Detection and structural characterization of ras oncoprotein-inhibitors complexes by electrospray mass spectrometry

MS based methodology employing electrospray ionization (ESI) is described for the detection of ternary complexes in which SCH 54292 or SCH 54341 and GDP are noncovalently bound to oncogenic ras protein. The observed molecular weights of 19,816 and 19,570 Da confirmed the presence of noncovalent complexes of ras-GDP-SCH 54292 and ras-GDP-SCH 54341, respectively. We have also performed selective chemical modification of lysine residues of the ras protein complex followed by enzymatic digestion and on-line LC-ESI MS peptide mapping to determine protein-drug binding topography. There was a good correlation between nucleotide exchange inhibition as determined by the enzyme assay and evidence of complex formation as determined by MS.

Ras oncoprotein inhibitors: the discovery of potent, ras nucleotide exchange inhibitors and the structural determination of a drug-protein complex

The nucleotide exchange process is one of the key activation steps regulating the ras protein. This report describes the development of potent, non-nucleotide, small organic inhibitors of the ras nucleotide exchange process. These inhibitors bind to the ras protein in a previously unidentified binding pocket, without displacing bound nucleotide. This report also describes the development and use of mass spectrometry, NMR spectroscopy and molecular modeling techniques to elucidate the structure of a drug-protein complex, and aid in designing new ras inhibitor targets.

Induction of apoptosis and cytokine gene expression in T-cell lines by sera of patients with systemic lupus erythematosus

Accelerated apoptosis and improper expression of cytokine genes have been considered as important defects of lymphocytes for the development of systemic lupus erythematosus (SLE). This study was undertaken to test the possible contribution of serum factors obtained from SLE patients to these abnormalities. Molt-4 and Jurkat cells constantly exhibited a slower growth rate as well as more dead cells in culture with SLE sera tested than controls, although the cell cycle progression was apparently unaffected. Increased apoptosis was demonstrable among SLE sera-cultured cells by ELISA for apoptosis-specific DNA fragments and terminal deoxynucleotidyl transferase (TdT) in situ death analysis. Different levels of Fas, Fas-L, and Bcl-2 gene products were not detected between SLE sera-treated cells and the controls. The transcripts of interleukin-10 (IL-10) and interferon-gamma (IFN-gamma) genes of these two T cell lines were evidently increased in the presence of SLE sera, while IL-2 and IL-4 were unaffected. Elevated expression of IL-5 was also found in Molt-4 cells. By contrast, SLE sera reduced the transcripts of IL-6 gene in Jurkat cells. The effects of SLE sera were independent of corticosteroid medication. These results suggest that serum abnormalities may also play a role in T cell dysfunction.

Transient induction of apoptosis in serum-starved glioma cells by insulin and IGF-1

Insulin has a wide variety of biological effects. One of them is a mitogen-like activity whereby cell proliferation is stimulated. In this study we found a heretofore unreported insulin-elicited transient apoptosis of glioma cells. When serum-starved glioma cells were fed with a fresh regular medium, in the 6- to 12-h post-starvation period, the growth rate as determined by cell number was significantly suppressed by insulin, although cell cycle progression and DNA synthesis were actually accelerated. Increase in apoptosis in those growth-retarded cultures was demonstrable by Hoechst staining, detection of histone-associated DNA fragment, and in situ cell death detection. Apoptosis occurred among cells in all stages of cell cycle. After 24 h post-starvation, insulin increased the total cell number like a typical growth-promoting mitogen. In this regard, IGF-1, but not EGF nor TGF-beta 1, behaved like insulin.

[Experimental study on effects of mailuotong granule on anti-thromboangiitis obliterans]

Using experimental model of thromboangitis obliterans (TAO) in rats induced by injection of lauric acid into the femoral artery, the anti-thromboangitis obliterans effects of Mailuotong (MLT) Granule were observed. The results showed that MLT not only decreased significantly the lesion severity and extent of affected limb, plasma viscosity and level of fibrinogen, but also suppressed the arterial thrombosis, endotheliocytosis and inflammatory cell infiltration in vascular wall. MLT also reduced the organization of thrombus and facilitated thrombolysis. It showed that the therapeutic effect of MLT on TAO might be achieved by improving blood rheology, antithrombosis, thrombolysis, inhibiting endotheliocytosis and inflammatory reaction in vascular wall.

The effect of exclusive breastfeeding on development and incidence of infection in infants

Of 145 normal fullterm infants studied during the first year after birth, those exclusively breastfed for the first four months differed significantly from those not exclusively breastfed in physical and behavioral development, and resistance to infection. At four months of age, the mean weight of the exclusively breastfed group was higher (p < 0.05). At one year, the exclusively breastfed group showed more advanced. Personal-Social (p = 0.05) and gross Motor development (p < 0.05) on the Denver Developmental Screening TEst, and lesser cumulative incidence of infectious diseases (p < 0.05). This study demonstrated the beneficial effects of breastfeeding on development and resistance to infection in infants.

Chemical shift assignments and secondary structure of the Grb2 SH2 domain by heteronuclear NMR spectroscopy

The growth factor receptor-bound protein-2 (Grb-2) is an adaptor protein that mediates signal transduction pathways. Chemical shift assignments were obtained for the SH2 domain of Grb2 by heteronuclear NMR spectroscopy, employing the uniformly 13C-/15N-enriched protein as well as the protein containing selectively 15N-enriched amino acids. Using the Chemical Shift Index (CSI) method, the chemical shift indices of four nuclei, 1H alpha, 13C alpha, 13C beta and 13CO, were used to derive the secondary structure of the protein. Nuclear Overhauser enhancements (NOEs) were then employed to confirm the secondary structure. The CSI results were compared to the secondary structural elements predicted for the Grb2 SH2 domain from a sequence alignment [Lee et al. (1994) Structure, 2, 423-438]. The core structure of the SH2 domain contains an antiparallel beta-sheet and two alpha-helices. In general, the secondary structural elements determined from the CSI method agree well with those predicted from the sequence alignment.

