A phase II trial of gefitinib and pegylated interferon alfa 2b (PEG-IFN) in previously-treated renal cell carcinoma (RCC)

e16115

Background: Modulation of the epidermal growth factor receptor (EGFR) pathway is relevant to IFN activity in RCC. Cell lines sensitive to IFN's antiproliferative effects downregulate EGFR, while IFN treatment of resistant cells precludes such an effect. (Eisenkraft et al, Cancer Res. 1991) Lack of EGFR down-regulation may thus be responsible in part for IFN resistance. To explore this hypothesis, we conducted a trial of the EGFR tyrosine kinase inhibitor gefitinib plus PEG-IFN in RCC patients (pts). Methods: Unresectable or metastatic RCC pts (no limit on prior therapies; performance status 0–2, and adequate end-organ function) were eligible. Prior IFN was allowed. Dose schedule: PEG-IFN SQ weekly (6μg/kg/week or 4 μg/kg/week) × 12 weeks and gefitinib 250 mg po daily until progression. A 6-month progression free survival (PFS) rate of 50% was considered promising (vs. 30%) in a two-stage design incorporating the Green-Dahlberg rule. We accrued 21 patients in the first-stage of accrual. Results: Pt characteristics: Males -16; median age - 56 years; Prior nephrectomy - 12. All had > 1 prior systemic therapy . Accrual slowed with increased use of small molecule kinase inhibitors, bevacizumab, and temsirolimus for RCC. At 6 months, PFS was 26% (95% CI: 9%, 49%); 20% (4 pts) had died. Best responses by RECIST: complete (1), partial (4), stable (8); progression (4). Response duration: CR (35+ months) and PR (3, 5, 5, 38+ months). Median time to treatment failure was 18.4 weeks (95%CI: 7.4, 24.9). Median PFS and overall survival were 23 and 53 weeks, respectively. Most common treatment-related toxicities were leucopenia, thrombocytopenia, rash, nausea, diarrhea, and hyperglycemia. Conclusions: Although gefitinib plus PEG-IFN did not meet the pre-specified 6-month PFS of 50%, it appears to have activity similar to other first-line therapies even in this previously-treated setting. (Supported by Astra Zeneca)

[Table: see text]

Design of a phase 0 microdosing trial for correlation of platinum-induced DNA damage to chemotherapy outcomes

2543

Background: DNA damage is the critical step in cancer cell response to platinum (Pt) chemotherapy. We hypothesize that low levels of Pt-induced DNA damage are predictive of chemoresistance. Accelerator mass spectrometry (AMS), an ultrasensitive method for measuring radiocarbon, can detect [14C]carboplatin bound to the DNA of cancer cells from cell culture, mice bearing tumor xenografts and patients receiving subtoxic microdoses of compound. Methods: Cancer cells and mice bearing tumor xenografts were treated with one microdose (1/100th of the therapeutic dose) or one therapeutic dose of [14C]carboplatin. Relevant parameters such as drug influx/efflux, intracellular drug inactivation, DNA damage and repair, were measured and correlated with response to chemotherapy. A Phase 0 microdosing trial has been designed to study patients with non-small cell lung or bladder transitional cell cancers who are planning to receive Pt-based chemotherapy. One microdose of [14C]carboplatin is administered to these patients 4 hours before biopsy. Pt-induced DNA damage and repair in tumor biopsy specimens and other relevant parameters will be measured and correlated with the response and toxicity of chemotherapy. Results: Preclinical studies showed that AMS can detect Pt-DNA damage when cancer cells and mice with tumor xenografts are exposed to one microdose of [14C]carboplatin. The levels of microdose-induced DNA damage are directly proportional to the damage caused by a therapeutic drug dose (p<0.001); and these levels of DNA damage correlate with chemoresistance as measured by MTT assay. Measuring drug uptake/efflux and intracellular inactivation allows insights into resistance mechanisms. These data support the conclusion that the levels of DNA damage induced by microdosing can potentially predict chemoresistance in patients. Consequently, a Phase 0 microdosing trial is in progress. Conclusions: These results support a phase 0 microdosing trial employing AMS to identify chemoresistance and determine the underlying chemoresistant mechanisms for personalized therapy before patients receive cytotoxic chemotherapy.

[Table: see text]

Preoperative chemoradiation and postoperative adjuvant tetrathiomolybdate for patients with resectable esophageal cancer

e15504

Background: Tetrathiomolybdate (TM) is an oral copper chelator. Copper is necessary for blood vessel growth, and so TM functions as an antiangiogenic agent. Methods: Pts with resectable esophageal cancer were treated at the University of Michigan with chemoradiation followed by surgery, and then 2 years of TM. Chemoradiation was cisplatin 60 mg/m2 on days #1 and 22, paclitaxel 60 mg/m2 on days #1, 8, 15, and 22, and radiation 1.5 Gy fractions b.i.d. x 3 weeks to a total of 45 Gy. Transhiatal esophagectomy was performed on approximately day #50. TM 20 mg p.o. q.d. was started approximately 4 weeks post-op, and continued for 2 years. Doses were adjusted to maintain the ceruloplasmin level between 5 and 15. Results: Between 1/23/02 and 1/24/06, 69 pts were enrolled. Pt characteristics: males - 62 (90%), females - 7 (10%); median age - 60 (range 42–74); adenocarcinoma - 56 (81%), squamous cell carcinoma 13 (19%). The chemoradiation was well tolerated: grade 3 leukopenia in 15 pts (22%), and 17 pts (25%) required feeding tubes. 66 pts went to surgery. 61 pts had a complete resection; 4 pts had metastases discovered at surgery, and 1 pt had extensive positive margins. Histologic complete response rate was 10%. 21 pts never received TM because of metastases noted in the peri-operative period, long post-op recovery time, or pt refusal. 48 pts started TM after surgery and it was well tolerated. Grade 3 toxicities were diarrhea -2 (3%), nausea - 2 (3%), dizziness - 2 (3%). 13 pts completed the full 24 mos of treatment, 12 completed 10–23 mos, 15 completed 2–8 mos, and 8 completed only 1 month or less. 27 pts have had disease recurrence, the majority (23 of the 27) of which was distant. Current status of pts with median follow-up time of 55 months: 25 alive and disease-free, 1 alive with disease, and 43 have died. 3-year survival probability is 47% (95% CI 35%-58.6%). 3-year recurrence-free probability is 51% (95% CI 38%- 62.7%). Conclusions: TM is an antiangiogenic agent which is fairly well tolerated. Prolonged adjuvant treatment over 2 years is difficult but not impossible to complete. Disease-free survival and overall survival are promising when compared to historical controls treated with a very similar chemoradiation regimen without TM in the past at the University of Michigan.

