Characterization of neuronal cell death in normal and diabetic rats following exprimental focal cerebral ischemia

We have studied the forms of cell death following ischemia/reperfusion, and the influence of diabetes mellitus (DM) as an additional factor. Based on the models of diabetes and middle cerebral artery occlusion (MCAO), characteristics of cell death after ischemia/reperfusion were evaluated synthetically by different methods: pathology, FCM, TUNEL and DNA agarose electrophoresis. The results showed that the occurrence of cerebral injury after ischemia/reperfusion was accompanied by cell necrosis and cell apoptosis. Cell apoptosis was mainly located in the ischemic penumbral (IP) zone around the densely ischemic focus. The ischemic core was characterized by cell necrosis. At the same time, the results showed that the process of ischemic cerebral injury worsened by DM was related to inducing cell apoptosis in IP and mid zone. In conclusion, there existed not only cell apoptosis but cell necrosis in brain damage following focal cerebral ischemia/reperfusion and showed a close, internal relationship between them. Brain damage following cerebral ischemia/reperfusion was worsened distinctly under diabetic conditions.

Safety of ozonated solution as an antiseptic of the ocular surface prior to ophthalmic surgery

PURPOSE

To evaluate the safety of an ozonated solution as an antiseptic of the ocular surface prior to ophthalmic surgery.

METHODS

In experiment 1, a primary culture of rabbit corneal epithelium was established. Then, 0, 4 and 10 ppm ozonated solution and 1.25% povidone-iodine, respectively, were applied to confluent cells on collagen-coated filter inserts (Millicell-CM) for 10 min followed by replacement with fresh medium. The transepithelial electrical resistance (TER), which is a good indicator of cell barrier function, was sequentially measured for 30 min. In experiment 2, adult pigmented rabbit eyes were washed with 20 ml of 4 ppm ozonated solution, 1.25% povidone-iodine solution or saline. Slitlamp examinations were performed before and after washing.

RESULTS

In experiment 1, 4 ppm ozonated solution did not change the TER as compared with the control. 10 ppm ozonated solution and 1.25% povidone-iodine similarly reduced the TER values significantly as compared with those of the control and 4 ppm ozonated solution. In experiment 2, 4 ppm ozonated solution and saline showed mild superficial punctate keratitis (SPK) in 8.3% of eyes. However, 1.25% povidone-iodine resulted in mild SPK in 17% of eyes and moderate SPK in 25% of eyes. The prevalence of SPK between two groups was significantly different (p = 0.03).

CONCLUSION

Ozonated solution may be safe and a useful antiseptic of the ocular surface prior to ophthalmic surgery.

[Clinical observation on treatment of non-small cell lung cancer with Chinese herbal medicine combined with bronchial arterial infusion chemotherapy]

OBJECTIVE

To explore the effect of treatment for non-small cell lung cancer (NSCLC) with Chinese herbal medicine (CHM) combined with bronchial arterial infusion chemotherapy (BAIC).

METHODS

Patients with moderate or advanced NSCLC were randomly divided into two groups, the 39 patients in the treated group treated with CHM plus BAIC therapy and 37 in the control group treated with BAIC alone. The short-term therapeutic effect, long-term survival rate, changes of clinical principal symptoms, quality of life and peripheral blood pictures in the two groups were observed and compared.

RESULTS

After treatment the rate of CR + PR + NC in the treated and the control group was 92.31% and 70.27% respectively, the inter-group comparison showed a significant difference (P < 0.05). The 0.5-, 1- and 2-year survival rate in the treated group was 79.49%, 56.41% and 51.28% respectively and in the control group, 72.97%, 51.35% and 24.32% respectively. The 2-year survival rate in the former was better than that in the latter (P < 0.05). Moreover, the improvement of clinical symptoms, Karnofsky scoring, body weight and peripheral blood picture in the treated group was superior to that in the control group.

CONCLUSION

Therapeutic effect of BAIC could be enhanced by combining it with CHM.

