Epidural abscess presented with psychiatric symptoms

Cranial epidural abscesses are unusual in neurosurgical practice. Mostly they are secondary to skull bone osteomyelitis of foreign body implantation as a result of trauma, or infection of paranasal sinus, otitis, and mastoiditis in adults or late adolescents. The purulent inflammatory process of the epidural abscess, thrombophlebitis of the venous drainage, septic thrombosis, direct extension into the orbit, carvenous sinus, superior orbital fissure give the epidural abscess a high mortality and morbidity. We present an interesting case, who has had psychiatric symptoms such as bizarre behavior, auditory and visual hallucination for about two years. Incidental brain computed tomograms, to exclude the organic-somatic disorder, revealed a huge brain abscess. Emergent surgical intervention was carried out and the episodes of talking to himself and auditory hallucination subsided. The removal of the epidural abscess eliminated the symptoms and cured the patient. All the right amygdata, entorhinal area, cingulate gyrus, hippocampus and parahippocampal gyrus of this patient were compressed by the huge abscess. All these structures belonged to limbic system. Diseases involving the limb system may cause emotional disturbances, such as delusions, illusions and hallucinations, emotional lability, pathological laughing and crying, rage reaction and aggression, apathy and placidity, even endogenous fear, anxiety, depression and euphoria. Dramatic improvement of the patient was found after surgical removal of the abscess. We highlight this interesting case for it will undoubtedly bring together a large cooperation of psychiatrists, neurologists and neurosurgeons.

The relapse patterns and outcome of postoperative recurrent tongue cancer

PURPOSE

The relapse patterns and salvage treatment results for patients who developed locoregional recurrence after surgery for squamous cell carcinoma of the tongue were retrospectively analyzed.

MATERIALS AND METHODS

Between April 1986 and January 1995, 77 cases with recurrent squamous cell carcinoma of the tongue were evaluated. Most of them were males in the early stages of initial disease. Although the surgical margins were negative in most cases (67 of 77), relapse eventually occurred. The relapse patterns showed 15 patients with primary recurrence, 45 patients with regional neck lymph node (LN) relapse, and 17 patients with relapse in both sites.

RESULTS

Salvage treatment was given to most of the patients, but their median survival time was only 9 months. Survival data were analyzed and compared with different types of relapse patterns, salvage treatments, disease-free intervals, age, and sex. In univariate analysis, the neck LN relapse and shorter relapse-free interval (< 6 months) were poor prognostic factors (P < .05), and surgical treatment showed a trend for better salvage results (P = .0575). In multivariate analysis, patients with neck LN relapse had the worst outcome (P < .05).

CONCLUSIONS

Recurrence of tongue cancer is not uncommon, but there are little data in literature regarding the prognosis. Although this study showed poor salvage results, various prognoses could be predicted on the bases of the different relapse patterns and salvage methods.

Liver involvement in epidemic haemorrhagic fever: in situ hybridization, immunohistochemical and pathological studies

In the present study, liver biopsy specimens from 37 patients with epidemic haemorrhagic fever (EHF) were investigated by using light and electron microscopy, immunohistochemistry for the EHF virus envelope protein G2 and in situ hybridization (ISH) for EHF viral RNA. Immunostaining and in situ hybridization were both positive, and a few of the aetiological agents, the EHF virus (EHFV) particles, were found individually within the dilated Golgi cisternae and vesicles, and the dilated rough endoplasmic reticulum of the hepatocyte. The pathological alterations of the liver cells infected with EHFV were: hepatocellular degeneration, cytoplasmic vacuolation, and spotty necrosis; moreover, zonal necrosis was present and adjacent to the narrowed and occluded sinusoids. In degenerated and spotty necrotic cells, the positive signals from of ISH for EHFV RNA and those from immunostaining for the virus protein were both stronger than those in the zonal liver cell necrosis area. The results showed that hepatocellular degeneration and spotty necrosis might be directly related to the virus and its duplication inside the liver cells, while the zonal necrosis was ischaemic and thought to be caused by microcirculation dysfunction.

Dislocation of total knee arthroplasty. A report of 6 cases with 2 patterns of instability

We report 6 cases of dislocation of total knee arthroplasty (TKA). We identified 2 patterns of instability in the sagittal plane, one with posterior translation of the tibia, occurring mainly in the postoperative period and usually resulting from a trauma, and the other with anterior translation of the tibia, occurring 6 months to 7 years postoperatively and with no preceding trauma. In the latter group, instability was manifested gradually as a lengthening of the posterior cruciate ligament and the posterior capsule, leading to a recurvatum deformity of the knee.

[Participatory action-research in the development of health policies for Izumo City, Japan]

The method of participatory action-research has been introduced in planning and implementing health and welfare projects for the elderly in Izumo City since 1993. Public health researchers have participated in the projects with other related administrative sectors, citizen and non-profit organizations. This study analyzes the establishment and implementation of health policies of Izumo from the following five aspects: policy-making, priority, education, intersectoral cooperation and community development. The participatory action-research method was useful for developing the ability of health-staff to work with citizens; for integrating community care and community development; for using community resources effectively for primary health care; and for developing community-based education of citizens, medical students and health staff. This method can be and should be adopted for strengthening the policy-making ability of public health researchers who learn through cooperation with citizens and non-profit organizations.

High-dose-rate intracavitary brachytherapy (HDR-IC) in treatment of cervical carcinoma: 5-year results and implication of increased low-grade rectal complication on initiation of an HDR-IC fractionation scheme

PURPOSE

To report the treatment results and rectal/bladder complications of cervical carcinoma radically treated with high-dose-rate intracavitary brachytherapy (HDR-IC). The current policy of using three-fraction scheme was examined.

METHODS AND MATERIALS

Between November 1987 and August 1990, 173 patients with cervical carcinoma were treated with curative-intent radiation therapy. Whole pelvic irradiation was administered with 10-MV X ray. Dose to the central cervix was 40-44 Gy in 20-22 fractions, following by pelvic wall boost 6-14 Gy in three to seven fractions with central shielding. 60Co sources were used for HDR-IC, and 7.2 Gy was given to Point A for three applications, 1-2 weeks apart. Duration of follow-up was 5-7.8 years.

