In utero galactose intoxication in animals

To assess in utero effects of galactose, diets containing large amounts of the sugar have been fed to pregnant rats with examination of the fetuses and newborns. Galactose levels in fetal blood parallel those of the dam and amniotic fluid contains high concentrations of galactose and galactitol. In the offspring and in the fetuses cataracts, and a decrease in brain weight, protein content and DNA are observed. There is an elevated content of galactitol and decrease in myo-inositol in the brain of galactose-intoxicated newborns. Brain synaptosomes of young rats whose mothers were fed galactose show a reduced response in vitro to acetylcholine as evidenced by a decrease in incorporation of myo-inositol into phosphatidylinositol and an inappropriate change in phosphatidylinositol content. The data indicate that there can be significant effects in the offspring of pregnant rats fed a high galactose diet. The findings support the concept that in utero toxicity may occur in the human galactosemic fetus.

Thymidylate synthase binds to c-myc RNA in human colon cancer cells and in vitro

Using an immunoprecipitation-reverse transcription-PCR technique, we characterized a thymidylate synthase (TS) ribonucleoprotein complex in cultured human colon cancer cells that consists of TS protein and the mRNA of the nuclear oncogene c-myc. TS protein is complexed in intact cells with the C-terminal coding region of c-myc mRNA that includes nucleotide positions 1625 to 1790. RNA electrophoretic gel mobility shift assays confirm a specific interaction between TS protein and c-myc mRNA and provide additional evidence that the C-terminal coding region represents an important cis-acting regulatory element. Further evidence demonstrates that the in vitro translational efficiency of c-myc mRNA is inhibited as a result of its direct interaction with TS protein. In addition, the presence of exogenous c-myc mRNA specifically relieves the inhibitory effects of TS protein on TS mRNA translation.

Uterine adenofibroma presenting as a cystic adnexal mass

Uterine adenofibroma is a form of mixed mesodermal tumor in which both the epithelial and stromal components are benign. Almost all previously reported cases have been confined to the endometrium or endocervical mucosa. Our patient presented with a cystic adnexal mass and had a hysterectomy.

Hypertension in pregnancy: hemodynamics and diurnal arterial pressure profile

OBJECTIVE

To characterize the 24-h arterial pressure (AP) profile and the left ventricular (LV) structures and functions in women with pregnancy-associated hypertension.

METHODS

Twenty nulliparous pregnant women after 20 weeks' gestation, 10 normotensive and 10 hypertensive women matched for gestational age, were hemodynamically investigated using 24-h AP monitoring and Doppler echocardiography to determine LV structures and functions, both systolic and diastolic.

RESULTS

The hypertensive women had significantly higher AP determinations throughout the 24 h, with no change in diurnal variation, i.e. nocturnal decline and early morning peaks. Their LV mass was greater and it was accompanied by a slight reduction in contractility and a significant reduction in LV relaxation. The increased AP was due to peripheral vasoconstriction, while cardiac output was preserved.

CONCLUSIONS

It appears that pregnancy-associated hypertension is caused mainly by arterial vasoconstriction and not by higher cardiac output. The hypertension increases the LV mass, which is associated with a fall in LV relaxation.

Transverse lower segment uterine incision in cesarean sections for transverse lie. A retrospective survey

A transverse lower uterine incision was made at cesarean section in 79 term patients with a singleton fetus in a transverse lie. The mean Apgar score was 9.5 (SD 0.8). One infant sustained a fractured femur, and another had a torticollis. In no case did the incision extend into the uterine vessels.

Pregnancy in a patient with fibrolamellar hepatocellular carcinoma

Pregnancy in a patient with hepatocellular carcinoma is rare. Fibrolamellar hepatocellular carcinoma is a distinct clinicopathologic variant with a better prognosis. We report such a case in which pregnancy was apparently not deleterious.

Uridine diphosphate hexoses in leukocytes and fibroblasts of classic galactosemics and patients with other metabolic diseases

To examine uridine diphosphate hexose (UDPhexose) content of cells that have more complete metabolic patterns than erythrocytes, which have been commonly used in the study of galactosemia, the concentrations of uridine diphosphate galactose (UDPgalactose) and uridine diphosphate glucose (UDPglucose) were determined in white blood cells (WBC) and fibroblasts cultured from skin biopsies. Leukocyte UDPgalactose and UDPglucose values were determined in 60 normal individuals, 14 classic galactosemics, and 18 patients with other metabolic diseases on protein-restricted and low-lactose diets. There was no difference in the average concentration of these compounds between any of these groups. There was no relationship between age and WBC UDPhexose content or correlation of WBC and erythrocyte UDPhexose levels in the same blood specimens. WBC from galactosemic individuals differ from their red blood cells because the former do not show the low average UDPgalactose levels and abnormal UDPglucose to UDPgalactose ratio previously reported for erythrocytes from galactose-1-phosphate uridyltransferase-deficient individuals. Fibroblast cell lines from 10 normal and 10 galactosemic individuals, cultured and grown to confluence in glucose medium, also showed no difference in nucleotide sugar concentrations. Thus far, of the cell types easily available, red blood cells appear to be unique in showing an abnormality in nucleotide sugar metabolism. The fact that galactosemic fibroblasts demonstrate no abnormality in the concentration of these compounds suggests that the defective galactosylation that has been observed in galactosemic fibroblasts is not due to unavailability of UDPgalactose.

Treatment of pelvic abscesses and other fluid collections: efficacy of transvaginal sonographically guided aspiration and drainage

OBJECTIVE

The purpose of this study was to evaluate the clinical efficacy of transvaginal sonographically guided aspiration and drainage of pelvic fluid collections.

