Acute Myeloblastic Leukemia: Management with High-Dose Cytosine Arabinoside, Daunorubicin and Marrow Transplantation; Malignancy; Current Clinical Practice

Combination high-dose cytosine arabinoside (ARA-C) and daunorubicin (DNR) for primary remission induction of patients with acute myeloblastic leukemia (AML) was evaluated in a single institution study. Patients aged 55 or less with an HLA-sibling received an allogeneic bone marrow transplant (alloBMT) in first remission; other responders were offered autologous BMT (autoBMT). For remission induction 93 patients aged less than 60 received DNR 45 mg/m(2) BSA x 3 and ARA-C 2 gm/m(2) BSA every 12 hours for 12 doses; 53 aged 60 or older DNR 25 mg/m(2) daily x 3 and ARA-C 1.5-2.0 gm/m(2) BSA every 12 hours for 12 doses. Consolidation doses of DNR were the same but ARA-C 100 mg/m(2) BSA/day x 5 was given by continuous intravenous infusion. The complete remission rate for patients less than 60 years was 69.9% (95% CI: 59.5-79.0%) and 47.2% (95% CI: 33.3-61.4%) for the older patients. The median duration of first remission for the younger patients was 13.0 months and of overall survival 17.9 months; for patients over 60 years 5.6 and 10.0 months respectively. Disease-free survival and overall survival of the 19 patients receiving alloBMT and the 13 patients undergoing autoBMT aged less than 55 years and in first or second complete remission were significantly increased compared with 22 patients in remission but not having BMT (p < 0.001 and p < 0.013). The results support the effectiveness of high-dose ARA-C for remission induction, a need for intensive consolidation therapy and a role for BMT in the management of AML.

Effects of recombinant human growth hormone (r-hGH) on experimental osteoporotic fracture healing

OBJECTIVE

To observe the effect of recombinant human growth hormone (r-hGH) on osteoporotic fracture healing in rats, and to provide an effective therapy for osteoporotic fracture.

METHODS

Thirty-six female 8-month-old SD rats were randomized into two groups: therapy group and control group. After the experimental model of osteoporotic fracture was established, the therapy group was treated with r-hGH of 2.7 mg/kg body weigh/day (1 mg=3 IU) for 10 days continuously by daily subcutaneous injection; whereas the control group was treated with equivalent saline. Plasma insulin-like growth factor I concentration was detected and bone mineral density (BMD) as well as biomechanical strength of callus were measured at 2, 4, 8 weeks.

RESULTS

Plasma insulin-like growth factor I concentration in the therapy group was higher than that in the control group (P<0.005) at 2nd week and began to decline at 4th week. At 8th week, there was no significant difference between the two groups. At 4th week, callus area and BMD in therapy group were higher than those in the control group, but at 8th week, they were lower and BMD had a significant difference between the two groups (P<0.001). Biomechanical testing of callus showed that torsional strength of the therapy group was higher than that of the control group at 4th or 8th week, meanwhile maximum torsional angle had a significant difference between the two groups (P<0.005).

CONCLUSIONS

The results show that exogenous r-hGH can stimulate osteoporotic fracture healing in rats.

[Effects of baicalin on hepatocyte apoptosis induced by TNF-alpha and act D in rats]

OBJECTIVE

To study the effects of baicalin on rat hepatocyte apoptosis induced by tumor necrosis factora (TNF-alpha) and actinomycin D (Act D) in vitro.

METHODS

Hepatocytes were cultured with different concentrations of baicalin and the cell apoptosis was induced by TNF-alpha and Act D in vitro. After culturing for 24 h, the activity of hepatocysts was examined by MTT assay and the function of hepatocytes for secreting albumin was detected by bromocresolum Viride method. Agarose gelelectrophoresis and flow cytometric analysis were used to determine the apoptotic cells.

RESULTS

The actively of the hepatocyte (A) and content of albumin (ALB) in the supernatant of cultured cells in the groups of 0.2 microgram.ml-1 and 2.0 micrograms.ml-1 of baicaline were significantly higher than those in apoptotic model group (A: P < 0.01; ALB: P < 0.01); respectively Even the ALB value in the group of 0.2 microgram.ml-1 baicalin was higher that of black control group (P < 0.01); The clear "ladder-like" streak-band of DNA fragments was found only in the apoptosis model group by the agarose gel electrophoresis. The flow cytometry showed that all the apoptosis rates in the three baicalin groups were lower than that of the apoptotic model group (P < 0.01).

CONCLUSION

Baicaline can restrain rat hepatocyte apoptosis induced by TNF-alpha and ActD in vitro.

Establishment of in vitro cellular model predicting histocompatibility in allograft

A novel in vitro cellular model producting recipient-donor histocompatibility in allograft was developed to select the donor validity. Fifteen couples of blood samples of donor and recipient in human BMT were examined using the model, and skin allograft in mice was performed to test the model. The results showed that the less the differences of histocompatibility evaluated by the model were, the later GVHR in human BMT occurred and the longer the survival time of skin allografts in mice. It was suggested that the model could be used to predict correctly histocompatibility between donor and recipient.

Early loss of synaptic protein PSD-95 from rod terminals of rhodopsin P347L transgenic porcine retina

Retinitis pigmentosa (RP), a type of retinal degeneration involving first rod and then slow cone photoreceptor degeneration, can be caused by any of a number of mutations in different genes. In the cases of mutations affecting rod-specific genes such as rhodopsin, it is unclear how the mutations may cause degeneration of cones. We have used the porcine retina, which is rod-dominated and has an abundance of cones, to study the mutation-induced changes in both rod and cone photoreceptors. Like patients with the same mutation, rhodopsin P347L transgenic swine manifest rod-cone degeneration. In addition, the rod bipolar cells fail to form synaptic connections with rods; instead, they form ectopic synapses with cones. The mechanisms that prevent the formation of the rod-rod bipolar cell synaptic connection are not known. We used specific antibodies and immunocytochemistry to show that the synaptic protein, PSD-95, is present in both normal and transgenic porcine retinas. During neonatal development, however, PSD-95 is lost from rod terminals in the transgenic swine. This loss is virtually complete (90%) by postnatal day 5, at a time when greater than 80% of rod cell bodies still remain. Furthermore, the remaining rods retain their outer segments and their gross morphology appears relatively normal. In contrast, PSD-95 expression continues in cone terminals, even in 10-month-old transgenic swine, where the rods have all disappeared and the cones show signs of severe degeneration. These results suggest that loss of PSD-95 may not be a general consequence of the deteriorating cell. Rather, the very early and selective loss of PSD-95 from the rod terminals may be causally related to the absence of rod-rod bipolar cell synapses in the rhodopsin P347L transgenic retina.

Ectopic synaptogenesis in the mammalian retina caused by rod photoreceptor-specific mutations

In addition to rod photoreceptor loss, many mutations in rod photoreceptor-specific genes cause degeneration of other neuronal types. Identifying mechanisms of cell-cell interactions initiated by rod-specific mutations and affecting other retinal cells is important for understanding the pathogenesis and progression of retinal degeneration. Here we show in animals with rod and cone degeneration due to mutations in the genes encoding rhodopsin and cGMP phosphodiesterase beta-subunit (PDE-beta) respectively, that rod bipolar cells received ectopic synapses from cones in the absence of rods. Thus, synaptic plasticity links certain rod-specific mutations to retina-wide structural alterations that involve different types of neurons.

Serotonin released from intestinal enterochromaffin cells mediates luminal non-cholecystokinin-stimulated pancreatic secretion in rats

BACKGROUND & AIMS

Similar to cholecystokinin (CCK), non-CCK-dependent duodenal factors stimulate vagal mucosal afferent fibers to mediate pancreatic enzyme secretion via a common cholinergic pathway. We tested the hypothesis that 5-hydroxytryptamine (5-HT) released from enterochromaffin (EC) cells plays an important role in the transduction of luminal information to the central nervous system via vagal afferent fibers to mediate pancreatic secretion.

