A case of combined gastrojejunal and gastrocolic fistula secondary to gastric cancer

A rare case of gastric cancer associated with gastrojejunal and gastrocolic fistula is presented. A 56-year-old man who had been diagnosed with advanced gastric cancer(Borrmann's type III) 5 months previously was admitted due to watery diarrhea and frequent vomiting for 2 weeks. Fluoroscopic examination was visualized two abnormal passage of contrast medium from the stomach, one to the colon, and the other to the jejunum. Gastrofiberscopy revealed that the tumor on the great curvature of the body appeared to penetrate into the colon, while the other one on the antrum directly invaded into the jejunum. The patient was treated conservatively with total parenteral nutrition and pain control.

A novel H1 mutation in the keratin 1 chain in epidermolytic hyperkeratosis

We report a novel mutation in a case of epidermolytic hyperkeratosis that results in a proline for arginine substitution in the penultimate residue position of the H1 subdomain of the keratin 1 chain, which is near the beginning of the rod domain. This causes a severe clinical disease classified as PS-2. Therefore, the H1 subdomain is probably equally important for the maintenance of keratin intermediate filament integrity as the rod domain. Since earlier concepts had implied that mutations in the H1 subdomain produce milder disease, this case suggests that attempts to correlate mutations with disease presentation remain problematic.

Chicken homeobox gene Prox 1 related to Drosophila prospero is expressed in the developing lens and retina

Prox 1 is the vertebrate homolog of Drosophila prospero, a gene known to be expressed in the lens-secreting cone cells of fly ommatidia. Chicken Prox 1 cDNAs were isolated from 14 day embryonic chicken lenses, and a complete open reading frame encoding an 83 kDa protein was elucidated. The homeodomains of chicken and mouse Prox 1 are identical at the amino acid level and are 65-67% similar to the homeodomains of Drosophila and C. elegans prospero. The homology between these proteins extends beyond the homeodomain. There is 56% identity between chicken Prox 1 and Drosophila prospero in the C-terminal region downstream of the homeodomain, whereas there is little similarity upstream of the homeodomain. Prox 1 is expressed most actively in the developing lens and midgut and at lower levels in the developing brain, heart, muscle, and retina. cDNA sequencing has established that there are alternatively spliced forms of the single Prox 1 gene, which probably account for the two abundant RNAs of about 2 and 8 kb and two less abundant RNAs close to 3.5 kb in length in the lens. In the lens fibers, only the shortest mRNA was present, whereas, in the epithelial cells, both short and long mRNAs were detected. By using in situ hybridization, expression of the Prox 1 gene was first detected at stage 14 in the early lens placode and slightly preceded the expression of delta 1-crystallin, the first crystallin gene expressed in the developing chicken lens. At later stages of development, Prox 1 mRNA was observed throughout the lens, but it appeared more abundant around the bow region of the equator than in the anterior epithelium or the fibers. In the retina, expression of the Prox 1 gene was detected mainly in the inner nuclear layer during later stages of histogenesis. The conserved pattern of Prox 1/prospero gene expression in vertebrates and Drosophila suggests that Prox 1, like Pax-6, may be essential for eye development in different systematic groups.

Interaction of P-glycoprotein with protein kinase C in human multidrug resistant carcinoma cells

Indirect evidence has suggested that P-glycoprotein (P-gp), the multidrug transporter, is phosphorylated by protein kinase C (PKC) and that phosphorylation modulates its transport function. To address the first premise more directly, ie., that P-gp is phosphorylated by PKC, we investigated the interaction between P-gp and PKC in sensitive and multidrug resistant MCF-7 and KB human carcinoma cell lines. We found that P-gp and PKC were coimmunoprecipitated from the multidrug-resistant cell lines MCF-7/AdrR and KB-V-1, using antibodies to either protein. The association between the two proteins was enhanced by phorbol 12-myristate 13-acetate, an analogue of diacylglycerol that induces translocation of PKC to the plasma membrane. The anti-P-gp immunoprecipitates contained PKC activity as measured by direct phosphorylation reactions. The interaction of PKC with P-gp displayed isozyme specificity: PKC-alpha, -beta, gamma, -epsilon, and -phi, but not -delta, -mu, -zeta, -lambda, were found to coimmunoprecipitate with P-gp. These studies indicate that P-gp closely interacts with PKC and serves as a substrate, and that specific isozymes of this kinase may be involved in the phosphorylation of the multidrug transporter.

Factors affecting urethrocystographic parameters in urinary continent women

To evaluate the urethrocystographic changes in different conditions, 154 women were evaluated by using introital sonography. Patients were divided into three groups: group 1 (n = 103) normal, including 10 postmenopausal women; group 2 (n = 46) pregnant, including 16 women in the first trimester, 15 in the second trimester, and 15 in the third trimester; group 3 (n = 15) severe genitourinary prolapse. None of the 154 women had a history of urinary incontinence. The following parameters were measured at rest: urethral thickness, uretheral length, urethral inclination, and posterior urethrovesical angle. On maximum straining, urethral inclination, posterior urethrovesical angle, and rotational angle were measured. In general, age, parity, and menopause did not affect the urethrocystographic parameters in Group 1 patients. Postmenopausal women had a significant decrease in the urethral thickness compared with the premenopausal women (p = 0.026). Patients in Groups 2 and 3 had a significantly lower urethral position than those in group 1. However, hypermobility of the urethra was found only in Group 3. Different menstrual ages did not affect the urethral position but could affect the posterior urethrovesical angle at rest in the first trimester. Introital sonography, without the risk of radiation exposure, enables the observation of static and dynamic changes in the lower urinary tract, both repeatedly and reproducibly.

Radiation-induced graft copolymer SBS-g-VP for biomaterial usage

The grafting of 4-vinyl pyridine (VP) to styrene-butadienestyrene triblock copolymer (SBS) by radiation-induced graft copolymerization was studied. The cohesive properties such as cohesive energy (Ecoh), molar volume (V), solubility parameter (delta), molar molecular weight (WM), specific volume (Vg), and density (1/Vg) of SBS-g-VP graft copolymer were calculated according to the group contribution of Fedors. The morphology of SBS-g-VP was studied by optical polarizing microscopy. We also measured the glass transition temperature and the mechanical properties of SBS-g-VP graft copolymer. Contact angle and blood-clotting time experiments were also performed to evaluate the biocompatibility of SBS-g-VP. A second domain was found in the SBS-g-VP graft copolymer, which resulted in different properties between SBS-g-VP and SBS. The blood compatibility of SBS-g-VP as measured by the Lee-White clotting test was better than that of SBS and polystyrene.