[Table: see text]

Assessment of mitral valve volume by quantitative three-dimensional echocardiography in patients with rheumatic mitral valve stenosis

BACKGROUND

Thickening of mitral leaflets in rheumatic mitral valve stenosis is well described in necropsy studies; however, volume computation of the thickening mitral leaflets has not been attempted. 4trial fibrillation is one of the complications of rheumatic mitral stenosis. Quantitative assessment of thickened mitral valve and its relation to clinical complications is clinically desirable.

HYPOTHESIS

The study was undertaken to compare measurement of mitral valve volume in normal subjects and in patients with rheumatic mitral valve stenosis.

METHODS

An HP Sonos 2500 echocardiographic system with 5 MHz multiplane transesophageal transducer was used for data acquisition, and TomTec Echoscan computer setup was used to off-line volume computation. Study subjects included 10 normal subjects (mean age 44.8 years) and 36 patients with rheumatic mitral valve stenosis (22 female, 14 male) with an age range of 25 to 69 years (mean age 47 +/- 9.6 years). Mitral valve volumes were compared between the normal subjects and patients with mitral valve stenosis, and further comparison was made between the sinus rhythm (SR) and atrial fibrillation (AF) groups in patients with mitral valve stenosis. In all study subjects, the mitral valve area (MVA) was determined by two-dimensional echocardiography.

RESULTS

Quantitative three-dimensional (3-D) echocardiography showed that mitral valve volume was significantly larger in patients with mitral valve stenosis than in normal subjects (9.0 +/- 2.2 and 4.5 +/- 0.7 ml, respectively, p < 0.001). When patients with mitral valve stenosis were divided into the SR and AF groups, mitral valve volume was found to be significantly larger in the AF group than in the SR group (9.76 +/- 2.2 ml. and 7.72 +/- 1.5 ml, respectively, p < 0.01) and patients in the AF group tended to be older (p < 0.05) with larger left atrial diameter (LAD) (p < 0.01). However, MVA between the two groups showed no statistical significance (1.1 +/- 0.43 and 1.0 +/- 0.34 cm2, respectively, p > 0.2). When the study subjects were divided into two groups (< 50 and > or = 50 years) according to age, the comparison of mitral valve volume between these two groups (9.37 +/- 2.18 and 8.56 +/- 2.14 ml, p > 0.2) showed no statistical significance.

CONCLUSIONS

Quantitative 3-D echocardiography can be applied for the measurement of mitral valve volume in vivo. Patients with rheumatic mitral valve stenosis with atrial fibrillation have a propensity to have a larger mitral valve volume and are older than the patients with sinus rhythm; however, the age per se does not seem to be a cause for larger mitral valve volume.

PCR-SSCP and &lt;i&gt;Hin6&lt;/i&gt;I PCR-RFLP detecting novel anonymous SNPs within ovine &lt;i&gt;PROP1&lt;/i&gt; gene (Brief report)

Abstract. PROP1 plays a direct or indirect key role in the ontogenesis of pituitary gonadotropes, as well as somatotropes, lactotropes and caudomedial thyrotropes (WU et al., 1998). Mutations of PROP1 are responsible for deficiencies of POU1F1, GH, prolactin (PRL) and thyroid stimulating hormone (TSH) in Snell and Jackson dwarf mice and in man, as well as deficiencies of LH and FSH, suggesting that the PROP1 gene is a potential candidate gene associating with production traits in animal breeding and genetics. To date, no polymorphism of PROP1 gene has been reported in ruminant animals except bovine (PAN et al., 2007). So, the objective of this study is to investigate the polymorphism of all coding regions within ovine PROP1 gene by PCR-SSCP, DNA sequencing and PCR-RFLP methods, which will possibly contribute to conducting association analysis and evaluating them as genetic markers in animal breeding and genetics.

Comparison of vildagliptin and acarbose monotherapy in patients with Type 2 diabetes: a 24-week, double-blind, randomized trial

AIMS

To compare the efficacy and tolerability of the dipeptidyl peptidase-4 inhibitor, vildagliptin, with the alpha glucosidase inhibitor, acarbose, in drug-naive patients with Type 2 diabetes.

METHODS

This multi-centre, randomized, double-blind, parallel-arm study compared the efficacy and tolerability of vildagliptin (100 mg daily, given as 50 mg twice daily, n = 441) and acarbose (up to 300 mg daily, given as three equally divided doses, n = 220) during 24-week treatment in drug-naive patients with Type 2 diabetes.

