Lack of retroperitoneal lymphadenopathy predicts survival of patients with metastatic renal cell carcinoma

PURPOSE

Patients with metastatic renal cell carcinoma have a reported 5-year survival of 0% to 20%. The ability to predict which patients would benefit from nephrectomy and interleukin-2 (IL-2) therapy before any treatment is initiated would be useful for maximizing the advantage of therapy and improving the quality of life.

MATERIALS AND METHODS

A retrospective analysis of the x-rays and charts of patients treated at the National Institutes of Health Surgery Branch between 1985 and 1996, who presented with metastatic renal cancer beyond the locoregional area and the primary tumor in place, was performed. Preoperative computerized tomography or magnetic resonance imaging, or radiological reports if no scans were available, were used to obtain an estimate of the volume of retroperitoneal lymphadenopathy. Operative notes were used to evaluate whether all lymphadenopathy was resected or disease left in situ, or if any extrarenal resection, including venacavotomy, was performed. Mean survival rate was calculated from the time of nephrectomy to the time of death or last clinical followup. If patients received IL-2 therapy, the response to treatment was recorded. Mean survival and response rate for IL-2 were compared among patients in 3 separate analyses. Patients without preoperatively detected lymphadenopathy were compared with those with at least 1 cm.3 retroperitoneal lymphadenopathy. Also, the patients who had detectable lymphadenopathy were divided into subgroups consisting of all resected, incompletely resected, unresectable and unknown if all disease was resected. Each subgroup was compared with patients without detectable preoperative lymphadenopathy. Patients with less than were compared to those with greater than 50 cm.3 retroperitoneal lymphadenopathy. Patients undergoing extrarenal resection at nephrectomy (complex surgery) due to direct invasion of the tumor into another intra-abdominal organ were compared with those undergoing radical nephrectomy alone, regardless of lymph node status. Statistical analysis was done with the Mantel-Cox test for comparison of survival on Kaplan-Meier curves and with Fisher's exact test for response rates for IL-2.

RESULTS

A total of 154 patients with metastatic renal cell carcinoma underwent cytoreductive nephrectomy as preparation for IL-2 based regimens. There were 82 patients with metastatic renal cell carcinoma and no preoperative retroperitoneal lymphadenopathy who survived longer (median 14.7 months) than the 72 with lymphadenopathy (median 8.5, p = 0.0004). Patients with incompletely resected, unresectable or an unknown volume resected had decreased survival compared to those with no retroperitoneal lymphadenopathy. A multivariate analysis of survival was performed evaluating the known prognostic indicators, performance status and tumor burden, as represented by the number of organs involved with metastases, and the new prognostic factor, lymphadenopathy. Lymphadenopathy was more closely associated with survival than performance status, and appeared to be a new prognostic variable. Patients with and without retroperitoneal lymphadenopathy at initial presentation had similar rates for treatment with IL-2 (54% for both groups). Of the 82 patients with no lymphadenopathy 11 (13%) had long-term survival greater than 5 years. Of the 6 complete responses to IL-2, 5 occurred in this group. Only 1 other patient with incompletely resected retroperitoneal lymphadenopathy survived longer than 5 years. No significant difference in survival was seen between patients who did or did not undergo complex surgery.

CONCLUSIONS

Patients who presented with metastatic renal cancer and retroperitoneal lymphadenopathy had a shorter survival than those with no detectable retroperitoneal lymphadenopathy. It is warranted to continue to perform complex extrarenal resection during nephrectomy since no significant difference in the response rate for IL-2 or mean survival compared with those of patients undergoing nephrectomy alone is currently detectable.

