Restoration of decreased N-methyl-d-asparate receptor activity by brain-derived neurotrophic factor in the cultured hippocampal neurons: involvement of cAMP

Brain-derived neurotrophic factor (BDNF) may play an important role in the modulation of N-methyl-d-asparate (NMDA) receptor function. To elucidate the underlying mechanisms, whole-cell patch-clamp recording was used to assess the effect of BDNF on the responses of cultured hippocampal neurons to the glutamate receptor agonist NMDA. We found that peak amplitude of NMDA-evoked currents in cultured hippocampal pyramidal neurons at Day 18 in vitro decreased significantly compared to that of NMDA currents at Day 10 or 14. Interestingly, NMDA-evoked currents were greatly enhanced by BDNF (50 ng/ml) in cultured neurons at Day 18, but not at Day 10 or 14. Treatment with Rp-cAMP abolished the potentiating effects of BDNF on NMDA current. Elevating the amount of cytosolic cAMP by preincubation with forskolin or Sp-cAMP also enhanced NMDA currents as effectively as BDNF in 18-day-old hippocampal neurons. Measurement of the cellular content of cAMP by RIA indicated that cultured hippocampal neurons showed decreased basal cAMP levels at the time NMDA currents were decreased and BDNF increased the decreased cAMP levels. Taken together, these results suggest that BDNF may restore decreased NMDA receptor activity in cultured hippocampal neurons by the cAMP pathway.

Analytical expressions of quadratic and cubic phases in a three-element resonator for kerr-lens mode locking

We present analytical expressions of quadratic and cubic phases in a three-element resonator for Kerr-lens mode locking. Variation of quadratic and cubic phases with wedge angles of Ti:sapphire and apex angles of a prismatic output coupler are calculated. The results provide a theoretical basis for the design of a three-element cavity.

Hyperinsulinemia and insulin resistance related metabolic syndrome

BACKGROUND

A cross-sectional study in northern Taiwan was conducted to investigate the role of serum insulin level on the development of hyperglycemia, hypertension, obesity and hyperlipidemia.

METHODS

Demographic data (age, gender), body mass index, blood pressure, and laboratory blood tests (uric acid, total cholesterol, triglycerides, glucose and immunoreactive insulin when fasting and two hours after loading 75 gm glucose) were collected. A logistic model or polychotomous model, treating each chronic disease (hyperglycemia, hypertension, obesity and hyperlipidemia) as a dependent variable, were fitted to study the effect of serum insulin level.

RESULTS

Four hundred and twenty one volunteers (women:men = 237:184) were recruited from 1991 to 1993. Women were more obese and had more hyperglycemia, while the frequency of hyperuricemia was lower than of men. Women with a higher level of the sum of fasting and 2-hour post glucose load insulin (SIRI) levels had higher frequencies of glucose intolerance, hypertension, obesity and hyperlipidemia, whereas SIRI was related to only obesity and hyperlipidemia in men. The high plasma SIRI was a risk factor for both impaired glucose tolerance (IGT) and obesity in women. Men with a high plasma SIRI showed a more than three-fold risk of obesity.

CONCLUSIONS

We have observed that a higher serum insulin level was significantly associated with the development of metabolic manifestations (glycemic status and obesity) in a suburban community in northern Taiwan. Men and women with a higher serum insulin level probably had a greater chance of developing obesity, and women had a greater chance of developing IGT.

Trends in the clinical characteristics of patients with papillary thyroid carcinoma in Taiwan

The incidence of thyroid cancer is influenced by many factors including socioeconomic status. As economic conditions have improved in Taiwan, the increased frequency of medical examinations in the general population has led to earlier diagnosis of this indolent malignancy. The purpose of this retrospective study was to compare the clinical characteristics of cases of papillary thyroid cancer diagnosed over a 6-year period from 1993 to 1998 with those patients diagnosed from 1977 to 1992 at a single medical center. Of the 1,485 pathologically verified cases of thyroid cancer from 1977 to 1998, 1, 093 had papillary thyroid carcinoma. The mean age of these patients was 40.4 +/- 14.6 years. In order to identify trends in the characteristics of patients with thyroid cancer, patients were divided into those diagnosed before and those diagnosed after 1993. Patients diagnosed in these two time periods were also categorized into disease-free or non-disease-free groups depending on their status at the end of 1998. Actuarial survival rates were calculated using the Kaplan-Meier method. Multivariate analysis was performed to assess the independent effect of these variables using the Cox model. By December 1998, 61 (5.6%) of the 1,093 patients with papillary thyroid carcinoma had died. Among them, only 35 (3.2%) patients had died of thyroid cancer. The 5-year Greenwood survival probabilities for the groups diagnosed before and after 1993 were 0. 9412 and 0.9817, respectively. The patients diagnosed after 1993 received more aggressive surgical procedures, had smaller tumor size, lower postoperative thyroglobulin levels, less advanced clinical stage at the time of diagnosis, showed more disease-free survival, and a lower mortality rate. In conclusion, the results of this study show that patients with a diagnosis of papillary thyroid cancer after 1993 had a smaller tumor size and a better prognosis than those diagnosed before 1993. This finding emphasizes the importance of early detection in thyroid cancer.

