Nonselective beta-adrenergic blockade with carvedilol does not hinder the benefits of exercise training in patients with congestive heart failure

BACKGROUND

Long-term beta-adrenergic blockade does not appear to be associated with drug-induced training in patients with congestive heart failure (CHF); whether exercise training can increase peak aerobic capacity in patients with CHF who are treated with beta-adrenergic blockers is currently unknown.

METHODS AND RESULTS

We studied 23 patients with CHF who were treated with carvedilol or propranolol in addition to ACE inhibitors, furosemide, and digoxin. Of the patients treated with carvedilol, 8 underwent exercise training and 8 remained sedentary. All 7 patients treated with propranolol underwent exercise training. Peak oxygen consumption (mL.kg-1.min-1) was serially measured in trained and sedentary patients. Peak reactive hyperemia (mL.min-1.100 mL-1) was determined in the calf and forearm immediately before and after 12 weeks of training. The peak oxygen consumption of trained patients treated with either carvedilol or propranolol increased from 12.9 +/- 1.4 to 16.0 +/- 1.6 (P < .001) and 12.4 +/- 1.0 to 15.7 +/- 0.9 (P < .001) mL.kg-1.min-1, respectively, whereas it did not change in the sedentary patients. Peak reactive hyperemia increased significantly in the calves but not the forearms of trained patients.

CONCLUSIONS

Long-term, nonselective beta-adrenergic blockade with carvedilol or propranolol does not prevent patients with CHF from deriving systemic and regional benefits from physical training.

Dissociation between upper and lower neck N13 potentials following paired median nerve stimuli

Cervical N13 potential in response to the median nerve stimulation can be recorded either from upper (Cv2) or lower (Cv6) neck with almost equal amplitudes and latencies. It has long been debated whether they represent the same or different generator sources. Using a conditioning-test paired stimuli paradigm, we examined the differences of recovery function of Cv2- and Cv6-N13, anterior neck (AN)-P13, and scalp recorded P13/P14 in 6 healthy subjects. All cervical electrodes were referenced to the non-cephalic site. Scalp response was recorded with linked ear reference. The inter-stimulus intervals ranged from 4 to 20 ms with 2 ms increments. Throughout 4 to 18 ms ISI, Cv6-N13, AN-P13 and scalp P13/P14 were suppressed, whereas Cv2-N13 was facilitated. All but scalp P13/P14 returned close to the control at 20 ms ISI. The findings indicate that Cv2-N13, Cv6-N13 and scalp P13/P14 are independent each other and arise from different generator sources. The suppression of Cv6-N13 is consistent with a postsynaptic nature of this potential and may indeed be mediated through dorsal horn interneurons creating a current field orientation in the posterior-anterior direction. The facilitation of Cv2-N13 suggests that this is a presynaptic potential and may travel through the dorsal column with vertical orientation. The longer period of suppression of scalp P13/P14 suggests it to be of polysynaptic origin and to arise at least rostral to the cuneate nucleus.

Molecular characterization of the V regions of four IgE antibodies specific for trichosanthin

We report here the cDNA cloning and variable region nucleic acid sequences of the heavy and the light chains of four monoclonal IgE and one monoclonal IgG1 antibodies against trichosanthin (TCS), all of which recognized a similar or related antigenic determinant. Sequence analysis revealed that the VH regions of the four IgE antibodies use different V gene segments from the 7183, 36-60 and J558 families. The DH genes varied extensively in nucleotide sequence and length, with D segments DSP2, DFL16 and DQ52 being used with equal frequency. All JH gene segments except JH1 were present in the epsilon transcripts. In contrast, there appeared to be restricted L-chain utilization. All four L-chain V genes cloned belonged to the V kappa 21 family and a bias in the use of J kappa 1 gene was also observed. The VL sequences of the anti-TCS monoclonal antibodies showed much less diversity than the VH sequences. We propose that the L-chain rather than H-chain may play a more significant role in specific binding with allergenic determinant on TCS.