Adoptive transfer of cloned melanoma-reactive T lymphocytes for the treatment of patients with metastatic melanoma

This report describes a phase I study of the adoptive transfer of cloned melanoma antigen-specific T lymphocytes for therapy of patients with advanced melanoma. Clones were derived from peripheral blood lymphocytes or tumor-infiltrating lymphocytes of patients who had received prior immunization with the melanoma-associated antigen, gpl00. In response to its cognate antigen, each clone used for treatment secreted large amounts of interferon-gamma and granulocyte-macrophage colony-stimulating factor, lesser amounts of interleukin (IL)-2 and tumor necrosis factor-alpha, and little or no IL-4 and IL-10. Clones also demonstrated recognition of human leukocyte antigen-matched melanomas using cytokine secretion and lysis assays. Twelve patients received 2 cycles of cells alone; 11 patients received additional cycles of cells and were randomized between two schedules of IL-2 (125,000 IU/kg subcutaneously daily for 12 days versus 720,000 IU/kg intravenously every 8 h for 4 days). A total of 51 cycles of cells were administered, with an average of 1 x 10(10) cells per cycle. Peripheral blood samples were analyzed for persistence of transferred cells by T-cell receptor-specific polymerase chain reaction. Transferred cells reached a maximum level at 1 h after transfer but rapidly declined to undetectable levels by 2 weeks. One minor response and one mixed response were observed (both in the high-dose IL-2 arm). This report demonstrates the safety and feasibility of cloned T-cell transfer as a therapy for patients with cancer. The lack of clinical effectiveness of this protocol suggests that transfer of different or additional cell types or that modulation of the recipient host environment is required for successful therapy.

Serum endostatin levels are elevated in patients with soft tissue sarcoma

BACKGROUND

Solid tumors are angiogenesis dependent, and elevated levels of proangiogenic cytokines have been reported in a variety of histologies. Endostatin is an antiangiogenic fragment of the basement membrane protein, collagen XVIII. Because antiangiogenic protein fragments may be generated by tumor-derived proteases, the authors sought to determine whether circulating levels of endostatin were elevated in patients with localized soft tissue sarcoma.

METHODS

The authors analyzed preoperative serum levels of endostatin, vascular endothelial growth factor (VEGF), and basic fibroblast growth factor (bFGF) in 25 patients (14 males and 11 females; mean age, 44 years) with soft tissue sarcoma. For each serum sample, two aliquots were assayed in duplicate using a competitive enzyme immunoassay. Serum levels were compared with levels from 34 age-matched and gender-matched volunteer blood donors.

RESULTS

Endostatin levels were significantly higher in sera from sarcoma patients than in sera from healthy controls (43.0 ng/mL vs. 25.8 ng/mL, respectively; P = 0.0002; Mann-Whitney U test). Significant elevations also were noted in VEGF and bFGF levels (P = 0.0002 and P = 0.0001, respectively). Furthermore, endostatin levels > 2 standard deviations above the control mean (55 ng/mL) were associated with an increased risk of tumor recurrence after resection (P = 0.047; log-rank test).

CONCLUSIONS

Serum endostatin, VEGF, and bFGF levels are elevated in patients with soft tissue sarcoma. Elevated endostatin levels appear to be associated with tumor aggressiveness. The role of these cytokines in sarcoma angiogenesis and as potential targets for therapy warrants further study.

Solution structure of a C-terminal coiled-coil domain from bovine IF(1): the inhibitor protein of F(1) ATPase

Bovine IF(1) is a basic, 84 amino acid residue protein that inhibits the hydrolytic action of the F(1)F(0) ATP synthase in mitochondria under anaerobic conditions. Its oligomerization state is dependent on pH. At a pH value below 6.5 it forms an active dimer. At higher pH values, two dimers associate to form an inactive tetramer. Here, we present the solution structure of a C-terminal fragment of IF(1) (44-84) containing all five of the histidine residues present in the sequence. Most unusually, the molecule forms an anti-parallel coiled-coil in which three of the five histidine residues occupy key positions at the dimer interface.