Possible role of valvular serotonin 5-HT(2B) receptors in the cardiopathy associated with fenfluramine

Dexfenfluramine was approved in the United States for long-term use as an appetite suppressant until it was reported to be associated with valvular heart disease. The valvular changes (myofibroblast proliferation) are histopathologically indistinguishable from those observed in carcinoid disease or after long-term exposure to 5-hydroxytryptamine (5-HT)(2)-preferring ergot drugs (ergotamine, methysergide). 5-HT(2) receptor stimulation is known to cause fibroblast mitogenesis, which could contribute to this lesion. To elucidate the mechanism of "fen-phen"-associated valvular lesions, we examined the interaction of fenfluramine and its metabolite norfenfluramine with 5-HT(2) receptor subtypes and examined the expression of these receptors in human and porcine heart valves. Fenfluramine binds weakly to 5-HT(2A), 5-HT(2B), and 5-HT(2C) receptors. In contrast, norfenfluramine exhibited high affinity for 5-HT(2B) and 5-HT(2C) receptors and more moderate affinity for 5-HT(2A) receptors. In cells expressing recombinant 5-HT(2B) receptors, norfenfluramine potently stimulated the hydrolysis of inositol phosphates, increased intracellular Ca(2+), and activated the mitogen-activated protein kinase cascade, the latter of which has been linked to mitogenic actions of the 5-HT(2B) receptor. The level of 5-HT(2B) and 5-HT(2A) receptor transcripts in heart valves was at least 300-fold higher than the levels of 5-HT(2C) receptor transcript, which were barely detectable. We propose that preferential stimulation of valvular 5-HT(2B) receptors by norfenfluramine, ergot drugs, or 5-HT released from carcinoid tumors (with or without accompanying 5-HT(2A) receptor activation) may contribute to valvular fibroplasia in humans.

Identification of familial hypercholesterolemia in Taiwan: report of eleven cases

BACKGROUND

Familial hypercholesterolemia is associated with a very high risk of premature coronary heart disease. In order to identify cases of familial hypercholesterolemia in Taiwan, we screened the hyperlipidemic patients in our metabolic clinics.

METHODS

Hyperlipidemic patients were screened in the metabolic outpatient department and the cases which fulfilled the clinical criteria of definitive or possible familial hypercholesterolemia were further analyzed. Their clinical characteristics, including age, gender, physical findings, past history of coronary heart disease or cerebrovascular accident (CVA), family history, and lipid profiles before and after medical treatment, were reviewed.

RESULTS

Eight women and 3 men fulfilled the diagnostic criteria. The mean age at diagnosis was 51.1 +/- 11.9 years old. Tendon xanthomas were found in 5 patients with definitive familial hypercholesterolemia. Coronary heart disease was confirmed in one patient and old CVA was noted in another 2 patients. The mean total cholesterol level was 390.3 +/- 88.9 mg/dl and the mean low density lipoprotein-cholesterol (LDL-cholesterol) level was 309.6 +/- 89.9 mg/dl before treatment. After a mean treatment duration of 45.2 months, the mean total cholesterol level and LDL-cholesterol level were 326.8 +/- 87.8 mg/dl and 249.1 +/- 91.1 mg/dl, respectively.

CONCLUSION

Clinically diagnosed familial hypercholesterolemia indeed exists in Taiwan. As compared to other reports, the mean age at diagnosis in our series was older and the majority of patients were women. Most patients were not vigorously treated and the family members were not thoroughly screened. Adequate treatment of patients with familial hypercholesterolemia in clinical practice and screening their family members are crucial in preventing new or recurrent coronary heart disease.