Simultaneous effects of carbachol on intracellular Na+ activity, action potential, and twitch tension in guinea-pig cardiac ventricular papillary muscles

Effects of carbachol (CCh) on the twitch tension, intracellular Na+ activity (aNai), and action potential were simultaneously measured in guinea-pig cardiac ventricular papillary muscles. In fibers driven at 60 beats/min, 100 microM CCh significantly increased the twitch tension and aNai, and decreased the action potential duration at 30 and 90% repolarization (APD30 and APD90) without changing the maximum rate of the rise of the upstroke (Vmax). Staurosporine (1 microM) alone gradually decreased the twitch tension and aNai without changing the action potential. In the presence of staurosporine, the administration of CCh restored aNai and caused the same changes in twitch tension and APD shortening with no effect on Vmax. Pretreatment with 1 microM atropine completely eliminated the effects of 100 microM CCh. Cesium (20 mM) depolarized the cell membrane and significantly increased the twitch tension and APD90 with decreases in the Vmax and aNai. CCh (100 microM) in the presence of 20 mM Cs+ biphasically decreased and increased the twitch tension and significantly decreased the Vmax and aNai with an increase in the APD90. The results suggest that the muscarinic receptor-mediated increase of aNai is protein kinase C-independent. The aNai increase is associated with the positive inotropic effect and the abbreviation of the action potential duration. In addition to the increase in aNai, the increase of the myofibrillar calcium sensitivity involved is responsible for the positive inotropic effect which is still evident after the sodium influx is inhibited by Cs+.

Interactions between inositol trisphosphate and Ca2+ dependent Ca2+ release mechanisms on the endoplasmic reticulum of permeabilised bovine aortic endothelial cells

In this paper we describe data from cultured bovine aortic endothelial (BAE) cells demonstrating a Ca2+ induced Ca2+ release (CICR) process which appears to have pharmacological properties different from CICR mechanisms in other cell types. CICR was measured in saponin permeabilised cells in which the internal stores had been preloaded with 45Ca2+. Step increases in the free Ca2+ concentration of the bathing solution, from 10 nM up to 10 microM were found to increase 45Ca2+ loss. This process was completely inhibited by ruthenium red. Caffeine induced a small release of 45Ca2+ and the response to a subsequent stimulation with a Ca2+ step was reduced. In intact cells, ryanodine activated small oscillations in intracellular Ca2+ in the presence, but not the absence, of external Ca2+. However, in permeabilised cells, ryanodine had no effect on either basal efflux or the increased efflux of 45Ca2+ seen following a step increase in free Ca2+. These data suggest the operation of a ruthenium red sensitive but ryanodine insensitive CICR mechanism on the endoplasmic reticulum (ER) which may also be modulated by caffeine. An IP3 dependent 45Ca2+ release was also observed. In the presence of ruthenium red, the IP3 induced 45Ca2+ release was reduced suggesting that CICR may operate to amplify the magnitude of the IP3 response. The Ca2+ dependence of the IP3 induced release was also measured. Co-operativity between IP3 and Ca2+ could not be detected between 100-300 nM Ca2+. The results suggest that the regulation of IP3 induced Ca2+ release may be different in BAE cells, and point to the operation of a 'novel' CICR process and to complex interactions between Ca2+ release systems in BAE cells.

Effects of phenylephrine on intracellular Na+ and H+ activities in guinea-pig cardiac ventricular papillary muscles

Effects of phenylephrine (PE) on the contractility, intracellular Na+ activity (aNai), intracellular H+ activity (pHi), and membrane potential in guinea-pig cardiac ventricular papillary muscles were studied. In beating fibers, PE significantly increased the twitch offsion, pHi and the action potential duration but decreased aNai. These effects could be inhibited by phentolamine, but not by propranolol. In quiescent fibers, PE also increased the resting tension and pHi, and decreased aNai. Pretreatment with phentolamine completely abolished the effect of PE. Methylisobutyl amiloride (MIA), a potent inhibitor of Na(+)-H+ exchanger, significantly decreased membrane potential, aNai, and pHi without changing the resting tension. PE in the presence of MIA increased the resting tension and further decreased aNai without significant changes in membrane potential and pHi. Ouabain significantly decreased membrane potential and pHi, and increased the resting tension and aNai. In the ouabain-treated fiber, PE further increased the resting tension without decreasing aNai or increasing pHi. From these results, it appears that PE activates the Na(+)-K+ pump and Na(+)-H+ exchange through alpha-adrenoceptors. Activation of the Na(+)-K+ pump contributes, at least in part, to the enhanced Na(+)-H+ exchange. The increase in contractile force associated with a decrease in aNai is suggested to result from the intracellular alkalization and increased sensitivity of contractile protein to Ca2+.

Amplification of 19q13.1-q13.2 sequences in ovarian cancer. G-band, FISH, and molecular studies

In this study of ovarian carcinoma, we extended previous findings by performing FISH using chromosome 19 paint and microFISH probes and patient samples with and without abnormalities of chromosome 19 identified by G-banding. Karyotype interpretations of der(19) were confirmed, while additional 19 translocations were also detected by FISH with 19WCP in some cases. Similar FISH studies of ovarian carcinoma cell lines found chromosome 19 abnormalities even after extensive in vitro culture. MicroFISH probes were generated by chromosome microdissection from two cases with hsr(19) and mapped to 19q13.2 and 19q13.1-.2, respectively. FISH with these microFISH probes alone or in combination with a 19WCP probe to four patient samples and seven cell lines showed that 65% of chromosome 19 structural abnormalities contained 19q13.1-q13.2 sequences, sometimes as large hsrs. Ovarian cancer cell lines showed amplification and overexpression of the AKT2 putative oncogene, but not the ERCC-2 DNA repair gene in this chromosomal region. In addition to AKT2, amplification and overexpression of other yet-unidentified genes in the 19q13.1-q13.2 region may contribute to ovarian carcinoma pathogenesis or progression.

