Inhibition of InhA, the enoyl reductase from Mycobacterium tuberculosis, by triclosan and isoniazid

Structural and genetic studies indicate that the antibacterial compound triclosan, an additive in many personal care products, is an inhibitor of EnvM, the enoyl reductase from Escherichia coli. Here we show that triclosan specifically inhibits InhA, the enoyl reductase from Mycobacterium tuberculosis and a target for the antitubercular drug isoniazid. Binding of triclosan to wild-type InhA is uncompetitive with respect to both NADH and trans-2-dodecenoyl-CoA, with K(i)' values of 0.22+/-0.02 and 0.21+/-0.01 microM, respectively. Replacement of Y158, the catalytic tyrosine residue, with Phe, reduces the affinity of triclosan for the enzyme and results in noncompetitive inhibition, with K(i) and K(i)' values of 36+/-5 and 47+/-5 microM, respectively. Consequently, the Y158 hydroxyl group is important for triclosan binding, suggesting that triclosan binds in similar ways to both InhA and EnvM. In addition, the M161V and A124V InhA mutants, which result in resistance of Mycobacterium smegmatis to triclosan, show significantly reduced affinity for triclosan. Inhibition of M161V is noncompetitive with K(i)' = 4.3+/-0.5 microM and K(i) = 4.4+/-0.9 microM, while inhibition of A124V is uncompetitive with K(i)' = 0. 81 +/- 0.11 microM. These data support the hypothesis that the mycobacterial enoyl reductases are targets for triclosan. The M161V and A124V enzymes are also much less sensitive to isoniazid compared to the wild-type enzyme, indicating that triclosan can stimulate the emergence of isoniazid-resistant enoyl reductases. In contrast, I47T and I21V, two InhA mutations that occur in isoniazid-resistant clinical isolates of M. tuberculosis, show unimpaired inhibition by triclosan, with uncompetitive inhibition constants (K(i)') of 0.18+/-0.01 and 0.12+/- 0.01 microM, respectively. The latter result indicates that InhA inhibitors targeted at the enoyl substrate binding site may be effective against existing isoniazid-resistant strains of M. tuberculosis.

Identification of a homeodomain binding element in the bone sialoprotein gene promoter that is required for its osteoblast-selective expression

Bone sialoprotein is a 70-kDa extracellular matrix component that is intimately associated with biomineralization, yet the cis-acting elements of the Bsp gene that restrict its expression to mineralizing cells remain uncharacterized. To identify such elements, we analyzed a 2472-base pair fragment of the murine promoter that directs osteoblast-selective expression of a luciferase reporter gene and found that the region between -338 and -178 relative to the transcriptional start is crucial for its osteoblast-selective activity. We identified an element within this region that binds a protein complex in the nuclear extracts of osteoblastic cells and is required for its transcriptional activity. Introduction of a mutation that disrupts a homeodomain binding site within this sequence eliminates both its in vitro binding and nearly all of the osteoblastic-selective activity of the 2472-base pair promoter. We further found that the Dlx5 homeoprotein, which is able to regulate the osteoblast-specific osteocalcin promoter, can bind this element and stimulate its enhancer activity when overexpressed in COS7 cells. These data represent the first description of an osteoblast-specific element within the bone sialoprotein promoter and demonstrate its regulation by a member of a family of factors known to be involved in skeletogenesis.

[The change of intestinal microcirculation blood flow and its relationship with bacterial translocation in burned rats receiving delayed fluid resuscitation]

OBJECTIVE

To investigate the change of intestinal microcirculation blood flow and its relationship with bacterial translocation in burned rats receiving delayed fluid resuscitation.

METHODS

Twenty-four Wistar rats inflicted by 30% TBSA III degree followed by delayed fluid resuscitation were taken as the model. The rats were randomly divided into four groups, i.e. burn shock without resuscitation (BSNR), delayed resuscitation (fluid given from 8 hours postburn, DR), immediate resuscitation (IR), and sham operation (SO). The incidence of bacterial translocation, intestinal microcirculation blood flow volume of intestinal wall at terminal ileum as well as the change of systemic mean arterial pressure were monitored.

