Heterogeneous blood pressure response to furosemide and captopril in primary aldosteronism

The hypertension associated with primary aldosteronism (PA) is often regarded as volume dependent/salt-sensitive. However, not all patients sustain an increase in blood pressure upon sodium loading. In order to examine the sodium sensitivity in PA, 21 patients with aldosteronoma were tested for acute hypotensive response to intravenous furosemide and oral captopril. Ten patients having a decrease in mean blood pressure (MBP) exceeding 5% at the second hour after a 20 mg furosemide injection were defined as diuretic-responders (DR), while the remainder were defined as diuretic-non-responders (DN). The DR group had a higher baseline MBP (135 +/- 6 [mean +/- SE] vs 121 +/- 4 mmHg, p < 0.05) and serum sodium concentration (145.7 +/- 1.4 vs 143.0 +/- 0.7 mmol/L, p < 0.05) than the DN group. The extent of natriuresis induced by furosemide was not different between the two subgroups. Following 100 mg of captopril administered orally, the DR group had a smaller change in MBP (%) than the DN group (3.08 +/- 5.14 vs -7.78 +/- 3.37, p < 0.05). According to the different BP responses to furosemide and captopril, we conclude that PA patients may be further divided into DR and DN. The DR group had a good response to diuretics whereas the DN group responded better to converting enzyme inhibitors. This classification of PA in terms of blood pressure response to furosemide may have therapeutic implications.

Relationship of sperm antibodies in women and men to human in vitro fertilization, cleavage, and pregnancy rate

PROBLEM

The presence of anti-sperm antibodies (ASA) in female serum has been correlated with decreased fertilization in the in vitro fertilization (IVF) program; however, the impact of each type of ASA (IgG, IgA, IgM) is not known.

METHOD

To clarify the role of each ASA subtype, the immunobead binding technique was used to identify IgG, IgA, and IgM ASA in the female sera and on the spermatozoa from 137 couples undergoing the IVF program.

RESULTS

Couples with ASA on spermatozoa had a lower fertilization rate and lower number of transferred embryos: and IgG was the major immunoglobin involved. Couples with ASA in female sera showed significant decreases in the rates of fertilization, cleavage, and number of transferred embryos only when IgM was detected, but not IgG or IgA. However, the presence of IgA ASA in female sera was only associated with a decrease in pregnancy rate, although the number of transferred embryos was not reduced.

CONCLUSION

These findings suggest that ASA can influence the results of IVF and that the specific effect is dependent upon the subtypes of ASA.

Valve ring abscess associated with infective endocarditis: echocardiographic features and clinical observations

The presence of a valve ring abscess in patients with infective endocarditis adds appreciably to the expected rates of morbidity and mortality. From January 1989 to October 1991, a total of 43 consecutive patients with infective endocarditis seen at National Taiwan University Hospital were enrolled in this study. There were 30 men and 13 women, ranging in age from 14 to 75 years (mean +/- SD 38.5 +/- 15.0 years). The presence of infective endocarditis was documented by surgery in 26 patients and was based on a clinical diagnosis in the remaining 17 patients. A valve ring abscess was detected in five patients, either by transthoracic or transesophageal echocardiography, and all were confirmed at surgery. Aortic valve endocarditis was more frequently found in patients with valve ring abscesses (100% vs 31.6%, p < 0.01), and the infecting organism was most often Staphylococcus aureus (60.0% vs 15.8%, p < 0.05). The proportion of urgent operations was also higher in the group with abscesses (80.0% vs 23.7%, p < 0.05). The hospital mortality was 40.0% in patients with abscesses and 5.3% in patients without abscesses, but the difference did not reach significance (p = 0.056). Transthoracic echocardiography identified valve ring abscesses in the first three patients, but transesophageal echocardiography was more useful in detecting abscesses located in the posterior aspect of the aortic root in the other two patients, in which the lesion was overlooked or only suspected by the transthoracic approach.(ABSTRACT TRUNCATED AT 250 WORDS)