MATERIALS AND METHODS

Forty patients underwent transvaginal sonographically guided aspiration of a possible pelvic abscess (41 pelvic collections). In patients with clinical findings highly suggestive of infection, both purulent and nonpurulent collections were immediately drained via a catheter. In patients with clinical findings moderately suggestive of infection, nonpurulent collections were completely removed by aspiration and the aspirates were cultured; however, purulent collections were immediately drained via a catheter.

RESULTS

All collections were successfully accessed by transvaginal sonography. For 27 of the 41 collections, the aspirate was purulent (18 collections) or the patient's clinical findings were highly suggestive of infection (nine collections) and catheter drainage was performed. Seventeen of the 27 collections completely resolved and surgery was not required. Four of the 27 collections were in patients who had surgery for reasons other than persistent infected collection. For six of the 27 collections, catheter treatment was not successful and surgery was required. The overall success rate of catheter drainage was 78%. In the remaining 14 of the 41 collections, the aspirate was serous or serosanguineous, and the patient's clinical findings were moderately suggestive of infection. Cultures of aspirates of seven collections were positive for microorganisms. Eleven collections were successfully treated with antibiotics or no therapy was required (based on culture results); for three, surgery was required. Two complications occurred: one vaginal fistula after catheter drainage and one disruption of vaginal sutures after aspiration.

CONCLUSION

Transvaginal sonographically guided drainage is effective treatment of pelvic abscess, being either completely curative or temporizing in 78% of patients. Catheter treatment was unsuccessful and surgery was necessary in 22% of patients. For nonpurulent collections, catheter drainage is indicated only when clinical findings are highly suggestive of infection.

Inhibition of topoisomerase I activity by tyrphostin derivatives, protein tyrosine kinase blockers: mechanism of action

DNA topoisomerase I (topo I) is a member of a group of essential nuclear enzymes which control and modify the topological state of DNA and is recognized as the target for anticancer drugs. During the course of the catalytic activity of topo I, a covalent bond is formed between a tyrosine group at the active site of the enzyme and a 3' phosphate group along the DNA backbone. This chemical reaction resembles the protein kinase-mediated tyrosine phosphorylation process. We assumed, therefore, that tyrphostins, potent and selective blockers of protein tyrosine kinases, might affect topo I activity. We found that of three derivatives of tyrphostins (AG-555, AG-18, and AG-213) that inhibited topo I activity in an in vitro assay, AG-555 was the most active. Examination of the mechanism by which these compounds act as topo I inhibitors revealed that AG-555 blocked the binding of this enzyme to the DNA due to its interaction with the topo I enzyme. We showed that its mode of action differed from that observed for camptothecin, a known topo I inhibitor. However, AG-555 did not affect the activity of other major DNA binding enzymes (i.e., DNA ligase, DNA polymerase I, and reverse transcriptase). This study suggests that tyrphostins may serve as a new class of topo I inhibitors, and these results also present additional explanations for their antiproliferative effect.

Renal brush border membrane lipid composition in Basenji dogs with spontaneous idiopathic Fanconi syndrome

To comprehend the renal defect underlying idiopathic Fanconi syndrome in the Basenji dog, we have focused on delineating the lipid profiles of renal brush border membranes isolated from affected and normal Basenji dogs to establish any physical or compositional changes underlying previously observed transport and membrane-fluidity changes. The lipid composition was studied with respect to total lipid, cholesterol, and phospholipid content, cholesterol to phospholipid ratio, distribution of the major phospholipid classes, and fatty acid composition. Total phospholipid of the isolated renal brush border membranes from Fanconi syndrome dogs analyzed by 31P nuclear magnetic resonance showed no difference compared with that of normal dogs. Examination of total fatty acids in both membranes using gas-liquid chromatography analysis of fatty acid methyl esters showed no difference in the mole percents of the major fatty acids. Our data suggest that changes in bulk membrane fluidity of the Fanconi syndrome dog renal brush border as measured by 1,6-diphenyl-1,3,5-hexatriene cannot be attributed to phospholipid and fatty acid compositional change. In the membranes isolated from affected dog kidney, the cholesterol content determined by gas-liquid chromatography analysis was 66 mol% higher than in membranes isolated from normal dog kidney. This correlates with the higher cholesterol to phospholipid molar ratio of 0.82 +/- 0.08 in the affected animal as compared with 0.58 +/- 0.04 in the normal. Cholesterol content and its microdomain in the membrane bilayer may be important in modulating transport functions. Increased membrane cholesterol content may affect the conformational motility of membrane transport proteins and thus affect their function.

Regulation of murine Max (Myn) parallels the regulation of c-Myc in differentiating murine erythroleukemia cells

Max is a basic region-helix-loop-helix-leucine zipper protein that consists of two major isoforms, p22 (long form, Max-L) and p21 (short form, Max-S). These proteins are encoded by two [the 1.9- and the predominant 2.3-kilobase (kb) forms] of the five alternatively spliced max mRNA species. We now demonstrate that N,N'-hexamethylene bisacetamide-mediated differentiation of murine erythroleukemia cells leads to a pattern of biphasic down-regulation of the 1.9- and the 2.3-kb myn (murine max) mRNAs that closely parallels that which occurs for myc mRNA. In contrast, the p22/Myn-L and p21/Myn-S protein isoforms down-regulate in monophasic fashion. Unlike the short-lived myc mRNA, the myn message is quite stable. However, its half-life of 3-6 h is still consistent with the biphasic down-regulation that accompanies differentiation. Furthermore, unlike myc, the overexpression of which prevents differentiation, elevated max levels merely delay differentiation. Coincident with this is a delay in the second decline of c-myc mRNA. In N,N'-hexamethylene bisacetamide-induced cells blocked from differentiating by overexpression of c-, N- or L-myc, myn mRNA expression is constitutive. These findings suggest that myn may also be involved in differentiation.

