The IsdA gene is necessary for sexual development inhibition by a salt in Aspergillus nidulans

Using one of 17 expressed sequence tags (ESTs) previously identified as specific to the late sexual developmental (LSD) stage of Aspergillus nidulans, a gene for the subject EST was isolated. The determined DNA sequences revealed an open reading frame encoding a 356 amino acid polypeptide which does not share a sequence similarity to previously identified genes or proteins. The isolated gene was named lsdA (late sexual development), since it was expressed abundantly at the LSD stage. The lsdA gene expression began earlier than at the LSD stage. Disruption of the lsdA gene in the veA+ background strongly induced sexual development under conditions where sexual development in wild-type strains is almost completely inhibited. In contrast, in the veA1 background, an lsdA null mutant failed to show any phenotypic difference in sexual development under the various conditions tested. These results indicate that the lsdA gene may be responsible for inhibiting the sexual development of veA+ strains by a high concentration of a salt.

Ovarian expression of melatonin Mel(1a) receptor mRNA during mouse development

Melatonin, secreted by the pineal gland, is involved in the regulation of many physiological functions of various species of animals. In the present study, the expression of gene for melatonin Mel(1a) receptor (MelR) was evaluated in the ovary, hypothalamus, and pituitary according to the developmental stages in female mice. Semiquantitative reverse-transcription polymerase chain reaction (RT-PCR) and in situ PCR techniques were applied. According to the developmental stages, gene for MelR was differently expressed on ovary, hypothalamus, and pituitary. MelR gene was first expressed on pituitary prior to the expression in hypothalamus and ovary. Ovarian MelR gene started to express at birth. Unlike hypothalamic expression of MelR gene which was identified after birth, in pituitary, it was expressed at 16 days post coitum. In the ovary, the expression signal of MelR gene was identified on granulosa cells. However, the signal was not detected in the theca cells. It was weak in the primordial and atretic follicles. Taken together, it can be considered that melatonin has a pivotal role in the folliculogenesis.

High dose chemotherapy as adjuvant treatment in operable breast cancer with 10 or more involved axillary lymph nodes

BACKGROUND

it is well known that breast cancer patients with more than 10 axillary lymph nodes involved have poor prognosis even with extensive adjuvant chemotherapy. To improve this poor outcome, high-dose adjuvant chemotherapy has been applied to the these patients. This study was intended to clarify the efficacy and usefulness of high dose adjuvant chemotherapy (HDC) for high-risk breast cancer patients and its efficacy was compared with conventional adjuvant chemotherapy (non-HDC group).

PATIENTS AND METHODS

Twelve patients with breast cancer involving more than 10 axillary nodes received high-dose chemotherapy with peripheral progenitor-stem cell transplantation (PBSCT). This regimen consists of BCNU (carmustine) 130 mg/m(2) x 3, CBDCA (carboplantin) 500 mg/m(2) x 3 and CPA (chyclophosphamide) 50 mg/kgx 2 after induction chemotherapy with 3 cycles of CE (chyclophosphamide 600 mg/m(2), epirubicin 60 mg/m(2)).

RESULTS

Twelve patients completed the high-dose chemotherapy regimen as planned, no patient died of chemotherapy related toxicity. After a median follow-up period of 44 months, disease-free and overall survival at 48 months after the operation for 12 patients determined by Kaplan-Meier methods was 63 % and 83 %, respectively. Disease-free survival was superior in the high-dose chemotherapy group compared with the control group but a statistical difference was not observed.

CONCLUSION

High-dose chemotherapy seems to be an effective and feasible treatment for high-risk breast cancer patients. However, the usefulness of high-dose adjuvant chemotherapy for high-risk breast cancer patients should be confirmed by a large-scale randomized trial.

