Cellular and humoral immune responses to adenovirus and p53 protein antigens in patients following intratumoral injection of an adenovirus vector expressing wild-type. P53 (Ad-p53)

The immune responses of 10 patients with advanced non-small cell lung cancer receiving monthly intratumoral injections of a recombinant adenovirus containing human wild-type p53 (Ad-p53) to adenovirus and transgene antigens were studied. The predominate cellular and humoral immune responses as measured by lymphocyte proliferation and neutralizing antibody (Ab) formation were to adenovirus serotype 5 vector antigens, with increased responses in posttreatment samples. Consistent alterations in posttreatment cellular and humoral immune responses to p53 epitopes were not observed, and cytotoxic Abs to human lung cancer cells were not generated. Patients in this study had evidence of an antitumoral effect of this treatment with prolonged tumor stability or regression; however, neither Abs to p53 protein nor increased lymphocyte proliferative responses to wild-type or mutant p53 peptides have been consistently detected.

Localization of epileptogenic zones in F-18 FDG brain PET of patients with temporal lobe epilepsy using artificial neural network

For an objective interpretation of cerebral metabolic pattern to find epileptogenic zones in patients with temporal lobe epilepsy (TLE), we developed a computer-aided classifier using an artificial neural network (ANN). We studied 261 epilepsy patients diagnosed as no abnormal findings (NA, n = 64), left TLE (n = 116), or right TLE (n = 81) on interictal brain F-18-fluorodeoxyglucose positron emission tomography (FDG PET) by the consensus of two expert physicians. Seventeen asymmetry indexes between the mean counts of the 34 mirrored regions were extracted from the spatially normalized images and used as input parameters. The three diagnoses of NA, left TLE, and right TLE were used as outputs of the ANN. The structure of the ANN was optimized with variable error goals and the number of hidden units. On the criteria of agreement of diagnoses with those of expert viewers, the best classifier was chosen, which yielded a maximum average agreement of 85% for the test set when we used an error goal of 20 (sum of squared error) and ten hidden units. We could devise an ANN that performed as well in diagnosing left or right TLE on FDG PET as human experts and could be used as a clinical decision support tool.

Cloning and characterization of the human novel gene encoding 6.2 kDa protein highly expressed upon ultraviolet irradiation in DNA-PK-deleted human glioma M059J cells

The full length of a gene isolated using a methylated DNA binding column as previously reported (Cross et al., 1994) has been cloned. The gene encodes 55 amino acids (6.2 kDa), and has a transcript of approximately 0.45 kb. It has 2 exons in the genome. After searching for sequence homology (BLAST), a homology to hypothetically 6.3 kDa protein located at cosmid ZK652 (protein P34660; EMBL Accession No. L14429) of C. elegans chromosome 3 was noted (51.9% amino acid homology). It has 1 site (-SQ-) for DNA-dependent protein kinase (DNA-PK) phosphorylation and 2 sites of myristilation. This novel gene is very strongly expressed (about 25.6 times) in DNA-PK-deleted human glioma cell line (M059J) 2 hrs after ultraviolet (UV) irradiation compared to the DNA-PK +/+ cell line (M059K) which expresses the gene at a relatively low level (about 7.5 times). Therefore, this result suggests that DNA-PK may negatively regulate the transcriptional level of this gene in M059K cells upon UV damage (50 J/m2), associated with cell toxicity.

Novel approaches to locally advanced unresectable non-small cell lung cancer

The management of advanced non-small cell lung cancer (NSCLC) is rapidly evolving. Advances in combined chemo-radiation therapy have led to improvements in patient survival which are statistically significant, but most patients still succumb to their disease. New chemotherapeutic agents, such as taxanes (paclitaxel, docetaxel), topoisomerase inhibitors (topotecan, irinotecan), and novel analogs (gemcitabine, vinorelbine), may offer the promise of improved outcome, but have not yet been tested in phase III trials. Molecular therapeutics, such as gene therapy, drugs that target specific oncogene activation (such as Ki-ras inactivation by farnesyl transferase inhibitors), and hypoxic cell toxins (such as tirapazamine), are in clinical trials. The optimum use of these agents awaits more rapid and widespread molecular diagnostics. Finally, technological advances in radiotherapy will allow higher tumor doses, while minimizing doses to dose-limiting normal structures, such as the esophagus, normal lung and heart. We describe a move towards molecular strategies, both for therapy and diagnostics, that may result in more effective treatment. While the outcome for patients with advanced non-small cell lung carcinoma is still poor, new agents are being developed rapidly and offer the hope of improved survival.