METHODS

Pancreatic secretions were examined in conscious rats after intragastric administration of chopped rodent chow in the presence and absence of CCK or 5-HT(3) and 5-HT(2) antagonists. Pancreatic responses to intraduodenal administration of maltose, hyperosmolar NaCl, and light mucosal stroking were examined in rats pretreated with various pharmacological antagonists or after surgical or chemical ablation of vagal and 5-HT neural pathways.

RESULTS

Administration of L364, 718 inhibited 54% of pancreatic protein secretion evoked by intragastric administration of rodent chow. L364,714 and ICS 205-930, a 5-HT(3) antagonist, combined produced a 94% inhibition. Vagal afferent rootlet section eliminated pancreatic secretions evoked by intraduodenal stimuli. p-Chlorophenylalanine, a 5-HT synthesis inhibitor, but not 5,7-hydroxytryptamine, a 5-HT neurotoxin, also eliminated the pancreatic response to these luminal stimuli. The 5-HT(3) antagonist markedly inhibited pancreatic secretion induced by maltose and hyperosmolar NaCl. 5-HT(2) and 5-HT(3) antagonists combined inhibited the pancreatic response to light stroking of the mucosa.

CONCLUSIONS

Luminal factors such as osmolality, disaccharides, and mechanical stimulation stimulated pancreatic secretion via intestinal vagal mucosal afferent fibers. It is likely that 5-HT originating from intestinal EC cells activated 5-HT(3) and 5-HT(2) receptors on vagal afferent fibers to mediate luminal factor-stimulated pancreatic secretion.

The effect of the prostaglandin I2 analogue OP-2507 on adrenaline-induced pulmonary edema in rabbits and analysis of hemodynamic changes

This study was carried out to understand the onset mechanism of adrenaline (ADR)-induced pulmonary edema (PE) and the effect of drugs related to the arachidonate cascade in a rabbit model. ADR was administered intravenously by a bolus injection to the rabbits at 50, 75 and 100 microg/kg. To evaluate the severity of PE, the lung-water ratio (LWR) was calculated as a ratio of the difference between wet and dry lung weight to dry lung weight. The PE incidence and LWR exhibited a dose-dependent increase, and LWR correlated with the left atrial pressure (LAP). The involvement of the arachidonate cascade was evaluated by the co-administration of flurbiprofen, a cyclooxygenase inhibitor; ozagrel, a thromboxane synthase inhibitor; and OP-2507 (15-cis-(4-n-propylcyclohexyl)-6,17,18, 19,20-pentanor-9-deoxy-6,9-alpha-nitriloprostaglandin F1 methyl ester), a prostaglandin I2 analogue. Co-treatment of the rabbits with ADR and flurbiprofen resulted in an increase in LAP and the incidence of PE, whereas co-administration of ozagrel did not exhibit any significant changes in the measured parameters. Conversely, OP-2507 reduced the LAP, PE incidence and LWR when co-administered with ADR. Rabbits co-treated with OP-2507 displayed an improved cardiac function. The results of these studies demonstrated the effectiveness of OP-2507 in protecting the lung and cardiac function from the ADR-induced PE.

BAG-1 promotes apoptosis induced by N-(4-hydroxyphenyl)retinamide in human cervical carcinoma cells

N-(4-hydroxyphenyl)retinamide (4-HPR) is a synthetic apoptosis-inducing retinoid with cancer chemopreventive properties and lower toxicity than all-trans retinoic acid. BAG-1 is an antiapoptotic gene that is overexpressed in cervical and other cancers. In this study, we examined whether BAG-1 can inhibit 4-HPR-induced apoptosis in the C33A cervical carcinoma cell line. Surprisingly, although it inhibited apoptosis induced by five different apoptotic stimuli, overexpression of BAG-1 enhanced apoptosis induced by 4-HPR, producing a 2.5-fold lower IC(50) of 4-HPR. The effects of BAG-1 on 4-HPR-induced apoptosis were mediated by enhancing the caspase-3 activation pathway. Deletion mutation experiments showed that the central ubiquitin homology domain of BAG-1 protein was necessary for its promotion of 4-HPR-induced apoptosis, whereas its C-terminal Hsp70/Hsc70-interacting domain was required for its inhibition of staurosporine-induced apoptosis. These in vitro results suggest that the effectiveness of 4-HPR against the development of malignancy may be due to the overexpression of BAG-1 in cancer cells.

Identification of antiangiogenic and antiinflammatory proteins in human amniotic membrane

PURPOSE

To identify the potential antiangiogenic and antiinflammatory proteins expressed in human amniotic membrane tissue.

METHODS

Human amniotic epithelial and mesenchymal cells were isolated from human amniotic membranes by sequential trypsin and collagenase digestion. Total RNAs were harvested from freshly obtained human amniotic epithelial and mesenchymal cells. Antiangiogenic and antiinflammatory proteins were detected by the reverse transcriptase-polymerase chain reaction (RT-PCR) technique and further confirmed by DNA sequencing of PCR-amplified transcripts. The distribution of tissue inhibitors of metalloproteinase (TIMPs) were studied further by immunohistochemistry performed on paraffin-embedded amniotic membrane tissue.

RESULTS

RT-PCR results showed that both human amniotic epithelial and mesenchymal cells express interleukin-1 receptor antagonist, all four TIMPs, collagen XVIII, and interleukin-10. Thrombospondin-1 was expressed in all of the epithelial cell specimens and in one out of five mesenchymal cell specimens. Furthermore, immunohistochemistry studies performed on freshly prepared amniotic membrane confirmed that all members of the TIMP family were present in epithelial and mesenchymal cells as well as in the compact layer of the amniotic stroma. In cryopreserved amniotic membranes, positive staining was seen in residual amniotic cells and stroma.

CONCLUSIONS

Human amniotic membrane epithelial and mesenchymal cells express various antiangiogenic and antiinflammatory proteins. Some of those proteins also were found in amniotic membrane stroma. These findings may explain in part the antiangiogenic and antiinflammatory effects of amniotic membrane transplantation.

[Study on human leukemia cell apoptosis inducing effect of fraction C of Naja naja Actra Venom]

OBJECTIVE

To study the effect and mechanism of fraction C isolated from Naja naja Actra Venom (FCNNAV) in inducing apoptosis of human leukemia cells.

METHODS

Light microscope, transmission electron microscope, DNA electrophoresis, flow cytometry and RT-PCR assay were used to observe the changes of human leukemia cells in morphology and biochemistry, and Bcl-2/Bax expression after exposing to FCNNAV.

RESULTS

FCNNAV could induce HL60 cells apoptosis demonstrated by the typical morphological and biochemical changes. Flow cytometry showed that J6-1, K562, HL60 and fresh leukemia cells apoptosis could be induced by FCNNAV, and the apoptosis rate was dose-dependent. RT-PCR detection showed the Bcl-2 gene expression of HL60 cells was down-regulated by FCNNAV, whereas the Bax expression was unaffected.

CONCLUSION

FCNNAV could induce apoptosis of human leukemia cells and this effect is related to down-regulation of Bcl-2 gene expression level.

[Study on clinical and laboratory features of preleukemia patients]

OBJECTIVE

To explore prospective diagnostic criteria for preleukemia.

METHODS

A case control study of the discrepancies of clinical and laboratory features between patients with preleukemia and those with chronic aplastic anemia (CAA) or atypical paroxysmal nocturnal hemoglubinuria (a-PNH).