Combinatorial control of prion protein biogenesis by the signal sequence and transmembrane domain

The prion protein (PrP) is synthesized in three topologic forms at the endoplasmic reticulum. (sec)PrP is fully translocated into the endoplasmic reticulum lumen, whereas (Ntm)PrP and (Ctm)PrP are single-spanning membrane proteins of opposite orientation. Increased generation of (Ctm)PrP in either transgenic mice or humans is associated with the development of neurodegenerative disease. To study the mechanisms by which PrP can achieve three topologic outcomes, we analyzed the translocation of proteins containing mutations introduced into either the N-terminal signal sequence or potential transmembrane domain (TMD) of PrP. Although mutations in either domain were found to affect PrP topogenesis, they did so in qualitatively different ways. In addition to its traditional role in mediating protein targeting, the signal was found to play a surprising role in determining orientation of the PrP N terminus. By contrast, the TMD was found to influence membrane integration. Analysis of various signal and TMD double mutants demonstrated that the topologic consequence of TMD action was directly dependent on the previous, signal-mediated step. Together, these results reveal that PrP topogenesis is controlled at two discrete steps during its translocation and provide a framework for understanding how these steps act coordinately to determine the final topology achieved by PrP.

Methoxy[meso-5,10,15,20-tetrakis(2,6-difluorophenyl)porphyrinato]iron(III), [Fe(TDFPP)(OCH3)]

The crystal structure of the title compound, [Fe(C(44)H(20)F(8)N(4))(CH(3)O)], has been determined. The Fe atom lies 0.485 (1) A out of the plane of the four N atoms to which it is coordinated and from the inversion centre at the origin of the unit cell. The methoxy group is axially coordinated to the Fe atom with O-Fe-N angles of 106.3 (2) and 102.4 (2) degrees, a C-O-Fe angle of 128.3 (5) degrees and an Fe-O distance of 1.788 (5) A. Difluorophenyl rings are tilted from the porphyrin (por) plane with torsion angles of -68.1 (6) and 77.7 (5) degrees across the two C(por)-C-C-C(ar) systems.

Midterm outcome of partially thrombosed intracranial aneurysms treated with guglielmi detachable coils

SUMMARY

We evaluated the results of Guglielmi detachable coil (GDC) treatment in partially thrombosed aneurysms and determined if there is high rate of recanalisation on follow-up. Among 149 treated aneurysms in 141 patients, 25 CT- or MR-confirmed partially thrombosed aneurysms were selected for evaluation. The features of thrombosed aneurysms and percentage of occlusion were analysed on initial angiograms. Follow-up angiograms, which were available in 18 cases, were evaluated for aneurysm lumen recanalisation. The recanalisation rate was compared with that of non-thrombosed aneurysms treated with GDCs. Locations of aneurysms were as follows: cavernous carotid ten; ophthalmic four; p-com. two; MCA one; A-com. one; basilar tip four; midbasilar two; PICA one. The size of the aneurysm lumen ranged from 5 to 30 mm (mean 16.8 mm) on angiograms, but on cross sectional images the size of aneurysms ranged from 13 to 70 mm (mean 24.6 mm). The extent of aneurysmal thrombosis ranged from 10 to 90 per cent (mean 46.4 per cent). On initial GDC treatment, total to subtotal occlusion was achieved in 18 cases out of 25 (72%). Of the 18 follow-up angiograms, 14 cases (77.8%) showed recanalisation ranging from 10 to 60 per cent of aneurysm size. Luminal recanalisation was due to migration (10 of 14) or compaction (4 of 14) of coil masses. In two cases, symptoms recurred in association with aneurysm recanalisation, but in no instance was haemorrhage noted. Attempts for retreatment were made in ten cases with success in six. In comparison, 14 (15.9%) out of 88 nonthrombosed cases revealed recanalisation on follow-up angiography. Midterm follow-up angiograms in partially thrombosed aneurysms treated with GDC revealed a fivefold higher rate of recanalisation than in non-thrombosed cases. Close follow-up is necessary in patients with thrombosed aneurysms treated with GDCs.