Circulating levels of cytokines and their endogenous modulators in patients with mild to severe congestive heart failure due to coronary artery disease or hypertension

OBJECTIVES

This study sought to determine the circulating levels of cytokines and their respective endogenous modulators in patients with congestive heart failure of variable severity.

BACKGROUND

Activation of immune elements localized in the heart or periphery, or both, may promote release of cytokines in patients with congestive heart failure. Although an increased circulating level of tumor necrosis factor-alpha (TNF-alpha) and its soluble receptor type II (sTNF-RII) is well documented, less is known about other cytokines (i.e., interleukin-1-beta [IL-1-beta], interleukin-6 [IL-6] and interleukin-2 [IL-2] and their soluble receptor/receptor antagonists).

METHODS

Circulating levels of TNF-alpha and sTNF-RII, IL-1-beta, IL-1 receptor antagonist (IL-1-Ra), IL-6, IL-6 soluble receptor (IL-6-sR), IL-2 and IL-2 soluble receptor-alpha were measured using enzyme-linked immunosorbent assay kits (Quantikine, R&D Systems) in 80 patients with congestive heart failure due to coronary artery disease or hypertension. The severity of their symptoms, which ranged from New York Heart Association functional class I to IV, was confirmed by measurement of peak oxygen consumption.

RESULTS

The percentage of patients with elevated levels of cytokines and their corresponding soluble receptor/receptor antagonists significantly increased with functional class. For TNF-alpha and IL-1-beta, the percentage of patients with elevated levels of soluble receptor/receptor antagonists was higher than that of patients with elevated levels of the cytokine itself. For IL-6, the percentage of patients with elevated levels of IL-6-sR tended to be lower than that of patients with elevated levels of IL-6. All but two patients had undetectable levels of IL-2, and all but seven had levels of IL-2-sR within a normal range.

CONCLUSIONS

In patients with congestive heart failure, circulating levels of cytokines increased with the severity of symptoms. In these patients, circulating levels of sTNF-RII and IL-1-Ra are more sensitive markers of immune activation than are circulating levels of TNF-alpha and IL-1-beta, respectively. Levels of IL-2 and IL-2-sR are not elevated when congestive heart failure is due to coronary artery disease or hypertension.

Diagnosing narcolepsy through the simultaneous clinical and electrophysiologic analysis of cataplexy

OBJECTIVE

To demonstrate the utility of accurate clinical and electroencephalographic characterization of provoked cataplexy spells in the diagnosis of narcolepsy.

METHODS

Four individuals, three with suspected and one with known narcolepsy, were clinically assessed during split-screen, video polysomnographic monitoring sessions after cataplectic events were induced by emotional provocation.

RESULTS

The subjects experienced a total of nine cataplectic-like events, one occurring spontaneously (sleep paralysis) in association with a hypnagogic hallucination. During all events, the patients appeared to be sleeping with polysomnographic rapid eye movement sleep patterns, but when questioned they were able to give appropriate verbal responses. The diagnosis of narcolepsy was substantiated in all cases using standard overnight polysomnograms and multiple sleep latency tests.

CONCLUSION

The diagnosis of narcolepsy can be greatly enhanced by documenting cataplexy with thorough clinical assessment and demonstration of typical rapid eye movement sleep patterns during provoked spells in the course of polysomnographic monitoring sessions.

