Quantitative structure-activity relationships of estrogenic steroids substituted at C14, C15

The uterotropic activity of thirty 3-methoxyestradiol derivatives is measured and discussed on the basis of X-ray crystallographic results and quantitative structure-activity relationship analyses involving hydrophobic substituent constants pi and f as well as steric parameters Pr and L. In addition, estrogenicity is compared to data of interceptive activity and receptor binding affinity. All the biological data exhibit a high degree of intercorrelation. 17 beta-Hydroxysteroids having 14 alpha configuration reveal a generally better capability of high-affinity binding than those being 14 beta configurated. Between the uterotropic activity and the hydrophobicity of C14, C15 substituents, statistically significant correlations are found which suggest a close contact between the steroidal D-ring subsite and the receptor protein (e.g. for 14 alpha steroids: log UDD = -0.996 pi -0.392; n = 9, r = -0.943, s = 0.235, t = -7.5, alpha less than 0.001). The hydrophobic nature of both 14 alpha and 14 beta medium-sized substituents employed is shown by QSAR regressions to exert a stronger influence than steric effects. Furthermore, there are indications to additional hydrogen bonding and steric repulsion phenomena. As to the receptor-binding models discussed in the literature, it is concluded that the receptor protein has a high conformational flexibility to accommodate very different drug structures all having the common phenolic ring A. But, if an appropriate spacing of steroidal key atoms is recognized by the receptor and, consequently, the steroid-receptor complex is formed, the binding is complemented by hydrophobic interactions also in the D-ring region.

Semi-quantitative assessment of anti-insulin total IgG and IgG sub-classes in insulin-immunized patients using a highly sensitive immunochemical micromethod

An immunochemical micromethod was designed to estimate total IgG and IgG sub-classes of anti-insulin antibodies in immunized diabetic patients. Insulin, immobilized on a solid phase, was allowed to react with serum samples containing anti-insulin antibodies. Bound anti-insulin IgG interacted with mouse monoclonal antibodies specific for total IgG or for each IgG isotype. The fixation of mouse monoclonal antibody was subsequently detected using a horseradish peroxidase-conjugated rabbit anti-mouse IgG in the presence of a chromogenic substrate. The test was standardized by an immunocapture assay utilizing coated rabbit anti-human IgG and known concentrations of purified human myelomatous proteins of each sub-class. Results of anti-insulin IgG and anti-insulin IgG sub-classes assay could therefore be expressed in ng equivalent myelomatous proteins per ml of serum. Analysis of serum samples from 24 insulin-immunized diabetic patients revealed a quasi absence of IgG2 anti-insulin antibodies and an increase of the relative abundance of the other three anti-insulin IgG isotypes. In our series, anti-insulin IgG1 was predominant, followed by IgG3 (in 17/24 patients) or IgG4 (in 7/24). Insulin immunization was deduced to be of polyclonal nature, the isotype pattern of which is not representative of the relative proportion of IgG sub-classes in whole normal serum.

Lack of evidence for involvement of known human retroviruses in multiple sclerosis

The recent report by Koprowski et al. that human T-cell lymphotropic retroviruses (HTLVs) may be involved in the development of multiple sclerosis (MS) has aroused much interest. The report was based largely on immunological evidence, using enzyme-linked immunosorbent assays (ELISAs) with viral antigens or disrupted virions. We have accordingly sought confirmation by screening sera and cerebrospinal fluid (CSF) samples from MS patients against cell lines infected respectively with adult T-cell leukaemia (ATL) virus (ATLV/HTLV-I) of Japanese cells (MT-1 and MT-2 lines), our own isolate from British black patients with ATL, the MoT cell line which produce HTLV-II, and our own T-cell line containing a local isolate of acquired immune deficiency syndrome (AIDS) virus (C-LAV/HTLV-III). We have failed to find antibodies against these retroviruses in the sera or CSF. Furthermore, neither virus could be isolated from the peripheral white blood cells of two MS patients.

Fibrinogen--proteolysis in acute myelogenous leukemia (AML)

Fibrinopeptides were measured as direct indices of thrombin, plasmin and elastase in plasma samples obtained from patients with AML. Peptide patterns observed were consistent with spontaneous or drug induced plasmin-specific fibrinogenolysis (AML FAB M 1/3), elastase mediated proteolysis (AML FAB M 3/4) or DIC (AML FAB 4/5). DIC was also observed in septic, agranulocytotic patients.