RESULTS

The incidence of bacterial translocation in DR group (54.2%) was significantly higher than that in IR group (P < 0.01), but no remarkable difference with that in BS group (P < 0.05). In addition, microcirculation blood flow of intestinal wall recovered to some degree at 4 hours after delayed fluid resuscitation but far below that in IR group at the same time point. Nevertheless, the systemic mean arterial blood pressure had restored to the normal range at that time.

CONCLUSION

The incidence of intestinal bacterial translocation sustained at high level after burn shock with delayed fluid resuscitation, which might be the result of delayed improvement of microcirculation blood flow of the intestinal wall.

[The relationship between postburn gene expression of modulators in gut associated lymph tissue and the change in IgA plasma cells]

OBJECTIVE

To investigate the relationship between the postburn change in IgA plasma cells and those of IL- 4 and IL-6 in gut associated lymph tissue (GALT).

METHODS

One hundred and twenty -- five SPF mice were enrolled in the study and randomly divided into three groups -- normal control (A), microbial inoculation (B) and microbial inoculation followed by burn injury. (C) In groups Band C, the mice were gavaged with candida albicans, and the mice in group C, were inflicted with 20% TBSA III degree burn at the 14th day after inoculation. The mice were sacrificed thereafter on 1, 2 and 3 postburn days and the samples were obtained aseptically. The number of candida albicans adhering to intestinal mucosal membrane was counted. The number of IgA plasma cells in lamina propria was determined by immunohistochemical staining. The gene expression of IL-4 in Peyer patch was detected by dothybridization and that of IL-6 in lamina propria was determined by insitu hybridization.

RESULTS

(1) The postburn gene expression of IL-4 in Peyer patch decreased, but the IL-6 level in intestinal lamina propria increased. (2) The number of IgA plasma cells in lamina propria decreased significantly, but the adherence of candida albicans to intestinal mucous membrane increased obviously.

CONCLUSION

The decrement of postburn gene expression of IL-4 in Peyer patch might lead to IgA plasma cell decrease, resulting in the increase of candida albicans adhering to intestinal mucosal membrane.

A DNA damage signal is required for p53 to activate gadd45

We provide direct evidence that overexpression of p53 is not sufficient for robust p53-dependent activation of the endogenous gadd45 gene. When p53 was induced in TR9-7 cells in the absence of DNA damage, waf1/p21 and mdm2 mRNA levels were increased, but a change in gadd45 mRNA was barely detectable. Activation of the gadd45 gene was observed when camptothecin was added to cells containing p53 in the absence of a further increase in the p53 level. Phosphorylation of p53 at serine 15 and acetylation at lysine 382 were detected after drug treatment. It has been suggested that p53 posttranslational modification is critical during activation. However, inhibition of these modifications by wortmannin was not sufficient to block the transactivation of gadd45. Interestingly, after camptothecin treatment, increased DNase I sensitivity was detected at the gadd45 promoter, suggesting that an undetermined DNA damage signal is involved in inducing chromatin remodeling at the gadd45 promoter while cooperating with p53 to activate gadd45 transcription.

[Protection of hypertonic saline/mannitol to thymic cell apoptosis induced by endotoxin (LPS) in mice]

To observe the effect of HSM (hypertonic saline/mannitol) on thymic cell apoptosis induced by endotoxin (LPS) in mice, twenty-four mice were divided into three groups (8 mice/each group): 1. Control group, each mouse was intraperitonealy injected with normal saline; 2. LPS group, each mouse was intraperitonealy injected with LPS; 3. LPS + HSM group, each mouse was intraperitonealy injected with HSM before and after injection of LPS. The results showed that the percentage of apoptosis of HSM + LPS group was lower than that of LPS group (P < 0.01); the ladder of nucleosomal DNA fragments by agarose gel eletrophoresis of HSM group was not typical as compared with that of LPS group. It is suggested that HSM might protect the apoptosis of mouse thymic cell induced by LPS and may improve the immune function.

