High prevalence of antithrombin III, protein C and protein S deficiency, but no factor V Leiden mutation in venous thrombophilic Chinese patients in Taiwan

We studied the prevalence of antithrombin III (AT III), protein C (PC) and protein S (PS) deficiencies and factor V Leiden mutation in thrombophilia in Taiwan. Eighty-five consecutive and unrelated patients with otherwise unexplained venous thrombophilia were studied. Both antigen and activity of inhibitors were determined using commercial kits (Stago), activated PC sensitivity ratio (APC SR) by Coatest (Chromogenix), and factor V mutation by polymerase chain reaction with sequence specific primer. Of 85 patients, 41 were male, 44 female, and mean age 49.4 years (17-82 years). None had factor V mutation, or APC SR of less than 2; 50 (58.8%) showed a deficiency of inhibitor proteins; 34 (68.0%) were hereditary, 16 (32.0%) non-hereditary; 3 had an AT III deficiency, 16 a PC deficiency, 28 a PS deficiency, and 3 a combined deficiency. Thirty-five were non-deficient without a known cause. The average age at the first thrombotic episode was 48.5 years (13-81 years). Thrombosis occurred spontaneously in 39 (78.0%) of 50 deficient patients. In conclusion, a relatively higher prevalence of AT III, PC and PS deficiency (59%), but no factor V Leiden mutation, was found in venous thrombophilic Chinese patients in Taiwan compared to that in western countries. Screening for inhibitor protein deficiency in Chinese thrombophilic patients is highly recommended.

Synthesis and anti-hepatitis B virus activity of 9-(2-deoxy-2-fluoro-beta-L-arabinofuranosyl) purine nucleosides

Since the discovery of 2'-fluoro-5-methyl-beta-L-arabinofuranosyluracil (L-FMAU) as a potent anti-HBV and anti-EBV agent, we have studied the structure-activity relationships of 2'-deoxy-2'-fluoro-beta-L-arabinofuranosylpyrimidine nucleosides as anti-HBV agents. Therefore it is rational to extend this study to the purine nucleosides. Thus, 3,5-di-O-benzoyl-2-deoxy-2-fluoro-beta-L-arabinofuranosyl bromide (1), which was prepared from L-xylose via a multistep procedure, was coupled with several purines by the sodium salt method. From this general synthesis, 10 purine nucleosides containing the 2-deoxy-2-fluoro-beta-L-arabinofuranosyl moiety have been obtained. The anti-HBV activity and toxicity of the synthesized nucleosides were evaluated in HepG2 2.2.15 cells. Among them, the adenine (10) and hypoxanthine (15) derivatives exhibit good in vitro anti-HBV activity (EC50 = 1.5 and 8 microM, respectively) without significant toxicity up to 200 microM.

Prognostic significance of proliferating cell nuclear antigen expression in transitional cell carcinoma of the upper urinary tract

BACKGROUND

Haphazard cell proliferation is a fundamental biologic defect in cancer. Thus, assessment of the growth fraction provides a valuable index of biological property for human neoplasm. Proliferating cell nuclear antigen (PCNA) expression has been used to estimate the growth fraction of human cancer, and its prognostic value. Information in transitional cell carcinoma (TCC) of the upper urinary tract, however, is very few.

MATERIALS AND METHODS

A total of 73 patients with TCC of the upper urinary tract was collected between July 1988 and December 1995 for this study. The labeling index of PCNA immunostaining was correlated with clinicopathologic factors and compared for its prognostic value with a median follow-up of 54 months.

RESULTS

The PCNA index was positively associated with histological grading, tumor stage and patient prognosis (P = 0.00, respectively). Multivariate analysis demonstrated that significant factors in relation to patient survival were tumor stage (P = 0.01), followed by PCNA index (P = 0.04) and gender of patients (P = 0.04). Multiple comparison revealed that PCNA index set at 0.30 had prognostic value in terms of patient survival (P = 0.00), and the risk of metachronous bladder recurrence (P = 0.02).