RESULTS

Twenty-eight patients (16%) developed central-regional recurrences. Overall 5-year actuarial pelvic control rate was 83%. By stage, 5-year actuarial pelvic control rates were 94%, 87%, and 72% for Stages IB + IIA, IIB + IIIA, and IIIB + IVA, respectively. Thirty-one patients (18%) developed distant metastasis. Overall 5-year actuarial survival rate was 58%. By stage, 5-year actuarial survival rates were 79%, 59%, and 41% for Stages IB + IIA, IIB + IIIA, and IIIB + IVA, respectively. Sixty-six (38%) and 19 patients (11%) developed rectal and bladder complications, respectively. For rectal complication, the overall actuarial rate was 38% at 5 years. By grade, 5-year actuarial rectal complication rates were 24%, 15%, 4%, and 3% for Grades 1-4, respectively. Overall prevalence of rectal complications was 37% and 14% at 2 and 5 years, respectively. Prevalence of low-grade rectal complication (Grades 1 and 2) was dominant at 2 years (30%), but declined to 8% at 5 years. Prevalence of high-grade, severe rectal complication (Grades 3 and 4) remained steady at 2 and 5 years (7% and 6%, respectively). Five-year actuarial bladder complication was 9%. Five-year prevalence of bladder complication was 2%.

CONCLUSION

Using a three-fraction scheme, survival rate appeared comparable with the existing results of the low-dose-rate technique. The incidence of rectal complication with this scheme remained relatively high. The increased part of rectal complication was predominantly low grade. This result suggested that therapeutic gain with this scheme may not be good enough to circumvent its biologic disadvantage. Numbers of fractions >3 must be considered in future trials.

A study of the referral patterns of obstetric clinics and the performance of receiving neonatal intensive care units in Taiwan

To study the referral patterns of obstetric clinics, and the performance of receiving intensive care units measured by the survival of transported neonates, transport records were collected prospectively between July, 1991 and June, 1992. Two hundred and fifty-four transported neonates born in 51 obstetric clinics (level I units) in Tainan City and County, in southern Taiwan, were enrolled in this study. Nineteen percent of the transported neonates were very low birthweight infants (< 1500 g). Nearly equal numbers of them were transported to eight district hospitals (level II units) and to a tertiary center (level III unit), but these infants were 1.5 times more likely to die in a level II unit than a level III unit. In addition, equal numbers of infants assisted by mechanical ventilators were transported to level II and III units, but these infants were three times more likely to die in a level II unit than a level III unit (P = 0.006). Seventy-seven percent of the normal birthweight infants (> or = 2500 g) were transported to level II units, and the mortality in this group was 12.3% compared with 0% in those transported to the level III unit. Approximately 56% of these normal birthweight infants in level II units died of severe birth asphyxia. The referral patterns of level 1 units had an unfavorable effect on the survival of neonates requiring mechanical ventilation. Enhancing the skills of the staff in level I units to recognize and stabilize such infants, elevating the capability of level II units in treating some of these cases, and increasing the hospital beds for level III care are necessary to increase their chance of survival.

Microtubule active taxanes inhibit polycystic kidney disease progression in cpk mice

Homozygous cpk/cpk mice develop polycystic kidney disease and die of uremia between the fourth and fifth weeks of age. Cpk/cpk mice treated weekly with paclitaxel (Taxol) can live to over six months of age. This dramatic moderation of polycystic kidney disease progression has been postulated to be a result of paclitaxel's ability to stabilize microtubules. In this study, the ability of taxanes with differing abilities to promote spontaneous in vitro assembly of tubulin dimers into microtubules were tested for their ability to inhibit the progression of polycystic kidney disease in polycystic cpk/cpk mice. We found that taxanes that are active in promoting microtubule assembly, including paclitaxel, 10-deactyl-taxol and cephalomannine increased the survival of polycystic cpk/cpk mice significantly longer than control animals. In contrast, the microtubule inactive taxane baccatin-III has no effect on the progression of renal failure in cpk/cpk mice. We conclude that the ability to promote microtubule assembly may be necessary for paclitaxel and related taxanes to modulate the progression of polycystic kidney progression in cpk/cpk mice.

Effect of megestrol acetate and prepulsid on nutritional improvement in patients with head and neck cancers undergoing radiotherapy

BACKGROUND AND PURPOSE

Anorexia is a common problem in cancer patients who receive radiotherapy. In this current study, we attempt to determine the effect of megestrol acetate and prepulsid on appetite and nutritional improvement in patients with head and neck cancers undergoing radiotherapy.

MATERIALS AND METHODS

One hundred twenty-nine consecutive patients with head and neck cancers treated between July 1993 and June 1994 were prospectively randomized to receive either megestrol acetate, 40 mg qid (megace group), prepulsid, 5 mg tid (cisapride group), or a placebo treatment (control group) during radiotherapy. Before radiotherapy, body weight (kg), appetite score, performance status, biochemical parameters and hematological parameters were evaluated, and the above-noted clinical and biochemical parameters were assessed and recorded every other week. All patients received 6- 10 MV X-rays or Co-60 gamma-ray to head and neck region for a full course of radiotherapy, 61.2-75.6 Gy/7-9 weeks.

RESULTS

Forty-eight patients were enrolled in the megace group, 41 patients in the cisapride group, and 40 patients in the control group. At the 2nd, 4th, 6th and 8th week, as the radiation dose escalated, the megace group had significantly less body weight loss than did the cisapride and control groups (P = 0.045, 0.024, 0.006, 0.003, respectively). The appetite scores of the megace group were significantly higher than those of the cisapride and control groups (P = 0.0001). However, there were no statistically significant differences in the change of albumin level among these three groups at the 2nd, 4th, 6th and 8th week (P > 0.05, respectively).

CONCLUSIONS

Megestrol acetate can significantly decrease the degree of body weight loss, and can prevent the deterioration of appetite in patients with head and neck cancers receiving radiotherapy. However, prepulsid lacks the above-mentioned clinical benefits.

Management of infected total knee arthroplasty

BACKGROUND

Deep wound infection after total knee arthroplasty is an infrequent but very serious complication. Treatment is difficult and challenging. Antibiotic therapy alone can not replace surgery in the management of infected total knee arthroplasty.

METHODS

Fourteen infected total knee arthroplasties in 13 patients were treated by the author. Nine patients underwent two-stage reimplantation, one patient one-stage reimplantation, one patient arthroscopic debridement, and one patient knee fusion. Four knees in three patients were excluded because of less than 12 months follow-up. This study retrospectively analyzed the results of treatment in 10 infected total knee arthroplasties in 10 patients.

RESULTS

All patients were followed up for 12 months or longer. The length of follow-up ranged from 12 months to 69 months with an average of 28 months. All infections were successfully controlled, and there was no recurrence of infection. However, only 67% of the patients showed satisfactory functional results.

CONCLUSION

Based upon the results in this study, most of the infection after total knee arthroplasty could be successfully controlled by combined surgical treatment and intravenous antibiotic therapy. The result of two-stage reimplantation was more consistent and predictable. The functional result of infected total knee arthroplasty was less satisfactory as compared with that of the non-infected counterpart. Furthermore, the impact of infection or the longevity of total knee prosthesis could only be determined by long-term follow-up.