Follicle-stimulating isohormones: regulation and biological significance

Follicle-stimulating hormone (FSH) is a key hormone in the regulation of follicular development. Although the existence of FSH heterogeneity is well established, the physiological significance of this pleomorphism remains unknown. Observed changes in circulating FSH heterogeneity during critical reproductive events such as puberty and reproductive cyclicity suggest that different combinations of FSH isoforms reach the target sites during different physiological states to influence a variety of biological end points such as cellular growth, development, steroidogenesis and protein synthesis. Considering that these FSH isoforms have different physicochemical properties and potential to bind not only their cognate receptors but also structurally related, non-FSH receptors with various affinities, the regulatory implications of FSH heterogeneity in modulating the various FSH-induced functions are enormous. However, assigning functional significance to FSH heterogeneity has been hampered because of (1) difficulties associated with procurement of highly purified, naturally occurring, circulating FSH isoforms; (2) absence of reference standards that contain the entire repertoire of FSH isoforms present in biological fluids; and (3) specificity issues inherent to the detection systems used. If particular FSH isoforms do possess selective biological functions, specific combinations of FSH isoforms could be generated to regulate fertility in farm animals and humans.

Erythroid Kruppel-like factor is recruited to the CACCC box in the beta-globin promoter but not to the CACCC box in the gamma-globin promoter: the role of the neighboring promoter elements

The programmed expression of the five beta-like globin genes (epsilon, (A)gamma, (G)gamma, delta, and beta) is characterized by a series of switches that are developmentally regulated. The (A)gamma- and (G)gamma- (fetus) to beta-globin (adult) switch depends on transcription factor erythroid Krüppel-like factor (EKLF), which, like Sp1, binds to CACCC boxes. EKLF is essential for the expression of the beta-globin but not the gamma-globin gene. Because both gamma-globin and beta-globin promoters contain the CACCC box, and their promoter elements are similar, it is not known why the two promoters behave so differently. In this report, we searched for the functional differences between the two promoters by studying their ability to recruit EKLF. We used the in vivo PIN*POINT assay to show that EKLF is recruited to the beta-globin promoter but not to the gamma-globin promoter. We show that this selectivity is a result of differences in surrounding promoter elements and not CACCC box alone. One of the differences between the two promoters with a functional consequence is the CCTTG repeat that is present in the gamma-globin promoter but not in the beta-globin promoter. The repeat, when inserted in the beta-globin promoter, decreases EKLF recruitment to and activity of the beta-globin promoter, suggesting that the repeat functions as a suppressor element. The CCTTG repeat can also suppress the SV40 promoter in cis, and the suppressor factor binding to the repeat can be squelched with a plasmid containing a high copy number of the repeat. These findings may have implications in designing drug targets for treatment of beta-globin disorders.

hCds1-mediated phosphorylation of BRCA1 regulates the DNA damage response

Mutations in the BRCA1 (ref. 1) tumour suppressor gene are found in almost all of the families with inherited breast and ovarian cancers and about half of the families with only breast cancer. Although the biochemical function of BRCA1 is not well understood, it is important for DNA damage repair and cell-cycle checkpoint. BRCA1 exists in nuclear foci but is hyperphosphorylated and disperses after DNA damage. It is not known whether BRCA1 phosphorylation and dispersion and its function in DNA damage response are related. In yeast the DNA damage response and the replication-block checkpoint are mediated partly through the Cds1 kinase family. Here we report that the human Cds1 kinase (hCds1/Chk2) regulates BRCA1 function after DNA damage by phosphorylating serine 988 of BRCA1. We show that hCds1 and BRCA1 interact and co-localize within discrete nuclear foci but separate after gamma irradiation. Phosphorylation of BRCA1 at serine 988 is required for the release of BRCA1 from hCds1. This phosphorylation is also important for the ability of BRCA1 to restore survival after DNA damage in the BRCA1-mutated cell line HCC1937.

