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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Reconstruction of orbital floor fractures with maxillary bone

OBJECTIVE

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

DESIGN

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

SETTING

Major metropolitan teaching hospital.

PATIENTS

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

MAIN OUTCOME MEASURES

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

RESULTS

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

CONCLUSION

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

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

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

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

BACKGROUND

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

METHODS AND RESULTS

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

CONCLUSIONS

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

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

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

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

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

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

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

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

BACKGROUND

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

OBJECTIVES

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

STUDY DESIGN

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

RESULTS

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

CONCLUSIONS

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

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

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

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

BACKGROUND AND OBJECTIVES

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

GOALS

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Tertiary amine N-oxides as bioreductive drugs: DACA N-oxide, nitracrine N-oxide and AQ4N

Tertiary amine N-oxides of DNA intercalators with alkylamino sidechains are a new class of bioreductive drugs. N-oxidation masks the cationic charge of the amines, forming prodrugs with low DNA binding affinity and low toxicity which can be activated selectively by metabolic reduction under hypoxic conditions. This study compares three intercalator N-oxides (NC-NO, DACA-NO and AQ4N), which, respectively, give nitracrine (NC), DACA and AQ4 on reduction. In aerobic cell culture all three N-oxide were much less toxic than the corresponding amines, and showed large increases in cytotoxicity under hypoxia. The topoisomerase poisons DACA and AQ4 (and their N-oxides) were less active against non-cycling than cycling cells. However, only AQ4N was active against the mouse mammary tumour MDAH-MCa-4. This dialkylaminoanthraquinone-di-N-oxide has activity at least as great as the reference bioreductive drug RB 6145 against this tumour, both with and without radiation and when combined with the tumour blood flow inhibitor 5,6-dimethylxanthenone-4-acetic acid (DMXAA). It is suggested that the high in vivo activity of AQ4N relative to the other topoisomerase-targeted N-oxide, DACA-NO, may be in part due to release in hypoxic cells of an intracalator with sufficiently high DNA binding affinity that it is retained long enough to kill non-cycling cells when they eventually re-enter the cell cycle.

Hypoxia-selective antitumor agents. 13. Effects of acridine substitution on the hypoxia-selective cytotoxicity and metabolic reduction of the bis-bioreductive agent nitracrine N-oxide

A series of nuclear-substituted derivatives of nitracrine N-oxide (2; a bis-bioreductive hypoxia-selective cytotoxin) were prepared and evaluated, seeking analogues of lower nitroacridine reduction potential. Disubstitution with Me or OMe groups at the 4- and 5-positions did not provide analogues with one-electron reduction potentials significantly lower than those of the corresponding monosubstituted derivatives (E(1) ca. -350 mV for both the 4-OMe and 4,5-diOMe compounds). This appears not to be due to a concomitant raising of the acridine pKa but to a lack of direct electronic effect of substituents in the ring not bearing the nitro group. Conversely, placing two OMe groups in the nitro-bearing ring does result in a substantial further lowering of reduction potential (the 2,4-diOMe analogue has an E(1) of -401 mV). The mono- and disubstituted N-oxides have substantially lower cytotoxicities than the parent nitracrine N-oxide 2 but generally retain very high hypoxic selectivity. The OMe-substituted N-oxides all showed greater metabolic stability than 2 in hypoxic AA8 cell cultures, and the 4-OMe compound 6 had improved activity in EMT6 multicellular spheroids suggesting that this metabolic stabilization may allow more efficient diffusion in tumor tissue. The parent compound 2 was selectively toxic to hypoxic cells in KHT tumors in vivo and clearly superior to nitracrine itself (although only at doses which would eventually be lethal to the host). The analogues of lower E(1), including 6, were not superior to 2 in vivo, indicating that metabolic stabilization of the nitro group is not alone sufficient to improve therapeutic utility.