Factors affecting recurrence rates in superficial bladder cancer

A prospective study of all patients with superficial bladder cancer diagnosed in Northern Alberta (population 1.2 million) from 1977 to 1983 was performed to establish patterns of recurrence. Of the 761 patients with all stages of bladder cancer at diagnosis, 642 were deemed to be free of disease after primary treatment consisting of transurethral resection, fulguration, or laser surgery. Follow-up of these patients showed that approximately two-thirds of first recurrences occur within 18 months of diagnosis and that more of these patients have died of unrelated causes (n = 73) than of bladder cancer (n = 34). Censored disease-free interval comparisons showed that initial recurrences occurred sooner in patients with multifocal rather than unifocal disease and also sooner in females than in males. Known risk factors (occupational exposure to chemicals and cigarette smoking) and suspected risk factors (coffee consumption and artificial sweetener use) had no effect on disease-free interval and are not related to tumor multiplicity.

Experimental chelation therapy in chromium, lead, and boron intoxication with N-acetylcysteine and other compounds

The usefulness of N-acetylcysteine (NAC) as a chelating agent was studied for the toxin potassium dichromate, lead tetraacetate, and boric acid. Mature Sprague-Dawley rats were intoxicated with these substances and placed in metabolic cages. Urinary excretion rates of intoxicant and total urine volume were determined during treatment with N-acetylcysteine, calcium EDTA, and/or dimercaptosuccinic acid, N-acetylcysteine proved to be the most effective agent at increasing the excretion of chromium and boron and was also able to reverse the oliguria associated with these toxins. Dimercaptosuccinic acid was most effective at the chelation of lead. NAC did not increase the excretion of lead. We conclude that NAC may be useful in intoxications due to chromate and borate and is effective at reversing the oliguria associated with these intoxicants.

Informational needs of families of intensive care unit patients

Although results of the study are specific to St Michael Hospital's ICU, the implications of those results are not limited to the study site. Families of patients admitted to any critical care unit may experience similar needs as those identified in this study. Intensive care unit nurses need to identify these needs as a first step in the process toward family-centered care. Critical care nurses can view families either as further stressors on their time or as integral components of their nursing plan and valuable resources in the well-being and recovery of their patients. Tailoring interventions to the main concerns of families can allow ICU nurses to maintain their high standards of professional care while helping families cope with critical illness. Using a unit-based quality assurance study, critical care nurses can implement research-based interventions to address the information and emotional needs of families.

Interactions of pH and K+ conductance in cultured bovine retinal pigment epithelial cells

Passive ion transport properties were studied in confluent monolayers of cultured bovine retinal pigment epithelial cells using intracellular microelectrode technique. The mean stable intracellular (designated by subscript i) potential was -59.1 +/- 0.8 (SE) mV. Extracellular (designated by subscript o) acidification induced a depolarization, whereas alkalinization induced a hyperpolarization. These effects were observed both in bicarbonate-free as well as in HCO3- Ringer (pHo changed by varying [HCO3-]o at constant pCO2). Acidification of pHi (changed by addition and removal of butyrate, CO2 or NH3) also caused a depolarization. Complete removal of HCO3-/CO2 at constant pHo caused a hyperpolarization. K+ transference, checked by applying high K+o, increased with K+o. It decreased with both extra and intracellular acidification and increased with alkalinization. In the presence of Ba2+, voltage reactions to changes in either pHo or pHi were greatly reduced. Depolarization by 40 mM K+ caused a similar reduction. It is suggested that K+ conductance of bovine retinal pigment epithelial cells is reduced by either intra- or extracellular acidification at normal [K+]o. Depolarization by high K+ induces an increase in K+ transference and reduces pH sensitivity.

Further report on the endocrinological profile of two synthetic estrogens with antifertility properties, STS 456 and STS 593

Two synthetic estrogens, STS 456 and STS 593, with noteworthy post-coital antifertility properties in the rat were studied for their estrogenic, antiestrogenic, progestagenic, antiprogestagenic, antigonadotrophic, androgenic and antiandrogenic effects in laboratory animals. Beside their weak estrogenic activity which corresponds to their slight affinity to the uterine estrogen receptor in the rat, both steroids show remarkable antiestrogenic effects. No progestagenic, androgenic and antiandrogenic effects were found but STS 593 showed some antiprogestagenic activity. The antigonadotrophic efficacy of STS 456 was relatively high while STS 593 was scarcely active. The results are discussed with respect to possible application of these drugs for interceptive purposes.