RESULTS

Monotherapy with vildagliptin or acarbose decreased glycated haemoglobin (HbA(1c)) (baseline approximately 8.6%) to a similar extent during 24-week treatment. The adjusted mean change from baseline to end-point (AMDelta) in HbA(1c) was -1.4 +/- 0.1% and -1.3 +/- 0.1% in patients receiving vildagliptin and acarbose, respectively, meeting the statistical criterion for non-inferiority (upper limit of 95% confidence interval for between-treatment difference < or = 0.4%). The decrease in fasting plasma glucose was similar with acarbose (-1.5 +/- 0.2 mmol/l) and vildagliptin (-1.2 +/- 0.1 mmol/l). Body weight did not change in vildagliptin-treated patients (-0.4 +/- 0.1 kg) but decreased in acarbose-treated patients (-1.7 +/- 0.2 kg, P < 0.001 vs. vildagliptin). The proportion of patients experiencing any adverse event (AE) was 35% vs. 51% in patients receiving vildagliptin or acarbose, respectively; gastrointestinal AEs were significantly more frequent with acarbose (25.5%) than vildagliptin (12.3%, P < 0.001). No hypoglycaemia was reported for either group.

CONCLUSIONS

Vildagliptin is effective and well tolerated in patients with Type 2 diabetes, demonstrating similar glycaemic reductions to acarbose, but with better tolerability.

Diagnosis and treatment for tuberculosis infection in liver transplant recipients: case reports

AIM

Tuberculosis (TB) infection after liver transplantation was described, diagnosed and treated herein.

METHODS

We reviewed the clinical presentation, methods of diagnosis, and treatment of 2 cases of TB infection posttransplantation.

RESULTS

Mycobacterium TB infection occurred in 2 of 110 (1.8%) patients undergoing liver transplantation between 2001 and 2006. Pyrexia, poor appetite, and weight loss were common presentations. The diagnosis was confirmed using lymph node biopsy and treated with standard antituberculous agents. One patient was suspected of having TB infection by clinical presentation, and tentative anti-TB drugs were used. The duration of treatment was 9 months.

CONCLUSIONS

Early diagnosis and treatment are important in these patients. Careful monitoring of liver function and immunosuppressant levels are essential for patients who receive standard anti-TB drugs.

Spectroscopic imaging of the pilocarpine model of human epilepsy suggests that early NAA reduction predicts epilepsy

Reduced hippocampal N-acetyl aspartate (NAA) is commonly observed in patients with advanced, chronic temporal lobe epilepsy (TLE). It is unclear, however, whether an NAA deficit is also present during the clinically quiescent latent period that characterizes early TLE. This question has important implications for the use of MR spectroscopic imaging (MRSI) in the early identification of patients at risk for TLE. To determine whether NAA is diminished during the latent period, we obtained high-resolution (1)H spectroscopic imaging during the latent period of the rat pilocarpine model of human TLE. We used actively detuneable surface reception and volume transmission coils to enhance sensitivity and a semiautomated voxel shifting method to accurately position voxels within the hippocampi. During the latent period, 2 and 7 d following pilocarpine treatment, hippocampal NAA was significantly reduced by 27.5 +/- 6.9% (P < 0.001) and 17.3 +/- 6.9% (P < 0.001) at 2 and 7 d, respectively. Quantitative estimates of neuronal loss at 7 d (2.3 +/- 7.7% reduction; P = 0.58, not significant) demonstrate that the NAA deficit is not due to neuron loss and therefore likely represents metabolic impairment of hippocampal neurons during the latent phase. Therefore, spectroscopic imaging provides an early marker for metabolic dysfunction in this model of TLE.

Five novel single nucleotide polymorphisms (SNPs) of the prophet of PIT1 (<i>PROP1</i>) gene in bovine (Brief report)

Abstract. The prophet of Pit1 (PROP1) gene encodes a paired class homeodomain transcription factor of 226 amino acids and is organized of 3 exons. PROP1 is necessary for the specification, differentiation and proliferation of cells. Its function is essential for anterior pituitary organogenesis, and heritable mutations in this gene are associated with combined pituitary hormone deficiency (CPHD) in human patients and animals (SAVAGE et al., 2003; CARVALHO et al., 2006). To date, no polymorphisms of the bovine PROP1 gene were described. In the present experiment, the 5' flanking region, the coding region and partial introns of bovine PROP1 were scanned for single nucleotide polymorphism (SNPs) in five cattle breeds of China.

Nicotine inhibits apoptosis induced by cisplatin in human oral cancer cells

Oral cancer demonstrates a strong epidemiological association with smoking, but little is known about the effect of nicotine on oral cancer cell apoptosis. Nicotine, a major component of cigarette smoke, can regulate cell proliferation and angiogenesis and suppress apoptosis induced by chemotherapeutic drugs. The main aim of this study was to investigate the effects of nicotine on apoptosis induced by cisplatin, which is commonly used to treat advanced oral cancers, in the human oral cancer cell line Tca8113. The cells were stimulated with nicotine in the presence or absence of cisplatin, and apoptosis was assayed. The results showed that nicotine inhibited apoptosis induced by cisplatin. It was also observed that survivin played a role in the inhibitory effect of nicotine on apoptosis. Depletion of survivin reduced the protective effect of nicotine against cisplatin-induced apoptosis. Akt, a physiological survivin kinase, is activated by nicotine. Treatment of Tca8113 cells with the phosphatidylinositol 3-kinase (PI3K) inhibitor LY294002 blocked nicotine-induced survivin expression and enhanced cell apoptosis. These studies suggest that exposure to nicotine might negatively impact on the apoptotic potential of chemotherapeutic drugs, and that survivin plays a key role in the anti-apoptotic effect of nicotine. The Akt pathway may be required for nicotine function.