Oral sustained-release ritodrine as a substitute for prolonged intravenous tocolysis

Prolonged administration of intravenous ritodrine is necessary in some pregnant women with recurrent preterm labor as serum levels achieved by oral administration of ritodrine are insufficient to prevent recurrent contractions. New oral sustained-release ritodrine at 320 mg/day was given to 38 women with recurrent preterm labor. Serum levels of the drug at this dosage are considered comparable with levels achieved by i.v. treatment. The average duration of treatment was 8 days (range, 1-22). Patient tolerance was acceptable, and major maternal complications did not occur. We conclude that in selected cases, it may be possible to substitute oral sustained-release ritodrine at 320 mg/day for prolonged i.v. treatment.

Invasiveness and metastasis of NIH 3T3 cells induced by Met-hepatocyte growth factor/scatter factor autocrine stimulation

The met protooncogene product, Met, is the tyrosine kinase growth factor receptor for hepatocyte growth factor/scatter factor (HGF/SF). NIH 3T3 cells express HGF/SF endogenously and become tumorigenic in nude mice via an autocrine mechanism when murine Met is expressed ectopically (Metmu cells) or when human Met and human HGF/SF are coexpressed (HMH cells). Here, we show that Metmu and HMH cells are invasive in vitro and display enhanced protease activity necessary for the invasive phenotype. In experimental and spontaneous metastasis assays, Metmu or HMH cells metastasize to the lung, but lower numbers of subcutaneously injected Metmu and HMH cells produced invasive tumors in the heart, diaphragm, salivary gland, and retroperitoneum. It has been reported elsewhere that Met expression increased with tumor passage in athymic nude mice, and these tumor explants show enhanced activity in the metastasis assays. Autocrine-mediated Met-HGF/SF signal transduction in NIH 3T3 mesenchymal cells may provide an important system for understanding the biological process of metastasis.

Some aspects of the humoral immunity and the phagocytic function in newborn infants

Newborn infants, particularly those born prematurely, are prone to develop life-threatening pyogenic infections. Different studies have demonstrated impairment of various aspects of the humoral immunity and the phagocytic activity of neutrophils in newborns. We conducted a comprehensive study evaluating the complement function (CH50 and AP50) and the level of the vast majority of the complement components (Clq, Clr, Cls, C2-C9, FB and properdin) in preterm and full-term newborn infants as compared to adults. Furthermore, we investigated the effect of autologous and heterologous serum on the bactericidal activity of neutrophils, by crossing newborn serum with adult cells and vice versa. Results showed that preterm and full-term newborns have an impaired complement activity as compared to adults (CH50 P < 0.05, AP50 < 0.01) and significantly reduced complement components except for C7, which was found to be normal in full-term infants and in most appropriate-for-gestational age preterm newborns at 34-36 weeks. A statistically significant correlation was found between gestational age and the level of most of the complement components. CH50 and AP50 also showed a positive trend which, however, was not statistically significant. No correlation was found between birthweight and complement activity or complement component levels. The neutrophil bactericidal activity of full-term newborns was about one-third that of adults (P < 0.001). Adult serum improved the bactericidal activity of newborn neutrophils by 93%, indicating a considerable neonatal humoral defect. Conversely, neonatal serum blunted the adult bactericidal activity by 86%. Our results support the fact that both humoral and phagocytic functions in newborn infants are impaired, which may possibly account for their increased tendency to develop severe pyogenic infections.

Reversal of the measles virus-mediated increase of phosphorylating activity in persistently infected mouse neuroblastoma cells by anti-measles virus antibodies

To investigate the effect of persistent measles virus infection on signal transduction in cells of neuronal origin, the mouse neuroblastoma cell line NS20Y/MS, which is persistently infected with measles virus, was used. The results demonstrate an approximate 50% increase in total phosphorylation and a similar increase in protein kinase C (PKC) activity. Western blot analysis with anti-total PKC or anti-PKC-alpha antibodies revealed a significant increase in the level of an 80K immunoreactive PKC in NS20Y/MS cells. Following incubation of NS20Y/MS cells with polyclonal anti-measles virus antibodies, which down-regulate the level of measles virus proteins, total and PKC-mediated phosphorylation returned to the basal level of uninfected cells. This effect was reversible and removal of the antibodies resulted in restoration of the high level of total and PKC-mediated phosphorylation. The release of infectious measles virus was strongly inhibited by incubation of NS20Y/MS cells with the PKC inhibitor, 1-(5-isoquinolinylsulphonyl)-2-methylpiperazine (H-7). These results demonstrate that measles virus induces elevation in cellular phosphorylation which is essential for measles virus production.

Incidence and contribution of predisposing factors to transverse lie presentation

OBJECTIVES

Reassessment of predisposing factors to transverse lie presentation.

METHODS

Retrospective analysis of delivery data on 92 women with transverse lie presentation, using ultrasonography, and 92 randomly chosen control vertex deliveries.

RESULTS

The association between transverse lie and multiparity, prematurity, placenta previa, polyhydramnios and uterine anomalies is reaffirmed. Predisposing factors were found in 66% of primiparas but in only 33% of multiparas.