CONCLUSION

Our data suggested that assessment of PCNA index may be used as an adjuvant prognostic factor for patients with TCC of the upper urinary tract.

Processing of the gap junction protein connexin50 in the ocular lens is accomplished by calpain

Gap junction channel forming connexins share a common membrane topology which has four transmembrane spanning segments with the amino- and carboxy termini both located on the cytoplasmic side. Both, mutation and truncation of the carboxyl tail of some connexins have been shown previously to have profound effects on channel function. Truncation of the carboxyl tail of connexin50 (Cx50) and connexin46 (Cx46) occurs naturally during the maturation of fiber cells in the mammalian lens. This system therefore offers the unique opportunity to study not only the cleavage process but also the functional role played by the cleaved domain, in a physiologically relevant context. As a first step, we now report on the cleavage of the 70 kDa ovine isoform of Cx50. The calcium-activated neutral protease calpain (EC 3.4.22.17) was identified as the enzyme which removed a 32 kDa carboxyl portion from the Cx50 molecule in mature lens fiber cells. The amino-terminal 38 kDa portion remained embedded in the plasma membrane and was isolated and visualized as channel structures. The amino-terminal sequence of the cleaved 32 kDa portion matched an interior portion of the published amino acid sequence of the ovine Cx50 isoform. Thus, two closely spaced calpain cleavage sites were identified in the Cx50 molecule which were located carboxy-terminal from the predicted exit of the fourth transmembrane spanning segment by 62 or 72 amino acid residues, respectively. These data provide the basic information required for the future construction of Cx50 mutants to explore the functional consequences of this cleavage.

Retreatment with nafarelin for recurrent endometriosis symptoms: efficacy, safety, and bone mineral density

OBJECTIVE

To assess the efficacy, safety, and effect on bone mineral density of a 3-month course of retreatment with intranasal nafarelin acetate for recurrent symptoms of endometriosis.

DESIGN

Multicenter, open-label, nonrandomized clinical trial.

SETTING

Eleven hospital-based and private practices.

PATIENT(S)

Thirty-six women with endometriosis symptoms recurring after 3 or 6 months of treatment with nafarelin.

INTERVENTION(S)

Nasal nafarelin 200 micrograms twice daily for 3 months.

MAIN OUTCOME MEASURE(S)

Assessments for dysmenorrhea, dyspareunia, pelvic pain, tenderness, and induration. Measurement of bone mineral density of the lumbar spine.

RESULT(S)

Improvements from admission to the end of retreatment were significant for dysmenorrhea, pelvic pain, tenderness, induration, and dyspareunia. Three months after retreatment ended, mean symptom scores for dysmenorrhea and pelvic tenderness, although worse than at the end of retreatment, were still significantly better than scores at admission. Mean bone mineral density 3 months after retreatment was 0.56% lower than before retreatment and 1.94% lower than before initial treatment.

CONCLUSION(S)

Three-month nafarelin retreatment for recurrent endometriosis symptoms was effective and safe.

Structure of the monophosphoryl lipid A moiety obtained from the lipopolysaccharide of Chlamydia trachomatis

