Interleukin 12 gene therapy of cancer by peritumoral injection of transduced autologous fibroblasts: outcome of a phase I study

A phase I dose-escalation clinical trial of peritumoral injections of interleukin 12 (IL-12)-transduced autologous fibroblasts was performed in patients with disseminated cancer for whom effective treatment does not exist. The goals of this study were to assess the safety and toxicities as well as the efficacy, and ancillarily the immunomodulatory effects, of peritumoral IL-12 gene transfer. Primary dermal fibroblasts cultured from the patients were transduced with retroviral vector carrying human IL-12 genes (p35 and p40) as well as the neomycin phosphotransferase gene (TFG-hIL-12-Neo). Patients received four injections at intervals of 7 days. Nine patients were enrolled in this dose-escalation study, with secreted IL-12 doses ranging from 300 ng/24 hr for the first three patients to 1000, 3000, and 5000 ng/24 hr for two patients in each subsequent dosage level. Although a definite statement cannot be made, there appears to be perturbation of systemic immunity. Also, the locoregional effects mediated by tumor necrosis factor alpha (TNF-alpha) and CD8+ T cells were observed with tumor regression. Treatment-related adverse events were limited to mild to moderate pain at the injection site; clinically significant toxicities were not encountered. Transient but clear reductions of tumor sizes were observed at the injected sites in four of nine cases, and at noninjected distant sites in one melanoma patient. Hemorrhagic necrosis of tumors was observed in two melanoma patients. These data indicate that gene therapy by peritumoral injection of IL-12-producing autologous fibroblasts is feasible, and promising in patients with advanced cancer.

Possibility of reciprocal infection of methicillin-resistant Staphylococcus aureus between medical personnel and patients undergoing middle ear surgery

The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection after middle ear surgery has recently increased in our hospital. In this study we tried to determine whether the strains of MRSA isolated from infected patients are identical to those obtained from medical personnel, to prove a reciprocal transmission between medical personnel and patients. Surveillance bacterial cultures of medical personnel were performed from the anterior nares and from the fingertip. Molecular epidemiological studies, ribotyping and pulsed-field gel electrophoresis (PFGE) were used to compare the 12 MRSA strains obtained from carriers among medical personnel with the 60 strains identified from patient's otorrhea. Six different MRSA strains were identified from ribotyping, and three subtypes from PFGE. There was a particular subtype which was the most frequently identified strain found in both medical carriers and patients. Postoperative MRSA infection rates after the treatment of medical carriers and application of preventive procedures decreased from 11.9 to 5.7%. These findings suggest that the MRSA transmissions have occurred between medical personnel and patients.

Supplemental oxygen controls cellular proliferation and anastomotic intimal hyperplasia at a vascular graft-to-artery anastomosis in the rabbit

PURPOSE

The purpose of this study was to determine whether the administration of 40% supplemental oxygen (O ( 2) ) will decrease cellular proliferation and intimal hyperplasia (IH) at a prosthetic vascular graft (PVG)-to-artery anastomosis.

METHODS

Twenty New Zealand white rabbits underwent placement of a 3-mm polytetrafluoroethylene graft in their infrarenal aorta. Four groups of five rabbits were placed either in a normoxic (21%) environment or in a 40% supplemental O ( 2) environment for 7 or 42 days. Twenty-four hours before the rabbits were humanely killed for aortic graft harvest, BrDU (5-bromo-2'-deoxyuridine) was injected into the rabbits intraperitoneally. Image analysis (Bioquant) morphometrics were used to measure cells with BrDU staining and intimal areas at the distal anastomosis. Cellular proliferation is defined as positively staining BrDU cells divided by all cells in the artery wall. IH is reported as a ratio between the intimal area and the medial area to standardize the varying aortic size and degree of aortic fixation among rabbits. The Student t test was used to compare cellular proliferation and IH between control and O ( 2) -treated rabbits.