Effects of isopropyl unoprostone ophthalmic solution on cultured rabbit corneal epithelial cells

PURPOSE

To investigate the effects of isopropyl unoprostone (referred to as unoprostone) ophthalmic solution on the barrier function of cultured rabbit corneal epithelium grown on permeable supports.

METHODS

Rabbit corneal epithelial cells cultured on collagen-coated filter inserts were administered one of the following for 30 min: unoprostone in vehicle solution (polysorbate 80), unoprostone in vehicle solution with a preservative (benzalkonium chloride), preservative only or vehicle only. For a control, no chemicals were added to the medium. After administration, the transepithelial electrical resistance (TER) measurement, a sensitive method by which to investigate the barrier function, and morphological observation using phase-contrast microscopy were performed before exposure and at 0.5, 1, 3, 6, 12, 24, 48 and 72 h after exposure. The transmission electron-microscopic observation was performed before and 72 h after exposure in all experimental conditions.

RESULTS

The cells exposed to unoprostone with the preservative showed a significant decrease in the TER, although no morphological changes were observed. The corneal epithelial cells exposed to unoprostone without preservative, the vehicle only or the preservative only did not show any differences from the control group at any measurements.

CONCLUSION

The corneal barrier function is damaged by a combined solution of unoprostone and preservative, but not by a single solution of unoprostone, in vitro.

Synthesis and Src kinase inhibitory activity of a series of 4-phenylamino-3-quinolinecarbonitriles

Screening of a directed compound library in a yeast-based assay identified 4-[(2,4-dichlorophenyl)amino]-6,7-dimethoxy-3-quinolinecarbonitrile (2a) as a Src inhibitor. An enzymatic assay established that 2a was an ATP-competitive inhibitor of the kinase activity of Src. We present here SAR data for 2a which shows that the aniline group at C-4, the carbonitrile group at C-3, and the alkoxy groups at C-6 and C-7 of the quinoline are crucial for optimal activity. Increasing the size of the C-2 substituent of the aniline at C-4 of 2a from chloro to bromo to iodo resulted in a corresponding increase in Src inhibition. Furthermore, replacement of the 7-methoxy group of 2a with various 3-heteroalkylaminopropoxy groups provided increased inhibition of both Src enzymatic and cellular activity. Compound 25, which contains a 3-morpholinopropoxy group, had an IC(50) of 3.8 nM in the Src enzymatic assay and an IC(50) of 940 nM for the inhibition of Src-dependent cell proliferation.

Inhibitors of src tyrosine kinase: the preparation and structure-activity relationship of 4-anilino-3-cyanoquinolines and 4-anilinoquinazolines

Src is a nonreceptor tyrosine kinase involved in signaling pathways that control proliferation, migration, and angiogenesis. Increased Src expression and activity are associated with an increase in tumor malignancy and poor prognosis. Several quinolines and quinazolines were identified as potent and selective inhibitors of Src kinase activity.

[Modification of L-asparaginase with colominic acid and the new characteristics of the modified enzyme]

The colominic acid was covalently coupled to L-asparaginase molecule by reductive amination. Depending on the molar ratios of colominic acid-asparaginase (30:1, 50:1 and 100:1), a modified enzyme molecule contained 4.7, 7.2 and 12 colominic acid molecule, they retained 58%, 56% and 33.2% of the initial asparaginase activity, respectively. In comparison with the native enzyme, modified enzyme had lower immunogenicity and antigenicity, longer half-life time (in vitro), more resistance ability to trypsin proteolysis, and similar Km value for L-asparagine.