Serum endostatin levels are elevated in patients with soft tissue sarcoma

BACKGROUND

Solid tumors are angiogenesis dependent, and elevated levels of proangiogenic cytokines have been reported in a variety of histologies. Endostatin is an antiangiogenic fragment of the basement membrane protein, collagen XVIII. Because antiangiogenic protein fragments may be generated by tumor-derived proteases, the authors sought to determine whether circulating levels of endostatin were elevated in patients with localized soft tissue sarcoma.

METHODS

The authors analyzed preoperative serum levels of endostatin, vascular endothelial growth factor (VEGF), and basic fibroblast growth factor (bFGF) in 25 patients (14 males and 11 females; mean age, 44 years) with soft tissue sarcoma. For each serum sample, two aliquots were assayed in duplicate using a competitive enzyme immunoassay. Serum levels were compared with levels from 34 age-matched and gender-matched volunteer blood donors.

RESULTS

Endostatin levels were significantly higher in sera from sarcoma patients than in sera from healthy controls (43.0 ng/mL vs. 25.8 ng/mL, respectively; P = 0.0002; Mann-Whitney U test). Significant elevations also were noted in VEGF and bFGF levels (P = 0.0002 and P = 0.0001, respectively). Furthermore, endostatin levels > 2 standard deviations above the control mean (55 ng/mL) were associated with an increased risk of tumor recurrence after resection (P = 0.047; log-rank test).

CONCLUSIONS

Serum endostatin, VEGF, and bFGF levels are elevated in patients with soft tissue sarcoma. Elevated endostatin levels appear to be associated with tumor aggressiveness. The role of these cytokines in sarcoma angiogenesis and as potential targets for therapy warrants further study.

A preliminary report on the Chinese Cancer Pain Assessment Tool (CCPAT): reliability and validity

BACKGROUND

This study was to establish the validity and reliability of the Chinese Cancer Pain Assessment Tool (CCPAT) for Chinese patients with cancer pain in Hong Kong.

METHODS

It was a quasi-experimental study. The CCPAT was tested for its reliability and validity by 26 cancer pain patients and 26 chronic non-cancer pain patients. McGill Pain Questionnaire (MPQ), with its established reliability and validity, was used as the criterion tool for comparison.

RESULTS

An internal consistency of 0.88 and the inter-rater reliability of 0.96 were obtained for the CCPAT. The Spearman's Rho correlations between the functional and emotional dimensions of the CCPAT and the present pain intensity of the MPQ positively correlated. This indicated a satisfactory concurrent validity. Discriminant validity was performed with MANOVA. The CCPAT was able to predict 80.8% of the subjects correctly as cancer pain patient from the cancer pain group.

CONCLUSIONS

The constructed CCPAT is a valid and reliable cancer pain assessment tool in a Chinese context. The developed CCPAT is the first of its kind for the Chinese community in Hong Kong. It is anticipated that the results can provide the health care professionals with the best possible instrument and indicator. The CCPAT also lays the theoretical construct for the professionals with a better understanding of the experience of cancer pain from a multidimensional perspective.

HMG-D complexed to a bulge DNA: an NMR model

An NMR model is presented for the structure of HMG-D, one of the Drosophila counterparts of mammalian HMG1/2 proteins, bound to a particular distorted DNA structure, a dA(2) DNA bulge. The complex is in fast to intermediate exchange on the NMR chemical shift time scale and suffers substantial linebroadening for the majority of interfacial resonances. This essentially precludes determination of a high-resolution structure for the interface based on NMR data alone. However, by introducing a small number of additional constraints based on chemical shift and linewidth footprinting combined with analogies to known structures, an ensemble of model structures was generated using a computational strategy equivalent to that for a conventional NMR structure determination. We find that the base pair adjacent to the dA(2) bulge is not formed and that the protein recognizes this feature in forming the complex; intermolecular NOE enhancements are observed from the sidechain of Thr 33 to all four nucleotides of the DNA sequence step adjacent to the bulge. Our results form the first experimental demonstration that when binding to deformed DNA, non-sequence-specific HMG proteins recognize the junction between duplex and nonduplex DNA. Similarities and differences of the present structural model relative to other HMG-DNA complex structures are discussed.