Isolation of presumptive Streptobacillus moniliformis from abscesses associated with the female genital tract

We report three cases in which Streptobacillus moniliformis was isolated from abscesses. Abscess material in each case contained small, pleomorphic, gram-negative to gram-variable bacilli. Anaerobic blood agar cultures yielded pinpoint colonies adjacent to small gray-white colonies. The pinpoint colonies did not gram stain, and the gray-white colonies varied from gram-variable coccobacilli to long, curly, gram-variable rods. The pinpoint colonies microscopically resembled L-forms on Dienes-stained agar preparation. Subculture to serum-supplemented thioglycolate broth demonstrated "puff ball" colonies. Fatty acid profiles obtained with use of gas chromatography coupled with mass spectrometry showed major peaks for C16:0, C18:2, C18:1, and C18:0 fatty acids, a profile characteristic of S. moniliformis. Results of biochemical testing of each isolate were equivocal. S. moniliformis, bacterial L-forms, and common isolates from genital tract abscesses are discussed.

The proximal promoter of the human transglutaminase 3 gene. Stratified squamous epithelial-specific expression in cultured cells is mediated by binding of Sp1 and ets transcription factors to a proximal promoter element

The transglutaminase 3 enzyme is expressed during the late stages of the terminal differentiation of the epidermis and in certain cell types of the hair follicle. The enzyme is thought to be critically involved in the cross-linking of structural proteins and in the formation of the cornified cell envelope, thereby contributing to rigid structures that play vital roles in shape determination and/or barrier functions. To explore the mechanisms regulating the expression of the transglutaminase 3 gene (TGM3), 3.0 kilobase pairs of sequences upstream from the transcription start site were assessed for their ability to control the expression of a chloramphenicol acetyltransferase reporter gene. Deletion analyses in transiently transfected epidermal keratinocytes defined sequences between -126 and -91 as the proximal promoter region of the gene, and which can confer epithelial-specific expression to the TGM3 gene in vitro. Mutation and DNA-protein binding analyses indicated that a complex interaction between adjacent Sp1- and ets-like recognition motifs with their cognate binding factors is required for the function of the TGM3 promoter. As these TGM3 sequences can confer promoter/enhancer activity to reporter genes at a level comparable to the powerful SV40 promoter, they may be useful for gene therapy in keratinocytes.

Central and peripheral hemodynamics in severe preeclampsia

BACKGROUND

Doppler velocimetry, a new tool for measuring blood flow, vascular resistance, and central hemodynamics can be applied to monitor those patients at risk and provide therapeutic concepts for preeclampsia. This study was designed to use a Doppler velocimetry study to correlate the relationship between central hemodynamics, uteroplacental circulation, and the perinatal outcome in severe preeclampsia.

METHODS

Thirty-one patients with severe preeclampsia, not superimposed with any medical disorder and not on antihypertensive treatment prior to admission, were enrolled in this study. On admission, laboratory determination of the maternal blood chemistry and hematogram, together with a Doppler ultrasound study of the maternal hemodynamics, and umbilical and uterine arteries, were performed. Antihypertensive agents including hydralazine, atenolol, and labetolol were given according to the state of the maternal central hemodynamics. Data were collected on the general status of the patients, the results of the Doppler ultrasound study, and the perinatal outcome.

RESULTS

Patients were divided into three groups based on the systemic vascular resistance. The left ventricular function and cardiac index declined with increase in vascular resistance. The high-resistance group had a significantly high incidence of infants small for gestational age. Poor fetal growth in the high-resistance group could be attributed to the summation of underperfusion due to decreased uteroplacental blood flow and was frequently associated with maternal hemoconcentration.

CONCLUSIONS

Although global vasospasm has been considered to be the basic pathophysiology of preeclampsia, the central hemodynamics varies between, and even in the same, patients. Regional vasospasm in the uteroplacental circulation occurs earlier than in the systemic circulation as a whole. A high cardiac-output in low systemic-vascular-resistance might compensate in those pregnancies with high uterine artery resistance to maintain adequate uteroplacental perfusion.

Effects of severe preeclampsia with different doppler velocimetries on extra- and intrauterine environments

We evaluated the perinatal outcome of fetuses and maternal condition of 47 patients with severe preeclampsia. Antepartum fetal surveillance (within 2 days of delivery or fetal death) included the nonstress test, Doppler velocimetry of the umbilical and uterine arteries, amniotic fluid assessment, maternal blood chemistry and hemogram. Pregnancies with abnormal Doppler velocimetry in the umbilical and uterine arteries had poor perinatal outcomes as judged by the incidence of abnormal antepartum fetal surveillance, acute fetal distress mandating immediate delivery, small for gestational age infants, perinatal morbidity and mortality and prematurity. These fetuses were at a high risk of acute and chronic hypoxia. Maternal blood chemistries and hemograms revealed a high incidence of hepatocellular dysfunction, renal insufficiency, hemoconcentration and thrombocytopenia. In cases of severe preeclampsia, those with abnormal Doppler velocimetry of both umbilical and uterine arteries, had poor extra- and intrauterine environments. Therefore, aggressive rather than expectant management was more suitable. For those with normal umbilical artery resistance and either normal or abnormal uterine artery resistance, careful management with close monitoring of both maternal and fetal status was possible in patients who were far from term.

Regional mapping of the human platelet-activating factor receptor gene (PTAFR) to 1p35-->p34.3 by fluorescence in situ hybridization

The human platelet-activating factor cell-surface receptor (PTAFR) is a G protein-coupled receptor thought to contribute to many atopic and inflammatory diseases and, perhaps, to the growth of some neoplasms. Exploring the possibility that the PTAFR might be involved in the genetic predisposition to any disease requires knowledge of its chromosomal localization. In this paper we have used a 20-kb human genomic fragment containing the coding sequence of the cloned PTAFR to determine the regional chromosomal localization of the gene. Using fluorescence in situ hybridization, the localization of the human PTAFR gene was mapped to 1p35-->p34.3.

Identification of metabolites of azaperone in horse urine

Two metabolites of the tranquilizer azaperone were extracted from alkalinized horse urine after treatment with beta-glucuronidase/sulfatase from limpets (Patella vulgata). The metabolites were identified by a combination of independent chemical synthesis and GC/MS and 1H NMR analysis. The metabolites were identified as 1-(fluorophenyl)-4-[4-(5-hydroxy-2-pyridinyl)-1-piperazinyl]-1-butanol, designated as 5'-hydroxy-azaperol, and 1-(fluorophenyl)-4-[4-(5-hydroxy-2-pyridinyl)-1-piperazinyl]-1-butanone, designated as 5'-hydroxyazaperone. A TLC screening test was developed for detecting both metabolites in basic extracts of horse urine treated with beta-glucuronidase/sulfatase. The screening test was used to detect azaperone metabolites in extracts of horse urine collected for 24 h after intravenous administration of azaperone. The administration of azaperone to horses was confirmed by GC/MS identification of 5'-hydroxyazaperone and 5'-hydroxyazaperol from basic extracts of horse urine treated with beta-glucuronidase/sulfatase. The extracted metabolites were treated with bis(trimethylsilyl)acetamide to produce trimethylsilyl (TMS) ether derivatives, and mass spectra and retention times were compared to those of the synthesized metabolites treated in the same manner.

