Angiotensin I converting enzyme gene polymorphism and insulin resistance in patients with hypertension

BACKGROUND

The homozygote deletion (DD) genotype of the angiotensin I converting enzyme (ACE) gene has been shown to be associated with an increased risk of coronary heart disease independent of other risk factors.

OBJECTIVE

To investigate the possible association of the insertion/deletion (I/D) polymorphism of the ACE gene with insulin resistance in a Chinese population with and without hypertension.

SUBJECTS AND METHODS

The I/D polymorphism of the ACE gene was determined for 361 Chinese including 148 women and 96 men with normal blood pressures and 64 male and 53 female patients with mild-to-moderate hypertension. Insulin resistance was estimated by the insulin suppression test and glucose intolerance evaluated with an oral glucose-tolerance test for all of the subjects.

RESULTS

Three hypertensive subgroups with DD, DI and II genotypes having similar ages and body mass indexes presented insignificantly different degrees of glucose intolerance and insulin resistance both among men and among women. Similar results were found for normotensive subjects. In addition, ACE genotypes were not significant predictors of insulin resistance and glucose intolerance either among men or among women after adjustment for age, body mass index, and hypertension.

CONCLUSION

The present data indicated that the I/D polymorphism of the ACE gene was not related to insulin resistance for Chinese hypertensive and normotensive subjects. The increased risk of coronary heart disease associated with the DD genotype need not be mediated through the mechanism of insulin resistance and glucose intolerance for Chinese patients with hypertension.

Gemfibrozil treatment of hypertriglyceridemia: improvement on fibrinolysis without change of insulin resistance

The fibrinolytic and metabolic changes associated with gemfibrozil treatment of hypertriglyceridemia were evaluated in 16 patients with type IV hyperlipidemia by criteria of triglyceride levels > 250 mg/dl and total cholesterol levels < 220 mg/dl. The plasma triglyceride level was significantly lower (323 +/- 71 vs 189 +/- 57 mg/dl; p = 0.000) and high-density lipoprotein cholesterol level significantly higher (33.5 +/- 4.6 vs 38.0 +/- 6.7 mg/dl; p = 0.005) after 3 to 4 months of gemfibrozil treatment. However, the glucose and insulin metabolism measured by oral glucose challenge and insulin suppression tests showed no significant changes after gemfibrozil therapy. In contrast, plasma plasminogen activator inhibitor-1 antigen (36.9 +/- 12.4 vs 27.3 +/- 11.4 ng/ml; p = 0.008) and activity (15.5 +/- 5.5 vs 11.8 +/- 3.0 IU/ml; p = 0.009) and tissue plasminogen activator antigen (13.2 +/- 4.0 vs 10.4 +/- 3.7 ng/ml; p = 0.007) were significantly depressed, and tissue plasimogen activator activity (0.57 +/- 0.31 vs 0.69 +/- 0.38 IU/ml; p = 0.015) was significantly elevated by gemfibrozil. The data indicate that lowering plasma triglyceride and raising high-density lipoprotein cholesterol levels by gemfibrozil treatment also improved the fibrinolytic system without changes of insulin resistance and glucose intolerance in patients with isolated hypertriglyceridemia.

Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function

OBJECTIVES

This study assessed the clinical utility of mitral annulus velocity in the evaluation of left ventricular diastolic function.

BACKGROUND

Mitral inflow velocity recorded by Doppler echocardiography has been widely used to evaluate left ventricular diastolic function but is affected by other factors. The mitral annulus velocity profile during diastole may provide additional information about left ventricular diastolic function.

METHODS

Mitral annulus velocity during diastole was measured by Doppler tissue imaging (DTI) 1) in 59 normal volunteers (group 1); 2) in 20 patients with a relaxation abnormality as assessed by Doppler mitral inflow variables (group 2) at baseline and after saline loading; 3) in 11 patients (group 3) with normal diastolic function before and after intravenous nitroglycerin infusion; and 4) in 38 consecutive patients (group 4) undergoing cardiac catheterization in whom mitral inflow velocity and tau as well as mitral annulus velocity were measured simultaneously.