Discrepant pattern of solid and liquid gastric emptying in Chinese patients with type II diabetes mellitus

While abnormal gastric emptying has been widely reported in patients with diabetes, its clinical relevance is still uncertain. We conducted scintigraphic gastric emptying studies in patients with Type II diabetes mellitus who had symptoms suggestive of delayed gastric emptying in an attempt to evaluate the incidence of abnormal gastric emptying and to assess the clinical parameters of the different patterns of gastric emptying. Seventy male diabetic patients were included in the study. The patients were divided into four groups according to the results of liquid and solid gastric emptying: group 1, normal liquid and solid emptying (n = 22); group 2, normal liquid but delayed solid emptying (n = 30); group 3, delayed liquid but normal solid emptying (n = 7); group 4, delayed liquid and solid gastric emptying (n = 11). To assess clinical significance, we compared duration of disease, status of blood sugar control, presence or absence of vascular complications and of peripheral neuropathy among the four groups. Of the 70 patients, 18 (25.7%) showed delayed liquid gastric emptying and 41 (58.6%) delayed solid gastric emptying. There were no significant differences in the clinical parameters of the four groups, except that patients with good sugar control were likely to have normal liquid gastric emptying. Based on the results of this study, delayed solid gastric emptying is more common than liquid gastric emptying in symptomatic Type II diabetes mellitus patients. Of the different patterns of gastric emptying, delayed liquid gastric emptying with normal solid gastric emptying is the most unusual. For Type II diabetic patients with symptoms suggestive of delayed gastric emptying, both liquid and solid gastric emptying studies should be performed.

Synthesis, antitumor activity, and chemical properties of silaplatin and related platinum (II) and platinum (IV) complexes derived from beta-silyl amines

Platinum (II) and platinum (IV) coordination complexes derived from beta-silyl-substituted amines were prepared. The solubility of selected complexes in water and physiological saline was measured, and the effect of the beta-silicon on the reactivity of the complex in aqueous solution was determined by HPLC. The stabilities of selected silyl complexes were compared to the carbon analogues. The cyclic complexes 2a ("silaplatin") and its Pt(IV) analogue, 2b, were very active against L1210 leukemia in vivo. Both the platinum (II) complex 2a and the platinum (IV) complex 2b produced a significant number of cures over the dose range 10-40 mg/kg. The platinum (II) complex 2a, silaplatin, was very active in vivo against an L1210 leukemia subline that was resistant to cisplatin; 2a was also active, when given ip, against ic implanted L1210. The cyclobutanedicarboxylic acid complex 3c was synthesized; this complex was active against both cisplatin sensitive and resistant L1210 leukemia but was less potent than the analogous dichloro compound 2a. The acyclic platinum (II) and platinum (IV) complexes 1a,b were synthesized and unexpectedly found to be inactive in vivo against L1210 leukemia. More lipophilic silaplatin analogues were prepared--Pt(II) complex 2c and Pt(IV) complex 2d have one additional methylene carbon compared to 2a,b, whereas Pt(II) complex 2e and Pt(IV) complex 2f have two additional methylene carbons. Cyclization of the alkyl groups attached to the silicon gave the spiro bicyclic Pt(II) complexes 10a and 11a and the Pt(IV) complexes 10b and 11b.

A proposal for a theory and detection method of cavitation potential of mitral bileaflet heart valve

We believe that cavitation damage to mitral bileaflet heart valve (MBHV) is caused by microcracks of hydrophobic pyrolite carbon. Our proposal is to detect cavitation potential of MBHV with an acoustic technique under various conditions of transvalvular pressures, ventricular dp/dt, leakage flow, and gas concentration in fluid, This modality, different from recent research in theory and technique, will lead to a standardized noninvasive and sufficiently sensitive technique for the detection of MBHV, to reject those valves believed to cause cavitation damage, and to develop cavitation-resistant MBHV.

Impact of alcohol consumption and cigarette smoking on stroke among the elderly in Taiwan

BACKGROUND AND PURPOSE

We investigated the influence of alcohol consumption and cigarette smoking on all types of stroke and cerebral infarction, in particular among a representative sample of elderly residents in Taiwan.

METHODS

This study was a component of a nationwide survey of health and living status of residents aged 65 years or older in Taiwan in which subjects received detailed physical, neurological, and laboratory examinations. Inquiries were made about medical history, and information on the amount and duration of drinking and smoking was obtained. Diagnoses of stroke were made according to the results of brain computed tomography at the onset of disease or were based on criteria established by the World Health Organization.

RESULTS

Of the 2600 subjects, there were 155 elderly persons with stroke (prevalence, 6%). Excessive drinking of more than 367.6 g/wk of alcohol was associated with a high prevalence of cerebral infarction. Consumption of < or = 367.5 g/wk of alcohol did not have an influence on stroke prevalence. The relationship between duration of alcohol drinking and stroke was equivocal. More than 30 pack-years of cigarette smoking was a significant risk factor for all types of stroke and cerebral infarction in particular. Using multiple logistic regression to control for possible confounders, it was found that smoking was an independent risk factors for all stroke and was of borderline significance for cerebral infarction. Although excessive drinking was a significant risk factor for cerebral infarction in univariate analysis, this effect was lost after adjustment for other confounders.

CONCLUSIONS

Cigarette smoking was a more important risk factor for stroke and cerebral infarction than excessive drinking of alcohol.

[Protrusion of thoracic intervertebral disk: report of 11 cases]

The authors reported 11 cases of thoracic intervertebral disk protrusion examined with plane film, myelography, CT and CT-myelography in 11 cases and MR imaging in 3. All of the 11, cases were confirmed by operation. There were 13 protrusions in the 11 cases with the locations of T10-11 in 4, T11-12 in 5 cases and T12-L1 in 4. 9 protrusions fell into central type, 1 into paracentral type and 1 into lateral type. The clinical symptoms were prominent with all 11 cases, however, most primary clinical diagnoses were erroneously given as lumber intervertebral disk protrusions and even the disorders of heart, lung, alimentary tract and urinary system. It was concluded that the main causes of the misdiagnosis included: (1) not easily to think of this entity for the clinic physicians due to its low incidence, (2) the untypical clinical manifestations. The authors considered that the exam method with the highest accuracy is CT-myelography.

