Evaluation of urinary cadmium and lead as markers of background exposure of middle-aged women in Korea: dietary intake as an influential factor

The study was conducted to examine the validity of urinary cadmium (Cd) and lead (Pb) in comparison with the metals in blood as a biological marker of non-occupational exposure of general populations. Participants in four survey sites in Korea (107 non-smoking Korean women aged 30-49 years) offered peripheral blood, morning spot urine, and 24-h total food duplicate samples. Analysis of Cd and Pb was accomplished by graphite furnace atomic absorption spectrophotometry. The analyse levels were evaluated on an individual basis (n = 107) and also on a survey site basis, i.e. in terms of geometric means for the groups in the survey sites (n = 4). Cd in urine (as observed, or after correction for creatinine concentration or a specific gravity) correlated with Cd in blood on an individual as well as survey site basis, and tended to correlate with Cd in food duplicates on the survey site basis. Correlation of Pb in urine with Pb in blood was weaker than that of Cd in urine with Cd in blood both on the individual and survey site basis. Pb in urine correlated with Pb in food duplicates either weakly or even negatively when examined on a survey site basis. It was concluded that Cd in urine can be most probably employed as a biological marker of environmental Cd exposure of general population, whereas less support was obtained for Pb in urine as an exposure marker.

Three new allelic mouse mutations that cause skeletal overgrowth involve the natriuretic peptide receptor C gene (Npr3)

In 1979, a BALB/cJ mouse was identified with an exceptionally long body. This phenotype was found to be caused by a recessive mutation, designated longjohn (lgj), that mapped to the proximal region of chromosome 15. Several years later, a mouse with a similarly elongated body was identified in an outbred stock after chemical mutagenesis with ethylnitrosourea. This phenotype also was caused by a recessive mutation, designated strigosus (stri). The two mutations were found to be allelic. A third allele was identified in a DBA/2J mouse and was designated longjohn-2J (lgj(2J)). Analysis of skeletal preparations of stri/stri mice indicated that the endochondral ossification process was slightly delayed, resulting in an extended proliferation zone. A recent study reported that mice overexpressing brain natriuretic peptide, one of the members of the natriuretic peptide family, exhibit a skeletal-overgrowth syndrome with endochondral ossification defects. The Npr3 gene coding for type C receptor for natriuretic peptides (NPR-C), which is mainly involved in the clearance of the natriuretic peptides, mapped in the vicinity of our mouse mutations and thus was a candidate gene. The present study reports that all three mutations involve the Npr3 gene and provides evidence in vivo that there is a natriuretic-related bone pathway, underscoring the importance of natriuretic peptide clearance by natriuretic peptide type C receptor.

Apolipoprotein E polymorphism in non-diabetic patients with acute coronary syndrome

Since a decade ago, apolipoprotein (apo) E polymorphism has been focussed as a risk factor for cardiovascular disease. ApoE plays a central role as a receptor ligand for the uptake of lipoproteins from the circulation. There was an agreement on apoE polymorphism being one of the major risk factors for coronary artery disease (CAD) by its effects on lipid profiles. However, the effects of apoE have not been noted in all populations and conflicting results in the risk of CAD have been noted. Recently, in situ expression of apoE on the atherosclerotic plaque has been studied. We, therefore, investigated the effects of apoE genotype on patients with acute coronary syndrome, including unstable angina and acute myocardial infarction, in non-diabetic patients. While we could not find significant risk effects of apoE on coronary artery disease and lipid profiles on simple comparison with the normal control group, we could find significantly decreased frequencies of apo epsilon 3 allele in patients with acute coronary syndrome compared with stable angina patients (77.8% vs 88.8%). We suggest that the apoE genotype could be associated with acute coronary events in CAD and further study with in situ biochemical methods will be needed on the effects of apoE polymorphism on plaque stability.

Meta-analysis of trials comparing beta-blockers, calcium antagonists, and nitrates for stable angina

CONTEXT

Which drug is most effective as a first-line treatment for stable angina is not known.