An agonist anti-human CD40 monoclonal antibody that induces dendritic cell formation and maturation and inhibits proliferation of a myeloma cell line

CD40, a 48-50 KD cell membrane molecule, member of the nerve growth factor receptor and tumor necrosis factor receptor superfamily, is an important costimulatory molecule during the immune response. Anti-CD40 monoclonal antibody (MAb) has been shown earlier to costimulate with IgM or phorbol esters resting B cells to proliferate, differentiate, secrete immunoglobulins, and switch isotype. Here we report on an agonistic mouse anti-human CD40 MAb 5C11. The specificity of this MAb was verified by flow cytometry, Western blotting, and competition with anti-CD40 MAb 89. We studied the effects of MAb 5C11 on a multimyeloma cell line, XG2, that expresses the CD40 antigen strongly and found that this MAb caused the homotypic aggregation of XG2, strongly suppressed XG2 proliferation, and led to its apoptosis after 24 hr of treatment. Interestingly, MAb 5C11 also triggered the generation, proliferation, and maturation of dendritic cells from peripheral blood monocytes, either by itself or in combination with GM-CSF and IL-4.

Three-dimensional arrangement of collagen fibrils in human ciliary body

The purpose of this study is to visualize the three-dimensional arrangement of collagen fibrils in aged human ciliary body and discuss their significance. The ciliary bodies obtained from two human eyes were treated with a NaOH cell-maceration method for 7 days, then prepared conventionally for light and scanning electron microscopy. The general morphology of the collagen tissue in the ciliary body appeared almost the same as that normally observed. Cellular elements were completely removed, but collagen fibrils were well preserved. In the stroma of the ciliary body, collagen fibrils were arranged irregularly. In the areas of the radial and circular ciliary muscles, considerable numbers of collagen fiber bundles were observed running in a circular direction. A honeycomb structure was seen in the pars plana, the walls and base of which were formed by interweaving collagen fibrils. The results suggested that collagen fibrils in the aged human ciliary body may be largely involved in the presbyopia.

Threshold distributions of phenylthiocarbamide (PTC) in the Chinese population

The ability to taste phenylthiocarbamide (PTC) is a well-documented Mendelian trait. Mapping and cloning the gene(s) responsible for the PTC tasting ability would help to delineate the molecular basis for the variations in PTC tasting ability in humans and to shed new light on taste chemosensory functions. In view of the spectacular successes in genome science, the positional cloning strategy seems to be a feasible approach to the isolation of the gene(s) underlying the PTC tasting ability. As a first step toward mapping the gene(s), we collected PTC taste threshold data on 106 individuals, most of them being university students, in Shanghai, China. Using various parametric and nonparametric statistical methods, we have found that the data set is best described by a bimodal distribution. The frequency of PTC nontasters is estimated to be 10%. This is consistent with the view that the PTC nontasting ability follows a recessive mode of inheritance. Several authors had previously reported PTC data on Chinese living outside China. Our data are, to our knowledge, the first ever collected from the Chinese population within China.

Rhs elements comprise three subfamilies which diverged prior to acquisition by Escherichia coli

The Rhs elements are complex genetic composites widely spread among Escherichia coli isolates. One of their components, a 3.7-kb, GC-rich core, maintains a single open reading frame that extends the full length of the core and then 400 to 600 bp beyond into an AT-rich region. Whereas Rhs cores are homologous, core extensions from different elements are dissimilar. Two new Rhs elements from strains of the ECOR reference collection have been characterized. RhsG (from strain ECOR-11) maps to min 5.3, and RhsH (from strain ECOR-45) maps to min 32.8, where it lies in tandem with RhsE. Comparison of strain K-12 to ECOR-11 indicates that RhsG was once present in but has been largely deleted from an ancestor of K-12. Phylogenetic analysis shows that the cores from eight known elements fall into three subfamilies, RhsA-B-C-F, RhsD-E, and RhsG-H. Cores from different subfamilies diverge 22 to 29%. Analysis of substitutions that distinguish between subfamilies shows that the origin of the ancestral core as well as the process of subfamily separation occurred in a GC-rich background. Furthermore, each subfamily independently passed from the GC-rich background to a less GC-rich background such as E. coli. A new example of core-extension shuffling provides the first example of exchange between cores of different subfamilies. A novel component of RhsE and RhsG, vgr, encodes a large protein distinguished by 18 to 19 repetitions of a Val-Gly dipeptide occurring with a eight-residue periodicity.

