Cytotoxic effects of pyridino[2,3-f]indole-4,9-diones on human tumor cell lines

The cytotoxicities of pyridino[2,3-f]indole-4,9-dione derivatives were examined against human lung tumor cell lines (A 549), human ovarian tumor cell lines (SK-OV-3), human melanoma tumor cell lines (SK-MEL-2), human CNS tumor cell lines (XF 498) and human colon tumor cell lines (HCT 15) in vitro using a Sulforhodamine B assay. 3-Ethoxycarbonyl-1-(2-methoxyethyl)-2-methyl-1H-pyridino[2,3-f]ind ole-4,9-dione (5) showed excellent cytotoxicity against XF 498 and HCT 15. The ED50 values of 5 were 0.006 microg/ml against XF 498 and 0.073 microg/ml against HCT 15, while those of doxorubicin were 0.012 and 0.264 microg/ml, respectively. 1-Benzyl-3-ethoxycarbonyl-2-methyl-1H-pyridino[2,3-f]indole-4,9-di one (7) (ED50 value 0.065 microg/ml) was also significantly more cytotoxic against HCT 15 compared with doxorubicin.

Introduction of human immunodeficiency virus 2 infection into South Korea

Although human immunodeficiency viruses 1 and 2 (HIV-1 and HIV-2) share mode of transmission, their epidemiologic characteristics differ and international spread of HIV-2 has been limited. To investigate the extent of HIV-2 infection in South Korea and to clarify the characteristic of HIV-2 isolates, we describe epidemiological, serological and genetic analyses of five HIV-2 isolates from South Korea. Five of 964 HIV antibody-positive serum specimens showed positive reactivity by HIV1/2 enzyme immunoassay (EIA), HIV-2 Western blot analysis, HIV-2 particle agglutination (PA) test and line immunoassay (LIA) but negative or indeterminate one by HIV-1 PA test and HIV-1 Western blot analysis. To confirm HIV-2 infection by genetic analysis, reverse transcription-polymerase chain reaction (RT-PCR) was performed on five HIV-2 seropositive samples. PCR products from gag (197 bp) and env gene regions (137 bp) were obtained with three of the five samples with HIV-2 specific gag primers and with all the five samples with env primers. To obtain larger sequences for a more comprehensive phylogenetic analysis, we performed PCR for a 1191 bp env region of HIV-2 but only two such products were obtained. For the phylogenetic analysis, three 197 bp gag and two 1191 bp env PCR products were cloned and sequenced. Based on the gag and env sequences alignments, three isolates (KR4063, KR7051 and KR8091) were clustered phylogenetically within HIV-2 subtype A. In conclusion, HIV-2 virus is present in South Korea and was detected in five subjects. Furthermore, the prevalence of HIV-2 infection should be monitored continuously in South Korea to assess the spread of this virus and to assist in the diagnosis of HIV infection.

Protective effects of asiaticoside derivatives against beta-amyloid neurotoxicity

Asiaticoside (AS) derivatives were tested for potential protective effects against Abeta-induced cell death. Of the 28 AS derivatives tested, asiatic acid (AA), asiaticoside 6 (AS6), and SM2 showed strong inhibition of Abeta-induced death of B103 cells at 1 microM. The three AS derivatives were further tested for their effects on free radical injury and apoptosis. All three AS derivatives reduced H(2)O(2)-induced cell death and lowered intracellular free radical concentration, but AA showed the strongest protection. In contrast, SM2 was the most effective blocker of staurosporine-induced apoptosis. These results suggest that the three AS derivatives block Abeta toxicity by acting through different cellular mechanisms. When applied to hippocampal slices, AA, SM2, and AS6 did not alter n-methyl-D-aspartic acid (NMDA) or non-NMDA receptor-mediated synaptic transmission, paired-pulse facilitation or induction of long-term potentiation in the field CA1. These results indicate that the three AS derivatives do not alter physiological properties of the hippocampus at the concentration that blocks Abeta-induced cell death. Therefore AS6, AA, and SM2 can be regarded as reasonable candidates for a therapeutic Alzheimer's disease drug that protects neurons from Abeta toxicity.

Comparison of cilostazol versus ticlopidine therapy after stent implantation

The aim of this study was to evaluate the efficacy of cilostazol for prevention of stent thrombosis compared with ticlopidine. Cilostazol is a potent antiplatelet agent with less serious side effects. However, few data are available about the effect of cilostazol in preventing stent thrombosis after coronary stent implantation. Four hundred ninety patients selected for elective stent placement were randomized to receive aspirin plus ticlopidine (n = 243) or aspirin plus cilostazol (n = 247) for 1 month. Clinical and laboratory evaluations were performed at regular interval. There were no differences in baseline characteristics between the 2 groups. During the first 30 days after stent implantation, major cardiac events or adverse drug effects were similar between the 2 groups: ticlopidine (2.9%) vs cilostazol (1.6%) group, p = NS; stent thrombosis (0.4% vs 0.8%, p = NS, respectively), myocardial infarction (0.4% vs 0.8%, p = NS), severe leukopenia (1.2% vs 0%, p = NS), severe thrombocytopenia (0.4% vs 0%, p = NS), and cerebral hemorrhage (0.4% vs 0%, p = NS). Adverse effects led to drug withdrawal in 7 patients in the ticlopidine group (2.9%) and in 5 in the cilostazol group (2.0%). There was no death during the follow-up period. Thus, aspirin plus cilostazol may be an effective antithrombotic regimen with comparable results to aspirin plus ticlopidine after elective coronary stenting.