RESULTS

In group 1, mean +/- SD peak early and late diastolic mitral annulus velocity was 10.0 +/- 1.3 and 9.5 +/- 1.5 cm/s, respectively. In group 2, mitral inflow velocity profile changed toward the pseudonormalization pattern with saline loading (deceleration time 311 +/- 84 ms before to 216 +/- 40 ms after intervention, p < 0.001), whereas peak early diastolic mitral annulus velocity did not change significantly (5.3 +/- 1.2 cm/s to 5.7 +/- 1.4 cm/s, p = NS). In group 3, despite a significant change in mitral inflow velocity profile after nitroglycerin, peak early diastolic mitral annulus velocity did not change significantly (9.5 +/- 2.2 cm/s to 9.2 +/- 1.7 cm/s, p = NS). In group 4, peak early diastolic mitral annulus velocity (r = -0.56, p < 0.01) and the early/late ratio (r = -0.46, p < 0.01) correlated with tau. When the combination of normal mitral inflow variables with prolonged tau (> or = 50 ms) was classified as pseudonormalization, peak early diastolic mitral annulus velocity < 8.5 cm/s and the early/late ratio < 1 could identify the pseudonormalization with a sensitivity of 88% and specificity of 67%.

CONCLUSIONS

Mitral annulus velocity determined by DTI is a relatively preload-independent variable in evaluating diastolic function.

In vivo determination of surface tension in the horse trachea and in vitro model studies

We measured the surface tension in the trachea of the non-anaesthetised horse from the spreading behaviour of fluid drops, using videotracheoscopy. To do this, we placed small oil drops onto the tracheal wall with a thin Teflon tubing inserted into a videocolonoscope used in humans. Either 5 ml of saline (control) or 5 ml of bovine lipid extract surfactant (BLES) at 4 mg/ml were administered. Tracheal surface tension was 31.9 +/- 0.54 mN/m (Mean +/- SEM, n = 30) in the control experiments and 24.5 +/- 0.51 mN/m (Mean +/- SEM, n = 21) in the entire trachea after the administration of BLES. These values were determined from calibration curves relating film surface tension to the relative diameter of test fluid droplets. In the calibration experiments, the test fluid droplets were placed onto a surfactant film at various surface tensions in either a modified Langmuir-Wilhelmy balance or a captive bubble surfactometer. The spreading behaviour of a given test fluid droplet in the model studies did not only depend on the film surface tension but also on the thickness of the aqueous layer below the surfactant film. Hence, the computed surface tensions in the trachea depend on the choice of which in vitro model is applied.

Characterization and expression of two members of the S-adenosylmethionine decarboxylase gene family in carnation flower

S-adenosylmethionine decarboxylase (SAMDC; EC 4.1.4.50) is one of the key enzymes in polyamine biosynthesis, and the product of its catalytic reaction, decarboxylated S-adenosylmethionine (dcSAM), serves as an aminopropyl donor in the biosynthesis of spermidine and spermine. In order to provide information on the structure and regulation of SAMDC, we have isolated and sequenced two different SAMDC cDNA clones from carnation petals. The nucleotide sequences of CSDC9 and CSDC16 show 78.3% identity, and the deduced amino acid sequences show 81.7% identity and 86.5% similarity [12]. There are several regions with highly conserved sequences among SAMDC cDNAs of potato, spinach, periwinkle, man and yeast. These conserved regions include a cleavage site for the processing of SAMDC proenzyme and a putative PEST sequence that may be relevant to the rapid degradation of SAMDC protein. Carnation SAMDC cDNAs have long transcript leaders of 472 bp and 502 bp for CSDC9 and CSDC16, respectively. Both sequences contain short upstream open reading frames (uORFs) in their 5'-untranslated regions. The CSDC9 uORF is 54 amino acids from 152 to 317 while the corresponding sequence in CSDC16 is 52 amino acids located from 156 to 314 in each 5'-untranslated region. The nucleotide sequences of uORFs in CSDC9 and CSDC16 were 89.9% identical. In vitro transcription/translation experiments showed: (1) each proenzyme of both cDNAs of SAMDC was converted to two polypeptides consisting of a large subunit (calculated as 31,544 Da and 32,537 Da, respectively) and a small subunit (calculated as 9704 and 9041 Da, respectively) after 20 min of translation; (2) the processing occurs rapidly during the translation of protein. But once the translation process is stopped accumulation of the subunits slows and never reaches completion even after 300 min. The processing of carnation SAMDC enzyme is not stimulated by putrescine in in vitro transcription/translation reaction.