Somatic mutagenesis studies of NF-kappa B signaling in human T cells: evidence for an essential role of IKK gamma in NF-kappa B activation by T-cell costimulatory signals and HTLV-I Tax protein

NF-kappa B plays a pivotal role in normal T-cell activation and may also mediate human T-cell leukemia virus (HTLV)-induced T-cell transformation. Activation of NF-kappa B by both T-cell costimulatory signals and the HTLV Tax protein involves stimulation of I kappa B kinase (IKK). As a genetic approach to dissect the intermediate steps involved in NF-kappa B activation in human T cells, we performed somatic cell mutagenesis to isolate signaling-defective mutant Jurkat T-cell lines. One of the mutant cell lines was shown to have a specific blockade in the IKK signaling pathway but remained competent in the c-Jun N-terminal kinase and MAP kinase pathways. Interestingly, this mutant cell line lacks expression of IKK gamma, a non-catalytic component of the IKK complex. Expression of exogenous IKK gamma in the mutant cells restored NF-kappa B activation by both the T-cell costimulation agents and Tax. These findings provide genetic evidence for the requirement of IKK gamma in NF-kappa B signaling triggered by both T-cell costimulatory signals and HTLV-I Tax protein.

Inoculation of stumps with Hypholoma fasciculare as a possible means to control armillaria root disease

Hypholoma fasciculare (Huds. ex Fr.) Kummer was paired with Armillaria ostoyae (Romagn.) Herink in a variety of ways in the laboratory and then it was inoculated onto A. ostoyae infected stumps in the field. The ability of H. fasciuclare colonies to overrun A. ostoyae colonies in culture was confirmed. Hypholoma fasciculare fully colonized discs of tree roots where A. ostoyae was well established, and prevented A. ostoyae from occupying root segments when both fungi were introduced simultaneously. A simple method for inoculating H. fasciculare into stumps is described, and data supporting successful field inoculations are presented. The ability of H. fasciculare to invade freshly killed stumps, even those occupied by Armillaria, is demonstrated, and it is speculated that the ability of this saprophyte to invade fresh stumps is dependent upon its inoculum potential.Key words: biocontrol, woody debris, fungal warfare, Armillaria ostoyae.

[Application of bio-electrical impedance analysis in the compensation period of intracranial pressure increasing]

In the compensation period of intracranial pressure increasing, brain impedance rises continuously while cerebrospinal fluid volume changes. Along with the illness progressing, intracranial pressure would rise obviously, but the intracranial component relative volume would go near to constant; at the same time, brain impedance fluctuates around a baseline and there appears an inflection point on the impedance track record curve after the compensation period.

MAPK pathways activate and phosphorylate the osteoblast-specific transcription factor, Cbfa1

The bone-specific transcription factor, Cbfa1, regulates expression of the osteocalcin (OCN) gene and is essential for bone formation. However, little is known about the mechanisms regulating Cbfa1 activity. This work examines the role of the MAPK pathway in regulating Cbfa1-dependent transcription. Stimulation of MAPK by transfecting a constitutively active form of MEK1, MEK(SP), into MC3T3-E1 preosteoblast cells increased endogenous OCN mRNA, while a dominant negative mutant, MEK(DN), was inhibitory. MEK(SP) also stimulated activity of a 147-base pair minimal OCN promoter, and this stimulation required an intact copy of OSE2, the DNA binding site for Cbfa1. Effects of MEK(SP) were specific to Cbfa1-positive osteoblast-like cells. A purified His-tagged Cbfa1 fusion protein was directly phosphorylated by activated recombinant MAPK in vitro. Furthermore, (32)P metabolic labeling studies demonstrated that MEK(SP) clearly enhanced phosphorylation of Cbfa1 in intact cells, while MEK(DN) decreased phosphorylation. The specific MEK1/MEK2 inhibitor, PD98059, inhibited extracellular matrix-dependent up-regulation of the OCN promoter, indicating that the MAPK pathway and, presumably, Cbfa1 phosphorylation are also required for responsiveness of osteoblasts to extracellular matrix signals. This study is the first demonstration that Cbfa1 is controlled by MAPKs and suggests that this pathway has an important role in the control of osteoblast-specific gene expression.