CONCLUSIONS

Known predisposing factors to transverse lie presentation withstood a closer and more accurate assessment of their incidence.

Pneumomediastinum in labor

We describe pneumomediastinum in a primigravida with delay in the second stage of labor. The pathophysiology, clinical presentation, and management are reviewed.

The expression of HLA class I antigen in prostate cancer in relation to tumor differentiation and patient survival

The expression of HLA class I antigens was studied using the immunoperoxidase technique on 30 patients with prostate cancer and 29 patients with benign prostatic hypertrophy (BPH). Forty-three percent of the tumors stained positive, in contrast to 21% of the BPH. An inverse relationship was noted between class I expression and degree of tumor differentiation: 88% of the well-differentiated tumors (8/9) expressed class I antigen, compared with 33% (3/9) of the moderately differentiated and 16% (2/12) of the poorly differentiated tumors. No significant survival difference was found between those with class I-positive and -negative tumors. However, when both class I expression and degree of differentiation were considered, those with positive tumors at each level of differentiation had better survival than those with negative tumors. These data suggest that HLA class I expression may serve as a finite prognostic factor and may have relevance in future immunotherapy.

Identification of a thymidylate synthase ribonucleoprotein complex in human colon cancer cells

Translation of thymidylate synthase (TS) mRNA is controlled by its own protein product, TS, in an autoregulatory manner. Direct binding of TS protein to two different cis-acting elements on the TS mRNA is associated with this translational regulation. In this study, an immunoprecipitation-reverse transcription-PCR technique was used to identify a TS ribonucleoprotein (RNP) complex in cultured human colon cancer cells. Using antibodies specific for TS protein, we show that TS is complexed in vivo with its own TS RNA. Furthermore, evidence demonstrating a direct interaction between the mRNA of the nuclear oncogene c-myc and TS protein is presented.

Differential-effects of max proteins (long and short) on growth and differentiation of murine erythroleukemia-cells

The myc gene product belongs to a family of basic, Helix-Loop-Helix, Leucine Zipper (b-HLH-LZ) proteins involved in cell growth, differentiation and tumorigenesis. The Max protein dimerizes with Myc to form a complex which binds to DNA and promotes transcription of target genes. Max exists in two major forms, Max-9 (long) and Max (short), which differ by 9 amino acids just amino to the basic region. We compared the in vivo behavior of the two forms in stable transfectants of long and short wild type (Lwt, Swt) and basic region mutants (Lbm, Sbm). While both Lwt-max and Swt-max clones exhibit delays in cell growth and differentiation, these delays are far more pronounced in the Lwt-max clones. In contrast, no difference is noted between Lbm-Max and Sbm-Max in their observed ability to delay growth, to accelerate HMBA-induced differentiation and to induce spontaneous differentiation. We suggest that a difference in affinity for DNA underlies the differential activities of Lwt- and Swt-Max.

Uridine diphosphoglucose content of human erythrocytes: assessment by conversion to uridine diphosphoglucuronate

To settle the ongoing controversy regarding differential uridine diphosphoglucose (UDPG) and uridine diphosphogalactose (UDPGal) content of erythrocytes, which may be important in evaluating the metabolic abnormality in patients with galactosemia, we derived a combined enzymatic-high-performance liquid chromatography (HPLC) assay. Uridine diphosphoglucuronate (UDPGA), the unique product of UDPG dehydrogenase activity, was separated and quantified by HPLC in extracts of human erythrocytes. The quantity of UDPGA produced in cell filtrates incubated with the enzyme corresponds to the amount of UDPG directly determined by HPLC. The amount of UDPGA produced was independent of the enzyme purity or activity used. On the other hand, the amounts of UDPG estimated by fluorometric measurement of the production of reduced nicotinamide adenine dinucleotide varied with the enzyme purity and activity. The combined enzymatic-HPLC method confirms the direct determinations of UDPG content of normal erythrocytes. The results indicate that, under appropriate conditions, the fluorometric-based assay will give accurate estimates of UDPG, but the direct HPLC method yields consistent and correct UDPG and UDPGal determinations.

The effect of H-ras expression on tumorigenicity and immunogenicity of Balb/c 3T3 fibroblasts

In an attempt to define immunological parameters affected by the H-ras oncogene, we have used Balb/c 3T3 cells transfected with either H-ras (98/6), H-ras+v-myc (98/4v) or plasmid only (98/1). We found that while control and oncogene-transfected Balb/c 3T3 cells exhibit similar low sensitivity to lysis by natural killer (NK) cells, H-ras+v-myc-transfected cells could immunize syngeneic Balb/c mice and induce cytotoxic T cells (CTL) with broad specificity, that lysed all types of Balb/c 3T3 cells tested. Immunization of Balb/c mice with 98/4v cells prevented homologous tumor formation and partially inhibited the formation of tumors derived from H-ras-transfected cells. 98/6 cells were not immunogenic in vivo and did not protect the animals from a challenge of 98/6 cells. The results suggested that CTLs but not NK effector cells were important for eliciting in vivo tumor rejection of H-ras+v-myc-transfected cells. In contrast, antigens eliciting the cytotoxic T-cell response, and possibly also the in vivo tumor cell rejection response, were expressed on all cell types tested but were immunogenic only on the surface of 98/4v cells. We further determined major histocompatibility complex (MHC) class-I molecule expression on the outer cell surface and found that H-2K was down-regulated in H-ras-transfected cells. The results support the observation that oncogenes can down-regulate specific MHC antigens, thereby preventing presentation of tumor antigens and allowing tumor escape from immune recognition.