[Zellweger's syndrome (cerebro-hepato-renal syndrome)--its clinical picture, morphology and biochemical diagnosis]

The cerebro-hepato-renal (Zellweger) syndrome is characterised by dysmorphic features, severe muscular hypotonia, hepatic dysfunction and early death in infancy. Recently it has been shown that the disease is an inborn error of metabolism with an unusual variety of metabolic disturbances affecting pipecolic acid, bile acids, plasmalogens and very long chain fatty acids. Ultrastructural and biochemical findings confirming the diagnosis are illustrated. The syndrome is inherited as an autosomal recessive trait, prenatal diagnosis has become possible.

[Tetrasomy 9p]

A newborn male with multiple malformations and an extrachromosome is presented. The cytogenetic study of peripheral blood lymphocytes revealed tetrasomy 9p: 47,XY, + t(9;9)(pter----q13::p11----pter). The C-banding pattern provided evidence for maternal origin of the extrachromosome. Tetrasomy for the short arm of chromosome 9 is a very rare condition; reports about only ten further patients have been found in the literature. The phenotypic expression resembles trisomy 9p, but tetrasomy 9p has more severe additional malformations.

Sibs of probands with neural tube defects--a study in the Federal Republic of Germany

Data for the risk of neural tube defects in sibs of affected children are needed for genetic counselling, for decision on prenatal studies, and for planning of preventive measures. Data have been reported from various populations but were lacking for Germany. This study presents data on the siblings of 240 index patients in the Western part of the Federal Republic of Germany. The prevalence among sibs of affected individuals was found to be 2.6%. This figure agrees well with reports from other countries in Continental Europe and the United States, and fits the expectation of lower recurrence risks in low incidence populations.

Relationship between patient variables and lithium dosage requirements

The relationships between several patient variables and lithium dosage requirements were determined in 71 inpatients receiving a slow-release lithium product. Age, weight, ideal body weight, sex, body surface area, creatinine clearance, presence of depression, concurrent use of tricyclic antidepressants, and acuteness of symptoms were significantly related to dosage requirements. The contribution of each factor to dosage requirements was further defined using multiple regression analysis and used to assess a published patient variable-based lithium dosing technique. Addition to that model of information concerning presence of depression, acuteness of symptoms, and creatinine clearance minimally improved predictability. The published model is recommended as an alternative to empiric methods.

Effects of antifertility estrogens and progestins on the endometrial surface of early pregnant rats. A scanning electron microscopic study

Two estrogens, mestranol and 3-methoxy-14 beta, 15 beta-methyleneestra-1,3,5(10)triene-17 beta-ol (STS 593), and two progestins, levonorgestrel and 17 alpha-cyanomethyl-17 beta-hydroxyestra-4,9(10)-diene-3-one (STS 557), all having antifertility properties in rodents, were examined for their effects on the uterine luminal surface of early pregnant rats. Scanning electron microscopic studies showed that there are clear qualitative differences between the effects of estrogens and progestins on both morphology and microvillous pattern of the endometrial surface while STS 557 showed intermediate effects. The results are discussed with respect to the anti-implantation activity of steroids.

Analysis of "time to second primary" in patients with gynecological cancers

Lifetable survival curves have been adapted to measure "time to second primary" and used to compare incidence of second primary in all patients in the Alberta Cancer Registry with a primary malignancy in cervix, endometrium and ovary. Comparisons were also obtained within each diagnostic category between patients treated or not treated with radiation. Results show that there are no statistically significant differences in the 25 years following diagnosis of the first primary in "time to second primaries" in patients with cancer of the cervix, endometrium or ovary. Similarly, within each diagnostic category, there are no differences between radiation treated patients and those not treated by radiation, when adjustments for age differences are made and when patients are selected by length of survival.