Temperature-guided radiofrequency catheter ablation of accessory pathway

OBJECTIVES

This study was performed to evaluate the usefulness of temperature-guided radiofrequency catheter ablation for the elimination of accessory pathway conduction in patients with Wolff-Parkinson-White syndrome.

METHODS

Temperature-guided radiofrequency catheter ablation was attempted in 138 patients with 144 accessory pathways (88 pathways along the left free wall, 5 in the anteroseptal region, 2 in the midseptal region, 19 in the posteroseptal region and 30 along the right free wall). The energy source was a HAT 200S which regulated the power automatically to the set temperature of 70 degrees C. Radiofrequency current was delivered through a thermocatheter to the atrial or ventricular side of mitral or tricuspid annulus.

RESULTS

Accessory pathway conduction was eliminated in 130 of 144 pathways (90.3%). The mean power outputs of the successful ablations at the atrial side of the annulus were higher than those at the ventricular side (34.0 +/- 8.9W versus 20.0 +/- 7.6W, p < 0.01), but the maximum temperatures were lower at the atrial side of the annulus than those at the ventricular side (66.4 +/- 14.0 degrees C versus 77.2 +/- 6.4 degrees C, p < 0.01). There were 3 non-fatal complications (2.1%), 2 patients with hemopericardium and 1 with femoral artery thrombus, during or after ablation procedures. Recurrences of AV re-entrant tachycardia or delta wave on the electrocardiogram occurred in 4 patients (2.8%) who had successful second procedures. There were no late complications during a mean follow-up period of 41 +/- 25 months (range, 3 to 55).

CONCLUSION

We conclude that 1) temperature-guided radiofrequency catheter ablation can be performed reliably and safely in eliminating accessory pathway conduction in patients with WPW syndrome, and 2) temperature monitoring and adjustment of the power to the set temperature during ablation would be useful for the avoidance of impedance rises and coagulum formation.

Measurements of serum müllerian inhibiting substance in the evaluation of children with nonpalpable gonads

BACKGROUND

Müllerian inhibiting substance, produced constitutively by the prepubertal testes, promotes involution of the müllerian ducts during normal male sexual differentiation. In children with virilization and nonpalpable gonads, only those with testicular tissue should have detectable serum concentrations of müllerian inhibiting substance.

METHODS

We measured serum mullerian inhibiting substance in 65 children with virilization at birth and nonpalpable gonads (age at diagnosis, 2 days to 11 years) and serum testosterone in 54 of them either after the administration of human chorionic gonadotropin or during the physiologic rise in testosterone that occurs in normal infants.

RESULTS

The mean (+/-SD) serum mullerian inhibiting substance concentration in the 17 children with no testicular tissue was 0.7+/-0.5 ng per milliliter, as compared with 37.5+/-39.6 ng per milliliter in the 48 children with testes (P<0.001). In the latter group, the mean values in the 14 children with abnormal testes and the 34 with normal testes were 11.5+/-11.8 and 48.2+/-42.1 ng per milliliter, respectively (P< 0.001). The sensitivity and specificity of the serum müllerian inhibiting substance assay for detecting the absence of testicular tissue were 92 percent and 98 percent, respectively, as compared with 69 percent and 83 percent for the measurement of serum testosterone. Furthermore, measurement of serum mullerian inhibiting substance was more sensitive than serum testosterone measurement for the identification of children with abnormal testes (67 percent vs. 25 percent), whereas the specificity of the two tests was similar.

CONCLUSIONS

Measurements of serum mullerian inhibiting substance can be used to determine testicular status in prepubertal children with nonpalpable gonads, thus differentiating anorchia from undescended testes in boys with bilateral cryptorchidism and serving as a measure of testicular integrity in children with intersexual anomalies.

Practical considerations in acquiring biological signals from confocal microscope. II. Laser-induced rise of fluorescence and effect of agonist droplet application

Confocal laser scanning microscopy (CLSM) is extensively used in the study of cellular activities through monitoring the temporal and spatial changes of biologically active molecules such as cAMP and Ca2+ which have been rendered visible by fluorescent labels. During our work with fluo-3 and Ca2+, we noticed two potential sources of artifacts which can make interpretation of the experimental observations difficult. Firstly, the excitation laser light generates heat that enhances the conversion of residual non-fluorescent acetoxymethyl (AM)-esterified indicator to the fluorescent form, thus giving rise to erroneous signals. Secondly, addition of reagents onto the coverslips alters the position of the focal plane, again causing error. In this paper, we present the phenomena and suggest ways to control and eliminate false images.

