, EGF and bFGF in the epithelial cells, between the collagen thickness of the bronchi and the relative content for TGF-beta1, between the smooth muscle thickness of the pulmonary arterioles and the relative content for TGF-beta1 and EGF in the endothelial cells (P < 0.05 approximately 0.01).

CONCLUSION

TGF-beta1, EGF and bFGF may play an important role in the airway wall and pulmonary arteriole structure remodeling in COPD, the intervention against TGF-beta1 and long term inhalation of heparin mat be helpful for the inhibition of airway wall remodeling in human COPD and worth of further observation.

[Umbilical cord blood stem cells transplantation from an unrelated donor into an adult with severe aplastic anemia]

OBJECTIVE

To evaluate the availability of the treatment of adult severe aplastic anemia with unrelated allo-cord blood stem cell transplantation (CBSCT).

METHODS

HLA-matched unrelated cord blood transplantation has been successfully performed for an adult severe aplastic anemia patient. A unit of cord blood provided by Guangzhou Cord Blood Bank containing 1.89 x 10(7)/kg mononucleated cells, 1.8 x 10(4)/kg CFU-GM and of CD(34) positive cells was 0.009. The patient was conditioned with CTX (60 mg/kg) and anti-lymphocyte globulin (ALG, 120 mg/kg). GVHD prophylaxis consisted of both MTX and CsA. The CsA had been given for 8 months.

RESULTS

The lowest ANC was 0.6 x 10(9)/L post-transplantation. The patient achieved an ANC of greater than 0.5 x 10(9)/L at 10 days, and the platelet of greater than 50.0 x 10(9)/L at day 20 after transplantation. He developed Grade 1 GVHD in the tenth month after grafting. Microsatellite DNA fingerprinting indicated a stable donor-recipient mixed chimerism, whilst the circulating red cells remained host origin.

CONCLUSION

It is the first report in China on successful treatment of adult severe aplastic anemia by unrelated allo-CBSCT.

Development of thermally formed glass optics for astronomical hard X-ray telescopes

The next major observational advance in hard X-ray/soft gamma-ray astrophysics will come with the implementation of telescopes capable of focusing 10-200 keV radiation. Focusing allows high signal-to-noise imaging and spectroscopic observations of many sources in this band for the first time. The recent development of depth-graded multilayer coatings has made the design of telescopes for this bandpass practical, however the ability to manufacture inexpensive substrates with appropriate surface quality and figure to achieve sub-arcminute performance has remained an elusive goal. In this paper, we report on new, thermally-formed glass micro-sheet optics capable of meeting the requirements of the next-generation of astronomical hard X-ray telescopes.

Serological and histological findings in infection and transmission of GBV-C/HGV to macaques

Seven healthy macaques were inoculated with the GBV-C/HGV-RNA serum from a non-A-E hepatitis patient. The serology and pathology of the liver in the animals were observed. The results indicated that all inoculated animals were infected with a GBV-C/HGV-RNA viremia and had mildly abnormal alanine transaminase levels during the infectious period. The histology, immuno-histochemistry, and in situ hybridization in the liver tissues of the inoculated animals also showed that there was a very mild hepatitis with the positive antigenic expression and the genome of GBV-C/HGV-NS5 in hepatocytes. The pathological changes in the infected animals appeared to become normal whether or not GBV-C/HGV-RNA viremia persisted. There is a possibility that the mild virulence of the GBV-C/HGV to the host became harmless with time after inoculation. Infection and the transmission of the GBV-C/HGV virus in the macaques provides an appropriate animal model and new information about GBV-C/HGV infection in both humans and animals. It is possible that this virus is a mild and self-limited pathogenic agent to the hepatic cells of primates.

[Ultrasound in trauma (FAST)]

During last 20 years ultrasonography has been widely used in Europe to investigate abdominal trauma. In United States it has not been considered a reliable test especially because of its lack of sensitivity in diagnosing parenchymal injuries. Recently American surgeons reconsidered ultrasonography in trauma and codified its use into FAST (Focused Assessment for the Sonographic examination of the Trauma patients). The goal is to detect hemoperitoneum and pericardial effusion. Advantages are remarkable: ultrasound is cost-effective, fast, non-invasive, can be performed by surgeons even on unstable patients. FAST is now included in ATLS framework for examination of thoraco-abdominal trauma.