Monophosphoryl lipid A was prepared from the lipopolysaccharide of Chlamydia trachomatis, converted to the methyl ester, and fractionated by reverse-phase high-performance liquid chromatography. The peak fractions were collected and analyzed by mass spectrometry. Matrix-assisted laser desorption/ionization and liquid secondary ion mass spectrometry of the first of two major high-performance liquid chromatographic fractions showed multiple quasi-molecular ions of MNa+ at m/z 1780, 1794, 1808, 1822, and 1836. The positive-ion liquid secondary ion mass spectrometry spectrum also showed a minor series of peaks at m/z 1916, 1930, 1944, 1958, and 1971, consistent with the formation of matrix adducts with 3-nitrobenzyl alcohol. Oxonium ions representing the distal subunit were observed at m/z 1057, 1071, 1085, 1099, and 1113. The second fraction was similarly analyzed and found to contain structural homologs of the first fraction. Based on this study, the major lipid A component of chlamydial lipopolysaccharide is a glucosamine disaccharide that contains five fatty acids and a phosphate in the distal segment. Three fatty acyl groups are in the distal segment, and two are in the reducing end segment. The acyloxyacyl group is located in the distal segment in amide linkage. Two structural series, differing by 14 atomic mass units in the reducing subunit, were observed. Chlamydial lipid A is complex and consists of at least 20 homologous structural components. The relatively low potency of Chlamydia trachomatis lipopolysaccharide in activating lipopolysaccharide-responsive cells might be related to the unusual fatty acid composition of the lipid A moiety.

Primary transplantation of allogeneic peripheral blood stem cell for severe aplastic anemia

Primary allogeneic peripheral blood stem cell transplantation (allo-PBSCT) has not been previously described in the treatment of severe aplastic anemia (SAA). We report a patient with SAA who underwent primary allo-PBSCT with cells from her HLA-identical sibling and achieved rapid bone marrow reconstitution. The patient has been in complete remission with normal blood counts for 9 months following allo-PBSCT. This suggests that primary allo-PBSCT is a safe and effective alternative in the treatment of SAA.

Modulation of the immunostimulating effect of autologous tumor vaccine by anti-TGF-beta antibody and interferon-alpha on murine MBT-2 bladder cancer

Our aims were to: a) elucidate whether MBT-2 cells, lethally irradiated or nonirradiated, express TGF-beta 1 mRNA and secrete TGF-beta 1 protein, and b) to investigate whether the adverse effects from IRMBT-2-secreting TGF-beta 1 in the tumor vaccine can be abrogated by exogenous addition of monoclonal anti-TGF-beta 1 antibody and/or IFN-alpha.

MATERIALS AND METHODS

using the Northern hybridization analysis and the two-antibody sandwich ELISA, we demonstrate that both irradiated IRMBT-2 and nonirradiated MBT-2 cells secrete TGF-beta 1. The effect of anti-TGF-beta and/or IFN-alpha were studied by an in vitro splenocyte proliferation assay and in vivo tumor rechallenge study on day 17-TBM.

RESULTS

Both IRMBT-2 and splenocytes from day 17-TBM secrete TGF-beta 1 which can express suppression of the proliferation of the splenocytes from day 17-TBM. This suppression can be partially reversed by the simultaneous addition of both anti-TGF-beta and IFN-alpha, either alone being insufficient. The result of the in vivo tumor rechallenge study on day 17-TBM reveals that a lower tumor outgrowth incidence can be obtained in groups of mice treated with postoperative vaccination with anti-TGF-beta modified tumor vaccine with or without an additional administration of IFN-alpha.

CONCLUSION

Apart from TGF-beta, MBT-2 cells, both irradiated and nonirradiated, may also secrete other suppressive factors that adversely downregulate the immune response of TBM which can not then be adequately reversed by IFN-alpha.

Significance of urinary epidermal growth factor and its receptor expression in human bladder cancer

The expression of epidermal growth factor receptor (EGFR) has been suggested to play an important role in the progression of bladder cancer through paracrine stimulation by epidermal growth factor in the urine. However, there is no information regarding the expression of EGFR and urinary ligand measurement in corresponding tumors in patients with bladder cancer.

MATERIALS AND METHODS

Paired analysis of urinary levels of epidermal growth factor (U-EGF) and the expression of EGFR was performed on 48 cases of bladder cancer. U-EGF test and EGFR status were correlated with clinicopathologic factors of bladder cancer, and compared for their prognostic value with a mean follow-up of 39.7 months.

