Interferon alpha /beta promotes cell survival by activating nuclear factor kappa B through phosphatidylinositol 3-kinase and Akt

Interferons (IFNs) play critical roles in host defense by modulating gene expression via activation of signal transducer and activator of transcription (STAT) factors. IFN-alpha/beta also activates another transcription factor, nuclear factor kappaB (NF-kappaB), which protects cells against apoptotic stimuli. NF-kappaB activation requires the IFN-dependent association of STAT3 with the IFNAR1 chain of the IFN receptor. IFN-dependent NF-kappaB activation involves the sequential activation of a serine kinase cascade involving phosphatidylinositol 3-kinase (PI-3K) and Akt. Whereas constitutively active PI-3K and Akt induce NF-kappaB activation, Ly294002 (a PI-3K inhibitor), dominant-negative PI-3K, and kinase-dead Akt block IFN-dependent NF-kappaB activation. Moreover, dominant-negative PI-3K blocks IFN-promoted degradation of kappaBox alpha. Ly294002, a dominant-negative PI-3K construct, and kinase-dead Akt block IFN-promoted cell survival, enhancing apoptotic cell death. Therefore, STAT3, PI-3K, and Akt are components of an IFN signaling pathway that promotes cell survival through NF-kappaB activation.

Effect of endplate conditions and bone mineral density on the compressive strength of the graft-endplate interface in anterior cervical spine fusion

STUDY DESIGN

Destructive compression tests and finite element analyses were conducted to investigate the biomechanical strength at the graft-endplate interface in anterior cervical fusion.

OBJECTIVES

To investigate the effect of endplate thickness, endplate holes, and bone mineral density of the vertebral body on the biomechanical strength of the endplate-graft interface in an anterior interbody fusion of the cervical spine.

SUMMARY OF BACKGROUND

Subsidence of the graft into the vertebral body is a well-known complication in anterior cervical fusion. However, there is no information in the literature regarding the compressive strength of the graft-endplate interface in relation to the endplate thickness, holes in the endplate, and bone mineral density of the vertebral body.

METHODS

Biomechanical destructive compression tests and finite element analyses were performed in this study. Cervical vertebral bodies (C3-C7) isolated from seven cadaveric cervical spines (age at death 69-86 years, mean 79 years) were used for compression tests. Bone mineral density of each vertebral body was measured using a dual energy radiograph absorptiometry unit. Endplate thickness was measured using three coronal computed tomography images of the middle portion of the vertebral body obtained using a computer-assisted imaging analysis. Then each vertebral body was cut into halves through the horizontal plane. A total of 54 specimens, consisting of one endplate and half of the vertebral body, were obtained after excluding eight vertebrae with gross pathology on plain radiograph. Specimens were assigned to one of three groups with different endplate conditions (Group I, intact; Group II, partial removal; and Group III, complete removal) so that group mean bone mineral density became similar. Each endplate was slowly compressed until failure using an 8-mm-diameter metal indenter, and the load to failure was determined as a maximum force on a recorded force-displacement curve. The effect on the strength of the graft-endplate interface of various hole patterns in the endplate was studied using a finite element technique. The simulatedhole patterns included the following: one large central hole, two lateral holes, two holes in the anterior and posterior portion of the endplate, and four holes evenly distributed from the center of the endplate. Stress distribution in the endplate was predicted in response to an axial compressive force of 110 N, and the elements with von Mises stress greater than 4.0 MPa were determined as failed.

RESULTS

The endplate thickness and bone mineral density were similar at all cervical levels, and the superior and inferior endplates had similar thickness at all cervical levels. There was no significant association between bone mineral density and endplate thickness. Load to failure was found to have a significant association with bone mineral density but not with endplate thickness. However, load to failure tends to decrease with incremental removal of the endplate, and load to failure of the specimens with an intact endplate was significantly greater than that of the specimens with no endplate. Finite element model predictions showed significant influence of the hole pattern on the fraction of the upper endplate exposed to fracture stress. A large hole was predicted to be more effective than the other patterns at distributing a compressive load across the remaining area and thus minimizing the potential fracture area.

CONCLUSION

Results of this study suggest that it is important to preserve the endplate as much as possible to prevent graft subsidence into the vertebral body, particularly in patients with poor bone quality. It is preferable to make one central hole rather than multiple smaller holes in the endplate for vascularity of the bone graft because it reduces the surface area exposed to fracture stresses.

Characterization of UV-irradiated dense/porous collagen membranes: morphology, enzymatic degradation, and mechanical properties

Collagen-based membranous materials of various shapes (gel, film, sponge) are known to be the most promising materials in terms of facilitating the regeneration of dermal defects. In this study, dense and porous collagen membranes were fabricated using air-drying and freeze-drying processes, respectively, and the effect of ultraviolet (UV) radiation on the degree of membrane crosslinking was evaluated by in vitro biodegradation and mechanical testing. A non-irradiated membrane group was used as the negative control and a glutaraldehyde (GA) treated group as the positive control. Scanning electron microscopy showed that, as the freezing temperature decreased to -196 degrees C, the resultant mean pore sizes also decreased; optimal pore size was obtained at a freezing temperature of -70 degrees C. In vitro biodegradation and mechanical testing demonstrated that GA treatment or 4 hours of exposure to UV radiation significantly increased both resistance to collagenase and mechanical strength versus the untreated controls, regardless of the collagen membrane type (dense or porous). Our results suggest that UV treatment is a useful tool for the fabrication of collagen membranes designed to be used as dermal dressings.

Analysis of metronidazole, clarithromycin and tetracycline resistance of Helicobacter pylori isolates from Korea

Antibiotic resistance in Helicobacter pylori varies according to geographical region. We studied the primary resistance rates among 652 H. pylori isolated from Korea in relation to collection date, disease presentation, age and gender. Resistance rates were 40.6% (metronidazole), 5.9% (clarithromycin), 5.3% (tetracycline), 0% (amoxycillin), 1.5% (furazolidone) and 1.5% (nitrofurantoin). Resistance to metronidazole and clarithromycin increased from 1994 to 1999 (from 33.3 to 47.7% and 4.8 to 7.7%, respectively), but the differences only reached significance when rates of metronidazole resistance in women were compared with those in men (48.6 versus 36.9%).

Alternative medicine use in HIV-positive men and women: demographics, utilization patterns and health status

Between 1995 and 1997, 1,675 HIV-positive men and women using complementary and alternative medicine (CAM) were enrolled into the Bastyr University AIDS Research Center's Alternative Medicine Care Outcomes in AIDS (AMCOA) study. Funded by the National Institutes of Health (NIH) Office of Alternative Medicine (OAM) and National Institute of Allergy and Infectious Diseases (NIAID), the AMCOA study collected information on participant demographics, health status and use of conventional and CAM therapies. Participants from 46 states completed a baseline questionnaire, while additional clinical information (such as CD4 count and HIV-RNA viral load) was obtained from laboratory records. AMCOA participants reported using more than 1,600 different types of CAM therapies (1,210 CAM substances, 282 CAM therapeutic activities and 119 CAM provider types) for treating HIV/AIDS. Approximately two-thirds (63% n = 1,054) of the AMCOA cohort reported using antiretroviral drug therapy (ART) during the six-months previous to completing the baseline questionnaire, while 37% (n = 621) indicated they were not using ART. Of those not using ART, 104 subjects reported never having used any conventional medications for their HIV and 12 subjects used only non-prescription diarrhoea medications. The most frequently reported CAM substances were vitamin C (63%), multiple vitamin and mineral supplements (54%), vitamin E (53%) and garlic (53%). CAM provider types most commonly consulted by the AMCOA cohort were massage therapists (49%), acupuncturists (45%), nutritionists (37%) and psychotherapists (35%). CAM activities most commonly used were aerobic exercise (63%), prayer (58%), massage (53%) and meditation (46%). The choice of CAM therapies among the AMCOA cohort does not appear to be solely based on scientific evidence of efficacy of individual therapies. The majority of AMCOA subjects could be characterized as using integrated medicine, since an overwhelming proportion of the cohort consult with both conventional and CAM providers and use both conventional and CAM medications, yet few subjects reported that their conventional and CAM providers work as a team. These data and this cohort set the stage for conducting studies of health status changes associated with specific CAM therapies.