Serological and histological findings in infection and transmission of GBV-C/HGV to macaques

Seven healthy macaques were inoculated with the GBV-C/HGV-RNA serum from a non-A-E hepatitis patient. The serology and pathology of the liver in the animals were observed. The results indicated that all inoculated animals were infected with a GBV-C/HGV-RNA viremia and had mildly abnormal alanine transaminase levels during the infectious period. The histology, immuno-histochemistry, and in situ hybridization in the liver tissues of the inoculated animals also showed that there was a very mild hepatitis with the positive antigenic expression and the genome of GBV-C/HGV-NS5 in hepatocytes. The pathological changes in the infected animals appeared to become normal whether or not GBV-C/HGV-RNA viremia persisted. There is a possibility that the mild virulence of the GBV-C/HGV to the host became harmless with time after inoculation. Infection and the transmission of the GBV-C/HGV virus in the macaques provides an appropriate animal model and new information about GBV-C/HGV infection in both humans and animals. It is possible that this virus is a mild and self-limited pathogenic agent to the hepatic cells of primates.

Molecular analysis of the GCF gene identifies revisions to the cDNA and amino acid sequences(1)

GC factor (GCF) was reported as a transcriptional regulator that binds to a specific GC-rich sequence in the epidermal growth factor receptor (EGFR) gene promoter and represses its expression. In this paper, we present the data on three revisions of the cDNA sequence that lead to significant changes of the amino acid sequences of the published GCF. Firstly, 5'-rapid amplification of cDNA end (5'-RACE) analysis revealed that the 308 nucleotides of 5'-end of the previously published GCF cDNA does not exist at the 5'-end of the RACE product. Simultaneously, the correct 5'-end cDNA sequence of 31 nucleotides was identified. Secondly, the 'T' at the position 787 of the published GCF cDNA was not observed. Finally, a new sequence of 114 nucleotides was identified between the positions 851 and 852 of the published cDNA sequence. The revisions result in a GCF cDNA of 2661 nucleotides that encodes a protein of 781 amino acids, replacing the highly basic region of the amino-terminus of the published GCF with a new sequence of 147 amino acids. In this era of massive gene cloning and sequencing, this study is a warning to the biological research of recent years.

[Revisions of the cDNA and primary protein structure of human transcription factor GCF]

GC factor (GCF) was reported as a transcriptional regulator that binds to specific GC-rich sequences in the epidermal growth factor receptor (EGFR) gene promotor, repressing its transcription (Kageyama R. and Pastan I. Cell, 59: 815-825, 1989). In this paper, the author presents revisions of the cDNA and the amino acid sequences of the GCF. 1) 5' rapid amplification of cDNA end (5'RACE) for analysis of RNA of a cancer cell line, A431, was performed, which revealed that the 5' end of GCF cDNA was fused to a 308 bp fragment of other cDNA; simultaneously, the real 5' end cDNA sequence with 31 bp was identified. RNase protection assay presented a main protected band, which was consistent with the result of the RACE analysis. 2) T at the position 787 of the previously reported GCF cDNA was absent from RT-PCR on A431 total RNA. 3) A new sequence with 114 bp was observed on A431 RNA between the positions 851 and 852 of the already reported cDNA by RT-PCR. These observations were confirmed by RT-PCR analyses of RNAs prepared from several other human cell lines, including a non-transformed one (HFL), and white blood cells derived from a normal person. 4) Sequence of genomic GCF DNA was consistent with the new cDNA sequence but not with the previously reported one. 5) The remaining sequence of GCF cDNA was found to be identical to that of the previously reported GCF, based on the results of RT-PCR analyses of RNA prepared from human white blood cells. 6) By the corrections, the GCF cDNA consisted of 2661 bp nucleotides. This revised GCF cDNA (the wild type) encodes a protein of 781 amino acids, including two new sequence regions of 186 amino acids on the N-terminal side of this protein. The revisions eliminated the highly basic region of the amino-terminus of the previously reported GCF, while the other three fourth amino acid sequences of the GCF protein that contained leucine-zipper-like domain had not changed. The revised GCF had no highly homologous protein in the database except the previously reported GCF. 7) The author has developed a specific antibody to human GCF protein. This antibody specifically recognized a protein with a molecular weight of approximately 100 kDa present in the extracts from human cell lines, as confirmed by immunoprecipitation followed by Western blotting. 8) Indirect immunofluorescence of A431 and HeLa cells using the anti-GCF antibody showed that the GCF protein was localized in the nucleus, suggesting that the revised GCF is a nucleoprotein.