Dissipation and movement of acaricide chlorobenzilate in the environment

The dissipation of acaricide chlorobenzilate in selected soil and river water samples was studied. Under incubation conditions at 25 degrees C and 90% field capacity of moisture for 21 days, the residues of chlorobenzilate were 14 and 55% in Lukang silty clay loam and Pincheng clay, respectively. More than 80% of chlorobenzilate remained in the natural water (pH 7.2 and 7.3, respectively) and in the water adjusted to pH 5.0 when water samples collected from Green Lake and Wai-Shuang River near Taipei were treated with chlorobenzilate and then incubated for 34 days. But when the pH was adjusted to 9.0, only 60% was found in Green Lake water and 29% in Wai-Shuang River water. The dissipation of chlorobenzilate in the soil was fitted to first-order kinetics with half-lives of 5 to 36 days under various conditions in the laboratory experiments. No chlorobenzilate was detected in the leachate by a leaching experiment on the soil column for 18 days; most chlorobenzilate remained in the upper 3 cm of the column. According to assessment by the groundwater pollution-potential model (GWP), chlorobenzilate seemed to be safe in regard to groundwater contamination.

Functional approach to treatment of back pain in primary care: a preliminary report

BACKGROUND

Back pain is one of the most common problems encountered in primary care clinics and causes great loss of work time, economy and expenditure of medical care. Knowledge of the cause of low back pain and effective treatment are rudimentary. We studied the functional approach to treatment of back pain of two acute (M:F = 1:1) and thirty chronic (M:F = 12:18) patients with back pain seen at a rural primary care clinic in September and October 1992.

METHODS

Patients were included after completing an agreement form regarding the treatment plan (emphasizing therapeutic exercise, health education and as little medication as possible) in the first interview. A primary care physician specialised in family medicine personally gave treatment to the patients with free attendance to the clinic. A functional approach was adopted in four categories-therapeutic exercise, static and dynamic body biomechanics, awareness of proprioception, and maintenance of relaxed and balanced muscle tone. The patients were encouraged to perform daily activities rather than rest.

RESULTS

Two patients with acute back pain gained complete relief without medication, modalities, equipment or other treatment one and two weeks after the first visit, respectively. Among the 30 chronic patients, after eight weeks of treatment, 12/30 (40%) gained complete relief from pain, 4/30 (13.3%) obtained more than 3/4 and less than complete relief, 7/30 (23.3%) had more than 1/2 and less than 3/4 relief, 2/30 (6.7%) gained less than 1/2 pain relief, 1/30 (3.3%) had no improvement, 1/30 (3.3%) deteriorated, and 3/30 (10%) were lost during surveillance. The patients reported no loss of work time attributed to back pain. Two acute patients visited the clinic four times and three times, respectively. The former received three prescriptions for an upper respiratory infection one month after complete remission of back pain, and the latter received no prescriptions for medication. On average, each chronic patient visited the clinic 4.83 times in 8 weeks. In only 25 of 145 (17.2%) visits was medication prescribed for other indications, and in 8 of 145 (5.5%) visits vitamin B complex or Alinamin-F for placebo was prescribed. We used neither modalities nor equipment. Only 7/30 (23.3%) patients received concurrent treatment from other medical institutions. Regarding compliance with the programmed exercise at home, two acute patients complied well. Among the 30 chronic patients, 22 (73.3%) had good compliance, 3 (10%) had poor compliance, 2 (6.7%) failed to comply and 3 (10%) were lost in follow up.

CONCLUSIONS

Treating patients with back pain in primary care clinics with a functional approach by physicians appropriately trained in primary care was a good, efficacious, economic, and practical way, although neglected elsewhere. Further research and practice in our society might be worth while.

Anaerobic biodegradability of cellulose and hemicellulose in excavated refuse samples using a biochemical methane potential assay

Improved techniques are needed to predict potential methane generation from refuse buried in landfills. The Biochemical Methane Potential (BMP) test was used to measure the methane potential of ten refuse samples excavated from a Berkeley, CA, landfill. The test was conducted in 125-ml serum bottles containing phosphate-buffered medium and inoculated with anaerobically digested sewage sludge. Comparison of the measured BMP to the theoretical BMP calculated from measured cellulose and hemicellulose concentrations indicated that cellulose plus hemicellulose is not well correlated with the measured BMP. The average of the measured to theoretical BMP was 19.1% (range 0-53%, s.d. = 16.9%). Measured sulfate concentrations showed that sulfate was an insignificant electron sink in the samples tested. Once methane production from the refuse was complete, 0.072 g of Whatman no. 1 filter paper was added to two of the four serum bottles incubated for each sample. An average of 84.9% (s.d. = 2.5%) of the added filter paper was recovered as methane, suggesting that some cellulose and hemicellulose present in refuse is recalcitrant or otherwise not bioavailable.

[A study on the pulmonary amine imaging in asthmatic patients and guinea pig asthma models]

Scintigraphic technique (SPECT) with intravenous injection of 131I-HIPDM was used to study pulmonary amine imaging in asthmatic patients and Guinea pig animal models. The results showed that the patients and animals had similar characteristic changes of amine imaging: the amine scanning pictures were not well-distributed, pulmonary amine uptake was significantly decreased but the clearance speed significantly increased as compared with those in healthy controls (P < 0.05-0.01). The only difference between the patients and the animals was that the amine imaging parameters in animals during remission recovered practically to normal, while that in patients during remission did not. The mechanism and clinical significance of the above changes were discussed.