Rat intestinal and hepatic ferritin subunit expression during development and after dietary iron feeding

Ferritin consists of 24 heavy (H) and light (L) subunits in varying proportions in different tissues and plays a significant role in iron metabolism. We studied rat ferritin subunit expression in the duodenum and liver during early life, when a cycle of iron depletion and repletion occurs. In both tissues, ferritin contents decreased to low levels from day 3 to day 12. The ferritin on day 3 had an H/L mRNA ration of 0.9 and an H/L subunit ratio of 0.6. The decrease of tissue ferritin levels, but not mRNA, on day 12 suggests translational repression consistent with iron depletion. In the duodenum, a twofold increase in both H and mRNA and subunit protein occurred on day 18. The subsequent increase of H mRNA was accompanied by a 50% decrease in L mRNA, resulting in the increase of H/L mRNA and subunit ratios to 7.9 and 9, respectively, by day 32. In contrast, liver H/L mRNA and subunit ratios were similar throughout development. The possibility that dietary iron regulates duodenal ferritin subunit expression was investigated. When day 12 rats were fed 6 ml of a milk formula containing 56 microgram/ml iron for 18 h, dietary iron increased the duodenal levels of L mRNA but not H mRNA. In contrast, hepatic H and L mRNA levels did not change. Dietary iron promoted greater increases in ferritin protein than mRNA in both tissues. Thus a shift from L-rich to H-rich ferritin isoforms occurs in the duodenum but not in the liver during neonatal development. This change is regulated at the pretranslational level and is independent of dietary iron.

Effects of exogenous cytokines on the ethanol-mediated suppression of murine thymocyte proliferation

Although attempts have been made to assess the effect of ethanol on murine thymocyte proliferation, the mechanism which accounts for the immunosuppressive effect of ethanol on the thymocyte proliferation has not been elucidated. Thus, a mouse model was used to determine (1) whether there is a similarity in the effect of ethanol exposure in vitro and in vivo on the proliferative response of thymocytes to phytohemagglutinin (PHA), (2) whether ethanol exposure affects the responsiveness of thymocytes to exogenous interleukin (IL)-1 and IL-2, and (3) whether ethanol affects IL-1 production by peritoneal macrophages. We found that the proliferative response of thymocytes from mice fed on an ethanol-containing diet was significantly inhibited (P < 0.05) compared to that in mice fed on maltose or standard diets. We also observed that low concentrations of ethanol (12.5 mM) appeared to enhance the mitogenic response of thymocytes to PHA, but the response was not significantly greater than that of controls (P > 0.05). Ethanol at higher concentrations (25-100 mM) significantly suppressed the mitogenic response of thymocytes to PHA (P < 0.05) in a dose-dependent manner. Our data also revealed that (1) ethanol did not significantly suppress IL-1 secretion by adherent macrophages stimulated by LPS, and (2) the addition of exogenous IL-1 was insufficient to restore full responsiveness in thymocytes from ethanol-fed mice. Taken together, these results suggest that the suppressive effect of ethanol on thymocyte proliferation is not mediated by insufficient IL-1. Finally, we present novel evidence that addition of exogenous IL-2 completely restores the impaired proliferative response of thymocytes from ethanol-fed mice to control levels. In summary, our results demonstrate that ethanol inhibits thymocyte proliferation in response to PHA, and that the inhibition is not due to insufficient IL-1. We also report that addition of exogenous IL-2 is sufficient to restore full proliferative capacity to thymocytes from ethanol-fed mice.

Topographic analyses of somatosensory evoked potentials following stimulation of tibial, sural and lateral femoral cutaneous nerves

Using topographic maps, we studied the scalp field distribution of somatosensory evoked potentials (SEPs) in response to the stimulation of the tibial (TN), sural (SN) and lateral femoral cutaneous (LFCN) nerves in 24 normal volunteers. Cortical peaks, i.e., N35, P40, N50 and P60 were generally dominant in the contralateral hemisphere for the LFCN-SEP, whereas all peaks except N35 had dominance in the ipsilateral hemisphere to TN- and SN-SEPs. The findings imply that ipsilateral or contralateral peak dominance for the lower extremity SEP is determined by where the cortical leg representation occurs. As a result, mesial hemisphere representation results in peak dominance projected to the hemisphere ipsilateral to stimulation. Representations at the superior lip of the interhemispheric fissure or lateral convexity lead to midline or contralateral peak dominance. These findings also suggest that the paradoxically lateralized P40 is not the result of a positive field dipole shadow generated by the primary negative wave in the mesial hemisphere, but is the primary positive wave, analogous to P26 of the median nerve SEP. Accordingly, contralaterally dominant N35 is likely equivalent to the first cortical potential of N20 in the median nerve SEP. The difference in vector directions of potential fields between N35 and P40 may account for the opposite hemispheric dominance for these peaks in TN- and SN-SEPs.

