Surface characterization and platelet compatibility evaluation of surface-sulfonated chitosan membrane

The effect of various sulfonated derivatives of chitosan on platelet activation and blood coagulation was examined. The surface properties of artificial biomaterials have been thought as the key factors which mediate the interactions between the biological environment and biomaterial itself. In this study, the sulfonation was directly performed on the chitosan membrane surface. The chitosan membrane was surface-sulfonated by reactions with sulfur-pyridine trioxide complex (SO3/pyridine) in H2O solution and N,N-sulfur-dimethylformamide trioxide complex (SO3/DMF) in DMF. Blood compatibility was evaluated by an in vitro platelet adhesion assay. The surface reaction of SO3/pyridine in aqueous acid medium yields N,O-sulfated chitosan with cationic NH3+ groups. After neutralization, this surface has been shown to induce a low degree of platelet adhesion and activation. When the surface-sulfonation is performed in an aqueous alkaline medium, although the degree of sulfonation is lower than the samples above, the N-sulfated chitosan significantly reduced the adhesion and activation of platelets. For the acidic SO3/DMF reaction system, N,O-sulfated chitosan was obtained with a high extent of sulfonation and cationic NH3+ groups. On this surface fully spread platelets and some platelet aggregates were found instead. This may be attributed to the ionic interactions between the platelets membrane surface and the cationic groups on the modified chitosan membrane.

Nonsteroidal selective glucocorticoid modulators: the effect of C-5 alkyl substitution on the transcriptional activation/repression profile of 2,5-dihydro-10-methoxy-2,2,4-trimethyl-1H-[1]benzopyrano[3,4-f]quinolines

The preparation and characterization of a series of selective glucocorticoid receptor modulators are described. The preliminary structure-activity relationship of nonaromatic C-5 substitution on the tetracyclic quinoline core showed a preference for small lipophilic side chains. Proper substitution at this position maintained the transcriptional repression of proinflammatory transcription factors while diminishing the transcriptional activation activity of the ligand/glucocorticoid receptor complex. The optimal compounds described in this study were the allyl analogue 18 and cyclopentyl analogue 32. These candidates showed slightly less potent, highly efficacious E-selectin repression with significantly reduced levels of glucocorticoid response element activation in reporter gene assays vs prednisolone. Allyl analogue 18 was evaluated in vivo. An oral dose of 18 showed an ED(50) = 1.7 mg/kg as compared to 1.2 mg/kg for prednisolone in the Sephadex-induced pulmonary eosinophilia model and an ED(50) = 15 mg/kg vs 4 mg/kg for prednisolone in the carrageenan-induced paw edema model.

Diffusion characteristics of collagen film

Collagen films prepared by treating collagen gel solutions with different concentrations of glutaraldehyde were evaluated as a biodegradable and biocompatible drug carrier for cosmetically effective agents in this study. The influences of concentration of glutaraldehyde (0, 0.05, 0.075, 0.1, 0.2, 0.25, and 0.3%, v/w) with a fixed concentration (1%, w/w) of collagen on the crosslinking rate of collagen gel solutions and on the crosslinking extent of the collagen contained within were examined by monitoring changes in viscosity. In addition, the influences of the addition of different model drugs (retinoic acid, retinol palmitate, ascorbic acid 6-palmitate, and tocopherol acetate) on viscosity changes of collagen gel solutions were compared. The results demonstrate that the maximal viscosity of collagen gel solutions increases with increasing concentrations of glutaraldehyde. When the concentration of glutaraldehyde exceeds 0.2%, the maximal viscosity of collagen gel solutions reaches a plateau. However, model drugs showed insignificant effects on viscosity changes of collagen gel solutions. The diffusion characteristics of collagen films prepared from those gel solutions crosslinked with different concentrations of glutaraldehyde were assessed using two different matrix forms of solution or gel for the model drugs in a flow-through diffusion system. The matrix effect on the flux of model drugs from both solution and gel matrix through collagen films was inconclusive. However, both fluxes show the same tendency to decrease when the concentration of glutaraldehyde used for crosslinking is increased. However, when the concentration of glutaraldehyde exceeds 0.2%, these model drugs, except retinoic acid, show similar diffusion characteristics across the collagen films.

Restricted killer cell immunoglobulin-like receptor repertoire without T-cell receptor gamma rearrangement supports a true natural killer-cell lineage in a subset of sinonasal lymphomas

The cellular lineage of sinonasal T/NK (natural killer) cell lymphoma remains controversial. Lineage assignment is difficult because T cells and NK cells have a similar morphology and surface markers. Consequently, the assignment must depend heavily on the status of T-cell receptor (TCR) rearrangement. A monoclonal TCR rearrangement supports a T lineage; however, a corresponding monoclonality test for NK cells has not yet been established. Each NK cell bears a distinct set of killer cell immunoglobulin (Ig)-like receptors (KIRs) that are randomly distributed over three groups. In principle, restriction of the KIR repertoire signifies a monoclonal or possibly oligoclonal NK-cell proliferation, just as Ig light-chain restriction usually indicates a monoclonal B-cell neoplasm. Using a novel group-specific reverse transcriptase-polymerase chain reaction, we found a restricted KIR repertoire in most sinonasal lymphomas (9 of 10), but only rarely in T-cell lymphomas (2 of 10) or reactive conditions involving T/NK cells (1 of 10). KIR+ sinonasal lymphomas usually lacked a monoclonal TCR-gamma rearrangement pattern, expressed another NK cell receptor, NKG2a, and were usually CD56-positve, cyclin-dependent kinase-6 (CDK6)-positive, CD44-negative, a phenotype already reported to indicate a true NK cell lineage. We conclude that, although sinonasal lymphomas have heterogeneous genotypes and phenotypes, a restricted KIR repertoire without TCR-gamma rearrangement provides preliminary support for the monoclonality hypothesis and can be used for defining a true NK-cell lineage in a subset of sinonasal lymphomas.

A new mode of percutaneous upper thoracic phenol sympathicolysis: report of 50 cases

OBJECTIVE

Our previous study demonstrated that a high concentration of phenol (75-90%) with minimal volume (0.02 ml) can elicit serious degeneration of ganglion cells of the stellate ganglia in cats. Another previous study in our clinical patients demonstrated that approximately 84 to 90% of the upper thoracic (T2-T3) sympathetic trunks can be found under an endoscope on the ventral side of the T2-T3 rib heads. In this report, we present a new mode of dorsal percutaneous thoracic phenol sympathicolysis (PTPS) for the treatment of palmar hyperhidrosis or axillary bromidrosis.

METHODS

Fifty patients with palmar hyperhidrosis or axillary bromidrosis were injected with 75% phenol into a total of 98 sides of the T2-T3 or T3-T4 sympathetic trunks and ganglia. The injected volume was 0.6 to 1.2 ml (average, 0.8 ml) for each side. The technique of dorsal percutaneous injection was performed under local anesthesia or local with intravenous general anesthesia and under the guidance of a C-arm fluoroscope.

RESULTS

Forty patients (80%) showed satisfactory results, including cessation of sweating. The success rates of PTPS were 83.7% (41 of 49 patients) on the left side and 91.8% (45 of 49 patients) on the right side. The skin temperature of the thumb increased by 5.3 to 5.4 degrees C approximately 1 hour after the phenol injection in patients with satisfactory results, whereas it increased by only 1.3 to 2.7 degrees C in patients who had unsatisfactory results.

CONCLUSION

PTPS may be a good alternative to endoscopic sympathectomy to treat palmar hyperhidrosis and axillary bromidrosis. The skin temperature of the thumb is still a useful index to evaluate preliminarily whether PTPS has been successful.

Synthesis and characterization of non-steroidal ligands for the glucocorticoid receptor: selective quinoline derivatives with prednisolone-equivalent functional activity

A novel class of functional ligands for the human glucocorticoid receptor is described. Substituents in the C-10 position of the tetracyclic core are essential for glucocorticoid receptor (GR) selectivity versus other steroid receptors. The C-5 position is derivatized with meta-substituted aromatic groups, resulting in analogues with a high affinity for GR (K(i) = 2.4-9.3 nM) and functional activity comparable to prednisolone in reporter gene assays of glucocorticoid-mediated gene transcription. The biological activity of these novel quinolines was also prednisolone-equivalent in whole cell assays of glucocorticoid function, and compound 13 was similar to prednisolone (po ED(50) = 2.8 mpk for 13 vs ED(50) = 1.2 mpk for prednisolone) in a rodent model of asthma (sephadex-induced eosinophil influx).