OBJECTIVE

To compare the relative efficacy and tolerability of treatment with beta-blockers, calcium antagonists, and long-acting nitrates for patients who have stable angina.

DATA SOURCES

We identified English-language studies published between 1966 and 1997 by searching the MEDLINE and EMBASE databases and reviewing the bibliographies of identified articles to locate additional relevant studies.

STUDY SELECTION

Randomized or crossover studies comparing antianginal drugs from 2 or 3 different classes (beta-blockers, calcium antagonists, and long-acting nitrates) lasting at least 1 week were reviewed. Studies were selected if they reported at least 1 of the following outcomes: cardiac death, myocardial infarction, study withdrawal due to adverse events, angina frequency, nitroglycerin use, or exercise duration. Ninety (63%) of 143 identified studies met the inclusion criteria.

DATA EXTRACTION

Two independent reviewers extracted data from selected articles, settling any differences by consensus. Outcome data were extracted a third time by 1 of the investigators. We combined results using odds ratios (ORs) for discrete data and mean differences for continuous data. Studies of calcium antagonists were grouped by duration and type of drug (nifedipine vs nonnifedipine).

DATA SYNTHESIS

Rates of cardiac death and myocardial infarction were not significantly different for treatment with beta-blockers vs calcium antagonists (OR, 0.97; 95% confidence interval [CI], 0.67-1.38; P = .79). There were 0.31 (95% CI, 0.00-0.62; P = .05) fewer episodes of angina per week with beta-blockers than with calcium antagonists. beta-Blockers were discontinued because of adverse events less often than were calcium antagonists (OR, 0.72; 95% CI, 0.60-0.86; P<.001). The differences between beta-blockers and calcium antagonists were most striking for nifedipine (OR for adverse events with beta-blockers vs nifedipine, 0.60; 95% CI, 0.47-0.77). Too few trials compared nitrates with calcium antagonists or beta-blockers to draw firm conclusions about relative efficacy.

CONCLUSIONS

beta-Blockers provide similar clinical outcomes and are associated with fewer adverse events than calcium antagonists in randomized trials of patients who have stable angina.

Monophosphoryl lipid A (MPL) upregulates major histocompatibility complex (MHC) class I expression by increasing interferon-gamma (IFN-gamma)

Tumor immunity is primarily mediated by cells as CD8+ cytotoxic T lymphocytes (CTL) recognize tumor antigen by MHC class I molecules. But most tumors are associated with a decreased expression of MHC class I to escape the antitumor immunity of the host. Our previous data have demonstrated that MPL has an antitumor effect on metastatic lung cancer of B16 melanoma with enhancing cytotoxicity due to increase of IFN-gamma and IL-2, and decrease of IL-4, which indicates the stimulation of type 1 helper T cells (Th1). To determine the effects of MPL, IFN-gamma, TNF-alpha, and IL-1 alpha on MHC class I expression of B16 melanoma cells, we evaluated the expression of MHC class I molecules with treatments of MPL, IFN-gamma, TNF-alpha, and IL-1 alpha by flow cytometry. The supernatant of MPL-treated spleen cells in vitro upregulated the expression of MHC class I molecules of B16 melanoma cells compared to the control supernatant of spleen cells. The MHC class I expression of B16 melanoma cells treated with IFN-gamma, but not TNF-alpha or IL-1 alpha, increased in a time-dependent manner. In conclusion, MPL upregulated MHC class I expression of B16 melanoma cells by activating spleen cells via IFN-gamma. These data suggest that increased IFN-gamma by MPL is responsible for the upregulation of MHC class I expression to augment cytotoxicity. Therefore, we suggest that MPL could play an important role in immunotherapy.

Epidemiology of eating disordered symptoms in the Korean general population using a Korean version of the Eating Attitudes Test

OBJECTIVE

The purposes of the present study were to estimate the proportion of subjects with a high score on the Korean version of Eating Attitudes Test--26 (KEAT-26), which may provide preliminary data regarding the prevalence rate of eating disorders in the Korean general population, and to further examine the sociocultural hypothesis of eating disorders.