Return rates and outcomes from ethnicity-specific mental health programs in Los Angeles

OBJECTIVES

The present study compared the return rate, length of treatment, and treatment outcome of ethnic minority adults who received services from ethnicity-specific or mainstream programs.

METHODS

The sample consisted of 1516 African Americans, 1888 Asian Americans, and 1306 Mexican Americans who used 1 of 36 predominantly White (mainstream) or 18 ethnicity-specific mental health centers in Los Angeles County over a 6-year period. Predictor variables included type of program (ethnicity specific vs mainstream), disorder, ethnic match (whether or not clients had a therapist of the same ethnicity), gender, age, and Medi-Cal eligibility. The criterion variables were return after one session, total number of sessions, and treatment outcome.

RESULTS

The study indicated that ethnic clients who attended ethnicity-specific programs had a higher return rate and stayed in the treatment longer than those using mainstream services. The data analyses were less clear cut when treatment outcome was examined.

CONCLUSIONS

The findings support the notion that ethnicity-specific programs seem to increase the continued use of mental health services among ethnic minority groups.

Caesarean section in a patient with protein S deficiency

Protein S is a nonenzymatic and vitamin K-dependent cofactor of activated protein C. Without protein S, the anticoagulant function of protein C is almost depleted and thrombotic events occur. We report a parturient with hereditary protein S deficiency in whom the risk of thromboembolism was further complicated by pregnancy and who required emergency Caesarean section for fetal distress.

Dissociated changes of frontal and parietal somatosensory evoked potentials in sleep

We studied the changes of frontal and parietal somatosensory evoked potentials (SEPs) in the awake state versus different stages of sleep in 10 normal adult subjects. Frontal and parietal SEP components were affected differentially as sleep stages progressed. In general, the amplitudes of frontal components, notably P22, were increased in sleep, whereas the amplitudes of parietal components were decreased in sleep. A sensitive waveform change from the awake state to sleep was present in the frontal response, where a subtle notched negativity, termed "N40," was present only in the awake state and quickly dissipated in all stages of sleep, including stage 1. The amplitude changes from the awake state to stage 3/4 sleep were neither linear nor parallel among SEP components. The most discordant changes occurred in stage 3/4. The amplitudes for the frontal N18-P22-N30 complex and parietal N20-P26-N32 complex increased from stage 2 to stage 3/4, while those for frontal N30-fP40 and parietal N32-pP40 decreased. In contrast to these divergent amplitude changes, the latencies of all components except P14 and frontal N18 showed progressive prolongation from the awake state to slow-wave sleep. The SEP waveforms and latencies in REM sleep approximated those in the awake state, although amplitudes for frontal peaks still remained slightly higher and amplitudes for parietal peaks slightly lower. We postulate that interactions of excitatory and inhibitory phenomena are responsible for the component-dependent and sleep-stage-dependent amplitude enhancement or depression in sleep.