Premorbid personality and behavioral symptoms in Alzheimer disease. Some cautions

OBJECTIVE

To evaluate the extent to which the previously reported relationship between premorbid personality and psychopathological symptoms after the onset of Alzheimer disease (AD) is due to the use of a single informant for both personality and symptom information.

DESIGN

Premorbid personality descriptions of patients with AD were obtained from 2 sources, primary caregivers and secondary informants, using the Personality Assessment Schedule and NEO-PI-R Neuroticism Scale, respectively. All information regarding depression and anxiety since the onset of AD was obtained from primary caregivers using clinical interviews and the Cornell Scale for Depression in Dementia.

RESULTS

When data were obtained from the same informant, significant relationships were found between premorbid personality and both presence of depression and the severity of anxiety symptoms. When data were obtained from 2 different informants, the only significant relationship was between premorbid neuroticism and anxiety severity.

CONCLUSION

As in a previous report, there was a relationship between premorbid personality and depressive symptoms in AD, but only when personality and symptom information was obtained from the same informant. On the other hand, there was a relationship between premorbid personality and severity of anxiety symptoms both when personality and symptom information came from different informants as well as from the same informant. These data suggest that retrospective bias contributes to the apparent consistency between premorbid personality and some aspects of psychiatric symptoms in AD, specifically depression.

Airway surfactant, a primary defense barrier: mechanical and immunological aspects

Epidemiologic studies have shown strong associations between mortality and morbidity from respiratory and cardiac causes and exposure to fine (PM10), but not coarse, particulates. A plausible mechanistic explanation for these associations is lacking. It has been shown that particles may be retained for an extended period of time in the airways, and that their clearance is inversely proportional to particle size. Such particles are localized in close association with the airway epithelium, and if they consist of low surface energy material, will be coated with an osmiophilic layer, consistent with surfactant. Particles are displaced into this position by surface and line tension forces exerted by the surfactant film at the air-aqueous interface. Particle displacement due to line tension is much greater for smaller particles in the micrometer range. The surface forces acting on the particles leave deep indentations on the epithelial cells. During the displacement process they may come into contact with airway macrophages in the mucous layer and/or dendritic cells situated in the airway epithelium. The smallest particles may even penetrate the mucosa to enter the interstitial compartment. In addition to altering the physical properties of particles, surfactant coatings reduce particle toxicity and enhance phagocytosis by opsonization. We speculate that surfactant acts as a primary defense barrier and plays a role in antigen presentation and elimination at the air-mucus interface of the airways.

Schwann cells stimulated by axolemma-enriched fractions express cyclic AMP responsive element binding protein

Both axolemma-enriched fractions (AEF) and cyclic AMP have been shown to regulate the proliferation and differentiation of cultured primary Schwann cells (SC). We have evaluated the role of CREB, a transcription factor that binds to the cAMP-responsive element, in mediating the AEF-stimulated SC proliferation and differentiation. We detected CREB in nuclear extracts derived from SC stimulated with 40 micrograms/ml of AEF for 16, 24, 48, 72, and 96 hr, using a DNA-electrophoretic mobility shift assay. Unstimulated quiescent SC contained low levels of CREB which increased to a maximal level after 48 hr of AEF treatment. Using anti-CREB antibodies and Western blot analysis, after 24 hr of AEF treatment we first detected CREB as a 45 kDa protein which reached a maximal level of expression after 72 hr. Double labeled immunocytochemistry using anti-CREB and anti-5-bromo-2'-deoxy-uridine antibodies demonstrated maximal CREB expression after 72 hr of AEF treatment, closely coinciding with the temporal expression of SC proliferation. At all times examined, all AEF-treated SC labeled by anti-CREB antibodies were also labeled with anti-BrdU antibodies. These observations are consistent with the view that CREB could play an important role in the induction of SC proliferation by AEF.