Anatomy and pathology of the septal region

Comprising the septal area and the subcortical nuclei, the septal region is gray matter structures with widespread projection systems and different neurotransmitters. Although their function is poorly understood, lesions of the septal nuclei result in a syndrome of hyper-reactivity, amnesia, and hypersexuality. The pathologic processes affecting the septal region are discussed.

Pituitary transplantation--a study on the response of hypophysis-adrenal axis to physiological stress

Previous studies on experimental intracerebral pituitary transplantation have shown survival and possible function of fetal pituitary glands grafted to the hypothalamic region of inbred strains. In the present study, fetal pituitary tissue was implanted into hypothalamic area of the hypophysectomized rat by stereotactic methods. We investigated the hormonal levels and secretions of fetal pituitaries grafted to the allogenic host and studied the effects of physiological stimuli on hypophysectomized rats with grafted pituitaries. We found that the fetal pituitary allografts released adrenal corticotropin (ACTH) and corticosterone in response to stimulation by corticotropin-releasing hormone (CRH), and released corticosterone alone in response to insulin-induced hypoglycemia. The grafts are acutely responsive to CRH and retain their potential for physiological regulation and function. The ACTH-releasing-signal generated in the host by insulin-induced hypoglycemia failed to activate the graft, so activation by other physiological stimuli cannot be ruled out.

Interaction of reactive and inert chemicals in the presence of oxidoreductases: reaction of the herbicide bentazon and its metabolites with humic monomers

The herbicide bentazon (3-isopropyl-1H-2,1,3-benzothiadiazine-4(3H)-one-2,2-dioxide), a relatively inert chemical, and some of its metabolites were incubated with a laccase or a peroxidase in the presence or absence of humic monomers to evaluate the incorporation of the herbicide and its metabolites into humic material by oxidative enzymes. Guaiacol and ferulic acid were used as representative electron donor co-substrates in most of the oxidative coupling reactions. Bentazon and its metabolites, with the exception of hydroxy metabolites, underwent little or no transformation by the two enzymes in the absence of guaiacol and ferulic acid, but in the presence of these co-substrates transformation occurred. The reaction of bentazon with guaiacol in the presence of the laccase or a peroxidase was almost complete in 30 min. 6-Hydroxy- and 8-hydroxy-bentazon were completely transformed by each enzyme both with and without co-substrates. At pH 3.0 and in the presence of laccase and guaiacol, the concentrations of bentazon and its metabolites 2-amino-N-isopropyl-benzamide (AIBA), des-isopropyl-bentazon and 8-chloro-bentazon decreased by 27, 57, 20 and 4%, respectively. The corresponding levels of transformation with peroxidase at pH 3.0 were 9, 70, 30 and 5%, respectively. The extent of transformation decreased with increasing pH. At low pH, the hydroxy-bentazons were completely transformed, followed by (in order of percentage transformation) AIBA, des-isopropyl-bentazon, bentazon and 8-chloro-bentazon. Transformation of bentazon by the laccase increased with increasing guaiacol concentration. In the presence of the peroxidase, the most effective co-substrates for transformation of bentazon were (in decreasing order) catechol, vanillic acid, protocatechuic acid, syringaldehyde and caffeic acid, while in the presence of the laccase, catechol was most effective, followed by caffeic acid, protocatechuic acid and syringaldehyde.

Hepatotoxicity of 1,3,5-trinitro-2-acetyl pyrrole derived from nitrosation of Maillard reaction product in BALB/C mouse

1,3,5-Trinitro-2-acetyl pyrrole (TNAP) is a product derived from the reaction of 2-acetyl pyrrole with nitrite in the model of Maillard browning systems. This compound is moderately mutagenic to the Salmonella strains TA98 and TA100 and is markedly cytotoxic to mouse C3H10T1/2 cells. Experiments are performed to investigate the effects of TNAP on the hepatic toxicity in mouse. Male BALB/C mice were subjected to a dose of 7.2 mg/kg body weight twice a week by i.p. injection for 24 weeks, then followed by a feeding diet for 21 weeks. TNAP-treated mice showed an increase in mortality and time-dependent appearance of lesions in the liver. TNAP is hepatotoxic as demonstrated by a marked increase in the activities of serum alanine transaminase (ALT) and aspartic transaminase (AST). TNAP-related lesions observed histologically in mice, included hapatic atrophy, mild fatty metamorphosis with multilocular cysts in the liver. In conclusion, TNAP was considered to be a toxic compound in mice as evidenced by increased incidences of mortality, and lesions of liver.

Inhibition of protein kinase C and proto-oncogene expression by crocetin in NIH/3T3 cells

Crocetin, a carotenoid isolated from the seeds of Gardenia jasminoides, was found to be a potent inhibitor of tumor promotion induced by 12-O-tetradecanoylphorbol-13-acetate (TPA) in mouse skin. When mouse fibroblast NIH/3T3 cells were treated with TPA alone, protein kinase C (PKC) translocated from the cytosolic fraction to the particulate fraction. Pretreatment with 60 and 120 microM crocetin for 15 min inhibited the TPA-induced PKC activity in the particulate fraction by 50% and 66%, respectively, but did not affect the level of PKC protein. Crocetin also reduced the level of TPA-stimulated phosphorylation of cellular proteins. Cells pretreated with crocetin (120 microM) had 55% less PKC [3H]phorbol dibutyrate-binding capacity. Suppression of TPA (100 ng/mL)-induced c-jun and c-fos gene expression was also observed in the mouse fibroblast cells pretreated with crocetin (30, 60, and 120 microM). Our results provided a basis for understanding the inhibitory effect of crocetin on TPA-mediated tumor promotion.

Effect of bromocriptine on the sensitivity of pituitary tumor cells to radiation

GH3 cells, a PRL-secreting rat pituitary tumor cell line, are sensitive to bromocriptine, and provide a useful model for the present studies. GH3 cells, in the presence or absence of 2.5 x 10(-5) M bromocriptine, were irradiated at doses ranging from 0 to 10 Gy. After irradiation the bromocriptine was washed out, cells were seeded at a density of 10,000 cells/ml, and growth curves were obtained by counting the cell number at weekly intervals for 1 month. Cell growth was inhibited by the radiation in a dose-dependent fashion, with complete inhibition of cell growth by 9 Gy. However, no protection against radiation damage was afforded by bromocriptine. These results might suggest that the combined therapies of tumor shrinkage by bromocriptine and stereotactic irradiation of the sella might be a useful clinical therapeutic strategy, particularly in patients with large tumors, severe hyperprolactinemia, and pre-existing hypopituitarism.