Conformation of a biologically active C-terminal hexapeptide analog of the pheromone biosynthesis activating neuropeptide by NMR spectroscopy

The solution conformation of a biologically active C-terminal hexapeptide analog of the pheromone biosynthesis activating neuropeptide Tyr-D-Phe-Ser-Pro-Arg-Leu-NH2 has been studied by NMR spectroscopy. A beta-turn conformation was identified from the NOE connectivities observed for the peptide in a mixed solvent of water and DMSO, indicating that this is the biologically active conformation of the peptide. This study also suggests that the use of such an aqueous-like solvent mixture allows the observation of a preferred conformation for small linear peptides in the presence of conformational averaging.

Ventricular septal summit stimulation in atrioventricular nodal reentrant tachycardia

In all, 18 consecutive patients with atrioventricular nodal reentry tachycardia (AVNRT) underwent right ventricular (RV) stimulation during AVNRT from either the RV apex or summit. Stimulation from the RV apex advanced the tachycardia with the same atrial sequence in 6 of 18 patients (33%), but never conclusively excluded the presence of a low atrial tachycardia. RV summit stimulation resulted in direct stimulation of the low septal right atrium in 6 patients. RV summit stimulation advanced the tachycardia in 4 patients, delayed it in 2 and terminated it in 3 without an atrial electrogram. The latter 2 findings exclude the presence of a low atrial tachycardia. Thus, in patients with AVNRT, application of extrastimuli closer to the putative reentrant site enables greater efficacy in tachycardia resetting and in excluding a low septal atrial tachycardia.

Effects of pulsatile reperfusion on globally ischemic myocardium

To evaluate the effects of pulsatile reperfusion on the post ischemic myocardium, two categories of sheep were put on cardiopulmonary bypass (CPB). In Category I, the hearts of 23 sheep were arrested by global ischemia for 30 min, reperfused with pulsatile flow in 10 animals (P group), and non pulsatile flow in 13 animals (NP group), and then defibrillated. The incidence of ventricular fibrillation was much higher in the NP group than the P group, 77% versus 40% (p < 0.05). The lipoperoxide products and creatinine kinase from coronary sinus blood were elevated, but there were no significant differences between the two groups during 2 hour reperfusion. In the P group, less ultrastructural damage was observed, and Na+ and H2O accumulations in the subendomyocardium were significantly less than in the NP group, at 7.11 +/- 0.60 versus 9.98 +/- 1.10 mg/g dry weight (p < 0.05) and 82.58 +/- 0.47% versus 84.3 +/- 0.38% (p < 0.05), respectively. In Category II, the ischemic time of 17 sheep (eight in the P group, nine in the NP group) was prolonged to 45 min, and animals were supported by CPB after defibrillation. Myocardial energy phosphates were measured with high-performance liquid chromatography, and triphenyltetrazolium chloride was used to delineate the infarct size. After 2 hour of reperfusion, there were no significant differences in myocardial AMP and ADP between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Hepatitis D virus infection among prostitutes in Taiwan

Two hundred and sixty-three adult licensed, 233 adult and 157 teenage unlicensed prostitutes from Taiwan were studied for prevalence and risk factors of hepatitis D virus (HDV) infection. The hepatitis B carrier rate among the three groups was 21, 15 and 20%, respectively, not significantly different from that of the general population in this area. However, the prevalence of HDV infection among carrier prostitutes was 55, 36 and 16%, respectively, much higher than that in general hepatitis B carriers. Univariate analysis revealed that the history of conducting paid sex for more than 12 months (P < 0.03), ear-piercing (P < 0.02), tattooing (P < 0.02), and gonorrhoea or syphilis (P < 0.005) were significant factors associated with HDV infection among these subjects. Multivariate analysis revealed that the history of ear-piercing and venereal diseases (P < 0.001) were still significant. In summary, genital ulcers caused by venereal diseases due to frequent sexual contact with multiple partners, and use of unsterilized needles in ear-piercing or tattooing play important roles in the high prevalence of HDV infection in prostitutes.

[Effect of anhydrous glycerol injection into the mental foramen of rabbit on inferior nerve:An experimental study]

In this experiment anhydrous glycerol was injected into the mental foramen of rabbits to determine neurolytic effects on the peripheral trigeminal nerve by electrohysiologic and morphologic methods.The rabbits underwent unilateral injection of anhydrous glycerol and the control side was injected with normal saline.The results show that partial fibers are effected (myelinated and unmyelinated fibers at random).Glycerol injection increased the average latencies and reduced the average amplitudes of compound action potentials.Morphologic examination disclosed myelin swelling,disintergrationan d axonal shrinking,axonolysis.One week after the injection,eletrophysiologic and morphologic changes were most severe and signs of regeneration were noted in the fifth week,By 16 weeks after injection,the nerve fibers appeared almost normal.

Electrocardiographic and electrophysiologic characteristics of anterior, midseptal and right anterior free wall accessory pathways

OBJECTIVES

The objective of this study was to define the electrocardiographic (ECG) and electrophysiologic characteristics of midseptal, anteroseptal and right anterior free wall accessory pathways.

METHODS

The fully pre-excited 12-lead surface ECGs and ECGs during orthodromic atrioventricular (AV) reentrant tachycardia were compared for 13 patients with an anteroseptal, 7 with a midseptal and 7 with a right free wall accessory pathway. Routine electrophysiologic studies were performed in all and stimulation of the right ventricular summit during tachycardia was accomplished in 10 patients.

RESULTS

Differences in the surface ECGs were not sufficiently sensitive to distinguish among accessory pathway locations. Premature ventricular complexes induced from the right ventricular septal summit during ventricular activation either advanced the succeeding atrial depolarization or terminated the tachycardia in three of six patients with a septal pathway and in none of the four with a right anterior pathway. The change in ventriculoatrial (VA) interval with the development of right bundle branch block during orthodromic AV tachycardia proved most helpful in distinguishing these pathways. Patients with a right anterior free wall pathway showed a change in VA interval > or = 40 ms, whereas those with an anteroseptal pathway showed changes of 20 to 30 ms and those with a midseptal pathway showed no change.