Transcriptional regulation of intestinal hydrolase biosynthesis during postnatal development in rats

Lactase-phlorizin hydrolase (LPH) and sucrase-isomaltase (SI) are intestine-specific microvillus membrane hydrolases whose specific activities demonstrate reciprocal regulation during development but whose mechanisms of regulation have not been fully defined. To investigate transcriptional control of these two proteins, the rat LPH and SI genes were cloned, and antisense probes for preprocessed mRNAs (pre-mRNAs) were developed from intron sequence. LPH mRNA, as measured by quantitative ribonuclease (RNase) protection assays, was abundant before weaning and decreased two- to fourfold during weaning, whereas SI mRNA was first detected 14 days after birth and increased rapidly to abundant levels by age 28 days. LPH and SI pre-mRNA levels paralleled those of their respective mRNAs. LPH transcriptional rate declined during weaning, whereas that of SI increased during this time as determined by RNase protection assays of pre-mRNAs and nuclear run-on assays. In the adult rat, LPH mRNA was restricted to the jejunum and proximal ileum, whereas SI mRNA was detected throughout the small intestine, a pattern regulated by transcriptional rate as confirmed by nuclear run-on assays. Lactase and sucrase specific activities correlated well with their respective protein and mRNA concentrations in all experiments. We conclude that gene transcription plays a major role in the developmental and horizontal regulation of LPH and SI biosynthesis and that these two genes are regulated differently in rat small intestine.

Stress exacerbates neuron loss and cytoskeletal pathology in the hippocampus

Glucocorticoids (GCs), the adrenal steroids secreted during stress, endanger the hippocampus, compromising its ability to survive neurological insults. GCs probably do so by disrupting energetics in the hippocampus, thus impairing its ability to contain damaging fluxes of excitatory amino acids and calcium. Superficially, these observations suggest that stress itself should also exacerbate the toxicity of neurological insults. However, most studies have involved unphysiologic GC manipulations, limiting speculations about the endangering effects of stress. In this study, rats were infused with the excitotoxin kainic acid (KA) after either having been adrenalectomized and replaced with a range of physiologic concentrations of GCs, or having been stressed intermittently. We observed that within the CA3 region, increasing CORT concentrations exacerbated the KA-induced neuron loss, the extent of tau immunoreactivity, and of spectrin proteolysis. The transitions from low to high basal GC concentrations and from high basal to stress GC values were both associated with significant exacerbation of neuron loss and tau immunoreactivity; the extent of spectrin proteolysis was less sensitive to increments in GCs. As would be expected from these data, exposure to intermittent stress prior to KA infusion also exacerbated neuron loss, tau immunoreactivity, and spectrin proteolysis in CA3. Thus, physiological elevations of GCs, and stress itself, can exacerbate hippocampal neuron loss and the attendant degenerative markers following an excitotoxic insult. Of significance, seizure and hypoxia-ischemia provoke considerable GC stress responses, which may thus worsen the resultant damage. Furthermore, a number of neuropsychiatric disorders, as well as aging, are associated with elevated basal GC concentrations, which may endanger the hippocampus in the event of neurological insult.

Development and hormonal modulation of postnatal expression of intestinal alkaline phosphatase mRNA species and their encoded isoenzymes

In the rat, intestinal alkaline phosphatase (IAP) activity in the duodenum, but not jejunum, increases on day 22-24 after birth and exhibits higher activity hydrolysing phenyl phosphate (PhP) than beta-glycerophosphate (beta GP) [Moog and Yeh (1973) Comp. Biochem. Physiol. 44B, 657-666]. The mechanism underlying these developmental changes remains unknown. To define possible mechanisms, we have measured IAP activity and mRNA levels, and analysed IAP mRNA species and isoenzymes on postnatal days 12, 18, 24 and 32. Duodenal IAP activity and mRNA content were identical on postnatal days 12 and 18, but were 7-fold and 3-fold higher on day 24, respectively than on day 18. The increased IAP activity exhibited a high PhP/beta GP ratio and was accompanied by initial appearance of the 3.0 kb mRNA and 90 kDa isoenzyme. On day 32, duodenal IAP activity did not increase over the levels on day 24, whereas mRNA levels doubled. The lack of enzyme increase might be related in part to increased apical release, as luminal IAP activity increased from 2% of total mucosal IAP on days 12 and 18 to 7% and 14% on days 24 and 32 respectively. In the jejunum, IAP activity decreased postnatally, but mRNA content was unaltered; only the 2.7 kb mRNA and 65 kDa IAP isoenzyme were present. Administration of cortisone or cortisone+thyroxine induced simultaneous appearance of the duodenal 3.0 kb mRNA and 90 kDa isoenzyme with an increased PhP/beta GP ratio. Thus postnatal increase in duodenal IAP activity is related to the expression of a 90 kDa PhP-preferring isoenzyme encoded by the 3.0 kb mRNA. The low-PhP/beta GP-ratio 65 kDa isoenzyme is expressed in the duodenum and in the jejunum and is encoded by the 2.7 kb mRNA.