METHOD

Using a multi-stage questionnaire sampling method, we surveyed 3062 subjects (1249 males, 1813 females) from 3896 Korean adults in a nationwide area.

RESULTS

8.5% (260/3062) of subjects scored above the cut-off on the KEAT-26. Their demographic correlates, eating traits, and other characteristics relating to general psychopathology were similar to those of patients with eating disorders and female Caucasian controls in Western countries.

DISCUSSION

These results suggest that changes in various sociocultural aspects have increased the risk of developing eating disorders in Korea, and support the sociocultural hypothesis of eating disorders.

Mutations affecting ligand specificity of the G-protein-coupled receptor for the Saccharomyces cerevisiae tridecapeptide pheromone

Random mutations were generated in the G-protein-coupled receptor (Ste2p) for the tridecapeptide pheromone (alpha-factor) of Saccharomyces cerevisiae. These mutants were screened for variants that responded to antagonists. Because multiple mutations were detected in each mutant receptor recovered from the screen, site-directed mutagenesis was used to create single-site mutant receptors. Three receptors containing mutations F55V, S219P, and S259P were analyzed for their biological responses to various alpha-factor analogs and for their ligand binding profiles. Cells expressing each of the mutant receptors responded to alpha-factor as well as or better than wild-type cells in a growth arrest assay. In contrast, the binding of alpha-factor to the F55V and S219P mutant receptors was at least 10-fold reduced in comparison to wild-type receptor indicating a complex non-linear correlation between binding affinity and biological activity. Cells expressing mutant receptors responded to some normally inactive analogs in biological assays, despite the fact that these analogs had a low affinity for Ste2p. The analysis of these mutant receptors confirms previous findings that the first and sixth transmembrane regions of Ste2p are important for ligand interaction, ligand specificity, and/or receptor activation to initiate the signal transduction pathway. Changes in binding affinity of pheromone analogs to wild-type and mutant receptors indicate that residue 55 of Ste2p is involved with both ligand binding and signal transduction.

Urinary 5-aminolevulinic acid (ALA) adjusted by creatinine: a surrogate for plasma ALA?

5-Aminolevulinic acid (ALA) is the first intermediate substrate in the heme synthetic pathway and is the substrate of aminolevulinic acid dehydratase (ALAD, porphobilinogen synthase). Because lead effectively inhibits ALAD activity, resulting in accumulation of ALA in urine and blood, urinary ALA (ALAU) has been used as a biomarker for lead exposure or early biologic effect of lead. Intraindividual variation in urinary excretion of ALA requires the use of 24-hour urine samples or adjustment of single urine samples by other normalizing variables, such as urinary creatinine concentration. Previous studies of ALAU concentration have used various adjustment methods; however, few have compared creatinine-adjusted ALAU concentration with ALA concentration in plasma (ALAP) from subjects with low (< 30 micrograms/dL) to moderate (< 60 micrograms/dL) levels of blood lead. To determine if creatinine-adjusted ALAU is associated with ALAP, we measured ALAU, ALAP, and urinary creatinine in 65 Korean lead workers with blood lead concentrations in the range of 14-60 micrograms/dL. ALAU, ALAU/creatinine, or ALAU/log creatinine all correlated with ALAP. However, ALAU/creatinine correlated more closely with ALAP based on Spearman's r (rs = 0.40, P, = 0.0009), supporting the use of ALA/creatinine in single urine samples as a surrogate for ALAP.

Experimental hypercholesterolemia induces ultrastructural changes in the elastic laminae of rabbit aortic valve