Cloning and characterization of cDNA encoding zebrafish Danio rerio NM23-B gene

A full-length zebrafish NM23-B cDNA was cloned and sequenced. The zebrafish NM23-B cDNA consists of 624bp with an open reading frame of 153 amino acids. NM23-B mRNA of approximately 0.7kb is present in adult zebrafish tissues. Zebrafish NM23-B his-tagged protein (17kDa) was produced in E. coli and characterized by binding and UV-cross-linking to a single-stranded telomeric repeat (TTAGGG)(6). This is the first report to show that fish have a NM23-H2 homologue that is similar to that in humans.

NTR1 encodes a floral nectary-specific gene in Brassica campestris L. ssp. pekinensis

We have characterized a gene specifically expressed in the floral nectaries of Brassica campestris L. ssp. pekinensis. Differential screening led to the isolation of a floral nectary-specific cDNA clone. Northern hybridization indicated that its mRNA transcript is 1450 nucleotides long and specific to the flower base. In situ hybridization and immunolocalization showed that its mRNA and protein are localized specifically to both the lateral and median nectaries of flowers. The cDNA codes for a 43.8 kDa polypeptide 392 amino acids long. The protein was named nectarin1 (NTR1) after floral nectary protein. NTR1 was located in the cytoplasm of nectariferous cells in the nectaries and was also observed in nuclei at a much lower level. The level of the transcript increases with flower development, especially during nectary development, but decreases abruptly with the opening of the flower. Genomic Southern blot analysis indicated that at least three copies of homologous genes were present in the genome of B. campestris, but that only a single copy was present in both Arabidopsis thaliana and Lycopersicon esculentum. The deduced amino acid sequence of NTR1 shows similarity to S-adenosyl-L-methionine:salicylic acid carboxyl methyltransferase of Clarkia breweri which is expressed mostly in petals. The function of the gene is speculated to be involved in the methylation of a plant secondary metabolite in the floral nectaries.

Continuous ethanol production from concentrated wood hydrolysates in an internal membrane-filtration bioreactor

Continuous culture for the production of ethanol from wood hydrolysate was carried out in an internal membrane-filtration bioreactor. The hydrolysate medium was sterilized at a relatively low temperature of 60 degrees C with the intention of reducing the formation of inhibitory compounds during the sterilization. The maximum ethanol concentration and productivity obtained in this study were 76.9 g/L and 16.9 g/L-h, respectively, which were much higher than those (57.2-67 g/L and 0.3-1.0 g/L-h) obtained in batch cultures using hydrolysate media sterilized at 60 degrees C. The productivity was also found to be much higher than that (6.7 g/L-h) obtained in a continuous cell retention culture using a wood hydrolysate sterilized at 121 degrees C. These results show that the internal membrane-filtration bioreactor in combination with low-temperature sterilization could be very effective for ethanol production from wood hydrolysate.

The Internally Self-fertilizing Hermaphroditic Teleost Rivulus marmoratus (Cyprinodontiformes, Rivulidae) beta-Actin Gene: Amplification and Sequence Analysis with Conserved Primers