[Chemical study of Alpinia officinarum]

Seven compounds were isolated from Alinia officinarum Hance and were identified as beta-sitoterol, 1,7-diphenyl-5-ol-3-heptone, 1-phenyl-7-(3'-methoxyl-4'-hydroxyl) phenyl-5-ol-3-heptone, glandin, kaempferol-4'-methylether and 3,4-dihydroxylbenzoic acid by IR, 1HNMR, 13CNMR, FAB-MS and EA. Among these compounds, 3,4-dihydroxylbenzoic acid was the first time obtained from Alpinia officinarum Hance. Furthermore, 1-phenyl-7-(3'-methoxyl-4'-hydroxyl) phenyl-5-ol-3-heptone and a new compound 1,7-diphenyl-3,5-heptandiol-phenyl-7-(3'-methoxyl-4'-hydroxyl) phenyl-3,5-heptaxdiol were obtained from 1,7-diphenyl-5-ol-3-heptone and 1-phenyl-7-(3'-methoxyl-4'-hydroxyl) phenyl-5-ol-3-heptone via chemical reductions.

[Experimental study of the effect of dexamethasone on pulmonary diffuse hemorrhage and energy metabolism of mitochondria in the liver of guinea pig infected with leptospirosis]

This experiment was designed to study the curative effect of dexamethasone on leptospirosis with pulmonary diffuse hemorrhage (PDH) in guinea pig model. The guinea pigs were randomly divided into four groups: the infected group, all animals developed PDH(n = 10); the infected plus treated group(n = 10); the treated control group(n = 10); and the normal control group(n = 10). The gross and microscopic observations in lung, liver and kidney were made. Also, ultrastructural changes of mitochondria in liver were examined, and the lactic acid level and mitochondrial ATPase activity in liver were determined. The results showed that there was significant difference in mortality, in gross and microscopic changes in lung, liver and kidney, and in the changes of mitochondrial ultrastructures, ATPase activity and lactic acid level in liver between the infected group and the infected plus treated group (P < 0.01). These findings suggest that the pharmacologic dose of dexamethasone injected intravenously in the early stage of PDH may have some beneficial effect on the emergency treatment of leptospirosis with PDH. The mechanism appears to be related to its effect on the inhibition of glycolysis and increasing oxidative phosphorylation in mitochondria.

Calreticulin is transported to the surface of NG108-15 cells where it forms surface patches and is partially degraded in an acidic compartment

Although calreticulin (Crt) is primarily localized to the endoplasmic reticulum (ER), our results using biotinylation and immunocytochemical methods indicate that a small but significant amount of Crt is present and forms large patches on the surface of NG108-15 cells (a mouse neuroblastoma-rat glioma hybrid cell line). (35)S-labelled Crt molecules begin to reach the cell surface after only 10 min of labelling and disappear slowly from the cell surface. After 4 hr of labelling, approximately half of the newly synthesized Crt molecules are on the cell surface. We believe that some Crt molecules may escape from the KDEL receptor-mediated salvage pathway as they are synthesized and proceed through the secretory pathway to the cell surface. Immunoprecipitation from the culture medium shows that Crt is not released from the cell surface to the medium, suggesting tight binding to surface molecules. NH(4)Cl can block the degradation of Crt; therefore, Crt is presumably degraded in the lysosome pathway. However, blockage of the disappearance of surface Crt is less efficient than that of internal Crt. This suggests that the disappearance of Crt from the cell surface may not be due solely to its degradation, but may reflect transport into another cell compartment such as the ER.