CONCLUSIONS

Anteroseptal, midseptal and right anterior free wall pathways may be distinguished by using programmed stimulation of the summit of the right ventricular septum and especially with changes in the VA interval with development of right bundle branch block during orthodromic AV reentrant tachycardia.

Insular cistern hematoma. A special type of subarachnoid hemorrhage

The clinical manifestations of 20 cases of insular cistern hematoma were characterized by sudden onset violent headache, vomiting, bloody CSF, and subhyaloid hemorrhage (1/3 cases). CT scan showed semilunar high density image centering on the insular cistern with serrate internal edge. The average volume of the hematoma was 20 ml. By means of cerebral angiography, operation and/or autopsy, 7 cases were identified as aneurysm of middle cerebral artery, 6 as aneurysm of posterior communicating artery, and 2 as amyloid angiopathy. In the other 5 cases, the etiology was unknown.

Use of suppressor analysis to identify DNA polymerase mutations in herpes simplex virus which affect deoxynucleoside triphosphate substrate specificity

Herpes simplex virus DNA polymerase mutations which map in the N-terminal part of the protein and appear to alter deoxynucleoside triphosphate (dNTP) substrate specificity are described. These mutations suppress a drug hypersensitivity associated with the downstream mutation, Aphr10. We suggest that the mutant residues form part of the dNTP-binding site, a site previously thought to be confined to the C terminus.

Radiofrequency catheter ablation for treatment of bundle branch reentrant ventricular tachycardia: results and long-term follow-up

Seven of 120 consecutive patients with inducible sustained ventricular tachycardia (from September 1, 1988 to January 1, 1991) had bundle branch reentrant tachycardia and underwent percutaneous radiofrequency ablation of the right bundle branch. The seven patients had been unsuccessfully treated with a mean of 3 +/- 1 drugs. Four patients presented with syncope and three with aborted sudden death. The baseline electrocardiogram revealed a left bundle branch block pattern in three patients and an intraventricular conduction defect in four. The baseline HV interval was prolonged in each case (79 +/- 2 ms). With use of programmed ventricular extrastimuli, sustained bundle branch reentrant tachycardia was inducible in all patients at a mean cycle length of 283 +/- 17 ms (range 230 to 350). Bundle branch reentrant tachycardia characteristics included atrioventricular dissociation, a His deflection that preceded each QRS complex and spontaneous His to His variation that preceded changes in ventricular tachycardia cycle length. A quadripolar catheter was positioned across the tricuspid valve with the distal electrode tip of the catheter near the right bundle branch. One to three applications of continuous unmodulated radiofrequency current at 300 kHz between the distal electrode and a large posterior skin patch resulted in complete right bundle branch block in all patients, after which none had inducible bundle branch reentrant tachycardia on restudy. On restudy, three of the seven patients had ventricular tachycardia of myocardial origin (not bundle branch reentry). One patient required no therapy; drug or defibrillator therapy was used in the others.(ABSTRACT TRUNCATED AT 250 WORDS)

Patients with supraventricular tachycardia presenting with aborted sudden death: incidence, mechanism and long-term follow-up

A total of 13 (4.5%) of 290 patients with aborted sudden death had either documented (7; 54%) or strong presumptive evidence of supraventricular tachycardia that deteriorated into ventricular fibrillation. Six (46%) of the 13 had an accessory conduction pathway and either atrial fibrillation (5 patients) or paroxysmal atrioventricular (AV) reentrant tachycardia (1 patient) that deteriorated into ventricular fibrillation. Three patients with AV node reentrant tachycardia and four with atrial fibrillation and enhanced AV node conduction presented with supraventricular arrhythmias that deteriorated into ventricular fibrillation. Patients were treated with medical, surgical or catheter ablative procedures designed to prevent recurrences of supraventricular arrhythmias. Four patients received an implanted automatic defibrillator, but none had an appropriate device discharge. Over a follow-up period of 41.6 +/- 33.6 months, 12 patients are alive without symptomatic arrhythmias. One patient died because of severe chronic lung disease and heart failure. Supraventricular tachycardia was the cause of aborted sudden death in approximately 5% of patients referred for evaluation of sudden cardiac death. Treatment directed at prevention of supraventricular tachycardia was associated with an excellent prognosis. Current treatment techniques appear to obviate the need for automatic defibrillator therapy in these patients.

Parkinson's disease in China. Coordinational Group of Neuroepidemiology, PLA

An epidemiological study on the incidence and prevalence of Parkinson's disease (PD) was carried out in 29 provinces, cities and autonomous regions in this country in 1986. The survey was conducted in 117 areas, and 566 patients with PD were found among 3,869,162 persons examined, giving a point prevalence for men and women of 16.9/10(5) and 12.4/10(5), with the highest prevalence after the fifth decade of age. The disease was most prevalent in the southern part of China, especially in Hunan and Guangxi provinces. The incidence was 1.5/10(5)/yr in 1986. Both the prevalence and incidence of PD in China are lower than those in the white race and Japanese.

Influences of Polyactin A on activities of human monocytes in vitro

Effects of Polyactin A (PAA) on abilities of human monocytes to synthesize and secrete interleukin-1 (IL-1) and to modulate natural killer (NK) cell activity in large granular lymphocytes (LGL) were investigated in vitro. Over a wide range of concentrations (0.01-100 micrograms.ml-1), PAA directly induced IL-1 synthesis and secretion, showing the maximal effect at 10 micrograms.ml-1, and evidently synergized with lipopolysaccharides (LPS) of E coli in stimulation of IL-1 production by human monocytes. The manifestation of PAA pretreated autologous monocytes in modulation of NK cell activity was closely related to PAA concentration. A boosting effect of PAA-treated monocytes on NK activity was observed when PAA 10-100 micrograms.ml-1 were used for pretreatment of monocytes, while an inhibitory influence of monocytes was found when PAA 0.01-0.1 microgram.ml-1 were used. These results demonstrate significant effects of PAA on functions of human monocytes, enhancing IL-1 production and affecting their regulative activity on NK cell cytotoxicity.