Mechanism of the impaired T-cell proliferation in adult rats exposed to alcohol in utero

Although attempts have been made to assess the effect of ethanol on the immune responses in individuals with fetal alcohol syndrome, there is no consensus as to the effect of ethanol on the immune system. Evidence that fetal alcohol-exposed (FAE) humans and animals have diminished proliferative response of T-cells to mitogenic lectins is well established. However, little is known about the mechanism of a toxic effect of ethanol on T-cell growth. Thus, a rat model was used to delineate the mode of ethanol action on T-cell proliferation. We found that the diminished T-cell proliferation in young adult FAE rats was due to a decreased responsiveness to interleukin 2 (IL2), but not to an impaired production of IL2 and expression of IL2 receptors (IL2R). Furthermore, the decreased proliferative response did not result from the presence of an excessive suppressor T-cell activity. Measurements of [Ca+2]i and T-cell proliferation were concurrently performed in batches of cells from the same animals. It was demonstrated that an increase in [Ca+2]i induced by Concanavalin A (Con A) in T-cells from FAE rats was not impaired, although the T-cell proliferation induced by Con A was significantly diminished. The results of the IL2-binding study showed that the Kd values and the number of both high- and low-affinity IL2R binding sites on the T-cells of FAE rats were comparable to those of pair-, or chow-fed rats. Finally, the results of the kinetics and rate of the internalization of IL2 showed that (1) the amount of the internalized IL2 was significantly reduced in T-cells from FAE rats, and (2) the half-time (t1/2) for dissociation of IL2 from the receptors in the T-cells from FAE rats was also greater than that of the control rats. These results taken together indicate that ethanol suppresses T-cell proliferation by interfering with events following the IL2-IL2R interaction.

Update on current models of HIV-related neuronal injury: platelet-activating factor, arachidonic acid and nitric oxide

This review aims to summarize recent work related to the pathogenesis and possible treatment of neuronal injury in the acquired immunodeficiency syndrome (AIDS), especially with reference to potential neurotoxic substances released by HIV-infected or gp120-stimulated macrophages/microglia. Approximately a third of adults and half of children with AIDS eventually suffer from neurological manifestations, including dysfunction of cognition, movement, and sensation. Among the various pathologies reported in brains of patients with AIDS is neuronal injury and loss. A paradox arises, however, because neurons themselves are for all intents and purposes not infected by human immunodeficiency virus type 1 (HIV-1). This paper reviews recent evidence suggesting that at least part of the neuronal injury observed in the brains of AIDS patients is related to excessive influx of Ca2+ after the release of potentially noxious substances from HIV-infected or gp120-stimulated macrophages/microglia. There is growing support for the existence of HIV- or immune-related toxins that lead indirectly to the injury or demise of neurons via a potentially complex web of interactions between macrophages (or microglia), astrocytes, and neurons. HIV-infected monocytoid cells (macrophages, microglia or monocytes), especially after interacting with astrocytes, secrete substances that potentially contribute to neurotoxicity. Not all of these substances are yet known, but they may include eicosanoids, i.e. arachidonic acid and its metabolites, as well as platelet-activating factor. Other candidate toxins include nitric oxide (NO.), superoxide anion (O2.-), and the N-methyl-D-aspartate (NMDA) agonist, cysteine. Similarly, macrophages activated by HIV-1 envelope protein gp120 also appear to release arachidonic acid and its metabolites, and cysteine.(ABSTRACT TRUNCATED AT 250 WORDS)