Production and characterization of monoclonal antibodies against alpha and beta spectrin subunits

Twenty monoclonal antibodies against human erythrocyte spectrin were generated using purified native spectrin as the immunogen. Thirteen out of 20 monoclonal antibodies reacted to the alpha subunit, and the remaining seven monoclonal antibodies reacted to the beta subunit in Western blot analysis. One anti-beta subunit and two anti-alpha subunit monoclonal antibodies cross-reacted with the cell lysate of the non-erythroid T. lymphoma, J. Jhan, cell line. Identification of 20 monoclonal antibodies to the respective tryptic domains was also achieved. The specificity of these antibodies to respective tryptic domains of spectrin confirms the alignments and uniqueness of each of the previously identified five domains in the alpha subunit and four domains in the beta subunit, and establishes the identity of proteolytic daughter peptide fragments.

Mapping the putative RNA helicase genes by sequence overlapping

An 'electronic' gene mapping procedure based on computer-aided search for overlapping gene sequences was used to identify adjacent genes and localize several putative RNA helicase genes to different chromosomes. PRP28 and AMD1 genes map to the right arm of chromosome IV next to sup2, which encodes a tyrosine tRNA. PRP16, previously mapped to chromosome XI, is tightly linked to MRP-L20. PRP22 is adjacent to PRE1, whose chromosomal location is currently unknown. The utility of this approach in yeast gene mapping is evaluated.

Characterization and nucleotide sequences of the variable regions of a monoclonal antibody against alpha-fetoprotein

alpha-Fetoprotein (AFP) is a well-known tumor marker of hepatocellular carcinoma (HCC). Monoclonal antibodies against AFP possessing specific binding ability to HCC are potential candidates for immunoscintigraphy and immunotherapy. A new monoclonal antibody against AFP (0325-6-9) was isolated. Its specificity and targeting tumor ability were characterized by enzyme-linked immunosorbent assay (ELISA), cell immunostain and complement killing. These results suggest that 0325-6-9 is specific to hepatoma cells. The nucleotide sequences of variable regions of 0325-6-9 were determined by M13 dideoxynucleotide sequencing method. With the information of nucleotide sequence, this antibody then could be modified by recombinant technology for its usage in in vivo diagnosis and immunotherapy.

Purification of radioiodinated human insulin by high performance liquid chromatography for a sensitive radioimmunoassay

The optimal sensitivity of a radioimmunoassay depends on the purity of the radiolabeled antigen. The conventional purification methods are not complete and are time consuming. The combination of a Sep-pak C18 cartridge and high performance liquid chromatography (HPLC) for the purification of 125I-labeled insulin in our study revealed that the Sep-pak cartridge can serve as the preliminary step to remove unreacted radioactive iodide, the reactants, and labeled but presumably damaged materials unadsorbed to the cartridge. The fractions eluted from the Sep-pak containing high radioactivity and high immunoreactivity to the antibody were chosen for further purification by HPLC to eliminate undesirable radiolabeled substances with a lesser immunoreactivity. The purified radiolabeled insulin was used to develop a sensitive radioimmunoassay with detecting limits of 0.03 microU/mL per tube.

Acute exacerbations of chronic type B hepatitis are accompanied by increased T cell responses to hepatitis B core and e antigens. Implications for hepatitis B e antigen seroconversion