Predictors of diffuse-type in-stent restenosis after coronary stent implantation

Diffuse-type in-stent restenosis (ISR) is associated with higher rate of restenosis after balloon angioplasty, requiring new therapeutic modalities; therefore, it is clinically important to identify the determinants of diffuse-type ISR. We evaluate the clinical and angiographic variables to predict diffuse-type ISR after coronary stent placement. Two hundred and ten ISR lesions in 196 patients (diffuse ISR, 114 lesions; focal ISR, 96 lesions) were reviewed in this study. Clinical, procedural and quantitative coronary angiographic parameters were analyzed. Diffuse-type ISR was defined as a > or = 50% lumen narrowing and > or = 10-mm length. Univariate analysis revealed that initial lesion length, smaller vessel size, diabetes, multivessel disease, multiple stents, and long stent were significantly associated with diffuse-type ISR. However, diabetes was the only independent predictor of diffuse-type ISR by stepwise multiple regression analysis (OR, 3.3; 95% CI, 1.4-7.4, P = 0.001). Diabetes was associated with diffuse-type ISR after coronary stent placement. It may reflect enhanced rate of neointimal hyperplasia within the stent in diabetic patients.

Paroxysmal tachycardia and hypertension with or without ventricular fibrillation during laparoscopic adrenalectomy: two case reports in patients with noncatecholamine-secreting adrenocortical adenomas

We present two cases of sudden unanticipated cardiovascular complications in patients with noncatecholamine-secreting adrenocortical adenomas during laparoscopic adrenalectomy. In the first case, the patient developed paroxysmal tachycardia and hypertension followed by ventricular fibrillation shortly after clipping of the adrenal vein. In the second case, the patient suffered hypertension and bigeminy during manipulation of the adrenal gland just around the adrenal vein. Awareness of such complications during either conventional or laparoscopic adrenalectomy is important even if the operation is performed in a patient with an apparently noncatecholamine-secreting adrenocortical adenoma.

Immediate results and late clinical outcomes after new CrossFlex coronary stent implantation

This study evaluates the safety and efficacy of the new CrossFlex stent in the treatment of native coronary artery disease. The CrossFlex stent is a flexible, balloon-expandable new device with an excellent flexibility, radial strength, conformability, and radio-opacity. Little data are available concerning the clinical and angiographic outcomes of this device. The CrossFlex stent was implanted in 209 consecutive patients with 226 lesions. Follow-up angiography was performed at 6 months, and clinical evaluation was undertaken at regular intervals after stent implantation. Procedural success was achieved in all lesions without in-hospital complications. Angiographic follow-up data were available in 153 of the 187 eligible lesions (follow-up rate, 82%), and the overall angiographic restenosis rate was 16.3%. Minimal lumen diameter immediately after stent placement was the only predictor of angiographic restenosis. Clinical follow-up was obtained in all patients at 10.5 +/- 5.2 months. There were 4 deaths (1 cardiac in origin, the others noncardiac in origin), and 1 nonfatal myocardial infarction (nonstented artery) during follow-up. Target lesion revascularization was required in 15 patients (7%), and the overall event-free survival rate (death, myocardial infarction, and repeat revascularization) was 87% at the end of the follow-up period. The CrossFlex stent is a safe and effective device with a high procedural success rate, and a favorable late clinical outcome for treatment of native coronary artery disease. Further randomized trials are needed to compare the CrossFlex stent with standard slotted-tube stents.

Experimental animal models of traumatic brain injury: medical and biomechanical mechanism

The numerous traumatic brain injury models were designed to study the nature of the human brain injury. The properties of six experimental injury models were reviewed in this article. Weight-drop models with or without skull protection were compared in terms of experimental setup, possible error source, and biomechanical prospect. The modified percussion models with or without rigid cortical impact were contrasted with regard to reliability, histopathological production, and deformation. The focal contusion model by mechanical suction force represented isolated cortical injury without compression brain injury. As a class of traumatic brain injury, brain retraction damage was reviewed in this article.

Spontaneous regression of a herniated cervical disc in a patient with myelopathy. Case report

The authors present a case of spontaneous regression of a herniated cervical nucleus pulposus in a patient with myelopathy. This 37-year-old woman developed sudden quadriparesis; she had reported no history of trauma. Magnetic resonance (MR) imaging revealed a large disc herniation and increased signal intensity of the cord at the C5-6 level. The extruded disc fragment was found to have resolved on follow-up MR imaging after 28 months, despite the fact that the patient had undergone no specific treatment. The patient's symptoms had subsided almost totally. This is the first case of MR-documented regression of a cervical disc herniation in a patient with myelopathy.

Characterization of the murine cdc2 gene

A 1204 bp full-length cDNA encoding murine cdc2 was isolated and used as a probe to obtain four overlapping cdc2 genomic clones which span the entire cdc2 sequence. Characterization of these clones revealed that the cdc2 mRNA is distributed over 28 kb and in 8 exons ranging in size from 63 to approximately 303 bp. Since the 5'-untranslated sequence is interrupted by intron 1, the initiation codon is located in exon 2. The PSTAIRE region is in exon 3, and the stop codon is in exon 8. Primer extension analysis of cdc2 mRNA isolated from immobilized anti-CD3 activated T-cells demonstrated that the murine cdc2 gene utilizes multiple transcriptional start sites. No consensus sequence for a TATA box exists at an appropriate position within the promoter region. Instead, several putative transcription factor binding sites for PEA3, CREB, C/EBP, E box factor, YY1, ATF-like, Spl, and E2F were detected. Analysis of the promoter activity of the 5'-flanking region suggests that the sequence between -188 to -38, which possesses two Spl and one E2F motif, contains a major positive regulatory activity for the expression of murine cdc2.