Diagnostic pitfalls of fine-needle aspiration cytology and prognostic impact of chemotherapy in thyroid lymphoma

BACKGROUND AND PURPOSE

Fine-needle aspiration cytology (FNAC) is an important method in the evaluation of goiter. However, difficulties are encountered when using this technique to distinguish Hashimoto's thyroiditis from thyroid lymphoma. This study sought to determine the diagnostic sensitivity of FNAC and to determine the effectiveness of chemotherapy in the treatment of thyroid lymphoma.

METHODS

We retrospectively reviewed the clinical manifestations, diagnostic methods, treatment, and prognosis in 14 consecutive patients with histopathology-verified thyroid lymphoma treated in National Taiwan University Hospital from 1981 to 2000.

RESULTS

Eleven of the 14 patients underwent FNAC, which identified six lymphomas, one anaplastic carcinoma, three cases of Hashimoto's thyroiditis, and one case of Riedel's struma. Because all cases were promptly biopsied, the mean survival times for patients with or without the correct initial diagnosis (15 mo vs 43 mo) did not differ significantly (p = 0.098 by Student's t-test). Thyroid lymphoma was diagnosed before 1990 in four patients, three of whom were treated with local radiotherapy and one with surgical resection. The mean survival time of these four patients was 60 days. Thyroid lymphoma was diagnosed after 1990 in 10 patients, nine of whom underwent systemic chemotherapy, with additional adjunctive radiotherapy in three patients. The mean survival time in the nine of these 10 patients with follow-up was 60 months. A significant difference was found in the mean disease-free survival times between patients treated before and after 1990 (60 d vs 60 mo, p = 0.005).

CONCLUSIONS

In this study, FNAC had a sensitivity of only 55%, its major limitation being misdiagnosis of lymphoma as Hashimoto's thyroiditis in three patients. However, such initial misdiagnosis does not affect the prognosis if promptly corrected by histopathology. As evidenced by the improved survival of patients receiving chemotherapy after 1990, we conclude that chemotherapy is effective in the treatment of thyroid lymphoma.

Colonoscopic manifestations of primary colorectal lymphoma

BACKGROUND AND STUDY AIMS

Little is known about the colonoscopic manifestation of colorectal lymphoma. This article describes the use of colonoscopy for diagnosis of primary colorectal lymphoma.

PATIENTS AND METHODS

We analyzed colonoscopic findings in 13 retrospectively collected cases of primary colorectal lymphoma diagnosed between 1990 and 1999 at our hospital.

RESULTS

The primary colorectal tymphomas were distinguished into three colonoscopic types: a) the mucosal type, which included six lymphomas (46%), which were classified into two subtypes, erosive (two lymphomas) and ulcerative (four tymphomas); b) the polypoid type, which included three tymphomas (23%); and c) the massive type, which included four (31%). The proportion of patients with T-cell lineage lymphoma (5 of 12, 42%) was higher than in previous studies. Three cases were diagnosed as enteropathy-associated T-cell (EAT)-like lymphoma: one presenting with multicentric ulcerations, one as a massive type and another as a polypoid type. Of those with B-cell lineage lymphoma (7 of 12, 58%), three presented as massive type, two as polypoid type and two as erosive subtype.

CONCLUSIONS

Based on the analysis of colonoscopic records, we have proposed three main types of primary colorectal lymphoma. An unusually high proportion of T-cell lineage lymphomas was noted, but as the number of cases was low, further study is still needed for confirmation.

Neutralizing peptide ligands selected from phage-displayed libraries mimic the conformational epitope on domain III of the Japanese encephalitis virus envelope protein

The envelope (E) protein of Japanese encephalitis virus (JEV) contains 500 amino acids with six "conserved" disulfide bonds to maintain its conformational structure. Neutralizing epitopes located on the E protein are mostly conformational dependent. In this study, we used phage-displayed 12-residue combinatorial peptide libraries to select high-affinity peptide ligands bound to monoclonal antibody E3.3. The specific peptide ligands presented on ten high-affinity phage clones displayed six different amino acid sequences, all showing a novel cis-proline turn structure. After being superimposed onto the best fit of the three-dimensional structure of JEV E protein, these peptide structures were mapped to a conformational region constituted by three continuous polypeptide segments (E307-E309, E327-E333, E386-E390) in domain III. Synthetic peptide ligands based on one peptide sequence (E18) were further investigated using alanine scanning within the cis-proline turn structure to demonstrate its unique molecular characteristics. Our results showed that three residues forming the novel cis-proline turn structure were all important in eliciting JEV-specific neutralizing antibodies in mice.

Preparation of EVAL membranes with smooth and particulate morphologies for neuronal culture

In this work, the in vitro interaction of cerebellar granule neurons prepared from 7-day-old Wistar rats and poly ethylene-co-vinyl alcohol (EVAL) membranes was investigated. Cells were cultured in smooth and particulate EVAL membranes for up to 7 days. Particulate membranes were prepared by using 1-octanol to precipitate EVAL solutions in DMSO. Such a membrane was microporous characterized by a packed bed of particles. Voids left between the aggregated particles formed a continuous and interconnected porous network. Crystallization of the EVAL polymer induced by 1-octanol is responsible for the formation of particulate morphology. The membrane structure and its relationship with cells were examined by scanning electron microscopy and the MTT assay. It was observed that the particulate membrane was more favorable for the neuron culture than the smooth membrane. Neurons seeded on the particulate membrane were able to regenerate with formation of an extensive neuritic network. Therefore, the particulate structure may spatially mediate cellular response that can promote neuronal cell attachment, differentiation and neuritic growth, indicating that the particulate structure should be useful as a new polymer scaffold for nerve repair.

Polarization gating in ultrafast-optics imaging of skeletal muscle tissues

By comparing the results of polarization-dependent, time-resolved intensity profiles of photons transmitted through diluted milk, chicken breast tissue, and chopped chicken breast tissue, we found that the inherent anisotropic optical property of skeletal muscle tissue resulted in coherent coupling between two mutually perpendicular polarization directions. This coupling process led to difficulty in using the conventional polarization gating method for imaging unless the anisotropy characteristics were well understood. However, imaging based on polarization gating in diluted milk and chopped chicken breast tissue, which had an isotropic random-scattering nature, was quite effective.

In vitro and in vivo studies for modified ethyl cyanoacrylate regimens for sclerotherapy

Cyanoacrylates have known for their ability to polymerize rapidly in the presence of traces of weakly basic moieties such as water. The tissue adhesive, Histoacryl(R) (N-butyl 2-cyanoacrylate), has been reported to control bleeding through endoscopic sclerotherapy. But the commercially available Histoacryl(R) is expensive, and it has the problem like other cyanoacrylates that the glue tends to flow/run away from the point of application, which is inherent to the low viscosity, making precise application difficult. In this study, ethyl cyanoacrylate (ECA), the main constituent of "super glue," was employed instead of Histoacryl(R) due to its lower cost. The aim of the research is to modify the compositions of ECA regimen and evaluate its feasibility for sclerosant application through both in vitro flow circuit model and in vivo animal tests. It was noted that the difference in the relative hardening rate between the in vitro Hepes-Tyrodes buffer flowing model and the in vivo rat model for the ECA and Histoacryl(R) was related to the existence of the blood protein, such as albumin, in the physiological milieu. It was also noticed that the ECA setting rate was greatly increased either in Hepes-Tyrodes buffer or in blood (to a comparable rate as Histoacryl(R) in vivo) by adding a few doses of caffeine, which acts as a polymerization initiator. This would lead to far better injection precision during sclerotherapy. Furthermore, in vivo histological examination for the occluded lumen of the rat's inferior vena cava and a clinical piglet portal vein occlusion experiment have suggested this new sclerosant regimen, caffeine/ECA, is of great promise in endoscopic sclerotherapy.

An adaptive 3-D discrete cosine transform coder for medical image compression

In this communication, a new three-dimensional (3-D) discrete cosine transform (DCT) coder for medical images is presented. In the proposed method, a segmentation technique based on the local energy magnitude is used to segment subblocks of the image into different energy levels. Then, those subblocks with the same energy level are gathered to form a 3-D cuboid. Finally, 3-D DCT is employed to compress the 3-D cuboid individually. Simulation results show that the reconstructed images achieve a bit rate lower than 0.25 bit per pixel even when the compression ratios are higher than 35. As compared with the results by JPEG and other strategies, it is found that the proposed method achieves better qualities of decoded images than by JPEG and the other strategies.