L ferritin accumulation in macrophages infiltrating the lung during rat Angiostrongylus cantonensis infection

A 22-kDa protein was increased quantitatively, as measured by sodium dodecyl sulfate-polyacrylamide gel electrophoresis techniques, in lung microsomes prepared from Angiostrongylus cantonensis-infected rats. However, it was almost absent in normal rats. The protein was purified by sequential chromatography on Superdex 200 columns and identified chemically and immunologically as ferritin. Using isoelectric focusing and anion exchange chromatography, it was identified as L ferritin. Distribution of this 22-kDa protein in the lung tissue of A. cantonensis-infected rate was studied by immunocytochemistry. Positively stained cells were mainly infiltrated macrophages. Our results suggest that L ferritin accumulation in the macrophages may be related to the proliferation of connective tissue elements and the inflammatory response to A. cantonensis dwelling in the pulmonary arteries of the rat.

Direct molecular diagnosis of CYP21 mutations in congenital adrenal hyperplasia

The majority of congenital adrenal hyperplasia (CAH) cases arise from mutations in the steroid 21-hydroxylase (CYP21) gene. Without reliance on HLA gene linkage analysis, we have developed primers for differential polymerase chain reaction (PCR) amplification of the CYP21 gene and the non-functional CYP21P gene. Using the amplification created restriction site (ACRS) approach for direct mutational detection, a secondary PCR was then performed using a panel of primers specific for each of the 11 known mutations associated with CAH. Subsequent restriction analysis allowed not only the detection but also the determination of the zygosity of the mutations analysed. Existing deletion of the CYP21 gene could also be detected. In the analysis of 20 independent chromosomes in 11 families of CAH patients in Taiwan, four CYP21 mutation types, besides deletion, were detected. Interestingly, in five different alleles, the CYP21P pseudogene contained some polymorphisms generally associated with the CYP21 gene. These results suggest gene conversion events that are occurring in both CYP21P and CYP21 genes. Our combined differential PCR-ACRS protocol is simple and direct and is applicable for prenatal diagnosis of CAH using chorionic villi or amniotic cells.

Anti-IL-4 antibody inhibits antigen specific IgE response but fails to prevent chicken gamma globulin-induced active systemic anaphylaxis: evidence for the involvement of IgG antibodies

It has recently been reported that interleukin-4 (IL-4) is required for the production of IgE, and anti-IL-4 monoclonal antibody (mAb) inhibits in vivo IgE responses. These suggest that blocking of IL-4 activity may be useful for the prevention or treatment of immediate hypersensitivity disorders. In this study we investigated whether anti-IL-4 has a regulatory role in chicken-gamma globulin (CGG)-induced active systemic anaphylaxis. Multiple injections of anti-IL-4 (up to 40 mg/mouse) failed to protect the mice from fatal anaphylaxis. Anti-IL-4 strongly suppressed CGG-specific IgE response (> 90%) without any suppressive effect on CGG-specific IgG (IgG1, IgG2a, IgG2b, and IgG3) responses. Because these data suggest the possibility that fatal anaphylaxis could be induced by IgG antibodies, we examined the possibility using anti-CGG polyclonal and the subclasses of IgG monoclonal antibodies. Passive sensitization of mice with polyclonal antibodies elicited severe and fatal anaphylactic shock; about 50% of the mice died. The activity of antibodies was not diminished by heat treatment (56 degrees C, 2h), suggesting that the anaphylaxis was not mediated by IgE. Shock was also elicited by each subclass of IgG mAb; of these, IgG1 was the most effective. Combination of the IgG subclasses elicited more exaggerated shock; about 30% of mice died. These data indicate that IgG antibodies are themselves sufficient to induce systemic anaphylaxis. Therefore, the failure of anti-IL-4 to prevent active anaphylaxis is probably due to the inability of anti-IL-4 to suppress the production of IgG antibodies.