Geographic differences in the distribution of intestinal metaplasia in duodenal ulcer patients

OBJECTIVE

A strong correlation exists between atrophic gastritis and the intestinal type of gastric carcinoma. Duodenal ulcer disease characteristically has an antral predominant gastritis and a lower risk for gastric cancer. The aim of this study was to investigate the extent and distribution of intestinal metaplasia in duodenal ulcer in countries differing in gastric cancer incidence.

METHODS

Topographically mapped gastric biopsy specimens (median 11) were obtained from patients with duodenal ulcer in four countries (Korea, Colombia, USA, and South Africa). Sections were stained with a triple stain and evaluated for Helicobacter pylori (H. pylori), active inflammation, and intestinal metaplasia.

RESULTS

One hundred and sixty-five patients with duodenal ulcer were examined (29 from Korea, 52 from Colombia, 62 from the USA, and 22 from South Africa). The percentage of biopsies with intestinal metaplasia was significantly greater in Korean patients (86%) compared with that in other countries (50%) (p = 0.0004). Intestinal metaplasia was most prevalent in the antrum lesser curve and greater curve, and the body lesser curve. Intestinal metaplasia was present in the gastric corpus of 38% of duodenal ulcer patients from Korea compared with an average of 10% elsewhere (p = 0.018). No differences were observed in the density or distribution of H. pylori infection or in the degree of active gastritis between countries.

CONCLUSIONS

Although antral predominant gastritis is the prevalent pattern of gastritis in duodenal ulcer, intestinal metaplasia in the gastric corpus may be found with geographic differences. These findings suggest that duodenal ulcer and gastric cancer are not mutually exclusive diseases but are rather ends of the spectrum of H. pylori infection.

Relevance of vacA genotypes of Helicobacter pylori to cagA status and its clinical outcome

BACKGROUND

Determination of vacA mosaicism may be important because specific Helicobacter pylori vacA genotype can be used to predict different clinical outcome. The aim of this study was to assess the relationship of vacA genotypes of Helicobacter pylori to cagA status and its development of peptic ulcer diseases in Korean patients.

METHODS

Gastric biopsy specimens were obtained from 53 patients with gastric ulcer(GU), 57 with duodenal ulcer (DU) and 26 with chronic gastritis(CG) patients; all patients were infected with Helicobacter pylori. Bacterial mRNAs in the gastric mucosa were amplified by RT-PCR, using synthetic oligonucleotide primers specific for the vacA and the cagA gene. Patients with vacA s1 subtype were further examined to determine whether they had s1a or s1b subtype.

RESULTS

There was no correlation in frequency of vacA s1 and/or s1a genotype between CG and either GU or DU, as the vacA s1 and s1a/m1 were present in the majority of strains independent of clinical status(s1; 100.0% versus 94.3% or 93.0% and s1a/m1; 76.9% versus 62.3% or 64.9%, respectively). Likewise, there was no difference in the prevalence of the cagA gene between CG and either GU or DU patients (92.3% versus 90.6% or 98.2%, respectively). In addition, the cagA-negative status did not predict the presence of vacA s2 genotype.

CONCLUSION

These results strongly suggest that either cagA or vacA s1 and/or s1a is not proved to be a useful marker to distinguish disease-specific Helicobacter pylori strains for the development of peptic ulcer diseases in Korean patients.

6,7-Bis(bromomethyl)-2,11,18,21,24-pentaoxatetracyclo

The 17-crown-5 unit, C(26)H(26)Br(2)O(5), consisting of a 1,2-bis(bromomethyl) group, three benzo groups and diethylene glycol, was prepared from the reaction of 1,2,4,5-tetrakis(bromomethyl)benzene and bis-phenol in the presence of sodium hydride as a base. This molecule seems to offer an internal cavity for the formation of a host--guest complex.

Association of the vitamin D receptor start codon polymorphism (FokI) with bone mineral density in postmenopausal Korean women

We undertook this study in order to examine the association between bone mineral density (BMD) and a polymorphism at the first of two potential translation initiation codons in the vitamin D receptor (VDR) gene. This polymorphism was detected by restriction fragment length polymorphism analysis, using polymerase chain reaction (PCR) and the restriction endonuclease FokI. The f allele indicates the presence of the FokI site, and the F allele its absence. The FokI genotype was determined in 174 postmenopausal Korean women, aged 43-71 years. The distribution of FokI genotypes in Koreans was found not to differ significantly from those found in Caucasians and Japanese, although it does differ significantly from that found in the black American population. We observed a significant association between the FokI polymorphism and lumbar BMD; P = 0.048, analysis of covariance [ANCOVA], but no association with femoral neck BMD (P = 0.505, ANCOVA). Those with the ff genotype had a 13.3% lower BMD in the lumbar spine than the FF subjects. In addition, a significantly higher prevalence of the ff genotype was observed in osteoporotic compared with osteopenic or normal women (P = 0.036, chi2 test). These data suggest that the ff genotype of the VDR gene correlates with decreased BMD in the lumbar spine in postmenopausal Korean women.

Extracranial radiosurgery: immobilizing liver motion in dogs using high-frequency jet ventilation and total intravenous anesthesia

PURPOSE

Extracranial radiosurgery requires control of organ motion. The purpose of this study is to quantitatively determine the extent of liver motion in anesthetized dogs with continuous i.v. propofol infusion with or without muscle relaxants and high-frequency jet ventilation.

METHODS AND MATERIALS

Five dogs were used in the experiment. Each dog was restrained while anesthetized in the supine position using an alpha cradle. Surgical metal clips were implanted around the liver periphery so that its motion could be visualized using a fluoroscopic imaging device in a conventional simulator. Initially, two orthogonal simulation films were taken to correlate locations of implanted clips. Two orthogonal views of fluoroscopic images for each anesthetized dog were recorded on a magnetic tape and analyzed from the post-imaging data. Liver motion was documented under the following three conditions: 1) ventilated with a conventional mechanical ventilator, 2) ventilated with a high-frequency jet ventilator, and 3) ventilated with a high-frequency jet ventilator and total muscle paralysis (with vecuronium injection). The maximum liver motion for each dog was analyzed in three orthogonal directions: the inferior-to-superior direction, the anterior-to-posterior direction, and the right-to-left direction.

RESULTS

When the anesthetized dogs were ventilated with a conventional mechanical ventilator, the average liver motions were 1.2 cm in the inferior-to-superior direction, 0.4 cm in the anterior-to-posterior direction, and 0.2 cm in the right-to-left direction, respectively. After the introduction of high-frequency jet ventilation, the average liver motions were reduced to 0.2 cm in the inferior-to-superior direction, 0.2 cm in the anterior-to-posterior direction, and 0.1 cm in the right-to-left direction. The maximum liver motion was dependent on ventilator settings. There was no additional measurable motion reduction with the addition of the muscle relaxant.

CONCLUSION

The liver motion in each anesthetized dog was controlled under 3.0 mm in all directions with the use of high-frequency jet ventilation. No detectable advantage was identified by the injection of muscle relaxant in terms of further reducing the liver motion. The preclinical animal study indicated that the use of high-frequency jet ventilation (HFJV) would be able to limit the liver motion to an extent acceptable for the application of extracranial radiosurgery in humans. Radiosurgery for localized liver tumors warrants further investigation.

