A comparison of the binding and functional properties of alpha-1 adrenoceptors and area density of smooth muscle in the human, canine and rat prostates

The present study was designed to compare the binding and functional properties of alpha-1 adrenoceptors and the area density of smooth muscle in the human, canine and rat prostates. Chloroethylclonidine (CEC)-sensitive and -insensitive alpha-1 adrenoceptors were characterized on slide-mounted prostatic tissue sections using the ligand [3H]prazosin. The mean equilibrium dissociation constants (Kd) for [3H]prazosin binding sites were not significantly different among the three different species. The densities (Bmax) of CEC insensitive [3H]prazosin binding sites in the human, canine and rat prostates were 1.71 +/- 0.32, 0.35 +/- 0.04 and 0.84 +/- 0.11 fmol/mg of wet weight, respectively. The Bmax of CEC-sensitive [3H]prazosin binding sites in the human, canine and rat prostates were 1.32 +/- 0.83, 0.44 +/- 0.11 and 0.25 +/- 0.10 fmol/mg of wet weight, respectively. The contractile response elicited by the rat prostate in the presence of phenylephrine was consistently negligible. The mean maximal force after phenylephrine challenge (phenylephrine Emax) in the human and canine prostates were 0.125 +/- 0.025 g of force/mm2 cross-sectional area and 0.096 +/- 0.014 g of force/mm2 cross-sectional area, respectively. CEC inactivated 80 and 53% of the phenylephrine contractile response in man and dog, respectively. The mean percentage of area densities of smooth muscle in the human, canine and rat prostates were 38.8, 12.9 and < 1%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Premature carotid atherosclerosis: does it occur in both familial hypercholesterolemia and homocystinuria? Ultrasound assessment of arterial intima-media thickness and blood flow velocity

BACKGROUND AND PURPOSE

Homocystinuria due to cystathionine beta-synthase deficiency and familial hypercholesterolemia are inherited disorders of metabolism that are associated with premature development of cardiovascular disease. This study addresses the possibility that different patterns of carotid wall damage and cerebral blood flow hemodynamics are present in these two metabolic diseases.

METHODS

Twelve patients with homocystinuria due to cystathionine beta-synthase deficiency (mean age, 24 years), 10 patients with homozygous familial hypercholesterolemia (mean age, 26 years), and 11 healthy control subjects (mean age, 26 years) underwent a vascular examination by noninvasive methods. B-mode ultrasound imaging was used to obtain measurements of intima-media thickness of common carotid, bifurcation, and internal carotid arteries as an index of atherosclerosis. Cerebral blood flow velocity was estimated from vascular examination of the middle cerebral artery by transcranial Doppler. Systolic, diastolic, and mean velocities were measured. Pulsatility index, a possible indicator of vascular resistance in the cerebral circulation, was also calculated.

RESULTS

Mean maximum intima-media thickness was 1.4 mm in patients with familial hypercholesterolemia, 0.6 mm in patients with homocystinuria, and 0.6 mm in control subjects. The difference between hypercholesterolemic and homocystinuric patients or control subjects was statistically significant (P < .001). Diastolic blood flow velocities were significantly reduced in the middle cerebral arteries of hypercholesterolemic patients compared with homocystinuric patients or control subjects (P < .05), whereas systolic or mean velocities did not differ. The pulsatility index, a possible indicator of vascular resistance in the cerebral circulation, was significantly higher in hypercholesterolemic patients compared with homocystinuric patients or healthy control subjects (P < .01). A direct relation was demonstrated between pulsatility index of the middle cerebral artery and mean maximum intima-media thickness of carotid arteries on the same side (P < .001).

CONCLUSIONS

Familial hypercholesterolemia is responsible for diffuse and focal thickening of carotid arteries and possibly also for hyperlipidemic endothelial dysfunction extending to small resistance arteries and leading to a disturbed cerebral blood flow. Patients with homocystinuria due to homozygosis for cystathionine beta-synthase deficiency seldom have plaques in their carotid arteries. They are similar to healthy control subjects with regard to both intima-media thickness and blood flow velocity in the middle cerebral artery. Therefore, it is unlikely that typical atherosclerotic lesions precede thrombotic events in homocystinuria. However, it is possible that arterial dilatations caused by medial damage lead to thrombosis in homocystinuric patients.

The alpha 1-adrenergic receptor that mediates smooth muscle contraction in human prostate has the pharmacological properties of the cloned human alpha 1c subtype

Molecular cloning studies have revealed the existence of three subtypes of alpha 1-adrenergic receptors. However, the link between any individual subtype and its functional role in the body has remained elusive. In an effort to bridge the gap between molecular biology and pathophysiology, we have chosen a model smooth muscle system, the human prostate, and investigated the role of alpha 1 subtypes in this tissue. To determine which alpha 1-adrenergic receptor subtype mediates the contractile response of the human prostate, we first studied the pharmacological properties of three cloned human alpha 1 subtypes (alpha 1a/d, alpha 1b, and alpha 1c). Prazosin, terazosin, doxazosin, alfuzosin, and abanoquil showed no selectivity for the human alpha 1 subtypes. WB-4101 and 5-methylurapidil showed a rank order of potency of alpha 1c > alpha 1a/d >> alpha 1b. Indoramin and (+)-niguldipine were selective for the alpha 1c-adrenergic receptor, with at least 10-fold lower affinity at either alpha 1a/d or alpha 1b subtypes. SK&F104856 was found to be 6-fold more potent at the alpha 1a/d receptor subtype than at alpha 1b- or alpha 1c-adrenergic receptors. We next determined the potency of these antagonists to inhibit the phenylephrine-induced contraction of human prostatic tissue in vitro. The potencies of indoramin, 5-methylurapidil, and SK&F104856 to inhibit the contractile response and to displace [3H]prazosin from the cloned human alpha 1c subtype were similar. Our data suggest that the alpha 1 receptor that mediates the contraction of human prostate smooth muscle has the pharmacological properties of the cloned human alpha 1c-adrenergic receptor. The findings of the present study suggest that selective alpha 1c-adrenergic receptor antagonists may be clinically more efficacious and better tolerated agents for the treatment of symptomatic benign prostatic hyperplasia.