To determine the ease and feasibility of amplifying the beta-actin gene in fish by the polymerase chain reaction (PCR), genomic DNAs of several fish (Rivulus, Southern top mouth minnow, common fat minnow, oily bitterling, carp, Far Eastern catfish, medaka, and European flounder) were extracted and used as a template with conserved primers, designed on the basis of high amino acid homology (approximately 98% or more). Among them, the self-fertilizing hermaphroditic fish Rivulus marmoratus was chosen for further characterization. After amplification of the Rivulus beta-actin PCR product with Taq polymerase, PCR product was subcloned to pCRII vector. After restriction enzyme mapping of Rivulus beta-actin gene, the amplified insert was sequenced using ALF Express automatic DNA sequencer with conserved internal primers. The R. marmoratus beta-actin gene consists of 1763 bp encoding 375 amino acids including 5 exons and 4 introns. The splicing and acceptance sites of the exon and intron boundaries of the Rivulus beta-actin gene were highly conserved with consensus sequences (GT/AG). The amino acid homology of R. marmoratus beta-actin to other species was high: 98.93% to human; 98.93%, Atlantic salmon; 98.93%, common carp; 98.93%, grass carp; 98.93%, zebrafish; 98.67%, medaka; and 98.40%, sea bream. To determine the expression of the R. marmoratus beta-actin gene in liver and ovary, reverse transcriptase-polymerase chain reaction was carried out with internal primers. In conclusion, these universal primers are successful in the rapid cloning of the fish beta-actin gene by PCR, based on a high homology of the beta-actin gene conserved through evolution. This approach will be applicable to the isolation of other beta-actin homologues in the investigation of phylogenetic comparisons of fish species, along with a possible application to cloning strategy in other conserved genes.

Bilateral emphysematous pyelonephritis with perirenal abscess cured by conservative therapy

Emphysematous pyelonephritis is a rare life-threatening infection of the renal parenchyma. It usually affects unilateral kidney and occurs mostly in diabetic patients. It is characterized by the presence of gas within the renal parenchyma and requires prompt diagnosis and early aggressive therapy. Bilateral emphysematous pyelonephritis is even more rare and is associated with high mortality. We describe a case of a 62-year-old diabetic woman who presented with nonketotic hyperosmolar coma and bilateral emphysematous pyelonephritis caused by Klebsiella pneumoniae. Diagnosis of bilateral emphysematous pyelonephritis was confirmed by an abdominal computed tomographic scan and microbiologic studies. Our patient was successfully treated using percutaneous catheter drainage and long-term antibiotic therapy.

Fusion of coregistered cross-modality images using a temporally alternating display method

As an aid to the interpretation of functional images, cross-modality coregistration of functional and anatomical images has grown rapidly. Various ways of easily interpreting and visualising coregistered images have previously been investigated; for their display, an intensity-weighted temporally alternating method is used. For brain images, geometric registration involves the automatic alignment method, using the head scalp boundary extracted from the sinogram of a PET emission scan and a surface-matching algorithm; images of the chest or abdomen are registered semi-automatically using a paired point matching algorithm. For the simultaneous display of geometrically registered images, rapid image switching is applied; both images are written with independent colour scales. The rapidly alternating display of two images, synchronised with monitor scanning, induces the fusion of images in the human visual perception system. The accuracy of registration of PET and MRI images is within 2 mm for two point sets. A resulting image is intensified by weighting the display time and/or controlling the intensity map of each image with the degree of interest. This method may be useful for the interpretation and visualisation of coregistered images.

The management of superior sulcus tumors

Lung cancers arising from the extreme apex of the lung-superior sulcus tumors (SST)-have distinct symptoms and signs at presentation and a characteristic appearance on imaging. However, in their early stages, these tumors are often missed by traditional anterior/posterior chest X-rays. Recent advances in computed tomography (CT) and magnetic resonance imaging (MRI) have made selection of patients with potentially resectable of SST more accurate. If mediastinoscopy reveals no mediastinal lymph nodes involved, the patient can be treated with surgery followed by radiation therapy with or without chemotherapy. If mediastinoscopy reveals microscopic mediastinal lymph node involvement, the patient can be treated with induction radiation therapy and concurrent chemotherapy followed by surgery. If mediastinoscopy reveals gross mediastinal lymph node involvement (N2), or if CT reveals N3 or T4 lesions, the patient can be treated with concurrent chemotherapy and radiation therapy to relieve symptoms; the outcome of such treatment appears to be better than that of sequential chemotherapy followed by radiation therapy. Whenever possible, to enhance the patient's quality of life, surgery should be considered to improve function and relieve pain.

