Development of brain injury in mice by Angiostrongylus cantonensis infection is associated with the induction of transcription factor NF-kappaB, nuclear protooncogenes, and protein tyrosine phosphorylation

Eosinophilic meningitis or meningoencephalitis caused by Angiostrongylus cantonensis is endemic to the Pacific area of Asia, especially Taiwan, Thailand, and Japan. Although eosinophilia is an important clinical manifestation of A. cantonensis infection, the role of eosinophils in the progress of the infection remains to be elucidated. In this experiment, we showed that A. cantonensis-caused eosinoplia and inflammation might lead to the induction of NF-kappaB and protooncogene expression via activation of the tyrosine phosphorylation signal pathway. After mice were infected daily with 30 third-stage larvae of A. cantonensis by oral adminstration for 6 weeks, no significant differences PKC-alpha, MEK-1, ERK-2, JNK, and p38 protein expression were found between the control and infected mice. However, the protein tyrosine phosphorylation levels, NF-kappaB, and iNOS protein products were significantly increased by 3.5-, 3.3-, and 6.3-fold, respectively, after 3 weeks of A. cantonensis infection. The same pattern was found for c-Myc, c-Jun, and c-Fos proteins, which were elevated by 3.2-, 2.3-, and 3.4-fold, respectively, compared to control animals after 3 weeks. The expression potency of these proteins started increasing in week 1, reaching maximal induction in week 3, and then declining in week 5 after A. cantonensis infection. Another consistent result was noted in the pathological observations, including eosinophilia, leukocyte infiltration, granulomatous reactions, and time responses in brain tissues of infected mice. These data suggest that the development of brain injury by eosinophlia of A. cantonensis infection is associated with NF-kappaB and/or nuclear protooncogenes expression, which is activated by the tyrosine phosphorylation pathway.

Mutation analysis of the Bcl 10 gene in hepatocellular carcinoma

The Bcl 10 gene was recently discovered to be involved in the pathogenesis of lymphoma of mucosa-associated lymphoid tissue and several types of tumorous cell lines. We examined the mutation of Bcl 10 gene in 31 hepatocellular carcinomas along with their corresponding non-tumorous tissues by single strand conformation polymorphism (SSCP) and direct sequencing. The results showed that 11.3% chromosomes had codon 5 GCA to TCA mutation, 4.8% chromosomes had codon 8 CTC to CTG mutation, and 12.9% chromosomes had codon 213 GGA to GAA mutation. These mutations were found not only in the hepatoma tissues but also in paired non-cancerous tissues and the normal population. We suggest that these three changes are polymorphisms, and there is no relationship with the development of hepatocellular carcinoma.

Qualitative determination of urinary morphine by capillary zone electrophoresis and ion trap mass spectrometry

A rapid, sensitive method for the determination of morphine and amphetamine was developed using capillary zone electrophoresis coupled with electrospray interface (ESI), ion-trap tandem mass spectrometry (CE-ESI-MS2). Morphine and amphetamine were separated in 20 mM ammonium acetate buffer (pH 6.6) and detected by ion-trap mass detector in different analytical time segments (0-6.25 min for amphetamine and 6.25-12.0 min for morphine) in which the tune file for each compound was used separately. Molecular ions of morphine (m/z 286) and amphetamine (m/z 136) were detected at 5.77 and 6.83 min, respectively, while product ions of MS2 for each compound (m/z 229, 201 for morphine and m/z 119 for amphetamine) were detected almost exactly at the same time with their parent compounds. The limits of detection (LOD) for MS2 determination were 30 and 50 ng/mL for amphetamine and morphine, respectively, with an S/N ratio of 3. For more sensitive detection of morphine, the sample was injected for a longer time (i.e., 80 s) and hydrodynamically transported into a CE capillary for MS detection. Morphine and its product ion appear at 0.36 and 0.39 min on the ion chromatogram, respectively, with a five-fold increase of detection sensitivity (LOD, 10 ng/mL). The CE-MS system thus established was further applied for forensic urine samples screened as morphine-positive by fluorescence polarization immunoassay (FPIA). These results indicated the feasibility of CE-ESI-MS2 for confirmative testing of morphine in urine sample.

Analysis of the chimeric CYP21P/CYP21 gene in steroid 21-hydroxylase deficiency

BACKGROUND

A single nonfunctional chimeric gene with its 5' and 3' ends corresponding to CYP21P and CYP21, respectively, is caused by unequal gene crossover in the CYP21 genes during meiosis. The presence of the chimeric CYP21P/CYP21 molecule can not be detected by conventional PCR methods and therefore may be lost in PCR amplification. This leads to a false result and diagnostic discordance.

METHODS

We developed a rapid and direct method to detect a chimeric CYP21P/CYP21 gene that uses a 3'-specific primer for the CYP21 gene and two different 5' primers for both CYP21 and CYP21P to amplify the wild-type CYP21 and the chimeric CYP21P/CYP21 genes. A secondary PCR that can differentiate the chimeric from the wild-type gene was also performed. The PCR product was directly analyzed on agarose gel.

RESULTS

After careful titration, we found that earlier failure to detect the chimeric CYP21P/CYP21 gene could be caused by unequal concentrations of two independent alleles as the PCR template or by the lack of primers to amplify chimeric molecules. We successfully amplified the chimeric gene using our improved method.

CONCLUSIONS

The chimeric CYP21P/CYP21 is present in a large portion of congenital adrenal hyperplasia patients. By adding a CYP21P/CYP21-specific primer, we were able to amplify and detect both homozygous and heterozygous chimeric genes. Therefore, our new PCR-based assay is a more effective way to analyze congenital adrenal hyperplasia mutations.

Analysis of an SMN gene-like DNA fragment

Part of a survival motor neuron (SMN) gene-like DNA fragment has been identified. This DNA fragment was accidentally isolated from cDNA by RT-PCR using primers specific for the region between exon 3 and 6 of the SMN gene. This fragment was used as a probe to hybridize the mRNA from several tissues, but we have been unable to detect any transcript of this SMN-like gene in these tissues. Thus, we have inferred this SMN gene-like fragment was a genomic product contaminant that was amplified in the reaction. Sequencing analysis of this fragment, which contains several stop codons, revealed a 74.6% nucleotide homology with the SMN gene. From these results, we believe that this DNA fragment is not a mutated form of SMN gene. Rather, it is an SMN-like pseudogene, which is variably present even in normal individuals.

Rapid identification of the ABO genotypes by their single-stand conformation polymorphism

The ABO locus on chromosome 9 contains many more alleles than are currently used routinely in forensic science. The use of single-strand conformation polymorphism (SSCP) can separate sequence polymorphisms that differ by only one base. The SSCP process used allows for both single- and double-stranded polymerase chain reaction (PCR) products to be visualized. The six ABO genotypes can be differentiated by the allele-specific B and O SSCP patterns. The double-stranded DNA produced 'hybrid' bands due to heterozygous samples and allowed sequence diversity to be detected between alleles of heterozygotes. These 'hybrid' bands are valid markers to confirm genotypes of specimens.