[Anaerobic infection and its rapid detection in surgical patients]

OBJECTIVE

To investigate anaerobic infection and its rapid detection in surgical patients.

METHODS

372 specimens were collected from surgical patients for anaerobe detection. To find a rapid detectable method, 110 specimens were collected for comparative studies by using indirect immunofluorescent antibody technique (IFA), enzyme labeled antibody technique (ELAT) and general cultural method (CM).

RESULTS

The isolation rate of anaerobes was rather high in pyothorax (88.9%), abdominal abscess (86.7%), appendicitis (83.9%) and cerebral abscess (all five cases were positive). In burn wounds, the rate was about 23.6% especially in deep burn wounds. Among 212 strains detected, the predominant anaerobes were as follows B. melaninogenicus (28.8%), B. fragilis (25%), F. nucleatum (7.5%), C. perfringens (7.5%), and peptostreptococcus (5.7%); most of them (87.8%) were non-sporing anaerobes. Mixed infection with aerobes accounted for 64%. The survey of rapid detection was conducted in B. fragilis, B. melaninogenicus, C. perfringens, F. nucleatum and peptostreptococcus. The detectable rate was higher in IFA (79.1%) and ELAT (80.9%) than in CM (37.3%).

CONCLUSION

IFA and ELAT might be rapid, specific, sensitive, and simple for detecting anaerobes.

Roles of tyrosine 158 and lysine 165 in the catalytic mechanism of InhA, the enoyl-ACP reductase from Mycobacterium tuberculosis

The role of tyrosine 158 (Y158) and lysine 165 (K165) in the catalytic mechanism of InhA, the enoyl-ACP reductase from Mycobacterium tuberculosis, has been investigated. These residues have been identified as putative catalytic residues on the basis of structural and sequence homology with the short chain alcohol dehydrogenase family of enzymes. Replacement of Y158 with phenylalanine (Y158F) and with alanine (Y158A) results in 24- and 1500-fold decreases in k(cat), respectively, while leaving K(m) for the substrate, trans-2-dodecenoyl-CoA, unaffected. Remarkably, however, replacement of Y158 with serine (Y158S) results in an enzyme with wild-type activity. Kinetic isotope effect studies indicate that the transfer of a solvent-exchangeable proton is partially rate-limiting for the wild-type and Y158S enzymes, but not for the Y158A enzyme. These data indicate that Y158 does not function formally as a proton donor in the reaction but likely functions as an electrophilic catalyst, stabilizing the transition state for hydride transfer by hydrogen bonding to the substrate carbonyl. A conformational change involving rotation of the Y158 side chain upon binding of the enoyl substrate to the enzyme is proposed as an explanation for the inverse solvent isotope effect observed on V/K(DD-CoA) when either NADH or NADD is used as the reductant. These data are consistent with the recently published structure of a C16 fatty acid substrate bound to InhA that shows Y158 hydrogen bonded to the substrate carbonyl group and rotated from the position it occupies in the InhA-NADH binary complex [Rozwarski, D. A., Vilcheze, C., Sugantino, M., Bittman, R., and Sacchettini, J. C. (1999) J. Biol. Chem. 274, 15582-15589]. Finally, the role of K165 has been analyzed using site-directed mutagenesis. Replacement of K165 with glutamine (K165Q) and arginine (K165R) has no effect on the enzyme's catalytic ability or on its ability to bind NADH. However, the K165A and K165M enzymes are unable to bind NADH, indicating that K165 has a primary role in cofactor binding.