Phase II trial of the epidermal growth factor receptor (EGFR) inhibitor erlotinib (E) in patients (pts) with advanced papillary renal cell carcinoma (pRCC)—SWOG S0317

15516

Background: Clear cell RCC often has mutations of the von Hippel-Lindau (vHL) gene and over expression of vascular endothelial growth factor (VEGF). pRCC has mutations of c-met and not vHL. Pre-clinically, normal vHL expression is associated with greater activity of EGFR inhibitors in clear cell RCC (Clin Can Res 6:1518, 2000). PRCC has no effective treatment. Given the absence of vHL mutations we undertook a study of E in pts with pRCC. Methods: Pts with histologically confirmed advanced or metastatic pRCC with measurable disease received E 150 mg PO QD from day 1 to disease progression, pt refusal, unacceptable toxicity, or a delay of therapy >3 wks. Central path review and tissue submission for vHL gene analysis were required. The primary endpoint was response. Further study of this regimen would be considered if the observed response rate (RR) was =20% (i.e. 5+ observed responses). Results: 52 pts from 27 SWOG and 2 ECOG institutions were registered. 7 pts were ineligible (no path submission-3; incorrect histology-1; no measurable disease-2; scans outside timeframe-1). Central path review is ongoing for 7 pts, leaving 39 pts evaluable for response including 30M/9F with a median age of 60.2 y (range 27.9 to 82.3). Median follow-up was 12.8 months (range 1.5 to 35.4 m). 4 pts had confirmed PRs for a RR of 10% (95% CI: 3 - 24%). Five evaluable patients with inadequate response assessment were assumed to be non-responders. Median OS was 26.9 months (95% CI lower limit 12.8 m, upper limit not yet estimable). Probability of freedom from treatment failure at 6 m is 30% (95% CI: 15–45%). There was one Grade 5 adverse event (AE) of pneumonitis thought to be possibly drug-related and one Grade 4 thrombotic AE. 8 pts experienced Grade 3 AEs common to E including rash, anorexia, diarrhea and fatigue. vHL mutation was observed in two patients with stable disease. Conclusions: Though the observed RR in pts with pRCC receiving E is similar to pts with clear cell RCC we did not see enough responses to warrant further study. As this is the first phase II trial reported (to our knowledge) for the subset of pts with pRCC we have demonstrated that less common and distinct histological subtypes can be independently studied in the cooperative group setting.

[Table: see text]

Dual AKT inhibition with perifosine and GCP enhances apoptosis in prostate cancer: Clinical implications

14096

Background: Genistein combined polysaccharide (GCP) has been shown to exhibit anti-cancer properties in both experimental and clinical models of prostate cancer (CaP). Perifosine is an alkylphospholipid with clinical anti-neoplastic activity. Both agents inhibit the AKT signaling pathway. Methods: Prostate cancer cell lines (LNCaP, LNCaP stably transfected with R273H or P151S p53 mutant allele, cds1, and PC3) were treated with GCP, perifosine, or both. IC50 values were established using the MTT assay. Apoptosis was assessed by flow cytometry, Western blot of PARP cleavage, and caspase activity. Clonogenic potential was assessed by colony assay. Status of AKT, p53, p21, AR and PSA was determined by Western blot. All experiments were performed in triplicate. Results: Perifosine inhibited AKT activity in all the cell lines. GCP had little or no effect on AKT activity but reduced AR and PSA levels. The combination of GCP and perifosine further increased the level of AKT inhibition and maintained inhibition for longer when compared to treatment with perifosine alone. Flow cytometric analysis of LNCaP revealed that combination treatment dramatically increased SubG1 levels (23-fold increase versus a 4.4-fold increase for GCP alone and a 6.5% increase for perifosine alone). Apoptosis was confirmed by PARP and caspase analysis. As single agents, the main effect of GCP or perifosine was to induce growth arrest as shown by a decrease in S-phase and increased p21. The cds1 cell line responded similarly to LNCaP, however, cell lines that expressed mutant p53 or were p53 null were not susceptible to GCP/perifosine-induced apoptosis. Combination treatment further decreased the clonogenic potential in all of the cell lines assessed when compared to treatment with the single agents alone. Conclusions: Treatment with a combination of the AKT inhibitors GCP and perifosine dramatically increases apoptosis and/or inhibits clonogenic potential in several CaP cell lines. The effect of the combination treatment on apoptosis appears to be dependent on p53 status. Clinical validation of these findings is warranted. A clinical trial of hormone therapy with or without GCP/perifosine is presently in development.

No significant financial relationships to disclose.

Regional energetic dysfunction in hippocampal epilepsy

OBJECTIVES

There is increasing evidence for a dysfunctional metabolic network in human mesial temporal lobe epilepsy (MTLE). To further describe this, we evaluated the bioenergetic status in unilateral MTLE inter-regionally and in relation to neuropathology.

MATERIALS AND METHODS

We used whole brain high field (4 T) 31P MR spectroscopic imaging to determine in vivo PCr and ATP, studying n=22 patients (all candidates for hippocampal resection) and n=14 control volunteers. The degree of bioenergetic impairment was assessed by calculating the ratio of PCr to ATP.

RESULTS

Compared to controls, patients demonstrated significant decreases in PCr/ATP from the ipsilateral amygdala and pes (0.84 +/- 0.14, 0.87 +/- 0.10, respectively, patients vs 0.97 +/- 0.15, 0.98 +/- 0.16, controls). In patients, the ipsilateral thalamic energetics positively correlated with contralateral hippocampal energetics. In addition, the ipsilateral thalamic and striatal energetics negatively correlated with hippocampal total glial counts.