RESULTS

Cellular proliferation in the intima at 7 days was significantly reduced in the O ( 2) -treated animals (1.7% +/- 1%) versus the control animals (28.6% +/- 3%) ( P =.0001). The cellular proliferation in the intima at 42 days returned to preoperative levels in the O ( 2) -treated group (0.15%) and in the control group (0.11%) ( P = not significant). IH at 7 days was minimal, and no difference between the O ( 2) -treated group (0.017 +/-.006) and the control group (0.009 +/-.03) ( P = not significant) was found. IH was significantly reduced at 42 days in the O ( 2) -treated animals (0.031 +/-.012) when compared with the control animals (0.193 +/-.043) ( P =.006).

CONCLUSIONS

Supplemental O ( 2) (40%) significantly reduces cellular proliferation and IH at the distal anastomosis of a PVG-to-artery anastomosis in the rabbit model.

Acquired bleeding disorder in a patient with malignant lymphoma: antibody-mediated prothrombin deficiency

BACKGROUND

Bleeding manifestations secondary to acquired hemostatic abnormalities in cancer patients have been well described. Bleeding due to the development of hemostatic inhibitors is observed less frequently. In this report, the authors describe a patient with a low grade lymphoma who presented with an acquired bleeding disorder and abnormal hemostatic screening tests.

METHODS

Patient plasma samples were collected initially and during the course of treatment. Mixing studies and specific coagulation factor assays were performed to detect and confirm any deficiencies. Patient immunoglobulin G was isolated from plasma, and binding to prothrombin was demonstrated by immunoblot method and enzyme-linked immunosorbent assay (ELISA) techniques.

RESULTS

Initial prolongations in the prothombin time and the activated partial thromboplastin time suggested a factor deficiency in the common pathway of coagulation. Factor assays confirmed that the coagulation abnormality in this patient was the result of an acquired prothrombin (factor II) deficiency. This was confirmed by an immunoassay for prothrombin antigen. Further studies demonstrated the presence of a noninhibitory antibody to prothrombin that interacted with a calcium dependent epitope.

CONCLUSIONS

Successful treatment of the lymphoma resulted in clearance of the antibody and complete correction of all hemostatic abnormalities and manifestations. An acquired prothrombin deficiency has not been reported previously in association with a malignancy, and this patient represents the first such documented case.

Revascularization and quality of life for patients with limb-threatening ischemia

Traditional outcomes following revascularization for chronic critical limb ischemia consider limb retention and hemodynamic results. Health-related quality of life is not measured. This study was undertaken to determine if surgery for chronic critical limb ischemia improves health-related quality of life. Forty-six patients undergoing revascularization (anklebrachial index <0.4 for nondiabetics, ankle-brachial index <0.6 for diabetics and rest pain or nonhealing ischemic ulcers) completed pre- and postoperative Short-Form 36 questionnaires, which were used to assess health-related quality of life in patients undergoing arterial reconstruction for chronic critical limb ischemia. Patients reported a mild improvement in functional status postoperatively, and overall low health-related quality of life. Health-related quality of life is slow to show progress following revascularization. Health-related quality of life should become an important outcomes end point.

Application of computerized image analysis in pigmentary skin diseases

BACKGROUND

Melanocyte number and the amount of melanin pigment are related to diagnosis and treatment of pigmentary skin diseases. Various histologic methods are used, such as Fontana-Masson stain for melanin pigment or immunohistochemical stain for melanocytes. Recently, computerized image analysis has been applied to many fields to avoid interobserver bias. In this study, we applied a computerized image analysis to assess the melanin content and melanocyte density of human epidermis.

METHODS

We evaluated the skin biopsy specimens (paraffin blocks) from normal human skin (33 +/- 6.6, n = 11) and diseased skins; vitiligo (32 +/- 10.0, n = 8), melasma (35 +/- 8.6, n = 11), and lentigo senilis (40 +/- 7.2, n = 11) (mean age +/- SD). Each specimen was stained with Fontana-Masson for melanin pigments and immunohistochemical method for melanocytes. Quantitative analysis of melanin pigment and melanocyte number (density) were investigated through two methods: (1) two dermatologists measured the visual scales; and (2) computerized image analysis was used to measure melanin content indices (MCI). The data were evaluated using one-way ANOVA.