Expression of cyclin-dependent kinase 6 (cdk6) and frequent loss of CD44 in nasal-nasopharyngeal NK/T-cell lymphomas: comparison with CD56-negative peripheral T-cell lymphomas

Lymphomas involving the nasal and nasopharyngeal region mainly include CD56-positive natural killer (NK)/T-cell lymphomas, CD56-negative peripheral T-cell lymphomas (PTL), and B-cell lymphomas. Among these, the CD56-positive lymphoma, presumably of an NK/T-cell nature, is frequently seen in Asian, Mexican, and South American patients. NK cells are proposed to be closer developmentally to T cells than to other lymphoid cells, because bipotential common progenitor cells of NK/T-cell lineage have been isolated. In this study, we collected 47 cases of nasal lymphoma and investigated the phenotypic difference between NK/T-cell lymphoma and PTL by examining the pattern of the developmentally differentially expressed molecules cdk6 (cyclin-dependent kinase 6), CD44, CD117, and by examining the rearrangement of the T-cell receptor gene (TcR-GR). cdk6, an essential regulator of the cell cycle in G1 progression, was over-expressed in a subset of cortical thymocytes, but absent in mature thymocytes. In contrast, CD44, a glycosylated adhesion molecule, was absent in cortical thymocytes, but present in mature thymocytes and peripheral activated T cells. We found both over-expression of nuclear cdk6 (n-cdk6) and frequent absence of CD44 in nasal CD56-positive NK/T-cell lymphomas, in contrast to most nasal CD56-negative PTL, which were CD44-immunoreactive with weak or no expression of n-cdk6. Almost all tested cases of NK/T-cell lymphoma displayed a germ-line configuration of TcR, without evidence of gene rearrangement. Thus, there seems to be a useful distinction between the classical NK/T type of nasal lymphoma (CD56+/n-cdk6+/CD44-/TcR-GR-) and PTL (CD56-/n-cdk6-/CD44+/TcR-GR+) involving the nasal region. The presence of Epstein-Barr virus does not seem to be a good marker for distinguishing between NK/T lymphoma and PTL involving the nasal region.

Genetic analysis and clinical evaluation of vacuolating cytotoxin gene A and cytotoxin-associated gene A in Taiwanese Helicobacter pylori isolates from peptic ulcer patients

The aims of this study were to investigate the cytotoxin-associated gene A (cagA) and vacuolating cytotoxin gene A (vacA) subtype in Taiwanese H. pylori isolates from patients with gastroduodenal diseases and to assess the relationship between genotypes of isolates and clinical features. The vacA s1a allele was found in all isolates and vacA m1 allele was found in 15% of isolates. The cagA gene was found in 82.5% of isolates. The vacA s1a/m2 strains had a significantly higher prevalence rate than vacA s1a/m1 strains in Taiwan (p < 0.05). By aligning and comparing the nucleotide and amino acid sequences of vacA from the Taiwanese isolates, the signal sequence and N-terminal region were found to be highly conserved, but the middle region was found to be highly heterogeneous. Determining the relationship between the genotypes and clinical features, we found that the cagA gene was more closely associated with duodenal ulcer than with gastric ulcer and the vacA s1a/m2 strain was more closely associated with active chronic gastritis and atrophic gastritis than with chronic gastritis. Together, our results indicated that (i) the middle region of vacA gene in Taiwanese isolates was heterogeneous; (ii) s1a/m2 vacA strains had a high prevalence in Taiwanese peptic ulcers; and (iii) the cagA gene was significantly associated with duodenal ulcer.

Differential expression of human topoisomerase IIIalpha during the cell cycle progression in HL-60 leukemia cells and human peripheral blood lymphocytes

Human topoisomerase IIIalpha (huTop IIIalpha) has been demonstrated to belong to type IA subfamily. In this study, we found that huTop IIIalpha expressed constitutively and remained at high levels throughout the cell cycle in HL-60 cells when compared to the cell-cycle-dependent expression of huTop IIIalpha in phytohemagglutinin-activated peripheral blood lymphocytes. During the cell cycle progression, this protein remained accentuated in the nucleolus without significant translocation from the nucleolus to the nucleoplasm. In addition, during the course of granulocytic maturation in DMSO-treated HL-60 cells, huTop IIIalpha levels decreased when cells stopped proliferation and nucleoli diminished in size. However, its level remained unchanged during the course of monocytic maturation of vitamin D(3)-treated HL-60 cells which still retained its proliferative capacity and did not change the size of the nucleolus. The data suggested that huTop IIIalpha is involved in rDNA metabolism, such as rDNA transcription. Its cellular level appeared to be under control during the cell cycle progression of normal lymphocytes, but was found to be deregulated in HL-60 cells which may be associated with the tumor transformed cell phenotypes.

Astrocytes modulate thapsigargin-induced changes in calcium concentration and neuronal survival

When mature cerebellar granule neurons (CGN) grown in high K+ (25 mM K+, HK)-serum containing medium are subjected to the HK/serum deprivation, they are destined for neuronal death. In this study, we attempted to elucidate the roles of endoplasmic reticular (ER) Ca2+-store and co-cultured astrocytes in HK/serum deprivation induced neuronal death. Thapsigargin (TG), an inhibitor of ER Ca2+-ATPase was simultaneously applied with normal K+ (5 mM K+, NK) serum free medium, and its effects on neuronal death in either astrocyte-poor or astrocyterich culture were examined. By means of the fura-2 microfluorimetric technique, we monitored the changes of the intracellular Ca2+ concentration, [Ca2+]i, associated with neuronal death under various treatments. The results obtained showed that in astrocyte-poor cultures of mature CGN (10 days in vitro, DIV), the basal level of [Ca2+]i markedly decreased from 184 +/- 5 to 89.7 +/- 5 nM 24 h after HK/serum deprivation. Although treatment with TG slightly increased the [Ca2+]i to 117.6 +/- 4 nM, the survival rate of the neurons was even worse; it was reduced from 49 +/- 4% to 28 +/- 2%. In the astrocyte-rich cultures, HK/serum deprivation also caused a profound reduction of neuronal [Ca2+]i, from 166 +/- 3 to 90.2 +/- 6 nM, accompanied by even more serious neuronal death (95.5 +/- 1%). On the other hand, treatment with TG in astrocyterich cultures further lowered the [Ca2+]i to 65 +/- 2 nM but markedly improved the neuronal survival rate from 4.5 +/- 1% to 60 +/- 2% in a concentration-dependent manner. The strong implication of these findings is that ER Ca2+-store and astrocytes participate in modulating the responses of neurons to stress stimulation.

Pulse oximeter-associated toe injuries in a premature neonate: a case report

Pulse oximetry is noninvasive and widely used in the intensive care unit and during surgery. Complications associated with the use of pulse oximetry have been reported, including burns, pressure erosion, skin necrosis and digital sensory loss. The causes of these complications may be due to the incompatibilities between the probes and the monitors used from different companies, pressure duration for too long on a single skin site or overheating induced by a short circuit of the probe cable. We report a 940-g premature infant who had severe pulse oximetry-associated injury to the oximetry site. This may have been due to the infant's susceptibility to injury resulting from his critical condition, including low cardiac output, poor peripheral circulation and poor heat dissemination. Our experience shows that, when pulse oximetry is used, especially in critically ill, premature infants, frequent checking of the sensor and the site where the sensor is applied is required to avoid burn injury or pressure erosion of the skin.

De novo CD5+ Burkitt lymphoma/leukemia

CD5 is a T-cell marker aberrantly expressed in B-cell chronic lymphocytic leukemia and mantle cell lymphoma. Other B-cell neoplasms, including Burkitt lymphoma, are usually CD5-. We report 4 cases of de novo CD5+ Burkitt lymphoma/leukemia in elderly patients, all of whom were in a leukemic phase and had variable lymph node and splenic involvement. The blasts were typically medium sized, with folded nuclei, distinct but not prominent nucleoli, and moderate amounts of somewhat vacuolated basophilic cytoplasm; they were terminal deoxynucleotidyl transferase--negative and surface immunoglobulin--positive. All 4 cases demonstrated c-myc rearrangement, but none had t(14;18), t(11;14), or cyclin D1 overexpression or rearrangement. Only 1 patient achieved complete remission after hyper-CVAD (hyperfractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone) therapy. One patient responded poorly to hyper-CVAD, and 2 patients died during induction chemotherapy. These rare cases of aggressive lymphoid malignancy with CD5 positivity and molecular features associated with Burkitt lymphoma/leukemia are best classified as Burkitt leukemia. However, the morphologic and immunophenotypic similarity to the blastoid variant of mantle cell lymphoma are diagnostically challenging. The diseases can be distinguished at the genetic level, since Burkitt lymphoma involves the rearrangement of c-myc, and mantle cell lymphoma usually the overexpression or rearrangement of cyclin D1.