Furazolidone- and nitrofurantoin-resistant Helicobacter pylori: prevalence and role of genes involved in metronidazole resistance

The prevalence of furazolidone, nitrofurantoin, and metronidazole resistance among Helicobacter pylori strains was assessed with 431 clinical isolates. Fifty-two percent were metronidazole resistant, compared to 2% (7 of 431) with resistance to furazolidone and nitrofurantoin. All seven furazolidone- and nitrofurantoin-resistant isolates were also metronidazole resistant. rdxA, frxA, and fdxB knockouts did not result in furazolidone or nitrofurantoin resistance. These data suggest that furazolidone and nitrofurantoin may be good alternatives to metronidazole for treating H. pylori infection.

IFNalpha/beta promotes cell survival by activating NF-kappa B

IFNs play critical roles in host defense by modulating the expression of various genes via signal transducer and activator of transcription factors. We show that IFNalpha/beta activates another important transcription factor, NF-kappaB. DNA-binding activity of NF-kappaB was induced by multiple type 1 IFNs and was promoted by IFN in a diverse group of human, monkey, rat, and murine cells. Human IFN promoted NF-kappaB activation in murine cells that express the human IFNalpha/beta receptor-1 signal-transducing chain of the type 1 IFN receptor. IFN promotes inhibitor of kappa B alpha (IkappaBalpha) serine phosphorylation and degradation, and stimulates NF-kappaB DNA-binding and transcriptional activity. Importantly, IFN promotes cell survival by protecting cells against a variety of proapoptotic stimuli, such as virus infection and antibody-mediated crosslinking. Expression of superrepressor forms of IkappaBalpha, besides inhibiting IFN-mediated NF-kappaB activation and IkappaBalpha degradation, also enhanced apoptotic cell death in IFN-treated cells. We conclude that NF-kappaB activation by IFNalpha/beta is integrated into a signaling pathway through the IFNalpha/beta receptor-1 chain of the type 1 IFN receptor that promotes cell survival in apposition to various apoptotic stimuli.

25,27-(6-Tosyl-3,9-dioxa-6-azaundecane-1,11-diyldioxy)-26,28-(3,6, 9-trioxaundecane-1,11-diyldioxy)calix[4]arene

A new calix[4]-crowned azacrown ether, C(51)H(59)NO(11)S, consisting of four phenyl rings in a 1,3-alternate conformation was synthesized from the reaction of 25, 27-bis(5-chloro-3-oxapentyloxy)calix[4]crown-5 and p-toluenesulfonamide in the presence of Cs(2)CO(3). A crown-5 loop was attached on the two facing lower rims of the calix[4]arene and the N-tosyl azacrown group was attached on the other set of lower rims of the calix[4]arene backbone. This molecule seems to offer an inside cavity for the formation of a host-guest complex.

A humanized anti--4-1BB monoclonal antibody suppresses antigen-induced humoral immune response in nonhuman primates

The interaction of 4-1BB and its ligand plays an important role in the regulation of T-cell-mediated immune responses. In this study, the authors examined the effect of a humanized anti--4-1BB monoclonal antibody (H4B4) on ovalbumin-induced immune responses in baboons. Previously, a mouse monoclonal antibody, 4B4 against the human 4-1BB molecule, was generated and characterized. Based on this antibody, a humanized version of 4B4 monoclonal antibody was constructed and the resultant antibody, H4B4, showed full recovery of the binding activity of the original antibody 4B4: a 1.5-fold increase in affinity for 4-1BB. In addition, H4B4 mediated antibody-dependent cellular cytotoxicity of activated human peripheral blood T cells and CEM cells in a dose-dependent manner. Weekly administration of H4B4 at doses of 1 or 4 mg/kg could suppress immunoglobulin G production against ovalbumin. This was not a result of the overall immune suppression, because the numbers of B and T cells and the total immunoglobulin G production were not altered during treatment with H4B4. These findings suggest that treatment with H4B4 may be a valid therapeutic approach to control unwanted immune responses in persons with autoimmune diseases.

Effects of benzothiazole on the xenobiotic metabolizing enzymes and metabolism of acetaminophen

Benzothiazole (BT) is present in tobacco smoke and widely used for industrial and pharmaceutical purposes. In this study we have investigated the influence of BT on the activities of hepatic cytochrome P450 monooxygenases (P450s) and UDP-glucuronyltransferase (UDP-GT), sulphotransferase and glutathione-S-transferase (GST) in male Sprague-Dawley rats. We also examined if BT would change the metabolism and toxification of acetaminophen (AA) through modulation of metabolizing enzymes. Benzothiazole (1 mmol kg(-1), p.o., 5 days) markedly increased the enzyme activities of P4501A1, 1A2, 2B1, 3A4, 2E1, UDP-GT and GST in liver. Pretreatment with BT significantly decreased the amount of total AA recovered in bile to 68.5% of controls, mainly as a consequence of reduced AA-glucuronide conjugate (35.3% of controls), whereas the AA-glutathione conjugate (AA-GS) was augmented to 1.6-fold. After pretreatment with BT, potentiation of the hepatotoxicity by AA (400 mg kg(-1), i.p., 24 h) was observed by measuring serum alanine aminotransferase activities in ICR mice. These results indicate that: BT is a potent inducer of P450s and phase II metabolizing enzymes; and the increase of AA-GS conjugate and aggravation of AA hepatotoxicity by BT may be related to induction of P450s.

A novel antibody to oxidized phosphatidylethanolamine that is specific for amino groups modified by lipid peroxides

ABSTRACT In this study, a novel antibody to oxidized phosphatidylethanolamine (PtdEtn) was generated and characterized. Oxidized PtdEtn antiserum recognized PtdEtn and not unoxidized. PtdEtn by ELISA. The antibody also immunstained cells previously incubated with lipid peroxides (LOOH). This antibody recognized only high-molecular-weight epitopes in plasma. Because this antibody recognizes a specific amino group modification without the accompanying alterations in amino acids that are usually encountered when proteins are incubated with LOOH, it might be useful for the selective detection of such epitopes in cells, tissues, and lipoproteins.

Multicentre hydrogen bonds in a 2:1 arylsulfonylimidazolone hydrochloride salt

The title compound, (S)-(+)-4-[5-(2-oxo-4, 5-dihydroimidazol-1-ylsulfonyl)indolin-1 -ylcarbonyl ]anilinium chloride (S)-(+)-1-[1-(4-aminobenzoyl)indoline-5- sulfonyl]-4-phenyl-4, 5-dihydroimidazol-2-one, C(24)H(23)N(4)O(4)S(+).Cl(-). C(24)H(22)N(4)O(4)S, crystallizes in space group C2 from a CH(3)OH/CH(2)Cl(2) solution. In the crystal structure, there are two different conformers with their terminal C(6) aromatic rings mutually oriented at angles of 67.69 (14) and 61.16 (15) degrees. The distances of the terminal N atoms (of the two conformers) from the chloride ion are 3.110 (4) and 3.502 (4) A. There are eight distinct hydrogen bonds, i.e. four N-H...Cl, three N-H...O and one N-H...N, with one N-H group involved in a bifurcated hydrogen bond with two acceptors sharing the H atom. C-H...O contacts assist in the overall hydrogen-bonding process.

Molecular cloning and sequencing of rat Cdc42 GTPase cDNA

Cdc42 is a member of the Rho family of small GTP-ase and plays an important role in intracellular signaling pathways regulating cell morphology, motility and stimulation of DNA synthesis. We have isolated cDNA encoding Cdc42 from a rat brain cDNA library using PCR-cloning strategy. The sequence of isolated gene revealed an open reading frame of 576 nucleotides with the potential to encode a protein of 191 amino acids with a predicted molecular weight of 21 kD. The resulting sequence was incorporated into the GenBank with accession number, AF205635. Sequence analysis revealed that overall cDNA sequence identity is 96% with human G25K and 52% with rat Chp, a homologue of the GTPase human Cdc42Hs, and having one nucleotide difference from the mouse Cdc42. However, putative protein sequence was identical to the mouse and human brain Cdc42Hs. On expression of the cDNA in COS-7 cells, a protein molecular weight of 21 kD was detected in immunoblotting using anti-human Cdc42 antibodies. Therefore, these results suggest that the cDNA we are reporting is most likely the rat homologue of the GTPase human Cdc42.