RESULTS

U-EGF was inversely correlated with the intensity of EGFR expression (p = 0.04); while no substantial relationship was observed with other conventional prognostic indicators (p > 0.1, respectively). Multivariate analysis revealed that factors correlated with the risk of recurrence were EGFR status (p = 0.03) and histological grading (p = 0.05). An important indicator associated with poor patient survival was size of tumor at diagnosis (p = 0.03).

DISCUSSION

Although measurement of U-EGF levels did not have any independent prognostic value, our data support the importance of urine EGF/urothelial EGFR interaction in the biological behavior of bladder cancer.

Clinicopathological features of bladder cancer associated with chronic exposure to arsenic

A high incidence of bladder cancer has been documented in an area of chronic arsenic (As) exposure. This study investigates the characteristics of As-associated (n = 49) and other (n = 64) bladder cancers. A higher histological grading was observed for the As-exposed tumours (P = 0.04), but no other difference in pathobiological features or prognosis was found between the two groups.

Effect of strychnine on rat locus coeruleus neurones during sleep and wakefulness

The noradrenergic neurones of the locus coeruleus (LC) discharge tonically during wakefulness, decrease their activity during slow wave sleep and are virtually quiescent during paradoxical sleep. We recently demonstrated an inhibitory glycinergic input to the locus coeruleus and proposed that this could be responsible for inhibition of the LC during paradoxical sleep. To test this proposal, we developed a method combining polygraphic recordings, iontophoresis and single-unit extracellular recordings in the unanaesthetized head-restrained rat. Iontophoretically applied strychnine, a specific glycine antagonist, induced strong excitation of LC neurones during paradoxical sleep, but also during slow wave sleep and wakefulness. These results suggest that glycine tonically inhibits noradrenergic LC neurones throughout the entire sleep-waking cycle and not only during paradoxical sleep.

Potential brain neuronal targets for amphetamine-, methylphenidate-, and modafinil-induced wakefulness, evidenced by c-fos immunocytochemistry in the cat

Much experimental and clinical data suggest that the pharmacological profile of modafinil, a newly discovered waking substance, differs from those of amphetamine and methylphenidate, two classical psychostimulants. The brain targets on which modafinil acts to induce wakefulness, however, remain unknown. A double-blind study using the protooncogene c-fos as experimental marker in the cat was, therefore, carried out to identify the potential target neurons of modafinil and compare them with those for amphetamine and methylphenidate. Cats were sacrificed after a single oral administration of amphetamine, methylphenidate, or modafinil at equivalent doses for wake induction (1, 2.5, or 5 mg/kg, respectively) and brain sections examined for Fos by immunocytochemistry. Administration of either amphetamine or methylphenidate evoked Fos-like immunoreactivity in a large number of neurons in the striatum and whole cortex, especially in the caudate nucleus and mediofrontal cortex, which are known to be dopaminergic targets. In contrast, administration of modafinil resulted in the labeling of few cells in these structures, but did induce marked Fos labeling in neurons of the anterior hypothalamic nucleus and adjacent areas. These results provide evidence for the potential brain targets of modafinil, which differ from those of amphetamine or methylphenidate, and suggest that modafinil induces wakefulness by mechanisms distinct from those of the two stimulants.

Modulation of antitumor immunity of tumor-bearing mice with low-dose cyclophosphamide