Effect of mouth washing on the

BACKGROUND

Mouth washing is often mentioned as a possible method to eliminate the interference of urease activity in the oral cavity before the [13C]-urea breath test (UBT). However, the effectiveness of mouth washing prior to testing has not been demonstrated clearly in the literature. Thus, the present study was designed to examine the consistency of the [13C]-UBT and the effects of mouth washing on it.

METHODS

A total of 101 healthy volunteers underwent the [13C]-UBT three times. The first and second tests used a standard protocol and collected samples at 5, 10, 15 and 30 min. In the third test, the procedure was the same except that mouth washing was omitted.

RESULTS

We used 5 permil (/1000) as the cut-off value and there were 21 (20.8%) positive cases. The kappa values for the samples collected at 5, 10, 15 and 30 min between the first and second tests were 0.68, 0.97, 1 and 1, respectively, and all showed good consistency, except for the sample collected at 5 min. Judging from the mean value of the [13C] enrichment of the first and second tests (with mouth washing) and the third test (without mouth washing), 50 (63.3%), 15 (18.8%), 0 and 0 cases at 5, 10, 15 and 30 min, respectively, changed from negative to positive. There were 14 (17.5%) and six (7.5%) cases at 15 and 30 min, respectively, whose [13C] enrichment changed from less than 3 (negative) to between 3 and 5 (border zone).

CONCLUSIONS

These results indicate that mouth washing had an important effect on samples obtained at 5 and 10 min, while this influence decreased at 15 min and was lowest at 30 min.

Medication lists for elderly patients: clinic-derived versus in-home inspection and interview

OBJECTIVE

To determine how often the lists of regular medications derived in geriatric clinics by examination of "medication bags" and interview matched those found during in-home inspections and interviews.

DESIGN

Prospective cross-sectional study.

SETTING

Geriatric clinics at three university-affiliated hospitals.

PARTICIPANTS

Consecutive community-dwelling outpatients 65 years or older who were newly referred.

METHODS

The in-home medication inspection used a semistructured interview followed by a room-to-room search. The medications identified in the home were compared with the medication list derived in clinic by examination of the "medication bag" and interview.

MAIN RESULTS

Fifty patients with a mean age of 78.9 years participated. The mean number of regular medications (prescription and nonprescription) was 6.3, and the mean number of regular prescription medications was 3.6. A comparison of clinic versus in-home medication lists revealed that 48% (95% confidence interval [95% CI], 34% to 62%) of patients had at least 1 omission of any regular medication and 19% (95%, CI 10% to 32%) of patients had at least 1 omission of a regular prescription medication.

CONCLUSION

The clinic-derived medication list resulted in a complete listing of all regular medications in only 52% taking regular medications. More specific instructions to patients to bring all prescription and nonprescription medications and all vitamins, herbal, and natural remedies, and more directed questions by physicians may result in more complete clinic medication lists.

Effects of melatonin, morphine and diazepam on formalin-induced nociception in mice

The possible analgesic effect of melatonin was investigated in young male ICR mice. The formalin test which elicits typically 2 phases of pain response, the acute (first) phase and tonic (second) phase, was used. The test was performed in the late light period when the mice have been reported to be more sensitive to pain. Compared to control mice, no significant difference in nociceptive response was observed when melatonin was injected intraperitoneally at doses of 0.1, 5, and 20, mg/kg body weight. The combined effects of melatonin with diazepam and/or morphine, were also investigated. Melatonin, injected at 20 mg/kg 15 min before formalin test, significantly increased the antinociceptive response of diazepam (1 mg/kg) or morphine (5 mg/kg) in the second phase. In addition, when melatonin was given at 20 mg/kg together with diazepam and morphine, antinociceptive responses in both the first and second phase were increased. These data indicate the synergistic analgesia effect of melatonin with morphine and diazepam and suggest the possible involvement of melatonin as an adjunct medicine for pain patients.