Escherichia coli strains with nonimmune immunoglobulin-binding activity

We have identified several strains of Escherichia coli which contain immunoglobulin-binding activity on the cell surface. Affinity-purified antibodies ordinarily used as secondary antibodies in immunodetection protocols were bound by 6 of 72 strains of the ECOR reference collection of E. coli. The Fc fragments of both human and sheep immunoglobulin G (IgG) were also bound, demonstrating the nonimmune nature of the phenomenon. Binding of conjugated IgG Fc directly to unfixed cells was observed by fluorescence microscopy. Western blots showed that the immunoglobulin-binding material occurs in the form of multiple bands, with the apparent molecular masses of the most prominent bands exceeding 100 kDa. No two of the strains have the same pattern of bands. The binding activity in extracts was sensitive to proteinase K. The binding activity of intact cells was reduced preferentially by trypsin digestion, demonstrating exposure at the cell surface. Expression of binding activity in Luria-Bertani broth cultures was favored by a temperature of 37 degrees C and entry into stationary phase of growth.

Mapping of a cytoplasmic domain of the human growth hormone receptor that regulates rates of inactivation of Jak2 and Stat proteins

It has been previously demonstrated that growth hormone (GH)-stimulated tyrosine phosphorylation of Jak2 and Stat5a and Stat5b occurs in FDP-C1 cells expressing either the entire GH receptor or truncations of the cytoplasmic domain expressing only the membrane-proximal 80 amino acids. However, other receptor domains that might modulate rates of GH activation and inactivation of this cascade have not been examined. Here we have defined a region in the human GH receptor between amino acids 520 and 540 in the cytoplasmic domain that is required for attenuation of GH-activated Jak/Stat signaling. Immunoprecipitations with antibodies to Jak2 indicate that the protein tyrosine phosphatase SHP-1 is associated with this kinase in cells exposed to GH. To address the possibility that SHP-1 could function as a negative regulator of GH signaling, liver extracts from motheaten mice deficient in SHP-1 or unaffected littermates were analyzed for activation of Stats and Jak2. Extracts from motheaten mice displayed prolonged activation of the Stat proteins as measured by their ability to interact with DNA and prolonged tyrosine phosphorylation of Jak2. These results delineate a novel domain in the GH receptor that regulates the inactivation of the Jak/Stat pathway and appears to be modulated by SHP-1.

Factors that influence the operative mortality after blunt hepatic injuries

OBJECTIVE

To analyse causes of death and possible factors that influenced the operative mortality in patients with blunt hepatic injuries.

DESIGN

Retrospective case study.

SETTING

Medical center, Taiwan.

PATIENTS

109 adult patients with blunt hepatic injuries were treated surgically over the four year period from September 1987 to August 1991.

MAIN OUTCOME MEASURE

Mortality.

RESULTS

36 patients (33%) had hepatorrhaphy or no repair, complex repairs were done for 73 patients (67%) and the overall mortality was 22% (24/109). Of those deaths, however, 4 were not liver-related, giving us a liver-related mortality of 19% (20/105). Fourteen of the liver-related deaths occurred within 24 hours of injury of hemorrhagic shock or coagulopathy. Six occurred after 24 hours of sepsis and multiple system organ failure. Multivariate analysis showed that higher initial aspartate aminotransferase (AST) and Injury Severity Score as well as increasing operative blood loss resulted in a worsening prognosis.

CONCLUSION

The initial AST activity and Injury Severity Score as well as the total operative blood loss were the significant factors that influenced the operative mortality after blunt hepatic injuries in our study. Prompt, expeditious, and appropriate surgical management to control operative loss is the only way for the surgeon to reduce the mortality of blunt hepatic injuries.