Altered intracellular calcium level in association with neuronal death induced by lithium chloride

In this study, we examined the effects of lithium chloride (LiCl) on the intracellular calcium levels ([Ca2+]i), and the survival of immature and mature cultured cerebellar granule neurons (CGNs) grown in medium containing high (25 mmol/L) or normal (5 mmol/L) potassium (K+) levels. LiCl dramatically reduced [Ca2+]i in immature CGNs maintained in high K+ (HK) medium and in those switched to serum containing normal K+ (NK) medium for 1 to 2 days. This reduction in [Ca2+]i led to massive neuronal death of immature neurons developed in both HK and NK medium. In mature (cultured 5-8 days in vitro) CGNs, LiCl exhibited potent toxicity when cells were grown in HK medium, and led to increased [Ca2+]i. Exposing mature CGNs to serum deprivation and normal extracellular K+ concentrations decreased [Ca2+]i and induced cell death, while the addition of LiCl in these conditions further decreased [Ca2+]i but prevented cell death. The morphologic features revealed by Nomarski optics further confirmed these effects of LiCl on neuronal survival. Together, these findings indicate that the effects of LiCl on [Ca2+]i and neuronal death, and the association between [Ca2+]i and cell death, depend on the developmental stage of CGNs and the growth conditions to which they are subjected. These findings may help in understanding the mechanism of neurotoxicity of LiCl during therapy.

Immunolocalization of the keratinocyte growth factor in benign and neoplastic human prostate and its relation to androgen receptor

BACKGROUND

Growth and development of the prostate are androgen-dependent. Keratinocyte growth factor (KGF), widely expressed by mesenchymal cells, is thought to act like an andromedin between stroma and epithelium of the prostate. Since KGF has recently emerged as an autocrine mediator in prostate cancer, we investigated the role KGF plays in the human prostate and its relationship to androgen receptor (AR).

METHODS

Normal (n = 13), benign hyperplastic (n = 5), and neoplastic (n = 14) human prostate tissues as well as cultured epithelial and stromal cells were analyzed using polymerase chain reaction (PCR), Western blot analysis, and immunohistochemistry.

RESULTS

Reverse transcriptase polymerase chain reaction and Western blotting showed KGF expression in stromal cultured cells of the normal prostate but not in epithelial cells. Using immunohistochemistry, KGF was found to be localized in fibroblasts and smooth muscle cells, independent of prostate disease. There was KGF expression in epithelial cells of BPH and prostate cancer. Human androgen receptor was uniformly expressed in the same secretory glandular cells that were positive for KGF in BPH and prostate cancer.

CONCLUSIONS

Our results provide evidence that KGF is a stromal-derived mediator, recently shown to act in a paracrine manner in normal prostate but now detected in epithelial cells in prostate cancer and BPH. These findings support the hypothesis that KGF might act as an autocrine factor in prostate cancer and BPH.

Endemic burkholderia cepacia bacteraemia: clinical features and antimicrobial susceptibilities of isolates

Burkholderia cepacia has emerged as a nosocomial pathogen, causing numerous outbreaks, particularly among cystic fibrosis (CF) patients. Reports of clinical features of endemic B. cepacia bacteraemia in non-CF patients are rare. Twenty-five patients with B. cepacia bacteraemia were matched with 25 controls with nosocomial Escherichia coli bacteraemia at China Medical College Hospital, Taichung, Taiwan, over a period of 3 y. Case-patients included 16 men and 9 women, from 13 to 75 y. All had severe underlying diseases, most commonly malignancy (44%). Twenty-four patients (96%) had nosocomial infections. Five patients (20%) had polymicrobial bacteraemia. Our controls included 11 men and 14 women, age range 18-80 y. The most common underlying disease was malignancy (44%). Multivariate analysis revealed that indwelling central venous catheter was the significant risk factor predisposing to B. cepacia bacteraemia (p= 0.025). Eleven case-patients met the definition of catheter-related bloodstream infection. Fifteen patients (60%) received appropriate antimicrobial therapy after notification of positive blood cultures and susceptibility patterns. The overall case-fatality rate was 12% (3/25), only 1 of whom died of B. cepacia bacteraemia. There was no statistically significant difference in overall mortality rate between case-patients and controls. All isolates were susceptible to ceftazidime, piperacillin and minocycline and 84% of the isolates were susceptible to imipenem. B. cepacia should be considered a potential pathogen in hospitalized patients with severe underlying diseases, particularly those with indwelling central venous catheters.

Roles of thapsigargin-sensitive Ca2+ stores in the survival of developing cultured neurons

The roles of the intracellular calcium pool involved in regulating the Ca2+ profile and the neuronal survival rate during development were studied by using thapsigargin (TG), a specific inhibitor of endoplasmic reticulum (ER) Ca2+-ATPase in cultured cerebellar granule neurons. Measuring the neuronal [Ca2+]i directly in the culture medium, we found a bell-shaped curve for [Ca2+]i versus cultured days in cerebellar granule neurons maintained in medium containing serum and 25 mM K+. The progressive increase in [Ca2+]i of the immature granule neurons (1-4 days in vitro) was abolished by TG, which resulted in massive neuronal apoptosis. When the [K+] was lowered from 25 to 5 mM, neither the progressively increasing [Ca2+]i nor the survival of immature granule neurons was significantly changed over 24-h incubation. Similarly, TG caused a dramatic decrease in the [Ca2+]i and survival rate of these immature neurons when switched to 5 mM K+ medium. Following maturation, the granule neurons became less sensitive to TG for both [Ca2+]i and neuronal survival. However, TG can protect mature granule neurons from the detrimental effect of switching to a 5 mM K+ serum-free medium by decreasing [Ca2+]i to an even lower level than in the respective TG-free group. Based on these findings, we propose that during the immature stage, TG-sensitive ER Ca2+-ATPase plays a pivotal role in the progressive increase of [Ca2+]i, which is essential for the growth and maturation of cultured granule neurons.

trans-2,6-,3,6- and 4,6-diaza-5,6,6a,7,8,12b-hexahydro-benzo[c]phenanthrene-10,11- diols as dopamine agonists

The title compounds were synthesized by replacing the thiophene moiety of A-86929(2a) with variously substituted pyridines. Dopamine D-1 and D-2 binding and adenylate cyclase assays indicate that 4,6-diaza compounds 15 are potent and selective full D1 agonists when R1 is H or a small substituent and R2 = H, with D1 binding affinity and adenylate cyclase functional potency equivalent to that of A-86929(2a).

Identification of an activin-follistatin growth modulatory system in the human prostate: secretion and biological activity in primary cultures of prostatic epithelial cells

PURPOSE

To determine if the activin/follistatin system is present in human prostate tissue and primary cultures of prostatic epithelium and if these growth factors play a role in the control of epithelial cell growth.

MATERIALS AND METHODS

Cells derived directly from human prostates were studied to determine: a) if they secrete activin and follistatin, and b) if they are growth inhibited by activin. Primary cell cultures were established from tissues removed from 13 unselected prostate carcinoma patients in order to examine the secretion of activin and follistatin and test the effects of these proteins on cell proliferation.

RESULTS

Both primary explant cells and epithelial cells isolated and sub-cultured from explant cultures secreted activin A and follistatin. Treatment of cultured cells with recombinant human activin A resulted in a dose-dependent inhibition of thymidine incorporation, with an IC50 of 0.22 nM. Recombinant follistatin neutralized the inhibitory effects of activin A on cell proliferation whilst adding follistatin alone enhanced thymidine incorporation, suggesting a similar neutralizing effect on the endogenous activin produced by these cells.

CONCLUSION

These results demonstrate that cells derived from human prostate tissue secrete activin and follistatin and, as observed in human prostate cancer cell lines, activin inhibited the growth of prostatic epithelial cells. Also consistent with our earlier studies of prostate cancer cell lines, the biological activity of activin was neutralized by follistatin. These observations support the hypothesis that the activin/follistatin system plays an important role in the local regulation of human prostate cell growth.