Atherosclerosis is the most severe problem in the high-pressure systemic circulation and similar changes also occur in the high-pressure loading valve. This study was designed to test the hypothesis that early atherosclerosis, induced by a high cholesterol diet in rabbits, is characterized by significant ultrastructural change in the elastic laminae of the aortic valve. However, it is not known whether this process is also taking place in the cardiac valve at the early stage of atherosclerosis. Animals were fed either a high cholesterol diet (n = 5) or a control diet (n = 5) for 10-12 weeks. Histologic analysis demonstrated that subendothelial thickening and foam-cell infiltration were evident in the arterialis of aortic valves. Confocal microscopy revealed an altered pattern characterized by fragmentation and disorganization of the arterialis elastic laminae of hypercholesterolemic valves. Computerized digital analysis of the images obtained by confocal scanning microscopy demonstrated that compared to normal valves, the arterialis elastic laminae of hypercholesterolemic valves decreased in percentage of their elastin content (29.03 +/- 1.10% vs. 42.94 +/- 1.35%, p = 0.023). Immunohistochemical staining for matrix metalloproteinase-3 (MMP-3) revealed MMP-3 immunoreactivity was increased in hypercholesterolemic valves, predominantly in the arterialis. This study demonstrated that early atherosclerosis, induced by a high cholesterol diet in rabbits, is characterized by significant ultrastructural change in the elastic laminae of the aortic valve. The arterialis endothelium of the aortic valve may be a more atherosclerosis-prone area compared with the ventricularis. The presence of ultrastructural defect in the elastic laminae may play a role in chronic degenerative change and a resultant valvular dysfunction.

Reduced lymphocyte proliferation and interleukin-2 production in anxiety disorders

OBJECTIVE

The purpose of this study was to examine the effect of anxiety on cell-mediated immunity.

METHOD

The subjects consisted of 31 patients with anxiety disorders and 31 normal controls, who were gender-matched. Cell-mediated immune function was measured by the lymphocyte proliferative response to phytohemagglutinin (PHA), Interleukin-2 (IL-2) production, and natural killer cell activity (NKA). The extent of anxiety was assessed by the Hamilton rating scale for anxiety and the anxiety subscale of symptom checklist-90 revised (SCL-90-R).

RESULTS

The patients with anxiety disorders were significantly lower than the normal controls in lymphocyte proliferative response to PHA and IL-2 production. However, there was no significant difference in NKA between the two groups. Also, no significant correlation was found between the duration of illness or the degree of anxiety and each immune measure in patients with anxiety disorders.

CONCLUSIONS

The results suggest a reduced cell-mediated immune function in patients with anxiety disorders, compared with normal controls. These findings also imply that a variety of immune measures should be assessed at the same time in this kind of psychoneuroimmunology research. This would help elucidate the relationship between anxiety and immune function, which has been unclear in most previous research using a single immune measure.

Evaluation of urinary cadmium and lead as markers of background exposure of middle-aged women in Korea

OBJECTIVE

The present study was initiated to investigate the validity of cadmium (Cd) and lead (Pb) in urine in comparison with the metals in blood as a biological marker of nonoccupational exposure of general populations to these metals as environmental pollutants.

DESIGN

Peripheral blood samples, morning spot-urine samples, and 24-h total food duplicate samples were collected from 107 nonsmoking women (aged 30-59 years) in four urban and rural survey sites in Korea.

METHODS

Portions of the samples were digested by heating in the presence of mineral acids, and the digests were analyzed for Cd and Pb by graphite furnace atomic absorption spectrophotometry. The metal concentrations in urine were adjusted for creatinine concentration and a specific gravity of 1.016. The analyte levels were evaluated on an individual basis (n = 107) and also on a group basis, i.e., in terms of geometric means for the survey sites (n = 4).

RESULTS

Cd in urine correlated with Cd in blood on an individual as well as survey-site basis and tended to correlate with Cd in food duplicates on a group basis. The correlation of Pb in urine with Pb in blood was weaker than that of Cd in urine with Cd in blood when evaluated on an individual and survey-site basis. Pb in urine correlated with Pb in food duplicates either weakly or even negatively when examined on a survey-site basis.

CONCLUSIONS

Cd in urine proved to be valid as a biological marker of environmental exposure of general populations, whereas less support was obtained for Pb in urine as an exposure marker.