Mapping of the cytoplasmic domain of the human growth hormone receptor required for the activation of Jak2 and Stat proteins

Incubation of cells with growth hormone (GH) stimulates both tyrosine phosphorylation of the Jak2 tyrosine kinase and, in some cells, the transcription factor Stat1 alpha (1-4). When the promyeloid cell line FDC-P1 is transfected with the human growth hormone receptor, these cells can grow in the presence of GH and in the absence of interleukin-3. Growth hormone treatment of cells expressing the human growth hormone receptor did not activate Stat1 alpha. However, a complex is present in extracts prepared from growth hormone-treated cells that binds to the gamma response region, an enhancer present in the promoter of the high affinity Fc gamma R1 receptor to which cytokine-activated Stat complexes bind. When truncations of the cytoplasmic domain of the receptor are expressed in FDC-P1 cells only the membrane-proximal 80 amino acids (containing box 1 and box 2) are required for activation of both a GH-stimulated binding activity (GHSF) and tyrosine phosphorylation of Jak2. Activation of GHSF can be inhibited in a cell-free system by the addition of a glutathione S-transferase fusion protein containing these 80 amino acids. Replacement of the one tyrosine in this region of the receptor with a phenylalanine does not alter the activation of either GHSF or Jak2, suggesting that tyrosine phosphorylation of the receptor is not required for GH activation of GHSF. Moreover, a cell line expressing a receptor with only the 54 membrane-proximal amino acids of the intracellular domain (including box 1) shows constitutively tyrosine-phosphorylated Jak2 as well as GHSF binding. With this truncated receptor, there is little if any additional GH-induced tyrosine phosphorylation of Jak2 or induced binding to the gamma response region. These results define the importance of the membrane-proximal 80 amino acids of the GH receptor (with the conserved box 1 and box 2 domains) with regard to GH activation of both Jak2 and Stat(s). They also suggest that within these domains there may be positive and negative elements that regulate Jak2 function.

Intracellular tyrosine residues of the human growth hormone receptor are not required for the signaling of proliferation or Jak-STAT activation

Ligand binding and dimerization of the growth hormone (GH) receptor leads to the rapid tyrosine phosphorylation of the intracellular kinase, Jak2, to the tyrosine phosphorylation and activation of STAT protein(s) and to the tyrosine phosphorylation of the receptor itself. Expression of the human GH receptor in the mouse promyeloid, interleukin-3-dependent cell line, FDC-P1, shows that this receptor can signal ligand-dependent proliferation in these cells as well as induce the tyrosine phosphorylation of Jak2 and the activation of transcription factors. We now examine the requirement for tyrosine phosphorylation of the GH receptor for these three events by expression of a receptor without tyrosine residues in the intracellular domain. Six of the seven intracellular tyrosine residues were removed by a carboxyl-terminal truncation, and the remaining tyrosine was changed to phenylalanine to yield the GH receptor D351Stop/Y314F. When expressed in FDC-P1 cells, this receptor retained its ability to induce the tyrosine phosphorylation of Jak2, to induce the activation of transcription factors, and to signal ligand-dependent cell proliferation. Thus, tyrosine phosphorylation of the GH receptor is not essential for the signaling of these three events at least in this system. This finding contrasts with that for the interferon-gamma receptor system where data indicate that the specific tyrosine phosphorylation of the interferon-gamma receptor leads to an association with the STAT protein, p91, that is the mechanism by which ligand couples the receptor to the signal transduction system.