Veno-occlusive disease of the liver after allogeneic bone marrow transplantation for severe aplastic anemia

There are few reports about the occurrence of hepatic VOD after BMT for severe aplastic anemia (SAA). We prospectively studied 17 patients with SAA after allogeneic BMT for the occurrence and severity of VOD. Plasma levels of protein C, protein S, antithrombin III, vWF, t-PA and PAI-1 were determined before preparative chemotherapy, on the day of marrow infusion, and on days 7, 14 and 21. VOD occurred in seven patients (41.2%) at a median of day 1 (range, day -2 to 15). Five had mild, and two moderate VOD. Platelet transfusion requirements were higher in the patients with VOD. The plasma levels of natural anticoagulants such as protein C, free protein S and antithrombin III decreased significantly on day 0 from the baseline levels. Plasma levels of t-PA, PAI-1 and vWF increased significantly in the early post-transplant period compared to the baseline levels. The mean plasma levels of t-PA on day 7 (P = 0.016) and PAI-1 on days 0 and 7 (P = 0.016, 0.032) were higher in the patients with VOD. In summary, we observed hypercoagulability and a high incidence of VOD after allogeneic BMT for SAA. Levels of t-PA and PAI-1 were significantly higher in the patients with VOD after BMT.

Reduction of aflatoxins by Korean soybean paste and its effect on cytotoxicity and reproductive toxicity--part 1. Inhibition of growth and aflatoxin production of Aspergillus parasiticus by Korean soybean paste (Doen-jang) and identification of the active component

The inhibitory effect of methanol extract of Korean soybean paste on the mold growth and aflatoxin production of a toxigenic strain of Aspergillus parasiticus ATCC 15517 was studied using different concentrations of the extract in yeast-extract sucrose broth. While inhibition in mold growth due to increasing the concentration of the extract was observed, the more remarkable effect was the inhibition of aflatoxin production. Reduction of mycelial weight as a result of addition of the extract was observed to range between 1.5 to 12.9% while reduction of aflatoxin production quantified by high-performance liquid chromatography ranged from 14.3 to 41.7%. Five percent of the extract significantly reduced aflatoxin production at the end of the incubation period (P < 0.05), although the effect on mycelial growth was less pronounced. This study indicates that soybean paste could also be an effective inhibitor of aflatoxin production even though mycelial growth may be permitted. The main active component identified by gas chromatography-mass spectroscopy was linoleic acid.

IFN-gamma inhibits the suppressive effects of PGE2 on the production of tumor necrosis factor-alpha by mouse macrophages

Tumor necrosis factor-alpha (TNF-alpha) has become known as a central mediator of responses to endotoxin, rheumatoid diseases, and other forms of inflammation. Current investigations indicate that the production of TNF-alpha is controlled by other mediators, including interferon-gamma (IFN-gamma) and prostaglandin E2 (PGE2). In the present study, we investigated the regulatory effects of IFN-gamma and/or PGE2 on LPS-induced TNF-alpha production and mRNA expression in mouse peritoneal macrophages using the enzyme immunoassay and Northern blot analysis, respectively. In response to 10 ng/ml of LPS, TNF-alpha production reached a maximum at approximately 4 hrs, followed by rapid decline. At the molecular level, TNF-alpha mRNA accumulated rapidly after LPS exposure, reaching a peak by 3 hr, and declined more rapidly than did the production of TNF-alpha. Exposure of macrophages to 100 U/ml of IFN-gamma caused an increase in both the TNF-alpha production and mRNA expression induced by LPS. Exogenous PGE2 caused a dose dependent reduction in LPS-induced TNF-alpha mRNA accumulation as well as TNF-alpha production. Macrophages primed with IFN-gamma showed the reduced responsiveness to the suppressive effect of PGE2 on the production of TNF-alpha and the accumulation of TNF-alpha mRNA. These findings indicate that the suppressive effects induced by PGE2 on the accumulation of TNF-alpha mRNA as well as the production of TNF-alpha can be reduced by the pretreatment of macrophages with IFN-gamma. These studies demonstrate the role of IFN-gamma as an immunomodulating compound that may effectively regulate TNF-alpha production by modulation of macrophage responsiveness to PGE2.

Molecular identification of main cellular lineages as a tool for the classification of gastric cancer

Gastric carcinomas (GC) are heterogeneous tumors comprising variable amounts of cells of different lineage phenotype, including gastric mucous cells (surface--SMC or gland--GMC) and intestinal cells (IC). The evaluation of tumor behavior has classically depended on strictly morphological classifications of tumors. Microsatellite instability (MSI) is frequently detected in GC, but whether MSI affects all gastric cellular lineages or exclusively occurs in unique cellular lineages in GC is not known. The aims of this study were to test a combination of anti-mucin antibodies to classify gastric cancer into predominant cell lineage phenotype and to determine whether MSI in GC is associated with particular cellular tumor phenotypes. Fifty-five GC were immunophenotyped with antibodies specific for SMC, GMC, or IC. DNA was extracted from tumor and non-neoplastic gastric tissues and amplified with 5 microsatellite markers. A mixed cellular pattern was the most frequent phenotype of GC (61%) and was seen in both glandular (63%) and diffuse (58%)-type tumors. No significant difference in the rate of MSI was found in tumors with predominant gastric, intestinal or mixed phenotype. However, tumors with null or low-level expression of cellular lineage differentiation markers displayed MSI more frequently than tumors with high-level expression (40% v 20%). In conclusion, different gastric carcinoma cell lineage patterns can be easily identified with the 3 immunohistochemical markers used in this study. The 3 main cellular lineage components of gastric cancer can be similarly affected by microsatellite instability, consistent with the notion that MSI is an early event in gastric carcinogenesis.

Effects of phenethylisothiocyanate on the expression of glutathione S-transferases and hepatotoxicity induced by acetaminophen

1. The effect of PEITC on the expression of hepatic glutathione S-transferases (GST) and the glutathione (GSH) conjugation has been investigated in the Sprague-Dawley rat, and it has been determined whether hepatotoxicity of acetaminophen (AA) could be inhibited through the induction of GST expression in mouse. 2. The hepatic GST activity and protein levels of alpha class (Ya, Yc) and mu class (Yb1, Yb2) of GST were elevated in a dose-dependent manner after treatment with PEITC (0, 3.16, 10, 31.6, 100 and 200 mg/kg, p.o., 3 days). The mRNA levels of GST Ya and GST Yb1 were also markedly increased 1 day after treatment with PEITC at dosages ranging from 31.6 to 200 mg/kg. The hepatic GSH content was significantly increased to 200% of control at dose of 200 mg/kg PEITC. 3. Pretreatment with 100 mg/kg PEITC significantly enhanced the biliary excretion of glutathione conjugate of AA 2-fold, whereas treatment with 200 mg/kg did not affect it. 4. In mouse, PEITC (100 and 200 mg/kg, 3 days) decreased the lethality and hepatotoxicity caused by AA. 5. These results indicate that (1) the induction of GST by PEITC is presumably under transcriptional regulation, and (2) PEITC may have a protective function against AA-induced hepatotoxicity by induction effect on GST, in combination of enhancement of hepatic GSH.