Hemodynamic effects of the geometric dimensions of graft vessels in coronary artery bypass graft models

The objectives of this investigation are to evaluate the rheologic properties in atherosclerotic disease treated with the various coronary artery bypass graft (CABG) models by numerical analysis, we used four different CABG models for the assessment of spatial fluctuation in wall shear stress, pressure variation and mass flow rate with Carreau model and Navier-Stokes equation. Wall shear stress was higher in a naturally tapered model (model 1) and a constant (non-tapered) diameter of the graft vessel the same as the distal LAD (model 4) than in others. Pressure variation along the native coronary artery and graft vessels was higher in a model 4, model 1 than in a reverse tapering model (model 2) and a constant diameter of the graft vessel the same as the proximal LAD (model 3). The mass flow rate of the distal part (kg/sec,.m(o)) was the highest in model 3. This study suggests that in vitro spatial simulation following CABG revealed that small caliber or tapered graft vessels have adverse hemodynamic effects on the native and graft vessels. By this technique it is possible to simulate the optimal distribution of local hemodynamic variables in patients treated with CABG, also to minimize the degeneration of graft vessel.

Computed numerical analysis of the biomechanical effects on coronary atherogenesis using human hemodynamic and dimensional variables

The objectives of this investigation were to evaluate biomechanical factors in the atherosclerotic process using human in vivo hemodynamic parameters and computed numerical simulation qualitatively and quantitatively. The three-dimensional spatial patterns of steady and pulsatile flows in the left coronary artery were simulated, using a finite volume method. Coronary angiogram and Doppler ultrasound measurement of the proximal left coronary flow velocity were performed in humans. Inlet wave velocity distribution obtained from in vivo data of the intravascular Doppler study allowed for input of in vitro numerical simulation. Hemodynamic variables, such as flow velocity, pressure and shear stress of the left anterior descending coronary bifurcation site were calculated. We found that there were spatial fluctuation of flow-velocity and recirculation areas at the curved outer wall of the left anterior descending coronary artery, which were due to the differences of flow-velocity and shear stress, especially during the declaration phase of pulsatile flow. This study suggests that rheologic properties may be a part of the atherogenic process in the coronary bifurcated and curved areas.

Aminolevulinic acid dehydratase genotype mediates plasma levels of the neurotoxin, 5-aminolevulinic acid, in lead-exposed workers

The first intermediate substrate in the heme synthetic pathway, 5-aminolevulinic acid (ALA), is neurotoxic in animal models and may be responsible for some of the adverse neurologic outcomes in lead poisoning and porphyria in adult humans. ALA is a substrate for the enzyme aminolevulinic acid dehydratase (ALAD; EC 4.2.1.24), which is encoded by the ALAD gene containing 2 co-dominant alleles, 1 and 2. We measured plasma ALA (ALAP) and urinary ALA (ALAU) in 65 Korean lead workers, of whom 44 were homozygous for ALADI (ALAD1-1 genotype) and 21 were heterozygous for ALAD (ALAD1-2 genotype). ALAP in subjects with the ALAD1-1 genotype was significantly higher than in those with the ALAD1-2 genotype (Wilcoxon rank sum test, P = 0.01). No difference between ALAD genotypes was found for age, zinc protoporphyrin (ZPP), blood lead levels (PbB), ALAU, or ALAU adjusted for creatinine. ALAP was significantly correlated with ZPP (Spearman's r = 0.38, P = 0.002) and with PbB (r = 0.34, P = 0.006), and marginally with employment duration (r = 0.22, P = 0.08). ALAP remained significantly elevated (P = 0.032) in ALAD1-1 subjects after adjustment for PbB and age by multiple linear regression. These results suggest that ALAD1-1 subjects respond differently and may be more susceptible than ALAD1-2 subjects to the ALA-mediated neurotoxic effects of lead.

Lemierre's syndrome

Lemierre's syndrome is an acute medical condition characterized by anaerobic oropharyngeal infection leading to septic thrombophlebitis of the internal jugular vein. The illness is often complicated by septic pulmonary emboli and distant metastatic infections. Treatment consists of surgical drainage of purulent collections and long-term intravenous antibiotic therapy. Although Lemierre's syndrome is rare, it is potentially fatal and remains an important entity for clinicians to recognize and treat appropriately.

delta-Aminolevulinic acid dehydratase genotype modifies four hour urinary lead excretion after oral administration of dimercaptosuccinic acid

OBJECTIVES

Previous research suggests that binding of lead by delta-aminolevulinic acid dehydratase (ALAD) may vary by ALAD genotype. This hypothesis was tested by examining whether ALAD genotype modifies urinary lead excretion (DMSA chelatable lead) after oral administration of dimercaptosuccinic acid (DMSA).