As a tumor progressively grows, the tumor-bearing host usually is under a tumor-mediated immune suppression status. Although surgical resection of the tumor may immediately eliminate most tumor-induced detrimental influences, perioperatively the antitumor immunity of the host remains temporarily suppressed. The major purpose of this study is to investigate the modulation effect of low-dose cyclophosphamide (CY) on the antitumor immunity of tumor-bearing mice (TBM). Using the C3H/He-MBT-2 murine bladder tumor model, we demonstrate that low-dose CY (100 mg/kg) intraperitoneal injection 2 days before tumor resection can significantly enhance the specific antitumor immunity of the TBM. It consequently suppresses the outgrowth of perioperative rechallenged tumor cells and improves the survival of the animals. Phenotypic analysis of cellular subset of spleen by flow cytometry revealed that low-dose CY, when given to both naive and tumor-bearing mice, causes significant reduction of both absolute number and percentage of cells with CD4-CD8- subset in the spleens of TBM. As a result of a parallel increase in the percentage of both CD4+CD8- and CD4-CD8+ subsets, the CD4+/CD8+ ratio remains unchanged. However, after short-term in vitro culture with IL-2 the percentage of the CD4-CD8- subset and CD4+/CD8+ ratio markedly decreased because of the relatively predominant proliferation of the CD4-CD8+ subset. Evidence from in vitro cytotoxicity assays on panel tumor cells and phenotypic analysis revealed that this enhancement of host antitumor immunity, following low-dose CY pretreatment, may be due to augmenting the activity of NK, LAK, and CD11b+ myeloid/macrophages in addition to cytotoxic T lymphocytes.

The caudo ventral pontine tegmentum is involved in the generation of high velocity eye saccades in bursts during paradoxical sleep in the cat

Cat eye movements were recorded in the head restrained condition, with the technique of the scleral search coil in a magnetic field, and the maximum velocity/amplitude relationships were analyzed for saccades in the following conditions, (1) during waking (W); (2) during paradoxical sleep (PS); and (3) during W following carbachol microinjections in the medioventral part of the caudal pontine tegmentum. These findings indicate that (1) the neurophysiological mechanisms underlying carbachol induced events are similar to those acting during PS and that the caudal pontine tegmentum might be the generator of high velocity eye saccades in bursts accompanied by ponto geniculo occipital waves (PGOw) during PS, and (2) caudal pontine tegmentum neurons show 'state-dependent' responsiveness to cholinergic inputs, suggesting that a change in the synaptic inputs and/or the membrane properties of these neurons during PS may be responsible for the induction of saccadic eye movements in bursts and associated PGOw.

Segmentation of multispectral magnetic resonance image using penalized fuzzy competitive learning network

Segmentation (tissue classification) of the medical images obtained from Magnetic resonance (MR) images is a primary step in most applications of computer vision to medical image analysis. This paper describes a penalized fuzzy competitive learning network designed to segment multispectral MR spin echo images. The proposed approach is a new unsupervised and winner-takes-all scheme based on a neural network using the penalized fuzzy clustering technique. Its implementation consists of the combination of a competitive learning network and penalized fuzzy clustering methods in order to make parallel implementation feasible. The penalized fuzzy competitive learning network could provide an acceptable result for medical image segmentation in parallel processing using the hardware implementation. The experimental results show that a promising solution can be obtained using the penalized fuzzy competitive learning neural network based on least squares criteria.

Transfusion of donor peripheral blood buffy coat cells as effective treatment for relapsed acute leukemia after transplantation of allogeneic bone marrow or peripheral blood stem cells from the same donor

BACKGROUND

The transfusion of same-donor peripheral blood buffy coat (PBBC) cells to chronic myelocytic leukemia patients in relapse after bone marrow transplantation has been increasingly used as an effective antileukemic therapy. A graft-versus-leukemia effect mediated by immunocompetent donor T cells underlies its success. In acute leukemia, however, the effect of this adoptive cellular immunotherapy has not been established, and the results are generally poor.

STUDY DESIGN AND METHODS

Five patients, three with acute lymphoblastic leukemia and two with acute myelocytic leukemia, who relapsed within 6 months after allogeneic marrow transplantation were enrolled in a nonrandomized pilot study to receive donor PBBC cell transfusions either before or after undergoing cytoreductive chemotherapy. ABO genotyping and polymerase chain reaction amplification of human tetrameric short tandem repeats DNA typing were used to test for marrow chimerism.