Comparison of class I- and II-restricted T cell recognition of the identical peptide

There is structural and functional evidence that both class I- and II-restricted T cells recognize short processed peptides bound to MHC molecules. Although the structural conformation of bound peptides remains unknown, no evidence of distinct structural motifs of class I- or class II-restricted peptides has been described. Conversely, two algorithms proposed to predict T cell epitopes, and based on primary amino acid sequence or tertiary structure, are both compatible with many observed class I- and class II-restricted peptides. We previously identified eight class I-restricted peptides which were also recognized by class II-restricted T cells. Based on functional and direct binding studies, additional examples of peptides with both class I and II restrictions have been identified. In this study, we have directly compared the fine specificity of T cell recognition of a single epitope in a single mouse strain in the context of both class I- and class II-restricted responses. Based on a panel of analogue peptides with amino acid substitutions and peptides of various lengths, we observed several striking similarities in the recognition patterns of both class I- and class II-restricted T cells. In addition, some characteristics of recognition were different in the two systems indicating that the recognition processes were similar but not identical.

Pathological study on cerebral amyloid angiopathy

The cerebral amyloid angiopathy (CAA) was pathologically confirmed in 26 cases in which there were 20 cerebral hemorrhages, 2 subarachnoid hemorrhages, 3 cerebral infarctions, and 1 subdural hematoma. The CAA mainly involved the media and extima of small and medium-sized arteries as well as the capillaries of the brain tissue. Half of all cases in our series had the CAA associated vasculopathies (CAA-AV), including microaneurysms, "double barreling", onion skin-like intima, fibrinoid necrosis, clusters of arterioles and perivascular lymphocytic infiltrations. The CAA was often accompanied with the senile plaques and neurofibrillary tangles.

Modified Wicomb's apparatus for preservation of heart for 24 hours

To prolong the time of heart preservation, we modified the Wicomb's perfusion apparatus, in which oxygen flow acts as the source of power and provides oxygenation for the perfused myocardium. Ten adult porcine hearts which had been preserved for 24 hours were resuscitated successfully and continued to beat steadily for more than 1.5-3 hours after reperfusion. Myocardial ultrastructure was observed at the end of preservation and 15-120 minutes after reperfusion. The damages of the myocardial ultrastructure at the end of preservation were reversible.

Characterization of autoreactive T cells. Relative importance of self-peptides versus MHC

The degree to which processed self-peptides contribute to the stimulation of autoreactive T cells has not been determined. In this study we have analyzed a panel of autoreactive T cell hybridomas from normal C57BL/26 mice produced by fusing peripheral lymph node cells with a variant of the BW5147 thymoma line, which does not express endogenous TCR alpha- and beta-chains. All of the autoreactive hybridomas responded to spleen cells expressing the syngeneic I-Ab allele, but not to allogeneic spleen cells. Although all hybridomas were I-Ab restricted, they demonstrated different patterns of reactivity to a panel of APC expressing I-Ab but derived from different genetic backgrounds. In a panel of APC expressing recombinant I-A molecules, changes in the second half of the first domain, which encodes alpha-helix segments that flank the Ag binding site and directly contact the TCR V regions in proposed models, eliminated reactivity of all hybridomas tested. In addition, most of the autoreactive hybridomas also demonstrated inhibition of reactivity to mutations in the amino half of the first domain of the I-A alpha- and beta-chains, which encodes the beta-pleated sheet of the floor of the Ag-binding groove. To confirm the role of processed peptides in the different patterns of reactivity, APC were incubated with competitor Ag and fixed by glutaraldehyde cross-linking before incubation with the autoreactive T hybridomas. The hybridomas were effectively inhibited by exogenous protein and peptide Ag. These results indicate that processed self-peptides are required to activate the autoreactive T cells.

Characterization of autoreactive T cells. Relative importance of self-peptides versus MHC

The degree to which processed self-peptides contribute to the stimulation of autoreactive T cells has not been determined. In this study we have analyzed a panel of autoreactive T cell hybridomas from normal C57BL/26 mice produced by fusing peripheral lymph node cells with a variant of the BW5147 thymoma line, which does not express endogenous TCR alpha- and beta-chains. All of the autoreactive hybridomas responded to spleen cells expressing the syngeneic I-Ab allele, but not to allogeneic spleen cells. Although all hybridomas were I-Ab restricted, they demonstrated different patterns of reactivity to a panel of APC expressing I-Ab but derived from different genetic backgrounds. In a panel of APC expressing recombinant I-A molecules, changes in the second half of the first domain, which encodes alpha-helix segments that flank the Ag binding site and directly contact the TCR V regions in proposed models, eliminated reactivity of all hybridomas tested. In addition, most of the autoreactive hybridomas also demonstrated inhibition of reactivity to mutations in the amino half of the first domain of the I-A alpha- and beta-chains, which encodes the beta-pleated sheet of the floor of the Ag-binding groove. To confirm the role of processed peptides in the different patterns of reactivity, APC were incubated with competitor Ag and fixed by glutaraldehyde cross-linking before incubation with the autoreactive T hybridomas. The hybridomas were effectively inhibited by exogenous protein and peptide Ag. These results indicate that processed self-peptides are required to activate the autoreactive T cells.

Effect of pulsatile reperfusion on myocardial high energy phosphates following global ischemia

To evaluate the effects of pulsatile reperfusion (PR) on the postischemic myocardial phosphometabolites, 17 sheep were put on cardiopulmonary bypass (CPB) and randomly divided into a pulsatile group (P group) and nonpulsatile group (NP group). The heart was arrested by global ischemia for 45 minutes, then defibrillated and reperfused for 2 hours while the circulation was supported by CPB. Myocardial needle biopsies were obtained, and ATP, ADP, and AMP were measured with high performance liquid chromatography. There were no significant differences between the two groups in myocardial ADP and AMP. However, after 120 minutes of reperfusion, the myocardial ATP was restored in the P group, but continued to decrease further in the NP group. Experimental results imply that PR might reduce reperfusion injury and promote recovery of the ischemic myocardium.