KDEL proteins are found on the surface of NG108-15 cells

Although KDEL proteins are primarily localized to the endoplasmic reticulum (ER), we have employed surface biotinylation method to demonstrate that the KDEL proteins calreticulin (Crt), protein disulfide isomerase (PDI) and the 78-kDa glucose regulated protein (GRP78) are found on the surface of the NG108-15 cell line. In contrast, the 94-kDa glucose regulated protein (GRP94), another KDEL protein, is not found on the cell surface. Calnexin (Cnx), a type-1 integral transmembrane ER protein which is partially homologous to Crt but lacks the KDEL sequence, is not detected on the cell surface either. While only small amounts of the total GRP78, PDI and Crt molecules exist on the cell surface at steady state, a significant fraction of the newly synthesized molecules are transported to the cell surface and transport of these proteins is inhibited by treatment with brefeldin A. The surface GRP78 contains the KDEL sequence. On the cell surface, GRP78, PDI and Crt associate with other proteins and form complexes of different sizes. Surface Crt is found to be essential for the neurite formation when NG108-15 cells are induced to differentiate using dibutyryl cAMP.

Heteronuclear NMR and crystallographic studies of wild-type and H187Q Escherichia coli uracil DNA glycosylase: electrophilic catalysis of uracil expulsion by a neutral histidine 187

The nature of the putative general acid His187 in the reaction catalyzed by Escherichia coli uracil DNA glycosylase (UDG) was investigated using X-ray crystallography and NMR spectroscopy. The crystal structures of H187Q UDG, and its complex with uracil, have been solved at 1.40 and 1.60 A resolution, respectively. The structures are essentially identical to those of the wild-type enzyme, except that the side chain of Gln187 is turned away from the uracil base and cannot interact with uracil O2. This result provides a structural basis for the similar kinetic properties of the H187Q and H187A enzymes. The ionization state of His187 was directly addressed with (1)H-(15)N NMR experiments optimized for histidine ring spin systems, which established that His187 is neutral in the catalytically active state of the enzyme (pK(a) <5.5). These NMR experiments also show that His187 is held in the N(epsilon)()2-H tautomeric form, consistent with the crystallographic observation of a 2.9 A hydrogen bond from the backbone nitrogen of Ser189 to the ring N(delta)()1 of His187. The energetic cost of breaking this hydrogen bond may contribute significantly to the low pK(a) of His187. Thus, the traditional view that a cationic His187 donates a proton to uracil O2 is incorrect. Rather, we propose a concerted mechanism involving general base catalysis by Asp64 and electrophilic stabilization of the developing enolate on uracil O2 by a neutral His187.

[Development of continuous rat infusion device]

In order to perform better scientific researches on fluid resuscitation, total parenteral nutrition and continuous drug administration in rats, we developed a set of rat infusion device. The device, the characteristics of reasonable design, simple operation, low cost, good practicability, and making it by oneself or buying a whole set, can not only assure rats to run around, drink water, eat food freely, but also insure continuous infusion and drug administration during the experimental study of rats.

Effect of benzene, toluene, xylene on the semen quality of exposed workers

OBJECTIVE

To examine the effects on semen and sperm quality of workers after a short and long term exposure to benzene, toluene, and xylene.

METHODS

The semen and blood of 24 married workers exposed to benzene, toluene, and xylene from shoemaking, spray painting, or paint manufacturing factories were collected. The concentration of benzene, toluene, and xylene in the blood and semen was determined by using headspace chromatographic method. Routine sperm test was carried out and acrosin activity detected.

RESULTS

The results showed that benzene, toluene, and xylene were found in the blood and semen of some ex-workers in a working environment where the air concentration of benzene, toluene, and xylene exceeded the maximum allowable concentration (MAC). This result was not found in workers of the control group. There were also some effects on the quality of semen in the exposed workers. For example, the percentage of semen with liquefaction time exceeding 30 minutes increased. The sperm vitality, motility and acrosin activity decreased. At the same time, there were a positive correlation between liquefaction time and the level of toluene in semen, and a negative correlation between sperm vitality, sperm activity or acrosin activity and working history.

CONCLUSIONS

The results suggested that the mixture could affect the quality of semen and sperm, which might be the main reason of the abnormal pregnancy outcome among the wives of workers exposed to benzene, toluene, and xylene. Further studies are, however, required to confirm these findings.