The lens model: assessment of cancer pain in a Chinese context

Obtaining a result closest to patients' reports about pain is crucial in pain management. The literature in the West supports the view that there are cultural differences in perception, interpretation, and expression of pain. However, there has been minimal review in Chinese communities. Therefore, the concepts of cancer pain among Chinese patients with cancer were explored by data source triangulation. There were 33 informants: 18 adult Chinese patients with cancer who were in pain, 7 physicians, and 8 nurses. The interview dialogue was transcribed into written Chinese, followed by coding and categorization. There were no predetermined themes for categorization. The dialogue was coded according to the contextual meaning. The nature and number of categories depended entirely on the coding. Five dimensions were identified: functional, pharmacologic, pain belief and meanings, psychosocial, and emotional. With reference to the five dimensions, a lens model was constructed to explain the cancer pain experience in a Chinese context. In the lens model, two lenses were used to illustrate the relations of the dimensions and cancer pain experience in the Chinese context. The pain experience was named as total pain intensity. The functional, pharmacologic, psychosocial, and emotional dimensions were the independent variables. The pain beliefs and meanings dimension was the mediating variable, and the dependent variable was the total pain intensity in the assessment of cancer pain.

Serum endostatin levels are elevated and correlate with serum vascular endothelial growth factor levels in patients with stage IV clear cell renal cancer

Clear cell renal carcinoma (CCRC) is a highly angiogenic tumor known to secrete vascular endothelial cell growth factor (VEGF). Endostatin is an endogenous antiangiogenic agent with antitumor activity in mice. The purpose of this study was to evaluate serum levels of endostatin in normal subjects and in patients with CCRC and to examine the relationship of these levels to circulating VEGF levels. Fifteen patients (mean age, 48 years) on a clinical protocol for stage IV CCRC at the National Cancer Institute were included in the study. Archived prenephrectomy serum samples were analyzed for endostatin and VEGF concentrations. Endostatin and VEGF levels were compared with those of an age-matched group of volunteer blood donors (n = 18) using a competitive enzyme immunoassay. Data were analyzed using the Mann-Whitney U test and the Spearman rank correlation. Median serum endostatin levels were 24.6 ng/ml (range, 15.1-54.0 ng/ml) in CCRC patients versus 14.1 ng/ml (range, 1.0-19.3 ng/ml) in healthy controls (P < 0.0001). Median VEGF levels were 3.4 ng/ml (range, 0.1-11.2 ng/ml) and 2.5 ng/ml (range, 0.1-4.2 ng/ml), respectively (P = 0.065). A highly significant correlation was observed between endostatin and VEGF levels among the CCRC patients (r = 0.81, P = 0.0003) but not among controls (r = -0.22, P = 0.37). Endostatin levels are detectable in serum from healthy subjects as well as from CCRC patients. Levels are significantly elevated and correlate with VEGF levels in CCRC patients. Elucidating the nature of this correlation may lend insight into the regulation of tumor angiogenesis in patients with renal cancer.

Preoperative Multidimensional Affect and Pain Survey (MAPS) scores predict postcolectomy analgesia requirement

OBJECTIVES

One aim of this study was to evaluate the relation of scores on the Multidimensional Affect and Pain Survey (MAPS) that was administered before surgery to postoperative morphine consumption and patient-controlled analgesia. A second aim of the study was to compare the ability of MAPS administered postsurgery with the commonly used Numerical Pain Rating Scale to predict patient-controlled analgesia behavior.

DESIGN

The MAPS questionnaire measures pain, suffering, and well-being. It was administered to patients 1 day before and 1 day after left hemicolectomy for colon cancer. The relations of the two scores to postoperative pain control were determined.

PATIENTS

Thirty-four patients in the surgical ward of a general hospital admitted for colorectal cancer surgery participated in this study.