Value of carcinoembryonic antigen in the management of colorectal cancer

PURPOSE

The practical value of carcinoembryonic antigen (CEA) assay in the management of colorectal cancer after surgery is controversial. The value of CEA in the management of colorectal cancer was reviewed and discussed to justify the use of CEA assay in the management of colorectal cancer.

METHODS

A retrospective study was performed on 318 patients who underwent resection by one surgeon (JYW) between 1981 and 1986 and who were followed for a minimum of 5 years or until death.

RESULTS

The incidence of preoperative CEA levels > 5 ng/ml in Dukes Stages A, B, C, and D were 0, 32, 48, and 79 percent, respectively. Five-year survival rates for groups with CEA levels < or = 5 ng/ml and > 5 ng/ml were 85 percent and 55 percent (P < 0.05), respectively, in Dukes Stage B patients and 64 percent and 37 percent (P < 0.05) in Stage C patients. The sensitivity and specificity of postoperative CEA monitoring in detecting recurrent diseases were 66 percent and 94 percent, respectively, for patients with a preoperative CEA value < or = 5 ng/ml and 97 percent and 88 percent for patients with a higher preoperative CEA value.

CONCLUSION

CEA is still the best tumor marker available to be used as an independent prognostic factor and as a monitor for recurrence of disease after primary tumor resection.

Localization of endothelin receptors in the human prostate

The objective of the present study was to localize endothelin receptors in the human prostate using quantitative autoradiography. Slide-mounted tissue sections 20 microns. in thickness were obtained from the transition zones of seven patients undergoing radical prostatectomies for low volume prostate cancer. Sarafotoxin (S6C) and BQ123 have been used to distinguish endothelin receptor subtypes (ETA and ETB). The prostatic tissue sections were incubated in four different stock solutions containing the following: 0.1 nM. 125I-endothelin-1 (125I-ET-1) (total ET-1 binding); 0.1 nM. 125I-ET-1 and 100 nM. S6C (total ETA binding); 0.1 nM. 125I-ET-1 and 1 microM. BQ123 (total ETB binding); and 0.1 nM. 125I-ET-1 and 1 microM. ET-1 (nonspecific ET-1 binding). Nonspecific binding accounted for only 12 and 15% of total 125I-ET-1 binding in the stroma and glandular epithelium. Autoradiograms were quantitatively analyzed using a computerized image analysis system. Specific radioactive densities (nCi/mg.) were determined for the stromal and glandular epithelial elements of the prostate. The specific radioactive densities of ETA and ETB binding sites in the stroma were 7.57 +/- 0.65 and 2.98 +/- 0.81. The specific radioactive densities of ETA and ETB binding sites in the glandular epithelium were 1.59 +/- 0.15 and 7.87 +/- 1.35. The present study demonstrates that the predominant endothelin receptors in the stroma and glandular epithelium are the ETA and ETB subtypes, respectively.

The effect of cell density on the production of xylitol from D-xylose by yeast

The rate of xylitol production from D-xylose increased with increasing yeast cell density. The optimal temperature for xylitol production is 36 degrees C, and the optimal pH range is from 4.0 to 6.0. At high initial yeast cell concentration of 26 mg/mL, 210 g/L of xylitol was produced from 260 g/L of D-xylose after 96 h of incubation with an indicated yield of 81% of the theoretical value.

Binding and functional properties of endothelin receptor subtypes in the human prostate

The objective of the present study was to characterize the binding and functional properties of endothelin (ET) receptor subtypes in the human prostate. Human prostatic tissue was obtained from male subjects undergoing radical prostatectomy for low-volume prostate cancer. The optimal assay conditions for characterizing human prostatic ET-1 binding sites on slide-mounted tissue sections were defined. Maximal specific 125I-ET-1 binding was achieved after a 10-min preincubation, a 120-min incubation, and a washing procedure that consisted of a brief rinse and a 1-min wash. The mean equilibrium dissociation constant (Kd) and density (Bmax) of ET-1 binding sites determined from six saturation studies were 0.72 +/- 0.13 nM and 40.4 +/- 6.9 fmol/mg of wet weight, respectively. The mean Hill coefficient was 0.99 +/- 0.01, indicating that 125I-ET-1 identifies a single population of binding sites. The pharmacology of 125I-ET-1 binding sites was characterized using competitive binding experiments. The competition plots for ET-1 were best fit by a one-binding site model, whereas the plots for sarafotoxin 6C (S6C) and BQ123 were consistently best fit by a two-site model. The mean Ki value of ET-1 was 0.34 +/- 0.12 nM. The mean Ki values for the high and low affinity S6C binding sites were 0.50 +/- 0.09 nM and 0.84 +/- 0.28 microM, respectively. The mean Ki values for the high and low affinity BQ123 binding sites were 5.51 +/- 1.05 nM and 24.9 +/- 6.5 microM, respectively. The ratio of ETA to ETB binding sites was approximately 2:1. The ET receptor subtype mediating prostatic smooth muscle tension was investigated using agonist-antagonist competition studies. ET-1, a nonselective ET agonist, elicited a potent contraction of prostate smooth muscle. The pA2 of BQ123 for inhibiting ET-1-mediated contraction was 6.84. S6C, a selective ETB agonist, also elicited a potent contraction of prostate smooth muscle. BQ123 at concentractions between 0.1 and 10 microM did not shift the S6C dose-response curve. These functional studies suggest that both ETA and ETB receptors mediate the tension of prostate smooth muscle. Endogenous ETS may be involved in the pathophysiology of bladder outlet obstruction in men with benign prostatic hyperplasia. If this is the case, then ET antagonists may represent effective treatment for benign prostatic hyperplasia.