Impaired flow-mediated vasodilation of epicardial coronary artery in vasospastic angina

To evaluate whether the flow-mediated vasodilation and coronary flow reserve are impaired or not in patients with vasospastic angina (VA), we measured the changes of epicardial coronary artery diameter and flow reserve in spasm related-left anterior descending coronary artery (LAD). The flow mediated-response of epicardial coronary arteries in 15 VA were compared with 15 controls. Using quantitative coronary angiography, we measured the diameter of proximal (pLAD) and middle segment (mid-LAD) of LAD under baseline conditions, during increased blood flow after distal adenosine injection and after proximal administration of nitroglycerin. An increased fraction of average peak velocity after injection of adenosine was similar in both groups [control 340 (mean)+/-24 (SEM)%; VA 330+/-19%]. Flow-mediated vasodilation was preserved in all controls (pLAD 13.1+/-1.4%; mid-LAD 15.8+/-2.5%) but it was significantly impaired in patients with VA (pLAD -1.0+/-1.8%; mid-LAD 0.1+/-3.5%). The vasodilator response to nitroglycerin was comparable in controls (pLAD 25.8+/-2.8%; mid-LAD 27.2+/-2.8%) and VA (pLAD 26.2+/-5.2%; mid-LAD 26.7+/-3.5%). Coronary flow reserve is preserved in patients with VA. However, the flow-mediated response of spasm related-epicardial coronary artery is impaired. This may play an important role in the pathogenesis of coronary artery spasm.

Combination chemotherapy of oral 5'-deoxy-5-fluorouridine and cisplatin in advanced gastric cancer: a phase II study

This study was designed to test the activity and feasibility of 5'-deoxy-5-fluorouridine (5'-DFUR) and cisplatin combination therapy in the treatment of advanced gastric cancer. Nineteen patients with inoperable and/or metastatic gastric cancer, which was histologically proven, were orally administered 5'-DFUR 1,200 mg/m2 on days 1 to 4 and days 15-18 combined with 70 mg/m2 of cisplatin being repeated every 4 weeks. Five partial responses (PRs) were achieved. Seven patients had stable disease and 6 progressed on therapy. The overall response rate was 27.7% (95% confidence interval: 9.69% to 53.5%). The median survival duration of all 18 patients was 25 weeks (9-64). The majority of patients had WHO grade I/II toxicity, but there was no treatment-related death. These data support that the combinations of oral 5'-DFUR and cisplatin are well tolerable and have a moderate activity with low toxicity in the treatment of advanced gastric cancer.

Comparison of slotted tube versus coil stent implantation for ostial left anterior descending coronary artery stenosis: initial and late clinical outcomes

Balloon angioplasty of ostial left anterior descending coronary artery (LAD) lesions has been associated with a high rate of acute complications and late restenosis. Recently, coronary stenting has been proposed as an effective treatment modality for ostial LAD lesions. To evaluate the effects of stent design on the development of late restenosis, we retrospectively analyzed the efficacy of slotted-tube stent implantation (40 patients, Palmaz-Schatz stent) and coil stent implantation (15 patients, tantalum Cordis stent) of ostial LAD stenosis. Six-month angiographic follow-up data were obtained in 31 patients (82%) with slotted-tube stent implantation and 12 patients (86%) with coil stent implantation. Angiographic restenosis was defined as > or =50% diameter stenosis. The angiographic restenosis rate was significantly lower in slotted-tube stent implantation (32%) than in coil stent implantation (67%) (p<0.05). Target lesion revascularization rate of slotted tube stent implantation was significantly lower (26%) than that of coil stent implantation (57%) (p<0.05). Coil stent implantation of ostial left anterior descending artery lesions was associated with higher late restenosis compared with slotted tube stent implantation. In conclusion, slotted-tube stent implantation might be considered to improve late clinical outcomes of ostial LAD lesions.

Expression of cyclin D1 and cyclin E in human gastric carcinoma and its clinicopathologic significance

Cyclin D1 and cyclin E are the mammalian G1 cydins that are both required and rate limiting for entry into S phase. Alterations in cell cycle regulators and subsequent deregulation of the cell cycle are frequently involved in tumorigenesis and/or tumor progression. We investigated the expression of cyclin D1 and cyclin E protein in 84 gastric carcinoma by immunohistochemical staining and also the relevance of each cyclin expression to the clinical outcomes. Overexpression of cyclin D1 and cyclin E was noted in 21 of 84 (25.0%) and 34 of 84 (40.5%) gastric cancer tissues, respectively. There was a significant correlation between overexpression of cyclin E and lymph node metastasis (p=0.003), recurrence (p=0.043), disease free survival (p=0.0378) and overall survival (p=0.0319), but no correlation was noted between overexpression of cyclin D1 and other clinicopathologic variables. These findings suggest that overexpression of cyclin E and cyclin D1 is a frequent finding in gastric cancer and immunohistochemical analysis for cell cycle regulators, especially cyclin E might be a useful prognostic indicator in gastric cancer.

Transverse testicular ectopia found by preoperative ultrasonography

Transverse testicular ectopia, an extremely rare anomaly, is a deviation of testicular descent resulting in unilateral location of both testes, usually associated with an inguinal hernia, with the spermatic cord of the ectopic testes originating from the appropriate side. In most reported cases, the correct diagnosis was not made preoperatively. But we made a diagnosis of transverse testicular ectopia preoperatively by using the ultrasonography in patient with right-side inguinal hernia and left-side cryptorchism. Left testis was found on the right inguinal area and right testis was found in the right scrotum by ultrasonography, so we could make a diagnosis of transverse testicular ectopia. After right inguinal hemiorraphy, both testes were easily brought down sequentially through the right groin into the scrotum. Left testis was placed in the left hemoscrotum through transceptal incision to the scrotal subdartous pouch.