Reduction of granulocyte-mediated lung injury in canine cardiopulmonary bypass by anisodamine infusion

The effect of infusing the M-cholinergic receptor blocker anisodamine during cardiopulmonary bypass (CPB) on granulocyte-mediated lung injury was evaluated in sixteen dogs undergoing CPB for 120 min with the aorta crossclamped for 90 min. The treated dogs (n = 8) received a total dose of 15 mg/kg anisodamine hydrochloride before and during CPB whereas the controls (n = 8) received saline only. A significantly reduced sequestration of granulocytes in the lungs was found in the treated dogs as indicated by a lower right-to-left atrium granulocyte gradient 15 minutes after pulmonary recirculation during CPB (p less than 0.05) and less granulocyte accumulation in the lung capillaries after CPB, as shown by histological examination (p less than 0.01). Moreover, oxygen free radical release as indicated by plasma malondialdehyde concentrations was significantly lower (p less than 0.05) in the treated dogs than in the controls towards the end of CPB. Finally, a significantly reduced lung-water content was found 30 min after CPB in the treated dogs as compared with the controls (p less than 0.01). These results suggest that anisodamine administration in this experimental model significantly inhibits pulmonary granulocyte sequestration in CPB and the consequent lung injury induced.

Immunodominance is altered in T cell receptor (beta-chain) transgenic mice without the generation of a hole in the repertoire

Despite the tremendous plasticity of the TCR repertoire, T cells recognize a limited number of antigenic sites (frequently a single site, or immunodominant epitope) on a complex protein Ag. Current models suggest that the immunodominant epitope of a complex protein is the processed peptide that binds to the MHC molecule with the highest affinity. Conversely, the inability of the T cell population to recognize a specific epitope, termed a "hole" in the repertoire, can prevent the immunodominance of a peptide despite efficient processing and MHC binding of the peptide. The role of specific TCR alpha- or beta-chains in determining MHC restriction and recognizing specific epitopes is complex and incompletely understood. To evaluate the contribution of each TCR chain to the functional diversity of the T cell repertoire, we investigated in vivo the T cell response to phage lambda-repressor protein in transgenic mice expressing a single rearranged beta-chain gene (C57L beta mice) in association with the complete germline alpha-chain repertoire. Our results demonstrate that expression of the TCR beta-chain transgene alters the immunodominant epitope recognized by T cells. However, after immunization with the appropriate peptide the transgenic mice can also respond to the nonimmunodominant epitope; thus, the expression of the TCR beta-chain transgene does not create a hole in the repertoire. These data indicate that the primary site, or immunodominant epitope, of an Ag recognized by T cells can be altered by the preimmune TCR repertoire independent of antigen processing and MHC affinity.

Immunodominance is altered in T cell receptor (beta-chain) transgenic mice without the generation of a hole in the repertoire

Despite the tremendous plasticity of the TCR repertoire, T cells recognize a limited number of antigenic sites (frequently a single site, or immunodominant epitope) on a complex protein Ag. Current models suggest that the immunodominant epitope of a complex protein is the processed peptide that binds to the MHC molecule with the highest affinity. Conversely, the inability of the T cell population to recognize a specific epitope, termed a "hole" in the repertoire, can prevent the immunodominance of a peptide despite efficient processing and MHC binding of the peptide. The role of specific TCR alpha- or beta-chains in determining MHC restriction and recognizing specific epitopes is complex and incompletely understood. To evaluate the contribution of each TCR chain to the functional diversity of the T cell repertoire, we investigated in vivo the T cell response to phage lambda-repressor protein in transgenic mice expressing a single rearranged beta-chain gene (C57L beta mice) in association with the complete germline alpha-chain repertoire. Our results demonstrate that expression of the TCR beta-chain transgene alters the immunodominant epitope recognized by T cells. However, after immunization with the appropriate peptide the transgenic mice can also respond to the nonimmunodominant epitope; thus, the expression of the TCR beta-chain transgene does not create a hole in the repertoire. These data indicate that the primary site, or immunodominant epitope, of an Ag recognized by T cells can be altered by the preimmune TCR repertoire independent of antigen processing and MHC affinity.

Membrane oxygenator prevents lung reperfusion injury in canine cardiopulmonary bypass

The effect of blood activation on lung reperfusion injury during cardiopulmonary bypass was investigated in 20 dogs with the use of a bubble oxygenator (n = 10) or a membrane oxygenator (n = 10). In the bubble oxygenator group, significant leukocyte and platelet right to left atrium gradients were found 15 minutes after lung reperfusion (p less than 0.05, p less than 0.01) accompanied by a sharp increase in plasma malondialdehyde concentration 5 minutes after lung reperfusion, whereas no significant right to left atrium gradient of leukocytes or platelets nor significant increase in plasma malondialdehyde concentration was observed in the membrane oxygenator group. In both the bubble oxygenator and membrane oxygenator group, similar mild to moderate lung histological changes were found before lung reperfusion. After lung reperfusion, however, more endothelial cell swelling (p less than 0.05), leukocyte (p less than 0.01) and platelet (p less than 0.01) accumulation in lung capillaries, leakage of erythrocytes into the alveolar space (p less than 0.05), and type I cell damage (p less than 0.05) were found only in the bubble oxygenator group. Eventually, a significantly higher lung water content was found in the bubble oxygenator group than in the membrane oxygenator group (p less than 0.01) after cardiopulmonary bypass. This study indicated that lung injury during cardiopulmonary bypass starts mainly after lung reperfusion, which was correlated with lung leukocyte and platelet sequestration associated with different types of oxygenators.