P-glycoprotein-mediated multidrug resistance: experimental and clinical strategies for its reversal

The study of the cellular, biochemical, and molecular biology and pharmacology of MDR has provided one of the most active and exciting areas within cancer research and one that holds great promise for translation into clinical benefit. While convincing evidence for the functional role of P-gp in mediating clinical drug resistance in humans remains elusive, studies of the clinical expression of P-gp and trials of chemosensitizers with cancer chemotherapy suggest "resistance modification" strategies may be effective in some tumors with intrinsic or acquired drug resistance. However, even if P-gp-associated MDR proves to be a relevant and reversible cause of clinical drug resistance, numerous problems remain to be solved before effective clinical chemosensitization may be achieved. Such factors as absorption, distribution, and metabolism; the effect of chemosensitizers on chemotherapeutic drug clearance; toxicity to normal tissues expressing P-gp; and the most efficacious modulator regimens all remain to be defined in vivo. Clearly, the identification of more specific, potent, and less clinically toxic chemosensitizers for clinical use remains critical to the possible success of this approach. Nonetheless, the finding that a number of pharmacological agents can antagonize a well-characterized form of experimental drug resistance provides promise for potential clinical applications. Further study of chemosensitizers in humans and the rational design of novel chemosensitizers with improved activity should define the importance of MDR in clinically resistant cancer.

Proliferation tissue polypeptide antigen distinguishes malignant mucinous cystadenocarcinomas from benign cystic tumors and pseudocysts

BACKGROUND

Cystic lesions of the pancreas include inflammatory pseudocysts, serous cystadenomas, and mucinous cystic tumors, some of which are malignant. Previous studies have shown that malignant mucinous tumors differ from benign pancreatic cysts in proliferative activity, secretion of tumor markers, and expression of growth factor receptors. Analysis of aspirated cyst fluid for tumor markers, viscosity, and cytologic examination has been proposed as an aid to preoperative differential diagnosis. Tissue polypeptide antigen (TPA) is a soluble proliferation antigen produced by rapidly dividing tissues, including conventional ductal pancreatic carcinoma. TPA levels in pancreatic cyst fluids have not been reported.

METHODS

Tissue polypeptide antigen levels were determined in 46 pancreatic cyst fluids using a commercial immunoassay technique.

RESULTS

Mucinous cystadenocarcinomas exhibited significantly higher levels of cyst fluid TPA than benign cystic lesions, including pseudocysts, serous cystadenomas, and benign mucinous cystadenomas (mean 910,672 U/mL, median 300,900 U/mL, range 16,600 to 4,210,000 U/mL for malignant mucinous cystadenocarcinomas; versus mean 16,082 U/mL, median 2,455 U/mL, range 0 to 155,000 U/mL for benign cystic lesions considered as a group; P < 0.0002). In 75% of the malignant cysts, the TPA values were in excess of 100,000 U/mL. Pseudocysts exhibited the lowest TPA levels (mean 2,108 U/mL, median 604 U/mL, range 0 to 20,240 U/mL) and were significantly lower than the values observed in cystic tumors (P < 0.0005). Serous and benign mucinous tumors had intermediate levels of TPA.

CONCLUSIONS

Elevated levels of the proliferation antigen TPA in malignant pancreatic cysts correlate with earlier observations of increased proliferative activity and overexpression of growth factor receptors in these tumors. The TPA measurement may be a useful addition to previously reported cyst fluid markers to aid in preoperative differential diagnosis. Markedly elevated or very low values indicate a malignant or benign cyst, respectively.

Calorimetric characterization of the formation of acrylic type bone cements

The formation of acrylic bone cements upon heating was investigated by differential scanning calorimetry (DSC). The effects of the contents of initiators, accelerator, biocompatibilizer, and crosslinking agents on the rate and the heat of polymerization during DSC heating were studied. The rate and the heat of polymerization (delta H) were characterized by the peak temperature and the area of the DSC exotherm, respectively. It was found that both the rate and heat of polymerization decreased with increasing heating rate. The delta H was increased considerably with increasing benzoyl peroxide (BPO) initiator concentration from 1 to 10% (w/v), whereas the rate of polymerization was reduced significantly. An increase in azobisisobutyronitrile (AIBN) initiator concentration also induced an increase in delta H, but the rate of reaction was not affected considerably. The addition of accelerator promoted the rate of reaction but resulted in a drop in delta H. The rate of polymerization for the system containing BPO initiator was increased quite significantly with the addition of hydroxyethyl methacrylate (HEMA) biocompatibilizer, while the delta H was slightly increased. For the system using AIBN as the initiator, the rate of polymerization was decreased slightly and the delta H dropped significantly with the addition of HEMA. The effect of ethylene glycol dimethacrylate (EGDMA) crosslinking agent was also examined. Polymerization became more rapid with the addition of EGDMA in the bone cement using BPO initiator, while it remained approximately constant for the system using AIBN as the initiator. No systematic change in delta H was observed with the addition of EGDMA in both systems. This study demonstrated that DSC is a potential tool to measure the amount of heat released and also the rate of polymerization for bone cements.

Sodium nonivamide acetate: a non-pungently antinociceptive capsaicin derivative with unusual anti-inflammatory properties

1. Bradykinin-induced vascular pain in conscious rats, hyperalgesia in the rat hind paw, rat hind paw edema induced by compound 48/80 and carrageenin and dye exudation induced by intraperitoneal injection of 0.7% acetic acid in mice were all inhibited by sodium nonivamide acetate (SNA). 2. Collagen and arachidonic acid-induced rabbit platelet aggregations were inhibited by SNA and capsaicin. In human platelet microsomes, prostaglandin E2 formation in arachidonic acid metabolite was not inhibited by SNA but was inhibited by capsaicin and indomethacin; thromboxane B2 formation and its synthetase activity were inhibited by SNA and capsaicin. 3. In the extracellular recording, SNA could not decrease the action potential amplitude of the vagus nerve. 4. The motor activity of mice induced by caffeine (1.0 mg/kg) was inhibited by SNA and capsaicin.