Efficacy of kallikrein in the treatment of oligozoospermia and asthenozoospermia: a double-blind trial

OBJECTIVE

To assess the effect of kallikrein on sperm motility and sperm count in infertile oligozoospermic and asthenozoospermic men.

DESIGN

Double-blind placebo-controlled clinical trial.

SETTING

Multicenter trial in three andrologic clinics.

PATIENTS

Infertile men with < 20 x 10(6) total sperm count and > 3 x 10(6) sperm cells/mL and/or sperm motility of < 30%.

INTERVENTIONS

One hundred fourteen men received either placebo or 600 kallikrein units of kallidinogenase by mouth daily for 12 weeks. Semen analyses were performed before and at 6-week intervals during the trial. Compliance and incidence of adverse effects were assessed.

RESULTS

The incidence of adverse effects was similar under placebo and under kallidinogenase treatment, usually mild, transient, and did not require the cessation of treatment in any patient. Kallidinogenase was not superior to placebo in improving sperm count and sperm motility.

CONCLUSIONS

At the doses and for the duration given, our results were disappointing. The absence of a therapeutical effect, as evidenced in the present study may be due to the very low absorption rate of kallidinogenase after oral administration. Probably a much higher dose of kallidinogenase should be used to achieve a therapeutic affect.

Developmental and tissue-specific modulation of rat galactose-1-phosphate uridyltransferase steady state messenger RNA and specific activity levels

To assess the role of genetic regulation as a modulating factor in the variability of rat tissue galactose-1-phosphate uridyltransferase (GALT) sp act, we have determined steady state GALT mRNA and sp act in rat liver during postnatal development. Steady state GALT mRNA levels increase from birth to d 5 and subsequently decrease toward adult levels. GALT sp act mirrors the mRNA pattern. A survey of steady state mRNA and GALT sp act of several adult rat tissues revealed marked tissue differences with a good correlation of the two parameters. Liver had the highest GALT mRNA and sp act; kidney, ovary, and heart had similar but lower mRNA and sp act; skeletal muscle and testes had the least GALT mRNA and enzyme sp act. These findings suggest that genetic regulation is important in the variable expression of GALT tissue sp act.

31P NMR spectra of intact red blood cells: quantitation of UDPGlucose and UDPGalactose

The combined levels of uridine diphosphogalactose (UDPGal) and uridine diphosphoglucose (UDPGlu) were measured directly by 31P NMR spectroscopy in intact fully oxygenated erythrocytes. Quantitative analysis was obtained using a sealed capillary of methylene diphosphonate (MDP) calibrated with standard solutions of UDPGlu and UDPGal of known concentration prepared in KRB/BSA. The combined peaks of UDPGlu and UDPGal were integrated after subtraction of the underlying broad component originating from membrane phospholipids. The average concentration of 27.16 +/- 5.18 nmole/ml or 8.08 +/- 1.36 mumole/100 g hemoglobin obtained for these metabolites correlated well with their total determined by HPLC of trichloracetic acid (TCA) extracts of the same samples.

Synchronous intrauterine and tubal pregnancies with subchorionic hematoma

A case of a heterotopic pregnancy is presented. Clinical manifestations included vaginal bleeding, and on ultrasonography a subchorionic hematoma was demonstrated. The subchorionic hematoma may be regarded as blood draining from the tubal pregnancy through the uterus.

RB-mediated tumor suppression of a lung cancer cell line is abrogated by an extract enriched in extracellular matrix

To examine whether the expression of retinoblastoma (RB) protein could mediate tumor suppression in a lung carcinoma cell line carrying multiple genetic defects, we transfected the Rb gene into a non-small cell lung cancer cell line with absent RB protein. We observed that the stable expression of a functional RB product was associated with a decreased efficiency of soft agar cloning and partial suppression of tumorigenicity in nude mice. The suppression of tumorigenicity was marked when 10(6) cells were injected into the flanks of nude mice but was less prominent when 10(7) cells were injected. RB-mediated tumor suppression, however, was consistently blocked by preincubation of the transfected cells with an extract enriched with an extracellular matrix (Matrigel). Analysis of tumors harvested from nude mice showed that they continued to express detectable levels of human RB protein which retained functional E1A binding activity and nuclear localization. RB-mediated inhibition of soft agar cloning was also blocked in a dose-dependent manner by the addition of Matrigel. These observations demonstrate that the expression of wild-type RB may suppress certain parameters of tumorigenicity in lung carcinoma cells that contain multiple genetic alterations. In addition, the reversal of tumor suppression by an extract enriched in basement membrane components may offer clues for further investigations into the mechanism of RB-mediated tumor suppression.

Oral blast injury caused by an accident

Blast trauma within the oropharyngeal cavity may be associated with superficial or deep injuries. Superficial injury generally needs only observation; deeper injury that violates the retropharyngeal space may produce dissecting emphysema into the neck and mediastinum followed by prevertebral soft tissue infections and mediastinitis. Injury involving the parapharyngeal space might damage vital cervical vessels. Life-threatening complications may result unless treatment is adequate. Three children who sustained oropharyngeal blast injury are presented. The direct cause was the blast effect of a new, spoiled, orange-flavor beverage just released on the market. The bottle cap of the soft drink and its effervescent liquid "exploded" into their mouths while they were trying to open the bottle with their teeth. Obviously, the failure to observe due precautions, as frequently happens among children, contributed to the occurrence of the accidents. This paper describes the diagnosis, management, and relevant educational and preventive measures of the problem.