Impaired cytosolic free calcium response in splenic T-cells from mice fed with ethanol-containing diet

Calcium-dependent signal transduction pathways of T-cell proliferation have been extensively studied in the past years. However, little is known about effects of ethanol on the calcium-dependent signal transduction pathway in T-cell proliferation. Thus, a murine model was used to determine effects of ethanol in vivo on T-cell proliferation and the intracellular free calcium concentration [Ca2+]i in response to Concanavalin A (Con A) and recombinant IL2 (rIL2) in T-cells. Splenic cells from young C57BL/6 mice, that had been fed on 3 different diets (ethanol-, maltose substitute- and standard liquid-diet) for 7-8 weeks were tested for their proliferative responses to Con A and rIL2. Concurrently, measurement was also made of [Ca2+]i in the nylon-wool-enriched resting T-cells induced by Con A and in Con-A-activated blast T-cells induced by rIL2. Our results showed that [Ca2+]i increases were seen in the splenic T-cells from three different groups of mice following Con A, but not rIL2 stimulation. However, this increase was much smaller in the splenic T-cells from ethanol-fed mice as compared to mice on maltose- or standard-diet. Furthermore, we also demonstrated that the impaired [Ca2+]i increase was seen in the T-cells of the same ethanol-fed mice having decreased the proliferative response to Con A. This reduced proliferation did not result from the presence of excessive suppressor T-cell activity. Finally, we also demonstrated that both the number of IL2 binding sites/cell and the Kd values of the low- and high-affinity IL2R on the T-cells from ethanol-fed mice were unaltered. Because evidence indicates that (1) a normal level of [Ca2+]i increase is a prerequisite for the production of IL2 by mitogen-stimulated T-cells, and (2) T-cells from ethanol-fed mice have normal capacities to produce IL2 that is the crucial growth factor controlling T-cells to progress through the cell cycle, these lines of evidence taken together with the results of this study suggest that the impairment in [Ca2+]i increases in T-cells from ethanol-fed mice may not be the primary factor contributing to the diminished T-cell proliferation in the same mice.

Use of pup in a cup model to study gastrointestinal development: interaction of nutrition and pituitary hormones

The novel technique of artificial rearing (AR) of rat pups circumvents the difficulty of controlling diet composition and caloric intake. For studies of effects of nutrition and hormone interactions on gastrointestinal development, an appropriate experimental approach is to use AR rats whose corticosterone production is inhibited or abolished. Hypophysectomized (Hx) rats were used to examine whether growth retardation after Hx results from reduced caloric intake. Hx, sham-Hx and intact rats were isocalorically fed a cow-milk formula from day 12 to 18. Mother-fed (MF) Hx and intact rats were used as baseline controls. MF-Hx showed retarded intestinal growth, decreased body weight gain and reduced skeletal growth. In contrast, AR-Hx rats showed intestinal hypertrophy, normal body weight gain and reduced skeletal growth. Intestinal lactase activity remained higher in MF-Hx or AR-Hx rats than in control groups. AR-Hx rats showed no precocious increase of intestinal maltase and sucrase activity as did AR controls. Trace levels of serum growth hormone was detectable in MF-Hx but not in AR-Hx rats. We conclude that caloric intake can promote intestinal and somatic growth in the absence of the pituitary gland and pituitary hormones are required for skeletal growth and intestinal enzymic differentiation.