Inhibitory effect of crocetin on benzo(a)pyrene genotoxicity and neoplastic transformation in C3H10T1/2 cells

Crocetin is a major component in the fruit of Gardenia jasminoides Ellis, a Chinese herbal medicine. In the work, we investigate the protective action and mechanism against benzo(a)pyrene [B(a)P]-induced genotoxicity and neoplastic transformation with a non-toxic dose of crocetin (0.01-0.10 mM) for 1 hour prior to the administration of 0.1 mM B(a)P. B(a)P genotoxicity was inhibited significantly by crocetin in a dose responsive manner. Pretreating C3H10T1/2 cells with crocetin (0.1 mM) also caused a decrease in the covalent binding of B(a)P-diol-epoxide to DNA, to about half that of cells without crocetin treatment. Crocetin also inhibited B(a)P-induced transformations. When the culture was treated with crocetin (0.01, 0.05 and 0.10 mM) for 7 days, the transformation frequencies were lower than that of the culture without crocetin treatment. Furthermore, pretreating cells with crocetin (0.01-0.10 mM) also caused an increase in the activity of GSH S-transferase (GST) to 18-71% that of the cells without crocetin treatment. These results suggest that the inhibition by crocetin of B(a)P-induced genotoxicity and neoplastic transformation in C3H10T1/2 cells is due to a mechanism that increases the activity of GST and decreases the formation of a B(a)P-DNA adduct.

Vital statistics of premature and low birthweight infants in Tainan area

Birth weight and gestational age are strongly associated with perinatal mortality and morbidity. This study was conducted to survey the vital statistics of premature and low birthweight infants in the Tainan area. Between July 1991 and April 1992, fifteen medical institutions were included on a voluntary basis: eight from level I (obstetric specialty clinic), six from level II (regional hospital), and one from level III (tertiary care center). A total of 14,307 deliveries were enrolled, accounting for about 60% of the total delivery for that year in the area. The proportions of delivery among level I, II and III were 52%, 41% and 7%, respectively. The incidence of premature singleton live birth was 4.6%, and the percentages of gestation between 20-27 weeks, 28-31 weeks and 32-37 weeks were 0.2%, 0.6% and 3.8%, respectively. The premature births accounted for 3.5%, 4.8% and 11.3% of live births at the level I, II and III hospitals, respectively. The incidence of low birthweight and very low birthweight singleton live births was 4.4% and 0.5%, respectively. The low birthweight births accounted for 3.5%, 4.5% and 11.1% of live births at the level I, II and III hospitals, respectively. The data revealed that the higher the level of hospital, the higher incidences of premature and low birthweight infant. Teenage mothers (< 20 year of age) had higher low birthweight rate. The risk of having low birthweight infants decreased progressively in mothers of age < 20 (6.3%), 20-24 (5.4%), 25-29 (4.1%) and 30-34 (3.8%), whereas it became higher in mothers older than 35 (4.8%).

CONCLUSION

The incidence of premature and low birthweight births in the Tainan area was low. Teenager or those with maternal age older than 35 year were high risk groups for producing these infants.

Surgical management of TSH-secreting pituitary adenomas

Two patients with hyperthyroidism due to a thyrotropin (TSH)-secreting pituitary tumor have been observed of a total of 172 patients (1.2%) with pituitary adenomas over a period of 10 years (1986-1995). The serum TSH elevated in spite of high thyroid hormone levels in these two patients. They underwent transsphenoidal adenomectomies to remove the TSH-secreting pituitary tumors with excellent results. Tumors secreting TSH are very rare and are less easily cured by surgery than other types of pituitary adenomas because of large size and invasive features. Our experience with these two patients suggested the importance of early diagnosis and surgery for successful treatment of TSH-secreting pituitary tumors.

Hibiscus protocatechuic acid protects against oxidative damage induced by tert-butylhydroperoxide in rat primary hepatocytes

Hibiscus protocatechuic acid (PCA), a simple phenolic compound isolated from Hibiscus sabdariffa L., was studied for its protective effects against oxidative damage induced by tert-butylhydroperoxide (t-BHP) in a primary culture of rat hepatocytes. It had been reported that exposure of isolated hepatocytes to t-BHP results in leakage of lactate dehydrogenase (LDH) and alanine transaminase (ALT), peroxidation of cellular lipids, and depolarization of mitochondria. The present investigations showed that PCA at concentrations of 0.05 mg/ml and 0.10 mg/ml significantly decreased the leakage of LDH (P < 0.01) and ALT (P < 0.05 and P < 0.01) and the formation of malondialdehyde (MDA; P < 0.05 and P < 0.01) induced by 30-min treatment with t-BHP (1.5 mM) in primary cultured rat hepatocytes. PCA also attenuated t-BHP (0.10 mM) induced mitochondrial depolarization as determined by a retention test of rhodamine 123 and DNA repair synthesis as evidenced by unscheduled DNA synthesis (UDS). In addition, PCA exhibited an effective ability to quench 1,1-diphenyl-2-picrylhydrazyl radicals (DPPH). In conclusion, PCA demonstrated protective effects against cytotoxicity and genotoxicity of hepatocytes induced by t-BHP. One of mechanisms of PCA's protective effect may be associated with its property of scavenging free radicals.

Inhibitory effect of atractylon on tert-butyl hydroperoxide induced DNA damage and hepatic toxicity in rat hepatocytes

Atractylon, a main sesquiterpenic constituent of Atractylodes rhizomes, was studied for the mechanism of its inhibitory effects on the tert-butyl hydroperoxide (t-BHP)-induced cytotoxicity and lipid peroxidation in primary culture of rat hepatocytes. In the preliminary study, atractylon showed an effective antioxidant property tested by its capacity for quenching 1,1-diphenyl-2-picrylhydrazyl radical (DPPH). Further investigations showed that atractylon at the concentrations of 0.01, 0.1 and 1.0 mg/ml decreased the formation of malondialdehyde (MDA), leakage of lactate dehydrogenase (LDH) and alanine aminotransferase (ALT) and repair synthesis of DNA induced by 30-min treatment of t-BHP (1.5 mM) in primary cultured rat hepatocytes. Addition of atractylon also attenuated the genotoxicity of t-BHP evaluated by unscheduled DNA synthesis. The sum of the results suggested that the protective effect of atractylon against oxidative stress induced by t-BHP is via its ability to quench free radicals.

Intrasellar meningiomas

Two cases of intrasellar meningiomas with preoperative diagnosis of pituitary macroadenomas are presented. The preoperative hormonal studies revealed decreased serum hormonal levels with a slightly elevated prolactin level in both cases, which may have been due to the compression of the hypophyseal stalk. It is difficult to differentiate intrasellar meningiomas from pituitary tumors. Correct preoperative diagnosis depends on clinical picture, neuroimaging and endocrine studies. Surgically, the transsphenoidal approach provides a relatively safe route to the intrasellar meningiomas and satisfactory results.