T cell proliferative responses to hepatitis B virus-encoded envelope antigen (S + preS2 + preS1), recombinant core antigen (HBcAg), and natural hepatitis B e antigen (HBeAg) were examined in 22 HBeAg-positive patients with chronic type B hepatitis and 17 healthy hepatitis B surface antigen (HBsAg) carriers. The results showed that HBeAg-positive patients had (a) higher levels of T cell responses to HBcAg/HBeAg than those of healthy HBsAg carriers (P less than 0.001 and P less than 0.01, respectively); (b) a further increase in these T cell responses during acute exacerbations (P less than 0.05 and P less than 0.05, respectively); (c) subsidence in the T cell responses to HBcAg/HBeAg after recovery from acute exacerbations and HBeAg seroconversion, whereas the responses would persist at high levels if the patients did not enter a clinical remission; and (d) low levels of T cell responses to S + preS2 + preS1 either before or after HBeAg seroconversion. The appearance of increasing T cell responses to HBcAg/HBeAg usually occurred in the early phase of acute exacerbations. These findings imply that HBcAg/HBeAg-specific T cells play an important role in the exacerbations of chronic hepatitis B and in HBeAg seroconversion. HBcAg/HBeAg-specific precursor T cell frequencies were serially studied in selected cases by limiting dilution assay. Elevation (two- to fourfold) of HBcAg/HBeAg-specific precursor T cell frequencies contributed to the increase of HBcAg/HBeAg-specific T cell proliferation during acute exacerbations.

Preparation of radioiodinated secretin for radioimmunoassay

Radioiodination of synthetic human secretin on its N-terminal histidyl residue was not difficult when a greater amount of Chloramine T and a longer reaction time were employed to achieve better incorporation of 125I. The radioiodinated tracer for an optimal radioimmunoassay required purification. The combination of Sep-pak C18 Cartridge and high performance liquid chromatography for the purification of 125I-secretin in our study revealed that the Sep-pak cartridge was a preliminary step in removing unlabeled radioactive iodide, the reactant, and labeled materials unadsorbed to the cartridge. The eluate eluted from the Sep-pak containing high radioactivity and high immunoreactivity to the antibody were selected for further purification by HPLC which eliminated undesirable radiolabeled substances with lower immunoreactivity. The purified radiolabeled secretin was used in developing a sensitive radioimmunoassay.

Colorectal ornithine decarboxylase activity in human mucosa and tumors: elevation of enzymatic activity in distal mucosa

To examine the value of ornithine decarboxylase (ODC) assay as a biological marker of potential malignancy in large bowel, we harvested 43 colorectal carcinoma, 7 adenoma, 6 polyps, and 77 normal-appearing mucosa at surgery from patients with colorectal carcinoma. In addition, 13 normal rectal mucosa were obtained at biopsy from patients with benign diseases or diseases unrelated to colorectal carcinoma as normal control. ODC activity was significantly higher in polyps and adenocarcinomas than in normal-appearing mucosa from patients with colorectal carcinoma. ODC activity in normal-appearing mucosa varied throughout the large intestine, with significantly higher activities in the distal segment of the large bowel. The higher ODC activity detected in the sigmoid colon and rectum correlates with the larger incidence of tumor development in this region of the large bowel. This observation needs to be taken into consideration when ODC activities of the colorectal mucosa are measured as biological markers of potential malignancies.

Long term and large-scale cultivation of human hepatoma Hep G2 cells in hollow fiber bioreactor

Long-term and large scale cultivation of an anchorage-dependent cell line using an industrial scale hollow fiber perfusion bioreactor is described. Hep G2 cells (a human hepatoma cell line) were cultivated in an Acusyst-P (Endotronic) with a total fiber surface area of 7.2 m2 6 x 1.2m2) to produce Hep G2 crude conditioned medium (CCM). Pretreatment of the cellulose acetate hollow fibers with collagen enhances the attachment of the anchorage-dependent cells. We have succeeded in growing the Hep G2 cells in an antibiotics- and serum-free IMDM medium, supplemented with 50 micrograms/ml of Hep G2 CCM protein at inoculation. The Hep G2 cells replicate and secrete CCM protein in quantities comparable to those produced in DMEM containing 10% fetal calf serum (FCS). The highest CCM protein productivity during the 80-day cultivation was 1.1 g/day with a total of 30 g of protein accumulated. Hep G2 CCM (20-40 micrograms protein/ml) was comparable to or even better than 10% FCS in supporting the growth of Molt-4 (a human T leukemia cell line) and FO (a mouse myeloma cell line) cells in vitro. The availability of this large amount of Hep G2 CCM will aid the further purification and characterization of growth factor(s) which could be used as serum substituents.