GDC Embolisation of Cavernous Internal Carotid Artery Aneurysms with Parent Artery Preservation

SUMMARY

We evaluated the clinical and angiographic results of endosaccular treatment with Guglielmi detachable coils (GDCs) in 19 cases of cavernous internal carotid artery (ICA) aneurysms. The size of the aneurysms ranged from 10 to 30 mm (mean 18.4 mm) and neck size ranged from 2 to 15 mm (mean 6.7 mm). Intraluminal thrombosis was found in ten cases. Main presenting symptoms were related to mass effect in 17 cases including cranial nerve palsy, headache and vomiting. On initial GDC embolisation, total occlusion was obtained in two cases, subtotal in eight, and incomplete in nine. In two cases with incomplete occlusion, parent arteries were occluded with balloons or GDCs during or just after the procedure because of underlying diseases. A higher rate of initial occlusion was obtained in smaller and non-thrombosed aneurysms. Symptoms resolved or improved in all cases except one after initial treatment. No complication occurred related to the procedure. Follow-up angiography was obtained in 15 cases among which ten cases (66.7%) showed luminal recanalisation. Symptoms recurred in one case with luminal recanalisation. Incidence of recanalisation was similar in both large and giant aneurysms but higher in the thrombosed than non-thrombosed group. Retreatment was done in five cases with success. In conclusion, although embolisation of cavernous ICA aneurysms with GDCs was safe and effective in relieving symptoms, the incidences of initial incomplete occlusion and follow-up recanalisation were high. Therefore, we think judicious selection of the cases is necessary for endosaccular GDC embolisation in cavernous ICA aneurysms.

Modulation of graft-versus-tumor effects in a murine allogeneic bone marrow transplantation model by tumor-derived transforming growth factor-betaI

Although graft-versus-leukemia effects in allogeneic bone marrow transplantation (alloBMT) are well documented, graft-versus-tumor (GVT) effects are poorly defined. To investigate the latter, we established a murine model of breast cancer using TS/A, a transforming growth factor (TGF)-beta1-secreting breast cancer cell line of BALB/c origin. In the setting of disparate (parent into F1) alloBMT, no appreciable GVT was identified. To assess whether TGF-beta1 secreted by the tumor might inhibit the antitumor response, TGF-beta1 antisense vector was transfected into the TS/A breast cancer cell line. Mice were inoculated with either TGF-beta1 antisense transfected or the mock transfected cell line and underwent syngeneic or alloBMT. No evidence of GVT was appreciated for the mock-transfected breast cancer cell line as assessed by an absence of a statistically significant difference in survival between syngeneic and alloBMT groups. However, there was a highly statistically significant survival difference between allogeneic versus syngeneic bone marrow transplantation groups inoculated with the TGF-beta1 antisense-transfected cell line (P = .00001) as well as when comparing the survival of mice that received alloBMT for TGF-beta1 antisense-transfected tumor versus mock-transfected tumor (P = .0008). These data suggest that (1) GVT exists against the antisense-transfected breast cancer cells in this experimental model and (2) TGF-beta1 may be involved in suppressing antitumor responses in the setting of alloBMT for breast cancer.

Conformation of a purified "spontaneously" inserting thylakoid membrane protein precursor in aqueous solvent and detergent micelles