Radiologic features of vasculitis involving the gastrointestinal tract

Vasculitides can cause local or diffuse pathologic changes in the gastrointestinal tract, resulting in nonspecific paralytic ileus, mesenteric ischemia, submucosal edema and hemorrhage, or bowel perforation or stricture. The extent and clinical course of disease depend on the size and location of the affected vessel and the histologic characteristics of the lesion. Vasculitis may primarily involve large vessels (eg, giant cell arteritis, Takayasu arteritis), medium-sized vessels (eg, polyarteritis nodosa, Kawasaki disease, primary granulomatous central nervous system vasculitis), or small vessels (eg, Wegener granulomatosis, Churg-Strauss syndrome, microscopic polyangiitis, Henoch-Schönlein syndrome, systemic lupus erythematosus, rheumatoid vasculitis, Behçet syndrome). Radiologic findings in various types of vasculitis often overlap considerably and therefore have limited value in making a specific diagnosis. Nevertheless, the possibility of vasculitis should be considered whenever mesenteric ischemic changes occur in young patients, are noted at unusual sites (eg, stomach, duodenum, rectum), have a tendency to concomitantly involve the small and large intestine, and are associated with genitourinary involvement. Knowledge of systemic clinical manifestations in affected patients may suggest and even help establish the specific diagnosis.

Insulin-like growth factors (IGFs), IGF-binding proteins (IGFBPs), and IGFBP-3 protease activity in the peritoneal fluid of patients with and without endometriosis

OBJECTIVE

To compare levels of insulin-like growth factor (IGF) components in the peritoneal fluid of patients with and without endometriosis.

DESIGN

Patients with endometriosis were compared with control patients.

SETTING

Seoul National University Hospital, Korea.

PATIENT(S)

Forty-three patients with endometriosis and 20 patients without endometriosis.

INTERVENTION(S)

Peritoneal fluid specimens were collected.

MAIN OUTCOME MEASURE(S)

Insulin-like growth factors, IGF binding protein (IGFBP) profiles and IGFBP-3 protease activity.

RESULT(S)

The IGF-I levels in peritoneal fluid were significantly higher in patients with endometriosis than in control patients, while the IGFBP-3 levels and the relative proportion of IGFBP-2 in peritoneal fluid were significantly lower in patients with endometriosis than in control patients. However, IGF-II levels, IGFBP-4 profiles, and IGFBP-3 protease activity did not differ significantly between the two groups. No correlation between these IGF components in peritoneal fluid and the stage of endometriosis was noted.

CONCLUSION(S)

The profiles of IGF components in peritoneal fluid of patients with pelvic endometriosis may play an important role in the growth of ectopic endometrium and endometriosis-induced infertility.

Implications in the management of pregnancy: II. Low levels of gene expression but enhanced uptake and accumulation of umbilical cord glycodelin

OBJECTIVE

We recently reported the presence of glycodelin in the endothelial cells of human umbilical cord. The objective of the current study is to determine whether human umbilical cord endothelial cells synthesize glycodelin.

DESIGN

Controlled clinical study.

SETTING

Healthy women undergoing normal delivery at Grady Memorial Hospital, Atlanta, Georgia.

PATIENT(S)

Healthy women undergoing normal delivery.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Human umbilical cord was collected after full-term delivery and total RNA from endothelial cells was isolated. Reverse-transcription polymerase chain reaction (RT-PCR) was performed by using primers from glycodelin sequence. Human umbilical cord endothelial cells at passage 3 were incubated with glycodelin-derived peptide or glycodelin-rich amniotic fluid. Immunocytochemical analysis was performed by using purified chicken anti-glycodelin peptide antibody to detect the accumulation of glycodelin in cells.

RESULT(S)

Little or no glycodelin message was detectable in the endothelial cells from human umbilical cord vein by RT-PCR and Southern blot analysis. However, these cells readily took up glycodelin protein and glycodelin-derived synthetic peptide from the medium.

CONCLUSION(S)

The presence and accumulation of glycodelin in the umbilical cord might indicate their potential role in the survival of fetal tissue in the maternal environment.

Implications in the maintenance of pregnancy: I. Presence of immunoreactive glycodelin in human umbilical cord vein endothelial cells

OBJECTIVE

We previously reported an antipeptide antibody to human glycodelin that recognizes glycodelin in amniotic fluid and epithelial glands of the endometrium. The objective of this study was to determine the presence of glycodelin in human umbilical cord.

DESIGN

Controlled clinical study.

SETTING

Healthy women undergoing normal delivery at Grady Memorial Hospital, Atlanta, Georgia.

PATIENT(S)

Healthy women undergoing normal delivery.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Umbilical cord vein was isolated from the cord and used for immunohistochemical studies. Human umbilical cords and placentae were collected after full-term delivery. Cords were washed and fixed with formal sucrose. Decidua tissues and blood vessels from placentae were dissected out and fixed. Cryostat sections were immunostained with anti-glycodelin peptide antibody and anti-von Willebrand factor antibody.

RESULT(S)

Endothelial cells of human umbilical cord vein and artery were strongly immunostained with antiglycodelin antibody. Endothelial cells of the vein were more strongly stained than those of the artery. These cells were confirmed as endothelial cells by positive immunostaining with anti-von Willebrand factor. The epithelial cells outlining the cord were stained with antiglycodelin antibody but not with anti-von Willebrand factor antibody.

CONCLUSION(S)

This is the first study showing that immunoreactive glycodelin is present in endothelial cells of the umbilical cord. Glycodelin in the umbilical cord may have immunosuppressive or other, unknown functions affecting the physiology or pathophysiology of pregnancy. Whether umbilical vein endothelial cells synthesize glycodelin or serve as reservoir for glycodelin is currently under investigation.

Secondary structural and phylogenetic implications of nuclear large subunit ribosomal RNA in the ectomycorrhizal fungus Tricholoma matsutake

The sequence of large subunit (LSU) and 5.8S rRNA genes has been determined for Tricholoma matsutake. A secondary structure model was predicted for both LSU and 5.8S rRNAs, showing most of the structural features consistent with those of the consensus secondary structure model proposed for the eukaryotic cytoplasmic LSU rRNAs. With a reconstructed eukaryotic phylogeny based on full-length LSU rDNA sequences, T. matsutake was placed on the same branch with Cryptococcus neoformans as its closest neighbor. We proposed that T. matsutake be considered as one of the representative members of the division Basidiomycota. Here we report for the first time the complete LSU rRNA gene sequence in T. matsutake, a member of Homobasidiomycetes.

Polychlorinated dibenzo-p-dioxins and dibenzofurans in sediment, soil, fish, shellfish and crab samples from Tokyo Bay area, Japan

Concentrations of tetra- to octa-chlorinated dibenzo-p-dioxins and dibenzofurans in samples collected in or near Tokyo Bay, Japan, with a densely inhabited catchment area, were congener-specifically determined and discussed. Analyzed in this study were samples of surface sediment covering the whole bay area, reference soil representing atmospheric impact, and fish, shellfish and crab commonly consumed as food. The range of concentrations were comparable to or higher than those in other parts of Japan. The origins of these compounds in the catchment area of the bay were investigated in terms of homolog and isomeric compositions in the sediment samples. Biota-sediment accumulation factors for benthic species declined as the degree of chlorination increased.

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

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

Molecular epidemiology of Helicobacter pylori: separation of H. pylori from East Asian and non-Asian countries

The predominant H. pylori strain circulating among geographic locations differs with regard to the genomic structure. This study determined whether structural subtypes of the cagA 3' repeat region could be used to identify the population of origin of H. pylori isolates. We examined 600 cagA-positive H. pylori (Colombia, 100; USA, 100; France, 100; Canada, 20; Italy, 20; Korea, 100; Japan, 100; Hong Kong, 20; Taiwan, 20; Vietnam, 20). The cagA 3' region was amplified by PCR using primers specific to Japanese and Western 3' cagA gene sequences. PCR using Japanese cagA primers resulted in PCR products in 99-6 % of strains from East Asia but no non-Asian strains. Conversely, PCR using Western cagA primers resulted in amplicons in 100% of non-Asian strains, and only one from East Asia. cagA genotyping is useful for molecular epidemiological studies as strains can be completely separated by differences in the cagA 3' region.