Carrier analysis and prenatal diagnosis of congenital adrenal hyperplasia caused by 21-hydroxylase deficiency in Chinese

Congenital adrenal hyperplasia (CAH) is a common autosomal recessive disorder mainly caused by defects in the steroid 21-hydroxylase (CYP21) gene. We screened 1,000 healthy people, using a previously developed differential PCR method combined with single-strand conformation polymorphism and amplification-created restriction site methods for the carrier detection of the CYP21 gene deficiency. Our results indicated that the rate of occurrence of the heterozygous CAH carrier was about 12 in 1,000, with a gene frequency of 0.0060 and an incidence frequency of 1 in 28,000 in the Chinese population. In addition, 9 cases of CAH families were performed with prenatal diagnosis. Among them, 3 cases were diagnosed as the severe form, 4 cases carried the heterozygous mutation, and 2 were normal. This is the first report of carrier frequency analysis and prenatal diagnosis of 21-hydroxylase deficiency in Chinese.

Effect of die relief on the seating, fit and retention of cast gold crowns cemented on human teeth

Die relief, by means of a paint-on die spacing material, is the most common method of achieving sufficient space between metal castings and tooth surfaces for cement to flow during seating. Several studies have determined the influence of cementing variables on crowns made for metal and plastic test dies. This study assessed the influence of die relief upon the seating and retention of cast gold crowns constructed for natural human teeth. Standard full crown preparations were made for 10 matched pairs of extracted human third molars, one each of which had been relieved with die spacer of approximately 40 microns thickness. Crowns were made by the indirect technique and were cemented with zinc phosphate cement in a static/dynamic jig. Seating behaviour and vertical discrepancies were measured electronically. Tensile bond strengths were determined in a universal testing machine. Results showed that die relief reduced vertical seating discrepancy associated with cementation by up to 79 microns. Differences between paired relieved and unrelieved samples were significant (p < 0.05). There were no statistically significant differences in tensile bond between paired relieved and unrelieved crowns.

Molecular analysis of Duffy, Yt and Colton blood groups in Taiwanese, Filipinos and Thais

We used a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method for DNA-based typing of Duffy, Yt and Colton blood groups in Taiwanese, Filipinos and Thais. A total of 200 Taiwanese, 115 Filipinos and 105 Thais were studied. In the Duffy blood group in Taiwanese, 180 cases (90%) were homozygote of Fya, 18 cases (9%) were double heterozygote of Fya and Fyb, and 2 cases (1%) were homozygote of Fyb. In Filipinos, 98 cases (85.2%) were homozygote of Fya, 16 cases (14.0%) were double heterozygote of Fya and Fyb and 1 case (0.8%) was homozygote of Fyb. In Thais, 87 cases (82.9%) were homozygote of Fya, 18 cases (17.1%) were double heterozygote of Fya and Fyb, and no case of Fyb was found. These results correlate well with serological phenotype. For the Yt blood group, only YT1 was found in Taiwanese. Among Filipinos, 114/115 (99.1%) was YT1/1 and 1/115 (0.9%) was YT1/2. In Thais, 103/105 (98.1%) was YT1/1 and 2/105 (1.9%) was YT1/2. For the Colton blood group, the results showed that there was only Coa allele in these three populations. Our results provide the first data of the Yt and Colton blood groups in these three populations.

Nitracrine N-oxides: effects of variations in the nature of the side chain N-oxide on hypoxia-selective cytotoxicity

The tertiary amine N-oxide (nitracrine-N-oxide, 1b) of the 1-nitroacridine nitracrine is a bis-bioreductive agent showing very high hypoxic selectivity (approximately 1000-fold) against tumour cells in culture, but only modest activity against the hypoxic subfraction of tumours in vivo. Because the hypoxic selectivity of 1b was considered to depend significantly on the rate of enzyme-mediated reduction of the N-oxide group, this paper reports the preparation and evaluation of a series of analogues in which the environment of this group was modified. Three analogues contained more weakly basic N-oxides, while two others had varying degrees of steric bulk around the N-oxide. In all but one case (an aromatic N-oxide), the N-oxides were much less cytotoxic (10- to 300-fold) than the corresponding tertiary amines towards AA8 Chinese hamster cells under aerobic conditions. Both the N-oxides and the corresponding amines were more cytotoxic to an ERCC-1 mutant defective in nucleotide excision repair, indicating that DNA alkylation was the cytotoxic event. However, there was no apparent correlation of these parameters with structure. All of the aliphatic N-oxides, with the exception of the aromatic N-oxide example, showed substantial (70- to 800-fold) hypoxic selectivity against AA8 cells in a clonogenic assay. While the weakly basic derivatives were the least selective, there was no apparent relationship between hypoxic selectivity and the steric environment of the N-oxide. Selectivity for hypoxic cells in culture is shown to depend on the hypoxic selectivity of the corresponding tertiary amine (reflecting O2-inhibitable reduction of the 1-nitro group) and the differential in aerobic toxicity between amine and N-oxide (a measure of the potential toxicity increase achievable by reducing the N-oxide). Four analogues whose structures fairly represented the range of steric and electronic modifications of the N-oxide site were evaluated against the hypoxic subfraction of cells in KHT tumours in vivo, but were inactive. These results suggest that either such modifications do not exert significant effects on N-oxide reduction, or that the rate of such reduction is not a factor limiting the in vivo activity of the parent analogue 1b.

Fracture toughness and durability of chemically or thermally tempered metal-ceramic porcelain

Thermocycling and water storage effects on fracture toughness (KIC) of chemically or thermally tempered metal-ceramic disks were investigated to evaluate the durability of tempering effects with regard to oral aqueous environment. Metal-ceramic disks (phi 10 mm x 2.0 mm) consisting of opaque porcelain (0.2 mm thick), body porcelain (1.3 mm) and Ni-Cr-Be alloy (0.5 mm) were prepared and the porcelain surfaces were polished with 1-micron diamond paste. The disks were subjected to ion exchange (potassium or rubidium) or thermal tempering treatments, then with the as-polished or further annealed disks, thermocycled for 8000, 15,000, and 22,000 cycles between 5 degrees C and 60 degrees C or stored in water at 37 degrees C for 33 days. After aging, KIC values of disks were determined by a Vickers indentation technique. Statistical analyses indicated that the KIC values of ion-exchanged and annealed disks were not significantly affected by the limited number of cycles and water storage, while the thermally tempered and untreated disks revealed a significant decrease in mean KIC from even 8000 cycles and after storage. However, there was no significant difference between thermocycling and water-storage effects on mean KIC of all surface treatment groups. Results indicate that chemical tempering (ion exchange) produced more durable residual stresses than does thermal tempering for metal-ceramic restorations. A low-thermal load only was unlikely to affect the apparent fracture toughness of porcelain.