METHODS

57 South Korean lead battery manufacturing workers were given 5 mg/kg oral DMSA and urine was collected for four hours. Male workers were randomly selected from two ALAD genotype strata (ALAD1-1, ALAD1-2) from among all current workers in the two plants (n = 290). Subjects with ALAD1-1 (n = 38) were frequency matched with subjects with ALAD1-2 (n = 19) on duration of employment in the lead industry. Blood lead, zinc protoporphyrin, and plasma aminolevulinic acid concentrations, as well as ALAD genotype, duration of exposure, current tobacco use, and weight were examined as predictors or effect modifiers of levels of DMSA chelatable lead.

RESULTS

Blood lead concentrations ranged from 11 to 53 micrograms/dl, with a mean (SD) of 25.4 (10.2) micrograms/dl. After 5 mg/kg DMSA orally, the workers excreted a mean (SD) 85.4 (45.0) micrograms lead during a four hour urine collection (range 16.5-184.1 micrograms). After controlling for blood lead concentrations, duration of exposure, current tobacco use, and body weight, subjects with ALAD1-2 excreted, on average, 24 micrograms less lead during the four hour urine collection than did subjects with ALAD1-1 (P = 0.05). ALAD genotype seemed to modify the relation between plasma delta-aminolevulinic acid (ALA) and DMSA chelatable lead. Workers with ALAD1-2 excreted more lead, after being given DMSA, with increasing plasma ALA than did workers with ALAD1-1 (P value for interaction = 0.01).

CONCLUSIONS

DMSA chelatable lead may partly reflect the stores of bioavailable lead, and the current data indicate that subjects with ALAD1-2 have lower stores than those with ALAD1-1. These data provide further evidence that the ALAD genotype modifies the toxicokinetics of lead-for example, by differential binding of current lead stores or by differences in long-term retention and deposition of lead.

Associations of subtypes of hemoglobin with delta-aminolevulinic acid dehydratase genotype and dimercaptosuccinic acid-chelatable lead levels

Hemoglobin in erythrocytes may be an important intravascular site of lead binding. We examined associations of hemoglobin subtypes A1 and A2 with delta-aminolevulinic acid dehydratase (ALAD) genotype, a protein that is another important site of erythrocyte lead binding. After oral administration of dimercaptosuccinic acid (DMSA-chelatable lead), we also examined 4-h lead excretion, which provides an estimate of bioavailable lead stores. We randomly selected 57 South Korean current lead battery manufacturing workers from two plants (N = 290 employees) and from two ALAD genotype strata (ALAD1-1 and ALAD1-2). These workers voluntarily administered 5 mg/kg oral DMSA. We frequency-matched subjects with ALAD1-1 (n = 38) to subjects with ALAD1-2 (n = 19) with respect to duration of employment in the lead industry. Blood lead levels ranged from 11 to 53 microg/dl (mean +/- standard deviation, 25.4 +/- 10.2 microg/dl). After administration of oral DMSA, workers excreted a mean lead level of 85.4 (standard deviation, 45.0 microg; range, 16.5-184.1 microg). Hemoglobin A1 and A2 ranged from 3.7% to 9.9% and 1.6% to 5.9%, respectively (mean +/- standard deviation, 6.2 +/- 1.0% and 2.7 +/- 0.8%, respectively). Subjects with ALAD1-1 had elevated mean hemoglobin A1 levels (adjusted p = .05). In addition, higher hemoglobin A1 levels were associated with higher DMSA-chelatable lead levels (adjusted p = .03). This, as well as the results of prior research, suggest that both ALAD and hemoglobin A1 may be important lead-binding sites that influence urinary lead excretion after administration of DMSA.