RESULTS

There were eight variables of significance: (1) lymphocytoid micromegakaryocytes in marrow; (2) immature granulocytes in peripheral blood; (3) >or= 2% myeloblasts in marrow; (4) positive periodic acid schiff (PAS) staining of nucleated erythrocytes; (5) myeloid differentiation index >or= 1.8; (6) clonal karyotypic abnormalities; (7) negative sister chromatid differentiation; (8) > 4.0 cluster/colony ratio of granulocyte-macrophage colony-forming units (CFU-GM). The following criteria was assigned: A: To meet (1) and at least two of the other seven variables; B: To meet at least four of the eight variables. All of the patients with preleukemia met A or B and none of the patients with CAA or a-PNH did.

CONCLUSION

Preleukemia is different from CAA or a-PNH. It has its own clinical and laboratory features, which may be useful for prospective diagnosis.

[Study of the expression and function of c-kit receptor on the bone marrow mononuclear cells of the patients with myelodysplastic syndromes]

OBJECTIVE

To determine the expression and function of c-kit receptor on bone marrow mononuclear cells (BMMNC) of the patients with myelodysplastic syndromes.

METHODS

c-kit protein (CD(117)) was detected by direct immunofluorescence assay, c-kit mRNA by reverse transcriptive polymerase chain reaction (RT-PCR) and the function of c-kit receptor by cell culture.

RESULTS

c-kit protein expression in MDS was significantly higher than that in control [(8.58 +/- 5.28)% vs (3.04 +/- 1.49)%, P < 0.05]. c-kit protein expression in RA patients was significantly lower than that in RAEB/RAEB-t patients [(5.12 +/- 2.13)% vs (10.01 +/- 5.07)%, P < 0.05]. The rate of c-kit protein expression was (32.43 +/- 18.16)% in AML cases transformed from MDS (t-AML). c-kit mRNA expression in MDS was correlated with c-kit protein expression. Addition of interleukin-3 (IL-3), erythropoietin (Epo) and stem cell factor (SCF) to the semi-solid culture of BMMNC showed significant stimulating effects on CFU-GM and BFU-E formation in normal controls, but did not in MDS patients.

CONCLUSION

The protein and mRNA expressions of c-kit receptor on BMMNC in MDS are higher than those in normal control, and the function of this receptor in MDS is abnormal.

[Establishment and identification of B cell lines with PNH phenotype]

OBJECTIVE

To establish B cell lines from patients with paroxysmal nocturnal haemoglobinuria (PNH) and normal controls.

METHODS

B lymphoid cells prepared from PNH patients and normal controls were infected with EB virus. Phenotype of the immortal cells was analyzed by flow cytometry. The immunomagnetic beads were used to select CD(55)(-) and CD(59)(-) B lymphoid cells, which were cloned by limiting dilution. The clonality of the cloned cells was confirmed by testing the pattern of Ig rearrangements using polymerase chain reaction (PCR).

RESULTS

From 2 PNH patients and 2 normal controls, CD(55)(-) and CD(59)(-) B lymphoblastoid cell lines were established which had PNH phenotype and normal phenotype, respectively.

CONCLUSION

B lymphoid cell lines from PNH patients can be obtained by EB virus infection.

Diazepam-binding inhibitor mediates feedback regulation of pancreatic secretion and postprandial release of cholecystokinin

Recently, we isolated a trypsin-sensitive cholecystokinin-releasing peptide (CCK-RP) from porcine and rat intestinal mucosa. The amino acid sequence of this peptide was determined to be identical to that of the diazepam-binding inhibitor (DBI). To test the role of DBI in pancreatic secretion and responses to feeding, we used pancreaticobiliary and intestinal cannula to divert bile-pancreatic juice from anesthetized rats. Within 2 hours, this treatment caused a 2-fold increase in pancreatic protein output and a >10-fold increase in plasma CCK. Luminal DBI levels increased 4-fold. At 5 hours after diversion of bile-pancreatic juice, each of these measures returned to basal levels. Intraduodenal infusion of peptone evoked a 5-fold increase in the concentration of luminal DBI. In separate studies, we demonstrated that intraduodenal administration of antiserum to a DBI peptide specifically abolished pancreatic secretion and the increase in plasma CCK levels after diversion of bile-pancreatic juice. To demonstrate that DBI mediates the postprandial rise in plasma CCK levels, we showed that intraduodenal administration of 5% peptone induced dramatic increases in pancreatic secretion and plasma CCK, effects that could be blocked by intraduodenal administration of anti-DBI antiserum. Hence, DBI, a trypsin-sensitive CCK-RP secreted from the proximal small bowel, mediates the feedback regulation of pancreatic secretion and the postprandial release of CCK.

Cell signaling in bovine ciliary epithelial organ culture

The ciliary epithelium secretes aqueous humor, an intraocular fluid whose production is regulated in part by transmembrane signaling pathways including those mediated by G protein-coupled receptors. Many drugs, such as beta-adrenergic receptor (AR) antagonists and alpha2-AR agonists, are used to lower intraocular pressure by presumably decreasing fluid transport across this epithelium. Hence, our purpose was to establish a ciliary epithelial organ culture system suitable for the study of cell signaling pathways. A trypsin-mediated dissection method was established to isolate bovine ciliary epithelial sheets. These sheets were cultured in a 5% CO2 incubator. The quality was assessed by light microscopy, by protein analysis, and by the evaluation of epinephrine-mediated phosphoinositide turnover. The cultured epithelial explants were viable as evidenced by minimal trypan blue staining. The explants were composed primarily of nonpigmented cells and some pigmented cells, but no other ciliary body tissues were present on histology. Membrane preparations showed proteins with a distribution from 31 to 116 kDa. Epinephrine caused a dose-dependent increase in [3H]inositol phosphates (InsPs) accumulation with a maximal increase of two- to three-fold over basal levels. This epinephrine-mediated increase was inhibited by prazosin. We established an organ culture system of isolated bovine ciliary epithelium suitable for the study of transmembrane signaling pathways.

Evi-1 and MDS1-Evi-1 genes in pathogenesis of myelodysplastic syndromes and post-MDS acute myeloid leukemia

OBJECTIVE

To investigate expression of Evi-1 and MDS1-Evi-1 genes in myelodysplastic syndromes (MDS) and post-MDS acute myeloid leukemia (post-MDS AML), and its role in pathogenesis or progression of MDS and post-MDS AML.

METHODS

Expression of Evi-1 and MDS1-Evi-1 genes was examined in 31 MDS, 11 post-MDS AML, and 34 de novo AML patients by a semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR).

RESULTS

Evi-1 expression was not detected in bone marrow samples of 8 normal controls, but low MDS1-Evi-1 expression levels (MDS1-Evi-1/GAPDH < 0.1) were detected in 3 of the 8 controls. Evi-1 RNA was expressed in 1 of 8 RA, 8 of 13 RAEB and 6 of 9 RAEB-T patients, and the percentage of Evi-1 expression in RAEB(T) patients was higher than that in RA (P < 0.05). MDS1-Evi-1 expression was detected in 5 of 8 RA, 9 of 13 RAEB and 5 of 9 RAEB-T patients, and MDS1-Evi-1 expression levels (MDS1-Evi-1/GAPDH > 0.1) were markedly higher than those in the controls. Evi-1 expression was gradually increased in 4 of 5 RAEB-T patients with transformation from MDS to AML. The percentages of Evi-1 and MDS1-Evi-1 expression in post-MDS AML patients were significantly (P < 0.01 and P < 0.05 respectively) higher than those in de novo AML. The colonies of hematopoietic progenitor cells were decreased in Evi-1 and MDS1-Evi-1-positive MDS patients as compared with those in Evi-1 and MDS1-Evi-1-negative patients.

CONCLUSION

Abnormal expression of the Evi-1 gene and overexpression of MDS1-Evi-1 gene may play a role in the pathogenesis or progression of MDS and post-MDS AML.