Microsatellite instability in gastric intestinal metaplasia in patients with and without gastric cancer

The role and significance of microsatellite instability (MSI) in gastric carcinogenesis remain unknown. This study determined the chronology of MSI in gastric carcinogenesis by examining intestinal metaplasia (IM) from patients with and without gastric cancer. DNA was obtained from gastric specimens of 75 patients with gastric IM (30 cancer, 26 peptic ulcer, and 19 chronic gastritis patients) and was amplified with a set of eight microsatellite markers. Eight (26. 7%) tumors and seven (9.3%) IM samples (three from cancer-free patients) displayed high-level MSI (three or more loci altered). Low-level MSI (one or two loci altered) was detected in 50% of the tumors, in 40% of IM samples coexisting with cancer, and in 38% of IM tissues of cancer-free individuals. Among the 30 cancer patients, microsatellites were more frequently altered in IM coexisting with tumors that showed MSI (P = 0.003). In addition, patients with low-level MSI in the tumor tissues were more likely to have active Helicobacter pylori infection than those with stable tumors (P = 0.02). In conclusion, this study indicates that MSI occurs not only in gastric IM of patients with gastric carcinoma, but also in IM of cancer-free individuals. These data suggest that the progressive accumulation of MSI in areas of IM may contribute to gastric cancer development, representing an important molecular event in the multistep gastric carcinogenesis cascade.

Cell density of the corneal endothelium in human fetus by flat preparation

PURPOSE

To count the number of the corneal endothelial cells per unit of tissue area in 25 human fetal eyes ranging from 12-40 weeks of gestation with the histologic method.

METHODS

The endothelium including Descemet's membrane was stained with hematoxylin-eosin by the flat preparation method. We photographed the endothelium using light microscopy. The number of nuclei was counted on each photograph. A calibrated micrometer was photographed with the light microscopy, and this was used to measure the number of corneal endothelial cells per square millimeter.

RESULTS

The prenatal endothelial cell density of the human cornea decreases rapidly from 14,095 cells/mm2 (12 weeks of gestation) to 6,820 cells/mm2 (40 weeks of gestation).

CONCLUSION

The estimate of the endothelial cell density at 12 weeks of gestation is twofold higher than the estimate at 40 weeks of gestation.

Decreased expression of mac25 mRNA in uterine leiomyomata compared with adjacent myometrium

PROBLEM

The pathogenesis of uterine leiomyomata is still unclear. Recently it has been suggested that mac25 plays a tumor-suppressive role in various tumors. The aims of this study were to evaluate a possible involvement of mac25 in the growth of leiomyoma and in the mechanism of a gonadotropin-releasing hormone agonist (GnRHa) inducing shrinkage of leiomyoma.

METHODS OF STUDY

Mac25 mRNA transcript was measured by Northern blot in total RNA extracted from the paired specimens of leiomyoma and adjacent myometrium from untreated patients (n = 25) and from leiomyoma specimens from GnRHa-pretreated patients (n = 10).

RESULTS

Mac25 mRNA expression was significantly lower in large leiomyoma (more than 150 cm3 in volume) than in adjacent myometrium and small leiomyoma (less than 120 cm3 in volume) from untreated patients. There was no difference in this expression between the proliferative and secretory phases of the menstrual cycle. Leiomyoma from GnRHa-pretreated patients had mac25 gene expression levels similar to myometrium and small leiomyoma from untreated patients.

CONCLUSIONS

Mac25 may be involved in the growth of uterine leiomyoma and the action of GnRHa may, in part, be mediated by mac25.

Cytotoxic constituents from Solidago virga-aurea var. gigantea MIQ

Activity-guided fractionation of the whole plant of Solidago virga-aurea var. gigantea M(IQ). (Compositae) has led to the isolation of three cytotoxic compounds, erythrodiol-3-acetate (1), alpha-tocopherol-quinone (2), and trans-phytol (3) from the hexane soluble fraction. It is the first report of those compounds from the genus.

Marked differences in the frequency of microsatellite instability in gastric cancer from different countries

OBJECTIVE

Previous studies have reported variable rates of microsatellite instability (MSI) in gastric cancer. We investigated the frequency of MSI in invasive gastric carcinoma of patients from three geographic regions.

METHODS

Genomic DNA from gastric cancer and nontumor tissue from 22 Korean, 20 Colombian, and 26 U.S. patients was amplified with five microsatellite markers.

RESULTS

MSI was more frequently seen in gastric cancer from Korea, affecting 50% of patients, in contrast with gastric cancers from the U.S. (7%) and Colombia (15%) (p = 0.003 and p = 0.03, respectively). MSI at one locus was significantly more frequent in gastric cancer from individuals >65 yr (p = 0.01). MSI was similarly associated with both diffuse and intestinal types of gastric cancer.

CONCLUSIONS

MSI affects the two major histological types of gastric cancer, and was more frequent in gastric cancer from Korea than in the other countries, suggesting that the relative importance of different pathways of gastric carcinogenesis may vary in diverse regions of the world.

The relationship among circulating insulin-like growth factor components, biochemical markers of bone turnover and bone mineral density in postmenopausal women under the age of 60

OBJECTIVES

The changes in circulating IGF components after the menopause and the potential role of new markers of bone turnover and circulating IGF components in predicting bone mass in postmenopausal women are still controversial and the relationship between these two systems has not been investigated. The aims of this study were to investigate the changes in circulating IGF components after the menopause, to evaluate whether new markers of bone turnover and circulating IGF components reflect bone mass in postmenopausal women under the age of 60 and to study the relationship between these two systems.

DESIGN, PATIENTS AND MEASUREMENTS

Serum IGF-I, IGF-II, IGFBP-1, IGFBP-2, IGFBP-3, osteocalcin (OST), bone specific alkaline phosphatase (BAP), urinary deoxypyridinoline (DPYD) and N-telopeptide of type I collagen (NTX) were measured in 31 premenopausal women aged 31-43 and 65 postmenopausal women aged 47-60: this latter group comprised 30 normal healthy women and 35 osteoporotic women.

RESULTS

Compared with premenopausal women or normal postmenopausal women, serum IGF-1 and IGFBP-3 levels were significantly lower in osteoporotic postmenopausal women while no significant differences in serum levels of IGF-II, IGFBP-1 and IGFBP-2 were observed. The correlations between bone turnover markers and circulating IGF components (except between serum BAP and IGF-II), and between bone turnover markers and bone mineral density (BMD) in postmenopausal women were not significant. However, serum IGF-I and IGFBP-3 correlated positively with BMD of the lumbar spine and/or Ward's triangle even if age, BMI and menopause duration were taken into account in a multiple regression analysis model.

CONCLUSIONS

Circulating IGF-I and IGFBP-3 may be involved in the mechanism of bone loss in postmenopausal women under the age of 60. They may also provide indirect information on the current bone microenvironment different from that provided by new markers of bone turnover.

Application of ozone for enhancing the microbiological safety and quality of foods: a review

Ozone (O3) is a strong antimicrobial agent with numerous potential applications in the food industry. High reactivity, penetrability, and spontaneous decomposition to a nontoxic product (i.e., O2) make ozone a viable disinfectant for ensuring the microbiological safety of food products. Ozone has been used for decades in many countries and recently, the generally recognized as safe (GRAS) status of this gas has been reaffirmed in the United States. Ozone, in the gaseous or aqueous phases, is effective against the majority of microorganisms tested by numerous research groups. Relatively low concentrations of ozone and short contact time are sufficient to inactivate bacteria, molds, yeasts, parasites, and viruses. However, rates of inactivation are greater in ozone demand-free systems than when the medium contains oxidizable organic substances. Susceptibility of microorganisms to ozone also varies with the physiological state of the culture, pH of the medium, temperature, humidity, and presence of additives (e.g., acids, surfactants, and sugars). Ozone applications in the food industry are mostly related to decontamination of product surface and water treatment. Ozone has been used with mixed success to inactivate contaminant microflora on meat, poultry, eggs, fish, fruits, vegetables, and dry foods. The gas also is useful in detoxification and elimination of mycotoxins and pesticide residues from some agricultural products. Excessive use of ozone, however, may cause oxidation of some ingredients on food surface. This usually results in discoloration and deterioration of food flavor. Additional research is needed to elucidate the kinetics and mechanisms of microbial inactivation by ozone and to optimize its use in food applications.