Nutritional evaluation of women in urban and rural areas in Korea as studied by total food duplicate method

Nutrient intake was studied by the total food duplicate method in 141 adult working women (at the ages of 21 to 56 years) in four regions (Seoul, Pusan, Chunan and Haman) in Korea. Clinical, hematological and anthropometrical examinations were conducted in parallel. The nutrient intakes were estimated in reference to the weight of each food item and the national standard food composition tables for Korean population, and evaluated in comparison with the nationally recommended dietary allowances (RDA). The intakes were essentially sufficient when evaluated on a group basis. Plant-based foods were major sources of both protein (67%) and lipid (72%). Dinner was the most substantial sources of all nutrients. Further evaluation on an individual basis taking 80-120% RDA as acceptable showed that young people (at the ages of 20-29 years) and those in Seoul had highest prevalence of insufficient intake of nutrients, especially energy, protein and iron. Consumption of rice, the traditional staple food, was the lowest in Seoul and in the youngest groups as compared with others. The prevalence of overweight cases was also the lowest in the Seoul participants. The two observations when combined apparently suggest the difficulties in public nutrition.

Ethnic variation in the prevalence of a common NAD(P)H quinone oxidoreductase polymorphism and its implications for anti-cancer chemotherapy

The NAD(P)H quinone oxidoreductase (NQO1:EC 1.6.99.2) is an important biotransformation enzyme system that is also known to metabolize important novel chemotherapeutic compounds. The gene that codes for this enzyme has recently been found to be polymorphic in humans. Here, we describe the ethnic distribution of the polymorphism and note that this may have implications for anti-tumour drug development and use.

The effect of diphenyl-dimethyl-dicarboxylate on cyclosporine-A blood level in kidney transplants with chronic hepatitis

An adequate blood level of cyclosporine-A (CsA) is essential to keep graft function in kidney transplants. Due to a narrow therapeutic index and highly variable pharmacokinetic properties associated with CsA, drug interactions may have a significant impact on the immunosuppressive efficacy or toxicity of CsA. Numerous drug interactions of potential clinical significance involving CsA have been reported. Dephenyl-dimethyl-dicarboxylate (PMC), a hepatotonic drug, is a substance derived from the synthesis of Schizandrae fructus elements. We have experienced two cases of drug interaction between CsA and PMC in kidney transplants with chronic hepatitis. In both cases, CsA troughs decreased markedly to a subtherapeutic level following administration of PMC. We, therefore, suggest that PMC could decrease the CsA trough level and thus a close monitoring of the CsA trough level is necessary during a PMC therapy.

Sex-determining genes on mouse autosomes identified by linkage analysis of C57BL/6J-YPOS sex reversal

A powerful approach for identifying mammalian primary (gonadal) sex determination genes is the molecular genetic analyses of sex reversal conditions (that is, XX individuals with testicular tissue and XY individuals with ovarian tissue). Here we determined the number and chromosomal location of autosomal and X-linked genes that cause sex reversal in C57BL/6J (B6) mice carrying a Y chromosome of Mus domesticus poschiavinus origin (YPOS). B6 XYPOS mice develop either as females with exclusively ovarian tissue or as true hermaphrodites with ovarian and testicular tissue. In contrast, the YPOS chromosome is fully masculinizing on most other inbred strain backgrounds. B6-YPOS sex reversal appears to result from the incompatibility of the Sry (sex determining region, Y chromosome) allele carried on the YPOS chromosome with B6-derived autosomal or X-linked loci. We found strong evidence for the location of one gene, designated tda1 (testis-determining, autosomal 1), at the distal end of Chromosome (Chr) 4 and a second gene, tda2, in the central region of Chr 2. A third gene, tda3, on Chr 5 is implicated, but the evidence here is not as strong. We suggest that B6 alleles at these loci predispose XYPOS fetuses to ovarian tissue development, but no single locus or combination of loci is necessary and sufficient to cause sex reversal. The TDA proteins may regulate Sry expression or form complexes with the SRY protein to regulate other genes, or the tda genes may be activated or repressed by the SRY protein.