CONCLUSIONS

These data are consistent with a view that in MTLE, the bilateral hippocampi, ipsilateral thalamus and striatum are linked in their energetic depression, possibly reflecting the propagation of seizures throughout the brain.

Pore-scale modeling of saturated permeabilities in random sphere packings

We use two pore-scale approaches, lattice-Boltzmann (LB) and pore-network modeling, to simulate single-phase flow in simulated sphere packings that vary in porosity and sphere-size distribution. For both modeling approaches, we determine the size of the representative elementary volume with respect to the permeability. Permeabilities obtained by LB modeling agree well with Rumpf and Gupte's experiments in sphere packings for small Reynolds numbers. The LB simulations agree well with the empirical Ergun equation for intermediate but not for small Reynolds numbers. We suggest a modified form of Ergun's equation to describe both low and intermediate Reynolds number flows. The pore-network simulations agree well with predictions from the effective-medium approximation but underestimate the permeability due to the simplified representation of the porous media. Based on LB simulations in packings with log-normal sphere-size distributions, we suggest a permeability relation with respect to the porosity, as well as the mean and standard deviation of the sphere diameter.

[Study on different responses of rats' small intestine mucous membrane and bladder transitional epithelium in the same carcinogenic urine environment]

OBJECTIVE

To preliminarily verify the tentative idea of replacement of bladder transitional epithelium with small intestine mucous membrane to prevent recurrence of carcinoma of bladder.

METHODS

A certain segment of small intestine was transplanted to the urinary bladder of the same body in 17 rats. Then N-butyl-N-(4-hydroxy-butyl) nitrosamine (BBN) was used to induce carcinoma of bladder. BBN was used to 11 control rats that did not undergo operation.

RESULTS

Bladder carcinoma failed to be found in the transplanted small intestine mucous membrane in all experimental rats except one. After stimulation of BBN, carcinoma of urinary bladder occurred in all rats' bladder transitional epithelium.

CONCLUSION

1) The carcinogenic substances in the urine of rats suffering from BBN-induced bladder carcinoma are carcinogenic only to bladder transitional epithelium and have no effect on small intestine epithelium. 2) Bladder transitional epithelium may be more sensitive to the urine carcinogenic substances and easier to be cancerized than small intestine epithelium. 3) The tentative idea of substitution of small intestine mucous membrane for bladder transitional epithelium to prevent the recurrence of bladder carcinoma is worth further studying.

Tissue tracking allows rapid and accurate visual evaluation of left ventricular function

AIMS

To evaluate the ability of tissue tracking for rapid assessment of left ventricular function by determination of the systolic mitral annular displacement. Tissue tracking is a new echocardiographic modality based on Doppler Tissue imaging allowing rapid visual assessment of the systolic baso-apical displacement of each myocardial segment in apical views by a graded colour display.

METHODS AND RESULTS

We studied 90 patients (69 male, age 60.4 +/- 10.1 years) with different left ventricular function (25 subjects with normal left ventricular function, 25 patients with homogeneous depression of left ventricular function and 40 patients with prior myocardial infarction). Systolic mitral annular displacement was determined by tissue tracking and M-mode echocardiography. Apical two-, three- and four-chamber views were used to determine the mitral annular displacement of six sites. Left ventricular ejection fraction was determined by two-dimensional echocardiography using Simpson's rule. Tissue tracking was possible in all patients. In the 50 patients with normal left ventricular function or homogeneous depression of left ventricular function, mean mitral annular displacement correlated closely with mitral annular displacement determined by M-mode (r=0.99,P <0.001) and with left ventricular ejection fraction (r=0.97, P<0.001). Left ventricular ejection fraction < or = 30% could be predicted with a sensitivity of 98% and a specificity of 78% using a cut-off value of 4.8mm for the mitral annular displacement determined by tissue tracking. In patients with prior myocardial infarction correlation between the mean mitral annular displacement and left ventricular ejection fraction was lower (r=0.87, P<0.001).

CONCLUSION

Systolic mitral annular displacement determined by tissue tracking correlates closely with mitral annular displacement determined by M-mode and with left ventricular ejection fraction. Thus, tissue tracking allows rapid semiquantitative evaluation of global left ventricular function by assessment of systolic mitral annular displacement.

Ligand-stabilized ruthenium nanoparticles: synthesis, organization, and dynamics

The decomposition of the ruthenium precursor Ru(COD)(COT) (1, COD = 1,5-cyclooctadiene; COT = 1,3,5-cyclooctatriene) in mild conditions (room temperature, 1--3 bar H(2)) in THF leads, in the presence of a stabilizer (polymer or ligand), to nanoparticles of various sizes and shapes. In THF and in the presence of a polymer matrix (Ru/polymer = 5%), crystalline hcp particles of uniform mean size (1.1 nm) homogeneously dispersed in the polymer matrix and agglomerated hcp particles (1.7 nm) were respectively obtained in poly(vinylpyrrolidone) and cellulose acetate. The same reaction, carried out using various concentrations relative to ruthenium of alkylamines or alkylthiols as stabilizers (L = C(8)H(17)NH(2), C(12)H(25)NH(2), C(16)H(33)NH(2), C(8)H(17)SH, C(12)H(25)SH, or C(16)H(33)SH), leads to agglomerated particles (L = thiol) or particles dispersed in the solution (L = amine), both displaying a mean size near 2--3 nm and an hcp structure. In the case of amine ligands, the particles are generally elongated and display a tendency to form worm- or rodlike structures at high amine concentration. This phenomenon is attributed to a rapid amine ligand exchange at the surface of the particle as observed by (13)C NMR. In contrast, the particles stabilized by C(8)H(17)SH are not fluxional, but a catalytic transformation of thiols into disulfides has been observed which involves oxidative addition of thiols on the ruthenium surface. All colloids were characterized by microanalysis, infrared spectroscopy after CO adsorption, high-resolution electron microscopy, and wide-angle X-ray scattering.