Multiresolution EEG comparison of rat ischemia models

Fourier transform of Electroencephalography (EEG) restricts EEG analysis due to its stationary properties with time change. It makes analysis difficult to ascertain the global effects of transient change in EEG signals. This study tested that multi-resolution analysis distinguishes different depths of ischemic insult related to the degree of residual blood flow in animal models. The results suggest that multi-resolution analysis demonstrate that little blood flowing to the brain has more detrimental effect to the EEG properties than no blood flowing, which is contrary to the common sense.

Real-time measurement of ischemia-evoked glutamate release in the cerebral cortex of four and eleven vessel rat occlusion models

Interstitial levels of the neurotransmitter glutamate and cerebral blood flow changes were compared in two models of rat forebrain ischemia using the dialysis electrode technique and laser doppler flowmetry with brain temperature controlled. Ten-minute periods of cerebral ischemia were elicited by the four and an eleven vessel occlusion and compared to carotid artery transection. Elapsed time from the onset of ischemia to the ischemic plateau was 76.8+/-57.9 s in 4VO vs. 14.8+/-1.3 s in 11VO animals. Percent residual cerebral blood flow (CBF) was 13.5+/-8.8% during 4VO as opposed to 4.5+/-2.9% during 11VO. Concomitantly, cerebral glutamate levels rose to 255. 7+/-72.8 micromol l-1 in the 4VO animals in comparison with levels of 138.5+/-78.7 and 135.7+/-40.2 micromol l-1 in the 11VO and carotid transection animals. During the first 89.6+/-47.4 s of reperfusion, glutamate levels rose to a second higher peak of 315. 1+/-179.2 micromol l-1 in 7 of 12 animals. Following reperfusion, glutamate levels in the 4VO and 11VO animals returned towards basal levels. This study demonstrates that 11VO causes a rapid drop in CBF to near zero levels, better mimicking complete forebrain ischemia than the traditional 4VO technique. Moreover, the 'low flow' state of cerebral ischemia, produced by traditional 4VO, results in a higher interstitial level of glutamate than a 'no flow' state, as exhibited by the 11VO technique. The dialysis electrode, used simultaneously with laser doppler flowmetry, real-time data acquisition, and continuous brain temperature control, in this new rat model, provides real-time evidence that glutamate levels in the interstitial space are enhanced during a low flow state of cerebral ischemia. Furthermore, not before demonstrated, glutamate transients are seen to occur during the first 90 s of reperfusion, and, to the best of our knowledge, the glutamate levels recorded by this technique are the highest in the literature.

Increased activity of matrix metalloproteinase-2 in human glial and neuronal cell lines treated with HIV-1 gp41 peptides

Part of the neurodegenerative cascade in AIDS dementia may involve overexpression of matrix metalloproteinases (MMPs). Here, we examined the possible effect of HIV-1 gp41, which has been shown as a key determinant associated with pathogenesis of AIDS dementia, on the activity of MMPs using human neuronal and glial cell lines. Zymographic analysis revealed that treatment with the gp41 peptide (aa 583-599) for 24 h markedly elevated the activity of MMP with Mr 66 kDa in the cultured media of glioblastoma cell line T98G in a concentration-dependent manner as well as of neuroblastoma cell line SK-N-SH despite of lower magnitude of the activity. In contrast, the immediately adjacent gp41 peptide (aa 598-613) as well as the reverse peptide (aa 598-583) had a little effect. Recombinant gp41 protein containing extracellular domain also elicited a similar effect, although with a lesser extent. This 66 kDa MMP was confirmed as gelatinase A (MMP-2) based on the results of its activity dependent on Ca2+ and inhibited in the presence of 1,10-phenanthroline or EDTA, as well as its specific immunoreactivity on the Western blot. N-acetyl cysteine (NAC) downregulated this gp41 peptide-induced MMP-2 activity in T98G. The soluble form of amyloid precursor protein (sAPP), which is synthesized in the Escherichia coli system, also inhibited the MMP-2 activity in vitro. Taken together, these results implicate that high production of HIV-1 gp41 or its metabolites containing aa 583-599 within central nervous system (CNS) could result in the increased activity of MMP-2 and that the extracellular deficiency of reducing agent or decreased level of sAPP within CNS could exacerbate this gp41-induced MMP-2 activity.

Mutational analysis for the role of C-terminal region of ecotin, a dimeric inhibitor of pancreatic serine proteases

Ecotin is a dimeric molecule that is capable of inhibiting a variety of serine proteases. To clarify the role of the C-terminal region, mutagenesis was performed to delete the C-terminal residues from 130 to 142. The mutant inhibitor behaved as a monomer upon cross-linking analysis followed by gel filtration. The mutation also resulted in a significant increase of the Ki of ecotin on trypsin, chymotrypsin, and elastase (i.e., by 1 to 2 order of magnitude). The mutant ecotin was slightly more sensitive to heating at 100 degrees C than the wild-type ecotin, but became much more sensitive to the heat treatment upon reduction of the intra-chain disulfide bond in its subunits. In addition, treatment with 4 M urea resulted in complete loss of the activity of the mutant ecotin but not that of the wild-type inhibitor. Thus, the C-terminal region of ecotin seems to be required not only for dimerization of the subunits but also for optimal interaction with target proteases and for maintenance in its structural stability, particularly under reducing or denaturing conditions.

Combining ADA, protein and IFN-gamma best allows discrimination between tuberculous and malignant pleural effusion

BACKGROUND

The purpose of this study is to assess the usefulness of various enzymes, cytokines and biochemical studies of pleural fluid for the differential diagnosis of tuberculosis from malignant pleural effusions, and to clarify the role of combining diagnostic tests.