Inhibition of retrovirus-induced disease in mice by camptothecin

We have previously shown that noncytotoxic doses of camptothecin (CPT), a topoisomerase I-specific antagonist, inhibit retrovirus replication in acutely and chronically infected cells. To evaluate the efficacy of CPT as an antiretroviral drug in vivo, we injected newborn BALB/c mice with Moloney murine leukemia virus and adult NFS mice with Friend spleen focus-forming virus. The Moloney murine leukemia virus-injected mice developed lymphoma, and the Friend spleen focus-forming virus-injected mice developed erythroleukemia. CPT, administrated together with the virus or 1 or 2 days after virus injection, prevented the onset of the disease in both cases. We showed that repeated CPT treatments increased the effectiveness of the drug when administrated 3 days after virus injection. This ability of CPT to inhibit retrovirus-induced disease in vivo without causing any apparent toxic side effects suggests its application as a legitimate remedy for the treatment of retroviral diseases.

Sonographic assessment of ovarian and endometrial changes during long-term Norplant use and their correlation with hormonal levels

OBJECTIVE

To study the probability of ovulation and subclinical abortion during long-term use of Norplant and to assess the concomitant endometrial development.

DESIGN

This was a prospective nonrandomized comparative study. The ovaries and endometrium were assessed daily by ultrasonography during 59 menstrual cycles in 50 women who were using Norplant for > 1 year. Serum concentrations of E2, P, FSH, LH, pregnancy specific beta 1 glycoprotein (Sp1), and hCG were also daily measured. The findings were compared with those in 35 ovulatory cycles in normal fertile women not using contraception.

SETTING

Clients of the Family Planning Clinic of Assiut University Hospital (Norplant users) and the hospital women staff (controls).

RESULTS

Sonographic and hormonal evidence of ovulation were observed in one third of Norplant users; two of them resulted in conception. However, the majority of these ovulatory cycles showed low midcycle peaks of E2, FSH, and LH and evidence of luteal phase defect (LPD). Excessive follicular enlargement was observed in 46% of the cycles. Norplant users had significantly thinner endometrium that did not exhibit the normal phasic changes in sonographic texture. Apart from conceptive cycles, no rise in Sp1 or hCG was observed.

CONCLUSIONS

Norplant acts mainly by inhibiting ovulation, but when this occurs, it is associated with LPD and subnormal endometrial development. Subclinical abortion does not contribute to the contraceptive effect.

Acanthosis nigricans and hyperandrogenism in a pregnancy complicated by diabetes

BACKGROUND

Acanthosis nigricans and hyperandrogenism have been associated with diabetes mellitus accompanied by insulin resistance. However, these manifestations have rarely been reported to occur as a result of the insulin resistance of pregnancy.

CASE

A 31-year-old woman with diabetes mellitus exhibited severe insulin resistance during pregnancy. At 32 weeks, daily administration of 500 U insulin was required to maintain glycemic control. Skin lesions typical of acanthosis nigricans appeared, and free testosterone levels were elevated (10.3 pg/mL). These manifestations resolved after delivery.

CONCLUSION

This case may demonstrate a correlation between reversible gestational insulin resistance and acanthosis nigricans.

Transfected wild-type and mutant max regulate cell growth and differentiation of murine erythroleukemia cells

Max protein forms specific DNA-binding dimeric complexes with itself and with proteins of the c-myc gene family. A large volume of data has accumulated on the role of the c-myc proto-oncogene in cell proliferation, differentiation and tumorigenesis. To elucidate the role of max in regulating c-myc functions and the effect of both proteins on cell proliferation and differentiation, we transfected murine erythroleukemia (MEL) cells with a full-length wild-type (wt) human max gene and a mutant containing a double point mutation in the basic region (bm), which abolishes specific DNA binding. All clones expressing wt-max grow slowly, and the process of inducer-mediated differentiation is delayed. Furthermore, cells transfected with the mutated max exhibit growth retardation, accumulation in the G0/G1 phase of the cell cycle and spontaneous differentiation. Our findings are consistent with a model in which a large excess of wt-Max in the cells enhances the formation of Max-Max growth-suppressor complexes, while elevated bm-Max deprives the cell of growth-promoting Myc-Max heterodimers in a dominant-negative manner, presumably by inactivating endogenous Myc and Max.

Emotional distress in Israeli women before and after abortion

Emotional distress in a group of Israeli women who requested legal abortion was compared with that in a group of women on the verge of delivery and in a random group of nonpregnant women on measures of anxiety and depression. Emotional consequences of the abortion were evaluated by before-and-after comparisons of the same measures in a subgroup of the aborting women. Findings indicated significantly greater distress in the aborting women, with lower levels after the abortion. The effects on emotional well-being of personal and contextual factors and their interactions were also examined.

Neglected transverse lie with uterine rupture

We present a case of neglected transverse lie with uterine rupture, which is rarely encountered in modern obstetric practice. The prominent clinical features, including uterine rupture and fetal death, are described. Treatment entails resuscitative measures and Cesarean delivery.

Role of natural killer cells in controlling local tumor formation and metastatic manifestation of different 3LL Lewis lung carcinoma cell clones

Using two cell clones derived from 3LL Lewis carcinoma; an NK-resistant (designated A6) and an NK-susceptible (designated F2) clone, we investigated the effect of the NK system on local tumor growth and metastasis. Both clones generated local tumors at the inoculation site somewhat faster in NK-deficient (bg/bg) than in normal mice. In addition, these tumors grew slightly faster in the bg/bg mice. However, the effect of the NK system on the metastatic spread of these clones was much more prominent. The F2 cells were profoundly less metastatic than the A6 cells when inoculated into normal mice, whereas in the NK-deficient mice, both clones were highly metastatic. Thus, the NK system appears to be effective primarily in controlling the metastatic spread of the 3LL cells and has a lesser effect on their local tumor formation.