Subunit W of photosystem II (PsbW) is a single-span thylakoid membrane protein that is synthesized with a cleavable hydrophobic signal peptide and integrated into the thylakoid membrane by an apparently spontaneous mechanism. In this study, we have analyzed the secondary structure of the pre-protein at early stages of the insertion pathway, using purified recombinant pre-PsbW. We show that the protein remains soluble in Tris buffer after removal of detergent. Under these conditions pre-PsbW contains no detectable alpha-helix, whereas substantial alpha-helical structure is present in SDS micelles. In aqueous buffer, the tryptophan fluorescence emission characteristics are intermediate between those of solvent-exposed and hydrophobic environments, suggesting the formation of a partially folded structure. If denaturants are excluded from the purification protocol, pre-PsbW purifies instead as a 180-kDa oligomer with substantial alpha-helical structure. Mature-size PsbW was prepared by removal of the presequence, and we show that this protein also contains alpha-helix in detergent but in lower quantities than the pre-protein. We therefore propose that pre-PsbW contains alpha-helical structure in both the mature protein and the signal peptide in nonpolar environments. We propose that pre-PsbW acquires its alpha-helical structure only during the later, membrane-bound stages of the insertion pathway, after which it forms a "helical hairpin"-type loop intermediate in the thylakoid membrane.

Formation and emission status of PCDDs/PCDFs in municipal solid waste incinerators in Korea

This study was carried out to examine the formation and the emission status of polychlorinated dibenzo-p-dioxins/polychlorinated dibenzofurans (PCDDs/PCDFs) in the flue gases of commercial-scale municipal solid waste (MSW) incinerators, and thus to provide the engineering data for the reduction of PCDDs/PCDFs emitted from MSW incinerators. The formation concentrations of the PCDDs/PCDFs generated at the outlet of waste heat boilers (WHB) were in the range of 1.18-29.61 ng-TEQ/N m3 (average 5.75 ng-TEQ/N m3), while the emission concentrations at the stacks were in the range of 0.026-4.548 ng-TEQ/N m3 (average 0.924 ng-TEQ/N m3). Two major 2,3,7,8-substituted congeners were 2,3,4,7,8-PeCDF and 2,3,4,6,7,8-HxCDF, and their concentrations were up to 50% and 64% of total TEQ values at the outlet of WHB and the stack, respectively. From the results of multi-regression analysis, the formation concentration of PCDDs/PCDFs could be predicted as follows with the correlation factor of r2 = 0.962: PCDDs/PCDFs (ng-TEQ/N m3) = 3.036 (Cl) + 0.094 (T1) - 0.472 (Combustibles) + 0.059 (CO) - 0.039 (THC) - 3.366 (H) + 22.157, where T1 (degrees C) is the temperature at the outlet of the WHB. Cl, Combustibles and H are given as percentages and the others are in parts per million.

Arch type pathologic suprapatellar plica

The authors encountered a case of arch type pathologic suprapatellar plica that was excised using an arthroscopic technique. It is reported with a review of the literature.

Arthroscopic anterior cruciate ligament reconstruction with quadriceps tendon composite autograft

At present, no single graft option clearly outperforms another. Autografts (patellar tendon, hamstring) and allografts (Achilles tendon, patellar tendon) are the grafts most often used. However, each grafts has advantages and disadvantages. Quadriceps tendon graft for anterior cruciate ligament reconstruction is not new, but an alternative composite graft is introduced here that consists of quadriceps tendon-patellar bone and bone obtained from a coring reamer used to create the tibial tunnel. This composite graft retains reduced morbidity while allowing the secure bone-to-bone fixation associated with bone-patellar tendon-bone graft.

Crystal structure of proteolytic fragments of the redox-sensitive Hsp33 with constitutive chaperone activity

Heat shock protein 33 (Hsp33) inhibits aggregation of partially denatured proteins during oxidative stress. The chaperone activity of Hsp33 is unique among heat shock proteins because the activity is reversibly regulated by cellular redox status. We report here the crystal structure of the N-terminal region of Hsp33 fragments with constitutive chaperone activity. The structure reveals that the N-terminal portion of Hsp33 forms a tightly associated dimer formed by a domain crossover. A concave groove on the dimeric surface contains an elongated hydrophobic patch that could potentially bind denatured protein substrates. The termini of the subunits are located near the hydrophobic patch, indicating that the cleaved C-terminal domain may shield the hydrophobic patch in an inactive state. Two of the four conserved zinc-coordinating cysteines are in the end of the N-terminal domain, and the other two are in the cleaved C-terminal domain. The structural information and subsequent biochemical characterizations suggest that the redox switch of Hsp33 occurs by a reversible dissociation of the C-terminal regulatory domain through oxidation of zinc-coordinating cysteines and zinc release.