NF-kappa B-dependent Fas ligand expression

Apoptosis of lymphocytes is triggered by different stimuli through the induced expression of Fas and Fas ligand (FasL). Using T cell activation-induced Fas/FasL expression as a model system, we observed a differential regulation of the induction of Fas and FasL. cAMP inhibited activation-induced apoptosis by an effective suppression of TCR-coupled FasL expres sion. In contrast, cAMP weakly interfered with activation-induced Fas expression, and the remaining Fas molecules on cAMP-treated T cells still mediated apoptosis. Among the major transcription elements on the FasL promoter, the activation of NF-kappaB, but not of NF-AT and AP-1, was suppressed by cAMP. The prominent role of NF-kappaB was further demonstrated by a better activation of the FasL promoter and an elevated expression of FasL induced by p65 (RelA) overexpression than those induced by AP-1 or NF-AT. Our results demonstrate the essential role of NF-kappaB for the expression of the death receptor ligand FasL, and suggest a direct link between NF-kappaB activation and the expression of FasL. NF-kappaB may be the common mediator in the induction of FasL through TCR activation and by various stress stimuli.

NF-kappaB-mediated up-regulation of Bcl-x and Bfl-1/A1 is required for CD40 survival signaling in B lymphocytes

Activation of CD40 is essential for thymus-dependent humoral immune responses and rescuing B cells from apoptosis. Many of the effects of CD40 are believed to be achieved through altered gene expression. In addition to Bcl-x, a known CD40-regulated antiapoptotic molecule, we identified a related antiapoptotic molecule, A1/Bfl-1, as a CD40-inducible gene. Inhibition of the NF-kappaB pathway by overexpression of a dominant-active inhibitor of NF-kappaB abolished CD40-induced up-regulation of both the Bfl-1 and Bcl-x genes and also eliminated the ability of CD40 to rescue Fas-induced cell death. Within the upstream promoter region of Bcl-x, a potential NF-kappaB-binding sequence was found to support NF-kappaB-dependent transcriptional activation. Furthermore, expression of physiological levels of Bcl-x protected B cells from Fas-mediated apoptosis in the absence of NF-kappaB signaling. Thus, our results suggest that CD40-mediated cell survival proceeds through NF-kappaB-dependent up-regulation of Bcl-2 family members.

Pediatric genitourinary tumors

Advances in our knowledge of pediatric genitourinary tumors are being made at a rapid pace at both the basic science and clinical levels. As the molecular mechanisms underlying these malignancies are being uncovered, treatment options are being modified to decrease morbidity and, ultimately, increase survival. This article reviews the recent literature on Wilms' tumor, rhabdomyosarcoma, and testicular tumors.

Neoadjuvant hormonal therapy in carcinoma of the prostate

The rising incidence of and mortality from prostate cancer has generated great interest in improving the results of current methods of treatment. It is well-established that large tumour volumes and positive surgical margins are correlated with higher rates of local failure and distant metastasis. Significant decreases in both tumour volume and the rates of positive surgical margins are seen with NHT. Follow-up data from one randomized trial of hormonal therapy before RT have shown significantly improved disease-free survival, but so far there has been no benefit in overall survival. However, the addition of adjuvant hormonal therapy has been reported to improve survival. The results suggest that neoadjuvant and adjuvant hormonal therapy may be a viable option in men with locally advanced prostate cancer in whom cure is probably impossible, but disease progression can potentially be slowed. What remains to be determined is whether hormonal therapy alone can produce the same results. For younger men with clinically localized prostate cancer, radical prostatectomy is increasingly the treatment of choice. Prospective randomized trials of NHT have produced impressive statistics for decreasing the incidence of positive surgical margins, but the potential to down-stage tumours remains controversial. Follow-up serum PSA measurements have thus far shown no benefit from neoadjuvant therapy. The possibility that patients who fail biochemically, whether they are from the pretreated or control group, may simply represent a subgroup with aggressive tumours that may not respond to androgen withdrawal, has yet to be proved. As more follow-up data are analysed within the next several years, there must be a clear survival advantage if NHT is to be offered as a treatment option. Despite the potential of neoadjuvant therapy, the use of androgen withdrawal before definitive surgical treatment should be limited to clinical trials until a clearer picture emerges. Some may argue that although there is no evidence of a true advantage for NHT, neither is there evidence of harm. However, it must be recognized that androgen withdrawal therapy has side-effects and adds significantly to the overall cost of treatment. Furthermore, NHT delays definitive treatment; clearly, this can be a source of anxiety for the patient and the impact on survival is unknown. Currently, the rates of pathologically organ-confined disease are high in some subsets of patients (e.g. low-stage, low-grade and low PSA) so that NHT is unlikely to have great additional benefit. Although the influence of hormones on prostate growth has been known for many decades, we are only now elucidating the biological mechanisms of hormonal therapy. Although androgen ablation therapy has been used in men with metastatic prostate cancer for more than 50 years, further research at the cellular and molecular level is essential if we are to refine treatment modalities for both localized and advanced disease. Furthermore, until we have more follow-up data from randomized clinical trials of NHT, it cannot be considered part of the standard treatment for carcinoma of the prostate. There are still too many unknown factors; only time will tell if the initial promise of NHT will be fulfilled.

Specificities of CD40 signaling: involvement of TRAF2 in CD40-induced NF-kappaB activation and intercellular adhesion molecule-1 up-regulation

Several tumor necrosis factor receptor-associated factor (TRAF) family proteins including TRAF2, TRAF3, TRAF5, and TRAF6, as well as Jak3, have been implicated as potential mediators of CD40 signaling. An extensive in vitro binding study indicated that TRAF2 and TRAF3 bind to the CD40 cytoplasmic tail (CD40ct) with much higher affinity than TRAF5 and TRAF6 and that TRAF2 and TRAF3 bind to different residues of the CD40ct. Using CD40 mutants incapable of binding TRAF2, TRAF3, or Jak3, we found that the TRAF2-binding site of the CD40ct is critical for NF-kappaB and stress-activated protein kinase activation, as well as the up-regulation of the intercellular adhesion molecule-1 (ICAM-1) gene, whereas binding of TRAF3 and Jak3 is dispensable for all of these functions. Overexpression of a dominantly active IkappaBalpha strongly inhibited CD40-induced NF-kappaB activation, ICAM-1 promoter activity, and cell-surface ICAM-1 up-regulation. These studies suggest a potential signal transduction pathway from the CD40 receptor to the transcriptional activation of the ICAM-1 gene.

Vezf1: A Zn finger transcription factor restricted to endothelial cells and their precursors

Using retroviral entrapment vectors, we identified a novel mouse gene whose expression is restricted to vascular endothelial cells and their precursors in the yolk sac blood islands. A 3.68-kb cDNA corresponding to the endogenous transcript was isolated using genomic DNA flanking the entrapment vector insertion as a probe. We have named this gene Vezf1 for vascular endothelial zinc finger 1. Vezf1 encodes a protein with a predicted molecular mass of 56 kDa and that contains six putative zinc finger domains and shows high homology to a previously identified human gene, DB1, that is believed to be involved in regulating expression of cytokine genes such as interleukin-3. In situ hybridization analysis revealed the onset of expression in advanced primitive streak-stage embryos being located in the extraembryonic mesodermal component of the visceral yolk sac and in the anteriormost mesoderm of the embryo proper. During head-fold and somite stages, expression was restricted to vascular endothelial cells that arise during both vasculogenesis and angiogenesis. Vezf1-related sequences were found to be highly conserved among higher vertebrate species that have acquired extraembryonic yolk sac membranes during evolution. The Vezf1 locus mapped to the proximal part of mouse chromosome 2, a region which has homology to human chromosome 9q. Vezf1 expression correlates temporally and spatially with the early differentiation of angioblasts into the endothelial cell lineage and the proliferation of endothelial cells of the embryonic vascular system. Thus, Vezf1 may play an important role in the endothelial lineage determination and may have an additional role during later stages of embryonic vasculogenesis and angiogenesis.