Transtubular potassium concentration gradient (TTKG) and urine ammonium in differential diagnosis of hypokalemia

BACKGROUND

Hypokalemia is a common and sometimes serious clinical problem, whose etiological diagnosis can frequently be based on the patient's history and the clinical setting. Measurement of urinary indices such as excretory rate of K+, random urine K+ concentrations and blood acid-base parameters have been employed in the pathophysiological diagnosis, though with some pitfalls.

METHODS

To investigate the diagnostic usefulness of the transtubular potassium concentration gradient (TTKG) and urine ammonium in the differentiation of hypokalemia, we measured serum K+ and osmolality, random urine electrolytes, osmolality and ammonium, the urinary [Na]/[K] ratio (U(Na)/K), plasma aldosterone and TTKG in 7 patients with diarrhea, 6 with vomiting, 7 with mineralocorticoid excess, 6 with diuretic usage, and compared them with those of 7 overnight fasted and acid-loaded healthy volunteers.

RESULTS

The urine K+ concentrations did not reflect urinary loss of potassium according to the subjects' hydration status. U(Na)/k in the hypokalemic patients with mineralocorticoid excess (1.4 +/- 0.5) was lower than in normal subjects (2.3 +/- 0.4) (p<0.05). TTKG was higher in hypokalemic patients with mineralocorticoid excess (13.3 +/- 4.4) and diuretic usage (8.6 +/- 1.3) and lower in those with diarrhea (1.6 +/- 0.3) than in the normal controls (5.0 +/- 0.7) (p<0.5). TTKG in the patients with vomiting (3.5 +/- 0.6) was the same as in normal controls. TTKG was stronger correlated with the plasma aldosterone levels in the hypokalemic patients due to renal potassium loss. Urine ammonium concentrations of the acid-loaded normal subjects (73.3 +/- 5.0 mEq/L), patients with diarrhea (74.4 +/- 2.0 mEq/L) and patients with mineralocorticoid excess (68.7 +/- 6.9 mEq/L) were higher than in overnight-fasted normal subjects (31.3 +/- 4.9 mEq/L).

CONCLUSION

TTKG and random urine ammonium were useful in the pathophysiological differential diagnosis of hypokalemia.

Detection of Hantaan and Seoul viruses by reverse transcriptase-polymerase chain reaction (RT-PCR) and restriction fragment length polymorphism (RFLP) in renal syndrome patients with hemorrhagic fever

BACKGROUND

Hemorrhagic fever with renal syndrome (HFRS), also called Korean hemorrhagic fever (KHF), is the most common cause of acute renal failure in the Far East. Two serotypes of hantavirus, Hantaan and Seoul viruses are known pathogens for HFRS in Korea.

PURPOSE

To elucidate the diagnostic applicability for the serotype diagnosis in HFRS patients, we used nested reverse transcriptase-PCR and restriction fragment length polymorphism (nRT-PCR/RFLP) to screen 2 prototype viruses, 11 virus isolates from HFRS patients, and 69 specimens obtained from 31 HFRS patients.

METHODS

The nRT-PCR was performed using primers specific for the G1 segments of the Hantaan (HF3 1140-1163, HB14 1363-1342) and Seoul (SF2 809-832, SB3 1200-1177) viruses. The initial PCR products were then further amplified using nested primers for the Hantaan (HF4 1141-1164, HB13 1360-1339) and Seoul (SF7 863-884, SB1 1165-1142 ) viruses. Amplified segments were then digested with restriction enzymes specific for either Hantaan (C1a I) or Seoul (Sac I) virus sequences.