METHODS

The study group included 39 cases with tuberculous effusions and 31 cases with malignant effusions, whose diagnoses were confirmed by pleural biopsy, cytology or microbiological methods. We compared pleural fluid levels of ADA, TNF-alpha, IFN-gamma, IL-2, IL-6, IL-8, pH, protein, glucose, cholesterol, triglyceride, amylase and lactic dehydrogenase between tuberculous and malignant effusions. Using stepwise logistic regression analysis, we evaluated the benefit of combining various parameters. Receiver operating characteristic(ROC) curves of ADA, cytokines and equations generated from regression analyses were plotted and compared with the area under curve(AUC). Cut-off values showing the best diagnostic accuracy were selected and compared.

RESULTS

Compared to malignant effusion, tuberculous effusion showed significantly higher levels of ADA, IFN-gamma, TNF-alpha and IL-2. There was a good correlation between IFN-gamma and TNF-alpha. By stepwise logistic regression analysis, IFN-gamma, protein and ADA were independent variables predicting tuberculous from malignant effusions. The diagnostic accuracy and AUC of regression equation was greater than any other single parameters.

CONCLUSION

For the differential diagnosis of tuberculosis and malignant pleural effusions, combining ADA, protein and IFN-gamma best allows discrimination.

Cerebral cortex blood flow and vascular smooth muscle contractility in a rat model of ischemia: a correlative laser Doppler flowmetric and scanning electron microscopic study

The present study was undertaken to ascertain the role of smooth muscles and pericytes in the microcirculation during hyperperfusion and hypoperfusion following ischemia in rats. Paired external carotids, the pterygopalatine branch of the internal carotids and the basilar artery were exposed and divided. Reversible inflatable occluders were placed around the common carotids. After 24 h, the unanesthetized rat underwent 10-min ischemia by inflating the occluders. Continuous cortical cerebral blood flow (c-CBF) was monitored by laser Doppler flowmetry. The measured c-CBF was below 20% of control (P < 0.001) during ischemia. A c-CBF of 227.5 +/- 54.1% (P < 0.001) was obtained during reperfusion hyperemia. A c-CBF of 59.7 +/- 8.8% (P < 0.001) occurred at the nadir of postischemic hypoperfusion, and this was followed by a second hyperemia. The cytoarchitecture of the vascular smooth muscles and pericytes was assessed by scanning electron microscopy. Samples were prepared using a KOH-collagenase digestion method. In control rats, arteriolar muscle cells showed smooth surfaces. Capillary pericytes were closely apposed to the endothelium. Immediately after reperfusion, transverse membrane creases were observed on the smooth muscle surfaces. During maximal hyperemia the creases disappeared. When c-CBF started to decrease the creases became visible again. Throughout the postischemic hypoperfusion the creases remained. Capillary endothelial walls became tortuous in the late phase of hypoperfusion. During the second hyperemia most arteriolar muscle cells showed smooth surfaces. Some pericytes appeared to have migrated from the vascular wall. The morphological changes of smooth muscle membranes suggest that they are related to specific perfusional disturbances during ischemia and reperfusion.

Increased expression of urokinase type plasminogen activator(u-PA), plasminogen activator inhibitor-1(PAI-1), and collagenases in Caco-2 cells infected by Salmonella typhimurium

Salmonella penetrates the basement membrane of intestinal epithelial cells into deeper tissues, in which process extracellular matrix proteases should be required. Hypothesizing that the proteases might be provided by host cells, we investigated the changes of expression of urokinase type plasminogen activator(u-PA), plasminogen activator inhibitor-1(PAI-1), and collagenases in epithelial cells(Caco-2) infected with Salmonella typhimurium. The change of mRNA levels, amount of the enzyme secretion and functional activity were analyzed by Northern blot, ELISA, and Zymography. The mRNA level of u-PA was elevated by Salmonella infection itself without any exogenous transcription regulators. u-PA was actively secreted into the medium and was enzymatically active. The synthesis and secretion of PAI-1 was increased over time from 2 hrs post infection(pi) to 8 hrs pi. Zymographic assay revealed that the secretion of collagenases (type IV, type V and interstitial collagenase) were also increased. Taken together, S. typhimurium infection might induce accumulation of pericellular proteolytic activity and consequently degrade the extracellular matrix surrounding the infected cells. These in turn might enable Salmonella to invade into deeper tissues.

Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. A randomized controlled trial. Nutritional Prevention of Cancer Study Group

OBJECTIVE

To determine whether a nutritional supplement of selenium will decrease the incidence of cancer.

DESIGN

A multicenter, double-blind, randomized, placebo-controlled cancer prevention trial.

SETTING

Seven dermatology clinics in the eastern United States.

PATIENTS

A total of 1312 patients (mean age, 63 years; range, 18-80 years) with a history of basal cell or squamous cell carcinomas of the skin were randomized from 1983 through 1991. Patients were treated for a mean (SD) of 4.5 (2.8) years and had a total follow-up of 6.4 (2.0) years.

INTERVENTIONS

Oral administration of 200 microg of selenium per day or placebo.

MAIN OUTCOME MEASURES

The primary end points for the trial were the incidences of basal and squamous cell carcinomas of the skin. The secondary end points, established in 1990, were all-cause mortality and total cancer mortality, total cancer incidence, and the incidences of lung, prostate, and colorectal cancers.

RESULTS

After a total follow-up of 8271 person-years, selenium treatment did not significantly affect the incidence of basal cell or squamous cell skin cancer. There were 377 new cases of basal cell skin cancer among patients in the selenium group and 350 cases among the control group (relative risk [RR], 1.10; 95% confidence interval [CI], 0.95-1.28), and 218 new squamous cell skin cancers in the selenium group and 190 cases among the controls (RR, 1.14; 95% CI, 0.93-1.39). Analysis of secondary end points revealed that, compared with controls, patients treated with selenium had a nonsignificant reduction in all-cause mortality (108 deaths in the selenium group and 129 deaths in the control group [RR; 0.83; 95% CI, 0.63-1.08]) and significant reductions in total cancer mortality (29 deaths in the selenium treatment group and 57 deaths in controls [RR, 0.50; 95% CI, 0.31-0.80]), total cancer incidence (77 cancers in the selenium group and 119 in controls [RR, 0.63; 95% CI, 0.47-0.85]), and incidences of lung, colorectal, and prostate cancers. Primarily because of the apparent reductions in total cancer mortality and total cancer incidence in the selenium group, the blinded phase of the trial was stopped early. No cases of selenium toxicity occurred.