RESULTS

Two acute lymphoblastic leukemia patients-both of whom underwent chemotherapy before PBBC cell transfusions, experienced a complete remission, and developed acute and then chronic, extensive graft-versus-host disease-have been leukemia-free for 9 and 7 months, respectively. Repeated molecular studies of their marrow as early as 2 weeks to 8 months after treatment confirmed that the marrow was of donor origin. The other three patients, who chose not to undergo chemotherapy before PBBC cell transfusions, failed to achieve remission and died 14, 16, and 30 days, respectively, after leukemia relapse.

CONCLUSION

Adoptive cellular immunotherapy may be effective for acute lymphoblastic leukemia patients in relapse after bone marrow transplantation if chemotherapy is administered before PBBC cell transfusions are initiated.

Multispectral magnetic resonance images segmentation using fuzzy Hopfield neural network

This paper demonstrates a fuzzy Hopfield neural network for segmenting multispectral MR brain images. The proposed approach is a new unsupervised 2-D Hopfield neural network based upon the fuzzy clustering technique. Its implementation consists of the combination of 2-D Hopfield neural network and fuzzy c-means clustering algorithm in order to make parallel implementation for segmenting multispectral MR brain images feasible. For generating feasible results, a fuzzy c-means clustering strategy is included in the Hopfield neural network to eliminate the need for finding weighting factors in the energy function which is formulated and based on a basic concept commonly used in pattern classification, called the 'within-class scatter matrix' principle. The suggested fuzzy c-means clustering strategy has also been proven to be convergent and to allow the network to learn more effectively than the conventional Hopfield neural network. The experimental results show that a near optimal solution can be obtained using the fuzzy Hopfield neural network based on the within-class scatter matrix.

Structure--activity relationships of 1-(2-Deoxy-2-fluoro-beta-L-arabinofuranosyl)pyrimidine nucleosides as anti-hepatitis B virus agents

Since 2'-fluoro-5-methyl-beta-L-arabinofuranosyluracil (L-FMAU) has been shown to be a potent anti-HBV agent in vitro, it was of interest to study the structure-activity relationships of related nucleosides. Thus, a series of 1-(2-deoxy-2-fluoro-beta-L-arabinofuranosyl)pyrimidine nucleosides have been synthesized and evaluated for antiviral activity against HBV in 2.2.15 cells. For this study, L-ribose was initially used as the starting material. Due to the commercial cost of L-ribose, we have developed an efficient procedure for the preparation of L-ribose derivative 6. Starting from L-xylose, 6 was obtained in an excellent total yield (70%) through the pyridinium dichromate oxidation of the 3-OH group followed by stereoselective reduction with NaBH4. It was further converted to the 1,3,5-tri-O-benzoyl-2-deoxy-2-fluoro-alpha-L-arabinofuranose (10), which was then condensed with various 5-substituted pyrimidine bases to give the nucleosides. Among the compounds synthesized, the lead compound, L-FMAU (13), exhibited the most potent anti-HBV activity (EC50 0.1 microM). None of the other uracil derivatives showed significant anti-HBV activity up to 10 microM. Among the cytosine analogues, the cytosine (27) and 5-iodocytosine (35) derivatives showed moderately potent anti-HBV activity (EC50 1.4 and 5 microM, respectively). The cytotoxicity of these nucleoside analogues has also been assessed in 2.2.15 cells as well as CEM cells. None of these compounds displayed any toxicity up to 200 microM in 2.2.15 cells. Thus, compound 13 (L-FMAU), 27, and 35 showed a selectivity of over 2000, 140, and 40, respectively.

Characterization of two urothelium cancer cell lines derived from a blackfoot disease endemic area in Taiwan