What kind of maternal factor might predict poor perinatal outcome in severe preeclampsia?: a study based on doppler velocimetry

BACKGROUND

Umbilical artery Doppler velocimetry has been used as an important perinatal tool to identify fetal compromise. However, the fact that it is both expensive and time-consuming makes it not always available. This study was a search for any maternal serum laboratory test which might be much simpler and easier than Doppler velocimetry, and still determining the perinatal outcome in severe preeclampsia.

METHODS

Forty-seven patients with severe preeclampsia were enrolled in this study. Doppler velocimetry of umbilical artery, maternal serum biochemistry and hematological tests were all performed within two days prior to delivery or fetal death.

RESULTS

By choosing a maternal hematocrit (Hct) of greater than 44% as the cutoff value, a significantly higher incidence of adverse perinatal events was noted in patients with abnormal value than those with normal value. Abnormal Hct level as a predictor of adverse perinatal outcome had a sensitivity of 50.0%, a specificity of 84.2%, a positive predictive value of 53.3% and a negative predictive value of 63.8%.

CONCLUSIONS

This study found that elevated maternal Hct (> 44%) levels might indicate a condition of hemoconcentration with reduced placental perfusion in severely preeclamptic patients. Hct level can serve as a clinically useful predictor of adverse perinatal outcome.

Mechanisms underlying aberrant glycosylation of MUC1 mucin in breast cancer cells

The product of the MUC1 gene, the polymorphic epithelial mucin (PEM) is aberrantly glycosylated in breast and other carcinomas, resulting in exposure of normally cryptic peptide epitopes. PEM expressed by breast cancer cells contains more sialylated O-glycans and has a lower GlcNAc content than that expressed by normal cells. The exposure of peptide epitopes is thus thought to be due to the sugar side chains being shorter on the tumour-associated mucin. To investigate possible mechanisms underlying the different pattern of glycosylation in breast cancer cells, we analysed the pathways involved in the biosynthesis of O-glycan chains of mucins in normal and cancerous mammary epithelial cells. An immortalized mammary epithelial cells line originating from normal human milk. MTSV1-7, and three human breast cancer cell lines, BT20, MCF-7 and T47D, were studied. Glycosyltransferase activities assembling, elongating and terminating O-glycan core-1 [Gal beta 1-3GalNAc alpha-R] and core-2 [GlcNac beta 1-6 (Gal beta 1-3) GalNAc alpha-R] were present in the normal mammary cell line. Many of the glycosyltransferase activities were also expressed at variable levels in breast cancer cells. However, a sialyltransferase activity (CMP-sialic acid Gal beta 1-3GalNAc alpha 3-sialyltransferase) was increased several fold in all three cancer cell lines. Moreover, mammary cancer cell lines BT20 and T47D have lost the ability to synthesize core-2, as shown by the lack of UDP-GlcNAc: Gal beta 1-3GalNAc (GlcNAc to GalNAc) beta 6-GlcNAc-transferase activity, which corresponded to the absence of the mRNA transcript. However, MCF-7 breast cancer cells expressed this enzyme. Thus, the mechanism for the exposure of peptide epitopes in BT20 and T47D cells is proposed to be the loss of core-2 branching leading to shorter, sialylated O-glycan chains. A different mechanism is proposed for MCF-7 breast cancer cells.

Transvaginal ultrasound-guided aspiration in the treatment and follow-up of tubo-ovarian abscess: a report of two cases

Two cases of tubo-ovarian abscess are presented in this study; treatment and follow-up were undertaken by transvaginal ultrasound. Transvaginal ultrasound-guided aspiration with anti-microbial therapy may be a useful alternative for treatment of unruptured tubo-ovarian abscess.

Mini-catheter used for bladder drainage following stress-incontinence surgery and the factors relating to drainage failure

OBJECTIVES

To determine the most effective length for the mini-catheter and to discuss factors relating to drainage failure.

METHODS

Prospective study of a No. 8 silastic feeding tube for bladder drainage omits the necessity of additional catheterization for measuring residual urine. This two-part study in which 146 patients took part, first, determined the suitable length for insertions for the perforated portion and the imperforated portion; then, gauged the effectiveness of the mini-catheter with desired proportions.

RESULTS

Drainage is better when the imperforated portion is at least 5 cm in length (p = 0.0129). The length of the perforated portion, on the other hand, has less impact of the resultant drainage provided that its length does not exceed 5 cm. Beyond this length, an obstruction often occurs. There were 2 obstructions (1.3%) induced by blood clot as well as 9 patients (5.8%) who suffered from one, or more, complications attributed to the mini-catheter for reasons other than the length of insertion.

CONCLUSIONS

When care is taken in creating a mini-catheter of the proper proportions, it offers many advantages and very few complications to gynecologists and patients alike.

Isolation and characterization of sulphoxidation metabolites of moricizine in rat and human biological fluids

The sulphoxidation metabolites of moricizine, moricizine sulphoxide (M-sulphoxide) and moricizine sulphone (M-sulphone) were isolated and identified in the rat bile and urine and in human plasma and urine following administration of moricizine hydrochloride. The sulphoxide and sulphone were synthesized chemically by peroxidation of moricizine hydrochloride with hydrogen peroxide at 25 degree C and 60 degree C, respectively, and were characterized by melting point determination (MP), infrared spectroscopy (IR), mass spectroscopy (MS), thin layer chromatography (TLC) and high performance liquid chromatography (HPLC). In the rats (n=7), which were kept in metabolic cages and given intravenous moricizine (0.72 mg), the mean +/- SD percentages recovered in the urine as moricizine, M-sulphoxide and M-sulphone were 0.11 +/- 0.09%, 0.74 +/- 0.45% and 5.16 +/- 4.24%, respectively. The corresponding recoveries in the bile were 0.13 +/- 0.04% as moricizine, 3.39 +/- 1.62% as M-sulphoxide and 2.16 +/- 1.07% as M-sulphone. After an oral dose of moricizine HCl (300 mg) the plasma concentrations of moricizine, M-sulphoxide and M-sulphone at 4 h in two healthy subjects were 0.43, 0.11 and 0.10 microg/ml and 0.32, 0.17 and 0.27 microg/ml, respectively for Subject 1 and Subject 2. The percentages of dose recovered in the urine as moricizine, M-sulphoxide and M-sulphone were 0.14 and 0.02%, 0.27 and 0.36%, and 0.30 and 0.24%, respectively for Subject 1 and Subject 2. It is suggested that an investigation of the disposition of moricizine and its sulphoxidation metabolites in patients will be valuable for elucidating the prolonged effects in the treatment of ventricular arrhythmias.