Characterization of Trichomonas vaginalis haemolysis

The haemolytic activity of live Trichomonas vaginalis organisms was investigated. Optimal haemolysis of human erythrocytes was observed at a parasite to erythrocyte ratio of 1:5 during a 2 h incubation period. No haemolytic activity was detected in concentrated culture supernatants after overnight growth of trichomonads or when parasites were separated from erythrocytes by a 3 microns filter, suggesting a contact-dependent mechanism for haemolysis. The haemolytic activity was temperature-dependent and maximal haemolysis occurred at 37 degrees C. Treatment of trichomonads with metronidazole reduced levels of haemolysis by greater than 50%. Maximal haemolysis occurred at the pH range of the vagina during trichomoniasis. N-alpha-tosyl-L-lysyl-chloromethyl ketone and iodoacetamide, inhibitors of trichomonad cysteine proteinases, reduced the haemolytic activity of live parasites.

The effect of birth order in twins on fetal umbilical blood gas and apgar score

Although recent reports have revealed no difference in perinatal mortality between a set of twins, more sensitive means other than perinatal mortality are necessary to evaluate differences in twins. This study examined differences between 34 twin pairs with respect to Apgar score, umbilical venous and arterial blood gas, and acid-base data. The parameters were measured in paired samples and compared with the paired t test and Fisher's exact probability test. The most coherent findings were a higher umbilical venous PO2 and umbilical arterial PO2 in twin A. Their differences were not due to the route of delivery, interval between twins, presentation or chorionicity. The data suggest that the second-born twin has potentially greater susceptibility to hypoxia and trauma.

Specific erythrocyte binding is an additional nutrient acquisition system for Trichomonas vaginalis

Specific receptor-mediated binding by Trichomonas vaginalis of human erythrocytes was demonstrated. The ability of live parasites to internalize erythrocytes was also documented. In vitro growth assays during lipid-free and iron-limiting conditions that do not support the survival of T. vaginalis organisms showed that purified erythrocyte lipids and hemoglobin were each able to provide lipids and/or hemoglobin iron for trichomonal growth and multiplication. Parasites bound hemoglobin in a highly specific receptor-mediated fashion, and only the homologous unlabeled hemoglobin, but not lactoferrin and transferrin, competed with iodinated hemoglobin binding. Two antibody-crossreactive surface proteins of the parasites were identified as adhesins, and antibody to the individual adhesins inhibited T. vaginalis recognition and binding of erythrocytes. Finally, patient sera possessed antibody to the adhesins, showing the immunogenic nature and in vivo relevance of the trichomonad proteins during infection.

Supplemental vitamin A prevents the tumor-induced defect in wound healing

To test our hypothesis that supplemental vitamin A would mitigate the impaired healing that occurs in tumor-bearing animals, six groups of C3H mice, eight per group, eating a standard commercial mouse chow ad libitum that supports normal growth, reproduction, and longevity were innoculated with 200,000 C3HBA cells. When tumors measured approximately 6 mm in diameter, the mice were anesthesized and wounded (dorsal skin incisions and subcutaneous polyvinyl alcohol sponges). Twenty-four hours later, two groups (one continued on the chow and the other started on the chow supplemented with 150,000 IU vitamin A/kg chow) underwent local tumor irradiation; two groups, one ingesting the chow, the other the vitamin A supplemented chow, were started on cyclophosphamide therapy; two groups, one ingesting the chow, the other the vitamin A supplemented chow, received neither local tumor irradiation nor cyclophosphamide therapy. An additional two groups ingesting the chow, one group neither innoculated with tumor nor wounded, the other wounded by not innoculated, served as controls. Wound breaking strength and sponge reparative collagen accumulation (assessed by hydroxyproline proline measurement) were used as indicators of wound healing. The mice were killed 12 days after wounding. Tumor presence decreased wound breaking strength and sponge hydroxyproline content; these effects were largely negated by supplemental vitamin A. Local tumor irradiation diminished the adverse effect of tumor on sponge reparative collagen content but to a lesser extent than the supplemental vitamin A. Supplemental vitamin A added to the irradiation effect on healing but irradiation did not add to the vitamin A effect. Cyclophosphamide, a systemic radiomimetic anti-tumor agent, did not alter the impaired wound healing of the tumor-bearing mice. Supplemental vitamin A mitigated the impaired wound healing in the cyclophosphamide-treated tumor-bearing mice. Supplemental vitamin A also moderated the effects of wounding, tumor, and tumor therapies (local irradiation and cyclophosphamide) on the increase in adrenal size, leukopenia, thrombocytopenia, and thymic involution (except the last was not moderated in the cyclophosphamide-treated tumor-bearing rats). The splenic enlargement in the untreated tumor-bearing wounded rats and in those treated with cyclophosphamide was lessened by supplemental vitamin A. We hypothesize that these anti-stress effects of vitamin A underlie, in part, its action in mitigating the impaired wound healing of tumor-bearing mice, including those treated by local irradiation or cyclophosphamide. These findings have implications for the care of patients with malignant tumors.