RESULTS

The visual scale of the Fontana-Masson stain was the highest for lentigo senilis (3.8 +/- 0.40), followed by melasma (2.6 +/- 0.67), normal skin (1.8 +/- 0.60) and vitiligo (0) (P < 0.05). These findings were consistent with objective measurements made by computerized image analysis. MCI values were 120.3 +/- 20.74 for lentigo senilis, 81.1 +/- 19.27 for melasma, 45.5 +/- 16.92 for normal skin, and 0.3 +/- 0.30 for vitiligo in decreasing order (P < 0.05). MC/1E (melanocyte number per 1 mm epidermis) was about two fold larger in lentigo senilis (18.1 +/- 8.92) than melasma (9.7 +/- 2.40) or normal skin (9.3 +/- 2.67) (P < 0.05). MC/1B (melanocyte number per 1 mm basal layer) was about 1.5 fold higher in lentigo senilis (13.5 +/- 4.17), compared to normal skin (9.0 +/- 3.55) (P < 0.05). Melasma showed increased melanocyte numbers compared to normal skin, but it was not statistically significant (P > 0.05).

CONCLUSION

We believe this computerized image analysis could be useful tool for diagnosis and comparison of interval changes in pigmentary diseases like melasma or lentigo senilis by quantifying melanin pigments or melanocytes in skin biopsy specimens.

Quantum correlations in the nonperturbative regime of semiconductor microcavities

The nonlinear optical response of semiconductor microcavities in the nonpertubative regime is studied in resonant single-beam-transmission and pump-probe experiments. In both cases a pronounced third transmission peak lying spectrally between the two normal modes is observed. A fully quantized theory is essential for the agreement with the experimental observations, demonstrating that quantum fluctuations leading to intraband polarizations are responsible for this effect.

Expression of progesterone receptor in human keratinocytes

Despite the various responses of human skin to female sex hormones, cellular and subcellular targets and the mechanisms of action of estrogen and progesterone in human skin are not well understood. The detection of estrogen receptor (ER) and progesterone receptor (PR) in the skin is of great importance to understand the effect of estrogen and progesterone. In primary cultures of human keratinocytes, expression of ER and PR was monitored by immunocytochemistry and reverse transcriptase polymerase chain reaction (RT-PCR). Paraffin embedded skin tissues were stained with monoclonal antibodies to human ER and PR by immunohistochemistry. Cultured human keratinocytes expressed cytoplasmic PR protein and PR mRNA transcripts. By contrast, ER was detected only at the mRNA level. Suprabasal keratinocytes from samples of pruritic urticarial papules, plaques of pregnancy (PUPPP) and psoriasis were stained positively only for PR, while those from samples of erythema nodosum were negative for both ER and PR. Lesional epidermis of PUPPP showed positive PR immunoreactivity, while nonlesional epidermis did not. No other cells in the normal human skin were stained with ER and PR. The present study suggests that by expressing PR human keratinocytes act as targets for progesterone action.

Cross-resistance of triphenylethylene-type antiestrogens but not ICI 182,780 in tamoxifen-stimulated breast tumors grown in athymic mice

The triphenylethylene antiestrogens, idoxifene (Idox) and toremifene (Tor), are structurally related analogues of tamoxifen (Tam) and were developed to improve the therapeutic index for advanced breast cancer patients. However, the issue of cross-resistance with Tam for these new agents is critical for clinical testing because the majority of breast cancer patients have already received or failed adjuvant Tam. The goal of this study was to determine the effectiveness of Idox as an antitumor agent in three models of Tam-stimulated breast cancer in athymic mice and compare the results with the actions of Tor and ICI 182,780 in a Tam-stimulated MCF-7 tumor model. We first compared the activities of Tam and Idox in the 17beta-estradiol (E2)-stimulated MCF-7 tumor line MT2:E2. Tam and Idox reduced E2-stimulated growth by 65-70% (week 9: P = 0.0009 for Tam, P = 0.0005 for Idox versus E2 alone). However, Tam (1.5 mg daily) and Idox (1.0 mg daily) both produced T47D breast tumors in athymic mice during 23 weeks of treatment (12 tumors/22 sites and 15 tumors/18 sites, respectively). Tam and Idox stimulated tumor growth equally in two different Tam-stimulated MCF-7 models and in a T47D model. Tor was completely cross-resistant with Tam in the MCF-7 tumor model, which implied that neither Idox nor Tor would be effective as a second-line endocrine therapy after Tam failure and may offer no therapeutic advantages over Tam as adjuvant therapies. In contrast, ICI 182,780, a pure antiestrogen currently being tested as a treatment for breast cancer after Tam failure, had no growth-stimulatory effect on the MCF-7 Tam-stimulated breast tumor line. This agent may provide an advantage as an adjuvant therapy and increase the time to treatment failure.