Helicobacter pylori in gastric biopsies of Taiwanese patients with gastroduodenal diseases

This study was designed to study the in vivo prevalence and the heterogeneity of H. pylori in patients with gastroduodenal diseases in central Taiwan. H. pylori infection was detected in 74.1% (575/776) of the symptomatic population studied. The prevalence of H. pylori infection increased from 11.1% in those between the ages of one to 20, to 82.9% in those between the ages of 41 and 50, and to 84% in those between the ages of 51 and 60. There was no significant difference in the prevalence of H. pylori infection between men and women. Among different blood types, the prevalence and relative risk of H. pylori infection was significantly higher in blood group O patients (90.3%) than in blood group A (41%), blood group B (27.4%), or blood group AB (62%) patients. Metronidazole resistance was found in 6.7% of the primary isolates. The prevalence of metronidazole-resistant H. pylori strains was higher in women (7.69%) than in men (6.25%), but this difference was not significant. A total of 88% of H. pylori strains were cagA-positive. CagA gene-positive strains were present in 90.1% of duodenal ulcers, 90% of duodenal ulcers combined with gastric ulcer, 85.8% of gastric ulcers, and 69.2% of gastritis patients, and was significantly higher in peptic ulcer disease groups than in the gastritis group. In conclusion, there was a low incidence (6.7%) of metronidazole-resistant H. pylori strains and a high prevalence (88%) of H. pylori cagA-positive strains in central Taiwan. This study also demonstrated a significant in vivo correlation between active H. pylori infection and blood group O-positive patients, and showed a significant association between cagA gene-positive H. pylori strains and the development of peptic ulcers.

Androgen responsiveness of stromal cells of the human prostate: regulation of cell proliferation and keratinocyte growth factor by androgen

PURPOSE

Growth and development of the prostate are androgen dependent and mainly influenced by stromal-epithelial interaction. It is believed that indirect androgenic activation of paracrine factors like keratinocyte growth factor (KGF) in the prostatic stroma influences the growth of epithelial cells. In this study we investigated the role androgen plays in stromal cell growth and stimulation of KGF in the human prostate.

MATERIALS AND METHODS

Stromal cells were derived from explant primary culture of human normal or benign prostatic tissue. The effect of different dihydrotestosterone (DHT) concentrations on cell proliferation was measured using 3[H]thymidine incorporation assay. The effect of DHT on levels of KGF protein was determined by Western blotting. The effect of DHT on levels of KGF gene expression was measured by various cycles of polymerase-chain-reaction (PCR) and multiplex PCR.

RESULTS

Characterization of stromal cells showed epithelial cells less than 9.5% in all passages. DHT stimulated human prostate stromal cells in a dose dependent fashion over a concentration range of 0.001-10 nM. Immunocytochemical evaluation of KGF after DHT exposure showed a higher staining intensity. Relative quantitation of Western blotting showed a 1.93-fold increase in KGF protein in the androgen treated stromal cells. At 1 nM DHT conventional and multiplex PCR revealed a significant stimulation of the KGF mRNA expression.

CONCLUSIONS

These data show for the first time that androgen stimulates cell proliferation as well as KGF protein and gene expression in human prostate stromal cells. This supports the hypothesis that androgen-induced stromal-derived KGF stimulates prostate epithelial cell growth.

Dynamic MR imaging of hepatolithiasis

BACKGROUND

To report the dynamic magnetic resonance (MR) imaging findings of hepatolithiasis.

METHODS

Dynamic MR images (fast spoiled gradient echo sequence with intravenous injection of gadopentate dimeglumine) and computed tomography, cholangiography, or angiography of nine patients with hepatolithiasis are analyzed.

RESULTS

All affected hepatic segments showed atrophic changes and contained dilated intrahepatic ducts. These segments showed either iso- or hypointensity on T1-weighted imaging and hyperintensity on T2-weighted imaging. Preferential enhancement was noted throughout all phases of the dynamic study and persisted to delayed T1-weighted imaging in seven patients. In the last two patients, severe atrophic changes made evaluating signal intensity differences and enhancement patterns difficult.

CONCLUSION

In addition to intrahepatic stones and biliary dilatation, segmental atrophy, signal intensity differences, and preferential and persistent enhancement are important MR findings of hepatolithiasis.

Serratia marcescens bacteremia: clinical features and antimicrobial susceptibilities of the isolates

From July 1996 to June 1997, 22 adult patients with Serratia marcescens bacteremia were retrospectively studied at China Medical College Hospital. All patients had severe underlying disease, most commonly diabetes mellitus. Eighteen (82%) patients had nosocomial infection. Clinical syndromes included primary bacteremia (68%), pneumonia (14%), urinary tract infection (9%), suppurative thrombophlebitis (5%) and surgical wound infection (5%). Twelve patients had central venous catheters in place at the onset of bacteremia, but only one case met the definition of catheter-related infection. In 14 (64%) patients, portal of entry of S. marcescens infection was unknown. Five (23%) patients had concurrent polymicrobial bacteremia. The overall mortality rate was 50% (11/22). Seven (32%) of the 22 patients died of S. marcescens bacteremia. All isolates were resistant to ampicillin and cephalothin and susceptible to imipenem. Ninety-five percent of strains were susceptible to moxalactam, 68% to amikacin, 55% to ceftazidime, 45% to aztreonam, 32% to ceftriaxone, 27% to gentamicin, 18% to cefoperazone and cefotaxime, and 9% to piperacillin. MICs of various antibiotics demonstrated that ciprofloxacin and imipenem had good activities against S. marcescens, with MIC90 of 0.19 microg/mL and 1.0 microg/mL, respectively. Due to increasing multidrug resistance, choosing appropriate antimicrobial agents such as moxalactam, imipenem, and ciprofloxacin should be highly recommended for the treatment of S. marcescens infections.

Identification and expression of the Na+/H+ exchanger in mammalian cerebrovascular and choroidal tissues: characterization by amiloride-sensitive [3H]MIA binding and RT-PCR analysis

We report the initial characterization of [3H]5-(N-methyl-N-isobutyl)amiloride (MIA) binding to the Na+/H+ exchanger (NHE) and expression of its gene in mammalian cerebrovascular, choroidal and neocortical tissues. [3H]MIA bound reversibly to particulate fractions of rat, pig and human cerebral microvessels, choroid plexus and cerebral cortex. Scatchard analyses revealed binding to a single amiloride-sensitive site with dissociation constants (Kd) ranging from 20 to 90 nM for the various tissue preparations. The maximal binding capacities (Bmax) were between 2 to 17 pmol/mg protein and were several-fold greater in cerebral microvessels compared to the cerebral cortex. Amiloride, MIA, 5-(N, N-hexamethylene)amiloride (HMA), 5-(N, N-dimethyl)amiloride (DMA) and 5-(N-methyl-N-isopropyl)amiloride (IPA) variably displaced [3H]MIA binding to the microvessels in the following rank order: MIA>HMA>/=IPA>DMA>amiloride. Benzamil, a potent ligand of the Na+/Ca+ transporter was the least sensitive. These binding results were most compatible with the existence of the amiloride-sensitive NHE type 1 in the brain vascular and choroidal tissues. To substantiate this, we utilized reverse transcription polymerase chain reaction (RT-PCR) techniques to search for NHE-1 mRNA. Using primers corresponding to conserved sequences of the human growth factor-activatable NHE gene, RT-PCR revealed strong expression of NHE-1 mRNA in cerebral microvessels, choroid plexus, pial vessels and vascular smooth muscle cells relative to neocortical tissues from several species including rat, pig, cow, monkey and human subjects. Further confirmation of NHE-1 isoform mRNA expression in the cerebrovascular tissues was obtained by HpaII restriction digestion analysis and by subcloning and sequencing of the PCR amplified products. Our study suggests that mammalian cerebrovascular and choroidal tissues contain high amounts of the ubiquitous amiloride-sensitive [3H]MIA binding proteins consistent with the expression of NHE type 1 mRNA.

Induced expression of neuronal membrane attack complex and cell death by Alzheimer's beta-amyloid peptide

beta-amyloid peptide (A beta) and complement-derived membrane attack complex (MAC) are co-localized in senile plaques of brains from Alzheimer's disease (AD) patients. But the relationship between A beta and complement activation is unclear. We have used human neurotypic cells, differentiated SH-SY5Y, as a model system to examine regulation of neuronal MAC expression and cell death by A beta. We demonstrated that mRNAs (C1q, C2, C3, C4, C5, C6, C7, C8 and C9) and proteins (C1q, C3 and C9) for the major components of the classical complement cascade are present in the SH-SY5Y neurotypic cells, indicating that neuronal cells can synthesize the necessary proteins required for MAC formation. Furthermore, immunocytochemical studies showed the A beta-induced neuronal MAC expression on the SH-SY5Y cells after CD59 was removed by PIPLC or blocked by anti-CD59 antibody. Meanwhile, increased A beta-induced neuronal cell death was observed following treatment with anti-CD59. Taken together, these results suggest that A beta activates neuronal complement cascade to induce MAC, and a deficiency of endogenous complement regulatory proteins, e.g., CD59, may increase the vulnerability of neurons to complement-mediated cytotoxicity.