Development of calcium phosphate cement for rapid crystallization to apatite

The purpose of this study was to develop an alpha-tricalcium phosphate (alpha-TCP) cement which transforms to hydroxyapatite (HAP) in a relatively short period. We used calcium and phosphate solutions as the liquid phase for the alpha-TCP cement. The alpha-TCP powder was first mixed with CaCl2 solution, and then mixed with NaH2PO4 or Na2HPO3 solution for a total powder/liquid ratio of 1.8. The setting time became shorter with the increase in the concentration of calcium and phosphate solutions, reaching 5 min, whereas the setting time was longer than 30 min when distilled water was used as the liquid phase. X-ray diffraction analysis revealed that the cement was mostly transformed to HAP within 24 h when kept in an incubator. We concluded that alpha-TCP should be mixed with calcium and phosphate solutions since this results in a moderate setting time and fast transformation to HAP even if the method of mixing becomes a little complex.

Identification of four novel mutations in the CYP21 gene in congenital adrenal hyperplasia in the Chinese

Congenital adrenal hyperplasia (CAH) is a common autosomal recessive disorder mainly caused by defects in the steroid 21-hydroxylase (CYP21) gene. We have analyzed CYP21 gene sequences in 65 CAH families in Taiwan. All ten exons of the CYP21 gene were analyzed by differential polymerase chain reaction followed by single-strand conformation polymorphism electrophoresis and the amplification-created restriction site method. About 95% (123 chromosomes) contain mutations due to conversion of DNA sequences into its neighboring homologous pseudogene, CYP21P. Four novel mutations representing 5% of the total chromosomes have also been identified. The mutations were confirmed by sequencing an aberrant DNA fragment. These four mutations included a base change of the splicing donor site at intron 2 from GT to AT, a base substitution of C to T at codon 316, deletion of ten bases (TCCAGCTCCC) at codons 330-333 of exon 8, and duplication of 16 bases (CCTGGATGACACGGTC) at codons 393-397 of exon 9. The loss of the splicing donor site at intron 2 and the premature stop at codon 316 may result in aberrant splicing to reduce enzyme activity and a truncated protein with no enzyme activity, respectively. Likewise, both the duplication and the deletion forms create a frameshift and premature stop during translation. The resulting proteins lack the heme-binding domain and hence are expected to lose enzymatic activity. Since these mutations are not found in the neighboring CYP21P pseudogene, gene conversion should not be the cause of these novel mutations.

In vitro effects of various neuropharmacological agents on the motility of adult Clonorchis sinensis

Stimulatory effects were observed in vitro when 5-HT was applied to whole worm preparations of Clonorchis sinensis. The stimulatory action of 5-HT was antagonized by tryptophol, clomipramine and imipramine. Strychnine remarkably stimulated motility. The action of strychnine was enhanced by 5-HT but inhibited by tryptophol. GABA, Phenylephrine, isoproterenol, dibenamine and phentolamine showed little influence on motility. Inhibitory effects were caused by eserine, arecoline, carbachol, DMPP and hemicholinium-3, but not by ACh, pilocarpine and McN-A-343. The inhibitory actions of eserine or carbachol were not antagonized by d-tubocurarine, hexamethonium or atropine. These results suggest that in regulating the motility of C. sinensis ACh may function as an inhibitory neurotransmitter and 5-HT as an excitatory transmitter in a manner similar to that already established for other trematodes such as Fasciola hepatica and Schistosoma mansoni.

Synthesis and hypoxia-selective cytotoxicity of a 2-nitroimidazole mustard

A four-step synthesis of 5-[N,N-bis(2-chloroethyl)amino]-1-methyl-2-nitroimidazole from 1-methyl-2-nitroimidazole is described. This compound showed similar hypoxia-selective cytotoxicity to the dinitrobenzamide mustard SN 23,862 in UV4 cells (ca. 40-fold), and superior selectivity (> 7-fold) in repair-competent AA8 cells.

Conjunctivitis caused by Thelazia callipaeda infestation in a woman

Thelazia is a nematode (Spirurida) that can parasitize the mammalian conjunctival sac. This is the first reported case of ocular. Thelazia callipaeda infestation in Taiwan. A 41-year-old woman experienced swelling, itching sensation and occasional blurred vision of the right eye 2 weeks after a small group of flies swarmed her eye while she was hiking. Her symptoms were first misdiagnosed as allergic conjunctivitis at a local medical clinic. During her first visit to our outpatient department, five white thread-like living worms were discovered on the superior and inferior fornices. The worms were cream-colored, slender and approximately 1 cm in length. Follicular and papillary conjunctivitis was noted in her right eye. After removing the worms, the symptoms resolved and no other worms were found in the following 2 months. This case is a remainder to physicians that parasitic infestation should be included in the differential diagnoses of ocular itching, conjunctivities, and blurred vision after insect contact.

Energy, macronutrient, and food intakes in relation to energy compensation in consumers who drink different types of milk

To examine whether total fat intake is actually lower in reduced-fat (low-fat and skim) milk drinkers and whether reduced-fat-milk drinkers compensate for energy intake we compared the intakes of foods, energy, and energy-yielding nutrients in reduced-fat-milk drinkers and whole milk drinkers by using the US Department of Agriculture's 1989-1991 nationwide food intake database, the Continuing Survey of Food Intakes by Individuals. This database represents a national stratified sample population of 15 128 individuals. Of the survey population, approximately one-third consumed whole milk, one-third consumed low-fat milk, one-tenth consumed skim milk, and one-tenth consumed mixed types of milk. The data provided the following information: 1) total fat intake of reduced-fat-milk drinkers is significantly (P < or = 0.05) lower than that of whole milk drinkers; 2) in general, males but not females compensate for energy by increasing their carbohydrate intake; 3) reduced-fat-milk drinkers consume more fruit and vegetables (P < or = 0.05) and less red meat and sweets (P < or = 0.05) than whole milk drinkers; 4) through their reduction in total fat intake, several age groups of skim milk drinkers have achieved the US dietary goal for fat intake, ie, < or = 30% of energy intake from fat; 5) teenagers compensate for energy intake the least of all age groups; and 6) with advancing age, fewer people drink milk and fewer drink whole milk. The data indicate significant sex differences in energy compensation, that reduced-fat-milk drinkers consume significantly (P < or = 0.05) less fat than whole milk drinkers, and that the US dietary goal for fat intake may be practically achieved by consuming reduced-fat foods such as skim milk and limiting intakes of high-fat foods such as red meat.