Anti-colony-stimulating factor-1 antibody staining in primary breast adenocarcinomas correlates with marked inflammatory cell infiltrates and prognosis

BACKGROUND

Clinical studies have shown that a marked lymphoplasmocytic reaction in breast tumors is associated with poor prognosis. Such findings raise the possibility that an inflammatory cell reaction might be a tumor-induced response that tends to promote tumor growth.

PURPOSE

We assessed the expression of colony-stimulating factor-1 (CSF-1) as well as the prevalence of specific tumor-infiltrating lymphocytes and monocytes in breast tumors.

METHODS

Tissue sections were obtained from archival paraffin blocks from 196 breast cancer patients. Seventy-eight percent of the women had been treated by mastectomy and 22% by lumpectomy. Median age of the patients was 54 years, and median follow-up was 7.3 years. Immunohistochemical and in situ hybridization techniques were used to characterize the specimens.

RESULTS

Markedly high numbers of CD45RO-positive T- and L26-positive B-cell infiltrates were found in 13% and 17% of the tissue specimens, respectively. CSF-1 receptor-positive monocytes were detected in 48% and CD68-positive monocytes in 90% of the tumors. In turn, tumors with large fractions of CD68-positive monocytes also showed CSF-1 receptor-positive monocytes (P < .0001). CSF-1 was expressed significantly in 74% of the tumors and the CSF-1 receptor in more than 50% of the tumors. Tumors with high percentages of CSF-1 expressing cells also had marked monocyte infiltrates (P = .035). The presence of marked CD45RO-positive T-cell infiltrates and apparent nuclear staining of CSF-1 in tumor cells were associated with the more frequent occurrence of metastases (P = .02 and P = .04, respectively) and with poor survival (P = .02 and P = .03, respectively).

CONCLUSIONS

Large numbers of CD45RO-positive (activated memory but noncytotoxic) T cells as well as a predominant nuclear staining pattern for CSF-1 are associated with a poor outcome in breast cancer patients.

IMPLICATIONS

Nuclear retention of CSF-1 could reflect CSF-1 turnover and function in tumor cells, but new approaches are needed to establish the significance of these observations. Secreted CSF-1 appears to cause monocyte recruitment and activation, thereby modulating immune functions and potentially the expression of the CD45RO phenotype in T cells.

Characterization and localization of prostatic alpha 1 adrenoceptors using radioligand receptor binding on slide-mounted tissue section

Alpha 1 adrenoceptor binding sites have been characterized in prostatic tissue homogenates using radioligand receptor binding studies. The objective of the present study was to characterize and localize prostatic alpha 1 adrenoceptor binding sites using slide-mounted tissue sections and the ligand 3H-prazosin. The present study demonstrated that preincubation is not required; the optimal incubation interval is 40 minutes; and a 1-minute wash (once or twice) maximizes the proportion of specific 3H-prazosin binding. Saturation studies were performed at 8 different concentrations of 3H-prazosin ranging between 0.0625 nM. to 8.0 nM. The binding of 3H-prazosin was consistently saturable and of high affinity. The mean Kd and Bmax determined from 6 saturation studies was 4.16 x 10(-10) M. and 1.30 fmol./mg. wet weight, respectively. The pharmacology of these 3H-prazosin binding sites was characterized using competitive displacement experiments. The mean IC50 corrected for prazosin, phentolamine and yohimbine was 7.8 x 10(-10) M., 6.0 x 10(-9) M. and 2.1 x 10(-6) M. The rank order of the IC50 corrected values indicates that alpha 1 binding sites were measured under the assay conditions. In the present study, the mean values for Kd, Bmax and IC50 corrected are similar to values previously reported using prostatic tissue homogenates. Prostatic tissue sections were apposed to x-ray film after being incubated with 3 nM. 3H-prazosin (total prazosin binding) and 3 nM. 3H-prazosin + 8 microM. prazosin (nonspecific prazosin binding). The autoradiograms were analyzed using a computerized analyzing system. The specific radioactive densities of 3H-prazosin in the stroma and glandular epithelium were 1099 +/- 48 pCi/mg. and 163 +/- 42 pCi/mg. The present study validates the technique of assaying alpha 1 adrenoceptor binding sites on slide-mounted prostatic tissue sections and provides further evidence that alpha 1 adrenoceptor binding sites are localized primarily to the stromal elements of the prostate.