Human prolactinomas in cell culture: structure-function correlation and indication of early relapse

Cell cultures of 7 micro- and 16 macroprolactinomas obtained from twenty-three patients (10 males and 13 females) by transsphenoidal adenomectomies were found to be capable of secreting hormones in vitro. Prolactin levels in the culture media were measured during the culture periods and showed that the high PRL levels in culture media may indicate early relapse. Morphological features of both micro- and macroprolactinomas in vitro resembled those of the original tumors. Most macroprolactinomas harbored densely-granulated cells, while most microprolactinomas sparsely-granulated cells. The cell culture techniques combined with morphological studies of prolactinomas allow further investigation of structure-function correlation in human prolactinomas.

N-linked glycosylation of hepatitis B surface antigens is involved but not essential in the assembly of hepatitis delta virus

Hepatitis delta virus (HDV) is a defective virus requiring the hepatitis B virus (HBV) to provide hepatitis B surface antigens as the envelope protein. The hepatitis B surface antigens are posttranslationally modified by N-linked glycosylation, and its significance in HDV assembly was investigated with a cotransfection system using human hepatoma cell line Huh-7. After the N-linked glycosylation of HBsAg was blocked by tunicamycin treatment, the packaging of HDV in the culture system could be suppressed to a level as low as 5-10% of the untreated control. The extent of inhibition correlated with the increased concentrations of tunicamycin. In contrast, the loss of HBsAg glycosylation did not affect the efficiency of assembly of HBV particles. When the N-linked glycosylation site of small HBsAg at amino acid 146 was mutated from asparagine to glutamine, the mutant HBsAg packaged only a modest amount of HDV particles. The quantity and kinetics of formation of HDV particles in culture system were reduced by the depletion of HBsAg glycosylation. Therefore HDV, similar to influenza and vesicular stomatitis viruses, depends on glycosylation of the envelope proteins as a signal for envelope protein maturation and for virion formation.

L ferritin accumulation in macrophages infiltrating the lung during rat Angiostrongylus cantonensis infection

A 22-kDa protein was increased quantitatively, as measured by sodium dodecyl sulfate-polyacrylamide gel electrophoresis techniques, in lung microsomes prepared from Angiostrongylus cantonensis-infected rats. However, it was almost absent in normal rats. The protein was purified by sequential chromatography on Superdex 200 columns and identified chemically and immunologically as ferritin. Using isoelectric focusing and anion exchange chromatography, it was identified as L ferritin. Distribution of this 22-kDa protein in the lung tissue of A. cantonensis-infected rate was studied by immunocytochemistry. Positively stained cells were mainly infiltrated macrophages. Our results suggest that L ferritin accumulation in the macrophages may be related to the proliferation of connective tissue elements and the inflammatory response to A. cantonensis dwelling in the pulmonary arteries of the rat.

Patterns of distant metastases in nasopharyngeal carcinoma

The distant metastasis in nasopharyngeal carcinoma has remained the major cause of mortality and treatment failure despite better locoregional control of the disease in the past decades. Between 1987 and 1992, 125 out of 629 cases of nasopharyngeal carcinoma were found to have distant metastasis. The location of metastatic site, the timing and median survival were analyzed. The diagnosis of distant metastasis in the retrospective study was based on radiography, computed tomography, skeletal scintigraphy, abdominal sonography and pathology reports. The results showed that the frequencies of metastases were as follows: bone (75% of total metastatic patients), lung (46%), liver (38%), retroperitoneal lymph nodes (10%). Multiple organ involvement was high (57%). Most of the distant metastases (95%) occurred within 3 years after completion of radiotherapy, the first year (52%), the second year (23%) and the third year (20%). The median survival time from the discovery of distant metastasis was 11.2 months for bone metastasis, 16.3 months for pulmonary metastasis, and 3.2 months for hepatic metastasis. The results revealed that the skeletal system was the most common site of distant metastasis, followed by lung and liver. The incidence of retroperitoneal lymphadenopathy is higher than previous reports.

Topographic distribution of inguinal lymph nodes metastasis: significance in determination of treatment margin for elective inguinal lymph nodes irradiation of low pelvic tumors

PURPOSE

To study the distribution of gross inguinal lymph node metastasis and, in particular, its correlation with major pelvic bony structures on a simulation film.

METHODS AND MATERIALS

Thirty-seven cases of low pelvic tumors having gross inguinal lymph node metastasis that were treated with radiation therapy between November 1987 and December 1992 were segregated for study. The patient's nodes were palpated and marked with lead wire before the simulation film was assumed to be the origin of the previously uninfested node. A total of 84 such labeled nodes was taken. The geometric center of the usually round or elliptical node on the film was obtained from these 37 cases. These centers were transferred to and mapped collectively on a new simulation film showing major pelvic bony structures of left hemipelvis and upper femur.

RESULTS

Distribution of gross inguinal lymph nodes was found confined to the following area, as related to major pelvic bony structure: laterally, just abutting the tangential line that passes through lateral border of the femoral head; medially: 3 cm away from the body's midline axis; superiorly: 1 cm below the line that joins both upper borders of the femoral head; inferiorly: 2.5 cm below the low borders of ischial tuberosity. According to this rectangular boundary, three nodes were out of the field, nine nodes near the border less than 1 cm margin. This area adequately covered 86% (72 of 84) of the studied nodes.

CONCLUSION

Distribution study is important in determining the treatment margin. In general, an additional 1-2 cm beyond the area described above is the recommended treatment margin for elective inguinal lymph nodes irradiation with high confidence level of coverage.

Promotion of colon carcinogenesis through increasing lipid peroxidation induced in rats by a high cholesterol diet

To examine the influence of hypercholesteremia on 1,2-dimethylhydrazine (DMH)-induced rat colon cancer, Sprague-Dawley rats received dietary cholesterol (CH, 0-2%) and cholic acid (CA, 0.25%) with or without DMH (20 mg/kg, s.c. injection) for 18 weeks. The rats receiving dietary cholesterol and cholic acid all significantly increased total serum cholesterol and lipids but only a high cholesterol diet (2% CH plus 0.25% CA) decreased the activity of glutathione peroxidase (GSH-Px) and increased the formation of peroxides in the colon (P < 0.01). The rats that received the combination of DMH and high cholesterol diet enhanced these effects. At the end of the experiment, the diet group administered DMH and high cholesterol (2% CH plus 0.25% CA) developed colon adenoma at 50% of incidence in pathological examination, but no colon adenoma formed in the rats treated with high cholesterol alone. It is supposed that a non-carcinogenic agent like cholesterol may potentiate the carcinogenicity of DMH in rats via an increase of lipid peroxidation and decrease in the activity of peroxidase in the target organ.