Occupational exposure to HIV, hepatitis B, hepatitis C, and tuberculosis

This article reviews risk of occupational exposure to bloodborne pathogens, specifically HIV, hepatitis B, and hepatitis C to healthcare workers. Information regarding assessing the risk of exposure, appropriate actions to take if an exposure occurs, the most recent recommendations for treatment and follow-up postexposure, and prevention strategies for avoiding exposure are presented. Additionally, current recommendations for the prevention of the transmission of tuberculosis in healthcare workers and the regulatory guidelines governing this topic are discussed.

Malignant eccrine spiradenoma with florid squamous differentiation

Malignant eccrine spiradenoma (MES) is an exceedingly rare neoplasm of cutaneous adnexal origin. To date, 31 cases have been documented in the literature. We herein report an additional case of MES that arose in longstanding eccrine spiradenoma (ES). A 54-year-old woman was seen for a bluish nodular mass on the right flank that previously had been stable for 7 to 8 years and had recently increased in size and become tender. The excised mass (2.8 x 2.5 x 2.5 cm) had no attachment to the overlying epidermis. Microscopically, 2 to 3 sharply demarcated lobules were surrounded by a markedly thickened and hyalinized fibrous capsule. Of the lesion removed, approximately 20% of the tumor showed typical histologic features of benign ES. In the remaining malignant areas, the typical configuration of benign counterpart, consisting of peripheral rows of small dark basaloid cells and central layers of large pale cells partially forming lumina, was replaced with a massive solid proliferation of large pale cells showing nuclear pleomorphism, prominent nucleoli, increased mitotic activity (reaching 12/10 HPF) and loss of PAS-positive basement membrane. There were multiple foci of florid squamous differentiation in the malignant portion. Cytokeratin, focally S-100 and EMA were expressed in large pale cells, whereas alpha smooth muscle actin and S-100 were positive in small dark basaloid cells. Focal reactivity of CEA and EMA was found in the central lumina. P53 was not expressed in benign areas, whilst in malignant areas an occasional nuclear reaction was disclosed.

Anatomic and physiologic measurements of the internal and external anal sphincters in normal females

OBJECTIVE

To assess the correlation between anal sphincter magnetic resonance imaging (MRI) measurements and manometric anorectal vectography pressures.

METHODS

Ten healthy, nulliparous women underwent anal sphincter MRI with examination of sagittal, axial oblique, and coronal planes. Anal manometry was performed with a radial eight-channel catheter. Customary functional measurements were recorded, including anterior and posterior sphincter length, squeeze length, length of the high-pressure zone, and maximal resting and squeeze pressures. The Spearman rank correlation coefficient was used to assess correlation.

RESULTS

The manometric squeeze length and the manometric length to maximum squeeze pressure were correlated negatively with the posterior sphincter length by MRI (P = .049 and .044, respectively). The manometric high-pressure zone squeeze length was correlated positively with the posterior sphincter length by MRI (P = .042). The mean +/- standard deviation (SD) posterior sphincter length was 27.3 +/- 6.0 mm. Anatomically, the cylindric shape of the anal sphincter is characterized by a gradual increase in muscle thickness cephalad. The external striated sphincter was much thicker posteriorly (24.7 +/- 4.6 mm) than anteriorly (6.6 +/- 1.7 mm) in the proximal or caudal third. The proximal internal smooth muscle sphincter was nearly equal in thickness anteriorly and posteriorly (9.0 +/- 1.4 mm and 9.6 +/- 1.7 mm, respectively). Although variation in the thickness of both the smooth and striated muscle was found, manometric pressures did not correlate with the muscle thickness along the sphincter.

CONCLUSION

The length of the anal sphincter correlated positively with the functional information, as determined by manometry. An anal sphincter length of 3 cm is consistent, from an anatomic and functional view, in these ten normal women.

Reconstruction of orbital floor fractures with maxillary bone

OBJECTIVE

To evaluate the use of autogenous maxillary bone for the repair of orbital floor defects secondary to blunt facial trauma.

DESIGN

Retrospective case series of 41 patients with a mean follow-up of 1.7 years.

SETTING

Major metropolitan teaching hospital.

PATIENTS

Forty-one consecutive patients who underwent repair of orbital floor fractures with maxillary antral wall bone grafts.

MAIN OUTCOME MEASURES

Presence of diplopia, orbital dystopia, implant extrusion, enophthalmos, infection, and donor site complications.

RESULTS

On follow-up clinical examinations, none of the 41 patients presented with any evidence of orbital dystopia or complications relative to the implant or donor site. Two patients had persistent enophthalmos, and 4 had persistent infraorbital nerve paresthesia. Postoperative computed tomographic scans in 12 patients revealed an adequate maintenance of orbital volume without any evidence of resorption of the graft.

CONCLUSION

The use of maxillary antral wall bone for the repair of orbital floor fractures is a highly reliable technique that carries minimal morbidity.

Influence of modification of Na2O in a glass matrix on the strength of leucite-containing porcelains

The desirable thermal properties of matrix glass to the strength of feldspar porcelain with leucite crystal were investigated. Five kinds of feldspar glasses, each with different a content of Na2O, were prepared for the matrix glasses of the leucite-containing porcelains. The specimens were arranged by mixing each glass powder with high-purity natural leucite crystals (0, 20 and 40%) followed by firing. The thermal properties of the glass and the transformation temperature of the leucite were measured. A three-point bending test was performed to measure the flexural strength of the porcelains. The glass transition temperature and deformation temperature of the glass-only porcelains were decreased as the Na2O content increased. The Na2O-modified glasses were substantially strengthened by the leucite dispersion. However, the strength of the porcelains was affected by the relation between the transformation temperature of the leucite and the thermal properties of the glass matrix. It was concluded that control of the residual stress in the composite porcelain is an important factor in developing high strength porcelain containing leucite.

Dependency of contractile reserve on myocardial blood flow: implications for the assessment of myocardial viability with dobutamine stress echocardiography

BACKGROUND

Contractile reserve, improvement in contractile function during inotropic stimulation, is a proposed marker of viable myocardium. This study was designed to address, in patients with left ventricular dysfunction due to chronic coronary artery disease, whether contractile reserve depends on myocardial blood flow.