[Ultrasonic and CT diagnosis of large upper abdominal mass]

OBJECTIVE

To assess accuracy of ultrasonic (US) and CT diagnosis of big mass in the upper abdomen.

METHODS

Data from 38 clinically and pathologically confirmed cases were retrospectively analyzed and accuracy of their preoperative US and CT diagnosis compared.

RESULTS

US diagnosis was correct in 3 of 9 (33.3%) cases with a mass in the liver, in 16 of 21 (76.2%) cases with a mass in the adrenal gland and in 2 of 4 cases with a mass in the kidney. In contrast, CT diagnosis was correct in 2 of 9 (22.2%) cases with a mass in the liver, in 4 of 18 (22.2%) cases with a mass in the adrenal gland and none in a case with a mass in the kidney. In 4 cases with a mass in the spleen, neither US nor CT diagnosis was correct.

CONCLUSION

Because organs in the upper abdomen are closely located with each other, correct imaging localization of big mass in this region is not without difficulty. In this series, accuracy of diagnosis with US and CT is comparable, but for localizing tumor in the adrenal gland, US imaging seems superior. US and CT are both incapable of accurately diagnosing large mass in the spleen.

Evolutionary relationship between K(+) channels and symporters

The hypothesis is presented that at least four families of putative K(+) symporter proteins, Trk and KtrAB from prokaryotes, Trk1,2 from fungi, and HKT1 from wheat, evolved from bacterial K(+) channel proteins. Details of this hypothesis are organized around the recently determined crystal structure of a bacterial K(+) channel: i. e., KcsA from Streptomyces lividans. Each of the four identical subunits of this channel has two fully transmembrane helices (designated M1 and M2), plus an intervening hairpin segment that determines the ion selectivity (designated P). The symporter sequences appear to contain four sequential M1-P-M2 motifs (MPM), which are likely to have arisen from gene duplication and fusion of the single MPM motif of a bacterial K(+) channel subunit. The homology of MPM motifs is supported by a statistical comparison of the numerical profiles derived from multiple sequence alignments formed for each protein family. Furthermore, these quantitative results indicate that the KtrAB family of symporters has remained closest to the single-MPM ancestor protein. Strong sequence evidence is also found for homology between the cytoplasmic C-terminus of numerous bacterial K(+) channels and the cytoplasm-resident TrkA and KtrA subunits of the Trk and KtrAB symporters, which in turn are homologous to known dinucleotide-binding domains of other proteins. The case for homology between bacterial K(+) channels and the four families of K(+) symporters is further supported by the accompanying manuscript, in which the patterns of residue conservation are demonstrated to be similar to each other and consistent with the known 3D structure of the KcsA K(+) channel.

Management of allogeneic bone marrow transplant recipients at risk for cytomegalovirus disease using a surveillance bronchoscopy and prolonged pre-emptive ganciclovir therapy

BACKGROUND

Patients undergoing allogeneic bone marrow transplant (BMT) are considered to be at increased risk of cytomegalovirus (CMV) disease if they and/or their donor are CMV seropositive pre-transplant. Although several pre-emptive strategies have been shown to be effective in preventing early CMV disease, the ability of pre-emptive strategies using prolonged ganciclovir therapy to reduce the incidence of late-onset CMV infection, disease and mortality has not been fully evaluated.

OBJECTIVE

To assess the efficacy of 18 weeks of pre-emptive ganciclovir therapy in preventing late-onset (> 100 days post-transplant) CMV disease when administered to asymptomatic BMT patients found to have CMV in bronchoalveolar lavage (BAL) fluid obtained during a surveillance bronchoscopy approximately 35 days post-transplant. To determine whether or not survival of BMT recipients is influenced by pre-transplant donor and recipient CMV serostatus in the context of this pre-emptive ganciclovir strategy.

STUDY DESIGN

Consecutive patients undergoing allogeneic BMT were assessed for their risk of developing CMV disease based on their pre-transplant CMV serostatus and that of their donor. Patients who were CMV seropositive and/or received marrow from a CMV seropositive donor underwent a surveillance bronchoscopy and BAL approximately 35 days post-transplant. Patients with positive BAL fluid for CMV received pre-emptive ganciclovir therapy for 18 weeks at decreasing dose levels. Patients considered to be at low risk for the development of CMV disease (donor and recipient CMV seronegative) were followed without intervention.

RESULTS

Of 98 consecutive patients, 55 were considered to be at risk for CMV disease and underwent a surveillance bronchoscopy. Sixteen (29%) patients had a positive BAL fluid for CMV and were started on pre-emptive ganciclovir therapy. Two patients progressed and died with CMV-related pneumonia. One additional patient developed CMV-related enteritis on day 42 post-transplant and recovered with continuing ganciclovir treatment. Of the 39 patients with a negative BAL fluid for CMV, one developed a fatal CMV pneumonia 150 days post-transplant and two additional patients developed gastrointestinal CMV disease 28 and 57 days post-BMT, respectively. None of the patients in the low risk group developed CMV disease.

CONCLUSIONS

The strategy utilizing a surveillance bronchoscopy for CMV and initiating prolonged (18 weeks) pre-emptive ganciclovir therapy for patients with a positive BAL fluid for CMV resulted in a low incidence of CMV-related post-transplant complications. After a minimum follow-up of 16 months, late CMV reactivations (occurring > 100 days post-transplant) were not observed in the group of individuals pre-emptively treated with ganciclovir. This observation suggests that prolonged therapy with a reduced dose of ganciclovir may be important in the prevention of CMV reactivation. The CMV serostatus of donors and recipients prior to BMT did not correlate with survival.

[E-CD expression and its clinical significance in human bladder carcinoma]

OBJECTIVE

To invest the expression of the E-CD protein and its clinical significance in human recurrent bladder transitional cell carcinoma.

METHODS

Immunohistological chemistry method was employed to assess the expression of E-CD in 54 cases of bladder transitional cell carcinoma.

RESULTS

Decreased E-CD expression correlated with both increased grade and stage (chi(2) = 6.65, P < 0.05; chi(2) = 7.15, P < 0.01). More importantly, abnormal expression of E-CD correlated with the high recurrence in short time and the poor survival (chi(2) = 4.88, P < 0.05; Log-rank test: chi(2) = 4.6, P < 0.05).

CONCLUSIONS

The expression of E-CD is an useful parameter of malignancy of carcinoma. The detection of E-CD expression might be significant in determining the malignancy, recurrence and prognosis of bladder transitional cell carcinoma.

Multifrequency grating projection profilometry based on the nonlinear excess fraction method

Although promised to be a fast and accurate three-dimensional shape measurement technique, grating projection profilometry based on phase measurement has been frequently baffled by the difficulty in phase unwrapping. We introduce the conventional excess fraction method into profilometry and extend it to nonlinear domain. Nonlinear excess fraction method (NLEFM), on the basis of which a multifrequency grating projection profilometry is developed, can work as a robust temporal phase unwrapper, which may extend the reliable measuring range by dozens of times at no cost of accuracy. The principle of NLEFM is detailed, and experimental results are given in which complex profiles are reliably measured with the novel system.

Differential expression of antiapoptotic gene BAG-1 in human breast normal and cancer cell lines and tissues

BAG-1 is an antiapoptotic protein that binds to and enhances the antiapoptotic activity of Bcl-2. It binds several growth factor and hormone receptors and modulates their function. BAG-1 was also shown recently to be expressed as four protein isoforms, p50, p46, p33, and p29, through alternative translation initiation. Although many apoptosis-associated genes have been linked to oncogenesis of human breast cancer, the role of BAG-1 has not been fully elucidated. In this study, we examined the expression of BAG-1 RNA or protein isoforms and its interacting antiapoptotic proteins, Bcl-2 and BcI-X(L), in breast normal and tumor cell lines and tissues by Northern or Western blot analysis. We provide convincing evidence that both BAG-1 RNA and protein are overexpressed in human breast cancer cell lines. More importantly, we found that the expression of two isoforms of BAG-1, p46 and p33, was also much higher in breast primary tumors. The expression of Bcl-2 and Bcl-X(L) correlated with that of BAG-1 in breast normal and carcinoma cell lines but not tissues. Our study suggests that BAG-1 isoforms may serve as a molecular marker, independent of Bcl-2 and Bcl-X(L), for human breast cancer.