Relationship between acute fetal distress and maternal-placental-fetal circulations in severe preeclampsia

BACKGROUND

Hypoxic complications are thought to be the result of vascular lesions in the maternal-placental or fetal-placental circulation, with a resultant decrease in blood flow. This study was designed 1) to explore what kind of pathophysiological changes occur in the maternal-placental-fetal circulations associated with acute fetal distress, and 2) to determine whether umbilical velocimetry can be used as a predictor of acute hypoxia in severe preeclampsia.

METHODS

Eighty-nine cases of severe preeclampsia, who had Doppler ultrasonography, maternal blood chemistry and hematogram examinations all performed within two days of delivery or fetal death, were studied.

RESULTS

According to the absence or presence of acute fetal distress as determined by the fetal heart rate pattern, patients were divided into two groups: distress group and non-distress group. There was no significant difference between the two groups in maternal general status. However, patients in the distress group had a significantly shorter gestation age on admission and at delivery (p < 0.00001). In the distress group, the perinatal outcome was poor. Newborns in the distress group had, significantly, a lower birthweight, and a higher incidence of SGA, 1-min Apgar scores of less than 7, and fetal acidosis (pH < 7.2) (p < 0.001). Doppler ultrasonography also showed a significantly higher incidence of abnormal umbilical artery Doppler waveforms in the distress group (p < 0.05). However, there was no difference between the two groups in the uterine artery Doppler velocimetry. Maternal blood chemistry and hematogram examinations revealed significantly higher blood levels of hemoglobin, hematocrit, blood urea nitrogen, and creatinine but lower levels of total protein and albumin in the distress group. An abnormal umbilical artery SD ratio (> 95th centile) as a predictor of acute fetal compromise, judged by the incidence of abnormal fetal heart tracing mandating emergency delivery, 1-minute Apgar scores of less than 7, 5-minute Apgar scores of less than 7, and a pH value for the umbilical arterial blood of less than 7.2, had a sensitivity of 40.5-75%, specificity of 71.8-80%, positive predictive value of 12.5-75%, and negative predictive value of 64.5-98.4%.

CONCLUSION

In severe preeclampsia, early onset of disease superimposed with maternal hemoconcentration might initiate an acute insult and predispose the fetus to acute hypoxia.

Involvement of phospholipase C in heat-shock-induced phosphorylation of P-glycoprotein in multidrug resistant human breast cancer cells

The phosphorylation of P-glycoprotein has been appreciated for many years, yet little is known about the factors that initiate this post-translational modification. To determine whether the activation of P-glycoprotein phosphorylation could occur in response to cellular stress and to investigate the possible signal pathways involved, we studied the effect of heat shock on the phosphorylation of P-glycoprotein in sensitive and resistant MCF-7 human breast cancer cells. Treatment of multidrug resistant MCF-7/AdrR cells with heat shock increased the phosphorylation of P-glycoprotein. The response was not seen in the sensitive MCF-7 line, which does not express this drug transporter. Phosphorylation of P-glycoprotein induced by heat shock was not dependent on synthesis of new proteins, since phosphorylation was not inhibited by cycloheximide and the content of P-glycoprotein, as measured by immunoblotting, did not change after heat shock. The activation of P-glycoprotein phosphorylation by heat shock may be initiated through activation of phospholipase C, since heat shock stimulated the activity of this enzyme, as evidenced by increased formation of inositol trisphosphate and diacylglycerol and by phosphorylation of phospholipase C-gamma. U-73122, an inhibitor of phospholipase C and staurosporine, an inhibitor of protein kinase C, both decreased the heat-shock-induced phosphorylation of P-glycoprotein. These results suggest that heat shock induces phosphorylation of P-glycoprotein through the activation of the phospholipase C/protein kinase C pathway.

Preeclampsia in multiple pregnancy

BACKGROUND

Preeclampsia is one of the most common pregnancy-induced complications, and results in a large number of maternal deaths. How pregnancy incites or aggravates hypertension remains unresolved; despite decades of intensive research directed to hypertensive disorders, they remain among the most important unresolved problems in obstetrics. The incidence of preeclampsia is increased in multiple pregnancies, and several preeclampsia-related fetal risks may be particularly hazardous to the babies of multiple gestations.

METHODS

The records of 561 women with multiple pregnancies delivered consecutively at Mackay Memorial Hospital were reviewed retrospectively. Thirteen mild cases and 39 severe cases of preeclampsia in multiple pregnancies were compared with 52 control cases of multiple pregnancies without preeclampsia, but matched for maternal age and parity. The categories for comparison included parity, gestational age, time of onset of preeclampsia, route of delivery, mean birth weight, growth discordancy, maternal complications, neonatal morbidity and mortality.

RESULTS

The incidence of preeclampsia in our consecutive series of 561 multiple pregnancies was 9.3% compared with 1.8% in singleton pregnancies (p < 0.0001). In primiparas with multiple pregnancies, the incidence of preeclampsia was 12.2% compared with 6.2% (p < 0.05) in multiparas. Breech presentation was the most common indication for Cesarean section in all groups. The preeclamptic group had a significantly higher rate of Cesarean section compared with the control group (p < 0.006), with prolonged labor and fetal distress were the two main reasons for this difference. Severe preeclamptic patients had babies with significantly lower mean birth weights (p < 0.05), higher incidence of intrauterine growth retardation (p < 0.025) and neonatal respiratory distress syndrome (p < 0.0008) compared with those of the control group. All seven cases with maternal complications were in the severe preeclamptic group.

CONCLUSIONS

An unfavorable perinatal outcome was found to be associated with severe, but not with mild, preeclampsia in multiple pregnancies.