[A seroepidemiological study on hepatitis D virus (HDV) infection in Henan Province, China]

In order to investigate the distribution of HDV infection in Henan province, a seroepidemiological study on HDV infection was conducted. A total number of 1182 HBsAg positive serum samples was collected from 13 prefectures and cities between 1991 and 1993. HDV markers (HDAg, anti-HDV, anti-HDV-IgM) were tested with Enzyme Linked Immunosorbant Assay (ELISA). The prevalence rates of HDAg, anti-HDV, anti-HDV-IgM and HDV infection rate were 3.0%, 3.5%, 3.5% and 8.1%, respectively. There were no statistically significant differences in the prevalence rates of HDV infection in patients of different sexes but significant differences in the prevalence rates of HDV infection in patients of different ages, especially in age group above 60, were noticed. We also noticed that the infection rates of HDV were 8.7%, 4.6%, 7.7%, 6.3%, 11.9% and 0.0% in the groups of HBsAg carriers, acute hepatitis, chronic active hepatitis, chronic persistent hepatitis, liver cirrhosis and severe hepatitis, respectively. These findings indicated that HDV infection was important in the pathogenesis of chronic hepatitis B and in the exacerbation from liver disease to cirrhosis.

Recent experience of penile fracture (1989-1993)

Penile fracture is an uncommon injury in the genitourinary organ which occurs following a blunt injury on the rigid penis. Penile fracture with urethral injury is even rarer. A total of 11 new patients with penile fracture were treated at our institution from 1989 to 1993. All of these injuries occurred during sexual intercourse and received immediate surgical repair to preserve the sexual function. Only one patient with complete transection of the urethra received end-to-end anastomosis of the urethra. Unfortunately, he suffered from urethral-cutaneous fistula ten days later. Suprapubic urinary diversion was performed in 3 patients with partial urethral tearing, and they enjoyed satisfactory outcomes during the limited follow-up. Immediate surgical repair of tunica albuginea is recommended for preserving penile function. If associated with partial urethral tear, suprapubic urinary diversion is sufficient to treat urethral lesions.

[Distant metastasis after irradiation alone in carcinoma of the uterine cervix--the patterns and results]

From 1988 to May, 1992, there were 286 patients with pathology-proved carcinoma of the uterine cervix referred to Chang Gung Memorial Hospital, Kaohsiung to receive definite radiotherapy. Sixty-one (21%) patients were found to develop distant metastasis after radiotherapy for at least 2 years follow-up. By FIGO stage, the incidence of distant metastasis was as follows: I :2/39, II a:1/19, II b:20/118, III :34/101, IV a: 4/9. Eighty-five percent patients (52/61) began to develop distant metastasis within the first 2 years after radiotherapy. Twenty-three patients developed single organ metastasis, and 38 patients developed multiple organ metastasis. Lymph nodes (38 patients), lung (28 patients), bone (27 patients), and abdomen (20 patients) were the common sites of distant metastasis. Lymph nodes metastasis occurred most often at supraclavicular lymph nodes (15 patients), para-aortic lymph nodes (18 patients), and inguinal lymph nodes (5 patients). Spine (23 patients), especially the lumbar spine (20 patients) was the most common site of bony metastasis. Abdominal metastasis occurred in abdominal cavity (15 patients) or liver (5 patients). The incidence of metastasis within the first two years after radiotherapy was lung: 75% (21/28), bone: 62% (18/29), left supraclavicular lymph nodes: 60% (9/15), para-aortic lymph nodes: 72% (13/18), intra-abdominal cavity: 86% (13/15), liver: 66% (2/3), brain: 0% (0/4). The 2-year actuarial survival rate for the 61 patients after developing distant metastasis was 14%, with a median survival time of 6.4 months. There was no significant difference in survival when comparing patients with single organ metastasis and with multiple organ metastasis (p > 0.05), or patients with distant metastasis alone and with distant metastasis combined with local recurrence (p > 0.05). Otherwise, after distant metastasis twenty-three patients receiving chemotherapy or radiotherapy had a significantly higher 2-year survival rate than 38 patients receiving supportive care only after distant metastasis (34% vs. 2.4%, p < 0.05).

N-Nitroso-N-(3-keto-1,2-butanediol)-3'-nitrotyramine. A new genotoxic agent derived from the reaction of tyrosine and glucose in the presence of sodium nitrite

N-Nitroso-N-(3-keto-1,2-butanediol)-3'-nitrotyramine (NO-NTA) is a product of a model browning system in the presence of sodium nitrite. In this study, the chemical structure is confirmed by spectral studies, including UV, mass spectrometry, nuclear magnetic resonance and infrared spectroscopy. NO-NTA is strongly genotoxic to the rat hepatocyte and is moderately cytotoxic to mouse C3H10T1/2 cells. Results obtained in this study indicate that NO-NTA inflicted DNA damage through the formation of a DNA adduct. In addition, C3H10T1/2 cells were treated with NO-NTA and, following addition of 12-O-tetradecanoylphorbol-13-acetate (TPA) as promotor, the increase of transformed foci indicated that NO-NTA could possibly be an initiator [corrected] of TPA tumor promotion. A transformed cell line from NO-NTA initiated and TPA promoted foci increased saturation density and growth ability in soft agar reactive to the control line. These results suggest that the formation of a genotoxic agent of nitroso-derivatives may take place in a nitrite-containing food system during processing and cooking.

Crocetin protects against oxidative damage in rat primary hepatocytes

Crocetin is a major component in the fruit of Gardenia jaminoides Ellis, a Chinese herbal medicine. Its protective action and mechanism against oxidative damage were investigated and mechanism against oxidative damage were investigated. Reactive oxygen species (ROS) were generated enzymatically in the xanthine-xanthine oxidase (X/XO 5 microM/0.01 u/ml) system and non-enzymatically in the paraquat (PQ 5 mM) system. Both systems increased leakage of lactate dehydrogenase (LDH) and alanine transaminase (ALT) in rat primary hepatocytes, but the hepatotoxicity was significantly suppressed on pretreatment with crocetin (10, 20 microM). Crocetin decreased formation of malondialdehyde (MDA) as an index of lipid peroxidation induced by ROS. The oxyradical generation by X/XO or PQ caused DNA damage evaluated with unscheduled DNA synthesis (UDS) in rat primary hepatocytes. The addition of crocetin decreased genotoxicity evaluated with UDS in both systems. The data showed that crocetin also inhibited the formation of superoxide anion in the X/XO system and bleached the free radical 1, 1-diphenyl-2- picrylhydrazyl (DPPH). The protective action of crocetin operated via quenching of the superoxide anion and/or free radical.