[Detection of IgM-antibody to hepatitis G virus and its clinical significance]

OBJECTIVE

To provide a rapid and early serodiagnostic technique for the patients with hepatitis G virus(HGV).

METHODS

A capture ELISA was developed to detect anti-HGV IgM in sera using synthetic peptides of HGV NS3 NS5 gene regions conjugated with horseradish peroxidase.

RESULTS

This assay was not disturbed by competition of specific IgG or interfered by RF and did not cross-react with HAV, HBV, HCV, HEV, CMV and EBV. Among 46 sera of non-A-E hepatitis, 14 were positive for anti-HGVIgM, the positive rate was 30.43%, 6 was positive for HGV RNA the positive rate was 42.86%. 12 paired sera from acute stage of HGV patients were all positive by capture-ELISA.

CONCLUSION

This method is sensitive, specific, rapid and stable for detecting anti-HGV IgM, and is useful in the early diagnosis of HGV infection.

[Investigation of hepatitis G virus and human immunodeficiency virus infections in 831 healthy youths]

Antibodies to hepatitis G virus(HGV) and human immunodeficiency virus(HIV) by EIA were investigated in 831 healthy youths from 6 provinces. The results showed that the anti-HGV IgG positive rate was 2.53% (21/831). In 21 anti-HGV IgG positive sera, HGV RNA was detected in 8 sera by reverse transcription polymerase chain reaction(RT-PCR). The anti-HIV was negative in 827 sera. The data suggest that HGV infection actually exist in healthy youths.

[Antigenicity of nine synthetic peptides of human immunodeficiency virus]

To establish a ELISA method to detect the infection of human immunodeficiency virus (HIV), we synthesized nine peptides ranging in length between 10-27 amino acid (aa) of HIV located in the regions of gp41, p24 of HIV-1 and gp36 of HIV-2, according to the published amino acid sequence and the position of antigenic determinants of viruses, by a solid-phase method. We detected 10 positive sera of HIV-1 and 4 positive sera of HIV-2 by a indirect ELISA using these synthetic peptides as the coating antigen. The results indicated that all of 10 serum specimens of HIV-1 were positive using SP1, 5, 6, and 7 derived from gp41, and SP7 was the best in antigenicity. The 4 serum specimens of HIV-2 were positive using SP8 and SP9 in the region of gp36 and their antigenicity to HIV-2 were similar, but the antigenicity of SP8 to HIV-1 was higher than that of SP9. All sera of HIV-1 and HIV-2 were positive using SP7 and SP8 as the mixed coating antigen. A comparison of our reagent with UBI reagent in detection of 60 positive and 96 negative control sera for HIV showed that the coincident rate for positive ness was 98.33% (59/60), for negative ness was 100%, and the general coincident rate was 99.36% (155/156). It is concluded that SP7 and SP8 as the mixed coating antigen are applicable in the diagnosis of HIV infection.

[Expression of human ScFv against human immunodeficiency virus type 1 gp120]

In order to generate human antibody against HIV-1, using synthetic peptide from HIV-1 gp120 v3 loop as antigen, we screened the recombinant phage antibodies by immunoaffinity and selected positive clones carrying anti-gp120 ScFv gene. The phage DNA was extracted and transformed to E. coli HB2151 that allowed to express soluble ScFv proteins by inducing of IPTG. The results of SDS-PAGE and Western blot showed that the molecular weight of the expressed product is about 28 KD and exhibited anti-c-myc activity. ELISA and Dot blot analysis displayed that the soluble ScFv specifically bound to gp120 and had a higher specificity and affinity. Competitive ELISA further demonstrated that the product was specific to gp120.

[Study on the experimental infection of hepatitis G virus in rhesus monkey]

In order to study the experimental infection of HGV in rhesus monkey, the monkeys were infected using the plasma from a donor with HGV RNA positive. The second generation monkeys were infected with the sera of the first generation monkeys infected after 6 weeks, and also the third generation monkeys were infected with the sera of the second generation monkeys. HGV RNA were detected by RT-nPCR. The results showed that in sera of infected monkeys HGV RNA were positive after 1 week of inoculation, and were consecutively positive for up to 28 weeks at longest. The level of ALT raised a little in monkey No. 1 and higher than 100 U/L in No. 5. The liver biopsy showed viral hepatitis--like histological changes. Comparing the sequence of HGV 5'LTR from sera of the infected monkeys and the blood donor, the homogeneity, to strain HGU44402 was 98.33% and 95.83% to strain HGU36380 was 92.50% and 89.17%, respectively. The results suggested that the rhesus monkey is sensitive to HGV and is suitable for establishment of an animal model.