[Observation of the anterior ischemic optic neuropathy by color Doppler flow imaging]

OBJECTIVE

To study the characteristics of color Doppler flow imaging (CDFI) in anterior optic neuropathy (AION).

METHODS

Forty eyes of 25 patients clinically diagnosed to have progressive AION were studied by using CDFI. The peak systolic velocity (PSV), end-diastolic velocity (EDV), time averaged maximum velocity (TAMV) and resistance index (RI) of the central retinal artery (CRA), nasal and temporal posterior ciliary arteries (PCAs) and ophthalmic artery (OA) were detected. The diameter of retrobulbar optic nerve (ON) was detected at the same time. Thirty-four volunteers were served as the control group.

RESULTS

In the comparison with the control group, there were significantly reduced PSV, EDV and TAMV in PCAs (P < 0.001) and CRA (P < 0.001) and markedly increased RI in PCAs, CRA and OA in AION group. The retrobulbar optic nerve edema was found in 32/40 eyes.

CONCLUSIONS

The characteristics of reduced velocity and increased resistance index in retrobulbar arteries of the AION are demonstrated. CDFI is helpful to the diagnosis of AION.

[Relationship between GSTM1 genotype and susceptibility to senile cataract]

OBJECTIVE

To study the relationship between the glutathione s-transferase gene deletion and cataract formation.

METHODS

Blood cells of total of 77 cases with senile cataract and 76 controls were detected for GSTM1 gene, and the subcapsular epithelial cells of 22 cataract lenses were also detected for GSTM1 gene.

RESULTS

The GSTM1 gene deletion rate in cataract group was 53.25% and that in the control group was 46.05%, they being not significantly different statistically (chi(2) = 0.750, P > 0.05, OR = 0.75). GSTM1 gene deletion rate in the subcapsular epithelial cells of 20 cases was basically consistent with that in blood cells.

CONCLUSION

GSTM1 gene deletion is not related to senile cataract formation.

Overexpression of anti-apoptotic gene BAG-1 in human cervical cancer

Apoptosis is a programmed cell death process in which cells commit suicide under certain environmental conditions. Recent studies suggest that apoptosis is controlled by a variety of cellular genes, and dysregulation of these genes plays an important role in the pathogenesis of human diseases, including cancer. BAG-1 is a novel anti-apoptotic protein isolated by its interaction with another anti-apoptotic protein, Bcl-2. It binds to several hormone receptors and growth factor receptors and modulates their function in apoptosis. However, the role of BAG-1 in the oncogenesis of human cervical cancer has yet to be illustrated. In this study, we examined the expression of BAG-1 in cervical normal and carcinoma cultured cells and tissues. BAG-1 was overexpressed in human cervical carcinoma cell lines and tissues. Overexpression was regulated at the transcriptional level. The increased expression of BAG-1 was correlated with enhanced resistance of cervical carcinoma cells to apoptosis induced by a DNA-damaging reagent. In addition, overexpression of BAG-1 enhanced the resistance of cervical cells to apoptosis. This study provided the first evidence that BAG-1 is upregulated in human cervical cancer and may play an important role in apoptosis and human cervical carcinogenesis.

[Refractory anemia and preleukemia: an analysis of 92 cases]

OBJECTIVE

To investigate the relationship between MDS-RA (refractory anemia subtype of myelodysplastic syndromes) and preleukemia (PL).

METHODS

Hematological parameters of 86 RA and 6 PL patients were retrospectively analyzed.

RESULTS

Thirty-four RA cases (39.53%) transformed into acute leukemia (AL), RA with excess blasts (RAEB), or RAEB in transformation (RAEB-t). As compared with 52 non-transformed RA cases, the transformed cases showed the following hematological features: 1. higher frequencies of immature granulocytes (P < 0.005), erythroblasts (P < 0.05) and megaloerythrocytes (P < 0.05), and higher granulocyte nuclear lobulation (P < 0.001) in peripheral blood; 2. higher percentages of early erythroid and granulocytic lineages (P < 0.05), and higher frequencies of erythroblasts with multiple nuclei (P < 0.05), pseudo Pelger-Huet abnormality (P < 0.05), and micromegakaryocytes (P < 0.005) in bone marrow.

CONCLUSION

There is a higher overlap between RA and PL; the above hematological features may be useful for predicting the transformation of RA patients. Based on those findings, a score system for predicting the transformation of RA was proposed.

[Present situation and future subjects of N.SAS study--based on experience of managing data center]

The "National Surgical Adjuvant Study" (N-SAS) was established as a study group on carcinostatics on the market as part of the Ministry of Health and Welfare's 1995/1996 consignment project. Patient registration started in October 1996, and later it was restructured as a consignment study by Taiho Pharmaceutical Co., Ltd. in April 1997. It still continues to date. EPS Co., Ltd. has operated the "N.SAS Data Center" to conduct three clinical trials of N.SAS study. In the following, we analyse the current situation and subjects of N.SAS study from the viewpoint of the data center, recognising the necessity of infrastructure at medical institutions while complying with enforcement of newly GCP and GPMSP. First, the organization and function of N.SAS, and the role and position of data center on N.SAS study, are explained. Some notes are introduced from conducting In-house Monitoring on N.SAS, especially methods and formation of communicating information between N.SAS Data Center and institutions. We also propose an infrastructure which will be essential for smooth promotion of long-term and large-scale trials like the N.SAS study.

Killing effect of interleukin-2 and interferon-alpha activated leukemic bone marrow in remission on K562 leukemic cells

OBJECTIVE

To evaluate the killing effect of interleukin-2 (IL-2) and interferon-alpha (IFN-alpha) activated bone marrow cells on K562 cells.

METHODS

Semi-solid colony and 3H-TdR incorporating method were used.

RESULTS

Bone marrow from leukemia patients in remission was activated in vitro with IL-2 for 3 days. The activated bone marrow (ABM) displayed killing effects of 0.31-2.30 logs on K562 cells. This killing effect was further increased to 0.30-3.15 logs when IFN-alpha added with IL-2 to the marrow for activation. IL-2 alone or in combination with IFN-alpha showed no inhibition of CFU-GM and K562 cells. Compared with IL-2 or IFN-alpha alone, the combination of the two cytokines could more effectively maintain the killing effect of ABM on leukemic cells.

CONCLUSIONS

IFN-alpha can augment the purging effect of IL-2 ABM and combination of the two cytokines can effectively maintain the cytotoxicity of ABM.

Outcomes of extremely premature infants related to their peak serum bilirubin concentrations and exposure to phototherapy

OBJECTIVES

To analyze, in extremely low birth weight infants, associations between peak bilirubin concentration and evidence of brain damage, and between peak bilirubin concentration and blindness attributable to retinopathy of prematurity.

METHODS

Retrospective study of 128 infants of </=800 g birth weight and </=27 weeks gestation born between 1980 and 1989 and discharged from a tertiary neonatal intensive care unit. After screening analyses, multivariable analyses were conducted to identify associations between blindness and peak bilirubin concentration (dichotomized at different levels to create 3 binary variables), and between severe adverse neurodevelopmental outcome at 18 months postterm age and peak bilirubin levels.