The association between perioperative blood transfusion and survival of patients with colorectal cancer

BACKGROUND

The authors undertook this study to test the hypothesis that perioperative blood transfusion has an adverse effect on survival of patients with colorectal cancer.

METHODS

A retrospective analysis was performed on 725 patients who underwent curative resection for Dukes Stage B and C colorectal cancers in our institution between 1981-1985 and who were followed for 5-11 years.

RESULTS

Rectal cancers occurred more frequently in the transfused than in the nontransfused patients (64% versus 47%; P = 0.0001). In the patients with colon cancer, no significant effect of transfusion on recurrence-free survival was seen (P = 0.8, log-rank; P = 0.49, Cox regression analysis). The cumulative 5-year survival rate was 77% (95% confidence interval, 69-85%) for the nontransfused and 78% (72-83%) for the transfused patients. In patients with rectal cancer, the 5-year survival rate was 79% (67-87%) for the nontransfused and 67% (59-71%) for the transfused patients. A significant association was noted in patients with Stage B cancer (P = 0.002, log-rank; P = 0.02, Cox regression analysis), but not in those with Stage C cancer (P = 0.05, log-rank; P = 0.15, Cox regression analysis). In patients with Stage B rectal cancer, more frequent abdominoperineal resections (APR) were performed among the transfused patients (65% versus 32%; P = 0.0001). This subgroup was further stratified by operative procedure and reanalyzed using the same Cox regression model. Transfusion had no effect on survival of patients treated by APR (P = 0.31) or of those having a sphincter-saving procedure (P = 0.53).

CONCLUSION

The seemingly adverse effect of perioperative blood transfusion on the survival of patients with colorectal cancer may be explained by other covariates.

Endothelin-1 in the human prostate: tissue levels, source of production and isometric tension studies

Endothelins mediate contractile responses in many types of vascular and nonvascular smooth muscle. The present study represents the first detailed characterization of endothelins in the human prostate. The objectives of this study were to determine the tissue levels and source of endogenous endothelin-1 (ET1) in the human prostate. The contractile effects of ET1 were also investigated using in vitro isometric tension studies. The mean tissue level of ET1 was 0.58 +/- 0.08 pg./mg. tissue wet weight. Endothelin-like activity was markedly prominent in the glandular epithelium of the human prostate, whereas minimal endothelin-like activity was observed in the prostatic stroma. Strips of human prostatic tissue were suspended in isolated tissue chambers and challenged to a concentration response of ET1. The mean EC50 and Emax for ET1 was 3.2 x 10(-8) M. and 0.12 +/- 0.02 gm. force per mm.2 cross-sectional area (CSA), respectively. Preincubation with indomethacin, terazosin, or nifedipine did not alter the concentration-dependent response to ET1. A calcium-free buffer abolished the contractile response to ET1. Thus, ET1 mediates a potent contraction of human prostatic smooth muscle that is not mediated via alpha 1 adrenergic or dihydropyridine sensitive calcium channels or prostaglandin synthesis. The presence of marked endothelin-like immunoreactivity strongly suggests a biological significance for endogenous endothelins in the human prostate.

The association between perioperative blood transfusion and survival of patients with colorectal cancer

BACKGROUND

The authors undertook this study to test the hypothesis that perioperative blood transfusion has an adverse effect on survival of patients with colorectal cancer.

METHODS

A retrospective analysis was performed on 725 patients who underwent curative resection for Dukes Stage B and C colorectal cancers in our institution between 1981-1985 and who were followed for 5-11 years.

RESULTS

Rectal cancers occurred more frequently in the transfused than in the nontransfused patients (64% versus 47%; P = 0.0001). In the patients with colon cancer, no significant effect of transfusion on recurrence-free survival was seen (P = 0.8, log-rank; P = 0.49, Cox regression analysis). The cumulative 5-year survival rate was 77% (95% confidence interval, 69-85%) for the nontransfused and 78% (72-83%) for the transfused patients. In patients with rectal cancer, the 5-year survival rate was 79% (67-87%) for the nontransfused and 67% (59-71%) for the transfused patients. A significant association was noted in patients with Stage B cancer (P = 0.002, log-rank; P = 0.02, Cox regression analysis), but not in those with Stage C cancer (P = 0.05, log-rank; P = 0.15, Cox regression analysis). In patients with Stage B rectal cancer, more frequent abdominoperineal resections (APR) were performed among the transfused patients (65% versus 32%; P = 0.0001). This subgroup was further stratified by operative procedure and reanalyzed using the same Cox regression model. Transfusion had no effect on survival of patients treated by APR (P = 0.31) or of those having a sphincter-saving procedure (P = 0.53).

CONCLUSION

The seemingly adverse effect of perioperative blood transfusion on the survival of patients with colorectal cancer may be explained by other covariates.