Abnormal thyroid hormone levels in critical nonthyroidal illness

Low levels of thyroid hormone in the absence of clinical hypothyroidism often happen to patients with critical non-thyroidal illnesses (NTI). Low thyroid hormone concentrations in serum do not necessarily mean hypofunction of the thyroid gland; rather it is a helpful adaptation of the human body to the underlying diseases. We collected 133 hospitalized cases of critical NTI and analyzed the incidence of this phenomenon. Fifty-three per cent of the patients had T3 level lower than 60 ng/dl (normal:85-165 ng/dl) and 60% had T4 level lower than 6 ug/dl (normal:6-12 ug/dl). The lowest levels were observed in patients who had sepsis, were aged over 70 or died in this admission. Free T4 and TSH levels were within normal range in most cases. There is a strong negative correlation between the prognosis and the level of T4 in these patients. Those patients with markedly low levels of T3 and T4 should be treated more sophisticatedly.

Serotonin (5-HT1c) receptors in pig choroid plexus

It is very important to find suitable reaction conditions to attain a high specific binding (specific/total binding) in the receptor binding study. Membrane homogenates of pig choroid plexus are known to have exclusively serotonin (5-hydroxytryptamine, 5-HT) receptor of the subtype 5-HT1c. In this study, we used the membrane preparation of pig choroid plexus tissue and the specific binding of [3H]5-HT was 72-84% to serotonin receptor subtype 5-HT1c, as defined by the inhibition of 1 uM 5-HT, when a radioligand concentration of 0.5 nM of [3H]5-HT was used in the assay. Analysis of the properties of specific [3H]5-HT binding in pig choroid plexus tissue membrane preparation revealed linear Scatchard plots. In Tris-HCl buffer without CaCl2, pargyline or ascorbic acid, high average of affinity dissociation constant (Kd) of 1.3 +/- 0.2 nM (SEM, n = 4) and also a high average of receptor density (Bmax) of 284 +/- 12 fmol/mg of protein were found. Pig choroid plexus proves to be a good material for 5-HT1c receptor binding study.

Influences of a novel immunopotentiator polyactin A on interleukin 1 production and responsiveness in mice

Effects of a novel immunopotentiator Polyactin A (PAA), developed in China, on production and responsiveness of murine interleukin 1(IL-1) were investigated. The results demonstrated that: (1) PAA 0.01-100 micrograms.ml-1 directly induced IL-1 synthesis and secretion from murine peritoneal macrophages (PMO) and markedly enhanced IL-1 production of the mouse PMO stimulated by lipopolysaccharides (LPS) of E coli; (2) IL-1 release from the PMO cultured in PAA 0.1 micrograms.ml-1 was detectable as early as 2 h after the incubation, peaked at 24 h, and then decreased gradually; (3) PAA stimulated and enhanced both IL-1 synthesis and release, but its effect on IL-1 release was stronger; (4) PMO from the mice given po PAA 200 mg.kg-1.d-1 for 7 d produced a higher level of IL-1 than those from control group, and the increase in extracellular IL-1 was more significant than that in intracellular one; (5) in vivo, PAA had no effect on IL-1 receptor expression and IL-1 responsiveness of murine lymphocytes, but eliminated the suppressing effects of cyclophosphamide (Cyc) on IL-1 receptor expression and IL-1 responsiveness of mouse lymphocytes. The above findings provide new explanation for action of PAA and new basis for wider clinical applications of PAA.

Abelson murine leukemia virus transforms preneoplastic Emu-myc transgene-carrying cells of the B-lymphocyte lineage into plasmablastic tumors

E mu-myc transgenic mice were back-crossed to BALB/c mice up to back-cross generation 3. The offspring that included transgene-carrying and -negative mice in approximately equal proportions were randomly divided into 2 groups. Thirty-four mice (group I) were treated with pristane, followed by A-MuLV, and 40 (group II) were injected with A-MuLV alone. Altogether, 16 lymphoid tumors developed in group I and 17 in group II. Nine of the tumors in group I and 4 in group II appeared as ascitic tumors. The ascites contained lymphoblasts and 10 to 45% plasmacytoid cells. These tumors were designated as plasmablastic lymphomas (PLs). All tumors except one were transgene-positive and did not carry translocations. An exceptional tumor in group I carried a variant 6;15 translocation but not the transgene. It obviously corresponds to the regular Abelson + pristane-induced plasmacytoma. Among 11 tested PLs, 10 had a single retroviral insertion site, while one tumor showed 3. Among 18 untreated transgenic descendants (group III), chosen randomly during serial back-crosses, 15 (83%) developed lymphomas, with no sign of plasmacytoid differentiation. The incidence was comparable in all 3 groups, assuming 50% of the mice in groups I and II to be transgenic. The time distribution of tumor development was also similar. Spleen cells from transgene-carrying mice with no clinical sign of lymphoma were infected in vitro with A-MuLV and transplanted i.p. into BALB/c recipients. PLs developed in 26 of 31 pristane-treated recipients, but in only one of 18 untreated recipients. One of 6 PLs tested was monoclonal, whereas the remaining 5 were oligoclonal. They all expressed v-abl. These results show that some of the preneoplastic B-cells that expressed constitutively active myc transgene turned into plasmablasts after infection with A-MuLV. Full development of their neoplastic potential was facilitated by the presence of pristane-granuloma.

[Retinochoroidal changes in experimental severe ocular contusion]

In rabbit models of severe retinal contusion, the retinal edema at the posterior pole resolved in 2 weeks after trauma, leaving central depigmentation and encircling pigmentation. Electroretinogram was diminished permanently and fluorescein angiography showed leakage and staining. The pathologic changes comprised irreversible disruptions of choroidal capillaries, the outer layer of Bruch membrane, retinal pigment epithelium (RPE) and photoreceptor cells, indicating that the regenerative capacity of choroidal capillaries and RPE cells was limited. Transient edema in the inner retinal layers and erythro-phagocytosis by RPE cells were observed.