Arthroscopically assisted treatment of avulsion fractures of the posterior cruciate ligament from the tibia

BACKGROUND

The attachment of the posterior cruciate ligament to the posterior intercondylar fossa of the tibia is in a location that is difficult to access for arthroscopic surgical procedures. This report presents a variety of arthroscopically assisted reduction and fixation methods for managing avulsion fractures of the posterior cruciate ligament from the tibia.

METHODS

Thirteen patients (fourteen knees) who had an avulsion fracture of the posterior cruciate ligament were treated with an arthroscopic procedure. Eleven patients underwent the operation in the acute phase (four to ten days after the injury), and two patients had delayed surgery (at nineteen and twenty months after the injury) because of nonunion. The choice of fixation method was based on the size of the avulsed fragment. Six knees that had a small bone fragment (<10 mm) with comminution were fixed with use of multiple sutures. Two knees that had a small bone fragment without comminution were fixed with 23-gauge wires. Two knees that had a medium-sized fragment (10 to 20 mm) were fixed with Kirschner wires. Four knees that had a large single fragment of bone (>20 mm) that involved the condyles were fixed with one or two cannulated screws.

RESULTS

All patients had osseous union as determined on radiographs. Three injured knees in two patients showed limitation of motion after the operation. These patients had been immobilized for two or three months after the surgery because of concomitant fractures. The eleven patients who had undergone the operation in the acute phase, including two in whom postoperative arthrofibrosis had developed, showed no or trace posterior instability following the procedure. However, the two patients in whom the surgery had been delayed had residual grade-I posterior instability. The postoperative side-to-side differences, when measured with use of the KT-2000 arthrometer and posterior stress radiographs, showed better results in the patients in whom the surgery had been performed in the acute phase than in the patients in whom the operation had been delayed.

CONCLUSION

Arthroscopic procedures can be used to treat tibial avulsion fractures of the posterior cruciate ligament.

Isolation and characterization of a symbiosis-regulated ras from the ectomycorrhizal fungus Laccaria bicolor

Ectomycorrhizae formed by the symbiotic interaction between ectomycorrhizal fungi and plant roots play a key role in maintaining and improving the health of a wide range of plants. Mycorrhizal initiation, development, and functional maintenance involve morphological changes that are mediated by activation and suppression of several fungal and plant genes. We identified a gene, Lbras, in the ectomycorrhizal fungus Laccaria bicolor that belongs to the ras family of genes, which has been shown in other systems to be associated with signaling pathways controlling cell growth and proliferation. The Lbras cDNA complemented ras2 function in Saccharomyces cerevisiae and had the ability to transform mammalian cells. Expression of Lbras, present as a single copy in the genome, was dependent upon interaction with host roots. Northern analysis showed that expression was detectable in L bicolor 48 h after interaction as well as in the established mycorrhizal tissue. Phylogenetic analysis with other Ras proteins showed that Lbras is related most closely to Aras of Aspergillus nidulans.

Removal efficiencies of PCDDs/PCDFs by air pollution control devices in municipal solid waste incinerators

Removal efficiencies of polychlorinated dibenzo-p-dioxins/polychlorinated dibenzofurans (PCDDs/PCDFs) by air pollution control devices (APCDs) in the commercial-scale municipal solid waste (MSW) incinerators with a capacity of above 200 ton/day were evaluated. The removal efficiencies of PCDDs/PCDFs were up to 95% when the activated carbon (AC) was injected in front of electrostatic precipitator (EP). Spray dryer absorber/bag filter (SDA/BF) had high removal efficiency (99%)) of PCDDs/PCDFs when a mixture of lime and AC was sprayed into the SDA. When the AC was not added in scrubbing solution, the whole congeners of PCDDs/PCDFs were enriched in the wet scrubber (WS) with negative removal efficiencies of -25% to -5731%. Discharge of PCDDs/PCDFs was decreased with increasing the proportions of AC added in scrubbing solution. Selective catalytic reduction (SCR) system had the removal efficiencies of up to 93% during the test operation.