Amino acids of the human growth hormone receptor that are required for proliferation and Jak-STAT signaling

Dimerization of the GH receptor after ligand binding leads to the rapid association and tyrosine phosphorylation of the intracellular kinase, Jak2, as well as to the tyrosine phosphorylation and activation of STAT protein(s). The tyrosine phosphorylation of these and other related proteins has been shown to be required for intracellular signaling by the interferon receptors. Carboxyl-terminal truncations of the human GH receptor have been used to demonstrate that a 54-amino acid, intracellular region of the receptor is sufficient to signal cell proliferation in response to ligand binding. In this work, we examine 10 single and double amino acid mutations of this 54-amino acid region for their ability to signal the proliferation of stably transfected Ba/F3 cells, an interleukin-3 dependent pro-B cell line. The mutation of either of two proline residues or of a lysine residue abolished the GH-induced proliferation. These amino acids are located in or adjacent to a proline-rich sequence known as box 1 that is weakly conserved in other receptors of the GH/cytokine receptor family. The tyrosine phosphorylation of Jak2, as well as the activation of transcription factors (as judged by electrophoretic mobility shift assays), was also induced by GH in the transfected Ba/F3 cells. A consistent pattern of proliferation, Jak2 phosphorylation, and transcription factor activation was found for the 10 GH receptor mutants, a finding that is consistent with the hypothesis that the Jak-STAT pathway is required for the signaling of proliferation in these cells.

Inhibition of crevicular fluid neutrophil elastase by alpha 1-antitrypsin in periodontal health and disease

Gingival crevicular fluid (GCF) was collected from two healthy, two gingivitis and two periodontitis sites of two groups of individuals presenting for treatment of chronic adult periodontitis (group 1, 25 subjects; group 2, seven subjects) and from distal approximal sites of two incisors and one molar of 10 subjects with periodontal health. GCF eluates of periodontitis group 1 and controls, prepared by a technique that lysed polymorphonuclear leucocytes (PMN) in the samples, were assayed for functional neutrophil elastase (NE) and immunoreactive alpha 1-antitrypsin (alpha 1-AT) and alpha 1-antitrypsin-neutrophil elastase complex (alpha 1-AT-NE). Periodontitis group 2 GCF eluates, generated by a method that did not disrupt PMNs, were assayed for functional NE in the presence and absence of a specific NE inhibitor. A greater amount of NE (ng/5-s sample) was found in eluates of GCF from diseased sites irrespective of whether or not the eluates contained products of lysed PMNs. However, the GCF eluates prepared without disrupting PMNs contained only about one-tenth as much NE as eluates of corresponding sites that included constituents of lysed PMNs. The amount of alpha-AT in GCF was insufficient to inactivate most of the NE available for release into the gingival sulcus at either healthy or diseased sites. In addition, much of the alpha 1-AT in GCF was not complexed with NE under conditions of excess NE. More than 90% of the NE in GCF from each site category was inactivated by the NE specific inhibitor. It is concluded, because of the large quantity of NE available in PMNs compared to the amount of NE inhibitors in GCF, that at least locally transient free NE occurs, which contributes to tissue destruction in chronic adult periodontitis.

Xenopus muscle acetylcholine receptor alpha subunits bind ligands with different affinities

The acetylcholine receptor (AChR) from vertebrate skeletal muscle is a pentameric complex composed of two identical alpha (the ligand-binding subunit) and one each of beta, gamma, and delta subunits. All muscle-like alpha subunits appear to be encoded by a single gene except for Xenopus where two genes have been identified (X alpha 1a and X alpha 1b). By establishing stable cell lines expressing each Xenopus alpha subunit plus Torpedo beta gamma delta (XaT and XbT), we were able to investigate immunological and ligand-binding properties of these two Xenopus subunits. We determined that each subunit was capable of proper assembly with beta gamma delta subunits, each hybrid AChR cell line responded to bath-applied acetylcholine as determined by 22Na+ influx, but the two hybrid AChRs had distinct ligand-binding properties. The most striking difference between the two hybrids was observed with alpha-bungarotoxin (BuTx) binding. The KD for BuTx binding to XbT hybrids was virtually identical to that of Torpedo and most other muscle AChRs, approximately 10(-10)-10(-11) M. The KD for BuTx binding to XaT hybrids, however, was approximately 1000-fold weaker (6 x 10(-8) M). This weak binding was due primarily to a very rapid BuTx off-rate (4.4 x 10(-2) s-1 for XaT AChRs compared with approximately 1.6 x 10(-5) s-1 for all-Torpedo and XbT AChRs).