RESULTS

High preoperative MAPS scores on sensory and emotional words predicted postoperative morphine dosage, dose presses, and lockout presses. Greater morphine consumption was correlated positively with high presurgery MAPS scores in four of the eight "Suffering" subclusters (Depressed Mood, Anger, Anxiety, and Fear). High presurgery MAPS scores in 13 of the 17 "Sensory Qualities" subclusters (e.g., Bothersome, Intense Pain, Pain Extent, Incisive Pressure, Traction/Abrasion) were correlated positively with lockout presses. Neither the postsurgery MAPS nor the postsurgery Numerical Pain Rating Scale predicted patient-controlled analgesia behavior.

CONCLUSION

The emotional states and attitudes of the patients toward pain before surgery are important factors in determining patient-controlled analgesia pressing behavior and postoperative demand for analgesics.

The structural basis for the recognition of acetylated histone H4 by the bromodomain of histone acetyltransferase gcn5p

The bromodomain is an approximately 110 amino acid module found in histone acetyltransferases and the ATPase component of certain nucleosome remodelling complexes. We report the crystal structure at 1.9 A resolution of the Saccharomyces cerevisiae Gcn5p bromodomain complexed with a peptide corresponding to residues 15-29 of histone H4 acetylated at the zeta-N of lysine 16. We show that this bromodomain preferentially binds to peptides containing an N:-acetyl lysine residue. Only residues 16-19 of the acetylated peptide interact with the bromodomain. The primary interaction is the N:-acetyl lysine binding in a cleft with the specificity provided by the interaction of the amide nitrogen of a conserved asparagine with the oxygen of the acetyl carbonyl group. A network of water-mediated H-bonds with protein main chain carbonyl groups at the base of the cleft contributes to the binding. Additional side chain binding occurs on a shallow depression that is hydrophobic at one end and can accommodate charge interactions at the other. These findings suggest that the Gcn5p bromodomain may discriminate between different acetylated lysine residues depending on the context in which they are displayed.

[Effect of combined treatment of Shuanghuanglian and recombinant interferon alpha 2a on coxsackievirus B3 replication in vitro]

OBJECTIVE

To investigate the effect of combined treatment of Shanghanglian (SHHL) and recombinant interferon alpha 2a on Coxsackie virus B3 replication.

METHODS

Microdose cytopathogenic inhibition effect assay was used in Wish and Vero cultured cells. rIFN-alpha 2a was applied 12 hours before Coxsackievirus B3 inoculation and SHHL was applied 1 hour after Coxsackievirus B3 inoculation.

RESULTS

0.125 mg.ml-1 SHHL has a synergism with rIFN-alpha 2a to inhibit CPE caused by Coxsackievirus B3 on the Wish and Vero cells. The anti-cox-sackievirus activity of combined treatment was 2.58 times higher than that of rIFN-alpha 2a treatment.

CONCLUSION

This combined treatment of drugs may be useful in preventing and treating Coxsackie B3 Virus infection.

Bcl-2 does not inhibit the permeability transition pore in mouse liver mitochondria