Established cancer cell lines with distinct characteristics are valuable in many aspects of in vitro study pertaining to tumor biology, as well as the possible geographic significance. Two long-term cell lines, BFTC905 and BFTC909, were established from primary transitional cell carcinomas (TCC) of patients from a blackfoot disease endemic area in Taiwan, where the prevalence and standard mortality rates of this cancer are unusually high. BFTC905 derived from a grade III TCC of urinary bladder has an epitheloid morphology, and BFTC909 derived from the sarcomatoid component of a grade III TCC of renal pelvis exhibits a fibroblastic growth pattern. They share similar morphological and immunocytochemical characteristics with the tumors of origin, have multiple chromosomal aberrations, and are tumorigenic in nude mice. BFTC905 reveals a unique homogeneously staining region at 11q13, the amplification of which has been detected in 20% of transitional cell carcinoma. In addition to the rarity of renal pelvic origin, the vimentin expression associated with an aggressive clinical behavior and a relatively high tumorigenicity as demonstrated by BFTC909 cells has also rarely been mentioned in TCC cell lines, but has been well documented in vivo and in vitro in renal cell carcinoma and breast cancer.

Type I collagen and procollagen fragments in patients with metabolic bone diseases

The purpose of the present study was to evaluate the serum levels of two new markers, and to compare their clinical usefulness with two conventional markers. Healthy women and patients with aberrant bone metabolism were evaluated for serum or urine levels of different bone markers. We measured serum levels of the pyridinoline cross-linked telopeptide domain of type I collagen (S-ICTP) and carboxy-terminal propeptide of type I procollagen (S-PICP) as markers of bone resorption and formation, respectively. These levels were compared to the concentrations of serum bone gamma-carboxyglutamic acid protein (S-BGP) and total urinary pyridinium cross-links (U-PYD). The control group included 222 premenopausal and postmenopausal women, and the disease groups consisted of 61 individuals with malignancy-associated hypercalcemia, Graves' thyrotoxicosis or primary hyperparathyroidism. Both S-PICP and S-BGP reflected higher bone turnover in postmenopausal than premenopausal women. All patient groups had significantly higher S-ICTP and U-PYD than the controls. Increased S-PICP was seen in malignancy-associated hypercalcemia and Graves' thyrotoxicosis, but not in primary hyperparathyroidism, while higher S-BGP was seen in Graves' thyrotoxicosis and primary hyperparathyroidism, but not in malignancy-associated hypercalcemia. Discrepancy between S-PICP and S-BGP in malignancy-associated hypercalcemia and primary hyperparathyroidism was noted. S-ICTP and U-PYD had higher sensitivity and specificity in discriminating patients from controls. We conclude that S-ICTP is superior to U-PYD as an index of bone resorption in aberrant bone metabolism. S-PICP may also be a useful bone turnover marker but discrepancies between it and S-BGP in malignancy-associated hypercalcemia and primary hyperparathyroidism need further investigation.

Histaminergic descending inputs to the mesopontine tegmentum and their role in the control of cortical activation and wakefulness in the cat

We have demonstrated previously the importance of histaminergic neurons in arousal mechanisms. In addition to their ascending axons, these neurons also send heavy descending inputs to the mesopontine tegmentum (MPT), which plays a key role in cortical activation during wakefulness (W). This anatomical link suggests histaminergic control of the mechanisms of the MPT relevant to behavioral states. In this study, we sought to demonstrate, at the light microscopy level, hypothalamotegmental histaminergic pathways and their topographical interaction with MPT neurons in the cat and to explore further their involvement in sleep-wake control. Using immunohistochemistry of histamine (HA), either alone or together with that of choline-acetyltransferase or tyrosine hydroxylase, a large number of very fine, short and varicose HA-positive fibers and terminal-like dots were detected in the MPT, including the laterodorsal tegmental nucleus, locus coeruleus (LC), LC alpha, and peri-LC alpha. Furthermore, these fibers and terminal-like structures were found in close proximity to a great number of cholinergic or noradrenergic neurons. We also investigated the effects of microadministration of HA agonists and antagonist into the mediodorsal pontine tegmentum on the cortical electroencephalogram (EEG) power spectra and the sleep-wake cycle in freely moving cats. Microinjection of HA or 2-thiazolylethylamine (an H1-receptor agonist) caused a long-lasting suppression of cortical slow activity and an increase in quiet wakefulness (W). Paradoxical sleep, however, was less affected. The effects of HA were attenuated by systemic or in situ pretreatment with mepyramine (an H1-receptor antagonist), which when injected alone produced an increase in slow wave sleep. Microinjection of impromidine (an H2-receptor agonist) into the same area had no effect on either the cortical EEG or W. Because MPT ascending and presumed cholinergic neurons discharge tonically during cortical activation of W and because HA causes excitation of MPT cholinergic neurons via H1 receptors, we hypothesize that the histaminergic descending afferents in the MPT would promote cortical desynchronization and W, at least partially, via activation of H1 receptors situated on cholinergic neurons and that the interactions between histaminergic and cholinergic neurons constitute an important circuit in cortical activation during W.