Expression of corticotropin releasing factor, but not its binding protein, in CA1 pyramidal cells of gerbil hippocampus following transient ischemia

Recently, the ectopic expression of corticotropin-releasing factor (CRF) has been suggested as being associated with processes linked to neuronal injury and/or degeneration in response to a brain insult. However, there is little experimental data linking CRF directly to neuronal death induced by ischemia. Therefore, in the present study, we investigated the temporal and spatial alteration of CRF and its binding protein expressions in the hippocampus after transient ischemia. As a result, we found the selective increase of CRF immunoreactivity in the CA1 pyramidal cells and their processes at only 4 days post-ischemic insult. In contrast, CRF binding protein immunoreactivity was rarely detected in the CA1 region. These results suggest that transient ischemia may provoke selectively ectopic expression of CRF, but not of its binding protein, in vulnerable regions, and this enhancement of CRF may play important roles in the neurodegenerative process.

Global trends in resistance to antituberculosis drugs. World Health Organization-International Union against Tuberculosis and Lung Disease Working Group on Anti-Tuberculosis Drug Resistance Surveillance

BACKGROUND

Data on global trends in resistance to antituberculosis drugs are lacking.

METHODS

We expanded the survey conducted by the World Health Organization and the International Union against Tuberculosis and Lung Disease to assess trends in resistance to antituberculosis drugs in countries on six continents. We obtained data using standard protocols from ongoing surveillance or from surveys of representative samples of all patients with tuberculosis. The standard sampling techniques distinguished between new and previously treated patients, and laboratory performance was checked by means of an international program of quality assurance.

RESULTS

Between 1996 and 1999, patients in 58 geographic sites were surveyed; 28 sites provided data for at least two years. For patients with newly diagnosed tuberculosis, the frequency of resistance to at least one antituberculosis drug ranged from 1.7 percent in Uruguay to 36.9 percent in Estonia (median, 10.7 percent). The prevalence increased in Estonia, from 28.2 percent in 1994 to 36.9 percent in 1998 (P=0.01), and in Denmark, from 9.9 percent in 1995 to 13.1 percent in 1998 (P=0.04). The median prevalence of multidrug resistance among new cases of tuberculosis was only 1.0 percent, but the prevalence was much higherin Estonia (14.1 percent), Henan Province in China (10.8 percent), Latvia (9.0 percent), the Russian oblasts of Ivanovo (9.0 percent) and Tomsk (6.5 percent), Iran (5.0 percent), and Zhejiang Province in China (4.5 percent). There were significant decreases in multidrug resistance in France and the United States. In Estonia, the prevalence in all cases increased from 11.7 percent in 1994 to 18.1 percent in 1998 (P<0.001).

CONCLUSIONS

Multidrug-resistant tuberculosis continues to be a serious problem, particularly among some countries of eastern Europe. Our survey also identified areas with a high prevalence of multidrug-resistant tuberculosis in such countries as China and Iran.

Logistic discrimination of mixtures of M. tuberculosis and non-specific tuberculin reactions