METHODS AND RESULTS

We studied 19 patients, at rest and during dobutamine, with 2D echocardiography for regional mechanical function and PET for regional myocardial blood flow ([(15)O]water) and oxygen consumption ([11C]acetate). Of 166 myocardial segments, 21 had normal systolic function, 56 were dysfunctional but contractile reserve-positive, and 89 were dysfunctional and contractile reserve-negative. Myocardial blood flow at rest was lower in contractile reserve-negative (0.41+/-0.18 mL x g(-1) x min(-1)) than in contractile reserve-positive (0.50+/-0.22 mL x g(-1) x min(-1)) and normal segments (0.55+/-0.20 mL x g(-1) x min(-1), P<.009). After dobutamine infusion, blood flow increased less in contractile reserve-negative (0.63+/-0.38 mL x g(-1) x min(-1)) than in contractile reserve-positive (1.28+/-0.65 mL x g(-1) x min(-1)) and normal segments (1.93+/-0.83 mL x g(-1) x min(-1), P<.0001). Likewise, myocardial oxygen consumption was lower at rest in contractile reserve-negative (clearance rate of [11C]acetate, 0.043+/-0.012 min(-1)) than in contractile reserve-positive (0.048+/-0.01 min(-1)) and normal segments (0.058+/-0.008 min(-1), P<.02). Myocardial oxygen consumption with dobutamine increased less in contractile reserve-negative (0.060+/-0.013 min(-1)) than in contractile reserve-positive (0.077+/-0.016 min(-1)) and normal segments (0.092+/-0.024 min(-1), P<.0001). Of segments defined as viable by PET, 54% were contractile reserve-negative and exhibited lower blood flow with dobutamine (0.72+/-0.36 mL x g(-1) x min(-1)) than with viable, contractile reserve-positive segments (1.29+/-0.70 mL x g(-1) x min(-1), P<.0001).

CONCLUSIONS

Contractile reserve depends, in part, on the level of myocardial blood flow at rest and during inotropic stimulation.

Diagnosis of Neisseria gonorrhoeae infections in women by using the ligase chain reaction on patient-obtained vaginal swabs

The increased sensitivities of nucleic acid amplification tests such as ligase chain reaction (LCR) have the potential to simplify specimen collection for gonorrhea diagnosis. In this study patients took their own vaginal swab specimens for gonorrhea culture and LCR testing. Immediately following specimen collection by patients, a trained clinician obtained endocervical swab specimens for the same tests. By using LCR to diagnose gonorrhea, 54 (17.5%) of 309 patients had positive tests. Forty-five patients with positive cervical LCR tests also had positive vaginal LCR tests; for one patient, only a cervical LCR specimen was positive, and for eight patients, only vaginal specimens were positive. For specimens from patients whose gonorrhea cultures were positive, all vaginal swab specimens were positive by LCR and 42 (91%) of 46 cervical swab specimens were positive by LCR. LCR-positive specimens from eight patients with negative cultures (four with positive vaginal specimens only, one with a positive cervical specimen only, and three with positive vaginal and cervical specimens) were further evaluated with unrelated probe sets for gonococcal pilin B. Following resolution of the discrepancies between culture-negative and LCR-positive specimens, a diagnosis of gonorrhea could be confirmed for 52 of 54 patients with positive LCR tests. LCR testing with vaginal swabs was 100% sensitive and 99.6% specific and had a positive predictive value of 98.1% and a negative predictive value of 100%. In this study LCR testing of vaginal swab specimens obtained by patients themselves was significantly more sensitive for gonorrhea diagnosis of women than cervical LCR or culture (100% versus 84.6% for cervical LCR or culture; Mantel-Haenszel chi-square test result, 8.58; P = 0.003).

Diagnosis of genitourinary Chlamydia trachomatis infections by using the ligase chain reaction on patient-obtained vaginal swabs

We compared the ligase chain reaction (LCR) assay to cell culture for diagnosis of genitourinary chlamydial infections in women using swab specimens obtained by clinicians from the endocervix and by patients from their own vaginas. Specimens from 40 (12.9%) of 309 patients were positive for chlamydial infection by culture, while the specimens of 50 (16.2%) patients were positive by LCR. Chlamydia trachomatis infection was verified for 9 of 10 patients whose LCR specimens were positive but whose cultures were negative. Vaginal and cervical swab specimens were positive by LCR for 46 (93.9%) and 44 (89.8%) of 49 chlamydia-infected patients, respectively. These data suggest that LCR testing for chlamydia with vaginal swab specimens obtained by patients themselves is as sensitive as cervical LCR and more sensitive than cell culture.

Expression of a divergent expansin gene is fruit-specific and ripening-regulated

Expansins are proteins that induce extension in isolated plant cell walls in vitro and have been proposed to disrupt noncovalent interactions between hemicellulose and cellulose microfibrils. Because the plant primary cell wall acts as a constraint to cell enlargement, this process may be integral to plant cell expansion, and studies of expansins have focused on their role in growth. We report the identification of an expansin (LeExp1) from tomato that exhibits high levels of mRNA abundance and is specifically expressed in ripening fruit, a developmental period when growth has ceased but when selective disassembly of cell wall components is pronounced. cDNAs closely related to LeExp1 were also identified in ripening melons and strawberries, suggesting that they are a common feature of fruit undergoing rapid softening. Furthermore, the sequence of LeExp1 and its homologs from other ripening fruit define a subclass of expansin genes. Expression of LeExp1 is regulated by ethylene, a hormone known to coordinate and induce ripening in many species. LeExp1 is differentially expressed in the ripening-impaired tomato mutants Nr, rin, and nor, and mRNA abundance appears to be influenced directly by ethylene and by a developmentally modulated transduction pathway. The identification of a ripening-regulated expansin gene in tomato and other fruit suggests that, in addition to their role in facilitating the expansion of plant cells, expansins may also contribute to cell wall disassembly in nongrowing tissues, possibly by enhancing the accessibility of noncovalently bound polymers to endogenous enzymic action.

Differential serological diagnosis of HTLV-I and HTLV-II infection by external membrane protein peptide-based enzyme immunoassays

BACKGROUND

HTLV antibody screening assays detect both antibodies to the etiological agent of adult T-cell leukemia and tropical spastic paraparesis HTLV-I and to the less pathogenic HTLV-II. It is critical to make a differential diagnosis of the two viruses.

OBJECTIVES

To design and evaluate synthetic core and envelope-derived peptide enzyme immunoassays (EIA) for serological differential diagnosis.

STUDY DESIGN

Peptide EIAs were evaluated with a panel of 202 plasma samples comprised of HTLV antibody positive, serologically classified as confirmed, indeterminate, or non confirmed, characterized as HTLV-I, HTLV-II or neither by genomic amplification. The peptide EIA with the best performance was further used to differentiate between HTLV-I and HTLV-II antibodies in 807 samples from 18 countries in four continents and to provide ratios between the two infections.

RESULTS

The gp46 peptide EIA correctly identified 96.5% of HTLV-I and 98.6% of HTLV-II antibody-confirmed samples. HTLV-I was found exclusively in Japan and Caribbean countries; almost exclusively in Africa. HTLV-II represented 10-25% of samples from Canada, Chile and Venezuela and was predominant in the US.

CONCLUSIONS

Differential diagnosis between HTLV-I and HTLV-II can be reliably performed using specific peptides from the gp46 envelope protein of each virus.