Effects of phorbol esters on excitation-contraction coupling and protein kinase C activity of frog twitch muscle fibers

By recording the calcium transients evoked by voltage-clamp depolarizing pulse with arsenazo III as a calcium indicator, it has been shown that 1 micromol/l phorbol 12,13-dibutyrate (PDBu), a protein kinase C (PKC) agonist, causes a transient potentiation and then a depression of the calcium transients of twitch muscle fibers in frogs. PDBu also produces an initial translocation and activation of PKC, which is followed by a down-regulation. To find out whether the effect of PDBu on the calcium transients depends on PKC, a correlated study of the effect of phorbol esters on calcium transients and PKC activity was performed. The calcium transients and PKC activity were similarly affected by PDBu in ordinary and cold-accommodated frogs, but the effects occurred more quickly in the latter. However, they still changed in parallel as in ordinary frogs. 1 or 10 micromol/l, 4-alpha-phorbol, a PKC-inactive analogue of phorbol ester, caused a partial depression of the calcium transients in cold-accommodated frogs, while PKC activity was not affected. Moreover, the transient potentiation of the calcium transients induced by 1 micromol/l PDBu could be antagonized by the PKC inhibitors 10 micromol/l chelerythrine chloride or 10 micromol/l polymyxin B (PMB). All these results suggest that: (1) the transient potentiation of calcium transients induced by PDBu is caused by activation of PKC; (2) phorbol ester can depress the calcium transients by a mechanism that is independent of PKC.

Red light suppresses N-acetylserotonin but does not elevate 5-HT and 5-HIAA of the rat pineal glands at night

HPLC with EC detector was used to study the red light effect on the rhythmicity of catecholamines (NE, DOPAC and dopamine) and indoleamines (NAS, 5-HT, 5-HIAA) in the pineal glands and retinas of the Sprague-Dawley rat. We found the prominent nocturnal elevations of NAS in rat pineal glands and the suppression of the NAS but not the elevation of 5-HT and 5-HIAA after red light exposure at night. Our data show two findings: metabolic pathway of the indoleamines (5-HT, 5-HIAA and NAS) after red light exposure at night may be different from those by white light. Second, the increased HIOMT activity that effects on 5-HT and 5-HIAA may also be involved in the indoleamine formation after red light exposure at night.

Effects of aluminum potassium sulfate on learning, memory, and cholinergic system in mice

AIM

To study the relationship between aluminum potassium sulfate (APS) and memory deficits of mice.

METHODS

30, 60, or 90 d after the mice were given daily APS i.g., the step-through latency (STL) was determined with a passive avoidance task. Aluminum (Al) contents in brain and blood were assayed with atomic absorption spectrophotometry. Acetylcholine (ACh) content in brain was determined with chemiluminescent method and choline acetyltransferase (ChAT) activity was measured radiochemically.

RESULTS

APS 1 g.kg-1 increased blood-Al only after 30 d. After 60 d, STL, ACh content and ChAT activity decreased by 46.4%, 8.5%, and 22.6%, respectively. These parameters decreased by 50%, 11.1%, and 27.8%, respectively, with increased Al in blood and brain, after 90 d. APS 0.25 g.kg-1 had no effects on mice except blood-Al. In ethylcholine mustard aziridium chloride (AF64A) treated mice, APS 1 g.kg-1 only increased blood and brain-Al.

CONCLUSION

The intake of APS 1 g.kg-1.d-1 for 60 d induced learning and memory deficits in mice.

MEK inhibitors: the chemistry and biological activity of U0126, its analogs, and cyclization products

In search of antiinflammatory drugs with a new mechanism of action, U0126 was found to functionally antagonize AP-1 transcriptional activity via noncompetitive inhibition of the dual specificity kinase MEK with an IC50 of 0.07 microM for MEK 1 and 0.06 microM for MEK 2. U0126 can undergo isomerization and cyclization reactions to form a variety of products, both chemically and in vivo, all of which exhibit less affinity for MEK and lower inhibition of AP-1 activity than parent, U0126.

Limb-threatening necrotizing alternariosis salvaged by adjunctive hyperbaric oxygen therapy

We describe, to our knowledge, the first case of limb-threatening necrotizing alternariosis whose limbs were successfully salvaged by adjunctive hyperbaric oxygen therapy (HBO2). This 58-y-old patient was immunocompromised with both diabetes and Cushing's syndrome. She suffered from necrotizing soft tissue infection of both legs caused by Alternaria. It was impossible to halt the progression of the invasive infection with standard anti-fungal treatment and aggressive surgical debridement. After the use of HBO2, the wound was stabilized and eventually healed. Adjunctive HBO2 in this case has demonstrated its role in the treatment of complicating necrotizing soft tissue infection caused by invasive fungal infection. The possible mechanisms may be the potentiation of immune responses and the enhancement of fibroblast proliferation.