Structural basis and mechanism of enoyl reductase inhibition by triclosan

The enoyl-acyl carrier protein reductase (ENR) is involved in bacterial fatty acid biosynthesis and is the target of the antibacterial diazaborine compounds and the front-line antituberculosis drug isoniazid. Recent studies suggest that ENR is also the target for the broad-spectrum biocide triclosan. The 1.75 A crystal structure of EnvM, the ENR from Escherichia coli, in complex with triclosan and NADH reveals that triclosan binds specifically to EnvM. These data provide a molecular mechanism for the antibacterial activity of triclosan and substantiate the hypothesis that its activity results from inhibition of a specific cellular target rather than non-specific disruption of the bacterial cell membrane. This has important implications for the emergence of drug-resistant bacteria, since triclosan is an additive in many personal care products such as toothpastes, mouthwashes and soaps. Based on this structure, rational design of triclosan derivatives is possible which might be effective against recently identified triclosan-resistant bacterial strains.

Isolation and characterization of MC3T3-E1 preosteoblast subclones with distinct in vitro and in vivo differentiation/mineralization potential

A series of subclonal cell lines with high or low differentiation/mineralization potential after growth in the presence of ascorbic acid (AA) were derived from murine MC3T3-E1 cells. Subclones were characterized in terms of their ability to mineralize a collagenous extracellular matrix both in vitro and in vivo and express osteoblast-related genes. When compared with nonmineralizing cells, mineralizing subclones selectively expressed mRNAs for the osteoblast markers, bone sialoprotein (BSP), osteocalcin (OCN), and the parathyroid hormone (PTH)/parathyroid hormone-related protein (PTHrP) receptor. In contrast, alkaline phosphatase mRNA was present in certain nonmineralizing as well as mineralizing subclones, suggesting that its expression may be subject to different controls from other osteoblast markers. Only highly differentiating subclones exhibited strong AA-dependent induction of a transiently transfected OCN promoter-luciferase reporter gene, indicating that there was a good correlation between mRNA levels and transcriptional activity. Consistent with its postulated role in biomineralization, BSP as measured by Western blotting was only present in mineralizing subclones. After implantation into immunodeficient mice, highly differentiating subclones formed bone-like ossicles resembling woven bone, while poorly differentiating cells only produced fibrous tissue. Interestingly, subclones with both high and low differentiation potential produced similar amounts of collagen in culture and expressed comparable basal levels of mRNA encoding Osf2/Cbfa1, an osteoblast-related transcription factor. Although some strongly differentiating cells exhibited a modest AA-dependent up-regulation of Osf2/Cbfa1 mRNA, there was no clear relationship between levels of this message and induction of mRNAs for other differentiation markers. Thus, the mere presence of Osf2/Cbfa1 in a subclone was not sufficient for osteoblast differentiation. These subclones will be very useful for studying critical events in osteoblast differentiation and mineralization.

[Digital subtraction angiography of cerebrum for diagnosis of cavernous sinus fistula and its intravascular treatment]

OBJECTIVE

To evaluate the diagnosis of digital subtraction angiography (DSA) of cerebral arteries and the intravascular treatment for carotid artery-cavernous sinus fistula (CCF) mainly manifesting as pulsating exophthalmos.

METHODS

Digital subtraction angiography (DSA) of cerebral arteries was carried out for 15 patients with pulsating exophthalmos. Of them, detectable balloon and tungsten filament microcoil were used for intravascular embolism treatment in 12 cases, and the 3 cases with CCF of the branch of external carotid artery were not treated.

RESULTS

Of the 15 cases, 12 were fallen in the CCF of high flow type of unilateral internal carotid artery, and 3 in the CCF of low flow type of unilateral external carotid artery. The symptoms and signs of intravascular embolism disappeared after treatment in 11 cases.

CONCLUSION

Cerebral artery DSA and intravascular therapy are the ideal methods for the diagnosis and treatment of CCF mainly manifesting as pulsating exophthalmos.