Inflammation and NO(X)-induced nitration: assay for 3-nitrotyrosine by HPLC with electrochemical detection

The identification of 15N-labeled 3-nitrotyrosine (NTyr) by gas chromatography/mass spectroscopy in protein hydrolyzates from activated RAW 264.7 macrophages incubated with 15N-L-arginine confirms that nitric oxide synthase (NOS) is involved in the nitration of protein-bound tyrosine (Tyr). An assay is presented for NTyr that employs HPLC with tandem electrochemical and UV detection. The assay involves enzymatic hydrolysis of protein, acetylation, solvent extraction, O-deacetylation, and dithionite reduction to produce an analyte containing N-acetyl-3-aminotyrosine, an electrochemically active derivative of NTyr. We estimate the level of protein-bound NTyr in normal rat plasma to be approximately 0-1 residues per 10(6) Tyr with a detection limit of 0.5 per 10(7) Tyr when > 100 nmol of Tyr is analyzed and when precautions are taken to limit nitration artifacts. Zymosan-treated RAW 264.7 cells were shown to have an approximately 6-fold higher level of protein-bound NTyr compared with control cells and cells treated with N(G)-monomethyl-L-arginine, an inhibitor of NOS. Intraperitoneal injection of F344 rats with zymosan led to a marked elevation in protein-bound NTyr to approximately 13 residues per 10(6) Tyr, an approximately 40-fold elevation compared with plasma protein of untreated rats; cotreatment with N(G)-monomethyl-L-arginine inhibited the formation of NTyr in plasma protein from blood and peritoneal exudate by 69% and 53%, respectively. This assay offers a highly sensitive and quantitative approach for investigating the role of reactive byproducts of nitric oxide in the many pathological conditions and disease states associated with NO(X) exposure such as inflammation and smoking.

Detection of genitourinary tract Chlamydia trachomatis infection in pregnant women by ligase chain reaction assay

OBJECTIVE

To compare the sensitivity and specificity of a ligase chain reaction assay of cervical swabs and voided urine with those of cervical swab tissue culture for the detection of genitourinary tract infection with Chlamydia trachomatis in pregnant women.

METHODS

Infection with C trachomatis was assessed in cervical swabs by culture and in both cervical swabs and voided urine specimens by a ligase chain reaction assay specific for C trachomatis plasmid DNA. The matched cervical swab and voided urine specimens were collected from 462 women during routine visits to prenatal clinics. Standard criteria that defined infection included: 1) a positive cervical culture result or 2) a negative culture but a positive ligase chain reaction result in either the urine or cervical specimen that was confirmed by supplementary testing. Test performance was assessed by determination of sensitivity and specificity, and differences in paired results were determined using McNemar analysis.

RESULTS

The prevalence of genitourinary C trachomatis infection was 6.1% (n = 28) by cervical culture (sensitivity 30.1%; specificity 100%), 18.2% (n = 84) by ligase chain reaction of cervical swabs (sensitivity 90.3%; specificity 100%), and 16.9% (n = 78) by ligase chain reaction of urine (sensitivity 83.9%; specificity 99.5%). Relative to the number of women with a positive culture or a confirmed ligase chain reaction-positive cervical swab, the sensitivity and specificity were 82.8% and 97.9%, respectively, for ligase chain reaction of urine and 96.6% and 100%, respectively, for ligase chain reaction of cervical swabs. Ligase chain reaction of cervical swabs and urine detected 89.3% and 82.1%, respectively, of women with a positive cervical culture.

CONCLUSIONS

Ligase chain reaction assay of cervical or urine specimens detected considerably more pregnant women with C trachomatis infection of the genitourinary tract than did cervical culture. Ligase chain reaction testing of urine is a simple and effective means of screening pregnant women for genitourinary tract infection with C trachomatis.

Vulval swabs as alternative specimens for ligase chain reaction detection of genital chlamydial infection in women

A ligase chain reaction (LCR)-based assay was recently shown to be highly sensitive and specific for the detection of Chlamydia trachomatis not only in cervical specimens but also in first-void urine (FVU) specimens form women. The suitability of using vulval swabs as an alternative specimen that can be obtained by noninvasive means for the diagnosis of genital chlamydial infection by LCR was investigated. In a first study of 169 women, vulval, endocervical, and urethral swabs were tested by LCR, culture, and a combination of enzyme immunoassay (EIA) followed by confirmation by direct fluorescent-antibody assay (DFA), and the results were compared with those obtained by testing FVU specimens by LCR and EIA-DFA by using a specimen from an infected patient as a reference standard. Of the 169 women tested, 27 (16%) were shown to be infected. Whereas LCR showed high sensitivities with all specimen types (85.2% for vulval, urine, and endocervical specimens; 92.6% for urethral swabs), the sensitivities of culture and EIA-DFA were high only with endocervical swabs (74.1 and 70.4%, respectively), being 22.2 and 40.7%, respectively, with vulval swabs. In addition, urine testing by EIA-DFA also showed a poor sensitivity (48.1%). In order to further compare LCR performance with vulval specimens to that with FVU specimens, a second study was carried out with specimens from 312 women, of whom 26 were infected. Comparable sensitivity was obtained by LCR with vulval swabs (88.5%; 23 of 26) and FVU specimens (92.3%; 24 of 26). The results indicate that vulval swabs may serve as suitable alternative to specimens that can be obtained by noninvasive means for the detection of C. trachomatis by LCR.

Rapid detection of trisomy 21 by homologous gene quantitative PCR (HGQ-PCR)

Down's syndrome results from the production of three copies of chromosome 21 within a cell. We have devised a method termed the homologous gene quantitative polymerase chain reaction (HGQ-PCR), which uses one pair of primers and which can directly identify the additional copy of chromosome 21 by simultaneously amplifying two highly homologous genes of the human liver-type phosphofructokinase located on chromosome 21 (PFKL-CH21) and the human muscle-type phosphofructokinase located on chromosome 1 (PFKM-CH1) for self-detecting determination. On analysis of 34 cases of Down's syndrome, including two cases of unbalanced translocation 46, XY, der (14; 21) (q10; q10), + 21, and 100 normal individuals, the relative ratio of the PFKM-CH1/PFKL-CH21 product was 1.33 +/- 0.323 (mean +/- SD) and 0.40 +/- 0.16 (mean +/- SD) for disomy DNA and trisomy DNA, respectively. The difference between these two groups was highly significant (P < 0.001). These results indicate that this quantitative method is practical and may be used for the prenatal diagnosis of Down's syndrome caused by trisomy 21.

Usefulness of a peelaway sheath introducer with a splittable hemostatic valve for placement of permanent pacemaker lead

One hundred and twenty-two permanent pacemaker lead placements were performed by two physicians, utilizing a recently released peelaway sheath introducer with a splittable hemostatic valve. All introducers performed well and provided convenient bloodless surgical fields, as expected from the presence of a valve.

Cloning of STRL22, a new human gene encoding a G-protein-coupled receptor related to chemokine receptors and located on chromosome 6q27

Using PCR with pools of primers based on conserved sequences in chemokine receptors, we have cloned a human member of the G-protein-coupled receptor gene family. The new gene, which we have named STRL22, is predicted to encode a receptor related to chemokine receptors, including IL8RA (CXCR1), IL8RB (CXCR2), and CXCR4/fusin, and to the orphan receptors EBI1 and BLR1. Consistent with a role in leukocyte biology, STRL22 is expressed in lymphocytes and in lymphoid tissue. We have mapped STRL22 to chromosome 6q27. STRL22 cDNAs reflect alternative (or incomplete) mRNA processing in the 5'-nontranslated region, a phenomenon found in analysis of other chemoattractant receptor genes. In contrast to most chemokine receptor genes, the STRL22 coding sequence is not limited to a single exon.