Thyroid peroxidase autoantibodies and their effects on enzyme activity in patients with systemic lupus erythematosus

Thyroid microsomal antibodies (Ms-Ab) are recently proved to be directed to thyroid peroxidase (TPO). The aim of this study was to investigate whether the sera of patients with systemic lupus erythematosus (SLE) contain anti-TPO antibodies (TPO-Ab) and whether these antibodies influence enzyme activity. Sera from patient with Hashimoto's thyroiditis was also studied. Serum samples were obtained from 37 patients with SLE, 20 patients with Hashimoto's thyroiditis and 20 healthy subjects. TPO-Ab were detected by immunoprecipitation using crude microsomal preparations or enzyme-linked immunoabsorbent assay (ELISA) with recombinant TPO. Positive TPO-Ab by ELISA were found in 11 (61%) of 18 patients with lupus whose serum contained Ms-Ab. Low levels of TPO-Ab also were found in three (16%) of 19 lupus sera that did not contain Ms-Ab. All patients with Hashimoto's thyroiditis had high levels of TPO-Ab in serum. When measured by ELISA, TPO-Ab were highly correlated with the results of a TPO immunoprecipitation assay and with the titers of Ms-Ab in patients with lupus (r = 0.83, n = 18, P < 0.01; r = 0.63, n = 18, P < 0.01) and in Hashimoto's thyroiditis (r = 0.89, n = 20, P < 0.01; r = 0.75, n = 20, P < 0.01). When evaluating the direct influence of TPO-Ab on the activity of TPO, we found no significant inhibition of enzymatic activity in both guaiacol and iodide assays by lupus sera in contrast with sera from Hashimoto's thyroiditis.(ABSTRACT TRUNCATED AT 250 WORDS)

Determination of a cyclic guanine monophosphate phosphodiesterase inhibitor (SCH 51866) in rat serum using capillary zone electrophoresis

A capillary zone electrophoretic (CZE) assay was developed for the determination of cis-5,6a,7,8,9,9a-hexahydro-2-[4-(trifluoromethyl)phenylmethyl]-5-methyl - cyclopent[4,5]imidazo[2,1-b]purin-4(3H)-one, SCH 51866 (I), a cyclic guanine monophosphate phosphodiesterase inhibitor, in rat serum using acetonitrile deproteination as a clean-up step before injection. The calibration curve was linear over a serum concentration range of 0.5 to 10 micrograms/ml serum with a correlation coefficient (r) > 0.99. The limit of quantitation (LOQ) was established at 0.5 micrograms/ml. Fifty microliters of serum were used for analysis, which allowed serial bleeding (8 samples) from a single rat to characterize the pharmacokinetic profile of I after either oral or intravenous drug administration. In traditional pharmacokinetic and toxicokinetic studies in rodents, one animal provides only one serum sample since 1 to 2 ml of sample volume is required for chromatographic analysis, resulting in the use of a large number of animals per study. This assay yields a significant reduction in the use of animals, hence providing a large reduction in resources and time in drug discovery and development.

Expression of thyroid hormone receptors in human pituitary tumor cells

To understand the expression of thyroid hormone receptors (TRs) in various types of pituitary tumor cells, we performed the reverse transcription coupled to polymerase chain reaction (RT-PCR). Specimens of pituitary adenomas were obtained by transsphenoidal adenomectomies from 2 patients with acromegaly, 6 patients with prolactinoma, 3 patients with Cushing's disease, 2 patients with gonadotropin-secreting tumors, one patient with a TSH-secreting tumor, and 3 patients with non-functioning adenoma with no clinical evidence of pituitary hormone overproduction. Human thyroid hormone receptors beta 1 and alpha 1, alpha 2 (h-TR beta 1, alpha 1, alpha 2) are expressed in nonfunctioning adenomas; h-TR alpha 1 and beta 1 are specific for prolactinomas; h-TR beta 1 is involved in acromegalies and FSH-secreting tumors, while h-TR alpha 1, alpha 2, and beta 1 are not expressed in TSH-secreting and ACTH-secreting tumors. The results suggest that human thyroid hormone receptors are differentially expressed in human pituitary tumor cells, and our studies have shed new light on the understanding of the role of TRs in pituitary tumors.

Inhibitory effect of green tea extract on the carcinogenesis induced by asbestos plus benzo(a)pyrene in rat

In this experiment lung carcinoma was induced by crocidolite plus benzo(a)pyrene in rat. From the cancer models, we observed that the incidence (16.0%) of lung carcinomas was lower, and the survival time (376 days) of the first case of carcinoma and the mean survival time (758 days) of the rats with carcinoma were higher in the group of rats drinking 2% green tea extract for life than in the positive group (without drinking green tea extract). The mortality ratio (0.5047) was smaller in the experimental group than in the positive control group, and the survival curve of the experimental group significantly raised up, in comparison with the positive group.

Inhibition of 12-O-tetradecanoylphorbol-13-acetate-caused tumor promotion in benzo[a]pyrene-initiated CD-1 mouse skin by geniposide

The effects of topical application of geniposide on 12-o-tetradecanoylphorbol-13-acetate(TPA)-induced promotion of skin tumors, hyperplasia, ornithine decarboxylase (ODC) and inflammation were evaluated in female CD-1 mice. Topical application of geniposide (0.2 to 1.0 mumol) with TPA (15 nmol) twice weekly for 20 weeks to mice previously initiated with benzo[a]pyrene (B[a]P) inhibited the number of TPA-induced tumor per mouse by 84 or 89%, respectively. Pre-application of the same amount of geniposide also afforded significant protection against TPA-induced hyperplasia in the ear skin. Topical application of geniposide inhibited tumor promoter-caused induction of epidermal ODC activity by TPA (5 nmol). The topical application of geniposide (0.2 or 1.0 mumol) inhibited TPA-induced edema of mouse ears by 41 or 43%, respectively. Pretreatment of mouse skin with various amounts of geniposide caused inhibition of hydrogen peroxide (H2O2) and myeloperoxidase (MPO) formation by TPA. These results indicate that geniposide possesses potential as a cancer chemopreventive agent against tumor promotion.

Inhibition of tumor promotion in benzo[a]pyrene-initiated CD-1 mouse skin by crocetin

The effects of topical application of crocetin on 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced promotion of skin tumors, hyperplasia, hydrogen peroxide, ornithine decarboxylase (ODC) and inflammation were evaluated in female CD-1 mice. Topical application of crocetin (0.2 or 1.0 mumol) with TPA (15 nmol) twice weekly for 20 weeks to mice previously initiated with benzo[a]pyrene (B[a]P) inhibited the number of TPA-induced tumors per mouse by 69 and 81% respectively. Pre-application of the same amount of crocetin also afforded significant protection against TPA-induced hyperplasia in the ear skin. Topical application of crocetin inhibited tumor promoter-caused induction of epidermal ODC activity by TPA (5 nmol). The topical application of crocetin (0.2 or 1.0 mumol) inhibited TPA-induced edema of mouse ears by 76 and 87% respectively. Pretreatment of mouse skin with various amounts of crocetin caused inhibition of hydrogen peroxide and myeloperoxidase production by TPA. These results indicate that crocetin possesses potential as a cancer chemopreventive agent against tumor promotion.