RESULTS

In all cultured viruses, the serotypes identified by nRT-PCR/RFLP were consistent with those of PRNT. nRT-PCR/RFLP results indicated the presence of Hantaan virus in 10 patients and of Seoul virus in 15 patients. In 3 patients, both Hantaan- and Seoul-specific amplified bands were visualized in serially collected samples, and in 4 patients no amplicon was detected. Among 69 specimens, 55 were positive; these positive specimens were obtained between days 3 and days 33 of illness. The positive rate was not affected by the clinical phase, day of illness, or severity of HFRS.

CONCLUSIONS

nRT-PCR/RFLP is a rapid and convenient method for serotype diagnosis in most HFRS patients. It could also allow detection of genetic variation of hantavirus within the same serotype.

The possible cost effectiveness of peripheral blood stem cell mobilization with cyclophosphamide and the late addition of G-CSF

The purpose of this study was to develop a cost-effective protocol for the mobilization of peripheral blood stem cells (PBSC) in patients with malignancy. Thirty consecutive patients were randomized to mobilize PBSC with the late addition of a standard 250 microg dose of G-CSF (Neutrogen) from day 8 or early addition of the same dose of G-CSF from day 2, following cyclophosphamide (CY) 4 g/m2. The median yield of CD34+ cells from evaluated patients was 7.87 x 10(6)/kg (range, 2.06-27.25), collected in a median of four apheresis (range, 2-9). Target CD34 + cell doses > or = 2.0 x 10(6)/kg were achieved in all patients able to be evaluated. There were no statistically significant differences in CD34+ cell yields or toxicities. Overall engraftment occurred with median days to neutrophils > or = 0.5 x 10(9)/L or platelets > 20 x 10(9)/L of 11 and 17 days, respectively. However, the duration of G-CSF administration was markedly shorter in the late use of G-CSF group than in the early use of G-CSF group, with a median of 9 days compared with 15 days (p<0.001). PBSC harvesting after priming with CY plus delayed use of G-CSF made it a safe and cost-effective procedure.

Adenovirus-mediated p53 gene transfer in sequence with cisplatin to tumors of patients with non-small-cell lung cancer

PURPOSE

To determine the safety and tolerability of adenovirus-mediated p53 (Adp53) gene transfer in sequence with cisplatin when given by intratumor injection in patients with non-small-cell lung cancer (NSCLC).

PATIENTS AND METHODS

Patients with advanced NSCLC and abnormal p53 function were enrolled onto cohorts receiving escalating dose levels of Adp53 (1 x 10(6) to 1 x 10(11) plaque-forming units [PFU]). Patients were administered intravenous cisplatin 80 mg/m(2) on day 1 and study vector on day 4 for a total of up to six courses (28 days per course). Apoptosis was determined by the terminal deoxynucleotidyl- transferase-dUTP nick-end labeling assay. Evidence of vector-specific sequences were determined using reverse-transcriptase polymerase chain reaction. Vector dissemination and biodistribution was monitored using a series of assays (cytopathic effects assay, Ad5 hexon enzyme-linked immunosorbent assay, vector-specific polymerase chain reaction assay, and antibody response assay).

RESULTS

Twenty-four patients (median age, 64 years) received a total of 83 intratumor injections with Adp53. The maximum dose administered was 1 x 10(11) PFU per dose. Transient fever related to Adp53 injection developed in eight of 24 patients. Seventeen patients achieved a best clinical response of stable disease, two patients achieved a partial response, four patients had progressive disease, and one patient was not assessable. A mean apoptotic index between baseline and follow-up measurements increased from 0.010 to 0.044 (P =.011). Intratumor transgene mRNA was identified in 43% of assessable patients.

CONCLUSION

Intratumoral injection with Adp53 in combination with cisplatin is well tolerated, and there is evidence of clinical activity.