Synthesis of O-glycan core 3: characterization of UDP-GlcNAc: GalNAc-R beta 3-N-acetyl-glucosaminyltransferase activity from colonic mucosal tissues and lack of the activity in human cancer cell lines

UDP-GlcNAc: GalNAc-R beta 3-GlcNAc-transferase (core 3 beta 3-GlcNAc-T, where GlcNAc is N-acetyl-D-glucosamine, GalNAc is N-acetyl-D-galactosamine and T is transferase) is expressed in a tissue-specific fashion and is high in normal colonic tissue, but downregulated in colon cancer. To further study the control of this enzyme, we examined the activity in pig, rat and human colonic tissues, and several human cancer cell lines. The enzyme was difficult to solubilize by detergents and was extremely unstable in the solubilized form. Using synthetic derivatives of the GalNAc-R substrate, we showed that the specificity of the enzyme in normal rat and human colonic mucosa requires all the substituents of the GalNAc-sugar ring of substrates for maximal activity. Core 3 beta 3-GlcNAc-T was significantly influenced by the structure of the aglycon group. None of the inactive substrate derivatives could inhibit the activity. N-Iodoacetamido-galactosamine alpha-benzyl was a weak substrate and significantly inhibited the incorporation of GLcNAc into GalNAc alpha-benzyl by human colonic homogenates. Surprisingly, none of the colonic cancer cell lines or any other cancer and leukaemia cells examined exhibited detectable activity of the enzyme, although a number of other glycosyltransferase activities involved in O-glycan biosynthesis were active. Mixing experiments did not reveal an endogenous inhibitor in HL60 cells or an activator of core 3 beta 3-GlcNAc-T in human colonic mucosa. Thus, the lack of core 3 beta 3-GlcNAc-T in human colonic mucosa. Thus, the lack of core 3 beta 3-GlcNAc-T activity in cancer cell lines may be due to cell transformation or cell culturing.

Simultaneous determination of moricizine and its sulphoxidation metabolites in biological fluids by high-performance liquid chromatography

A simultaneous assay for moricizine, its two sulphoxidation metabolites, moricizine sulphoxide and moricizine sulphone, using high-performance liquid chromatography (HPLC) is described. The drug and metabolites and clozapine (internal standard) in biological fluids were extracted using pentanesulphonic acid into diethyl ether. The ethereal extract was evaporated to dryness and the residue was redissolved in the mobile phase (methanol-water-triethylamine, 65:35:0.5, v/v). The analyses were performed on a microBondapak reversed-phase C18 column housed in a Waters Z-module, linked to a C18 pre-column, with a run-time of 12 min. The retention times were 2.7, 3.5, 6.2 and 9.7 min for moricizine sulphone, moricizine sulphoxide, moricizine and clozapine, respectively. The recovery of the compounds from plasma ranged from 89.9% for the sulphoxide to 98.1% for clozapine. The limits of detection of the assay for moricizine, moricizine sulphoxide and moricizine sulphone were 20, 10 and 5 ng/ml, respectively.

Alterations of O-glycan biosynthesis in human colon cancer tissues

Human colon cancer is associated with antigenic and structural changes in mucin-type carbohydrate chains (O-glycans). To elucidate the control of the biosynthesis of these O-glycans is colon cancer, we have studied glycosyltransferase and sulphotransferase activities involved in the assembly of elongated O-glycan structures. We analysed homogenates prepared from cancer tissue, adjacent normal and distal normal tissue from 20 patients. Several transferase activities showed pronounced changes in cancer tissue. The changes correlate with previous findings of a loss of O-glycans in cancer mucins, but did not always correlate with levels of Tn, sialyl-Tn, T and Lex antigens in homogenates or with the differentiation status and Duke's stages of the cancer tissue or the patient's blood type, sex and age. UDP-GlcNAc: Gal NAc-R beta 3-N-acetylglucosaminyltransferase (where GlcNAc is N-acetyl-D-glucosamine and GalNAc is N-acetyl-D-galactosamine) synthesizing O-glycan core 3, GlcNAc beta 1-3GalNAc-, CMP-sialic acid: GalNAc-peptide alpha 6-sialyltransferase synthesizing the sialyl-Tn antigen and sulphotransferase activities towards O-glycan core 1, Gal beta 1-3GalNAc-, were found to be decreased in cancer. UDP-GlcNAc: Gal beta 1-3GalNAc beta 6-N-acetylglucosaminyltransferase was also decreased in cancer concomitant with a loss of the ability to synthesize the I antigen and core 4, GlcNAc beta 1-6(GlcNAc beta 1-3) GalNAc-, CMP-sialic acid: Gal beta 1-3GalNAc-R alpha 3-sialyltransferase and GDP-fucose: Gal beta-R alpha 2-fucosyltransferase, synthesizing the blood group H determinant, were found to be 4- and 3- to 8-fold increased, respectively, in cancer compared to normal tissue. The data suggest that the biosynthesis of antigens and mucin-bound O-glycan structures in colon cancer is subject to complex control mechanisms.

Desensitization of nicotine-stimulated 86Rb+ efflux from mouse brain synaptosomes

The desensitization of nicotine-stimulated 86Rb+ efflux from synaptosomes prepared from C57BL/6 mouse brain was investigated. Nicotine stimulated a saturable, concentration-dependent efflux of 86Rb+ from synaptosomes (EC50 = 0.60 microM), but the response decreased with time of exposure to nicotine. The rate of decrease of the response (desensitization) increased as the nicotine concentration was increased (EC50 = 0.35 microM; maximal rate of desensitization = 1.1 min-1). Desensitization of nicotine-stimulated 86Rb+ efflux was also observed when synaptosomes were exposed to low (1-200 nM) concentrations of nicotine that caused little or no stimulation of efflux (EC50 = 13 nM). The rate of desensitization observed with low nicotine concentrations (0.30 min-1) was less than that measured at stimulating concentrations. Desensitization was not fully reversible for synaptosomes exposed to nicotine concentrations between 10 nM and 10 microM: Only 60-40% of the control response was regained after a 10-min washout period. The kinetics of functional desensitization were compared with the kinetics of [3H]nicotine binding. [3H]Nicotine binding to midbrain particulate fractions displayed both a fast and a slow phase. The EC50 values for these two phases were 2.6 and 14 nM, respectively. Data obtained from functional desensitization and ligand binding experiments were analyzed using a two-state model. The kinetic constants obtained from the analyses of these two processes were very similar. Overall, the results suggest that nicotinic receptor function measured with ion flux desensitizes when exposed to either stimulating or nonstimulating concentrations of nicotine. In addition, the kinetic properties calculated for the functional desensitization are comparable to those for [3H]nicotine binding.