[Quality of rhizoma Anemarrhenae grown for different periods of time and gathered in different seasons]

The experimental results have shown that except the stem and leaves all kinds of Rhizoma Anemarrhenae and all parts of the herb contain sarsasapogenin, but the contents are different. Furthermore, the root and peel of Rhizoma Anemarrhenae may be used as drug instead of Rhizoma Anemarrhenae.

[Quality standards for qingwei huanglian pills]

In the paper systematic studies on quality standards for Qingwei Huanglian Pills are reported, along with the TLC identification of Gardenia jasminoides, Scutellaria baicalensis and Anemarrhena asphodeloides and the quantitative determination of berberine in Coptis chinensis and Phellodendron chinese by TLC densitometric method. To simplify the operation, the same solvent was used for both the identification and determination. The quantitative method is simple, sensitive, reproducible and accurate. The recovery of berberine is 99.48%. The coefficient of variation is 1.42%.

DCCD binds to cytochrome b6 of a cytochrome bf complex isolated from spinach chloroplasts and inhibits proton translocation

Radiolabeled N,N'-dicyclohexylcarbodiimide (DCCD) was bound selectively in a time- and concentration-dependent manner to cytochrome b6 of an enzymatically active cytochrome bf complex isolated from spinach chloroplasts. Maximum labeling of cytochrome b6 was observed with 30 nmol DCCD per nmol cytochrome b6 in the cytochrome bf complex incubated for 30-60 min at 12 degrees C. After incubation of the cytochrome bf complex with DCCD under these conditions, the rate of proton ejection in the complex reconstituted into liposomes was decreased approximately 65-70% when compared to controls; however, under these same conditions the rate of electron transfer through either the soluble bf complex or the complex reconstituted into liposomes was only decreased around 20%. These results suggest that the mechanism of proton translocation through the cytochrome bf complex of spinach chloroplasts is similar to that of the cytochrome bc1 complex from yeast mitochondria in which proton pumping but not electron transfer is also inhibited by DCCD (D. S. Beattie and A. Villalobo, 1982, J. Biol. Chem. 257, 14,745-14,752).

[Thyroid carcinoma with hyperthyroidism as the major clinical manifestations]

Twenty-two patients (17%) with thyroid cancer evidenced by major clinical features of hyperthyroidism were encountered out of 129 patients with thyroid cancer operated on. Clinical complains consisted of palpitation, dyspnea, nervousness, increased appetite, and weight loss. Preoperative BMR of 12 patients ranged from +17% to +41%, averaging +31.4%. Definite diagnosis was made by preoperative biopsy in two patients, the remainder was misdiagnosed as having primary hyperthyroidism (12), nodular goiter (6), and adenoma (2). The causes of misdiagnosis, coexistence of thyroid cancer and hyperthyroidism, and prognosis were discussed. we conclude that fine needle biopsy is the most effective way to establish correct preoperative diagnosis.

[An experimental study of chemical debridement of full-thickness burn in rabbits by N-acetylcysteine]

N-acetylcysteine, a mucolytic expectorant, was used for debridement of a full-thickness burn in rabbits. The drug was applied 24h postburn and repeated once a day. Debridement was completed in an average of 2.25 days with bloodless separation of any remaining eschar from the underlying healthy deep fascia layer by blunt dissection with a forceps. In the wounds treated with 25% N-acetylcysteine(pH 2.5), debridement was faster than those treated with glacial acetic acid mixture at the same pH. The debriding action of the drug is probably depolymerization of heat-denatured extracellular proteins (mainly denatured collagen and proteoglycans), disrupting specific linkage and lowering the molecular weight of eschar molecules. Acidity of the drug also promotes debriding process.