Effects of flupyrazofos on liver microsomal cytochrome P450 in the male Fischer 344 rat

1. The effects of flupyrazofos on liver microsomal cytochrome P450 were investigated in the male Fischer 344 rat. When rats were treated intraperitoneally with flupyrazofos for 3 consecutive days, the activities of ethoxyresorufin O-deethylase and testosterone 2 beta-hydroxylase were significantly reduced, whereas the activities of pentoxyresorufin beta-depentylase and testosterone 6beta- and 7 alpha-hydroxylases were induced in liver microsomes. 2. Within 24 h after treatment with 50 m kg(-1) flupyrazofos, most enzyme activities were decreased, indicating the interaction of flupyrazofos with cytochrome P450. 3. In Western immunoblotting, cytochrome P4502B1/2 proteins were clearly induced by treatment with flupyrazofos, whereas P4501A1/2 and 2C6 proteins were reduced in liver microsomes. 4. The present results indicate that flupyrazofos modulates the expression of cytochrome P450 in rat.

A new mineral trioxide aggregate root-end filling technique

Carrier and syringe-type devices are currently used to deliver mineral trioxide aggregate as a root-end filling material. In certain surgical situations these devices may be too difficult to use because of the location of the surgical site and the small size of the root-end preparation. This paper describes a new technique to overcome these difficulties by the formation and delivery of mineral trioxide aggregate pellets.

Use of a noncontact radiant heat bandage and Staphylococcus aureus dermal infections in an ovine model

Diabetic foot wounds are difficult to manage due to relative tissue ischemia and high rates of soft tissue infection. One potential treatment modality is the application of local radiant heat to promote wound healing and control infection. However, there are concerns that local heat will spread rather than control infection. We determined in this study the effect of a noncontact radiant heat bandage in controlling an ischemic soft tissue infection. Bilateral 10 x 15 cm dermal flaps were created in 15 adult range sheep. The flaps were inoculated intradermally with 107 Staphylococcus aureus in 3 separate areas. The control flap was left open to air, while the treatment flap was covered with a noncontact radiant heat bandage and heated to 38 degrees C for three 1-hour periods separated by two 1-hour nonheating periods daily. After 10 days, both dermal flaps were harvested and sent for quantitative bacteriology. Due to operative complications, 12 of 15 sheep completed the study. The heated flap temperature was significantly higher 39.2 +/- 0.5 degrees C (+/- SE) vs. the control flap 36.1 +/- 0.1 degrees C (p < 0.00001) and bacterial counts were significantly smaller in the heated flap (median 1.0 x 107 colony-forming units per gm tissue) when compared to the control flap (median 7.5 x 107) (p = 0.001). This study shows the use of a noncontact radiant heat bandage controls ischemic soft tissue infections in an ovine model.

Clinical experiences with acute mastoiditis--1988 through 1998

The incidence of acute mastoiditis has declined dramatically during the postantibiotic era. Even so, antibiotic-resistant or unusual pathogens can still cause this disease entity. At our hospital, we documented an increase in antibiotic-resistant and atypical pathogens such as Actinomyces spp. and Mycobacterium tuberculosis. In this paper, we discuss the optimal diagnosis and treatment strategy for acute mastoiditis, and we describe our retrospective review of 13 patients with mastoiditis who were treated at our hospital from 1988 through 1998. Eight of these patients recovered following treatment with intravenous antibiotics, with or without myringotomy, and five who had complications of disease were managed surgically. Among these five, one developed chronic otitis media and one developed cholesteatoma 3 years later. For patients with acute mastoiditis, we emphasize the need to be aware of any unusual pathogens that do not respond to empiric antibiotic therapy.