A specific enzyme immunoassay (EIA) with selective extraction for quantitation of a topical anti-inflammatory agent, SCH 40120, in human plasma

SCH 40120 is a potent anti-inflammatory agent under development for the topical treatment of dermal inflammatory and allergic disorders such as atopic dermatitis, contact dermatitis and psoriasis. We have previously described a sensitive enzyme immunoassay (EIA) for SCH 40120 in unextracted human plasma to support clinical studies. However, severe cross-reaction with unknown metabolites was observed during validation using samples from rats dosed with 14C-SCH 40120. Therefore, a selective extraction procedure was developed to remove the unknown plasma metabolites of SCH 40120 prior to EIA quantitation. The modified EIA using extracted plasma was cross-validated with an LC method using plasma samples from dosed subjects (human and rat), thereby confirming the specificity of the assay. The EIA can reliably quantitate SCH 40120 in plasma samples from 100 pg ml-1 to 10 ng ml-1 with good linearity, accuracy and precision, and is suitable for pharmacokinetic studies in man.

Mutagenicity and cytotoxicity of nitropyrrole compounds derived from the reaction of 2-acetyl pyrrole with nitrite

2-Acetylpyrrole (AP) is a product of model browning systems, and has been isolated as a major flavour component of many foods. Reaction of AP with nitrite produces two N-nitropyrrole compounds, 1-nitro-2-acetyl-pyrrole (NAP) and 1,3,5-trinitro-2-acetylpyrrole (TNAP), the chemical structures of which have been confirmed by spectral studies, including UV mass, nuclear magnetic resonance, infra-red and elemental analysis (EA). NAP and TNAP are moderately mutagenic to the Salmonella strains TA98 and TA100 in the absence of a mammalian activation system and are markedly cytotoxic to mouse C3H10T1/2 cells. These results suggest that the formation of direct-acting mutagens of nitro-derivatives may take place in nitrite-containing food or in vivo by nitrosation following ingestion of AP.

[Biological effects of diagnostic ultrasound on embryo in first trimester of pregnancy]

Biological effects of diagnostic ultrasound on the embryo during first trimester of pregnancy were studied. Normal pregnant women asked for induced abortion with gestational age of 6-8 weeks were recruited. Embryo in uterus were exposed to the diagnostic ultrasound for 5, 10 and 30 minutes respectively. Surgical evacuations were performed 5, 15, 24 and 48 hours after exposure and chorionic villi were obtained. The villi were determined for 4 lysosomal enzymes, malondialdehyde (MDA), and superoxide dismutase (SOD); and sister chromatid exchange and the ultrastructure of the villi were studied as well. In comparison to normal non-exposure group, the results showed various degrees of changes in lysosomal enzymes, MDA, SOD and ultrastructure of the villi in those exposed to ultrasound 10 and 30 minutes, and most significant changes were observed in the latter group. These included the hyperreaction of lipid peroxides; increased activities of some lysosomal enzymes; reduced SOD activity; and vesiculation and aberration of some mitochondrion, also transformation or disappearance of some microvilli in ultrastructure.

Modulatory effect of piperine on benzo[a]pyrene cytotoxicity and DNA adduct formation in V-79 lung fibroblast cells

Piperine, a major component of black pepper and long peppers, has been reported previously to have an effect on the activation and deactivation of some exogenous substances. In the present study, piperine was found to promote DNA damage and cytotoxicity induced by benzo[a]pyrene (B[a]P) in cultured V-79 lung fibroblast cells. The V-79 cells were treated with a non-toxic dose of piperine (1-20 microM) plus 10 microM B[a]P, or pretreated with piperine for 30 min or 2 hr prior to the administration of 10 microM B[a]P. B[a]P cytotoxicity was potentiated significantly by piperine under each experimental condition. The relative plating efficiency (RPE) was 71% when V-79 cells were exposed to 10 microM B[a]P alone. When the culture was exposed to B[a]P plus piperine or pretreated with piperine for 30 min prior to the administration of B[a]P, the RPE values were 63 and 44% (P < 0.001), respectively. Pretreatment with piperine for 2 hr had no significant effect (P > 0.05). Furthermore, the lowest activities (P < 0.05) of glutathione S-transferase (GST) and uridine diphosphate glucuronyl transferase (UDP-GTase) of piperine-treated V-79 cells occurred 30 min to 1 hr after the piperine pretreatment. Pretreatment of V-79 cells with piperine also caused an increase in the covalent binding of B[a]P-diol-epoxide to DNA, 2.3 times greater than that of the V-79 cells without piperine treatment. These results suggest that the promotion by piperine of B[a]P-induced cytotoxicity in V-79 lung fibroblast cells is due to mechanisms that decrease the activities of GST and UDP-GTase and increase the formation of a B[a]P-DNA adduct.

A sensitive enzyme immunoassay (EIA) for quantitation of the topical anti-inflammatory agent SCH 40120 in unextracted human plasma

SCH 40120 is a potent acute anti-inflammatory agent under development for topical treatment of dermal inflammatory and allergic disorders such as atopic dermatitis, contact dermatitis and psoriasis. In order to support percutaneous absorption studies, a competitive enzyme immunoassay (EIA) was developed to determine SCH 40120 in unextracted plasma samples. SCH 38280, a carboxylated analogue of SCH 40120, was used as the hapten and conjugated with bovine thyroglobulin (Thy). The hapten-Thy conjugate was used as the immunogen to immunize rabbits for antibody production. The hapten was also coupled to horseradish peroxidase (HRP) to form SCH 38280-HRP, which was used as the tracer. The EIA can detect SCH 40120 concentrations as low as 50 pg ml-1 of plasma, and can reliably quantitate SCH 40120 in plasma samples from 100 pg ml-1 to 10 ng ml-1 with good linearity, accuracy and precision. A variety of structurally related compounds and potential metabolites did not significantly cross-react with the antibodies, except for a few analogues. The availability of this sensitive assay makes it possible to evaluate the pharmacokinetics of SCH 40120 in man.

[Foreign body in the urinary bladder]

Foreign bodies in the urinary bladder are not uncommon, however, only a few cases have been reported in recent literature. This is not a fatal disease, however, it may lead to serious complications such as chronic cystitis, urolithiasis, or rectal abscess formation. These foreign bodies were inserted for autoerotic or unknown reasons by patients. In this paper we report 4 cases of foreign bodies in the urinary bladder. They include a cucumber, glass tube, chewing gum, and filliform catheter. We found that most of the foreign bodies in the urinary bladder can be removed endoscopically, but if the patients also had a lower urinary tract obstructive disease, removal necessitated surgical procedures. All of the four cases had no urological complications for at least one year after treatment.