Effect of benzene, toluene, xylene on the semen quality and the function of accessory gonad of exposed workers

The effects on semen and the function of accessory gonad of workers after short and long term exposure to benzene, toluene, and xylene were examined. The semen and blood of 24 married workers exposed to benzene, toluene, and xylene were collected. Routine sperm characteristic, acrosin activity, and Lactate dehydrogenase C4 (LDH-C4) relative activity were detected. The results showed that benzene, toluene, and xylene were found in the blood and semen of some ex-workers at workplaces where the air concentration of benzene, toluene, and xylene exceeded the maximum allowable concentration (MAC). No such solvents were detected in the blood and semen of workers of the control group. The sperm vitality and sperm motility decreased in the exposed workers. The mean acrosin activity, gamma-GT activity and LDH-C4 relative activity in the exposed workers were lower, and fructose concentration was higher than those in the control. There were negative correlations between sperm vitality, sperm activity, acrosin activity, or LDH-C4 relative activity and working history. These results suggest that the mixture of these solvents could affect the sperm and the function of accessory gonad. This might be one reason of the abnormal pregnancy outcome among the wives of workers exposed to benzene, toluene, and xylene.

[Coarse woody debris and its function in forest ecosystem]

Coarse woody debris (CWD) is an important structural and functional element in forest ecosystem. In this paper, the definition, dynamics, and role of CWD in a forest ecosystem were overviewed. CWD include all woody debris above and under the ground with a diameters > or = 2.5 cm, and mainly comes from the dead trees resulted from competition and disturbances. The biomass of CWD changes like "U" form along with the development of a forest community. The decay rate of CWD is determined by the compound course of the respiration and natural fragmentation. Insects and microorganisms play an important role in the course. CWD basically has two functions in an ecosystem. One is as the nutrition pool for some living creatures, and the other is that the large CWD can form some special habitats for animals and plants. Conclusively these two functions are helpful to reserve the biodiversity and the integrity of ecological process in a natural ecosystem. Gaps are formed while dead trees falling down, and all gaps in a forest succeed one another randomly in the development of a forest ecosystem, which pushes the inner circulation of the forest. Because of the vital roles of CWD in a forest ecosystem, much more attention should be paid in the management of forest ecosystem.

Monte Carlo simulation of morphologies of self-assembled amphiphilic diblock copolymers in solution

The Monte Carlo method has been applied to simulate the process of the self-assembling of amphiphilic diblock copolymers in a selective solvent. The simulations illustrated that the aggregates morphologies of A-b-B diblock copolymers in solution strongly depend on the length of corona-forming segments, i.e., with the decrease of the corona-forming segments, the transition of spherical micelles to rodlike aggregates occurs, which are in accord with the experimental results of Eisenberg and co-workers [Science 268, 1728 (1995); Macromolecules 32, 2239 (1999); 31, 3509 (1998); 29, 6359 (1996); 31, 9399 (1998)].

Identification of CD72 as a lymphocyte receptor for the class IV semaphorin CD100: a novel mechanism for regulating B cell signaling

We have identified the lymphocyte semaphorin CD100/Sema4D as a CD40-inducible molecule by subtractive cDNA cloning. CD100 stimulation significantly enhanced the effects of CD40 on B cell responses. Administration of soluble CD100 markedly accelerated in vivo antigen-specific antibody responses. CD100 receptors with different binding affinities were detected on renal tubular cells (K(d) = approximately 1 x 10(-9)M) and lymphocytes (K(d) = approximately 3 x 10(-7)M). Expression cloning revealed that the CD100 receptor on lymphocytes is CD72, a negative regulator of B cell responsiveness. CD72 thus represents a novel class of semaphorin receptors. CD100 stimulation induced tyrosine dephosphorylation of CD72 and dissociation of SHP-1 from CD72. Our findings indicate that CD100 plays a critical role in immune responses by the novel mechanism of turning off negative signaling by CD72.

CD72, a negative regulator of B-cell responsiveness

The ability of lymphocytes to respond to antigenic or mitogenic stimulation is regulated not only by specific receptor proteins, but also by both positive and negative regulatory proteins that set or fine-tune the threshold for responsiveness. CD72 is one such regulatory protein on B lymphocytes. It is a member of the C-type lectin superfamily and is expressed on the surface of B cells from the pro-B through the mature B-cell stage. Studies with anti-CD72 antibodies have suggested a positive regulatory role for CD72 in B-cell activation. However, the cytoplasmic tail of CD72 contains two potential immunoreceptor tyrosine-based inhibitory motifs, one of which has been shown to recruit the tyrosine phosphatase SHP- 1. These features suggest a negative regulatory role for CD72. We have generated CD72-deficient mice to elucidate the physiological role of CD72 in B-lymphocyte development and activation. Our analyses of these mice and their B-cell compartment demonstrate that CD72 is a nonredundant regulator of B-cell development and a negative regulator of B-cell responsiveness.