Characterization of monoclonal antibody binding site to the polymorphic length of hepatitis B surface antigen synthesized in a cell-free system

A combination of two modern biological techniques, hybridoma and recombinant DNA, was described to screen and characterize a monoclonal antibody binding site. Three monoclonal antibodies, M27, M9 and M01 recognizing to a specific domain of the hepatitis B virus surface antigen (HBsAg), were determined by their ability to immunoprecipitate the in vitro synthesized HBsAg in a polymorphic length. Results indicated that the M9 and M01 both recognize the S region of surface antigen while the M27 binds to the pre-S2 region of surface antigen.

[Large-scale production of monoclonal antibodies using hollow fiber bioreactor]

Development of large-scale monoclonal antibody production using industrial scale hollow fiber bioreactor is described. Hybridoma cell lines H505AC and A306AA were cultivated in the hollow fiber perfusion bioreactor with a total fiber surface area of 7.2 m2 (6 x 1.2 m2) to produce anti-hepatitis B surface antigen (anti-HBsAg) monoclonal antibody IgM and anti-alpha-fetal protein (anti-AFP) monoclonal antibody IgG. The highest anti-HBsAg IgM productivity obtained during 49 days cultivation of H505AC was 0.135 g/day and the total accumulated IgM was 1.90 g. Results from the cultivation of A306AA in the hollow fiber module for 23 days showed the highest anti-AFP IgG productivity and the total accumulated IgG were 0.672 g/day and 7.21 g, respectively.

Differential effects of parenteral nutrition on tumor growth and erythrocyte polyamine levels in the rat

The influence of total parenteral nutrition (TPN) on tumor growth and erythrocyte polyamine levels was evaluated in rats with a transplantable fibrosarcoma or a Ward colon tumor. During the experimental periods the fibrosarcoma grows exponentially when rats are fed chow ad libitum while the colon tumor reaches a plateau of its Gompertzian growth curve. A 12-day regimen of TPN resulted in an increased growth of the colon tumor but not the fibrosarcoma. The erythrocyte putrescine levels of fibrosarcoma-bearing rats and the levels of putrescine, spermidine, and spermine of Ward colon-tumor-bearing rats were significantly increased by TPN compared with similarly treated nontumor-bearing (NTB) rats. When the growth of the fibrosarcoma was slowed by feeding a restricted intake (RI) regimen, a subsequent 6-day regimen of TPN resulted in increased tumor growth. Erythrocyte polyamine levels of fibrosarcoma-bearing, RI-rats were elevated by TPN repletion. There was a consistent, significant, interaction between TPN and tumor presence on the erythrocyte putrescine levels in fibrosarcoma-bearing rats and the levels of all polyamines in Ward colon-tumor-bearing rats. The effects of TPN on tumor growth and erythrocyte polyamine levels of tumor-bearing rats may be dependent on the growth characteristics of the tumor. The data demonstrate that TPN consistently enhanced the tumor contribution to the erythrocyte putrescine pool.