Effects of high potassium and caffeine exposure on activities of Ca2+-dependent and Ca2+-independent protein kinase C in frog skeletal muscle

With the use of histone III-S as a protein kinase C (PKC) substrate, the activities of total and Ca2+-independent PKC in frog skeletal muscle were measured, and their difference is designated Ca2+-dependent PKC. In resting muscle, the total PKC was almost equally associated with the cytosol and membrane, and the ratio of membrane to cytosol PKC was about 1. However, the distribution of PKC was subtype dependent. About 60% of Ca2+-dependent PKC was located in the cytosol, whereas Ca2+-independent PKC was mainly associated with the membrane. High potassium exposure not only caused a significant translocation of Ca2+-dependent PKC from the cytosol to the membrane, but also changed the distribution of Ca2+-independent PKC, although to a lesser extent. However, in the preparations exposed to caffeine, the translocation of PKC occurred only in a Ca2+-dependent subtype. In addition, the biphasic change in membrane-associated PKC seen in high K+ exposed muscles was absent with caffeine treatment. The possible mechanisms of these differences are discussed.

Characterization of RNA products associated with or aborted by a viral RNA-dependent RNA polymerase

Ternary RNA-dependent RNA polymerase complexes were arrested at various stages of synthesis in vitro by limiting one or more NTPs. The RNAs synthesized prior to/during the arrest of the complex were characterized and the ability of the arrested complexes to continue elongation of these nascent RNAs in the presence of all four NTPs was analyzed. Nascent RNAs of 10 nt and longer remained associated with the RdRp complex and could be extended into full-length RNAs while shorter nascent RNAs were released by the complex. These results establish that previously observed RdRp-synthesized oligoribonucleotides of 8 nt or less are abortive initiation products and confirms that RdRp undergoes a transition from initiation to elongation after the synthesis of 8 nt.

Cytomegalovirus-induced massive small intestinal bleed. Case report and review of the literature

We report a case of massive small intestinal bleeding in a non-HIV positive patient treated with cyclophosphamide and steroids for polyarteritis nodosa. Tagged red blood cell studies, endoscopy, and angiograms were performed prior to exploratory laparotomy. Jejunal ulceration and bleeding were evident by serosal staining. Resected segments revealed intracytoplasmic inclusions positive for cytomegalovirus by immunoperoxidase staining. A second bleed after the resection was controlled with oral norepinephrine, prior to effective therapy with ganciclovir.

RNA synthesis by the brome mosaic virus RNA-dependent RNA polymerase: transition from initiation to elongation

The initiation and elongation phases of (-)-strand RNA synthesis in vitro by the brome mosaic virus RNA-dependent RNA polymerase (RdRp) are differentially sensitive to inhibitors. In an attempt to characterize further the transition RdRp makes from initiation to elongation, we determined the conditions needed to pause the ternary complex and complete only one round of RNA synthesis. During the transition we were able to discern step-wise increases in the affinity of RdRp for RNA by measuring sensitivity to heparin and competition for RdRp by an alternative template. Three distinct stability levels of RdRp-template interactions were found. The first stable RdRp-RNA complex was observed when RdRp bound to the RNA template. A further increase occurred when RdRp synthesized the first phosphodiester bond. A final increase occurred upon formation of between 3 and 13 phosphodiester bonds. After this last transition, RdRp appeared to be tightly committed to the template RNA. These results are analogous to the mechanism of action of DNA-dependent RNA polymerases and are relevant to protein-RNA interaction and template switching by an RdRp.