A mutation in the V1 end domain of keratin 1 in non-epidermolytic palmar-plantar keratoderma

Mutations in keratin 9 have been found in families with an epidermolytic form of palmar-plantar keratoderma (PPK). In another form of PPK (Unna-Thost type), epidermolysis is not observed histologically. We studied a pedigree with this non-epidermolytic form of PPK. By gene linkage analysis, the type I keratin locus could be excluded but complete linkage with the type II keratin region was found. Sequence analysis identified a single base change in the amino-terminal V1 variable subdomain of keratin 1, which caused a lysine to isoleucine substitution. This non-conservative mutation completely cosegregated with the disease and was not observed in 50 unrelated unaffected individuals. An examination of keratin amino-terminal sequences revealed a previously unreported 22-residue window in the V1 subdomain that is conserved among most type II keratins. The altered lysine is an invariant residue in this conserved sequence. Previously described keratin mutations affect the central regions important for filament assembly and stability, and cause diseases characterized by cellular degeneration or disruption. This is the first disease mutation in a keratin chain variable end region. The observation that it is not associated with epidermolysis supports the concept that the amino-terminal domain of keratins may be involved in supramolecular interactions of keratin filaments rather than stability. Therefore, hyperkeratosis associated with this mutation may be due to perturbations in the interactions of the keratin end domain with other cellular components.

Inhibition of protein synthesis in insect cells by baculovirus-expressed heme-regulated eIF-2 alpha kinase

To study further the regulation of the heme-regulated eIF-2 alpha kinase (HRI), we have produced functional wild type HRI using the baculovirus expression system. The amount of recombinant HRI protein expressed in insect cells is approximately 10 times higher than levels in reticulocytes. Baculovirus-expressed HRI (BV-HRI) is indistinguishable from HRI purified from rabbit reticulocytes. It is active both as an autokinase and an eIF-2 alpha kinase. BV-HRI is regulated by heme in vitro as well as in intact insect cells. Coexpression of the wild type HRI with the inactive K199R HRI, S51A eIF-2 alpha, or interleukin-1 beta (IL-1 beta) results in diminished expression of these proteins. Expression of wild type HRI also results in severe inhibition of general protein synthesis in Sf9 cells when compared with cells expressing K199R HRI or IL-beta. In addition, the guanine nucleotide exchange activity of eIF-2B is suppressed in Sf9 cells expressing wild type HRI but not in cells expressing the K199R HRI or IL-1 beta. Furthermore, expression of wild type HRI is increased by coexpression with the nonphosphorylatable S51A eIF-2 alpha or by the addition of hemin, which inhibits HRI activity. These results provide evidence that translational regulation by phosphorylation of eIF-2 alpha and sequestration of eIF-2B can operate in insect cells.

Structure and organization of the human transglutaminase 3 gene: evolutionary relationship to the transglutaminase family

The human haploid genome contains a family of at least five different transglutaminases that are differentially expressed in time- and tissue-specific ways. Of these, transglutaminase 3 (TGase3) is unusual in that it is a pro-enzyme requiring activation by proteolysis. To date it is known to be expressed only in terminally differentiating epidermal and hair follicle keratinocytes. In this paper we show that it is encoded by a gene (TGM3) of 42.8 kbp containing 13 exons. In the course of isolation of genomic clones for the TGM3 gene, we also found clones encoding the widely expressed tissue or TGase2 enzyme, perhaps due to high degrees of sequence homology. The structure of the TGM2 gene has not yet been reported. Our incomplete data suggest its exon/intron organization is very similar to that of TGM3. Although the common intron splice points of all members of the transglutaminase gene family have been conserved, the TGM3 and TGM2 genes, and the gene for the subplasma membrane transglutaminase-like protein band 4.2, lack two introns found in the TGM1 and factor XIIIa genes, and the exact intron splice point of another intron is shifted with respect to that of the TGM1 and factor XIIIa genes. Based on sequence homologies and gene structures, the data support a phylogenic tree in which the TGM2 and TGM3 genes belong on a branch distinct from other transglutaminases.

p53 protein overexpression and allele loss of p53 gene in gastric adenocarcinoma

Gene alterations of p53 tumor suppressor gene such as point mutations, deletions or insertions occur in various human cancers. p53 protein overexpression was studied immunohistochemically in 80 gastric adenocarcinomas using an anti-human p53 antibody (Pab 1801) and the avidin-biotin-peroxidase technique. We have also analyzed allele loss of the human p53 gene in 54 cases of gastric adenocarcinoma using polymerase chain reaction and restriction fragment length polymorphism. p53 immunostaining was also demonstrated in 48 of 80 carcinomas (60%). Normal mucosa was always negative. No relation could be found between p53 immunostaining and the degree of differentiation. 21 of the 54 patients(39%) were informative for the p53 exon 4. In ten of these informative cases(47.6%), tumor DNAs showed allele loss when compared with nonmetastatic lymph node DNAs. Seven of the ten(70%) showed p53 immunoreactivity. These findings suggest that mutations of the p53 gene may play a role in the development of gastric adenocarcinoma and that allele loss of p53 frequently occurs in p53 immunoreactive gastric adenocarcinoma.

A new beta-adrenoceptor blocking agent derived from dehydrozingerone

1. Dehydrozingeronolol (DZPN; 0.1, 0.5, 1.0 mg/kg, i.v.) produced a dose-dependent bradycardia response and a sustained pressor action in urethane-anesthetized normotensive rats. DZPN inhibited the tachycardia effects by (-)isoproterenol, but had no blocking effect on the arterial pressor responses induced by phenylephrine. 2. In in vitro study, DZPN antagonized (-)isoproterenol-induced positive chronotropic effects in guinea-pig isolated right atria and relaxation responses in rat isolated uterus horns. 3. DZPN causes mild direct cardiac depression at high concentrations without intrinsic sympathomimetic activity (ISA). 4. The order of potency of beta-adrenoceptor antagonists in competing for the [3H]dihydroalprenolol binding sites was (-)propranolol >> DZPN > or = atenolol.

Transvaginal color flow imaging in the follow-up of invasive gestational trophoblastic disease: a case report

A case of invasive gestational trophoblastic disease after partial hydatidiform mole was presented in this study in which the diagnosis was made along with the treatment being monitored by means of transvaginal color Doppler ultrasound. In this case, the appearance or disappearance of vascular changes induced by invasive mole corresponded with serum beta human chorionic gonadotropin (beta-hCG) titer. Vascular changes displayed on color Doppler scanning may thus complement the application of hCG in postmolar pregnancy surveillance.