Stimulatory influence of soy protein isolate on breast secretion in pre- and postmenopausal women

Soy foods have been reported to have protective effects against premenopausal breast cancer in Asian women. No studies have been reported on potential physiological effects of dietary soy consumption on breast gland function. We evaluated the influence of the long-term ingestion of a commercial soy protein isolate on breast secretory activity. We hypothesized that the features of nipple aspirate fluid (NAF) of non-Asian women would be altered so as to resemble those previously found in Asian women. At monthly intervals for 1 year, 24 normal pre- and postmenopausal white women, ages 30 to 58, underwent nipple aspiration of breast fluid and gave blood and 24-h urine samples for biochemical studies. No soy was administered in months 1-3 and 10-12. Between months 4-9 the women ingested daily 38 g of soy protein isolate containing 38 mg of genistein. NAF volume, gross cystic disease fluid protein (GCDFP-15) concentration, and NAF cytology were used as biomarkers of possible effects of soy protein isolate on the breast. In addition, plasma concentrations of estradiol, progesterone, sex hormone binding globulin, prolactin, cholesterol, high density lipoprotein-cholesterol, and triglycerides were measured. Compliance was assessed by measurements of genistein and daidzein and their metabolites in 24-h urine samples. Excellent compliance with the study protocol was obtained. Compared with NAF volumes obtained in months 1-3, a 2-6-fold increase in NAF volume ensued during months 4-9 in all premenopausal women. A minimal increase or no response was found in postmenopausal women. No changes were found in plasma prolactin, sex hormone binding globulin, cholesterol, high density lipoprotein cholesterol, and triglyceride concentrations. Compared with concentrations found in months 1-3 (no soy), plasma estradiol concentrations were elevated erratically throughout a "composite" menstrual cycle during the months of soy consumption. No significant changes were seen in plasma progesterone concentrations. No significant changes were found in plasma estrogen levels in postmenopausal women. A moderate decrease occurred in the mean concentration of GCDFP-15 in NAF in premenopausal women during the months of soy ingestion. Of potential concern was the cytological detection of epithelial hyperplasia in 7 of 24 women (29.2%) during the months they were consuming soy protein isolate. The findings did not support our a priori hypothesis. Instead, this pilot study indicates that prolonged consumption of soy protein isolate has a stimulatory effect on the premenopausal female breast, characterized by increased secretion of breast fluid, the appearance of hyperplastic epithelial cells, and elevated levels of plasma estradiol. These findings are suggestive of an estrogenic stimulus from the isoflavones genistein and daidzein contained in soy protein isolate.

Differential effects of chronic calcium channel blocker treatment on the inotropic response of diabetic rat myocardium to acute ethanol exposure

Cardiomyopathy is a consistent feature of diabetic myocardium as well as in prolonged alcohol consumption. Diabetes-induced myocardial dysfunction has been attributed, in part, to calcium overload within individual myocytes. The present study compares the effectiveness of the calcium channel blocker nifedipine (dihydropyridine-type) with verapamil (phenylalkylamine-type) in reversing myocardial dysfunction and diminishing the negative inotropic effect of ethanol on diabetic rat myocardium. Wistar rats were made diabetic with streptozotocin (55 mg/kg, i.v.) and isolated electrically stimulated papillary muscles were studied under isometric conditions in the absence and presence of clinically relevant concentrations of ethanol (80-240 mg/dl, i e., 17.4-52.1 mM). Subgroups of diabetic and normal animals received daily injections of verapamil or nifedipine 2 weeks after induction of diabetes for 8 weeks. Untreated diabetic animals exhibited hyperglycemia, hyperlipidemia, reduced growth, cardiomegaly, and hepatomegaly. Compared to verapamil chronic nifedipine treatment normalized or reversed the effects of diabetes on myocardial mechanical function. The negative inotropic effect of ethanol was attenuated only in muscles from verapamil-treated diabetic animals. Thus, chronic nifedipine treatment may be more effective than verapamil in reducing hyperglycemia, attenuating both cardiac and liver enlargement, and restoring myocardial mechanical function, in experimental diabetes. However, chronic verapamil therapy is more effective in diminishing the negative inotropic effect of ethanol on diabetic myocardium. These findings may have clinical significance among diabetic patients who consume alcoholic beverages while receiving long-term calcium blocker therapy.