The effect of dietary fruits and vegetables on urinary galactitol excretion in galactose-1-phosphate uridyltransferase deficiency

Even on a lactose-restricted diet, urinary galactitol excretion and erythrocyte galactose-1-phosphate levels are persistently elevated in patients with galactose-1-phosphate uridyltransferase deficiency. In order to determine the contribution of galactose in dietary fruits and vegetables to this phenomenon, (1) the content of galactose in a lactose-free diet was directly measured when a galactosaemic patient's diet was specifically enriched in those fruits and vegetables which contain relatively large amounts of free galactose and (2) galactitol excretion was determined during ingestion of this diet for 3 weeks and while on a synthetic diet for 1 week that provided < 8 mg galactose/day. For comparison the effect of a 3-week supplementation of 200 mg galactose/day was determined. The measured intake in total foodstuffs matched the theoretical content of galactose in the patient's diet based on amounts in fruits and vegetables alone, thus supporting the concept that fruits and vegetables are primarily responsible for galactose intake in a lactose-free diet. All of the dietary manipulations, however, had relatively little effect on metabolite levels, suggesting that endogenous galactose production is primarily responsible for the elevated levels of galactose metabolites routinely detected in patients on lactose-restricted diets.

Different regulatory levels are involved in the generation of hemopoietic cytokines (CSFs and IL-6) in fibroblasts stimulated by inflammatory products

In this present study we have characterized the array of hemopoietic cytokines generated by fibroblasts in response to inflammatory signals. It was shown that murine embryo fibroblasts (MEF) are able to generate colony stimulating factors (CSFs) [granulocyte-macrophage (GM-CSF), macrophage-CSF (CSF-1) and granulocyte-CSF (G-CSF)] as well as the hemopoietin interleukin 6 (IL-6), while the production of IL-3, IL-4 or tumor necrosis factor (TNF) could not be detected in MEF, as assessed by bioassays or expression of specific mRNA. The production of colony promoting activity was observed when fibroblasts were stimulated by lipopolysaccharide (LPS) or individual cytokines [IL-1, interferon-gamma (IFN-gamma), IL-2, IL-4 or TNF] in serum-free conditions as well as by serum itself. These inducers differentially stimulated in MEF the production of various CSFs; LPS induced mainly CSF-1, while cytokines or serum induced equivalent amounts of GM-CSF and CSF-1. The production of IL-6 was induced by LPS in serum-free conditions, while stimulation by cytokines (IL-1 or IFN-gamma) resulted in IL-6 production only in serum-supplemented cultures. Serum by itself did not induce IL-6 production by MEF. The secretion of IL-6 by fibroblasts was detected early and peaked after 6 hours, while CSF activity peaked after 24-72 hours, depending on the inducer. Constitutive mRNA expression of CSF-1 was detected in serum-free conditions in unstimulated MEF, however colony-promoting activity was detected only upon stimulation with cytokines, LPS or serum.(ABSTRACT TRUNCATED AT 250 WORDS)

Rat galactose-1-phosphate uridyltransferase coding sequence, transcription start site and genomic organization

Galactosemia is an inborn error of metabolism in humans due to deficient activity of the enzyme galactose-1-phosphate uridyl-transferase (GALT). Using a 1.3 kb Bam HI restriction fragment of the human GALT cDNA as a probe, three cDNAs, 786 bp, 265 bp and 1.4 kb were isolated from a rat liver cDNA library. The total rat GALT coding sequence obtained from these three clones was 1051 nt. Repeat cDNA library screening failed to isolate cDNA clones with additional 5'-coding sequence. Using the 786 bp cDNA as a probe, three genomic clones, RGG1, RGG2, and RGG3 were isolated from a rat genomic library. RGG2 and RGG3 contained additional 5'-coding sequence, missing from the cDNA clones, which was identified by comparison with the human cDNA sequence. The rat GALT sequence, from transcription start site to the polyadenylation tail, is 1254 nt and is divided into 11 exons which span over 3.5 kb of genomic sequence. Primer extension identified the transcription start site as 17 nt 5' to the translation start site. Rat GALT is 379 amino acids long, identical to human GALT, with a derived molecular weight of 43,312 Da similar to the 43,360 Da weight for human GALT. The derived rat amino acid sequence is 90% identical to the human sequence. The isolation of rat GALT genomic sequence will facilitate future investigations of the regulation of expression of the rat GALT gene.

Concentration of white blood cell UDPgalactose and UDPglucose determined by high performance liquid chromatography

We have applied a HPLC method to separate and quantitate UDPgalactose (UDPGal) and UDPglucose (UDPGlu) in human white blood cells (WBCs). Trichloroacetic acid-treated, protein-free filtrates were chromatographed on an anion-exchange column (Dionex CarboPac PA-1) using a gradient of 20-40% potassium phosphate buffer (pH 4.5). Recoveries of UDPGal and UDPGlu ranged from 93 to 106%, and the method was linear over a wide range of WBC protein concentrations. Volumes of blood as low as 2.5 ml (2.2 mg WBC protein) could be used to achieve quantitative recovery of the sugar nucleotides. The mean values and standard deviations of UDPGal and UDPGlu in 33 normal individuals ranging in age from 1 day to 65 years were 12.4 +/- 4.2 and 31.5 +/- 9.3 mumol/100 g protein, respectively. No statistical differences in UDPGal and UDPGlu values were observed between children and adults. No correlation was established between the concentrations of UDPGal and UDPGlu and either total WBC count or the number of lymphocytes obtained from Coulter counter analysis. There was no relationship between the concentrations of UDPGal and UDPGlu in WBCs and RBCs which were prepared from the same blood specimen.