Binding and functional properties of alpha1 adrenoceptors in different regions of the human prostate

The objective of the present study was to determine the density and functional properties of alpha 1 adrenoceptors in different regions of the human prostate. Binding and functional studies were performed on eight different topographical regions of the prostate. The contractile response (gm. force/mm.2 cross-sectional area [CSA]) was determined at varying concentrations of phenylephrine, and saturation experiments were performed at seven different concentrations of 125I-Heat. The maximal response to phenylephrine (Emax) ranged from 0.067 to 0.272 gm. force/mm.2 The CSA and the EC50 ranged from 25 to 41 microM. The differences between EC50 and Emax were not significantly different among the eight prostatic regions. A 1.8-fold difference between the Emax for peripheral and central regions of the prostate was statistically significant (p = 0.04). The equilibrium dissociation constant (Kd) of 125I-Heat and the receptor density Bmax were determined from the Scatchard plots. The mean Kd and Bmax ranged from 0.15 to 0.26 nM. and 0.30 to 0.72 fmol. per mg. wet weight, respectively. There were no statistically significant differences between mean Kd and mean Bmax for the eight prostatic regions. The 1.7-fold difference between central and peripheral mean Bmax was not statistically significant (p = 0.07). A direct relationship was not observed between phenylephrine mean Emax and mean Bmax. The present study demonstrates regional differences of the binding and functional properties of prostatic alpha 1 adrenoceptors in the human prostate. These regional differences must be taken into account when investigating the pharmacologic and physiologic properties of the prostate.

Alpha 1 adrenoceptor subtypes in the human prostate

High affinity alpha 1 adrenoceptors have been characterized in the human prostate. The tension of prostatic smooth muscle is mediated by the alpha 1 adrenoceptor. The present study represents the first characterization of human alpha 1 adrenoceptor subtypes using radioligand receptor binding techniques. Binding studies were performed on tissue homogenates obtained from the human prostate. Competitive inhibition studies were performed in the presence of an 80 pM. 125I-Heat and 16 concentrations of unlabelled 5-methylurapidil (5 MU) or WB-4101 (10(-10) M. to 10(-5) M.). Saturation experiments were also performed with and without chloroethylclonidine (CEC, 10(-5) M.), a compound that selectively inactivates the alpha 1B subtype. The individual displacement plots for WB-4101 and 5-MU in the human prostate were consistently best fit by a 2 binding site model. WB-4101 and 5-MU exhibited a 594- and 186-fold higher affinity for the prostatic alpha 1A binding site relative to the alpha 1B binding site. The ratios of prostatic alpha 1A/alpha 1B binding sites discriminated by WB-4101 and 5-MU were 1.8 and 1.6, respectively. CEC inactivated 44% of the prostatic alpha 1 binding sites. The binding studies suggest that the dominant alpha 1 subtype in the human prostate is the alpha 1A. We are characterizing the functional properties of the alpha 1 subtypes in the human prostate.

An alternative treatment of anal squamous cell carcinoma: combined radiotherapy and chemotherapy

The conventional surgical treatment of anal squamous cell carcinoma is abdominoperineal resection. A new approach of combined radiotherapy and chemotherapy has been proposed following the observation of excellent local control. In this retrospective study, 40 cases of primary anal squamous cell carcinoma without distant metastasis were collected between 1979 and 1986 and the individual prognosis of the above two methods of treatment was evaluated. Group I (20 cases) received abdominoperineal resection with or without postoperative radiotherapy. Postoperative radiation was given if regional lymph node biopsy was positive. Group II (20 cases) received combined radiotherapy and chemotherapy with or without wide local excision. Radiation was delivered to the anus, pelvis, and bilateral inguinal nodal areas to a total dose of 5,500 rads. A continuous infusion of 5-FU was started on day 2 of the irradiation at a dose of 1,000 mg/m2 body surface/day for 5 days and a bolus injection of mitomycin was given on day 2 at a dose of 10 mg/m2 body surface. The second course was given 1 month later to complete the chemotherapy. The wide local excision was performed if the disease still persisted after completion of combined radiotherapy and chemotherapy. All 40 cases were followed up for at least 5 years. All cases (100%) in group I survived 1 year, 18 cases (90%) 2 years, 14 cases (70%) 3 years, 10 cases (50%) 4 years, and 6 cases (30%) 5 years. Twenty cases (100%) in group II survived 1 year, 17 cases (85%) 2 years, 13 cases (65%) 3 years, 8 cases (40%) 4 years, and 5 cases (25%) survived 5 years. All the mortalities in both groups died of distant metastasis or abdominal carcinomatosis. From the above results, the overall survival rate of combined radiotherapy and chemotherapy was not significantly worse than that of conventional abdominoperineal resection. In conclusion, combined radiotherapy and chemotherapy may be chosen as an alternative management in treating anal squamous cell carcinoma.

The alpha-adrenoceptor subtype mediating the tension of human prostatic smooth muscle

We have characterized the alpha 1 adrenoceptor subtypes in the human prostate using radioligand receptor binding studies. The objective of the present study was to determine the alpha 1 subtype mediating the tension of prostatic smooth muscle. Fresh human tissue was obtained from 9 males between 50 and 80 years of age undergoing prostatectomy for BPH. The incubation of prostatic tissue with the irreversible antagonist chlorethyclonidine (CEC) resulted in an 80% reduction of the maximal contractile response produced by phenylephrine. However, the alpha 1A-selective antagonists WB-4101 and 5-methylurapidil (5-MU) competitively inhibited the contractile response induced by phenylephrine, with KB = 2.64 and 4.46 nM, respectively, consistent with their affinity at the alpha 1A receptor subtype. The pharmacological profile of the alpha 1-receptor-mediated contractile response of prostate smooth muscle is inconsistent with their classification as either an alpha 1A or alpha 1B subtype. Alternatively, when compared with the properties of the cloned alpha 1 receptors, our results suggest that the alpha 1 receptors involved in the contraction of prostate smooth muscle have some pharmacological properties similar to those encoded by the gene of the bovine alpha 1C receptor subtype. The findings of the present study suggest that efforts should be made to confirm the identity of the alpha 1-receptor subtype expressed by prostate smooth muscle, in order to develop subtype-selective alpha 1 antagonists, and to evaluate their safety and efficacy in benign prostatic hyperplasia (BPH).