4-[3-(5,6,7,8-Tetrahydro-5,5,8,8-tetramethyl-2-naphthalenyl)phenyl]benzoic acid and heterocyclic-bridged analogues are novel retinoic acid receptor subtype and retinoid X receptor alpha agonists

Aromatic retinoids having a meta-substituted aromatic ring bridge, such as 4-[3-(5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-naphthalenyl)phenyl]benzo ic acid and its 3,5-diaryl-substituted 4,5-dihydroisoxazole analogue, function as retinoid receptor panagonists by activating both retinoic acid and retinoid X receptors to induce gene transcription, and thereby provide novel scaffolds for retinoid drug development. Both classes of these ligand-inducible transcription factors are involved in mediating the inhibitory effects of retinoids on cancer cell growth.

sp2-bridged diaryl retinoids: effects of bridge-region substitution on retinoid X receptor (RXR) selectivity

RXR class selectivity and RXR transcriptional activation activity compared to those for the retinoic acid receptor subtypes were enhanced on the 4-(5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-naphthalenylethenyl)be nzoic acid scaffold and its 3-methyl analogue by replacing their 1,1-ethenyl bridge by a 1,1-(2-methylpropenyl) or cyclopropylidenylmethylene group.

[A study of the relation between ventricular repolarization duration and autonomic nervous system]

Cardiovascular disease is a growing problem recently. There has been a few attention in the study of ventricular repolarization duration variability. RDV is associated with some cardiac diseases. We studied vagal blockade effects on RDV in urethane-anesthetized rats. To study the relation between ventricular repolarization duration and autonomic nervous system in subjects, we changed the balance of autonomic nervous system by body posture. The HRV and RDV spectral analysis showed that HF peak was modulated by the frequency of controlled respiration. We also found a significant decrease in HFnu and increase in LF/HF in HRV and RDV during vagal blockade. There is a significant increase of LF/HF of subjects in HRV and RDV from supine to tilt, which is consistent with the state of autonomic nervous system. The result of our study is that the ventricular repolarization duration is dependent on the autonomic nervous system. The RDV analysis will be more helpful in the clinic. This approach will provide a more useful noninvasive evaluation of cardiac disease and function.

[Analysis of influence of axial length and keratometric value on the curative effects of excimer laser photorefractive keratectomy for myopia]

OBJECTIVE

To evaluate the influence of axial length (AL) and keratometric value (KV) on the curative effects of excimer laser photorefractive keratectomy (PRK) for myopia.

METHOD

A Keracor-17 excimer laser was used to treat 80 patients (121 eyes) with myopia. The cases were divided into three groups according to the AL and KV: The first group AL > 26 mm, KV <or= 45 D, 49 eyes; the second group AL <or= 26 mm, KV > 45 D, 36 eyes; the third group AL <or= 26 mm, KV <or= 45 D, 36 eyes. The curative effects were investigated.

RESULTS

The mean uncorrected visual acuity was 1.05 +/- 0.31, which had no significant difference among three groups (P > 0.05). The cases with uncorrected visual acuity >or= 0.5 had significant difference between the first and the second group and between the first and the third group (chi(2) = 6.30, P < 0.05). Multiple linear regression and correlative analysis showed that the increase in ocular axis was an unfavorable factor to visual acuity, while the increase in keratometric value was a favorable factor to visual acuity.

CONCLUSION

PRK for treatment of myopia is an effective and safe refractive surgery. When the myopic degrees are identical, the postoperative outcome of myopia with increase in keratometric value as the main pathogeny is better than the myopia with increase in axial length as the main pathogeny.

[A study of ventricular repolarization duration variability and dependence of RTm/RR]

As an important electrophysiological parameter that reflects cardiac depolarization and repolarization process, ventricular repolarization duration has been drawing growing attention. It is influenced by several physiological and pathological factors and associated with several cardiac diseases. We studied repolarization duration variability (RDV) and dependence of RTm/RR among normal subjects of different age-groups, as well as between normal subjects and subjects with cardiac diseases. It was found that RDV and dependence of RTm/RR are related to age. There are significant differences in the slope of RTm/RR, coherence, CV ratio and RDV between normal subjects and subjects with cardiac diseases. The RDV and dependence of RTm/RR can be employed in providing a more useful evaluation of cardiac disease and function in clinical care.

Synovial tissue in rheumatoid arthritis is a source of osteoclast differentiation factor

OBJECTIVE

Osteoclast differentiation factor (ODF; also known as osteoprotegerin ligand, receptor activator of nuclear factor kappaB ligand, and tumor necrosis factor-related activation-induced cytokine) is a recently described cytokine known to be critical in inducing the differentiation of cells of the monocyte/macrophage lineage into osteoclasts. The role of osteoclasts in bone erosion in rheumatoid arthritis (RA) has been demonstrated, but the exact mechanisms involved in the formation and activation of osteoclasts in RA are not known. These studies address the potential role of ODF and the bone and marrow microenvironment in the pathogenesis of osteoclast-mediated bone erosion in RA.

METHODS

Tissue sections from the bone-pannus interface at sites of bone erosion were examined for the presence of osteoclast precursors by the colocalization of messenger RNA (mRNA) for tartrate-resistant acid phosphatase (TRAP) and cathepsin K in mononuclear cells. Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to identify mRNA for ODF in synovial tissues, adherent synovial fibroblasts, and activated T lymphocytes derived from patients with RA.

RESULTS

Multinucleated cells expressing both TRAP and cathepsin K mRNA were identified in bone resorption lacunae in areas of pannus invasion into bone in RA patients. In addition, mononuclear cells expressing both TRAP and cathepsin K mRNA (preosteoclasts) were identified in bone marrow in and adjacent to areas of pannus invasion in RA erosions. ODF mRNA was detected by RT-PCR in whole synovial tissues from patients with RA but not in normal synovial tissues. In addition, ODF mRNA was detected in cultured adherent synovial fibroblasts and in activated T lymphocytes derived from RA synovial tissue, which were expanded by exposure to anti-CD3.