Rapid development of tamoxifen-stimulated mutant p53 breast tumors (T47D) in athymic mice

MCF-7 cells are used routinely to study tamoxifen-stimulated drug resistance in vivo. However, unlike MCF-7 cells, T47D cells express mutant p53 protein and lose the estrogen receptor (ER) during long-term estrogen deprivation in vitro [Pink et al., Br. J. Cancer, 74: 1227-1236, 1996 (erratum, Br. J. Cancer, 75: 1557, 1997)]. As a result, T47D tumors may respond differently from MCF-7 tumors to long-term tamoxifen treatment. Ovariectomized athymic mice were given injections bilaterally with T47D cells (5 x 10(5)) into the mammary fat pads. A rapidly growing estradiol responsive tumor (T47D:E2) was established and 0.5 mg of tamoxifen given daily blocked estrogen-stimulated growth. In subsequent experiments, low doses of tamoxifen (0.17 mg or 0.5 mg) did not produce tamoxifen-stimulated tumors at 14 weeks, whereas high-dose tamoxifen (1.5 mg) consistently produced tamoxifen-stimulated tumors (T47D:Tam; 17 tumors/20 sites) at 8 weeks. In contrast, 1.5 mg of tamoxifen produced tamoxifen-stimulated MCF-7 tumors (MCF-7: Tam2) at a slower rate (20 weeks) and less consistently (14 tumors/26 sites). When the T47D:Tam tumor was passaged, it grew maximally with either 1.5 mg of tamoxifen or a 1-cm estradiol (premenopausal levels) capsule, and similar results were obtained with MCF-7:Tam2 tumors. Interestingly, when T47D:Tam tumors were treated with the 0.5 mg of tamoxifen, tumors grew only to 50% maximum. All of the tumors originating from MCF-7 and T47D cells expressed ER at similar levels; therefore, tamoxifen did not select for an ER-negative tumor. In conclusion, we have shown that tamoxifen-stimulated T47D p53 mutant tumors can be developed rapidly with high-dose therapy (1.5 mg daily). The results from this model provide new opportunities to investigate the rapid development of drug resistance to adjuvant tamoxifen in patients with mutant p53 breast tumors.

Protective role of superoxide dismutase in rat eustachian tubal mucosa against acute otitis media induced by upper respiratory tract infection

Superoxide dismutase has been known to play a role as an anti-oxidative system against oxidative injury during acute inflammation. To investigate the role of superoxide dismutase in eustachian tubal mucosa during acute otitis media (AOM), an animal model was made. Sprague-Dawley rats were inoculated with Streptococcus pneumoniae through the nasal cavity following development of virus-induced upper respiratory infection. The animals were divided into three groups according to their tympanic cavity conditions following bacterial inoculation; inoculated animals with no resultant AOM (no-AOM), animals with resultant AOM (AOM) and animals with resolving otitis media (recovery). The changes of superoxide dismutase in each tubal mucosa were compared with that of the normal control using immunohistochemistry and immunoblotting methods. On Western blot, there were little changes of optical density and surface area in no-AOM (213.5 +/- 22.4, 13.2 +/- 0.8 mm2) and recovery group (219.3 +/- 18.7, 14.8 +/- 0.7 mm2) compared to the normal control (223.5 +/- 26.2, 16.7 +/- 0.4 mm2). However, a marked decrease was found in the AOM model (167.6 +/- 19.3, 6.5 +/- 0.9 mm2). These findings suggest that superoxide dismutase may play a role in protecting tubal mucosa from free radical injury during AOM.