Minimal templates directing accurate initiation of subgenomic RNA synthesis in vitro by the brome mosaic virus RNA-dependent RNA polymerase

Short regions of (-)-strand brome mosaic virus (BMV) RNA3, proscripts, were shown to direct accurate in vitro synthesis of (+)-strand subgenomic RNA by the BMV RNA-dependent RNA polymerase (RdRp), facilitating characterization of the sequences and/or structures directing subgenomic RNA synthesis. Proscripts retaining fewer than 8-nt of an 18-nt polyuridylate tract located just upstream of the core promoter sequence (French R, Ahlquist P, 1988, J Virol 62:2411-2420; Marsh LE, Dreher TW, Hall TC, 1988, Nucleic Acids Res 16:981-995) directed dramatically less synthesis of 26-nt or longer products. Original levels of RNA synthesis were not restored by replacement of the 3' polyuridylate tract with polyadenylate, polycytidylate, or polyguanylate tracts, or by movement of the polyuridylate tract to the 5' end of the proscript. The polyuridylate tract presumably binds some component(s) required for RdRp activity because the addition of poly(U) [but not poly(C)] RNA to RdRp reactions decreased RNA synthesis significantly. Quite surprisingly, deletions of the polyuridylate tract in proscripts directing synthesis of 24-nt or shorter products had little or no detrimental effect on subgenomic RNA synthesis, correlated with their inability to form a computer-predicted stem-loop present in longer proscripts requiring the polyuridylate tract. Successive 3' and 5' deletions demonstrated that the minimal elements required for accurate initiation of subgenomic RNA synthesis are within a proscript of 22-nt.

Initiation of (-)-strand RNA synthesis catalyzed by the BMV RNA-dependent RNA polymerase: synthesis of oligonucleotides

RNA replication, a process of fundamental importance for pathogenesis by many viruses, remains poorly understood at the mechanistic level because relatively few of the responsible enzymes have been purified and characterized biochemically. Partially purified RNA-dependent RNA polymerase (RdRp) from brome mosaic virus (BMV)-infected barley leaves is able to synthesize (-)-strand RNAs from input (+)-strand templates. In resolving RdRp products generated during (-)-strand BMV RNA synthesis, we found that an RNA of eight nucleotides was generated at approximately 10-fold molar excess to the full-length (-)-strand RNA. Production of the 8-mer was dependent upon and specific to BMV RNA templates. Furthermore, inhibitors of full-length (-)-strand RNA synthesis by RdRp also affected the production of the 8-mer. Analysis of the sequence of the 8-mer suggests that it is initiated at the authentic initiation site on the BMV RNA template, consistent with the possibility that the 8-mer is an abortive initiation product of RNA synthesis by RdRp in vitro. Addition of heparin or Mn2+ differentially affected production of the 8-mer and full-length (-)-strand RNA, as did some nucleotide changes near the site of RNA initiation. These studies further define the initiation process of (-)-strand RNA synthesis.

Initiation of minus-strand RNA synthesis by the brome mosaicvirus RNA-dependent RNA polymerase: use of oligoribonucleotide primers

Various DNA- and RNA-dependent RNA polymerases have been reported to use oligoribonucleotide primers to initiate nucleic acid synthesis. For the brome mosaic virus RNA-dependent RNA polymerase (RdRp), we determined that in reactions performed with limited GTP concentrations, minus-strand RNA synthesis can be stimulated by the inclusion of guanosine monophosphate or specific oligoribonucleotides. Furthermore, guanylyl-3',5'-guanosine (GpG) was incorporated into minus-strand RNA and increased the rate of minus-strand RNA synthesis. In the presence of GpG, RdRp's Km for GTP decreased from 50 microM to approximately 3 microM while the Kms for other nucleotides were unaffected. These results have implications for the mechanism of initiation by RdRp.

Comparison of the outcome between the calculated dosimetry and the estimated dosimetry of 131I in the treatment of hyperthyroidism

To compare the outcomes of different methods in prescribing the optimal dose of radioactive iodine (131I) for the treatment of hyperthyroidism, we retrospectively analyzed 52 patients with toxic diffuse goiter. They received single dose of 131I for the treatment of hyperthyroidism. In addition, all of them met the following criteria: 1) symptoms and signs of hyperthyroidism; 2) elevated blood triiodothyronine (T3) and thyroxin (T4) by radioimmunoassay (RIA) method; 3) diffuse goiter with increase of uptake proved by thyroid scintiscan; 4) only one dose of 131I was given during the follow-up period; 5) well-documented thyroid function test in the medical chart during the follow-up period (6 months, 1 year, 2 years and 5 years after 131I therapy). The enrolled patients were divided into estimated and calculated group. The dose of 131I in the calculated group was obtained from the measurement of size and 131I uptake of thyroid gland. The dose of 131I in the estimated group was prescribed according to the size of thyroid gland by physical examination, and the association with cardiac arrhythmia, congestive heart failure, or ischemic heart disease. The mean doses of 131I were 4.8 +/- 1.4 mCi and 7.0 +/- 1.1 mCi in the calculated and estimated group respectively. In this study, there were no significant difference in the incidence of euthyroidism, hyperthyroidism, and hypothyroidism between these two groups in thefollow-up period after 131I therapy. In view of simplicity and time-saving, it is a practical choice to prescribe the dose of 131I therapy for toxic diffuse goiter according to the size of thyroid gland and the associated cardiac condition.