In vitro and in vivo growth inhibition of SC-M1 gastric cancer cells by retinoic acid

Retinoids are differentiating agents that have been used successfully for the treatment of acute promyelocytic leukemia. When combined with interferons, they are active in preventing second malignancies in patients with head and neck cancer. Our previous studies have demonstrated cytostatic effects of alltrans-retinoic acid (tRA) on SC-M1 gastric cancer cells in vitro. The activity of tRA and 13-cis-retinoic acid (cRA) on SC-M1 cells was compared both in vitro and in vivo in this study. Measurement of total cellular DNA was used to determine cell growth in vitro. The effect of retinoic acid on tumor growth was evaluated by implanting sustained release tRA or cRA pellets into athymic nude mice. The results showed that tRA was more potent than cRA in suppressing the growth of SC-M1 gastric cancer cells in vitro. Both tRA and cRA were effective in suppressing the growth of SC-M1 tumors in athymic nude mice. No change in the differentiation status and cell cycle phase distribution in excised tumors was observed. Side effects such as bone fractures and weight loss were observed in mice of both treatment groups. The results suggest that retinoic acid may provide therapeutic advantages for the treatment of gastric cancer.

Influence of calcium channel blocker treatment on the mechanical properties of diabetic rat myocardium

The objective of this investigation was to determine whether calcium channel blocker (CCB) treatment effectively restores normal baseline mechanical function in diabetic myocardium and to evaluate its effect on the interval-strength relationship. Wistar rats were made diabetic with streptozotocin (55 mg/kg, IV). Left-ventricular papillary muscles from normal and diabetic (10 weeks) rats were superfused with Tyrode's solution at 30 degrees C. A subgroup of diabetic and normal animals received daily injections of verapamil or nifedipine (10 mg/kg, IP; 8 weeks) to compare the effectiveness of a phenylalkylamine to a dihydropyridine in reversing diabetes-induced contractile dysfunction in vitro. Muscles were electrically stimulated at 0.5 Hz with suprathreshold stimuli, and the following parameters were measured: peak tension developed, time to-peak tension, time-to-90% relaxation, and the maximum velocities of tension development and decay. Experimental diabetes was characterized by: severe hyperglycemia, hepatomegaly, reduced body weight gain, cardiomegaly, and increased plasma phospholipid levels. In addition, baseline values of peak tension developed, time to-peak tension, and time-to-90% relaxation were significantly greater in muscles from diabetic animals. Chronic nifedipine treatment reduced hyperglycemia and plasma phospholipid levels, normalized body weight gain, and reduced both heart and liver sizes in diabetic animals. Nifedipine treatment completely reversed diabetes-induced prolongation in both time-to-peak tension and time-to-90% relaxation. In diabetic myocardium, a slightly positive component was present in the interval-strength relationship between 0.01 and 1 Hz, resulting in a rightward shift in the entire curve across a wide range of stimulation frequencies (0.01-5 Hz). This positive component was absent in muscles from diabetic animals treated with both CCBs, and verapamil produced a leftward shift in the frequency response curve. The results of this study suggest that chronic nifedipine treatment may be more effective than verapamil in restoring normal baseline myocardial mechanical function, reducing hyperglycemia and hyperlipidemia, as well as attenuating both cardiac and liver enlargement in experimental diabetes. In contrast, verapamil treatment tended to normalize more effectively the inotropic response to changes in stimulation frequency in diabetic myocardium.

Mullerian inhibiting substance in humans: normal levels from infancy to adulthood

Mullerian-inhibiting substance (MIS) is a gonadal hormone synthesized by Sertoli cells of the testis and granulosa cells of the ovary. To facilitate the use of MIS for the evaluation of intersex disorders and as a tumor marker in women with MIS-expressing ovarian tumors, we measured MIS in 600 serum samples from males and females. These data show that mean MIS values for males rise rapidly during the first year of life and are highest during late infancy, then gradually decline until puberty. In contrast, MIS values in females are lowest at birth and exhibit a minimal increase throughout the prepubertal years. Whereas MIS is uniformly measurable in all prepubertal boys studied, it is undetectable in most prepubertal female subjects. These data reveal an easily discernible sexually dimorphic pattern of expression and confirm that MIS can be used as a testis-specific marker during infancy and early childhood. MIS values that are above the upper limits for females are discriminatory for the presence of testicular tissue or ovarian tumor, and those below the lower limits for males are consistent with dysgenetic or absent testes or the presence of ovarian tissue. These data will enable normal and abnormal levels of MIS to be differentiated with higher precision and will facilitate the use of MIS in the management of gonadal disorders.