Transarterial wall oxygen gradients at the deployment site of an intra-arterial stent in the rabbit

Intimal hyperplasia, common at the deployment site of an intra-arterial stent, may be caused by artery wall hypoxia. The purpose of this study was to determine the effect of an intra-arterial stent on artery wall oxygen concentrations. Transarterial wall oxygen gradients were measured by microelectrode at stent deployment sites in New Zealand White rabbits. Thinned artery walls and decreased oxygen tensions were noted throughout the artery wall immediately following stent deployment with a return toward control values at 28 days. Angioplasty alone had no acute effect on artery wall oxygen concentrations. Larger stent deployment diameters yielded acutely lower artery wall oxygen tensions. Using a linear one-dimensional model for the oxygen profile, we noted that stent deployment resulted in acute changes in oxygen consumption in the inner artery wall that rapidly returned to control values. Changes were noted without differences in blood pressure or arterial blood oxygen concentrations. Oxygen delivery to and consumption within the artery wall are altered by intra-arterial stent deployment. A role for artery wall hypoxia in artery wall pathology at the deployment site of an intra-arterial stent is supported by these findings.

Effects of handicap on life expectancy: the case of China

The purpose of this study was to quantify and partition the expected years of life with and without handicap for the Chinese population according to various types of handicaps, age-sex groups and regions. A large-scale sample survey on handicapped persons conducted in 1987, and the 1990 population census constitute the basis for computing the expected years of life free of handicapped condition using the method proposed by Sullivan. The expected years of life with handicap for the Chinese population in childhood (0-14 y), working ages (15-64 y) and the elderly (65 y+) were 0.40, 1.78, and 3.44 for males and 0.34, 1.69, and 4.55 for females. For the Chinese males over 65 y of age, there were about 1.83 expected years of life with aural handicap and 0.59 expected years of life with ocular handicap. For the Chinese females over 65 y of age, there were about 1.87 expected years of life with aural handicap and 1.16 expected years of life with ocular handicap. The burden of living with handicap is greater for females and the elderly. This general pattern hold for all types of handicap except for skeletal handicap. The expected years of life with handicap for the Chinese population provide useful information for setting public health policies, despite the difficulty in making comparisons with the similar data in other countries.

Early bronchiolitis obliterans following lung transplantation: accuracy of expiratory thin-section CT for diagnosis

PURPOSE

To evaluate the accuracy of thin-section computed tomography (CT) with expiratory scans in diagnosing early bronchiolitis obliterans after lung transplantation.

MATERIALS AND METHODS

Thin-section CT scans were reviewed by two observers blinded to the diagnoses in seven consecutive lung transplant recipients with histopathologically proved bronchiolitis obliterans (group A) and 21 with normal biopsy findings (group B). All patients had normal biopsy and stable pulmonary function test (PFT) results 2-36 weeks prior to CT. Patients with normal biopsy results were placed into subgroups based on abnormal (group B1) or stable (group B2) PFT results. Air-trapping extent on expiratory scans was scored on a 24-point scale.

RESULTS

The mean air-trapping score in group A (6.6) was not significantly different from that in group B (4.5, P =. 17). The air-trapping score was significantly higher in groups A and B1 than in group B2 (6.2 and 2.6, respectively; P =.03). The frequency of an air-trapping score of 3 or more in groups A and B1 was significantly higher than that in group B2 (P =.03). By using a score of 3 or more to indicate air trapping, the sensitivity of expiratory CT was 74%, specificity was 67%, and accuracy was 71%.

CONCLUSION

Thin-section CT, including expiratory scans, is of limited accuracy in diagnosing early bronchiolitis obliterans after lung transplantation.

Effects of angiogenesis inhibitor TNP-470 on tamoxifen-stimulated MCF-7 breast tumors in nude mice

The antitumor effect of TNP-470, antiangiogenic drug, was analyzed in the tamoxifen-stimulated MT-2 tumors inoculated in the athymic nude mice. TNP-470 was injected subcutaneously at a dose of 30 mg/kg body weight twice a week to mice which were randomized into three treatments: control (sham treatment), tamoxifen alone, and tamoxifen plus TNP-470. TNP-470 inhibited the growth of the tamoxifen-stimulated MT2 tumors without any major side effects or significant weight loss compared with tamoxifen-treated mice alone. The mean tumor area of the mice treated with tamoxifen plus TNP-470 was reduced 50% to those treated with tamoxifen alone. TNP-470 was shown to inhibit tumor neovascularization and to increase incidence of apoptosis in tumor cells. TNP-470 did not affect tamoxifen metabolism of the mice. In conclusion, TNP-470 could be evaluated clinically in patients with tamoxifen failure.