Anticomplement activities of oleanolic acid monodesmosides and bisdesmosides isolated from Tiarella polyphylla

Seven known oleanolic acid glycosides (1-7) were isolated from the MeOH extract of Tiarella polyphylla. The structures were identified to be 3-O-(beta-D-glucopyranosyl) oleanolic acid (1), 3-O-[beta-D-glucopyranosyl-(1-->3)-beta-D-glucopyranosyl] oleanolic acid (2), 3-O-[beta-D-glucopyranosyl-(1-->2)-beta-D-glucopyranosyl] oleanolic acid (3), 3-O-[beta-D-glucopyranosyl-(1-->3)-beta-D-glucopyranosyl] oleanolic acid 28-O-beta-D-glucopyranosyl ester (4), 3-O-[beta-D-glucopyranosyl-(1-->2)-beta-D-glucopyranosyl] oleanolic acid 28-O-beta-D-glucopyranosyl ester (5), 3-O-[a-L-rhamnopyranosyl-(1-->3)-beta-D-glucuronopyranosyl] oleanolic acid (6), and 3-O-[alpha-L-rhamnopyranosyl-(1-->3)-beta-D-glucuronopyranosyl] oleanolic acid 28-O-beta-D-glucopyranosyl ester (7) on the basis of physicochemical and spectral data. These triterpene glycosides were tested for the anticomplement activity and hemolytic activity. Bisdesmosidic saponins, 4, 5, and 7, showed anticomplement activity; in contrast, monodesmosidic saponins, 1-3, and 6, showed direct hemolytic activity. Methyl esterified monodesmosidic saponins showed anticomplement activity at a low concentration and hemolytic activity at a high concentration.

Relationship between the cagA 3' repeat region of Helicobacter pylori, gastric histology, and susceptibility to low pH

BACKGROUND & AIMS

The variation in size of Helicobacter pylori CagA is related to repeat sequences in the 3' region of the cagA gene. We investigated whether structural subtypes of the cagA 3' region are associated with presentation of the infection or to susceptibility to acid.

METHODS

We examined 319 cagA-positive H. pylori isolates: 84 isolates from Bogota, Colombia; 83 from Houston, Texas; 24 from Siena, Italy; and 128 from Seoul, Korea. The cagA 3' region was amplified by polymerase chain reaction. Gastric histology and susceptibility to pH 3 were evaluated in relation to the number of cagA repeat regions.

RESULTS

Strains with more than three repeat regions were associated with significantly higher scores for gastric mucosal atrophy and intestinal metaplasia than those with fewer repeat regions. H. pylori strains with three repeat regions were also significantly more susceptible to pH 3 than isolates with fewer repeat regions.

CONCLUSIONS

H. pylori strains with more than three repeat regions in the 3' region of the cagA gene are associated with enhanced histological injury and with reduced survival in acidic conditions. It is hypothesized that these variants arise within the stomach.

Myelodysplastic syndrome that progressed to acute myelomonocytic leukemia with eosinophilia showing peculiar chromosomal abnormality: a case report

Myelodysplastic syndrome is a closely related group of acquired bone marrow disorders characterized by ineffective and dysplastic hematopoiesis. These clonal disorders frequently progress to acute leukemia. Acute myelomonocytic leukemia with eosinophilia is characterized by an increase in abnormal eosinophils in the bone marrow, relatively good clinical course and inv (16) chromosomal abnormality. We experienced one case of refractory anemia with excess blasts which progressed to refractory anemia with excess blasts in transformation and finally to acute myelomonocytic leukemia with eosinophilia showing peculiar chromosomal abnormalities of der (1;7).

Relationship between Helicobacter pylori iceA, cagA, and vacA status and clinical outcome: studies in four different countries

There is continuing interest in identifying Helicobacter pylori virulence factors that might predict the risk for symptomatic clinical outcomes. It has been proposed that iceA and cagA genes are such markers and can identify patients with peptic ulcers. We compared H. pylori isolates from four countries, looking at the cagA and vacA genotypes, iceA alleles, and presentation of the infection. We used PCR to examine iceA, vacA, and cagA status of 424 H. pylori isolates obtained from patients with different clinical presentations (peptic ulcer, gastric cancer, and atrophic gastritis). The H. pylori isolates examined included 107 strains from Bogota, Colombia, 70 from Houston, Tex., 135 from Seoul, Korea, and 112 from Kyoto, Japan. The predominant genotype differed among countries: the cagA-positive iceA1 vacA s1c-m1 genotype was predominant in Japan and Korea, the cagA-positive iceA2 vacA s1b-m1 genotype was predominant in the United States, and the cagA-positive iceA2 vacA s1a-m1 genotype was predominant in Colombia. There was no association between the iceA, vacA, or cagA status and clinical outcome in patients in the countries studied. iceA status shows considerable geographic differences, and neither iceA nor combinations of iceA, vacA, and cagA were helpful in predicting the clinical presentation of an H. pylori infection.

CT features of intraperitoneal manifestations of parasitic infestation

OBJECTIVE

The purpose of this study was to evaluate the CT features of intraperitoneal manifestations with parasitic infestation in nine patients.

CONCLUSION

The CT features of intraperitoneal manifestations of parasitic infestation were single or multiple multiseptated cystic masses in the peritoneal cavity, hazy omental infiltration, or both. Recognizing these features is important to establish an early diagnosis that leads to rapid treatment and helps avoid unnecessary surgery.

Oxidation and the spermatozoa

The unusually high content of phospholipid-bound polyunsaturated fatty acids (PUFA) in the sperm plasma membrane drew attention to their potential physiological significance. Docosahexaenoic acid (22:6) is quantitatively the most important fatty acid. The high PUFA content of sperm membranes makes them vulnerable to peroxidative changes, since PUFA containing two or more double bonds are readily attacked by oxygen radicals. The effects of oxidation on sperm function have been suggested as detrimental as well as beneficial. Generation of reactive oxygen species (ROS) and peroxidation of sperm membrane can bring negative effects on motility, midpiece abnormalities, and sperm-oocyte fusion. ROS trigger sperm hyperactivation, and may support the capacitation of spermatozoa and fertilization. Spermatozoa are protected by various antioxidants and antioxidant enzymes in the seminal plasma or in spermatozoa itself. When the gametes are cultured in vitro, they become more susceptible to oxidative damage. Addition of antioxidants in the media brought beneficial effects in preventing loss of motility and inhibiting lipid peroxidation. Treating patients with antioxidants has shown to have a positive effect on improving fertilization in limited data. The mechanism of antioxidant effects on spermatozoa needs to be further studied.