[CSF-1 (colony stimulating factors 1) and CSF-1 receptor. General review and expression in invasive breast tumors]

CSF-1 (colony stimulating factor-1), initially considered to be a monocyte specific growth and differentiation factor [4], has recently been shown to be produced in human endometrium [16], placenta [7], as well as in numerous solid tumors [19-23, 26, 27]. The CSF-1 receptor (a protein product of c-fms) [24] is a member of the tyrosine kinase receptor family and an autocrine or paracrine mechanism of activation has been suggested. Overactivation of this receptor can lead to a malignant phenotype in various cell systems [20, 21]. We review the biology of CSF-1 and fms expression in normal as well as in malignant tissues with particular reference to a potential role for CSF-1 in breast tumour invasion.

M-CSF (monocyte colony stimulating factor) and M-CSF receptor expression by breast tumour cells: M-CSF mediated recruitment of tumour infiltrating monocytes?

Infiltrating immune cells in 30 primary human epithelial breast tumours were studied using specific anti-CD3 (T cells), anti-CD68 (macrophages), anti-CD57 (NK cells), and an anti-pan-B cell antibody (L26). The majority of tumour infiltrating inflammatory cells are T cells (40-50%) and monocytes/macrophages (15-35%). The macrophage specific chemo-attractant and growth factor CSF-1 is detected by immunohistochemical techniques (IHC) at the level of invasive breast cancer cells in 46/50 tumours but not at the level of in-situ (pre-invasive) cancer. A mosaic staining pattern was usually observed, with a very high expression in areas of obvious stromal invasion (90% cells positive) and absent or trace staining in intraductal carcinoma. Macrophages and plasma cells are equally intensely positive. In-situ hybridisation experiments confirm the production of CSF-1 (mRNA) by tumour cells and show the same pattern of expression. Expression of the CSF-1 receptor protein (fms) was also observed by IHC in 41/48 invasive tumours, albeit at weaker intensities than in tumour infiltrating monocytes/macrophages. A concomitant expression of both CSF-1 and fms in in-situ carcinoma was never seen (n = 14). It is therefore proposed that the associated expression of CSF-1 and its receptor may be linked to the invasive potential of breast cancer, the monocytic infiltrate being an indication of the quantitative importance of CSF-1 production by the tumour.

Postoperative adjuvant radiotherapy in Astler-Coller stages B2 and C rectal cancer

Between 1979 and 1983, 127 patients with Stages B2 or C rectal cancer treated with surgery plus postoperative adjuvant radiotherapy (RT group) and 122 patients treated with surgery alone (S group) were compared to evaluate the effect of postoperative radiotherapy on survival and disease recurrence. Each group was stratified into subgroups according to stage and tumor differentiation as follows: Subgroups BW (Stage B2 and well-differentiated tumor), BM (Stage B2 and moderately differentiated tumor), CW (Stage C and well-differentiated tumor), CM (Stage C and moderately differentiated tumor), and P (poorly differentiated tumor). Ninety-five percent of the patients were followed until death or, if alive, to five years after surgery. Postoperative radiotherapy was associated with a reduced five-year survival rate in Subgroup BW (67 vs. 87 percent; P = 0.02). In the remaining subgroups of the RT group, there was a statistically insignificant trend toward a worse survival rate (56 vs. 65 percent, 47 vs. 64 percent, 41 vs. 46 percent, and 50 vs. 36 percent for Subgroups BM, CW, CM, and P, respectively). The local failure rates for the S group and RT group were 10 vs. 23 percent (P = 0.15) in Subgroup BW, 32 vs. 21 percent (P = 0.4) in Subgroup BM, 24 vs. 25 percent (P = 0.6) in Subgroup CW, and 18 vs. 18 percent (P = 0.6) in Subgroup CM, respectively. Eight percent (9/127) had severe or life-threatening radiation-related complications. Postoperative adjuvant radiotherapy alone did not improve the survival of patients with Stages B2 or C rectal cancers. It may have led to worsened survival in the subgroup of patients with well-differentiated Stage B2 rectal cancer.

Binding and functional properties of alpha 1 adrenoceptors and area density of smooth muscle in the canine prostate

The present study was designed to compare the area density of smooth muscle, and the binding and functional properties of alpha 1 adrenoceptors in 8 different regions of the canine prostate. The area density of smooth muscle, alpha 1 adrenoceptor density, and contractile response to phenylephrine were investigated using immunoenzymatic staining with color assisted computer image analysis, radioligand receptor binding, and isometric tension studies, respectively. The equilibrium dissociation constants (Kd) for 125I-Heat binding and the alpha 1 adrenoceptor densities (Bmax) in the prostatic regions ranged between 138-230 pM and 0.32-0.52 fmol/wet wt., respectively. The maximal tension generated in the presence of phenylephrine (phenylephrine Emax) and phenylephrine EC50s ranged between 0.043-0.129 gm. force/mm.2 CSA and 4.0-11.0 microM, respectively. The differences between Kd, Bmax, Emax, and EC50 were not significantly different between the different regions of the prostate. The percent area density of smooth muscle ranged between 10.6-24.4%. A direct relationship was not observed between alpha 1 adrenoceptor density and phenylephrine Emax, or alpha 1 adrenoceptor density and percent area density of smooth muscle. A direct relationship was observed between the phenylephrine Emax and percent area density of smooth muscle (p = 0.003; r = 0.90). The phenylephrine Emax and percent area density of smooth muscle was threefold and 1.6-fold greater in the peripheral prostate relative to the central prostate, respectively. The morphometrical and isometric tension studies provides evidence that the canine prostate is a heterogeneous gland.