The mechanism by which the mitochondrially-localized Bcl-2 protein inhibits apoptosis is still unclear. Some authors have proposed that apoptosis is dependent on induction of the mitochondrial permeability transition pore (PTP), and that activators of apoptosis such as Bax work through activation of PTP, whereas inhibitors of apoptosis such as Bcl-2 work through inhibition of PTP, and the consequent activation or inhibition of PTP-dependent release of mitochondrial apoptotic factors, including cytochrome c. PTP opening is classically measured by a light-scattering assay of large-amplitude swelling of rodent liver mitochondria in sucrose media. Thus to test the hypothesis that Bcl-2 inhibits either the PTP or the PTP-dependent release of cytochrome c, the rate and extent of PTP, and PTP-dependent release of cytochrome c were compared in liver mitochondria from control and Bcl-2 transgenic mice. We demonstrated that Bcl-2 protein was expressed to high levels in mitochondria of transgenics versus controls. We confirmed that while control mice undergo massive hepatic cell death upon exposure to anti-Fas antibody, the Bcl-2 transgenic livers were resistant, by the criteria of gross morphology, serum enzyme release, and caspase 3 activity. We purified mitochondria from livers of the Bcl-2 transgenics and measured PTP directly by the mitochondrial swelling assay. Purified mitochondria from both transgenics and controls were induced to undergo large-amplitude swelling that was dependent on the classical PTP inducers calcium ion (Ca(2+)), t-butyl hydroperoxide (tBOOH) and atractyloside (Atr); and as expected, pretreatment of mitochondria with cyclosporin A (CsA) completely abolished mitochondrial swelling. However, there was no difference in the rate or final extent of PTP induction in Bcl-2 overexpressors versus control mitochondria. Furthermore, there was no difference in the PTP dependent release of cytochrome c from Bcl-2 overexpressors versus control mitochondria. Therefore, while we observe a strong inhibition of Fas-dependent apoptosis by Bcl-2 overexpression in mouse liver, we observe no effect of Bcl-2 overexpression on either the rate or extent of mitochondrial PTP, or upon the release of cytochrome c from mitochondria in which the PTP has been induced. The simplest explanation of these results is that Bcl-2 inhibits neither PTP nor PTP-dependent release of cytochrome c, however, other possibilities are discussed.

Ultrastructural study of extraocular muscle in congenital nystagmus

To determine the mechanism of congenital nystagmus (CN), the ultrastructure of the extraocular muscle in CN patients was examined with the transmission electron microscope. The specimen of muscle tissue was taken during surgery from horizontal recti in the slow and quick phase sides separately in the jerky type, and medial and lateral recti in the pendular type. The extraocular muscle was immediately fixed in 2.5% glutaraldehyde solution. (1) In the jerky type, the myocytes in the quick phase side showed myofibrillae that were perpendicular to axes of myocytes and had the structure of sarcomeres. In the slow phase side there were perpendicular myofibrillae in the periphery of myocytes. (2) In the pendular type, there were no perpendicular myofibrillae within myocytes. The myofibrillae that were parallel to the axes of myocytes were arranged disorderly. The length of the H and I bands in different myofibrillae was not identical. These results demonstrated, for the first time, the ultrastructural changes in the extraocular muscle of CN patients, which might provide the pathological basis for this disease.

Chemical modification of a variant of human MIP-1alpha; implications for dimer structure

A sequence variant of human MIP-1alpha, in which Asp26 has been replaced by Al alpha, has been chemically modified by the addition of 13C-labeled methyl groups at each of the lysine residues and the N-terminus. The sites of methylation have been verified by a combination of MALDI-TOF mass spectrometric experiments and tryptic digestion followed by N-terminal mapping. The effect of the modification on the structure and activity of the protein have been determined by analytical ultra-centrifugation, 13C NMR spectroscopy and receptor binding studies. The results of these experiments suggest that huMIP-alpha D26A (BB10010), when present as a dimer, adopts a globular structure, like MCP-3, rather than the elongated or cylindrical structure determined for dimers of huMIP-1beta and RANTES.

Combined effect of isoflurane and esmolol on sympathetic responses to tracheal intubation

BACKGROUND

Influences of isoflurane and esmolol on endotracheal intubation induced sympathetic changes could be different. The effect of isoflurane and its combination with esmolol on catecholamine, blood pressure and pulse during endotracheal intubation were investigated.

METHODS

Thirty patients were anesthetized with 3.0% isoflurane and tracheal intubation was carried out at the 5th min following the exposure to isoflurane. Half of them received intravenous saline and the other half received esmolol 2 mg/kg at the 4th min. Cardiovascular parameters were recorded and venous blood samples were taken for measurement of catecholamines every min.