CONCLUSIONS

Selenium treatment did not protect against development of basal or squamous cell carcinomas of the skin. However, results from secondary end-point analyses support the hypothesis that supplemental selenium may reduce the incidence of, and mortality from, carcinomas of several sites. These effects of selenium require confirmation in an independent trial of appropriate design before new public health recommendations regarding selenium supplementation can be made

Ligand-based identification of environmental estrogens

Comparative molecular field analysis (CoMFA), a three-dimensional quantitative structure-activity relationship (3D-QSAR) paradigm, was used to examine the estrogen receptor (ER) binding affinities of a series of structurally diverse natural, synthetic, and environmental chemicals of interest. The CoMFA/3D-QSAR model is statistically robust and internally consistent, and successfully illustrates that the overall steric and electrostatic properties of structurally diverse ligands for the estrogen receptor are both necessary and sufficient to describe the binding affinity. The ability of the model to accurately predict the ER binding affinity of an external test set of molecules suggests that structure-based 3D-QSAR models may be used to supplement the process of endocrine disruptor identification through prioritization of novel compounds for bioassay. The general application of this 3D-QSAR model within a toxicological framework is, at present, limited only by the quantity and quality of biological data for relevant biomarkers of toxicity and hormonal responsiveness.

Adjustment of urinary mercury in health risk assessment of mercury

The determination of adjustment method of urinary mercury in spot urine is one of the important issues in assessing the health risks of mercury workers. But there have been debates about whether creatinine or other forms of correction for urinary concentration are better in reducing the variation of urinary mercury. We evaluated four adjustment methods-specific gravity, creatinine, log creatinine and excretion rate-by correlation between values adjusted by the four methods and individual exposure levels which were the geometric mean of daily air mercury level for 2 or 5 days, and mercury concentrations in 24 hour urine were also investigated to compare the results of spot urine. The correlation between values of spot urine and mercury exposure level was over 0.8 in all adjustment methods for workers who worked over 1 year. All four adjustment methods for urinary mercury were found to be similar in assessing the exposure, log creatinine and excretion rate method however were not practical to use due to lack of reference values, and variable standard values of specific gravity. And the creatinine adjusted values were more sensitive in low mercury exposure level. We therefore recommend the creatinine adjustment method for adjustment of urinary mercury.

Unusual small bone metastases from epithelial malignancies: diagnosis by fine-needle aspiration cytology with histologic confirmation

Although epithelial malignancies can have bone metastases, involvement of small bones is exceedingly rare, representing either first manifestation of an occult carcinoma or late disseminated disease. Small bone metastases may mimic primary skeletal diseases leading to misdiagnosis and delayed treatment. We report three cases of metastatic epithelial malignancies diagnosed by computed tomography (CT)-guided fine-needle aspiration (FNA) biopsy in two patients with lytic calcaneal lesions and a patellar lesion in a third patient; all with histologic confirmation. Case 1, a 63-year-old female, presented with heel pain. FNA and tissue biopsy of the calcaneus revealed a clear cell malignancy consistent with a renal primary. Follow-up abdominal CT scan revealed a renal lesion consistent with renal cell carcinoma. Case 2, a 37-yr-old male with squamous cell carcinoma of the esophagus, presented with foot pain. FNA and tissue biopsy of the calcaneous revealed metastatic squamous cell carcinoma. Case 3, a 52-yr-old male with a history of squamous cell carcinoma of floor of mouth, presented with knee pain and swelling. FNA and tissue biopsy of the patella revealed metastastic squamous cell carcinoma. To the best of our knowledge, this is the first complete FNA cytology report with histologic confirmation of unusual small bone metastases of the feet and patella from epithelial malignancies and shows the value of FNA cytology in establishing a correct diagnosis, and excluding primary skeletal diseases.

Significance of epithelial membrane antigen in the work-up of problematic serous effusions

Differentiation of reactive and/or atypical mesothelial cells from malignant epithelial cells in serous effusions remains a frequent diagnostic problem. Since epithelial membrane antigen (EMA) positive malignant cells in serous effusions have been reported in almost all adenocarcinomas and most malignant mesotheliomas, immunoreactivity for EMA is felt to be less useful than other antibodies in the workup of problematic serous effusions. However, immunostaining of reactive and/or atypical benign mesothelial cells for EMA has not been well studied, with only a few series reporting either weak or negative staining for EMA. This study was undertaken to evaluate how often reactive and/or atypical appearing mesothelial cells stain positively for EMA. One hundred eighty serous effusions (115 pleural, 55 peritoneal, and 10 pericardial) from 123 females and 57 males ages 20 to 89 yr were evaluated in which an antibody panel including EMA was performed on cell blocks (141 cases), cytospins (36 cases), or both (3 cases). Of the 100 cytologically positive cases, EMA immunoreactivity was present in 97/100 (97%) cases. One EMA negative case suspicious for a metastatic renal cell carcinoma was lost to follow-up and not included in the analysis. The remaining three negative cases consisted of malignancies not expected to have EMA positive cells (small cell carcinoma, neuroblastoma, and synovial sarcoma). Therefore, EMA was positive in virtually 100% of the remaining malignant cases. In the 78 cytologically negative cases, EMA positivity was present in 3/78 (3.8%) cases. Clinical follow-up of up to 14 mo in these three cases revealed no evidence of malignancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Nucleotide sequence of the pectate lyase gene from alkali-tolerant Bacillus sp. YA-14

The nucleotide sequence of the pectate lyase gene (pe lK) from alkali-tolerant Bacillus sp. was identified and analyzed. A 1,260-base pair open reading frame for the pe lK gene was observed and encoded for a protein of 420 amino acids. The signal peptide was composed of 21 amino acid residues. In the deduced primary structure of this enzyme, the three conserved regions of several pectate lyases were found and showed high homologies.