Low-dose, dynamic, expiratory thin-section CT of the lungs using a spiral CT scanner

Seventeen patients with lung transplants were evaluated with inspiratory, postexpiratory, and low-dose, dynamic expiratory thin-section computed tomography (CT). Region of interest measurements were performed on inspiration and expiration images with both techniques, and mean lung attenuation changes between inspiration and expiration images were calculated and compared. Dynamic expiratory thin-section CT resulted in a significantly greater increase in lung attenuation than postexpiratory thin-section CT. Dynamic expiratory thin-section CT may prove useful in the evaluation of patients with lung diseases characterized by air flow obstruction with little increase in patient radiation dose.

In vitro maturation and in vitro fertilization of bovine oocytes cultured in a chemically defined, protein-free medium: effects of carbohydrates and amino acids

This study was conducted to examine the effects of carbohydrates and amino acids on the maturation and fertilization of bovine oocytes. To evaluate the effect of each treatment without any unpredictable interference, oocytes were cultured in a simply defined medium (modified Tyrode's medium; mT) without the addition of hormones and proteins. In Experiment 1, oocyte maturation to the metaphase-II stage was significantly (P<0.0001) enhanced after the addition of glucose (5.6 mM), lactate (10 mM) and/or pyruvate (0.5 mM) to mT (37-74%) than after no addition (0%). In mT supplemented with glucose, the addition of 19 essential and non-essential amino acids (aa; 0, 0.01, 0.1, 1, 5 or 10%) did not further improve in vitro maturation (Experiment 2) or in vitro fertilization (Experiment 3) of oocytes. However, more (P<0.05) pronuclear formation after in vitro-insemination was found in oocytes matured in mT with 1% aa and glucose than in oocytes matured in mT with glucose alone (56% vs. 35%). Penetration of spermatozoa into the ooplasm was initiated at 3 h after insemination and pronuclear formation from 8 h (Experiment 4). When cultured inseminated oocytes were examined up to 192 h post insemination, a significant (P<0.05) increase in the number of 2-cell (18 v. 38%) and 8-cell embryos, (7 v. 20%) and morulae (0 v. 8%) was found after the addition of 1% aa to mT with glucose than after no addition (Experiment 5). A limited number of oocytes matured in mT with aa and glucose developed to the blastocyst stage (6%). These results indicate that exogenous carbohydrates and amino acids are prerequisites for the maturation and fertilization of bovine oocytes in vitro. Glucose alone promotes the nuclear maturation of oocytes, whereas amino acids aid the pronuclear formation of fertilized oocytes.

Transarterial wall oxygen gradients at a prosthetic vascular graft to artery anastomosis in the rabbit

PURPOSE

Artery-wall hypoxia has been proposed to contribute to many kinds of artery-wall pathologic conditions, including atherosclerosis and intimal hyperplasia. Intimal hyperplasia is common at sites of arterial injury, including an anastomosis. The purpose of this study was to determine the effect of a prosthetic vascular graft (PVG)-to-artery anastomosis on the delivery of oxygen to the artery wall.

METHODS

The transarterial wall oxygen gradient in the infrarenal aorta of New Zealand White rabbits 2 mm distal to a PVG-to-artery anastomosis was measured with an oxygen microelectrode.

RESULTS

Oxygen tensions were significantly decreased in the outer artery wall immediately after the creation of the anastomosis and showed a further decrease in oxygen tensions at days 7 and 14, which correlated with the absence of a vasa vasorum. After day 14, the oxygen tensions gradually increased, returning to normal by postanastomosis day 42, correlating with a return of the vasa vasorum. These changes were noted without differences in blood pressure or arterial blood oxygen concentrations.

CONCLUSION

The delivery of oxygen to the artery wall is altered by the creation of a PVG-to-artery anastomosis. Low arterial oxygen tensions at a PVG-to-artery anastomosis support a role for artery-wall hypoxia in the formation of intimal hyperplasia at the site of a PVG-to-artery anastomosis.