Analytic performance and contamination control methods of a ligase chain reaction DNA amplification assay for detection of Chlamydia trachomatis in urogenital specimens

A ligase chain reaction (LCR) DNA amplification assay that targeted the cryptic plasmid of Chlamydia trachomatis was developed to detect C. trachomatis urogenital tract infection. The objectives of this study were to determine the cutoff and analytic performance of the LCR assay and to characterize the effectiveness of its postdetection contamination control method. The assay's cutoff was determined after receiver-operator characteristic (ROC) analysis of 4660 clinical data points. The assay detected one infectious unit per reaction of each of the 15 C. trachomatis serovars and did not cross-react with 13 Chlamydia pneumoniae strains, 13 Chlamydia psittaci strains, and 87 other bacteria, fungi, parasites, or viruses. In addition, the assay did not detect 77 processed urine specimens collected from patients with urinary tract infections caused by yeast or bacteria other than C. trachomatis. The assay was sufficiently precise to detect consistently two infectious units of C. trachomatis per reaction. False-positive assay results attributable to contamination with amplified product were minimized by the use of standard procedures as well as by a postdetection chemical inactivation method that could reduce the amount of amplified LCR product by a factor of > or = 10(7).

Gated conductances in native and reconstituted membranes from frog olfactory cilia

Although cAMP is well established as a second messenger for olfactory transduction in vertebrates, the role of inositol 1,4,5-trisphosphate (IP3) in this process remains controversial. We addressed this issue by comparing currents evoked by cAMP and IP3 in native and reconstituted membranes from olfactory cilia. We detected only a cyclic nucleotide-gated conductance in the native membrane but both cyclic nucleotide-gated and IP3-gated conductances in the reconstituted membrane. The magnitudes of the cyclic nucleotide- and IP3-gated conductances were not correlated with each other in reconstituted membranes, suggesting that cyclic nucleotide- and IP3-gated channels originate in different cellular compartments.

Localization of the gene for the human MIG cytokine on chromosome 4q21 adjacent to INP10 reveals a chemokine "mini-cluster"

MIG is a gamma interferon-inducible T cell chemoattractant that is a member of the chemokine family of cytokines. P1 clones containing the MIG gene were found also to contain the gene of a related chemokine, INP10. We localized MIG and INP10 to 4q21 by FISH, demonstrated by pulsed field gel electrophoresis that MIG and INP10 are distant from the tight cluster of other CXC chemokine genes at 4q12-->q13, and determined that MIG and INP10 are oriented head to tail with their start codons separated by less than 16 kb.

Noninvasive tests for diagnosis of Chlamydia trachomatis infection: application of ligase chain reaction to first-catch urine specimens of women

Ligase chain reaction (LCR) to diagnose Chlamydia trachomatis infection was evaluated using first-catch urine (FCU) specimens from 4053 women. Results were compared with those of cell culture (TC) isolation from cervix (all) and urethra (2812 women). The reference standard was TC positivity or positive LCR for chlamydial plasmid DNA confirmed by direct fluorescent antibody test or LCR for another chlamydial gene. Compared with cervical culture, LCR was 88.2% sensitive and 100% specific. Adding urethral culture increased TC sensitivity from 67.1% to 74% and reduced LCR sensitivity to 85.9%. The prevalence of chlamydial infection was 5% (142/2812) by the dual culture system and 5.9% (165/2812) by LCR on FCU specimens. LCR on FCU specimens is highly sensitive and specific for diagnosing chlamydial infection. It is more sensitive than TC and may well present public health authorities with a useful noninvasive screening test for chlamydial infection in asymptomatic women.

Advertising in dentistry--a position paper

The limitations on advertising set by current regulations are examined and the possible consequences of relaxing these regulation discussed. The opinions of the dental profession on this issue, as determined through a questionnaire survey of members of the Singapore Dental Association (SDA), are included. Finally, some recommendations are made with respect to modifying current advertising laws.