Evidence for coupled transport of bicarbonate and sodium in cultured bovine corneal endothelial cells

Using intracellular microelectrode technique, the response of the voltage V across the plasma membrane of cultured bovine corneal endothelial cells to changes in sodium and bicarbonate concentrations was investigated. (1) The electrical response to changes in [HCO3-]o (depolarization upon lowering and hyperpolarization upon raising [HCO3-]o) was dependent on sodium. Lithium could fairly well be substituted for sodium, whereas potassium or choline were much less effective. (2) Removal of external sodium caused a depolarization, while a readdition led to a hyperpolarization, which increased with time of preincubation in the sodium-depleted medium. (3) The response to changes in [Na+]o was dependent on bicarbonate. In a nominally bicarbonate-free medium, its amplitude was decreased or even reversed in sign. (4) Application of SITS or DIDS (10(-3) M) had a similar effect on the response to sodium as bicarbonate-depleted medium. (5) At [Na+]o = 151 mM and [HCO3-]o = 46 mM, the transients of V depended, with 39.0 +/- 9.0 (SD) mV/decade, on bicarbonate and, with 15.3 +/- 5.8 (SD) mV/decade, on sodium. (6) After the preincubation of cells with lithium, replacement of Li by choline led to similar effects as the replacement of sodium by choline, though the response of V was smaller with Li. This response could be reduced or reversed by the removal of bicarbonate or by the application of SITS. (7) Amiloride (10(-3) M) caused a reversible hyperpolarization of the steady-state potential by 8.5 +/- 2.6 mV (SD). It did not affect the immediate response to changes in [Na+]o or [HCO3-]o, but reduced the speed of regaining the steady-state potential after a change in [HCO3-]o. (8) Ouabain (10(-4) M) caused a fast depolarization of -6.8 +/- 1.1 (SD) mV, which was followed by a continuing slower depolarization. The effect was almost identical at 10(-5) M. (9) It is suggested, that corneal endothelial cells possess a cotransport for sodium and bicarbonate, which transports net negative charge with these ions. It is inhibitable by stilbenes, but not directly affected by amiloride or ouabain. Lithium is a good substitute for sodium with respect to bicarbonate transport and is transported itself. In addition, the effect of amiloride provides indirect evidence for the existence of a Na+/H+-antiport. A model for the transepithelial transport of bicarbonate across the corneal endothelium is proposed.

Effect of bicarbonate, pH, methazolamide and stilbenes on the intracellular potentials of cultured bovine corneal endothelial cells

Micropuncture of cultured bovine corneal endothelial cells led to registrations stable for hours. Intracellular potentials were mainly in the range of -40 to -55 mV, average 46.3 +/- 0.6 mV (SEM). Changes of extracellular [HCO-3] led to voltage transients, their amplitude depending logarithmically on [HCO-3] with a mean slope of 37.3 +/- 8.8 (SD) mV. After removal of bicarbonate/CO2, a steady-state depolarization was seen. This steady-state depolarization, but not the voltage transients, could be reduced by 1 mM Ba++. After removal of bicarbonate, the voltage response to changes of extracellular potassium was reduced. Alteration of pHi induced by permeable buffers (butyrate, glycodiazine and ammonium) also resulted in voltage transients, internal acidification being correlated with a hyperpolarization, and internal alkalinization with a depolarization. Also changes of external pH caused voltage responses, alkalinization causing a hyperpolarization, acidification a depolarization. Methazolamide, an inhibitor of carbonic anhydrase, as well as stilbenes (SITS or DIDS) caused a reduction of the voltage response to HCO-3 and pH. Their effects were additive. It is suggested that corneal endothelial cells possess one or two electrogenic transporters for HCO-3 or related species, one of which is inhibitable by stilbenes.

Influence of STS 557 on the mitotic activity in the endometrium of ovariectomized mice and comparison with the effects of progesterone and levonorgestrel

The numbers of mitoses in the epithelial and stromal tissues of mouse uteri were recorded after treatment with various doses of progesterone (P), levonorgestrel (LN), and STS 557 (17 alpha-cyanomethyl-17 beta-hydroxy-estra-4,9(10)-diene-3-one). All three progestins induced mitotic activity in the stromal tissue of the endometrium in which P and LN were much more active than STS 557. While the cell divisions in the luminal and glandular epithelium induced by P were only rare, LN and STS 557 enhanced the mitosis rates in these tissues significantly at a daily dose of 1.0 mg/animal on 5 consecutive days. The results are discussed with special regard to the post-coital antifertility effect of STS 557.