Expression of GCF protein is dependent on the cell cycle

GCF is reported to be a transcriptional regulator that binds to specific GC-rich sequences in the epidermal growth factor (EGF) receptor gene promotor and to represses its transcription. In this study, to examine the expression of GCF in cell cycle, we have developed antibodies against GCF protein. The anti-GCF antibody recognized a major band with a molecular weight of approximately 100 kda present in human Hela cell line by immunoprecipitation followed by Western blotting. Although GCF proteins were detected throughout the cell cycle, it reached the highest level in G1 phase, and fell down to the lowest level during G2/M phase. Thus, the expression of GCF is regulated in a cell cycle-dependent manner, suggesting a potential role of GCF in the control of cell growth.

[The establishment of antigen sandwiched ELISA for detection of total antibodies to hepatitis C virus]

An antigen sandwiched ELISA for detection of the total antibodies to HCV was established using genetically engineered proteins and synthesized peptides located in the structural and nonstructural regions of HCV genomes as coated antigens and were labeled by horseradish peroxidase, respectively. A comparison of antigen sandwiched ELISA with indirect ELISA showed that the sensitivity of sandwiched system (1:128) was little higher than that of indirect ELISA (1:64), the specificities of both systems were all 100%. This reagent may detect all classes of antibody to HCV in serum, mainly IgG and IgM and is a new diagnostic reagent for detection and early diagnosis of HCV infection.

[Primary analysis of the situation of hepatitis G virus infection in different groups of people]

In order to investigate the situation of hepatitis G virus (HGV) infection among different groups of people, two self-selected peptides from HGV NS5 were used to develop an indirect ELISA for anti-HGV IgG detection. 1209 sera from different peoples were detected and the positive rate of anti-HGV IgG was (3.8%). Among these groups the group of non A-E hepatitis had the highest anti-HGV positive rate (20.5%), higher than that in the groups of natural people (0.8%) and other hepatitis patients (3.3%), the difference was significant. The anti-HGV IgG positive rate in the group of HC patients 8.0% was higher than that in other hepatitis A-E patients, the positive rate (8.0%) in paid donors was higher than that in voluntary donors (0%), and that in groups with venereal diseases and HIV infection were 3.6% and 8.0%, respectively. The results suggested that there has higher rate of HGV infection in our country; HGV is the important factor causing non A-E, the paid donors is the dangerous group, they should be strictly screened, and the people with transfusion have higher rate of HGV infection. Since there is different rate of HGV infection in different human population so it is important to study further the epidemiological characteristics of HGV for its prevention.

[The detection of human immunodeficiency virus type 1/2 antibody using synthetic peptides]

Four peptides of human immunodeficiency virus (HIV) located in the regions of gp41, gp120, p24 of HIV-1 and gp36 of HIV-2 have been synthesized according to the published amino acid sequences and the positions of antigenetic determinants of viruses by a solid-phase method. An indirect ELISA for detecting antibody against HIV 1/2 was established using these synthetic peptides as the coating antigens. We detected 41 control sera provided by National Institute for the Control of Pharmaceutical and Biological Products. The results indicated that the general coincident rate were 100%, the variant coefficient was less than 10%. A comparison of our reagent with Huayi, Pasteur and Jinhao reagents in detection of 90 positive sera and 140 normal sera for HIV-1/2 showed that the coincident rate was 100% with Pasteur and Jinhao, 99.57% with Huayi. All of 186 sera from patients with other diseases were negative. The reagent are stable at 37 degrees C for 4 days. The results indicated that our reagent is highly specific, sensitive and stable, it can be used for detection of HIV-1/2 infections.

[Production of anti-enteric adenovirus monoclonal antibody by electrofusion and semi-solid medium culture]

Ten million splenocytes from the enteric adenovirus (Ad40/41) immunized mice were fused with 3 x 10(6) myeloma cells by electrofusion. Then, the cells were selectively cultured in methyl cellulose semi-solid medium. Eighteen clones of hybridoma were directely picked out from the culture plates and 7 of them could secret high level specific antibodies to enteric adenovirus. So far, the anti-Ad40/41 virus monoclonal antibodies were successfully generated by the protocal of electrofusion accompanied with selective culture in methyl cellulose semi-solid medium.