Interpretation of the Mantoux test for tuberculous infection can be complicated by cross-reactions caused by infection with non-specific mycobacteria. Thus, the distribution of positive indurations is a mixture of two distributions. To estimate tuberculous infection prevalence, the marginal distribution of indurations needs to be separated into its component distributions. Observations from several populations with different mixes of the two types of infection are required. Homogeneity across populations of distributions of indurations for each type of infection is assumed. A logistic model is specified for the probability of having tuberculous infection conditional on the observed induration size. No other assumptions about the two distributions are made. Maximum likelihood is used to estimate the logistic function. Goodness-of-fit criteria are discussed. The method is applied to a series of tuberculin surveys carried out in (South) Korea. Estimated infection prevalence agrees reasonably well with several ad hoc criteria. The goodness-of-fit test rejects underlying assumptions of homogeneity. One reason appears to be a decline over time in induration sizes caused by tuberculous infection. However, not all reasons for this rejection are obvious. The proposed method of mixture analysis provides an additional tool for the interpretation of prevalence survey data where the diagnostic test lacks specificity as a result of cross-reactions.

Incidence of pulmonary tuberculosis in Korean civil servants: second study, 1992-1994

SETTING

A survey based on biennial medical examinations for civil servants, including school teachers.

OBJECTIVE

To estimate the incidence of pulmonary tuberculosis (PTB) for the general population from a sample survey, and to compare it with the previous results from 1988-1990.

DESIGN

A retrospective follow-up study which started in April 1996 and ended in December 1997. Development of PTB among all South Korean civil servants who were tuberculosis-free in the 1992 biennial medical examination was followed up to the 1994 medical examination. The survey was based on newly-developed cases by 1) the findings of the biennial medical examination, 2) scrutiny of the medical records of all those claiming health insurance for tuberculosis, and 3) checking of the TB registers in all health centres during the period. Civil servants constituted 2.6% of the Korean population aged 20 to 64.

RESULTS

Of 958137 subjects who were found to be TB-free in the 1992 medical examination, 957216 were eligible for the study. Radiologically active PTB was found in 4146 cases over the 2-year period of the study. Bacteriological examinations were performed in 3306 patients: there were 1551 bacteriologically proven cases (46.9%), including 1049 smear-positives (31.7%) and 502 smear-negative culture-positives (15.2%). The age-sex adjusted incidence rate for the general population was 202/100000 in radiologically active PTB, 81/100000 in bacteriologically proven PTB, and 54/100000 in smear-positive PTB. Overall PTB incidence rates were higher in males (240/100000) than in females (163/100000), and in the age group 20-24 years (280/ 100 000) than in the other age groups.

CONCLUSION

Comparing the 1992-1994 PTB incidence with that observed in the 1988-1990 survey, the highest incidence was observed among young adults in both surveys, and it had not changed over time.

Recurrent focal segmental glomerulosclerosis following renal transplantation in Korean pediatric patients

The recurrence of focal segmental glomerulosclerosis (FSGS) in transplants is a well-known problem in pediatric renal transplantation (Tx). Recently, the race of the recipient was recognized as a major variable associated with disease recurrence. In view of this finding, we report on our single-center experience of FSGS recurrence in Korean children, an ethnically homogeneous Far East Asian population. Clinical records and renal biopsy specimens, both native and graft, were reviewed for all pediatric renal Txs (recipient age < or = 18 yr) performed at Seoul National University Hospital from 1984 to 1999. Twenty-two children with primary FSGS received 22 allografts for renal replacement. The mean age of disease onset in these patients was 5.9 yr. The grafts were from 12 living-related, six living-unrelated, and four cadaveric donors, and all recipients were immunosuppressed with cyclosporin A (CsA)-based regimens. Post-transplant recurrence of FSGS was confirmed in nine patients (41%). Long-term graft survival in recurrent and non-recurrent groups was not significantly different. Risk factor analysis showed that patients with a disease duration shorter than 48 months (odds ratio 11.7, 95% CI 1.53-89.1) and a glomerulosclerosis percentage of < 55% by renal biopsy (odds ratio 16.0, 95% CI 1.45-176) were at greater risk of disease recurrence. These results suggest that Korean children are similar to non-African-American youngsters in the USA and Europe with respect to post-transplant recurrence of FSGS. The same may be true of other Far Eastern Asian children.