Residue lookup table processor using an optical phase conjugation correlator

Described is a new optical residue lookup table (LUT) processor that is based on the residue LUT from an optical phase-conjugated correlation output of spatial position-encoded input vector patterns in a photorefractive BaTiO(3) correlator and a holographic mapping unit to group the same residue numbers. Some preliminary experimental results of these proposed techniques are presented and discussed.

Temperature dependence of optical properties for amorphous silicon at wavelengths of 632.8 and 752 nm

The temperature dependence of the optical properties for amorphous silicon is studied at wavelengths of 632.8 and 752 nm. Both the refractive index and extinction coefficient increase linearly with temperature for 752 nm, while the refractive index decreases and the extinction coefficient increases for 632.8 nm. The rate of increase of the extinction coefficient at 632.8 nm is twice as much as that for 752 nm.

Fine-needle aspiration cytology of primary large-cell lymphoma of the mediastinum: cytomorphologic findings with potential pitfalls in diagnosis

We report the fine-needle aspiration (FNA) cytomorphologic features of six cases of primary mediastinal large-cell lymphoma with sclerosis. The series consisted of three men and three women with a median age of 36 yr. All the patients presented with a large anterior or superior mediastinal mass with no evidence of peripheral lymphadenopathy or hepatosplenomegaly. Two of the cases showed typical findings of lymphoma, characterized by hypercellular specimens with numerous individually scattered markedly atypical lymphoid cells present, demonstrating nuclear irregularity with the presence of nucleoli and surrounding scant to slight amount of cytoplasm. Numerous lymphoglandular bodies were seen in the background. Both cases were correctly diagnosed as representing non-Hodgkin's large-cell lymphomas. Two other cases had slight cellularity with the presence of a few scattered atypical lymphoid cells. Although a definite diagnosis was not rendered in either case, the possibility of malignant lymphoma was considered. Two other cases consisted predominantly of microtissue fragments with some associated scattered individual atypical cells. Within the microtissue fragments, the cells were distorted with a tendency to elongate and spindle in a prominent fibrous matrix. Our experience demonstrates that FNA cytology of primary mediastinal diffuse large cell lymphoma with sclerosis can be challenging, with a potential for a false-negative diagnosis due to limited cellularity secondary to the sclerosis or a misdiagnosis as a spindle cell neoplasm due to distortion of these cells by the fibrous matrix. To the best of our knowledge, we believe this is the first FNA series of primary mediastinal diffuse large cell lymphoma with sclerosis.

Apocrine nevus: light microscopic, immunohistochemical and ultrastructural studies of a case

The apocrine nevus (AN) is a rare tumor occurring in the upper chest and the axilla. We report a case of a AN in a 33-year-old female occurring unilaterally. The presenting complaint related to tenderness and swelling in the right axilla. The initial impression was hidradenitis suppurativa. The gross specimen revealed the presence of irregular thickening just beneath the dermal subcutaneous interface. Microscopically the lesion was composed of mature apocrine glands with apical snouts. The glands were arranged in lobules divided by thin fibrous septa. Immunohistochemical studies revealed the following profile in the glandular epithelium: positive low molecular weight cytokeratin, epithelial membrane antigen, and gross cystic disease fluid protein reactivity and negative high molecular cytokeratin and S-100 protein reactivity. Carcinoembryonic antigen reactivity was found in the duct epithelium. Ultrastructural studies revealed cells lining the lumen of the glands with a concentration of granules in the apical region and light and dark granules. These findings support the previously described light microscopic observations and provide unreported ultrastructural studies in this rare tumor.

CEA immunoreactivity in metastatic malignant melanoma

Immunohistochemical techniques may aid in the diagnosis of poorly differentiated metastatic tumors. Anti-carcinoembryonic antigen (CEA) antibodies have been used in the identification of epithelial neoplasms. However, recent unpublished data report CEA reactivity in malignant melanoma and melanoma cell lines. We studied 28 cases of known metastatic malignant melanoma with an antibody panel for CEA (polyclonal and monoclonal), AE1:3, S-100, and HMB-45. Reactivity for CEA (polyclonal) was seen in 15 of 28 (53%) cases: nine exhibited strong diffuse positivity, five moderate focal positivity, and one globular cytoplasmic staining. Focal reactivity for cytokeratin (AE1:3) was seen in three of 28 cases. HMB-45 staining was present in 23 of 28 (82%, including strong positivity in the cytokeratin-reactive cases). Staining for S-100 protein was strong in all cases. No staining was seen for CEA (monoclonal). CEA immunoreactivity is seen in a significant number of metastatic malignant melanoma cases. This may be due to CEA expression by tumor cells, or crossreactivity of the polyclonal antibody with substances such as nonspecific crossreacting antigen (NCA) that share antigenic sites with CEA. These findings emphasize the need for care in interpreting immunohistochemical results. Immunohistochemical evaluation of CEA should not be made alone, but only as part of a diagnostic antibody panel.