Hypoxia-selective antitumor agents. 10. bis(nitroimidazoles) and related Bis(nitroheterocycles): development of derivatives with higher rates of metabolic activation under hypoxia and improved aqueous solubility

A series of analogues of the previously described compound N-[2-(2-methyl-5-nitroimidazol-1H-yl)ethyl]-4-(2-nitroimidazol- 1H-yl)butanamide (4), a novel hypoxic cell cytotoxin and radiosensitizer, have been prepared and evaluated for hypoxia-selective cytotoxicity and hypoxic cell radiosensitization in vitro. The new derivatives were designed to overcome the low aqueous solubility of 4 and its slow kinetics of killing under hypoxia. The nitroheterocycle unit had a significant effect on solubility, with 3-nitrotriazoles being about 6-fold more soluble than the corresponding 2-nitroimidazoles. Analogues with a range of neutral linker chains (polyhydroxy, alkanesulfonamide, and bisamide) showed only slightly improved solubility and were unable to be fully evaluated. However, a series of analogues with cationic amine linkers had adequate aqueous solubility (up to 280 mM). The amine analogues could not be prepared by direct reduction of precursor amides such as 4 and were most conveniently synthesized by aza-Wittig condensation of the appropriate azide and aldehyde components. The amine-linked compounds were more cytotoxic than 4, with the symmetrical bis(2-nitroimidazole) derivatives (13 and 14) up to 9-fold more potent. They showed hypoxic selectivities comparable to that of 4 (ca. 200-fold) but had much more rapid kinetics of killing under hypoxia, resulting in high hypoxic selectivity at early times in culture. The nature of the mechanism of cytotoxicity of these compounds remains unclear but appears not to be DNA cross-linking, with the compounds showing a lack of hypersensitivity toward repair-deficient UV4 cells. The enhanced solubility and hypoxia-selective cytotoxicity (at early times) of 13 compared with 4 represent significant potential advantages.

Detection of Chlamydia trachomatis in urine specimens from women by ligase chain reaction

The performance of a plasmid-based ligase chain reaction (LCR) with urine specimens was compared with those of cell culture of cervical swabs and enzyme immunoassay with urine specimens for the detection of Chlamydia trachomatis infection in women who had attended a family planning clinic. The prevalence of chlamydial infection determined by LCR was 3.1%. Discrepant results among the three assays were resolved by testing urine by a second LCR assay based on the C. trachomatis chromosomal gene encoding the major outer membrane protein. Sensitivity, specificity, and positive and negative predictive values for the cell cultures were 56.3, 100, 100, and 98.4%, respectively, whereas those for the enzyme immunoassay were 18.8, 100, 100, and 97.1%, respectively, and those for LCR were 87.5, 100, 100, and 99.5%, respectively. LCR thus provides a highly sensitive and specific noninvasive screening method for detecting genital chlamydial infections in women.

Detection of point mutations with a modified ligase chain reaction (Gap-LCR)

DNA amplification systems are powerful technologies with the potential to impact a wide range of diagnostic applications. In this study we explored the feasibility and limitations of a modified ligase chain reaction (Gap-LCR) in detection and discrimination of DNAs that differ by a single base. LCR is a DNA amplification technology based on the ligation of two pairs of synthetic oligonucleotides which hybridize at adjacent positions to complementary strands of a target DNA. Multiple rounds of denaturation, annealing and ligation with a thermostable ligase result in the exponential amplification of the target DNA. A modification of LCR, Gap-LCR was developed to reduce the background generated by target-independent, blunt-end ligation. In Gap-LCR, DNA polymerase fills in a gap between annealed probes which are subsequently joined by DNA ligase. We have designed synthetic DNA targets with single base pair differences and analyzed them in a system where three common probes plus an allele-specific probe were used. A single base mismatch either at the ultimate 3' end or penultimate 3' end of the allele specific probe was sufficient for discrimination, though better discrimination was obtained with a mismatch at the penultimate 3' position. Comparison of Gap-LCR to allele-specific PCR (ASPCR) suggested that Gap-LCR has the advantage of having the additive effect of polymerase and ligase on specificity. As a model system, Gap-LCR was tested on a mutation in the reverse transcriptase gene of HIV, specifically, one of the mutations that confers AZT resistance. Mutant DNA could be detected and discriminated in the presence of up to 10,000-fold excess of wild-type DNA.