RESULTS

Of 128 18-month survivors, 15 had severe visual loss attributable to retinopathy of prematurity, 21 had neurodevelopmental deficit, and 5 were deaf. Visual loss was significantly associated with low-peak serum bilirubin concentration (<9.4 mg/dL (<160 micromol/L) versus >/=9.4 mg/dL (odds ratio [OR] confidence interval [CI] 4.48 [1.15-17.43])), low gestational age (OR [CI] per week 1.95 [1.05-3.63]), and longer duration of phototherapy (OR [CI] per 10 hours 1.17 [1.02-1.33]). The association of neurodevelopmental impairment with grades 3 and 4 intraventricular hemorrhage was statistically significant (OR 5.39 [1.83-15.84]), but with high-peak serum bilirubin concentration >/=11.7 mg/dL (>/=200 micromol/L), was not significant (OR 2.89 [0. 87-9.53]).

CONCLUSIONS

In these infants, prolonged phototherapy and low-peak serum bilirubin concentrations were associated with severe visual loss attributable to retinopathy of prematurity. The findings should be interpreted with caution until the evidence is reinforced in other patient populations.

Intracellular transport of varicella-zoster glycoproteins

Previous observations have established that varicella-zoster virus (VZV) is enveloped in the trans-Golgi network (TGN) in cultures infected with VZV and that the glycoprotein gE is targeted to the TGN by a signal sequence (AYRV) and an acidic TGN signal patch in its cytosolic domain. Neither sequence is present in other VZV glycoproteins. Like gE, gI was targeted to the TGN when it was expressed in transfected cells, suggesting that gI also contains TGN targeting information (colocalized with gE and the AP-1 adaptin complex). In contrast, gB, gC, gH, and gL immunoreactivities were not detected in the TGN when they were expressed individually in transfected cells. In VZV-infected cells, gE, gI, gH, and gL were all concentrated in the TGN. Since VZV glycoproteins that lack targeting sequences (gB, gC, gH, and gL) concentrated in the TGN of infected cells, it is proposed that gE and gI, which have such sequences, serve as navigator glycoproteins, forming complexes that direct the signal-deficient glycoproteins to the TGN.

Anterior tibial artery and its actual projection on the lateral aspect of the tibia: a cadaveric study

The anterior tibial artery (ATA) is at risk of injury during high tibial osteotomy, Ilizarov wire placement, pin placement in external fixation, or proximal locking screw insertion, as the artery is not visualized intraoperatively. The ATA is anchored to the oval foramen of the interosseous membrane on the proximal tibia by the deep fascia and recurrent genicular vascular branches. Segment 1 (from the bifurcation of the popliteal artery to the level of the interosseous foramen) and the proximal part of segment 2 (from the interosseous foramen to the level where the artery crosses the anterior border of the tibia) may be damaged when pin, wire or screw placement is directed posterolaterally at that level. Distally, a straight mediolateral pin or Ilizarov wires may lacerate the artery. Segment 2 of the ATA descends against the interosseous membrane in its proximal part, which is projected on the posterior third of the tibia relative to the sagittal plane; in its middle part, it runs close to the lateral cortex of the tibia, it is projected on the middle third of the tibia; in its distal part it runs gradually towards the anterior third of the tibia and contacts with the anterior third of the tibial cortical surface. This information may help reduce risk of injury to the ATA during high tibial osteotomy, external fixation and pin placement or insertion of locking screws.

[Effect of Fusheng powder on activity of vascular endothelial cells and its adhesion to polymorphonuclear neutrophils]

OBJECTIVE

To explore the effect of Fusheng powder on the adhesion of polymorphonuclear neutrophils (PMN) in human peripheral blood to vascular endothelial cells (VEC).

METHODS

Using cultured human umbilical vein cells as target cells, while being incubated with high glucose (HG, 30 mmol/L), high-lipid (HL, 20%), tumor necrosis factor-alpha (TNF-alpha, 10%) and hypoxia (95% N2, 5% CO2, 37 degrees C, 30 min, and then in the air 30 min) for 24 h, respectively, the activity of VEC and the adhesive effect of PMN to VEC were surveyed.

RESULTS

It revealed that HG, HL, TNF-alpha and hypoxia could enhance obviously the adhesion of PMN to VEC, the cell attachment rate in normal control, HG group, TNF-alpha, hypoxia and HL after 30 minutes contact were 100%, 129.6%, 136.7%, 151.4% and 167.7% (all P < 0.01, compared with control group) respectively, but high and low dosage of the Fusheng powder could significantly inhibit the adhesion of PMN to VEC.

CONCLUSIONS

HG, HL, TNF-alpha and hypoxia could all activate EC respectively and enhance the adhesion of PMN to VEC, but the Fusheng powder could protect VEC and partly block the effect of this adhesion. However, the effects of Fusheng powder on anti-adhesion are of great importance in clinical cardiovascular and cerebral vascular diseases.

[The clinical value of intraoperative ultrasound of the liver]

OBJECTIVE

To evaluate usefulness of intraoperative ultrasound of the liver.

METHODS

A 5.0 MHz ultrasound transducer was used to detect liver lesions, their number, location and relation to the intrahepatic blood vessels.

RESULTS

Forty two patients with primary liver tumors received intraoperative ultrasonographic examination. Liver tumor was resected in 29 patients(69.0%). The tumors in 4 patients were unresectable due to their close relationship to the hepatic vasculature as judged by the ultrasound image. Multiple lesions were found in 6 patients during operation.

CONCLUSIONS

Intraoperative ultrasound of the liver is sensitive enough to detect most liver lesions and to locate them by liver segment which makes radical tumor resection possible. It is useful to define the tumor in relation to hepatic vasculature. It can compensate for missing lesions in preoperative imaging studies. Fenestration operation for liver abscess and intervention treatment for liver cysts can be performed during operation.

[Two-phase dynamic CT findings of gastric carcinoma and its value for tumor detection and gross classification]

OBJECTIVE

To analyze the two-phase dynamic CT features of gastric carcinoma and to assess its usefulness for tumor detection and gross classification.

METHODS

Two-phase dynamic CT was performed in 63 cases of gastric carcinoma proved histologically by fibro-gastroscopic biopsy. CT features of gastric carcinoma, tumor detection, and gross classification were correlated with surgical and pathologic findings.

RESULTS

The detectability by two-phase enhanced CT scanning of early and advanced gastric carcinoma was 100% and 98.2%, respectively. The overall accuracy of gross classification for advanced carcinoma was 65.4%, but for early gastric carcinoma, it was 0. The accuracy of Borrmann type II, III, IV was 85.7%, 100%, 55.6%, respectively. In the first phase (early enhancing phase) CT scan, the manifestation of early gastric carcinoma included local thickening of gastric wall, moderate or marked heterogeneous enhancement of lesions in 4 cases and mild enhancement in the other 4 cases. Local or extensive thickening of gastric wall, with or without ulceration, moderate or marked heterogeneous enhancement in early enhancing phase were shown in advanced gastric carcinoma. In the second phase, the degree of tumor enhancement in advanced carcinoma was slightly higher than that of the normal part of gastric wall. There were 4 cases with mucinous adenocarcinoma, a target or laminary appearance was present in 3 cases, and intramural calcification was present in 2 cases.

CONCLUSION

1. Enhanced dynamic CT scan plays a significant role in the diagnosis of gastric carcinoma, early enhancing phase scanning is the technique of choice nowadays for demonstrating tumor lesions. 2. Sophisticated scanning technique is mandatory in improving the diagnostic accuracy of gastric carcinoma.