Reduction of difluoromethylornithine-induced thrombocytopenia in rats with ornithine while maintaining antitumor activity

The purpose of this study was to evaluate the effect of a concomitant infusion of ornithine on the difluoromethylornithine (DFMO)-induced thrombocytopenia and antitumor activity. Male Fischer 344 rats with either a transplantable fibrosarcoma or Ward colon tumor were given a 12-day continuous infusion of DFMO (2000 mg/kg/day) alone or with ornithine. The dose of ornithine was defined as the molar ratio to DFMO. A continuous infusion of DFMO significantly reduced circulating platelet counts to 5-16% of the control. Concomitant ornithine treatment at a molar ratio of 0.2-0.5 resulted in protection of the rat from thrombocytopenia while the antiproliferative activity of DFMO against the fibrosarcoma or Ward colon tumor was unaffected. At a higher ornithine: DFMO molar ratio (0.7), the DFMO-induced inhibition of tumor growth was blocked. Tissue polyamine levels suggest a different sensitivity of tumor and normal tissue to DFMO. Concomitant ornithine resulted in a greater increase in the polyamine levels of normal tissues, compared with the tumor. These results suggest that ornithine can selectively inhibit DFMO-induced thrombocytopenia while not affecting the antitumor activity.

The production of polyclonal and monoclonal antibodies in mice using novel immunization methods

Two novel immunization methods (intrasplenic and intra-inguinal lymph node) have been developed for the production of polyclonal and monoclonal antibodies in mice. Freund's complete adjuvant and antigen were mixed in the ratio of 1:2 (v/v). Various concentrations of human serum albumin (HSA) were used as antigen. No primary immune response was induced with 0.1 microgram of HSA in either of the methods studied. Intrasplenic immunization resulted in the strongest primary immune responses using all other doses of HSA. The primary immune response induced by intrasplenic immunization with 0.5 microgram of HSA was higher than any response induced by subcutaneous immunization with various doses of HSA. Inguinal lymph node immunization was less effective than intrasplenic immunization but better than subcutaneous immunization with 1-50 micrograms of HSA. Comparisons were also made of the efficacy of different adjuvants when inducing primary immune responses with 1 microgram of HSA. Freund's complete adjuvant resulted in a much stronger response than Freund's incomplete adjuvant and alum. Both intrasplenic and inguinal lymph node immunization using 1-5 micrograms of HSA were able to induce strong primary immune responses. Secondary immunization with either method or intravenous injection 3 days before fusion resulted in a higher frequency of specific monoclonal antibodies.

Routine pretreatment evaluation in cervical carcinoma

A review of 573 previously untreated patients with invasive cervical carcinoma was undertaken to determine the significance of the routine pretreatment performance of chest x-ray, intravenous pyelography (IVP), cystoscopy and sigmoidoscopy. Chest x-ray was performed in 570 patients (99.5%), IVP in 514 (89.7%), cystoscopy, 502 (87.6%) and sigmoidoscopy, 496 (86.6%). The overall yield of tumor-related abnormalities demonstrated in chest x-ray, IVP, cystoscopy and sigmoidoscopy was 1.8%, 9.1%. 6.4% and 1.2% respectively. The chest x-ray findings changed the initial clinical stage in 1.3% of cases, IVP in 4.2%, cystoscopy in 4.0% and sigmoidoscopy in 0.6%. There were 5 instances of bladder involvement and 5 of bullous edema of the bladder found in patients originally classified as having stage I or stage II disease. Thus, to omit cystoscopy may not be so safe in patients with stage I and stage II diseases. We suggest that chest x-ray, IVP and cystoscopy should be performed as part of staging in all patients with cervical carcinoma, however, sigmoidoscopy can be reserved for those initially diagnosed to have advanced disease or symptomatic patients.