Overexpression of mitogen-activated protein kinase kinase kinase reversed cAMP inhibition of NF-kappaB in T cells

cAMP inhibits T cell activation by acting as an antagonist for selective kinases and transcriptional factors. We have recently demonstrated that cAMP inhibited c-Jun N-terminal kinase (JNK) but left the mitogen-activated protein (MAP) kinase cascade almost unaffected in T lymphocytes. In accordance with recent reports, we also observed a selective suppression of nuclear factor NF-kappaB activation by cAMP. The possible link between the JNK cascade and NF-kappaB activation was demonstrated by the fact that the active form of MAP kinase kinase kinase (deltaMEKK), a constitutive activator of JNK, induced NF-kappaB but not AP-1, Oct, and NF-AT in T cells. In contrast, the induction of MAP kinase kinase (MEK)-MAP kinase did not stimulate NF-kappaB activity. The specific activation of NF-kappaB by a single MEKK-JNK cascade was thus unusual, given that the activation of other transcriptional elements in T cells requires at least two signal pathways. This was further confirmed by the fact that cAMP inhibition of NF-kappaB activation was reversed by overexpression of deltaMEKK.

Effect of barium in porcelain on bonding strength of titanium-porcelain system

The bonding strength to titanium, thermal expansion, and bending strength of glassy porcelain containing barium of 5, 10, and 15 mass% were estimated and compared with those of barium-free porcelain, to estimate the effect of barium content on bonding strength to titanium. The three different glassy porcelains containing barium were made by melting at 950 degrees C. The bonding strength of a commercial porcelain to titanium increased with the addition of barium. Bending strength and thermal expansion were not affected by the barium content. Therefore, the addition of barium to porcelain is effective for strengthening the bonding of porcelain to titanium.

Purification and characterization of endogenous digoxin-like immunoreactive factors in chicken blood

Studies have been performed to determine whether an endogenous material capable of binding to digoxin antibodies is present in the chicken plasma. In the blood of 12 chickens without feed control, endogenous digoxin-like immunoreactive factors (DLIF) binding of digoxin antibodies in enzyme immunoassays amounted to 866 / 302 pg digoxin equivalents/mL of plasma (mean +/- SEM). Immunoreactivity of DLIF increased to 1848***331 pg/mL with a double value of control after boiling and acid pretreating the plasma. The major purification steps employed in this report were gel filtration column chromatography, high performance liquid chromatography (HPLC) and isoelectric focusing (IEF). Using HPLC for the separation, at least 10 chicken DLIFs with different molecular weight (MW) have been found. The MW of the smallest is 300 daltons (Da) while the largest is 100 kDa. The value of the isoelectric point of the most abundant type of DLIF from untreated chicken plasma is 6.3 as determined by IEF. The partially purified DLIF inhibits Na+, K(+)-ATPase from a porcine cerebral cortex as well as three human red blood cell membrane preparations in a dose-response fashion.

Detection of Chlamydia trachomatis and Neisseria gonorrhoeae by ligase chain reaction-based assays with clinical specimens from various sites: implications for diagnostic testing and screening

Ligase chain reaction (LCR)-based tests for the diagnosis of Chlamydia trachomatis and Neisseria gonorrhoeae infections in men and women attending a sexually transmitted disease clinic were evaluated. LCR testing of urethral swab and urine specimens from men and cervical swab and urine specimens from women was compared with culture of male urethral swabs and female cervical and urethral swabs, respectively. An expanded "gold standard" was defined as a positive culture or at least one specimen confirmed to be positive by LCR testing. The prevalence of C. trachomatis infection as detected by cell culture was 7.0% among 614 men and 5.0% among 602 women. By LCR, these values increased to 11.4 and 9.9% with urethral swabs and urine, respectively, for men and 9.6 and 9.1% with cervical swabs and urine, respectively, for women. Relative to the expanded gold standard, the sensitivity of cell culture with male urethral swabs or female cervical swabs was 57.3 and 45.5%, respectively, compared with corresponding values of 93.3 and 87.9% for LCR. The sensitivity of LCR with urine specimens was 77.3 and 78.8% for men and women, respectively. The prevalence of N. gonorrhoeae infection as detected by culture was 5.9% among 220 men and 2.9% among 383 women. The corresponding values were 8.2 and 5.5%, respectively, by LCR testing of swabs. Prevalence values by LCR testing of urine were 7.3% for men and 2.9% for women. The sensitivity of culture was 72.2% for men and 50.0% for women. The sensitivities of LCR were 100% with male urethral swabs, 95.4% with female cervical swabs, 88.9% with male urine, and 50.0% with female urine. These results indicate that the LCR-based assays represent a major improvement in C. trachomatis and N. gonorrhoeae diagnostics. The sensitivity of testing of urethral or cervical swabs by LCR was markedly greater than that by culture. The sensitivity of testing female or male urine specimens was equal to or greater than that of culturing cervical or urethral specimens. LCR testing of urine specimens may prove useful for screening for C. trachomatis.

Urine as a diagnostic specimen for the detection of Chlamydia trachomatis in Malaysia by ligase chain reaction

BACKGROUND AND OBJECTIVES

Noninvasive urine screening for Chlamydia trachomatis infections offers a valuable public health tool, which could be of vast importance in chlamydial control programs. The authors evaluated a new DNA amplification method, ligase chain reaction (LCR).

GOALS

The goal was to ascertain whether urine testing could be used as screening method to detect C. trachomatis infections in commercial sex workers, patients at sexually transmitted diseases clinic, and asymptomatic patients in Kuala Lumpur, Malaysia.

METHODS

First-void urine specimens from 300 men and 300 women were tested by LCR, as well as by a commercially available enzyme immunoassay. The LCR assay amplifies specific sequences within the chlamydial plasmid with ligand-labeled probes, and the resultant amplicons are detected by an automated immunoassay. Specimens with discrepant results were confirmed by another LCR of the specimen that targeted the gene for the major outer membrane protein (OMP1).

RESULTS

There were 31 LCR-positive male urine and 37 LCR-positive female urine specimens. The resolved sensitivity and specificity for the LCR of the male urine specimens were 100% and 99.6%, respectively, whereas for female urine specimens, the sensitivity and specificity were 100% and 98.5%, respectively. After resolution of discrepant test results by OMP1 LCR, the prevalence was 10% for men and 11% for women. The urine enzyme immunoassay was not useful in diagnosing C. trachomatis infections in either men or women, as the resolved sensitivities were 10% and 15.2%, respectively. The specificities were 99.6% for men and 98.9% for women.

CONCLUSIONS

Testing first-void urine specimens by LCR is a highly sensitive and specific method to diagnose C. trachomatis infections in men and women, providing health care workers and public health officials with a new molecular amplification assay that uses noninvasive urine specimens for population-based screening purposes.