A survey of the initial referral of children to an ophthalmology department

We report on a survey of the referral of 525 children making their first visit to an ophthalmology department. Information was gathered by interviewing the parents and reviewing the case notes. Parents and relatives initiated the referrals in 223 cases (42%) and health visitors initiated a further 123 cases (23%). General practitioners were rarely the first to notice a condition, though they played a major part in the subsequent referral process. Of 556 reasons for referral squint was the most important (319 cases, 57%), followed by poor vision (106 cases, 19%). There were 44 confirmed cases of amblyopia, of which 15 (34%) were not detected until the child was aged 5 years or over. The overall accuracy of referral was 66% (367 reasons for referral confirmed). In 109 cases (21%) the child was found to be normal. Parents and relatives first noticed 54% of cases of confirmed squint but only 15% of the cases of poor vision. Health professionals, especially health visitors, were of great importance in first detecting poor vision.

Results of surgical treatment in 6,123 cases of carcinoma of the esophagus and gastric cardia

Six thousand one hundred twenty-three cases of carcinoma of the esophagus and gastric cardia were treated surgically from 1965 to 1985. Overall resectability was 89.9%. Postoperative mortality was 3%, and incidence of postoperative complication, 10.3%. Follow-up rate was 91.3%, with 5 year survival of 36.8% (esophageal nearly twice that of gastric cardia), and 10 year survival of 17.2%. Factors affecting long-term survival were clinicopathologic staging and preoperative irradiation. Early discovery and timely treatment are the key to high resectability and improved long-term survival. More efficacious combined therapies are needed for the predominant late cases. We propose more radical resection because of the multifocal tendency of esophageal and extensive submucosal infiltration of cardia carcinoma. Continuing refinements of surgical technique helped to reduce postoperative leakage and structure.

Cellular responses to Pyrularia thionin are mediated by Ca2+ influx and phospholipase A2 activation and are inhibited by thionin tyrosine iodination

Pyrularia thionin, isolated from nuts of Pyrularia pubera, is a strongly basic peptide of 47 amino acids. The amino acid sequence and configuration of its four disulfide bonds place this plant peptide, known to be hemolytic, cytotoxic, and neurotoxic, among the thionins. We report and compare several cellular responses mediated by Pyrularia thionin: hemolysis of human erythrocytes, activation of an endogenous phospholipase A2 in Swiss 3T3 cells, cytotoxicity toward HeLa and mouse B16 melanoma cells in culture, viability of rat hepatocytes and lymphocytes measured by trypan blue exclusion, and lethality in mice. Cellular responses related to ion movement include a toxin-mediated influx of Ca2+ into mouse P388 cells measured by Fura-2 fluorescence, depolarization of mouse P388 plasma membrane measured by fluorescence of bis(1,3-diethylthiobarbituric acid)trimethine oxonol (bisoxonol), and depolarization of frog (Rana pipiens) sartorius muscle determined by direct measurement of membrane potential. Graded iodination of Pyrularia thionin leads to a related loss of activity for hemolysis, phospholipase A2 activation, cytotoxicity, and lethality in mice. The mediated Ca2+ influx into and depolarization of P388 cells require Ca2+ in the external medium and are inhibited by 100 microM Ni2+. Depolarization of sartorius muscle by Pyrularia thionin also requires a functional Ca2+ channel, as shown by verapamil inhibition. This muscle depolarization also involves phospholipase A2 activation because dexamethasone and quinacrin, but not indomethacin, protect against depolarization. The IC50 values for viability of rat hepatocytes and splenic lymphocytes measured by trypan blue exclusion were 0.17 and 40 microM, respectively. The general response of cells to Pyrularia thionin involves a membrane alteration leading to depolarization and a channel-mediated influx of Ca2+. There is a related activation of phospholipase A2 that results in loss of membrane integrity, hemolysis in the case of erythrocytes, and eventually cell death. Iodination of Pyrularia thionin leads to a corresponding inhibition of all three cellular responses, which indicates an essential role for tyrosine in either maintenance of peptide structure or interaction of the peptide with cellular membranes.