"Locked-in syndrome" after intrathecal cytosine arabinoside therapy for malignant immunoblastic lymphoma

A 22-year-old man with malignant immunoblastic lymphoma had "locked-in" syndrome within 48 hours of receiving a single (100 mg) dose of intrathecal cytosine arabinoside (ara-C) in conjunction with intravenous ara-C, cisplatin, and doxorubicin. Eight hours after therapy, the patient had central hypoventilation and blurred vision that progressed to blindness within 3 hours. During the next 10 hours, he became completely quadriplegic but remained intermittently alert and was able to respond to commands by eye or head movements. Radiographic studies showed necrosis of the medulla and swelling of the entire spinal cord. The patient persisted in a locked-in state until his death 3 weeks later, after removal of life support systems. Autopsy confirmed extensive necrosis of the lower medulla, optic chiasm, cranial nerves I and IV, and spinal cord. This case was unusual for its severity. The temporal relationship to ara-C instillation favors a toxic idiosyncratic response to chemotherapy. The authors advocate caution when bolus intrathecal and intravenous ara-C are administered to a patient within a short time of each other.

[The establishment of human anti-tetanus toxoid hybridomas with in vitro immunized human tonsil cells]

Human tonsil cells in vitro immunized with tetanus toxoid were fused with human-mouse heteromyeloma line RF to generate human-mouse hybridomas. Hybridoma 891112-50 was cloned and 2 subclones (891112-50-3 and -4) were obtained. The secreted antibodies from the subclones were antigen specific, since they did not cross react with three irrelevant antigens (OVA, TCS and F gamma G). The hybridomas were quite stable. After 13 passages in tissue culture flasks, they still retained their antibody secreting ability. From flow cytometry analysis the subclone 50-3 was more stable than the subclone 50-4. The human immunoglobulin contained in supernatant collected during regular passages was equivalent to 69.6 micrograms/ml.

Failure of beta-amyloid protein fragment 25-35 to cause hippocampal damage in the rat

Considerable excitement has been generated as of late over reports that fragments of the amyloid precursor protein can be neurotoxic both in vivo and in vitro. In this brief report we study the neurotoxicity of the fragment corresponding to amino acids 25-35 of the beta-amyloid protein in the hippocampus in vivo. Under the conditions studied, we do not observe any evidence of consistent, dose-related damage above that seen with vehicle alone.

[Cellular aspects of in vitro induction of antibody responses of human cells]

An in vitro system for induction of antibody responses of human cells has been established in our lab. B cell enriched fractions from excised human tonsils or trauma spleen were cultured for 7-14 days with tetanus toxoid or HBsAg vaccine with or without human T cell conditioned medium (C. M.) or a mixture of low concentrations of PWM and LPS (MTG). Positive antibody responses could be detected in cultures. Cells taken from different culture periods were subjected to FACS analysis in order to expound cellular changes during antibody induction periods so as to improve the in vitro antibody induction system. The results were described as follows: 1. Variations in total percentages of T cells during culturing periods seemed to be related its initial percentages. Cells with bigger initial percentages tended to decrease first and finally maintained at about 30%. While cells with smaller initial percentages tended to increase and finally also maintained at 30%. 2. CD4+ Th cells and CD8+ Ts cells from tonsils and spleen behaved somewhat differently. In tonsil cell cultures the percentages of CD4+ cells were often bigger than the percentages of CD8+ cells throughout the culture period. However, the inverted proportions of CD4+/CD8+ were shown in spleen cell cultures, especially in the culture with C. M. The possible relationships between the variations in CD4+/CD8+ proportions described as above and the intensities of antibody responses were discussed. Additionally, adding 1-Leucine-Methyl Ester showed no effects either on CD8+ or CD4+ cell percentages. 3. B cell (SIg+) percentages in both tonsil and spleen cultures were quite stable throughout the culture period, about 60% of total cells. CD19, a marker of B cell, was only present in part of the cultured SIg+ cells. The significance of the variations in CD19+, SIg+ cells was unclear. CD5+ B cells were known as cells secreting autoantibodies. Our results showed that these cells consistently maintained a relatively low percentage in the whole antibody induction period. 4. The reasonableness standard we used for "gating" in FACS analysis was discussed.