Diagnosis of Chlamydia trachomatis genitourinary infection in women by ligase chain reaction assay of urine

Genitourinary infection with Chlamydia trachomatis is a common and potentially serious sexually transmitted disease. Diagnosis of C trachomatis infection in women typically relies on culture of endocervical swabs, an invasive and expensive procedure. The ligase chain reaction (LCR) is an in-vitro nucleic acid amplification technique that exponentially amplifies selected DNA sequences. We have compared an LCR-based assay to detect C trachomatis plasmid DNA in first void urine with culture of endocervical swabs for matched specimens from 1937 women from four geographic regions. Discordant specimen pairs were further tested by direct fluorescent antibody staining for elementary bodies and an alternative LCR assay based on the chlamydial outer membrane protein gene. An "expanded gold standard" was defined to include all culture-positive as well as culture-negative, confirmed LCR-positive women. The sensitivity and specificity of the LCR assay with first void urine samples compared with the expanded gold standard were 93.8% and 99.9%, respectively; the corresponding values for culture were 65.0% and 100%, respectively. Thus, an automated LCR assay of readily obtained urine samples showed a detection rate for infected women almost 30% greater than that of endocervical swab culture. The LCR assay was highly effective for the detection of C trachomatis in urine from women with or without signs or symptoms of chlamydial genitourinary tract infection.

In vitro effects of VD-99-11 on Angiostrongylus cantonensis and isolated frog rectus

In vitro effects of VD-99-11 were examined using adult Angiostrongylus cantonensis and isolated frog rectus. In A. cantonensis, paralysis was elicited by VD-99-11 at 10(-9)-10(-6) g/ml. The paralysis caused by VD-99-11 (10(-8) g/ml) was antagonized by picrotoxin or bicuculline but not by phentolamine. A relationship between VD-99-11 and gabergic antagonists was observed in worm preparations contracted by eserine or pyrantel: VD-99-11 at higher concentrations (3x10(-6) g/ml) caused a marked contraction. In worm preparations contracted with eserine or pyrantel, the only additional contraction induced by VD-99-11 (5x10(-6) g/ml) was antagonized by strychnine. In experiments on the guanidine (2.5x10(-3) M)-induced twitch responses in isolated frog rectus, marked stimulation was caused by VD-99-11 (3-5x10(-6) g/ml). The stimulated responses induced by VD-99-11 were antagonized by tetrodotoxin, D-tubocurarine, strychnine, and hemicholinium-3, respectively. These results suggest that VD-99-11 seems superior to milbemycin D, milbemycin oxime, and ivermectin in some aspects, such as in vitro potency, though this new substance is similar to these drugs in having two different actions on the gabergic mechanism at lower concentrations and on the cholinergic mechanism at higher concentrations.

Regulation of cyclin D1, DNA topoisomerase I, and proliferating cell nuclear antigen promoters during the cell cycle