CONCLUSION

TRAP-positive, cathepsin K-positive osteoclast precursor cells are identified in areas of pannus invasion into bone in RA. ODF is expressed by both synovial fibroblasts and by activated T lymphocytes derived from synovial tissues from patients with RA. These synovial cells may contribute directly to the expansion of osteoclast precursors and to the formation and activation of osteoclasts at sites of bone erosion in RA.

CD72-deficient mice reveal nonredundant roles of CD72 in B cell development and activation

CD72, a B cell surface protein of the C-type lectin superfamily, recruits the tyrosine phosphatase SHP-1 through its ITIM motif(s). Using CD72-deficient (CD72-/-) mice, we demonstrate that CD72 is a nonredundant regulator of B cell development. In the bone marrow of CD72-/- mice, there was a reduction in the number of mature recirculating B cells and an accumulation of pre-B cells. In the periphery of CD72-/- mice, there were fewer mature B-2 cells and more B-1 cells. In addition, CD72 is a negative regulator of B cell activation, as CD72-/- B cells were hyperproliferative in response to various stimuli and showed enhanced kinetics in their intracellular Ca2+ response following IgM cross-linking.

Effect of benzene, toluene, xylene on the semen quality of exposed workers

OBJECTIVE

To examine the effects on semen and sperm quality of workers after a short and long term exposure to benzene, toluene, and xylene.

METHODS

The semen and blood of 24 married workers exposed to benzene, toluene, and xylene from shoemaking, spray painting, or paint manufacturing factories were collected. The concentration of benzene, toluene, and xylene in the blood and semen was determined by using headspace chromatographic method. Routine sperm test was carried out and acrosin activity detected.

RESULTS

The results showed that benzene, toluene, and xylene were found in the blood and semen of some ex-workers in a working environment where the air concentration of benzene, toluene, and xylene exceeded the maximum allowable concentration (MAC). This result was not found in workers of the control group. There were also some effects on the quality of semen in the exposed workers. For example, the percentage of semen with liquefaction time exceeding 30 minutes increased. The sperm vitality, motility and acrosin activity decreased. At the same time, there were a positive correlation between liquefaction time and the level of toluene in semen, and a negative correlation between sperm vitality, sperm activity or acrosin activity and working history.

CONCLUSIONS

The results suggested that the mixture could affect the quality of semen and sperm, which might be the main reason of the abnormal pregnancy outcome among the wives of workers exposed to benzene, toluene, and xylene. Further studies are, however, required to confirm these findings.

Three-dimensional pharmacophore hypotheses for the locust neuronal octopamine receptor (OAR3). Part 2: agonists

Three-dimensional pharmacophore hypotheses were built from a set of 43 agonists against octopamine receptor class 3 (OAR3) in locust nervous tissue. Among the 10 chemical-featured models generated by program Catalyst/Hypo, a hypothesis including hydrogen-bond acceptor (HBA), hydrophobic (Hp), and hydrophobic aliphatic (HpA1) features was considered to be important and predictive in evaluating OAR3 agonists. While the ideal and null hypotheses had a cost of 156.40 and 239.20, respectively, the 10 resulting hypotheses possessed costs from 169.89 to 175.81. The best hypothesis that was confirmed to have a 95% chance of true correlation yielded a low RMS of 0.757 and high regression r of 0.933. Active agonists mapped well onto all the features of the hypothesis such as HBA, Hp, and HpA1. On the other hand, inactive compounds were shown to be difficult to achieve the energetically favorable conformation which is found in the active molecules in order to fit the 3-D chemical feature pharmacophore models.

Three-dimensional molecular field analyses of octopaminergic agonists and antagonists for the locust neuronal octopamine receptor class 3

The quantitative structure-activity relationship (QSAR) of a set of 70 octopaminergic agonists and 20 antagonists against octopamine receptor class 3 (OAR3) in locust nervous tissue was analyzed by molecular field analysis (MFA). MFA of these compounds evaluated effectively the energy between a probe and a molecular model at a series of points defined by a rectangular grid. Contour surfaces for the molecular fields are presented. These results provide useful information in the characterization and differentiation of octopaminergic receptor types and subtypes.

[Clinical and experimental study of jianruling in treating hyperplasia of mammary gland]

OBJECTIVE

To observe the therapeutic effect of Jianruling (JRL) on hyperplasia of mammary gland (HMG) and to explore its mechanism in regulating sex hormones.

METHODS

Clinical changes of HMG were observed and serum sex hormones measured before and after JRL treatment. In experimental study, the effect of JRL was estimated by using electron microscope, pathologic and radioimmunoassay.

RESULTS

JRL could not only cure HMG, but also regulate the sex hormone secretion both in HMG patients and in rats. Clinical study showed that the clinical cure rate was 72.5%, and the total effective rate was 90.8%, it demonstrated a significant difference in comparing with the control group, P < 0.01. The estradiol and prolactin levels of patients lowered significantly after JRL treatment, P < 0.05, while progestogen and testosterone increased significantly, P < 0.05, but no significantly change of follicle-stimulating hormone and luteinizing hormone was found. JRL showed marked effect in treating and preventing experimental HMG in rats, it could modulate the secretive function of sex hormone, and improve the construction of mammary gland.

CONCLUSION

JRL has significant effect in treating HMG, it can adjust the endogenous sex hormone level, delay the development of chronic cystic hyperplasia of mammary gland.