Developmental expression of a candidate müllerian inhibiting substance type II receptor

We have isolated a candidate Müllerian inhibiting substance (MIS) type II receptor complementary DNA from an embryonic rat urogenital ridge library and have studied its binding to MIS, its developmental pattern of expression and tissue distribution. By in situ hybridization with a full-length riboprobe, the receptor is expressed in the mesenchymal cells surrounding the Müllerian duct at embryonic days 14, 15, and 16 and in tubular and follicular structures of the rat fetal gonads. Expression of the messenger RNA was also seen in the granules cells and seminiferous tubules of pubertal gonads. Northern analysis revealed that the MIS type II receptor messenger RNA is highly expressed in embryonic, pubertal, and adult testes and ovaries, as well as in the gravid uterus. The timing of expression in the gonads of both sexes was also analyzed by Northern analyses that showed high levels of expression at the time of Müllerian duct regression, much lower levels neonatally and prepubertally and then increased expression again with sexual maturation. The tissue and developmental specificity of expression of this receptor, which make it likely that this is the functional MIS type II receptor, can be used to advantage in therapeutic targeting strategies and to decipher the function of MIS in the gonads.

Effects of acid aerosol exposure on the surface properties of airway mucus

It was hypothesized that the mucous layer lining the tracheas of rats and guinea pigs contains surfactant material capable of lowering the air/mucus surface tension, gamma, and that exposure to an irritant aerosol would raise the gamma. The gamma of the surface film was measured directly by a spreading droplet technique and indirectly by displacement of polymethyl methacrylate particles into the aqueous layer. The morphology of the mucous film was examined by electron microscopy after nonaqueous fixation. gamma was 33.3 +/- 0.70 (SE) mN/m and 32.3 +/- 0.68 (SE) mN/m for the normal rat and guinea pig trachea, respectively. Exposure for 4 h to aerosols of sulfuric acid (94.1 +/- 18.68 (SD) and 43.3 +/- 4.57 (SD) mg/m3) caused a several-fold increase in thickness of the mucous layer with exudation of protein-like material. The osmiophilic surfactant film at the air/mucus interface became irregularly thickened and multilayered. Despite these morphological changes gamma remained low, 33.2 +/- 0.43 (SE) mN/m and 32.6 +/- 0.60 (SE) mN/m for rats and guinea pigs, respectively, and displacement of particles into the subphase was not compromised. The results indicate that rodent tracheas are able to maintain a low surface tension in the presence of injury.

Evolution of left atrial thrombus with anticoagulant therapy-follow-up by transesophageal echocardiography

OBJECTIVES

Atrial fibrillation is an important risk factor for systemic embolism. A number of clinical studies demonstrated the beneficial effect of anticoagulant therapy for the prevention of embolism. But there has been no study on the fate of left atrial thrombus demonstrated by transesophageal echocardiography in the course of anticoagulation therapy.

METHODS

Thirteen patients, demonstrated to have left atrial thrombus by transesophageal echocardiography were followed with anticoagulation therapy. Repeated transesophageal echocardiography was done 15 months after 1st study.

RESULTS

Among 9 patients with adequate anticoagulation effect (INR > 2.0), left atrial thrombus disappeared in 3 patients. The size of thrombus decreased from 2.2 +/- 0.8cm to 0.9 +/- 1.0cm (p < 0.05 by paired Student's t-test).

CONCLUSIONS

Left atrial thrombus could dissolve or decrease in size with adequate anticoagulation.

Targeted deletion of the TGF-beta 1 gene causes rapid progression to squamous cell carcinoma

To study the contribution of autocrine and paracrine TGF-beta 1 to tumor progression in a well-defined system of multistage carcinogenesis, keratinocytes with a targeted deletion of the TGF-beta 1 gene were initiated in vitro with the v-rasHa oncogene and their in vivo tumorigenic properties were determined by skin grafting initiated cells onto athymic mice in combination with either wild-type or null dermal fibroblasts. Grafts of v-rasHa-initiated null keratinocytes progressed rapidly to multifocal squamous cell carcinomas within dysplastic papillomas irrespective of the fibroblast genotype, whereas the initiated control genotypes formed well-differentiated papillomas. Malignant progression was not associated with mutations in the c-rasHa gene, alterations in p53 protein, or loss of responsiveness to TGF-beta 1. The tumor cell labeling index was elevated in grafts of initiated null keratinocytes with wild-type fibroblasts compared to tumors of other genotypes. However, labeling index in all tumors was reduced when TGF-beta 1 null fibroblasts formed the stroma. The null tumor cells could not accumulate TGF-beta 1 from the host, but grafts of uninitiated null keratinocytes, which formed a normal epidermis, became TGF-beta 1 positive even though they did not express TGF-beta 1 mRNA. These results demonstrate that autocrine TGF-beta 1 suppresses the frequency and rate of malignant progression, and that autocrine and paracrine TGF-beta 1 can have opposing effects on tumor cell proliferation. The lack of paracrine inhibition of tumor cell progression appears to result from the inability of tumor cells to localize host-derived TGF-beta 1 by a mechanism that operates in normal cells.