Cyclin D1, DNA topoisomerase I, and proliferating cell nuclear antigen (PCNA) are three important cell cycle regulatory proteins. Recently, their promoters have been isolated, thus facilitating molecular analysis of transcriptional control mechanisms of these genes. Transcription of these three promoters in stable K562 transfectants during different cell cycle phases was analyzed after cell cycle synchronization. About 1 kb of 5' flanking region from either cyclin D1 or DNA topoisomerase I gene is sufficient to confer G1- or S-phase-specific transcription activity to chloramphenicol acetyltransferase (CAT) reporter genes, respectively. In contrast, 2.8 kb of 5' flanking sequences from the PCNA gene led to constitutive transcription, but the inclusion of a segment of the PCNA gene first intron, which contains evolutionarily conserved sequences, could enhance transcription in G1/S-enriched nuclei. This PCNA intron region contains a binding site recognized by the transcription factor E2F. To test whether this site is functional, we cotransfected PCNA-CAT genes with E2F-1 and DP-1 expression plasmids. Expression of the E2F-1/DP-1 heterodimer activated the CAT gene with the PCNA intron. Therefore, this intron region, involved in transcriptional activation at the cell cycle G1/S boundary, is also E2F inducible.

Functional complementation of a yeast vesicular transport mutation ypt1-1 by a Brassica napus cDNA clone encoding a small GTP-binding protein

A cDNA clone (bra) encoding a small GTP-binding protein was isolated from Brassica napus by screening a root cDNA library with a degenerate oligonucleotide probe that corresponds to a highly conserved GTP-binding domain of the Ras superfamily. Sequence analysis shows that the clone contains an open reading frame of 219 amino acid residues with the estimated molecular mass of 24379 Da and this coding region contains all the conserved motifs of the Ras superfamily. The deduced amino acid sequence of the bra gene is most closely related to the Ypt/Rab family that functions in the vesicular transport (46% and 47% amino acid identity to the yeast Ypt1 and to the human Rab1, respectively) and is more distantly related to the other Ras-related families. The protein encoded by the bra gene, when expressed in Escherichia coli, shows the ability to bind GTP. Furthermore, when the bra gene is introduced into Saccharomyces cerevisiae under the regulation of the yeast GAL1 promoter, the gene can complement the temperature-sensitive yeast mutation ypt1-1 that has defects in vesicular transport function. The amino acid sequence similarity and the functional complementation of the yeast mutation suggest that this gene is likely to be involved in the vesicular transport in plants. Genomic Southern analysis shows that this gene is a member of a small gene family in Brassica napus.

Defecographic evaluation of patients with defecation difficulties

Defecographic studies were carried out in 36 females and 19 males with specific complaints of straining with defecation, incomplete rectal emptying and perineal descent. Of these, 91% had abnormal defecographic findings. Abnormalities were more common in females than in males. The female patients mean anorectal angles were 111.3 degrees (resting), 102.2 degrees (squeezing) and 124.7 degrees (straining). Their mean anterior rectocele size was 1.8 cm and the mean difference between the pelvic floor and the anorectal junction at rest and during maximal straining, the mean Ds-R, was also 1.8 cm. Ninety-one percent of the females had anterior rectoceles, 33% had internal rectal intussusception, 25% had hypertonic puborectalis slings and 22% had a Ds-R > 3 cm. The mean anorectal angles of the males were 116.3 degrees (resting), 102.0 degrees (squeezing) and 132.9 degrees (straining) and the mean Ds-R was 2.0 cm. Sixty-eight percent of the males had hypertonic puborectalis slings, 58% had internal rectal intussusception, and 42% had a Ds-R > 3 cm. All patients with hypertonic puborectalis slings had smaller, more acute straining angles. Males with abnormal perineal descent had a greater Ds-R than patients without perineal descent.

Ligase chain reaction to detect Chlamydia trachomatis infection of the cervix

We performed a multicenter evaluation of ligase chain reaction (LCR) in the diagnosis of Chlamydia trachomatis infection of the cervix. This LCR provides an amplification of target sequences within the chlamydial cryptic plasmid. The LCR results were compared with those of isolation in cell culture. Discrepant (tissue culture-negative and LCR-positive) test results were resolved by the application of a direct immunofluorescent-antibody test to detect chlamydial elementary bodies and by the use of alternate DNA primers that targeted the chlamydial major outer membrane protein gene. A total of 234 of 2,132 specimens (10.9%) could be confirmed as containing C. trachomatis. Of these, 152 were detected by isolation in cell culture and 221 were detected by LCR. The corresponding sensitivities were 94% for LCR and 65% for cell culture. There was greater variability among study site results for cell culture sensitivity (52 to 92%) than for LCR sensitivity (87 to 98%). The specificity of each test was greater than 99.9%. Thus, LCR offers a highly sensitive nonculture method for detecting chlamydial infection of the cervix.