Re-examination of 5' end of cDNA of transcription factor GCF

N-terminal region of transcriptional factor GCF was re-examined as the published amino acid sequence is extremely basic. 5'Rapid Amplification of cDNA End (5' RACE) analysis was performed and the result revealed that sequence of the first 308 bases of published GCF cDNA does not conform to the one obtained by 5' RACE. Sequence of genomic GCF DNA is consistent with the new cDNA sequence but not with the published one. Results of ordinal RT-PCR analyses are consistent with that of 5' RACE.

[Treatment of esophageal reflux by insertion of Angelchik prosthesis: analysis of the follow-up in 26 patients]

The authors report a retrospective analysis of the immediate and long-term results of treatment of gastroesophageal reflux refractory to medical therapy using the insertion of Angelchik's prosthesis in a group of 26 patients operated at the Institute of Emergency Surgery of Turin University from January 1980 to December 1993. All patients underwent pre- and postoperative endoscopy and were then controlled using esophagogastric X-ray, esophagogastroscopy, esophageal manometry and pH-metry in the event of disorders of esophageal motility. Operative mortality was nil and no major surgical complications were reported. Postoperative endoscopy showed the resolution of esophagitis in 23 patients (88.4%); symptoms of slight esophagitis persisted in 2 cases, and moderate esophagitis in another. Eighteen patients were monitored over time with a minimum follow-up of more than 2 years: persistent dysphagia appeared in 3 cases (16.6%), and in one patient this led to the need for endoscopic dilatations. Two patients (11.1%) presented "gas bloat syndrome" which gradually improved. It was never necessary to remove the device. No cases were observed of erosion, migration or destruction of the prosthesis. Follow-up exceeded 10 years in 7 patients, at present asymptomatic. Angelchik's prosthesis proved to be efficacious, rapid and simple to insert, and characterised by a lower morbidity rate and shorter postoperative course. The incidence of postoperative dysphagia makes only it is use indicated only in patients with a high operative risk, obese subjects and in case of recidivation of reflux after fundoplication.

[Indications for the surgical treatment of esophageal varices hemorrhage]

The authors present their experience in the treatment of acute bleeding from oesophageal varices. From 1983 to 1991, 596 patients underwent sclerotherapy during diagnostic endoscopy; a stop to bleeding was achieved in 512 cases (86%). Twenty-seven surgical emergency decompressive shunts were performed, 14 total portal-systemic and 13 selective; operative mortality was 64% and 54% respectively. One patient was submitted to oesophageal-gastric devascularization. Hundred-sixty elective shunts were performed, 99 total portal-systemic and 61 selective; operative mortality was 8% and 11% respectively. Since 1990 3 patients received liver transplantation. The 5-year survival rate of patients submitted to selective shunts was 46%; the 5-year survival rate of nonalcoholic cirrhotics submitted to shunt SRD was 73%.

A study of 3H-PK 11,195 binding to "peripheral-type" benzodiazepine receptors on human lymphocytes. Evidence of decreased binding in hepatic encephalopathy

In an attempt to assess the involvement of the "peripheral-type" benzodiazepine receptors (pBDZR) in hepatic encephalopathy (HE), we examined the binding of the isoquinoline carboxamide derivative 3H-PK 11,195 to lymphocyte membranes from a group of patients with liver cirrhosis with or without clinical signs of HE and normal controls. Lymphocyte 3H-PK 11,195 binding is saturable, with high affinity and presents the pharmacological specificity corresponding to pBDZR. A significant 40% decrease in the number of 3H-PK 11,195 binding sites, without a concomitant change in the apparent affinity, is observed in the group with HE as compared to the controls, but not in that with liver diseases without HE. The decrease in binding capacity correlates significantly with the clinical grading of HE, but not with age, sex, aetiology of cirrhosis or presence of surgical shunt. In contrast to the reduction of pBDZR, 3H-N-methylscopolamine binding to lymphocyte muscarinic receptors is not affected in HE. These findings are consistent with a role for pBDZR in HE and may stimulate studies of endogenous modulators and pharmacological agents for these receptors in the disease.

Imipenem-cilastatin in the treatment of hospital infections

Imipenem was tested on 65 gram-negative bacterial strains consecutively isolated in patients affected by hospital infection and used as empiric therapy in 52 patients presenting a hospital infection suspected of gram-negative origin. More than 96% of the tested strains resulted sensitive to imipenem. This antibiotic showed a good clinical result in more than 80% of the cases when used as therapy. Therefore imipenem could be considered the drug of first choice in patients with a severe prognosis and a nosocomial infection suspected to be due to a gram-negative microorganism.