Relationship of gingival calculus and bleeding on probing in CPITN code 2 sextants

The aims of this study were twofold: firstly, to evaluate the relationship of supra- or subgingival calculus and bleeding on probing (BOP) in sextants coded 2 in the Community Periodontal Index of Treatment Needs (CPITN); and secondly, to compare the differences in four investigations in Taiwan, Hong Kong, Japan and Norway. In a national survey, a total of 2658 Chinese dentate adults were examined by using modified CPITN in the Taiwan area from 1985 to 1987. Sextants given Code 2 were divided into four subclassifications: supragingival calculus with bleeding (I+), supragingival calculus without bleeding (I-), subgingival calculus with bleeding (II+) and subgingival calculus without bleeding (II-). The results showed that of the 9394 sextants given Code 2, the highest percentage (70%) were characterized by the presence of subgingival calculus with bleeding and the lowest percentage (4%) by supragingival calculus with bleeding. The ratio of sextants coded 2 with only supragingival calculus versus subgingival was 1:6.2. The bleeding to nonbleeding ratio of sextants coded 2 in this study was similar to the Hong Kong study. However, differences among Taiwan, Japan and Norway were found. The results indicated that sextants with subgingival calculus had a higher tendency to BOP, with a ratio of 4:1. Those with supragingival calculus had a ratio of 3:7. We conclude therefore, that it is essential to scale teeth to remove subgingival calculus for determination of the necessity of periodontal treatment.

Comparison of dietary habits, physical activity and body size among Chinese in North America and China

BACKGROUND

Chinese in North America have higher rates of many chronic diseases than do Chinese in Asia. However, there is a lack of data among comparisons of the environmental and lifestyle factors for Chinese in China and Chinese residing in North America.

METHODS

We examined self-reported dietary nutrient intakes, physical activity patterns and body mass index of 2488 healthy Chinese men and women residing in North America (US and Canada) and in the People's Republic of China.

RESULTS

On average, Chinese in China consumed more calories (males 2904 kcal in China, versus 2201 kcal in North America; females 2317 Kcal in China, versus 1795 Kcal in North America and more carbohydrate, but less fat (males 72.2 g in China versus 84.5 g in North America, females 56.6 g in China versus 70.8 g in North America), protein, vitamin A, beta-carotene and vitamin C than did Chinese in North America. Per cent calories from fat was 35% for Chinese in North America and 22% for Chinese in China. In contrast, the per cent of calories from carbohydrates was 62-68% in China and 48% in North America. Chinese in China reported spending more time in vigorous activity, sleeping and walking but less hours in sitting than Chinese in North America. Chinese in China weighted less and were leaner than North American Chinese.

CONCLUSIONS

These differences in nutrient intakes, physical activity and body size of Chinese living on two different continents suggest possible explanations for observed differences in chronic disease rates in the two populations.

Dietary habits, physical activity and body size among Chinese in North America and China

We examined the self-reported dietary nutrient intakes, physical activity patterns and body mass index (BMI) of 2488 healthy Chinese men and women residing in North America (and Canada) and in the People's Republic of China. On average, Chinese in China consumed more total energy (males 3024 kcal in China, vs 2122 kcal in North America; females 2351 kcal in China. vs 1745 kcal in North America) and carbohydrate but less fat (males 74.s g in China vs 82.0 g in North America, females 56.0 g in China vs 68.8 g in North America), protein, vitamin A, b -carotene and vitamin C than did Chinese in North America. Dietary fat provided 35% of total dietary energy for Chinese in North America and 22% for Chinese in China. Consumption of alcohol, particularly wine and hard liquor, was higher among Chinese in China than Chinese in North America. Chinese in China reported more kilocalories of energy expenditure per day, especially in vigorous activity and walking, than Chinese in North America. Chinese in China weighed less and were leaner than North American Chinese. These differences in nutrient intakes, physical activity and body size of Chinese living in two different continents suggest possible explanations for observed differences in chronic disease rates in the two populations.