Assessing myocardial perfusion with Albunex during coronary artery bypass surgery: technical considerations and safety of aortic root injections

OBJECTIVE

To test the safety and report on limiting technical considerations, including optimal dosing of Albunex (Molecular Biosystems, Inc, Mallinckrodt Medical, St. Louis, MO) for myocardial opacification after intra-aortic root injections during cardiac surgery.

DESIGN

This was a prospective randomized study with a control group who did not receive Albunex and a group who received intra-aortic root injections of Albunex.

SETTING

Multicenter (two) independent university hospitals.

PARTICIPANTS

32 patients scheduled for elective coronary artery bypass surgery were evaluated after individual informed consent was obtained.

INTERVENTIONS

2 to 8 mL of Albunex were injected before and after coronary revascularization.

MEASUREMENTS AND MAIN RESULTS

Quality of enhancement in each of four regions of the left ventricle was assessed from a short-axis mid-papillary ultrasound image by three experienced observers blinded to dose. Electrocardiogram (ECG), creatine phosphokinase (CPK) (MB fraction), and hemodynamics were evaluated at baseline and throughout the study period for up to 72 hours. No differences were noted between groups with respect to preoperative and postoperative CPK enzymes (CPK-MB fraction), ECG changes, hemodynamics, requirements for separation from CPB, need for postoperative inotropes, time to extubation, and time to discharge from the intensive care unit. The average total dose of Albunex injected was 19 mL +/- 4 (0.25 mL/kg). A single dose of 4.2 +/- 1.2 mL (0.05 mL/kg) appeared to offer optimal enhancement of contrast effect for myocardial perfusion assessment.

CONCLUSION

Albunex is safe and easy to use for myocardial opacification when administered via an antegrade cardioplegia catheter into the aortic root during CPB.

Association of somatotropin (BST) gene polymorphism at the 5th exon with selection for milk yield in Holstein cows

A selection project produced control cows from continuous matings with breed average bulls for predicted transmitting ability for milk (PTA-milk) in 1964 and select cows from matings to four of the highest PTA-milk bulls each year since 1964. Blood samples were collected in 1992 when milk yield difference of select and control line cows exceeded 3,800 kg of milk/305-day lactation. Genomic DNA from control (n = 49) and select (n = 101) cows was analyzed for the presence of variants associated with amino acid position 127 (leucine, AluI[+]; valine, AluI[-]) of bovine somatotropin (bST). Amplification of a 428 base-pair fragment of the bST gene from individual cows, subsequent restriction enzyme (AluI) digestion, and separation resulting fragments indicated three genotypes AluI(+/+), AluI(+/-), and AluI(-/-) in 110, 39, and 1 animal(s), respectively. Gene frequencies of leucine127 and valine 127 alleles were similar for control (0.867m 0.133) and select (0.861, 0.139) animals. United States Department of Agriculture-PTA values were compared between the two genotypes, AluI(+/+) and AluI(+/-). Estimated breeding value for milk (EBV-milk) and average yield deviation for milk (AYD-milk) were not associated with genotype for control animals. However, presence of the valine allele was correlated with decreased EBV-milk (P = 0.03) and AYD-milk (P = 0.16) in select animals and accounted for a decrease of approximately 170 kg of EBV-milk and 240 kg of AYD-milk.

Signaling mechanism of PMA-induced differentiation of K562 cells

We have studied the signaling pathways responsible for the monocytic and/or megakaryocytic differentiation of K562 cells. The results demonstrated that although the mitogen-activated protein kinase (MAPK) was activated during the phorbol myristate acetate (PMA)-induced monocytic and/or megakaryocytic differentiation of K562 cells, the overexpression of Ha-ras which can activate the MAPK did not induce the monocytic and/or megakaryocytic differentiation of K562 cells. Instead PMA-induced megakaryocytic differentiation of K562 cells was inhibited by the pretreatment of pyrrolidine dithiocarbamate, a specific nuclear factor kappaB (NF-kappaB) inhibitor. Taken together, these results suggest that the activation of NF-kappaB rather than that of MAPK might be involved in the PMA-induced megakaryocytic differentiation of K562 cells.