Introduction of human immunodeficiency virus 2 infection into South Korea

Although human immunodeficiency viruses 1 and 2 (HIV-1 and HIV-2) share mode of transmission, their epidemiologic characteristics differ and international spread of HIV-2 has been limited. To investigate the extent of HIV-2 infection in South Korea and to clarify the characteristic of HIV-2 isolates, we describe epidemiological, serological and genetic analyses of five HIV-2 isolates from South Korea. Five of 964 HIV antibody-positive serum specimens showed positive reactivity by HIV1/2 enzyme immunoassay (EIA), HIV-2 Western blot analysis, HIV-2 particle agglutination (PA) test and line immunoassay (LIA) but negative or indeterminate one by HIV-1 PA test and HIV-1 Western blot analysis. To confirm HIV-2 infection by genetic analysis, reverse transcription-polymerase chain reaction (RT-PCR) was performed on five HIV-2 seropositive samples. PCR products from gag (197 bp) and env gene regions (137 bp) were obtained with three of the five samples with HIV-2 specific gag primers and with all the five samples with env primers. To obtain larger sequences for a more comprehensive phylogenetic analysis, we performed PCR for a 1191 bp env region of HIV-2 but only two such products were obtained. For the phylogenetic analysis, three 197 bp gag and two 1191 bp env PCR products were cloned and sequenced. Based on the gag and env sequences alignments, three isolates (KR4063, KR7051 and KR8091) were clustered phylogenetically within HIV-2 subtype A. In conclusion, HIV-2 virus is present in South Korea and was detected in five subjects. Furthermore, the prevalence of HIV-2 infection should be monitored continuously in South Korea to assess the spread of this virus and to assist in the diagnosis of HIV infection.

Value of morphometric nuclear image analysis using the Feulgen reaction in renal cell carcinoma

OBJECTIVE

To evaluate retrospectively the ability of morphometric nuclear image analysis to predict survival in patients with renal cell carcinoma.

STUDY DESIGN

The subjects were 40 patients with previously untreated renal cell carcinoma. Pathologic stage was determined using Robson's stage system. Nuclear grade was assigned according to the criteria of Fuhrman et al. We used the Feulgen staining technique, which has been widely used for the histochemical assessment of nuclear DNA content. A minimum of 300 nuclei were analyzed from each subject. Five variables in morphometric nuclear image analysis were measured: nuclear area, nuclear perimeter, nuclear ellipticity, nuclear regularity and DNA content. Cox's proportional hazard model was applied to identify prognostic usefulness with respect to survival time.

RESULTS

All nuclear morphometric variables but nuclear regularity correlated with tumor grade. According to univariate survival analyses, Robson stage and nuclear ellipticity revealed a prognosis on survival with statistical significance. After adjustments for age and sex, nuclear ellipticity remained the only significant prognostic factor related to survival (P < .01). The survival rates were relatively high for patients with nuclear ellipticity > 773 as compared to those with nuclear ellipticity < 773 (P < .05).

CONCLUSION

These findings indicate that morphometric nuclear image analysis using the Feulgen reaction is a reliable and efficient technique and that nuclear ellipticity is the most discriminating morphometric variable for predicting the prognosis of renal cell carcinoma patients.

Early expression of IFN-alpha/beta and iNOS in the brains of Venezuelan equine encephalitis virus-infected mice

To investigate the roles of type I interferon (IFN-alpha/beta) and other mediators of innate immune responses (e.g., inducible nitric oxide synthase [iNOS]) in early dissemination of Venezuelan equine encephalitis virus (VEE) infection, we used mice with targeted deletions in either their IFN-alpha/beta-receptor (IFNAR-1-/-) or interferon regulatory factor 2 (IRF-2-/-) genes. Following footpad infection, both IFNAR-1-/- and IRF-2-/- mice were more susceptible than control mice to VEE. The IFNAR-1-/- mice also exhibit accelerated VEE dissemination to serum, spleen, and brain, and compared with control mice, they evidenced faster kinetics in the upregulation of proinflammatory genes. In contrast, in IRF-2-/- mice, iNOS gene induction was completely absent following peripheral virulent VEE infection. In evaluating the role of cells involved in iNOS production, primary microglial cell cultures were found to be highly permissive to VEE infection. Moreover, VEE infection increased levels of nitric oxide (NO) in resting microglial cultures but decreased NO production in IFN-gamma-stimulated microglia. Thus, these findings suggest that reactive nitrogen species play an important contributory role in VEE dissemination and survival of the host. Our results further suggest the necessity for a carefully balanced host response that follows a middle course between immunopathology and insufficient inflammatory response to VEE infection.