Prenatal diagnosis of beta-thalassemic mutations in Chinese by multiple restriction fragment-single strand conformation polymorphism analysis

A modified approach of polymerase chain reaction (PCR)-based single strand conformation polymorphism (SSCP) has been developed for prenatal diagnosis of beta-thalassemic mutations. In this method, a single PCR product (1,350-bp) is first generated, which is then digested by restriction enzymes (BbsI, BamHI, DraI) to generate multiple shorter restriction fragments for electrophoretic analysis in an SSCP gel. The method is thus termed multiple restriction fragment (MRF)-SSCP. Two cases of chorionic samples and the blood samples of their parents were studied. The previously described amplification-created restriction site (ACRS) method was used to confirm the SSCP results obtained. Two polymorphic sites of the beta-globin gene which would influence the MRF-SSCP patterns are described, including a previously undescribed polymorphic site located at codon 3 (CAT or CAC) of the beta-globin gene.

A multicentric seroepidemiological survey of HTLV-I/II in Italy

BACKGROUND

Several studies carried out in the USA and in Europe have shown the presence of HTLV-I/II antibodies in subjects belonging to high-risk groups for HIV infection as well as blood donors. Concern about the presence of HTLV-I/II markers in the normal population, as well as the efficient transmission of HTLV-I/II by whole blood or infected blood cells have led several countries to include screening for anti-HTLV-I/II among the mandatory serological testing of blood donors.

OBJECTIVE

In order to assess the risk of HTLV-I/II infection related to blood transfusions, a multicentric survey for antibodies against HTLV-I and HTLV-II was carried out involving 10 Italian sites during the spring of 1991.

STUDY DESIGN

Serum specimens were collected from 14,598 blood donors, 1,411 injecting drug users, 1,015 thalassemics, 142 hemophiliacs and 138 hemodialysis patients. HTLV antibodies were detected by a screening EIA which combines a viral lysate with a recombinant HTLV-I env protein (p21e). The serological confirmation was performed by a semi-automated dot-blot immunoassay that detects gag p19 and p24 and env p21e specific antibodies, while the discrimination of HTLV-I and HTLV-II reactivities was carried out by EIAs employing synthetic peptides of the ENV region specific for each virus.

RESULTS

The seroprevalence of confirmed positives was 0.034% among blood donors and 3.61% among IDUs, while no sample of the other categories could be confirmed, although several were indeterminate and one thalassemic reacted against HTLV-I on peptide testing. HTLV-I reactivity was observed in one blood donor, while all 38 of the 51 confirmed seropositive IDU's reacted only to the HTLV-II synthetic peptide.

CONCLUSIONS

These data confirm a high prevalence of HTLV-II among Italian IDUs and show an HTLV-I/II seroprevalence among blood donors very similar to that which was found in the USA volunteer blood donors. A surveillance program among blood donors seems advisable in order to establish the possible need of a mandatory screening for HTLV-I/II.