Progesterone supplementation increases luteal phase endometrial thickness and oestradiol levels in in-vitro fertilization

Luteal phase supplementation with natural progesterone appears to increase the pregnancy rate in in-vitro fertilization (IVF). The objective of this investigation was to examine the effect of intravaginal progesterone on endometrial thickness and hormonal parameters 7-9 days after embryo transfer. IVF patients receiving progesterone supplementation (Prog +, n = 64), who did not conceive, were compared to patients not receiving progesterone (Prog -, n = 23) because of failed fertilization. These two groups were also compared to 20 women (Preg) who conceived and to 16 women (control) in the mid-luteal phase of natural cycles. Endometrial thickness was greater (P < 0.01) in the Prog + (0.88 +/- 0.04 cm) and Preg (0.92 +/- 0.02 cm) groups compared to the Prog - (0.71 +/- 0.05 cm) and control (0.65 +/- 0.05 cm) groups. Mean luteal phase serum oestradiol levels were also higher (P < 0.05) in the Prog + (1118 +/- 112 pmol/l) and Preg (2267 +/- 757 pmol/l) groups than in the Prog - (574 +/- 70 pmol/l) and control (468 +/- 38 pmol/l) groups. These findings suggest that progesterone supplementation may affect pregnancy rates in IVF by increasing endometrial thickness, thereby enhancing receptivity for implantation. The mechanism through which this effect occurs is unclear but may involve serum oestradiol elevation.

Detection of scar dehiscence at delivery in women with prior cesarean section

Transcervical examination of a prior cesarean scar after vaginal delivery is commonly advised. A retrospective study of 1023 parturients with prior cesarean delivery was undertaken, 475 of whom delivered vaginally. Thirteen cases of scar dehiscence were found at laparotomy, and only one case was discovered by transcervical examination. The value of routine postdelivery examination of uterine scar is doubtful.

The H-ras oncogene regulates expression of 70- and 45-kDa cell-surface molecules whose expression correlates with tumor-cell immunogenicity

The effects of the H-ras oncogene on fibroblast cell tumorigenicity and immunogenicity was studied in transfectants of the BALB/c 3T3 clone A31 fibroblastoid cell-line. Cells that were transfected with MC29-LTR-H-ras (98/6) or MC29-LTR-v-myc + H-ras (98/4v) and were inoculated into syngeneic BALB/c mice were tumorigenic in 100% and 60% of animals respectively. By contrast, transfectants containing the pSV2neo plasmid alone (98/1) displayed normal characteristics both in vitro and in vivo. Inoculation of mice with mitomycin-C-treated 98/1 or 98/4v cells induced an effective protective immunity to a challenge of live 98/4v cells, and a partial immunity against 98/6 cells. Mitomycin-C-treated 98/6 cells failed to render immunity against a challenge of either 98/6 or 98/4v cells. To correlate immunogenicity and tumorigenicity of the different cell types with cell-surface-antigen expression, we prepared MAbs against 98/4v cells in syngeneic mice. Immunohistochemical and immunoblot analysis revealed that MAbs 102 and 104 recognized 2 protein band of 70 and 45 kDa respectively, which were expressed predominantly in 98/1 and 98/4v cells. A third immunoreactive protein band of 44 kDa that reacted with MAb 6 was expressed at a similar cell-surface density on all cell types. Cell-differentiation-inducing agents, such as DMSO, retinoic acid or sodium butyrate, were all found to induce 98/6 cell flattening and morphological changes toward a normal phenotype that were followed by up-regulation of the 70- and 45-kDa antigens. The results suggest that regulation of expression of the 70- and 45-kDa molecules is affected by H-ras, and that expression of these cell-surface molecules may be relevant to tumor cell immunogenicity.

EGF receptor activity and mitogenic response of Balb/3T3 cells expressing Ras and Myc oncogenes. EGF receptor activity in oncogene transformed cells

EGF receptors are found on the surface of most cells, usually with high and low binding affinities. To investigate functional relationships between EGF (EGF-like growth factors) and oncogenes we have characterized the expression of the epidermal growth factor receptor (EGFr) in H-Ras, v-Myc, and H-Ras-v-Myc transformed Balb/3T3 cells. H-Ras cells show a marked decrease in the number of EGFr molecules per cell compared to parental cells. v-Myc and H-Ras-v-Myc transformed cells express an intermediate level of receptors. The majority of the EGF receptors on the parental and oncogene transformed cells bind EGF with low affinity and this low affinity receptor is down-regulated by oncogene transformation. v-Myc expression, in the H-Ras-v-Myc transformed cells, abrogates the receptor down-regulation seen with H-Ras transformation. The mechanism of abrogation is not a result of a change in the p21-Ras concentration in the H-Ras-v-Myc transformed cells. In addition, the mitogenic response to EGF was examined. H-Ras and H-Ras-v-Myc transformed cells do not respond to EGF mitogenically. In contrast, EGF stimulates DNA synthesis in parental cells and v-Myc transfected cells; this result suggests that growth promoting signals from the EGF receptor may not be required in H-Ras transformed cells.