Fracture toughness of resin-based luting cements

STATEMENT OF PROBLEM

The introduction of resin-modified glass ionomer cements has expanded the choices of luting cements available to the clinician; however, few independent studies are available on the fracture toughness of the currently available resin-modified glass ionomer luting agents compared with the composite cements.

PURPOSE

This investigation evaluated the relative fracture toughness (K(IC)) of 3 composite luting cements (Panavia 21, Enforce, and C&B Metabond), 3 resin-modified glass ionomer luting cements (Advance, Vitremer Luting, and Fuji Duet), and a conventional glass ionomer luting cement (Ketac-Cem) at 24-hour and 7-day storage times.

MATERIAL AND METHODS

K(IC) was determined by preparing minicompact test specimens (n = 8) with introduced precracks. Specimens were stored in distilled water at 37 degrees C + 2 degrees C until testing. Testing was performed on an Instron testing machine at a displacement rate of 0.5 mm/min.

RESULTS

ANOVA (P <.001) and REGW Multiple Range Test (P <.05) demonstrated significant differences among several of the cements tested. The mean fracture toughness values of C&B Metabond at 24 hours and Enforce at both 24 hours and 7 days were significantly greater than use any of the other cements tested.

CONCLUSION

The resin-modified glass ionomer cements exhibited improved fracture toughness when compared with the conventional glass ionomer; however, they were still inferior to Enforce and C&B Metabond composite cements.

Influences of dietary uptake and reactive sulfides on metal bioavailability from aquatic sediments

Understanding how animals are exposed to the large repository of metal pollutants in aquatic sediments is complicated and is important in regulatory decisions. Experiments with four types of invertebrates showed that feeding behavior and dietary uptake control bioaccumulation of cadmium, silver, nickel, and zinc. Metal concentrations in animal tissue correlated with metal concentrations extracted from sediments, but not with metal in porewater, across a range of reactive sulfide concentrations, from 0.5 to 30 micromoles per gram. These results contradict the notion that metal bioavailability in sediments is controlled by geochemical equilibration of metals between porewater and reactive sulfides, a proposed basis for regulatory criteria for metals.

Anti-A isoagglutinin as a risk factor for the development of pure red cell aplasia after major ABO-incompatible allogeneic bone marrow transplantation

Delayed erythropoiesis and pure red cell aplasia (PRCA) have been reported after major ABO-incompatible BMT. We attempted to find risk factors for the development of PRCA in 27 patients who underwent major ABO-incompatible BMT. In all patients, the donor marrow was depleted of RBCs before infusion. In 22 patients, isoagglutinins were determined until they disappeared. In eight (29.6%) out of 27 patients, bone marrow examination following BMT showed the findings of PRCA. We analyzed various clinico-pathologic risk factors and isoagglutinin type was the only significant risk factor. Patients with anti-A isoagglutinins against donor RBC developed PRCA more frequently than patients with anti-B (8/17 vs 0/9). Median days to the disappearance of isoagglutinins tended to be longer in patients with PRCA (PRCA vsnon-PRCA, 200 vs 66 days) and in cases with anti-A isoagglutinins (anti-A vsanti-B, 160 vs 51 days). Times to disappearance of isoagglutinins correlated with times to reticulocytes over 1% and initial appearance of donor type RBC (R2 = 0.708 and 0.711). In conclusion, RBC engraftment following major ABO-incompatible BMT was dependent on the disappearance of isoagglutinins against donor RBC, and anti-A isoagglutinin was a risk factor for the development of PRCA after major ABO-incompatible allogeneic BMT. Bone Marrow Transplantation (2000) 25, 179-184.