Nonviable autologous bronchoalveolar lavage cell preparations induce intradermal epithelioid cell granulomas in sarcoidosis patients

Intracutaneous injection of sarcoidosis patients with Kveim-Siltzbach antigen (KSAg), a particulate suspension of granulomatous sarcoidal spleen, induces an influx of T-helper lymphocytes and monocyte-macrophages followed by epithelioid cell granuloma formation. In the lung, similar granulomas form from an alveolitis of similar mononuclear cells, which may harbor a Kveim-like granulomagenic factor. To assess this possibility, preparations of nonviable autologous bronchoalveolar lavage cells (NABC) and KSAg were injected intracutaneously at different sites and biopsied at 4 to 5 wk. Of 22 sarcoidosis patients, nine (41%) developed typical granulomas at the NABC site, while all developed granulomas at the KSAg site. Responders to NABC had more recent onset of symptoms than nonresponders (3.2 versus 23.7 months, p less than 0.01), but did not have significantly higher percentages of lavage lymphocytes or more rosetting of lymphocytes about alveolar macrophages. None of 11 normal volunteers developed granulomas in response to NABC. Epithelioid cell granulomas at NABC and KSAg sites were similar by hematoxylin-eosin staining and by biotin-avidin-peroxidase immunohistochemical staining with monoclonal antibodies Leu-1, Leu-14, Leu-2a, Leu-3a, anti-interleukin-2 receptor, and polyclonal antibodies against lysozyme and alpha 1-anti-chymotrypsin. Symptomatic onset of sarcoidosis is associated with an autologous lavage cell factor that induces intradermal epithelioid cell granulomas that are immunophenotypically similar to Kveim-induced granulomas.

CO uptake kinetics of red cells and CO diffusing capacity

The rate at which CO displaces oxygen from combination with hemoglobin in intact red cells was measured spectrophotometrically in whole blood thin films that minimize unstirred layer extra-cellular diffusion barriers. A step-change was made in CO tension from zero to one of four values (2, 7, 21 and 70 Torr) during a constant background of one of eight O2 tensions (0, 40, 70, 100, 153, 214, 285 and 428 Torr). For PO2 greater than 100 Torr measured red cell initial CO uptake rates were compared with calculated rates at the same PCO-PO2 based on the Gibson-Roughton rate equation (Gibson and Roughton, Proc. R. Soc. B 143: 310-334, 1955) for a well mixed Hb solution. Measured CO uptake rates expressed as initial rate of saturation change (delta S/delta t) quantitatively followed the theoretical rate equation (time in seconds) [sequence: see text] These measurements provide new values for theta CO, the specific conductance of whole blood (ml.min-1.Torr-1; PCO, PO2 in Torr): [sequence: see text] These results signify that in vivo, in normoxia and hyperoxia, red cell CO uptake rate is wholly reaction rate limited and that pulmonary capillary red cell CO diffusion equilibrium is rapidly achieved. The Bohr-Krogh assumption that red cell PCO = 0 during CO uptake is untrue.

Prenatal diagnosis of Pompe's disease (type II glycogenosis) in chorionic villus biopsy using maltose as a substrate

Uncultured trophoblasts obtained from chorionic villus biopsy during the gestation period of 8-12 weeks were assayed for alpha-glucosidase activity using maltose as the substrate. Only one major form of maltase activity with a pH optimum at 4.0 was demonstrated. Using this method, we performed prenatal diagnosis on three pregnancies at risk for the infantile form of type II glycogen storage disease. Two affected fetuses and one unaffected fetus were predicted and the diagnosis was subsequently confirmed. The maltose assay offered a direct, simple, and sensitive method for prenatal diagnosis of Pompe's disease in the first trimester.

Fine needle aspiration cytology of desmoplastic malignant melanoma. A case report

The cytologic features of a recurrent desmoplastic malignant melanoma (DMM) examined by fine needle aspiration biopsy are reported. Cytologic examination revealed multiple microtissue fragments as well as smaller, dissociative aggregates composed predominantly of spindle-shaped neoplastic cells with hyperchromatic nuclei, small but prominent nucleoli and no cytoplasmic pigment or intranuclear pseudoinclusions. The tumor cells exhibited weak cytoplasmic staining for S-100 protein. To the best of our knowledge, this is the first reported case report describing the cytologic findings of DMM. Problems in differential diagnosis are discussed.

Brain abscess in glycogen storage disease type Ib

Neutropenia, neutrophil dysfunction, and recurrent infections are important manifestations of glycogen storage disease type Ib. We report here a child who has had adequate metabolic control, but developed brain abscess, an infection not previously described in this disease. This case provides further evidence that the neutrophil anomaly is related to the basic enzyme defect, not secondary to the metabolic derangement.

Hemangiopericytoma of the spleen

A splenic tumor is reported with the light microscopic, immunohistochemical, and ultrastructural features of a hemangiopericytoma. The findings in this case are compared with the only previously reported splenic hemangiopericytoma. Differences in the clinical presentation and the gross appearance of the two cases are described, and similarities in the microscopic features are discussed.

45,X/47,XYY mosaicism: clinical discrepancy between prenatally and postnatally diagnosed cases

45,X/47,XYY mosaicism is a rare chromosomal disorder with clinical information limited to 11 postnatal cases in the literature and with uncertainty regarding prenatal prediction of phenotype and prognosis. We report on 7 new cases of 45,X/47,XYY mosaicism, three detected prenatally and 4 diagnosed postnatally. A clinical comparison of the cases of 45,X/47,XYY mosaicism is presented together with a literature review.

M input radix p optical logic operations in a photorefractive BaTiO(3) crystal

A generalized coding algorithm for multiple inputs multiple-valued logic operations is proposed. This algorithm can reduce the unused pixels generated in the encoding process of the odd number of inputs. Using circle-type coded patterns and the correlation property in a photorefractive BaTiO(3) crystal, m input radix p logic operations are made possible. Detailed descriptions and advantages of the proposed method are presented and its effectiveness is demonstrated in the case of a three-input binary system. Uses for the proposed method, including binary half-adder/subtractor and binary multiplier, are given.