Alpha 1-adrenoceptor properties of terazosin HCl and its enantiomers in the human prostate and canine brain

The objective of the present study was to characterize the alpha 1-adrenoceptor binding properties of terazosin and its enantiomers in human prostate and canine brain. Human prostate adenomas were obtained from 7 males undergoing prostatectomy for symptomatic BPH and canine cerebral cortices were obtained from 6 male beagles. Competitive displacement experiments were carried out on these tissue homogenates in the presence of a constant concentration ([180 pM]) of 125I-Heat and varying concentrations of unlabelled terazosin and its enantiomers. The Ki of terazosin and its enantiomers were determined from these binding studies. The mean Ki of rac-terazosin, R(+)-terazosin, and S(-)-terazosin in human prostate was 3.6 nM, 3.8 nM, and 2.8 nM, respectively. The differences between these mean Ki values were not statistically significant. The mean Ki of rac-terazosin, R(+)-terazosin, and S(-)-terazosin in canine brain were 6.7 nM, 8.4 nM, and 5.6 nM, respectively. The differences between these mean Ki values were not significantly different. The mean Ki of terazosin and its enantiomers were consistently lower in the human prostate compared to canine brain (P less than 0.05). The present study does not provide any evidence suggesting differential effects of terazosin enantiomers on the human prostate. The twofold difference between the Ki values in the prostate and brain suggests that different subtypes of the alpha 1-receptor might be present in these tissues.

Prognostic factors in management of traumatic perforation of colon and rectum

A retrospective analysis was made of the prognostic factors and management of traumatic perforation of the colon and rectum in 80 patients during the period of 1980 to 1988 at Chang Gung Memorial Hospital. The total mortality was 11%. Morbidity was 18% among the survivors. The mortality was higher in patients with old age (50% for those over 60 years old), delayed operation (50% for a delay of more than 72 hours), poor nutrition (57%), shock condition before or during operation (50%), severe abdominal fecal contamination (35%) and associated abdominal injury. We conclude that the surgical procedures for traumatic perforation of colon and rectum performed depend upon the patient's condition. The prognostic factors in patients with traumatic perforation are patient's age, timing of operation, degree of abdominal fecal contamination, injury to other abdominal organs and general condition such as nutrition and shock.

The binding and functional properties of voltage dependent calcium channel receptors in pediatric normal and myelodysplastic bladders

The present study was designed to compare the binding and functional properties of calcium channel receptors in normal and myelodysplastic bladders. Normal bladders were obtained from children with vesicoureteral reflux undergoing ureteral reimplantation. Myelodysplastic bladder specimens were obtained from patients undergoing bladder augmentation. The functional studies included agonist (calcium chloride) dose response experiments and the determination of apparent antagonist dissociation constants for various calcium channel antagonists. The receptor binding studies were performed using the ligand (+)-3H-PN200-110 (specific activity 86.6 Ci./mmol.). The mean maximal response of myelodysplastic bladders to calcium ions was 31% less than normal bladders (p greater than 0.05). The mean EC50 for calcium mediated isometric tension and the mean -log antagonist dissociation constant values of nifedipine, diltiazem and verapamil were similar in normal and myelodysplastic bladders. The radioligand receptor binding studies demonstrated that the equilibrium dissociation constant of (+)-3H-PN200-110 in myelodysplastic bladders was 4-fold greater than in normal bladders. The density of dihydropyridine binding sites in myelodysplastic and normal bladders was similar. Our study demonstrated that the pathophysiology of the poorly compliant hyperreflexic bladder is not related to up regulation of dihydropyridine calcium channel receptors or alterations in the response of detrusor muscle to calcium ions. The relative abundance of calcium channel receptors in the normal and myelodysplastic bladders, and the regulation of detrusor contraction by calcium ions suggest that calcium channel receptors have a meaningful role in detrusor function.

Brainstem sites differentially sensitive to beta-endorphin and morphine for analgesia and release of met-enkephalin in anesthetized rats

Mapping of the brainstem regions sensitive to beta-endorphin and morphine for antinociception and Met-enkephalin release was performed in rats. Antinociception was assessed by the tail-flick test in pentobarbital-anesthetized rats and the release of immunoreactive Met-enkephalin from the spinal cord was measured by lumbar-cisternal perfusion in urethane-anesthetized rats. The sites in the brainstem most sensitive to beta-endorphin (2 micrograms) for inhibition of the tail-flick response and Met-enkephalin release were located in areas in the caudal medial medulla such as raphe obsacurus nucleus and raphe pallidus nucleus and the adjacent midline reticular formation. Sites in the rostral medial medulla were less sensitive to beta-endorphin for both antinociception and release of Met-enkephalin. The regions 1 mm and more lateral to the midline were not sensitive to beta-endorphin. The sites sensitive to morphine sulfate (4 micrograms) for antinociception were located in areas in the rostral ventromedial medulla such as raphe magnus nucleus, gigantocellular reticular nucleus and gigantocellular reticular nucleus alpha. Raphe obscurus nucleus, which was sensitive to beta-endorphin, was not sensitive to morphine for antinociception. Locus coeruleus was sensitive to morphine and beta-endorphin for antinociception. No sites sensitive to morphine were found for Met-enkephalin release. The correlation between the brainstem sites sensitive to beta-endorphin for the production of antinociception and the release of Met-enkephalin suggests that the antinociception induced by beta-endorphin is mediated by the release of Met-enkephalin. The findings of different brainstem sites sensitive to beta-endorphin and morphine support the hypothesis of different modes of pharmacological actions for beta-endorphin and morphine.