Demonstration of the presence of lipid peroxide-modified proteins in human atherosclerotic lesions using a novel lipid peroxide-modified anti-peptide antibody

Immunohistochemical demonstration of oxidation-specific epitopes using antibodies developed against oxidized low density lipoprotein (Ox-LDL), LDL modified by products of lipid peroxidation (e.g. malondialdehyde-modified LDL), and lipid peroxide-modified albumin has been considered as strong evidence for the presence of oxidatively modified proteins in atherosclerotic lesions. However, the antigens used in the development of these antibodies were derived from lipoproteins and other proteins that are constituents of both normal and atherosclerotic arteries. In order to demonstrate the unequivocal presence of oxidatively modified proteins, we have used a 15 amino acid synthetic peptide derived from the sequence of human glycodelin. Using an antibody developed against this peptide and the second antibody developed against the lipid peroxide-modified peptide, we immunostained progressive human atherosclerotic lesions. Antibody to the unmodified peptide did not react with antigenic epitopes present in mild, moderate, or severe human atherosclerotic lesions. In contrast, the antibody developed against lipid peroxide-modified peptide highly reacted with tissue samples and provided strong evidence for the presence of lipid peroxide-modified proteins. This study suggests the presence of lipid peroxide-modified proteins in the lesion and that these epitopes are derived by direct interaction of lysine residues with lipid peroxides.

Xanthogranulomatous cholecystitis: radiologic findings with histologic correlation that focuses on intramural nodules

OBJECTIVE

The purpose of this study was to histologically classify intramural nodules associated with xanthogranulomatous cholecystitis and to evaluate the radiologic findings for each type of nodule.

MATERIALS AND METHODS

Pathologic slides and radiologic studies including 14 sonographic and 16 CT examinations in 19 patients (12 men, seven women; mean age, 61 years) with xanthogranulomatous cholecystitis were reviewed. Radiologic findings were correlated with the histologic type of intramural nodule: abscess, xanthogranuloma, or a combination of the two. The duration of symptoms for each type of intramural nodule was also evaluated.

RESULTS

Histologically, all patients had intramural nodules that were either abscesses (n = 11), xanthogranulomas (n = 5), or a combination of the two (n = 3). Radiologic studies revealed nodules in 10 patients (52.6%; four abscesses, four xanthogranulomas, and two combinations). For abscesses, the mean interval from onset of symptoms to surgery was 25 days; for xanthogranulomas, 70 days (p = .0057). Abscesses were associated with more complications of xanthogranulomatous cholecystitis.

CONCLUSION

Intramural nodules in patients with xanthogranulomatous cholecystitis were found to represent abscesses or xanthogranulomas at histology. Xanthogranulomas were more often revealed radiologically than were abscesses. Abscesses caused more clinical complications. Because symptoms lasted longer for xanthogranulomas, we hypothesized that abscesses may become xanthogranulomas.

Paclitaxel, 5-fluorouracil, and cisplatin combination chemotherapy for the treatment of advanced gastric carcinoma

BACKGROUND

Although the clinical efficacy of paclitaxel in the treatment of gastric carcinoma has not been clearly defined, recent reports have suggested a possible role in the treatment of upper gastrointestinal carcinomas in vitro and in vivo. In this study, the authors evaluated the efficacy and toxicity of a combination chemotherapy that included paclitaxel, 5-fluorouracil (5-FU), and cisplatin in the treatment of patients with advanced gastric carcinoma.

METHODS

Forty-one gastric carcinoma patients with metastatic disease, unresectable advanced disease, or relapsed disease were treated with the following regimen, administered every 28 days: paclitaxel 175 mg/m2 by 3-hour intravenous (i.v.) infusion on Day 1, 5-FU 750 mg/m2 by 24-hour continuous i.v. infusion on Days 1-5, and cisplatin 20 mg/m2 by 2-hour i.v. infusion on Days 1-5. Twenty-six patients had measurable disease, and 15 had evaluable disease. All patients were assessable for toxicity.

RESULTS

Twenty-one of the 41 patients (51%; 95% confidence interval [CI], 36.5-65.7%) demonstrated an objective response, including 4 complete responses (10%; 95% CI, 3.9-22.5%). Sixty-five percent of the patients with measurable disease (17 of 26; 95% CI, 58-92.5%) and 27% of the patients with evaluable disease (4 of 15: 95% CI, 11.1-52.3%) achieved a complete response or a partial response. The median response duration was 17 weeks (range, 4-90 weeks), and the median survival duration for all patients was 26 weeks (range, 8 to 118+ weeks). The major toxicity of this treatment was myelosuppression with neutropenia of World Health Organization Grade 3 and 4 in 24% and 10% of the patients, respectively. Nonhematologic toxicity included mucositis, nausea/vomiting, diarrhea, neurotoxicity, and alopecia. Fluid retention occurred in two patients, and one patient had an anaphylatic reaction. Dose reduction was necessary for one patient, because Grade 4 neutropenia and mucositis occurred.

CONCLUSIONS

Paclitaxel, 5-FU, and cisplatin was an active combination regimen in the treatment of advanced gastric carcinoma. The toxicity of this regimen was tolerable. Based on these findings, this combination regimen could be an attractive treatment in the preoperative setting.

Effect of Helicobacter pylori infection on antral gastrin and somatostatin cells and on serum gastrin concentrations

OBJECTIVES

Helicobacter pylori infection induces selective reduction of the number of antral D-cells and results in abnormal regulation of serum gastrin secretion. The purpose of this study was to investigate the relationship between H. pylori infection and the numbers of G-cells and D-cells.

METHODS

The numbers of antral G-cells and D-cells, the ratio of G-cells to D-cells and fasting serum gastrin concentrations were compared between 37 patients with (29 with duodenal ulcers and 8 with gastric ulcers) and 33 without H. pylori infection (22 with duodenal ulcers and 11 with gastric ulcers). Serum gastrin concentrations were measured using the radioimmunoassay technique. Antral mucosal biopsy specimens were examined using immunohistochemical staining with antibodies specific for gastrin and somatostatin and the numbers of G-cells and D-cells per gastric gland were counted.

RESULTS

Fasting serum gastrin concentrations were significantly higher in patients with H. pylori infection compared to patients without infection (80.3 +/- 23.5 vs 47.6 +/- 14.1 pg/ml, p < 0.001). The number of G-cells per gastric gland was similar in infected and uninfected patients (7.1 +/- 3.1 vs 7.3 +/- 3.9, respectively, p > 0.5). The number of D-cells was significantly lower in patients with H. pylori infection than in uninfected patients in both duodenal and gastric ulcer patients (1.3 +/- 0.4 vs 2.5 +/- 1.6, respectively, p < 0.001). The ratio of G-cells to D-cells was also significantly higher in infected patients compared with uninfected patients for both gastric and duodenal ulcers (5.7 +/- 2.7 vs 3.5 +/- 1.9, respectively, p < 0.001).

CONCLUSIONS

These results strongly suggest that Helicobacter pylori infection induces reduction of the number of antral D-cells. The resulting relative hypofunction of the inhibitory action of D-cells against G-cells may be responsible for increased serum gastrin secretion.

Serologic detection of Helicobacter pylori infection with cagA-positive strains in duodenal ulcer, gastric cancer, and asymptomatic gastritis

CagA has been suggested as a marker for more virulent strains of Helicobacter pylori. Studies using purified proteins and an enzyme-linked immunosorbent assay (ELISA) method for serological detection of antibodies against CagA reported considerable discordance between the results of the ELISA and molecular detection of the cagA gene, with a tendency for estimation of the prevalence of cagA-positive H. Pylori to be higher by ELISA than by colony hybridization. It is not clear whether the discordance was either due to simultaneous infections with both cagA-positive and -negative strains or because of false-positive ELISA results. We correlated the presence of cagA-positive H. pylori by Polymerase chain reaction (PCR) with the presence of serum antibodies against the CagA protein from denatured H. pylori lysates. Gastric biopsies and sera were obtained from 75 patients from Korea; 25 each with gastric carcinoma, duodenal ulcer, and simple gastritis. Seventy-four of 75 isolates (98.6%) were cagA-positive by PCR and 70 sera were CagA antibody-positive by Western blotting. The cagA gene is common in H. pylori isolates from Korea regardless of the underlying disease. The presence of cagA is almost always associated with antibody to the CagA protein as determined by Western blotting. Western blotting may be the preferred method for serological detection of infection with cagA-positive H. pylori.