A very small viral double-stranded RNA

UmV is a double-stranded RNA (dsRNA) virus of the corn fungal pathogen Ustilago maydis. UmV has no infectious cycle. Some UmV subtypes have viral dsRNAs encoding secreted toxins that kill sensitive cells of the same species and related species. There are three viral subtypes, P1, P4 and P6, which differ in the specificity of their secreted killer toxins. Each has three size classes of dsRNA: H (heavy), M (medium) and L (light). The L segments of UmV are unique in being derived from one end of the larger M segments. We have sequenced P1 L and placed it at the 3' end of the P1 M1 plus strand. In their overlapping regions, these dsRNAs are identical in sequence. In vitro translation of P1 M1 results in a peptide whose size is consistent with its being encoded by the non-L region of M1. P1 L is a very small dsRNA of 355 bp. It has no long open reading frames and produces no detectable in vitro translation product. The sequence of P1 L suggests that it is derived by a process unique among dsRNA viruses: replication and packaging of the 3' end fragment of a processed mRNA.

Polyamine-directed preferential nutritional repletion of normal tissues in tumor-bearing hosts

Our previous study demonstrated that total parenteral nutrition (TPN) increases erythrocyte (RBC) polyamines selectively in cancer patients but not in non-cancer patients, suggesting that these changes may relate to tumor presence. We therefore studied the possible relationship between RBC polyamine levels and potential tumor growth induced by TPN. In addition, we attempted to control tumor growth during TPN with alpha-difluoromethylornithine (DFMO), a suicide inhibitor of ornithine decarboxylase (ODC), in a fibrosarcoma-bearing rat model. Rats in a control group received chow ad libitum for 3 weeks and their tumors grew exponentially. A restricted intake (RI) tumor-bearing group received 8 g chow per day per rat; this produced malnourished rats in which tumor growth significantly slowed. The third group (RI----TPN) received the RI diet for 2 weeks and TPN for 1 week, which resulted in an increase in tumor growth. The last group (RI----TPN + DFMO) received a 2-week RI regimen and 1-week TPN plus DFMO regimen, which inhibited tumor growth to the level of the RI group due to the addition of DFMO (1 g/kg/day). Although the addition of TPN to the RI regimen markedly increased tumor ODC activity, as well as tumor putrescine and RBC putrescine levels, the addition of DFMO to the RI----TPN regimen entirely abolished these increases. Despite DFMO treatment, liver ODC activity in RI----TPN + DFMO group was unaffected. The plasma albumin level, an indicator of host nutrition, of the RI----TPN + DFMO group was significantly higher than that of the RI group. Liver, spleen, kidney and total body weights of the RI----TPN or RI----TPN + DFMO group were significantly higher than those of the RI group. These results indicate that TPN can enhance tumor growth in malnourished hosts and that the addition of DFMO to TPN can effectively control this TPN-enhanced tumor growth, leading to preferential nutritional repletion of the host.

Influence of total parenteral nutrition on tumor growth and polyamine biosynthesis of fibrosarcoma-bearing rats after induced cachexia

The effect of a protein-free diet (PF) or a restricted intake of chow (RI) and subsequent host repletion with total parenteral nutrition (PF-TPN, RI-TPN) on tumor growth and polyamine metabolism of fibrosarcoma-bearing rats was examined. Host weight was significantly reduced by PF and RI. Tumor growth was reduced in malnourished rats with the PF regimen resulting in the greatest decrease. Rats receiving TPN after 14 days of the RI or PF regimens had higher host weight and plasma albumin levels than malnourished rats. Tumor growth during TPN was evaluated as the percent increase and compared with that of the respective malnourished rats. The percent increase for RI-TPN rats was significantly greater although a trend toward an increase was also evident for PF-TPN rats. Tumor ornithine decarboxylase (ODC) activity and putrescine levels were increased for PF rats and decreased for RI rats while tumor ODC activity was consistently increased by TPN. Tumor growth, ODC activity, and putrescine levels were simultaneously increased only for those rats fed the RI regimen prior to TPN. These results show a disparity in tumor ODC activity, putrescine levels, and tumor growth in malnourished rats. The results of this study suggest that the nutritional origin of cachexia influences the response of the tumor to TPN and emphasizes the importance of considering the methods to induce malnutrition in designing therapuetic regimens.