K5.76Ga5.76Si10.24O32.3.4H2O, a gallosilicate with the zeolite gismondine topology

The title compound, K-GaSi-GIS, potassium gallium silicon oxide hydrate, was synthesized hydrothermally and its crystal structure was determined from data collected on a single crystal of dimensions 10 x 10 x 8 microm at a synchrotron X-ray source. The compound, which has the aluminosilicate (AlSi) zeolite gismondine (GIS) topology, Ca(4)[Al(8)Si(8)O(32)].16H(2)O, crystallizes in the tetragonal space group I4(1)/a. A disordered distribution of the framework Si/Ga sites leads to higher symmetry of the GIS-type network compared with the usual monoclinic symmetry in AlSi-GIS. Framework Ga substitution for Al in AlSi-GIS leads to substantial distortion of the crankshaft chains, reducing the effective pore dimensions and suggesting the possibility of pore-dimension control via partial framework-cation substitution.

Capsaicin inhibits the voltage-operated calcium channels intracellularly in the antral circular myocytes of guinea-pig stomach

Studies of the effect of capsaicin (CAP) on the smooth muscle contractions have shown both contraction and relaxation in various preparations. The direct effect of CAP on gastric smooth muscle itself has not yet been reported, though CAP was reported to relax the isolated guinea-pig stomach by releasing nitric oxide from the CAP-sensitive sensory neurons. Here we showed an evidence that CAP evokes a prolonged relaxation of gastric antral circular smooth muscle (CAP-induced relaxation) by blocking the voltage-operated Ca2+ channels (VOCC) from inside of the cell. CAP suppressed dose-dependently the spontaneous contractions of guinea-pig gastric circular muscle strip under the condition without neural influence (IC50 = 5.8 microM). The inhibitory effects of CAP both on the high K+ contracture induced by 50 mM K+ Tyrode solution and on the slow waves recorded using a conventional intracellular microelectrode technique were similar to those of Ca2+ channel antagonists, indicating that Ca2+ influx through the VOCC is decreased by CAP. Ca2+ channel current (I(Ba)) decreased in a concentration-dependent manner on superfusing the physiological salt solution containing various concentrations of CAP. The steady-state activation and inactivation curves of I(Ba) were not affected by the treatment with CAP. The experiment using a synthetic water-soluble analog of CAP, DA-5018 x HCl, suggested that the acting site of CAP is present in the intracellular side. Spontaneous transient outward K+ currents (STOCs) recorded at a holding potential of 0 mV were also inhibited by CAP and verapamil, Ca channel blocker. Taken together, these results indicate that CAP-induced relaxation is associated with the direct inhibitory action on the VOCC from inside of the cell.

A survey of spinal and epidural techniques in adult cardiac surgery

OBJECTIVE

To determine if a significant number of anesthesiologists are performing spinal and epidural techniques in adults undergoing cardiac surgery and if any neurologic injuries have been associated with these techniques.

DESIGN

Anonymous survey of clinical practice.

SETTING

Data collected via mail from members of the Society of Cardiovascular Anesthesiologists.

PARTICIPANTS

Attending anesthesiologists.

INTERVENTIONS

Anesthesiologists completed an anonymous survey of their use of spinal and epidural techniques in adult patients undergoing cardiac surgery.

MEASUREMENTS AND MAIN RESULTS

Of 3974 anesthesiologists, 974 (24%) responded to the questionnaire; 892 are at institutions that perform cardiac surgery. Of the 892 responders, 68 (7.6%) reported they use spinal techniques, whereas 62 (7%) reported they use epidural techniques. Nine (1%) anesthesiologists reported they use both techniques. There were no reports of neurologic complications related to the use of spinal or epidural techniques performed by the anesthesiologists responding to the survey.

CONCLUSIONS

A significant number of anesthesiologists are performing spinal and epidural techniques in adult patients undergoing cardiac surgery. Prospective, controlled trials should be performed to evaluate the benefits and risks of spinal and epidural techniques in this population.