Differential effects of transforming growth factor-beta 1 and bone morphogenetic proteins in cultured rat osteogenic sarcoma and mink lung epithelial cells

The effects of porcine bone morphogenetic protein (BMP) on DNA and collagen synthesis in cultured rat osteogenic sarcoma cells and mink lung epithelial cells were studied and compared with the effects induced by transforming growth factor-beta 1 (TGF-beta 1). In both cells, DNA synthesis was slightly but significantly increased by BMP whereas it was notably decreased by TGF-beta 1. The inhibitory action of TGF-beta 1 overrode the activation of DNA synthesis by BMP when the cells were incubated together with TGF-beta 1 and BMP. In osteogenic sarcoma cells, collagen synthesis was enhanced by both BMP and TGF-beta 1, but the stimulatory action of BMP was weaker than that of TGF-beta 1. In epithelial cells, TGF-beta 1 increased collagen synthesis but BMP induced no significant changes. No synergistic effects of TGF-beta 1 and BMP on collagen synthesis were observed in both cells. The present study demonstrates the possibility of direct actions of BMP and TGF-beta 1 on cultured rat osteogenic sarcoma cells and mink lung epithelial cells in vitro.

Serum response element-regulated transcription in the cell cycle: possible correlation with microtubule reorganization

The transcriptional response to growth factors and other mitogenic signals is mediated by the serum response elements (SREs) located in the promoters of many immediate early genes, including the c-fos and beta-actin genes. We investigated SRE-regulated transcription in cell cycle-synchronized nuclei and found that a SRE-regulated reporter gene was transcribed actively during G1 and, surprisingly, during G2-M as well. One possible mechanism involved in the latter event is microtubule reorganization. Microtubule disassembly is mimicked by microtubule-disrupting drugs, and we found that these drugs, including colchicine, nocodazole, and vinblastine, could activate SRE-dependent reporter genes, as well as the c-fos protooncogene, in asynchronously growing cells. Taken together, our results suggested a possible relationship between cytoplasmic microtubule dynamics and cell cycle gene expression. Although the detailed molecular mechanisms of drug action are not known, protein phosphorylations may be involved, since drug-induced stimulation could be abrogated by several protein kinase inhibitors. Furthermore, the overexpression of mitogen-activated protein kinase ERK1 could superinduce the stimulation of SRE-dependent reporter gene expression by colchicine and suggests that the microtubule disassembly signal may be transduced by microtubule-associated kinases.

Effects of gabergic anthelmintics at higher concentrations on the guanidine-induced twitch responses in isolated frog rectus preparations

Effects of various gabergic anthelmintics on the guanidine-induced twitch responses in isolated frog rectus preparations were examined. All gabergic anthelmintics such as milbemycin oxime, milbemycin D, avermectin B1a, ivermectin, and diethylcarbamazine (DEC) showed stimulatory effects on the guanidine-induced twitch responses at their higher concentrations. Only piperazine caused inhibitory effects on the twitch responses, even at higher concentrations. The stimulation of the twitch responses by the gabergic anthelmintics was antagonized with tetrodotoxin, hemicholinium-3, d-tubocurarine, and strychnine. These results suggest that all gabergic anthelmintics except piperazine stimulate the release of acetylcholine from the nerve endings and that all of them, including piperazine, have different effects on the gabergic mechanism at lower concentrations and on the cholinergic mechanism at higher concentrations.

Multiple hemorrhoidal bandings in a single session

PURPOSE

The aim of our study was to evaluate the risks of multiple hemorrhoidal bandings in a single session.

METHODS

We retrospectively examined all of the patients who had hemorrhoidal bandings from July 1989 to August 1992.

RESULTS

Patients with multiple hemorrhoidal banding in a single session when compared with patients with single banding had greater discomfort and pain (29 percent vs. 4.5 percent), but this discomfort was usually manageable with oral analgesia of limited duration. There were also more vasovagal symptoms (5.2 percent vs. 0 percent), local swelling and edema (2.6 percent vs. 0 percent), and urinary hesitancy and frequency (12.3 percent vs. 0 percent) in the multiple-banded patients. No major complication such as massive delayed bleeding and perineal or pelvic sepsis was noted.

CONCLUSION

Most patients tolerated multiple hemorrhoidal banding in a single session with acceptably low complications. Multiple banding in a single session is a safe and cost-effective alternative.