The rabbit as an intracavernous injection study model

We investigated the feasibility of using the rabbit as an animal model for intracavernous injection studies. The rabbit, having a penile structure rather similar to that of humans, offers the advantage of being a strain-specific, adequately sized, and easily controlled experimental animal. Using intracavernous injections of the two vasoactive drugs prostaglandin E1 (PGE1, 0.2-1.6 micrograms/kg) and papaverine (PAP, 0.25-1 mg/kg), which have been commonly used in the management of erectile dysfunction in man, increases intracavernous pressure (delta ICP) were induced. After intracavernous injection of PGE1, the maximal delta ICP ranged from 18 to 44 mmHg (mean 29.25 +/- 7.85 mmHg) with a duration of tumescence from 3.1 to 13.3 min (mean 8.61 +/- 3.71 min). Intracavernous injection of PAP also induced increases in ICP, with a maximal delta ICP ranging from 24 to 56 mmHg (mean 43.5 +/- 11.35 mmHg) and a duration of tumescence from 5.3 to 15 min (mean 10.25 +/- 3.39 min). The systemic blood pressures were unchanged after all intracavernous injections. In addition, administration of cAMP antagonist in combination with PGE1 inhibited the relaxing effects of PGE1 in a dose-dependent manner. Our results suggest that the effects of vasoactive drugs on the rabbit's corpus cavernosum are similar to those in humans; thus the rabbit model is a suitable alternative for further physiological and pharmacological studies of penile erection.

Implications of urinary basic fibroblast growth factor excretion in patients with urothelial carcinoma

1. Angiogenesis occurs in response to wounding, and is of vital importance for tumour growth and metastasis. Basic fibroblast growth factor, a well-known angiogenic factor, has been suggested to be a urine marker for urothelial carcinoma. However, the relevance of its detection has not been evaluated in a large number of patients. 2. Immunoassay of basic fibroblast growth factor was performed on urine samples from different aetiologies of urothelial disorder. Expression of basic fibroblast growth factor in the corresponding tumour was correlated with the urine level. 3. The excretion of basic fibroblast growth factor (ng/g creatinine) was significantly elevated in both inflammatory and neoplastic urological diseases compared with normal individuals (P < 0.05), while it was normalized in tumour-free subjects (P < 0.01). Receiver operating characteristic plotting revealed a sensitivity of 40% for tumour diagnosis at the cut-off point of 3.29 ng/g creatinine. The sensitivity of the test in predicting tumour recurrence was only 14%. The basic fibroblast growth factor level in urine showed a positive association with increasing age of cancer patients (P = 0.02) and with tumour grading (P = 0.05). However, no important relationship was observed regarding tumour stage, size, number, shape or degree of local inflammatory reaction (P > 0.01). Pairwise analysis of the basic fibroblast growth factor level in urine and its expression in corresponding tumours did not reveal a conspicuous correlation (r = -0.097, P = 0.43). 4. Our results suggested that estimation of urinary basic fibroblast growth factor cannot be satisfactory as a tumour marker. The measurement may represent one of the tissue responses to injury or the host-tumour interactions. A longitudinal study is required to elucidate the role of basic fibroblast growth factor in order to select the appropriate treatment strategy for urothelial carcinoma.