Human BAG-1/RAP46 protein is generated as four isoforms by alternative translation initiation and overexpressed in cancer cells

Previously, a Bcl-2-interacting protein, BAG-1, was cloned from mouse cells and was shown to interact with several other proteins and to be important for inhibition of apoptosis. Human BAG-1 (hBAG-1) cDNA, recently isolated by us and two other groups, has been shown to be identical to a hormone receptor-binding protein, RAP46. However, different molecular masses of hBAG-1 protein products were noted by these three groups. Here we demonstrated that hBAG-1 protein was expressed as four isoforms, designated p50, p46, p33 and p29, with apparent molecular masses of 50 kDa, 46 kDa, 33 kDa and 29 kDa, respectively. Deletion, site-directed mutagenesis and in vitro transcription/translation analysis showed that the four protein products of hBAG-1 were expressed by alternative initiation from four different start codons through a leaky scanning mechanism. Furthermore, we demonstrated that the distinct forms of hBAG-1 have different subcellular localizations, suggesting that they may have distinct functions in the cells. Characterization of hBAG-1 RNA and protein also showed that hBAG-1 was overexpressed in human cervical, breast and lung cancer cell lines. Taken together, these data clarify the conflicting observations reported in the literature and suggest that hBAG-1 is expressed as four forms of protein products, which may play a differential role in apoptosis and oncogenesis of human cells.

Asymmetry of the mean-variability tradeoff raises questions about the model in investigations of individual bioequivalence

Tradeoff between changes of intraindividual variations of 2 drug formulations and of the difference between their means is a characteristic of a procedure suggested for the determination of individual bioequivalence [Schall and Luus 1993] and to be proposed by the Food and Drug Administration for adoption. Hauck et al. [1996] investigated properties of the tradeoff. Their procedure was applied and extended in the present study. The tradeoff was shown to be asymmetric. Notably, a small change in intrasubject variations can elicit, under various conditions, a comparatively large change in the allowable difference between means which can still be compatible with the declaration of bioequivalence. For instance, when the intraindividual coefficients of variations are 40% and 38% for the reference and test formulations, respectively, the allowable difference between means may increase, as a benefit, by 12.3%. A penalty by 11.2% is elicited if the intrasubject variations of the reference and test products are 40 and 42%, respectively. In addition, 4-period crossover trials were simulated. Ratios of estimated variances of the 2 formulations followed an F-distribution. Distributions of changes in allowable deviations between means were calculated from the tradeoff relationships; generally substantial changes were noted with high probabilities. For example, with an intraindividual variation of 30% there is an estimated 37% probability that a benefit of 10% increase, or larger, is gained by chance in the allowable difference between means, and an additional 36% probability that a penalty of a 10%, or larger, decrease in the allowable difference is suffered. With an intrasubject variation of 40%, the estimated probabilities are 42% and an additional 42% for a 10% expansion and contraction, respectively, of the allowable difference between means. Consequently, the strong asymmetry of the tradeoff could result in very large probabilities for benefits and penalties. Therefore, the investigated model assessing individual bioequivalence does not appear to be suitable for implementation.

Structural models of the transmembrane region of voltage-gated and other K+ channels in open, closed, and inactivated conformations

A large collaborative, multidisciplinary effort involving many research laboratories continues which uses indirect methods of molecular biology and membrane biophysics to analyze the three-dimensional structures and functional mechanisms of K+ channels. This work also extends to the distant relatives of these channels, including the voltage-gated Na+ and Ca2+ channels. The role that our group plays in this process is to combine the information gained from experimental studies with molecular modeling techniques to generate atomic-scale structural models of these proteins. The modeling process involves three stages which are summarized as: (I) prediction of the channel sequence transmembrane topology, including the functionality and secondary structure of the segments; (II) prediction of the relative positions of the transmembrane segments, and (III) filling in all atoms of the amino acid residues, with conformations for energetically stabilized interactions. Both physiochemical and evolutionary principles (including sequence homology analysis) are used to guide the development. In addition to testing the steric and energetic feasibilities of different structural hypotheses, the models provide guidance for the design of new experiments. Structural modeling also serves to "fill in the gaps" of experimental data, such as predicting additional residue interactions and conformational changes responsible for functional processes. The modeling process is currently at the stage that experimental studies have definitely confirmed most of our earlier predictions about the transmembrane topology and functionality of different segments. Additionally, this report describes the detailed, three-dimensional models we have developed for the entire transmembrane region and important functional sites of the voltage-gated Shaker K+ channel in the open, closed, and inactivated conformations (including the ion-selective pore and voltage-sensor regions). As part of this effort, we also describe how our development of structural models for many of the other major K+ channel families aids in determining common structural motifs. As an example, we also present a detailed model of the smaller, bacterial K+ channel from Streptomyces lividans. Finally, we discuss strategies for using newly developed experimental methods for determining the structures and analyzing the functions of these channel proteins.

Enhanced expression of anti-apoptotic proteins in human papillomavirus-immortalized and cigarette smoke condensate-transformed human endocervical cells: correlation with resistance to apoptosis induced by DNA damage

Apoptosis plays an important role in various biological processes including embryogenesis, differentiation, homeostasis, and oncogenesis. We have developed a system composed of primary human endocervical cells (HEN), HEN immortalized by human papillomavirus (HPV) type 16, and their counterparts subsequently malignantly transformed by cigarette smoke condensate (CSC). To understand the role of apoptosis in the multistep oncogenesis of human cervical cells, we examined the expression of apoptosis-associated proteins in our in vitro model system. The results showed no significant difference in the levels of apoptosis-inducing proteins bak and bax among all the cell types examined. On the other hand, the levels of apoptosis-inhibiting proteins bcl-2, bcl-xL and BAG-1 increased progressively after immortalization and transformation. The p53 protein level decreased in the HPV16-immortalized HEN and increased in one of two lines of the CSC-transformed HEN. Further, the increased levels of apoptosis-inhibiting proteins in the HPV16-immortalized and the CSC-transformed HEN correlated with progressively increased resistance of these cells to apoptosis induced by staurosporine or cisplatin. This study provided the first evidence that overexpression of apoptosis-inhibiting proteins is important for both multistep oncogenesis and resistance of human endocervical cells to apoptosis induced by DNA-damaging reagents.

[Effects of Yunqitang on both esophageal mucosal morphology and esophageal motility in reflux esophagitis patients]

OBJECTIVE

To observe the effects of Yunqitang (YQT) on both esophageal mucosal morphology and esophageal motility in patients with reflux esophagitis (RE).

METHODS

According to Syndrome Differentiation of TCM, 42 RE patients were divided into three groups: Disharmony of Liver and Stomach (D) group, Deficiency-Cold of Spleen and Stomach (DC) group, Heat Syndrome caused by depression of Liver Qi (H) group. No. I, II, III of YQT were taken respectively for 4 weeks. Before and after treatment scores of typical symptoms were collected, gastroscope and esophageal motility were measured.

RESULTS

(1) The symptom remission rate was 81.1%, there were significant differences between the group DC with group D and Group H (P < 0.01). (2) The esophageal mucosal healing rate was 61.9%, the effective rate was 90.5%, and the ineffective rate 9.5%. There weren't significant difference of effective rates among the three groups (P < 0.05). (3) The changes of esophageal motility: lower esophageal sphictor pressure (LESP), average peristaltic pressure (APP) of group D were higher (P < 0.05), LESP, gastro-esophageal barrier pressure (GEBP) and peristaltic conduct speed (PCS) of group DC were remarkably higher (P < 0.05), GEBP of group H was improved (P < 0.05).

CONCLUSIONS

YQT has a good therapeutical effect, it's not only resolving reflux symptoms, healing esophageal mucosa, but also improving esophageal motile function.

[Study on expression of Evi1 and MDS1-Evi1 genes in myelodysplastic syndromes]

OBJECTIVE

To investigate expression of Evi1 and MDS1-Evi1 genes in myelodysplastic syndromes (MDS) and its role in pathogenesis of MDS.

METHODS

Expression of Evi1 and MDS1-Evi1 genes was examined in 31 MDS, 11 post MDS acute myeloid leukemia (post MDS AML) and 34 de novo AML patients by a semi-quantitative RT-PCR.