[User guide to change endotracheal tubes]

A new way to manage artificial airway was introduced and estimated in this research. Six patients, who needed replacements of endotracheal tubes by varies reasons, were studied by using a guide wire through the existing endotracheal tube then removing the tube, and a new one was threaded over the wire into the trachea. During the procedure, the patient's HR,SaO2 and other clinical symptoms were monitored. It was compared with the control group of ten patients in which the old changing method was used. The result showed that average replacing time of study group, which was 30 sec, was much shorter than that of the control group, which was 20 min. there were no significant changes of HR and SaO2, no complications happened, and all the tubes were changed successfully with one time in study group. For the control group, the HR increased about 27 beats/min, SaO2 decreased about 10%, some patients were restlessness, had nose bleeding, or intubated into the esophagus and one patient had apnea. The success rate was only 67%. It is recommended that the new method is easier, less dangerous, less painful, and more successful.

Activity of DMP 840, a new bis-naphthalimide, on primary human tumor colony-forming units

BACKGROUND

DMP 840 ((R,R)-2,2'-[1,2-ethanediylbis[imino(1-methyl-2,1-ethanediyl)]]- bis[5-nitro-1H-benz[de]-iso[quinoline-1,3(2H)-dione]dimethane- sulfonate; NSC-D640430) is one in a series of bis-naphthalimides that binds DNA with high affinity and has sequence specificity to multiple G and C bases. It is also a potent inhibitor of RNA synthesis. DMP 840 has been selected for clinical evaluation on the basis of a broad spectrum of activity (including cures) in human tumors in murine models.

PURPOSE

We evaluated DMP 840 in a human tumor clonogenic assay to estimate what plasma concentrations may be necessary for clinical cytotoxic activity and to determine what types of tumors potentially might be primary targets for initial phase II studies.

METHODS

A soft-agar cloning system assay was used to determine the in vitro effects of DMP 840 against cells from biopsy specimens of colorectal, breast, lung ovarian, renal cell, stomach, and bladder cancers and from other tumor types. A total of 260 human tumor specimens were exposed continuously during the assay to DMP 840; 103 were assessable (20 colonies or more on control plates and 30% or less survival for the positive control). An in vitro response was defined as at least a 50% decrease in tumor colony formation resulting from drug exposure compared with controls.

RESULTS

In vitro responses were seen in 10% (one of 10), 54% (55 of 101), 80% (82 of 103), and 89% (82 of 92) of specimens tested at 0.01, 0.1, 1.0, and 10.0 micrograms/mL of DMP 840, respectively. At a concentration of 0.1 microgram/mL, specific activity was seen against melanoma (80%) and against renal cell (80%), ovarian (63%), breast (54%), non-small-cell lung (42%), and colorectal cancers (33%). DMP 840 demonstrated activity in tumor specimens resistant in vitro to methotrexate (88%), doxorubicin (58%), platinum (57%), cyclophosphamide (53%), vinblastine (53%), etoposide (53%), fluorouracil (37%), and paclitaxel (36%).

CONCLUSIONS

At in vitro concentrations of 0.1 microgram/mL as a continuous exposure, DMP 840 has activity against a variety of human tumors, including a subgroup resistant in vitro to standard antineoplastic agents.

IMPLICATIONS

Further clinical development of DMP 840 is warranted.

[Operative treatment for vulvar cancer by different methods]

A retrospective analysis of 88 patients with vulvar cancer treated by radical vulvectomy and groin lymphadenectomy from July, 1958 to December, 1990 is presented. 88 cases are divided into two groups based on different operative methods: the enbloc group (25 cases) and the non-enbloc group (63 cases). No significant statistic differences are found in the 5-year survival rates (76.0% vs 79.8%) and the complications (erysipelas, lower extremity edema) between the two groups. The wound healing time is 14.4 days shorter in the non-enbloc group than enbloc group. Factors such as clinical staging, metastasis to the inguinal lymph nodes and histopathological classification are also investigated for correlation with the prognosis.