Incidence and clinical manifestations of Campylobacter enteritis in central Taiwan

BACKGROUND

Campylobacter species are recognized as a major cause of acute gastroenteritis in humans throughout the world and are increasingly associated with the development of Guillain-Barré syndrome. The age distribution of persons and the seasonal patterns of Campylobacter infection are different in many developed and developing countries. The present study reports the investigation of the clinical and epidemiologic features of Campylobacter infections in central Taiwan.

METHODS

From January 1994 to December 1996, stool specimens from patients with diarrhea or gastroenteritis were cultured for the Campylobacter species at the China Medical College Hospital. Data collected and evaluated included the type of Campylobacter species isolated, date of report, age and sex of the person from whom the isolate came, and clinical symptoms.

RESULTS

Of 6,540 patients with diarrhea or gastroenteritis, 162 Campylobacter isolates were identified, yielding an isolation rate of 2.5% from the population studied. One hundred and fifty-four patients (95%) with Campylobacter infection were younger than five years old, which was significantly different from the population studied (p < 0.001). The Campylobacter infection was significantly higher in males (62.3%) than females (37.7%) (p = 0.0017). In central Taiwan, the incidence of Campylobacter enteritis is higher during the winter (35.2%) than during the spring (19.1%), summer (24.1%) or fall (21.6%) (35.2 vs 24.1%, p = 0.021). Campylobacter jejuni was found to comprise 81% (132 strains) of 162 Campylobacter isolates, and its isolation rate was significantly higher than Campylobacter lari (10%) and Campylobacter coli (9%) (p < 0.001). From 1994 to 1996, isolation rates of Campylobacter species increased from 1.9 to 2.8% of the population studied (34/1, 754 vs 57/2, 187) and the positive isolation rate ratio of Campylobacter species to Salmonella species also increased from 15.4 to 27.8% (34/221 vs 57/205). However, no significant difference was found between these results (p > 0.05). Watery diarrhea is the most characteristic manifestation of illness, and fever occurs in more than half of the patients.

CONCLUSIONS

In central Taiwan, the incidence of Campylobacter enteritis in patients with diarrhea or gastroenteritis is lower than those in China and Tanzania, but the highest prevalence occurs before five years of age in central Taiwan as well as these countries. The Campylobacter infection rate was significantly higher in males than females, and occurred primarily in winter. We conclude that Campylobacter cultures should be performed for fecal specimens of all diarrheal children aged up to five years.

Tachykinins in propranolol-augmented, hyperpnoea-induced bronchoconstriction in Taida guinea-pigs: effects of dimethylthiourea

1. The present authors recently found that a marked hyperpnoea-induced bronchoconstriction (HIB) only occurred in guinea-pigs after treatment with propranolol, a non-selective beta-adrenoceptor antagonist. This study investigated tachykinin-dependent and antioxidant-modulated mechanisms for this propranolol-augmented HIB. 2. Guinea-pigs were pre-treated with an antioxidant, dimethylthiourea (DMTU), or saline for 3 days. On the day of study, each animal was given a dose of propranolol (0.5 mg kg(-1)), then the airway function was examined in the anaesthetized-paralysed animal before, during and after hyperpnoea with a dry 95% O2:5% CO2 gas mixture. Tracheal neutral endopeptidase (NEP) activity and plasma substance P (SP) level were measured after functional study. 3. In the presence of propranolol, HIB was augmented, and was found to be associated with decreased NEP activity and an increased plasma SP level. The augmented HIB was attenuated by DMTU. 4. Therefore, the present results suggest that propranolol-augmented HIB is tachykinin-dependent and is modulated by DMTU.

Attenuation of isocapnic hyperpnoea-induced guinea-pig bronchoconstriction by chronic hypoxia

Chronic hypoxia has been shown to augment the production of antioxidants in rat lungs and to reduce airway hyperreactivity in patients with asthma. This study investigated indirectly whether this increase in antioxidants occurs in guinea-pig lungs and whether the increased antioxidants affect hyperpnoea-induced bronchoconstriction (HIB). Guinea-pigs were divided into four groups: control (n=8); chronic hypoxia (n=7); capsaicin pretreatment (n=7); and capsaicin pretreatment plus chronic hypoxia (n=8). Control animals were not treated. Animals in the hypoxia group were intermittently exposed to an ambient pressure of 380 mmHg for 7 days. A five day pretreatment of capsaicin was used to deplete tachykinins. In the last group, animals were pretreated with capsaicin, followed by a seven day hypoxic exposure. On the day of the study, airway function was examined in the anaesthetized and paralysed animal. Fifteen minutes of hyperpnoea caused marked decreases in the maximal expiratory flow rate at 15% vital capacity, forced expiratory volume in one second, and dynamic respiratory compliance, indicating HIB. This HIB and plasma substance P levels were significantly attenuated by chronic hypoxia, capsaicin pretreatment, and capsaicin pretreatment plus chronic hypoxia. Furthermore, chronic hypoxia attenuated airway constriction induced by xanthine-xanthine oxidase. The results suggest that chronic hypoxia attenuates hyperpnoea-induced bronchoconstriction via a decrease in the oxygen radical-mediated release of tachykinins.

Clinical and microbiologic characteristics of Ochrobactrum anthropi bacteremia

Ochrobactrum anthropi is an oxidase-positive, nonfermenting, gram-negative bacillus that is an emerging pathogen in immunocompromised patients, particularly in those with indwelling central venous catheters. Reports of clinical manifestation of O. anthropi bacteremia are rare. Herein, we report the clinical and microbiologic characteristics of O. anthropi bacteremia in 15 patients. There were eight males and seven females, whose ages ranged from 1 month to 84 years (mean, 34 years). Ten infections were community acquired. All patients had severe underlying disease and manifested primary O. anthropi bacteremia with no obvious focus. Only three patients had central venous catheters in place at the onset of bacteremia, but none of these showed evidence of catheter-related infection. The mean duration of fever was 4 days (range 0-11) and the mean white blood cell count was 13 x 10(9)/L (range 5.5-28 x 10(9)). All O. anthropi isolates tested were resistant to ampicillin, cephalothin, cefonicid, amoxicillin/clavulanic acid, piperacillin, aztreonam, and ceftazidime, and all were susceptible to gentamicin, amikacin, imipenem, ceftriaxone, and cefoperazone. Most were also susceptible to cefotaxime and moxalactam. Monotherapy with an aminoglycoside or an appropriate beta-lactam (such as cefotaxime or ceftriaxone) yielded good clinical response. None of the 15 patients died directly from O. anthropi bacteremia. Our findings indicate that O. anthropi is often community acquired and can be pathogenic in critically ill or immunocompromised patients with or without indwelling catheters. Although O. anthropi can produce clinically significant infections, the organism seems to be of relatively low virulence.

Ultrasonic tissue characterization for coronary care unit patients with acute myocardial infarction

The ultrasonic integrated backscatter of myocardium changes in infarction and ischemia. On the third day after acute myocardial infarction, 30 patients underwent ultrasonic tissue characterization from the parasternal short-axis view. With a composite parameter, the phase-weighted variation, sensitivity, specificity, and accuracy for diagnosing multivessel coronary artery disease were 84.6%, 52.9% and 66.6%, respectively. Using 67 degrees as the cutoff value for the phase deviation of the backscatter power curve, the recanalization of the infarct-related artery could be detected with a positive predictive value of 77.7% and a negative predictive value of 66.6%. Ultrasonic tissue characterization is a feasible technique for detecting the multivessel coronary artery diseases and the recanalization of infarct-related artery for patients with acute myocardial infarction. The diminished cardiac cycle-dependent variation in integrated backscatter and increased phase deviation can differentiate patent coronary arteries from those coronary arteries with anatomically significant stenoses.

Preparation and pharmacological evaluation of physostigmine-loaded polyisobutylcyanoacrylate nanoparticles in rats

The nanoparticles of physostigmine were prepared by an emulsion polymerization of polyisobutylcyanoacrylate. The drug content, release and particle size distribution of the nanoparticles were characterized. In vitro drug release profiles displayed a retardation by the nanoparticles in comparison to the aqueous solution. Pharmacological evaluation of physostigmine nanoparticles in vivo were carried out with Sprague-Dawley rats. The endogenous acetylcholine was sampled by on-line microdialysis and determined by a sensitive microbore HPLC/ED system in the striatum of rats. The choline oxidase and catalase immobilized enzyme reactors were used as the pre-column to erase choline. Accordingly, this chromatographic flow sequence could be utilized for the quantitative assay of acetylcholine without interference. The results indicate that the increase of acetylcholine (%) in the rats striatum by the nanoparticle was 2.3 times (AUC) higher than that of aqueous solution.