RESULTS

Evi1 expression was not detected in 8 normal controls, but low MDS1-Evi1 expression levels (MDS1-Evi1/GAPDH < 0.1) detected in 3 of the 8 controls. Evi1 mRNA was expressed in 1 of 8 RA, 8 of 13 RAEB and 6 of 9 RAEB-t patients, and the percentage of Evi1 expression in RAEB(t) patients was higher than that in RA(P < 0.05). MDS1-Evi1 expression was detected in 5 of 8 RA, 9 of 13 RAEB and 5 of 9 RAEB-t patients, and MDS1-Evi1 expression levels (MDS1-Evi1/GAPDH > 0.1) in the patients were markedly higher than those in the controls. Evi1 expression was gradually increased in 4 of 5 RAEB-t patients with transformation from MDS to AML. The percentages of Evi-1 and MDS1-Evi1 expression in post MDS AML patients were higher than those in de novo AML (P < 0.01 and P < 0.05, respectively). The numbers of colony formation of progenitor cells in Evi1 and MDS1-Evi1-positive MDS patients were decreased as compared with Evi1 and MDS1-Evi1-negative patients.

CONCLUSION

Abnormal expression of Evi1 and overexpression of MDS1-Evi1 might play a certain role in the pathogenesis or progression of MDS and post MDS AML.

Rhodopsin transgenic pigs as a model for human retinitis pigmentosa

PURPOSE

To further characterize the retinas of Pro3471Leu rhodopsin transgenic pigs, a model for human retinitis pigmentosa.

METHODS

Retinas from normal and transgenic pigs, newborn to 20 months old, were processed for light and electron microscopic immunocytochemical examination.

RESULTS

At birth, rod numbers were normal in the transgenic retinas, but their outer segments were short and disorganized and their inner segments contained stacks of rhodopsin-positive membranes. The newborn rod synapses lacked synaptic vesicles and ribbons and had numerous rhodopsin-positive, filopodia-like processes that extended past the cone synapses into the outer plexiform layer. Rod cell death was apparent by 2 weeks and was pronounced in the mid periphery and central regions by 6 weeks. Far peripheral rods were initially better preserved, but by 9 months virtually all rods had degenerated. Cones degenerated more slowly than rods, but by 4 weeks the cone synapses were shrunken and some mid peripheral cones had lost their immunoreactivity for phosphodiesterase-gamma, arrestin, and recoverin. From 9 months to 20 months, the cone outer segments shortened progressively, and more cones lost immunoreactivity for these proteins.

CONCLUSIONS

The rhodopsin transgenic pig retina shares many cytologic features with human retinas with retinitis pigmentosa and provides an opportunity to examine the earliest stages in photoreceptor degeneration, about which little is known in humans. The finding of abnormal rhodopsin localization in newborn rods is consistent with misrouting of mutant rhodopsin as an early process leading to rod cell death. Novel changes in the photoreceptor synapses may correlate with early electrophysiological abnormalities in these retinas.

Treatment of locally recurrent rectal carcinoma--results and prognostic factors

PURPOSE

To assess the local control and survival in patients who received pelvic irradiation for locally recurrent rectal carcinoma.

METHODS AND MATERIALS

The records of 519 patients with locally recurrent rectal carcinoma treated principally with external-beam radiation therapy between 1975 to 1985 at a single institute were retrospectively reviewed. These included 326 patients who relapsed locally following previous abdominoperineal resection, 151 after previous low anterior resection, and 42 after previous local excision or electrocoagulation for the primary. No patients had received adjuvant radiation therapy or chemotherapy for the primary disease. Concurrent extrapelvic distant metastases were found in 164 (32%) patients at local recurrence and, in the remaining 355, the relapse was confined to the pelvis. There were 290 men and 229 women whose age ranged from 23 to 91 years (median = 65). Median time from initial surgery to radiation therapy for local recurrence was 18 months (3-138 months). Radiation therapy was given with varying dose-fractionation schedules, total doses ranging from 4.4 to 65.0 Gy (median = 30 Gy) over 1 to 92 days (median = 22 days). For 214 patients who received a total dose > or = 35 Gy, radiation therapy was given in 1.8 to 2.5 Gy daily fractions.

RESULTS

The median survival was 14 months and the median time to local disease progression was 5 months from date of pelvic irradiation. The 5-year survival was 5%, and the pelvic disease progression-free rate was 7%. Twelve patients remained alive and free of disease at 5 years after pelvic irradiation. Upon multivariate analysis, overall survival was positively correlated with ECOG performance status (p = 0.0001), absence of extrapelvic metastases (p = 0.0001), long intervals from initial surgery to radiation therapy for local recurrence (p = 0.0001), total radiation dose (p = 0.0001), and absence of obstructive uropathy (p = 0.0013). Pelvic disease progression-free rates were positively correlated with ECOG performance status (p = 0.0001), total radiation dose (p = 0.0001), and previous conservative surgery for the primary (p = 0.02).

CONCLUSIONS

Survival is poor for patients who develop local recurrence following previous surgery for rectal carcinoma. Pelvic radiation therapy provides only short-term palliation, and future efforts should be directed to the use of effective adjuvant therapy for patients with rectal carcinoma who are at high risk of local recurrence.

The role of ras gene mutation in gastric cancer and precancerous lesions

Abnormality of ras gene family was studied in a total of 206 cases of gastric cancer and precancerous lesions by PCR-RFLP, PCR-SSCP and DNA sequencing. The results showed that mutation rate of H-ras 12 codon in metaplasia, atypical hyperplasia, early-stage cancer and advanced cancer was 16.7%, 31.2%, 50.0%, and 32.2%, respectively. In the groups of superficial gastritis and normal controls, no mutation were detected in codon 12 of ras. Mutations of H-ras 61 codon and N-ras 12 codon in various groups were the same as those in normal control. K-ras 12 codon mutation was detected in only 2 cases of gastric cancer by using PCR-SSCP, but it was not detected by DNA sequencing, which may be polymorphism. All H-ras 12 codon mutations were G-->T mutation. There were significant difference between the groups of metaplasia, dysplasia, gastric carcinoma and normal control group (P < 0.05, P < 0.01, P < 0.01, respectively). It was concluded that H-ras 12 codon mutation was an early event and may play an important role in gastric carcinogenesis. Although K-ras, N-ras mutation rates are high in colon cancer and leukemia, it seems to bear no relationship with gastric cancer.

Immunophenotype of myeloid cells in myelodysplastic syndromes and its clinical implications

OBJECTIVE

To explore the immunophenotype of myeloid cells in myelodysplastic syndyomes (MDS) and its clinical implications.

METHODS

A panel of monoclonal antibody was used to detect CD13+, CD33+, CD15+ and CD14+ antigens on the membrane surfaces of myeloid cells in the bone marrow from 51 MDS, 21 aplastic anemia (AA), 21 paroxysmal nocturnal hemoglobinuria (PNH) patients. 10 acute myeloblastic leukemia (AML) patients and 15 normal subjects by immunoenzymatic assay. The morphology and chromosome karyotype of bone marrow cells of MDS patients were also examined.

RESULTS

CD14+, CD13+ and CD33+ cells in the bone marrow were more in MDS patients than in normal controls, AA patients and PNH patients. CD15+ cells in the bone marrow were less in MDS patients than in normal controls.

CONCLUSIONS

The percentages of CD14+, CD13+ and CD33+ positive cells in the bone marrow of MDS patients were related to the percentage of myeloblasts, the chromosomal aberrations and the response to treatment. It indicated that there is immunophenotypic misexpression of myeloid cells in MDS patients. Immunophenotype analysis of myeloid cells might be useful for the diagnosis and treatment of MDS patients.