RESULTS

One min after administration of isoflurane, there was increase of heart rate (P < 0.05), while at the same time the epinephrine level fell (P < 0.05) and norepinephrine level remained unaltered. Both catecholamines raised after intubation (P < 0.05). The sympathetic responses to and the beta-antagonistic effect of esmolol on intubation were not significantly changed in the presence of isoflurane.

CONCLUSIONS

Isoflurane increased heart rate while paradoxically decreased epinephrine. Norepinephrine was more specifically related to endotracheal intubation, for its serum level had little change before the event. Based on catecholamine findings, the mechanism of isoflurane effect on the sympathetic system is probably different from that of endotracheal intubation.

A morphometric evaluation of allograft matrix combinations in the treatment of osseous defects in a baboon model

Recent and ongoing research efforts have been made to increase the efficacy of biomaterials as structural fillers during in vivo bony reconstructions. Although the selection of the possible material choices has grown, a biomaterial that can be physically molded to the defect/void space as well as offer biomimetic tissue regeneration has yet to be made available. With the potential success of demineralized freeze-dried bone allografts (DFDBA) combined with tendonous collagen as an effective filling material, further research should help to elucidate its use. The purpose of this study was to evaluate the regenerative healing response of five allograft mixtures via the morphology of filled, periodontal defects. Critical size mandibular and maxillary osseous defects were surgically created in six adult baboons. The filling response of four combinations of DFDBA and tendon collagen was compared with an all-collagen graft after 3 months of implantation. The overall results indicate that all combinations of DFDBA and collagen provided a better fill response than the all-collagen matrix (P < 0. 05). Statistically, however, all of the combinations were similar (P > 0.05) with a 60:40 collagen to DFDBA mass ratio resulting in the largest defect fill response.

Morphine and methadone have different effects on calcium channel currents in neuroblastoma cells

Using patch-clamp technique, cellular calcium channel currents were studied on nine mouse neuroblastoma N1E115 cells. Both morphine and methadone decreased the T-type calcium currents in dose-dependent fashion. These effects were partially blocked by naloxane. On L-type calcium currents, morphine showed no effect. However, methadone inhibited the L-calcium currents in dose-dependent fashion. This effect was not antagonised by naloxone. Hence, the action of methadone on L-calcium channel is probably not associated with mu receptors.

Rapid and Semi-automated Method for Analysis of the Number of Atoms of Ultra-small Platinum Clusters on Carbon

Very high angle ( approximately 100 mrad) annular dark-field (HAADF) images in a dedicated scanning transmission electron microscope (STEM) can be used to quantitatively measure the number of atoms in a cluster on a support material. We have developed a computer program which will automatically find the location of the particles and then integrate the intensity to find the number of atoms per cluster. We have examined ultra-small Pt clusters on a C substrate by this novel mass-spectroscopic technique. We discovered that the Pt clusters maintain their three-dimensional shape, and are probably spherical.

Accurate diagnosis of Helicobacter pylori infection by stool antigen test and 6 other currently available tests in children

Invasive and noninvasive tests have been developed for the diagnosis of Helicobacter pylori infection. Because H pylori infection is acquired in childhood and adolescence, accurate diagnosis of the infection in the pediatric population is important. We conducted a study to compare invasive tests: culture, biopsy urease test, histology, and polymerase chain reaction on gastric biopsy specimens, with noninvasive tests: serology, (13)C-urea breath test, and a new diagnostic modality, stool antigen test to diagnose H pylori infection. A total of 53 children with symptoms were enrolled in this study, and all had completed the 7 diagnostic tests for H pylori. All the diagnostic tests except serology were excellent methods of diagnosing H pylori infection in children; the diagnostic accuracy was as follows: stool antigen test 96.2%, biopsy urease test 96.2%, histology 98.1%, polymerase chain reaction 94.3%, culture 98.1%, (13)C-urea breath test 100%, and serology 84.9%. The stool antigen test, being highly sensitive and specific, will be potentially very helpful in diagnosing H pylori infection in children.