Evaluation of CLO test and polymerase chain reaction for biopsy-dependent diagnosis of Helicobacter pylori infection

Helicobacter pylori is now recognized as possibly playing an etiologic role on the development of chronic gastritis, peptic ulcers and adenocarcinoma of the distal stomach. CLO test and polymerase chain reaction (PCR) assay are rapid, biopsy-dependent diagnostic tests for H. pylori identification. In this study, we assessed four diagnostic methods (CLO test, PCR assay, culture and histological examination) for H. pylori detection in biopsy specimens from 78 patients with gastroduodenal diseases and investigating the efficiency of CLO test and PCR assay for the diagnosis of H. pylori infection. H. pylori was identified in 75.6%, 75.6%, 64.1%, 69.2% of patients by CLO test, PCR assay, culture and histological examination, respectively. Compared with the detection of H. pylori by culture and/or histological examination, the sensitivity and specificity of the CLO test were 98.2% and 81.8%, respectively, whereas the sensitivity and specificity of PCR assay were 96.4% and 77.3%, respectively. According to the H. pylori infection state as determined from the results of three concordant tests, the sensitivities of culture, CLO test, histological examination, and PCR assay were 90.9%, 96.4%, 98.2% and 100%, respectively. Whereas, the specificity was 100%, 95%, 95% and 90% for culture, CLO test, histological examination, and PCR assay, respectively. We found that both CLO test and PCR assay were highly sensitive and specific for H. pylori identification; however, PCR assay was more sensitive than other methods for detecting the specimens after patients received treatment. The results of this study suggest that CLO test is a rapid and sensitive method of screening for H. pylori infection and that PCR assay could provide an accurate indication of the state of infection both during treatment for eradication of H. pylori and at follow-up.

Agrobacterium radiobacter bacteremia in a patient with chronic obstructive pulmonary disease

Agrobacterium radiobacter is a gram-negative bacillus, which is recognized as an emerging opportunistic human pathogen. To our knowledge, there have been only 25 cases of A. radiobacter bacteremia reported. In most of these, A. radiobacter was associated with long-term indwelling plastic central venous catheters. We describe a 78-year-old man who had a history of chronic obstructive pulmonary disease with long-term use of a corticosteroid. He was admitted to the China Medical College Hospital with pneumonia caused by Serratia marcescens. His general condition gradually improved after initiation of appropriate treatment. Unfortunately, he developed A. radiobacter bacteremia while hospitalized in the medical intensive care unit. With the onset of this infection, the patient had a high fever, leukocytosis, raised C-reactive protein level, and positive blood cultures for A. radiobacter. A central venous catheter-related infection was suspected because of redness and localized tenderness at the catheter site. The patient gradually recovered after removal of the catheter and appropriate antimicrobial treatment with latamoxef 1.5 g intravenously every 8 hours for 10 days.

Substituted hexahydrobenzo[f]thieno[c]quinolines as dopamine D1-selective agonists: synthesis and biological evaluation in vitro and in vivo

A series of substituted 9,10-dihydroxyhexahydrobenzo[f]thieno[c]quinolines (TB[f]Q), varying with respect to the position of the thiophene relative to the benzo[f]quinoline core and the nature and position of the substituent on the thiophene, were prepared and evaluated for their affinity and selectivity for the dopamine D1-like receptor. The thieno[3,2-c]B[f]Q regioisomers bearing a small alky1 (C1-C3) substituent at the 2 position were potent (Ki < 20 nM) and selective (D2/D1 > 50) D1 agonists with close to full agonist activity (IA > 85%). The compounds were resolved and found to exhibit a high level of enantiospecificity in their interaction with the D1 receptor. Selected compounds were tested in vivo in the 6-OHDA rodent model of Parkinson's disease and for their liability to produce seizure-like activities in mice. (5aR)-trans-2-Propyl-4,5,5a,6,7, 11b-hexahydro-3-thia-5-azacyclopent-1-ena[c]phenanthrene-9,10-diol (5) emerged as the compound with the best overall in vivo profile in terms of potency (ED50 = 0.04 mumol/kg) and safety.

Prevalence and heterogeneity of Helicobacter pylori in gastric biopsies of patients with gastroduodenal diseases

Helicobacter pylori is a risk factor for development of peptic ulcers and adenocarcinoma of distal stomach. There are several highly specialized virulence factors, such as the production of sialic acid-specific hemagglutinins, cytotoxins and enzymes. This study was designed to study the in vivo prevalence of H. pylori in patients with gastroduodenal diseases, the in vivo correlation between H. pylori infection and blood group O, and the heterogeneity of H. pylori isolates in central Taiwan. We enrolled 776 symptomatic patients residing in the central Taiwan area. The age-specific in vivo prevalence of H. pylori in patients with gastroduodenal diseases increased from 11.1% in those between the ages of 1 to 20, 73.1% in those between the ages of 21 and 30, and to 79.8% in those between the ages of 51 and 60. In conclusion, H. pylori was present in 70% of biopsied specimens of symptomatic patients with gastroduodenal diseases and had the highest incidence (86%) in patients with peptic ulcers. The prevalence of H. pylori cag A expression positive strains in central Taiwan was 92.5%. This study has also demonstrated the high correlation between H. pylori and the blood group O-positive patients with gastroduodenal diseases. The prevalence of H. pylori infection in blood O-positive patients in central Taiwan was 86.4%.

Minor structural differences in Boc-CCK-4 derivatives dictate affinity and selectivity for CCK-A and CCK-B receptors

We previously reported novel Boc-CCK-4 (Boc-Trp-Met-Asp-Phe-NH2) derivatives possessing the general structure Boc-Trp-Lys[N epsilon-CO-NH-(R-Ph)]-Asp-Phe-NH2 (Shiosaki et al. J. Med. Chem. 1991, 34, 2837-2842). In contrast to Boc-CCK-4, which is 70-fold selective for the CCK-B receptor, the modified lysine-bearing tetrapeptides were highly potent and selective full agonists at the CCK-A receptor. Further investigation of the structure-activity profile following modification of the substituted phenylurea moiety appended off the lysine revealed that moving certain substituents, e.g. nitro or acetyl, from the 2- or 3-position on the phenyl ring to the 4-position, a relatively minor and subtle structural modification within the tetrapeptide, resulted in loss of CCK-A receptor selectivity and development of a trend toward CCK-B selectivity. These tetrapeptides, e.g. Boc-Trp-Lys[N epsilon-CO-NH-(4-NO2-Ph)]-Asp-Phe-NH2 and Boc-Trp-Lys[N epsilon-CO-NH-(4-Ac-Ph)]-Asp-Phe-NH2, were full agonists relative to CCK-8 in stimulating intracellular calcium mobilization in a cell line that expresses the CCK-B receptor.

A novel 66-kilodalton protein complexes with Rrn6, Rrn7, and TATA-binding protein to promote polymerase I transcription initiation in Saccharomyces cerevisiae

We report the cloning of RRN11, a gene coding for a 66-kDa protein essential for transcription initiation by RNA polymerase I (Pol I) in the yeast Saccharomyces cerevisiae. Rrn11 specifically complexes with two previously identified transcription factors, Rrn6 and Rrn7 (D. A. Keys, J. S. Steffan, J. A. Dodd, R. T. Yamamoto, Y. Nogi, and M. Nomura, Genes Dev. 8:2349-2362, 1994). The Rrn11-Rrn6-Rrn7 complex also binds the TATA-binding protein and is required for transcription by the core domain of the Pol I promoter. Therefore, we have designated the Rrn11-Rrn6-Rrn7-TATA-binding protein complex the yeast Pol I core factor. A two-hybrid assay was used to demonstrate involvement of short leucine heptad repeats on both Rrn11 and Rrn6 in the in vivo association of these two proteins. This assay also verified the previously described strong association between Rrn6 and Rrn7, independent of the Rrn6 leucine repeat.

The amiloride-sensitive Na+/H+ exchange antiporter and control of intracellular pH in hippocampal brain slices

The intracellular pH, 7.54 +/- 0.03 (mean +/- S.D., n = 15), determined with the Neutral red method, of the hippocampal brain slice preparation under baseline incubation conditions is considerably more alkaline than the bath buffer pH. Neutralization by amiloride suggests that the alkalinity was due to Na+/H+ exchange antiporter activation. To characterize the brain Na+/H+ exchange antiporter we compared the inhibitory effects of MIA, amiloride and other 5-N substituted analogues on proton extrusion after acid loading by transient exposure to ammonium chloride in the isolated hippocampal brain slice preparation. The potencies of amiloride compounds on the initial recovery rate of intracellular pH after acid-loading were DMA > MIA > HMA = MHA > or = IPA-HCI > IPA > MNPA = Amil > Benzamil. The greater potency of the 5-N substituted analogs of amiloride over amiloride and benzamil strongly suggest that Na+/H+ exchange antiporter is the mechanism responsible for alkalinization in the isolated hippocampal brain slice in vitro.

Human astrocytoma U138MG cells express predominantly type-A endothelin receptor

Endothelin-1 (ET-1) binding to human astrocytoma U138MG cells was time-dependent, and bound [125I]ET-1 was difficult to dissociate. The B(max) and Kd values of [125I]ET-1 binding were 70 fmol/mg and 0.07 nM, respectively. Interestingly, different from other astrocytoma cells and astrocytes, the U138MG cells expressed predominantly ETA receptor as shown by RT-PCR results and binding studies. ET-1, FR139317, BQ123, PD142893 and Ro46-2005 inhibited specific [125I]ET-1 binding with Ki values of 0.10, 0.53, 4.3, 22, and 320 nM, respectively. ETB selective ligands ET-3 and IRL1620 were much less potent. The inhibitory effects of antagonists BQ123 and PD142893 on [125I]ET-1 binding diminished following the incubation time. ET-1 binding caused a modest stimulation in phosphatidylinositol hydrolysis with an EC50 value of 24 nM. In comparison to the human U373MG cells, ET-1-induced receptor internalization in U138MG cells was less efficient with 42% of bound ET-1 internalized after 30 min of incubation. These results imply that human astrocytoma cells/astrocytes are able to express either ETA or ETB receptor under different pathophysiological conditions.

Persistent activation of the dopamine D1 receptor contributes to prolonged receptor desensitization: studies with A-77636

A-77636 is a dopamine (DA) D1 receptor-selective agonist that was previously shown to elicit beneficial responses in animal models of Parkinson's disease (PD) (Kebabian et al.: Eur. J. Pharmacol. 229: 203, 1992). However, A-77636 is of limited potential for PD therapy because it induces rapid tolerance in vivo. To understand the basis of rapid onset of tolerance to the compound, we conducted studies to compare the in vitro properties of A-77636 and A-81686; the latter is a structurally related D1 agonist that did not induce significant tolerance in vivo under similar experimental conditions. With SK-N-MC, a neuroblastoma cell line, as an in vitro model for the D1 receptor, significant differences in D1 receptor function were noted after pretreatment with the two compounds. Specifically, 1-hr pretreatment with A-77636 resulted in significant residual cAMP production, even after the drug solution was removed and the cells were washed. The residual cAMP activity was selectively inhibited by SCH 23390, a selective D1 antagonist. The residual cAMP activity declined with pretreatment time, and after 4-hr pretreatment, little residual cAMP production was observed. Cotreatment of SK-N-MC cells with SCH 23390 and A-77636 did not prevent residual cAMP production by A-77636. In contrast, A-81686 did not elicit residual cAMP production is SK-N-MC cells. Although A-77636 treated cells were devoid of agonist response 4 hr after drug removal, A-81686-treated cells exhibited significant cAMP response after drug removal. Preincubation of rat striatal membranes with A-77636 resulted in a large decrease in D1 receptor binding, despite repeated washings, whereas A-81686 pretreatment caused only a small reduction in D1 receptor binding. On the basis of the present data, we conclude that A-77636 dissociates slowly from the D1 receptor. The continued activation of the D1 receptor by A-77636 leads to inability of the receptor to recover its responsivity, which may explain its long duration of action and its ability to induce rapid behavioral tolerance in vivo.

Effects of immortalization upon the induction of matrix metalloproteinases in rabbit synovial fibroblasts

Induction of stromelysin and collagenase mRNAs in response to phorbol myristate acetate (PMA) and autocrine factors (CAF) was compared in primary cultures of lapine synovial fibroblasts and an immortalized line of these cells known as HIG-82. In both cell types, message induction was quicker for CAF than for PMA. Appearance of both stromelysin and collagenase mRNAs occurred earlier in HIG-82 cells and, unlike primary cells, HIG-82 cells partially resisted inhibition by cycloheximide. To determine whether differences in AP-1 activity could account for these observations, the induction of c-fos and c-jun mRNAs was studied in conjunction with gel shift assays for AP-1 binding. Both inducers increased the abundance of c-fos mRNA, although the response was weaker in HIG-82 cells. However, the increase in c-jun mRNA was more marked in HIG-82 cells; furthermore, this increase was sustained for over 6 h. Gel shift assays confirmed that in both types of cells PMA and CAF increased AP-1 binding activity. In primary cells, this activity was sensitive to cycloheximide, but in HIG-82 cells, there was only partial sensitivity to cycloheximide. The gel shift analyses and data from experiments using an AP-1-CAT reporter construct revealed, in many cultures, constitutive AP-1 activity in the absence of stromelysin and collagenase expression, suggesting that AP-1 alone is insufficient for matrix metalloproteinase induction. Antisense oligonucleotides to c-fos and c-jun strongly inhibited the induction of stromelysin mRNA in primary cells treated with PMA, but was only weakly active against message induction in HIG-82 cells. In neither primary cells nor HIG-82 cells did antisense oligonucleotides strongly inhibit stromelysin induction in response to CAF. These data suggest there may exist an AP-1-independent route to message induction or that factors other than c-FOS and c-JUN may be used in certain circumstances. Western blot analyses detected no marked difference between HIG-82 cells and primary cells in their resting levels of c-FOS and c-JUN. Thus the differences reported here between HIG-82 cells and primary cells in their resting levels of c-FOS and c-JUN. Thus the differences reported here between HIG-82 cells and primary cells in the kinetics and cycloheximide sensitivity of MMP induction may reside in their abilities to modify posttranslationally the relevant transcription factors.

ABT-431: the diacetyl prodrug of A-86929, a potent and selective dopamine D1 receptor agonist: in vitro characterization and effects in animal models of Parkinson's disease

(-)-Trans 9,10-hydroxy-2-propyl-4,5,5a,6,7,11b-hexahydro-3-thia-5- azacyclopent-1-ena[c]phenanthrene hydrochloride (A-86929) is a potent and selective full agonist at the dopamine (DA) D1-like receptor. Judging by its binding affinities to the D1 and D2 classes of receptors, the compound is approximately 20-fold D1 receptor-selective, whereas relative potencies based on functional in vitro assays indicate that A-86929 is greater than 400-fold D1-selective. A-86929 has moderate to weak (Ki > 1 microM) affinity at other monoaminergic and peptidergic receptors, at ion channels and at monoamine uptake sites. The catechol of A-86929 was bis-acetylated to produce the prodrug, (-)-trans 9,10-acetoxy-2-propyl-4,5,5a,6,7,11-b-hexahydro-3-thia- 5-azacyclopent-1-ena[c]phenanthrene hydrochloride (ABT-431), which is more chemically stable yet is rapidly converted to the parent compound with a half-life of less than 1 min in plasma. Both A-86929 and ABT-431 produced contralateral rotation in rats bearing unilateral 6-hydroxydopamine lesions, with ED50 values of 0.24 mumol/kg s.c. and 0.54 mumol/kg s.c., respectively. A-86929 and ABT-431 improved behavioral disability scores and increased locomotor activity in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned marmoset model of Parkinson's disease in a dose-dependent manner (the minimum effective dose was 0.10 mumol/kg s.c.). When administered three times daily for 30 consecutive days to 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-lesioned marmosets, A-86929 significantly improved disability scores throughout the duration of the study. Current Parkinson's disease therapy includes L-dopa, which stimulates both classes of DA receptors by virtue of its conversion to DA in vivo, and direct-acting D2-selective agonists. Stimulation of the D2 receptor, which is associated with all current DA agonist-based therapies, may contribute to their dose-limiting side effects. An agent such as A-86929 (or its prodrug ABT-431), which selectively stimulates the D1 receptor, may represent a novel mechanism for Parkinson's disease therapy with the potential for an improved side-effect profile and, consequently, improved patient compliance.

Sampling variation caused by A/D cards due to external trigger

In electrophysiological recording, a microcomputer-based analog-to-digital (A/D) card is an indispensable instrument for signal acquisition and analysis. In our studies, evoked responses sampled by our A/D card showed variation among different cycles. If several cycles had been averaged, the resultant waveform would have a smaller peak amplitude and a longer duration. To explain this phenomenon, a simulated sampling model of compound action potential was proposed. Our experimental data agreed very well with the prediction of the simulated model. The long and varied delay time between the external trigger and the first sampling in each cycle by our A/D card might be the main cause of such variation. This problem could not be solved by any post-sampled programming. Hence, for those electrophysiological laboratories which sampled evoked responses, to buy a new A/D card might be the most straightforward solution to the problem.