Effect of quinine on the release of catecholamines from bovine cultured chromaffin cells

1. The effects of quinine on catecholamine release from cultured bovine chromaffin cells were studied. 2. Quinine (25-400 microM) produced a dose-related inhibition of catecholamine release in response to depolarizing concentrations (12.5-50 mM) of K+. 3. The inhibition of the secretory response to high K+ produced by quinine decreased with the increase in the extracellular concentration of Ca2+. 4. Stimulation of cultured chromaffin cells with 50 mM K+ produced a significant increase in Ca2+ influx. In the presence of 100 microM quinine a 54% inhibition of the K(+)-induced Ca2+ influx was observed. 5. Quinine treatment of chromaffin cell cultures produced a small but significant decrease in membrane resting potential and a less pronounced depolarization in response to 50 mM K+. 6. The results suggest that the inhibition of the K(+)-evoked release of catecholamines produced by quinine is at least partly due to a decrease in Ca2+ influx. Ca2+ influx is lower because quinine reduces the sensitivity of the membrane potential to changes in extracellular K+ but direct effects of quinine on Ca2+ channels cannot be excluded.

Different mechanisms mediate beta-endorphin- and morphine-induced inhibition of the tail-flick response in rats

The studies were done to determine whether inhibition of the tail-flick response induced by beta-endorphin and morphine microinjected into periaqueductal central gray (CG) was mediated by stimulating different types of opioid receptors and by activating different descending pain modulatory systems in rats. beta-Endorphin (0.3-20 micrograms) or morphine (0.3-20 micrograms) microinjected bilaterally into CG produced a dose-dependent inhibition of the tail-flick response. Naloxone (0.3-3 micrograms) injected into CG was more effective in antagonizing inhibition of the tail-flick response induced by CG administered morphine than by beta-endorphin. beta-Endorphin-(1-27) (3 micrograms) injected CG effectively antagonized CG beta-endorphin-induced inhibition of the tail-flick response but slightly potentiated CG morphine-induced inhibition. Intrathecal injection of naloxone (0.3-30 micrograms) dose-dependently reversed inhibition of the tail-flick response induced by beta-endorphin (2 micrograms) but not by morphine (4 micrograms) injected into CG. On the other hand, yohimbine (0.3-30 micrograms) injected intrathecally dose-dependently antagonized inhibition of the tail-flick response induced by morphine (4 micrograms) but not by beta-endorphin (2 micrograms) given into CG. It was concluded that beta-endorphin and morphine produce inhibitions of the tail-flick response by stimulating epsilon and mu opioid receptors, respectively, and the descending pain modulatory system activated by beta-endorphin from CG involves spinal opioid receptors but not alpha-2 adrenoceptors whereas the descending system activated by morphine from CG involves spinal alpha-2 adrenoceptors but not opioid receptors.

Differential actions of the blockade of spinal opioid, adrenergic and serotonergic receptors on the tail-flick inhibition induced by morphine microinjected into dorsal raphe and central gray in rats

Microinjection of morphine sulfate into dorsal raphe, ventrolateral central gray and dorsolateral central gray inhibits spinal nociceptive reflexes. The effects of the blockade of spinal opioid, adrenergic, and serotonergic receptors by intrathecal injection of naloxone, yohimbine and methysergide, respectively, on inhibition of the tail-flick response induced by morphine microinjected into dorsal raphe, ventrolateral central gray and dorsolateral central gray were studied. Naloxone (20 micrograms) given intrathecally effectively antagonized inhibition of the tail-flick response induced by morphine (4 micrograms) given into dorsal raphe and ventrolateral central gray, but not dorsolateral central gray. On the other hand, intrathecal injection of yohimbine (30 micrograms) antagonized inhibition of the tail-flick response induced by morphine given into ventrolateral central gray and dorsolateral central gray, but not dorsal raphe. Intrathecal injection of prazosin (30 micrograms) did not antagonize inhibition of the tail-flick response induced by morphine given into dorsal raphe or lateral central gray. Intrathecal injection of methysergide (30 micrograms) only partially antagonized inhibition of the tail-flick response induced by morphine given into dorsal raphe, but not ventrolateral central gray and dorsolateral central gray. It is concluded that the analgesia induced by morphine injected into dorsal raphe is mediated by spinal opioid receptors but not by spinal alpha 2-adrenergic receptors while the analgesia produced by morphine given into dorsolateral central gray is mediated by spinal alpha 2-adrenergic receptors. The analgesia induced by morphine given into ventrolateral central gray is mediated in part by both spinal alpha 2-adrenergic and opioid receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

Atypical spasmus nutans as an initial sign of thalamic neoplasm

A patient is described who presented with dissociated nystagmus (atypical spasmus nutans) and an underlying pulvinar-tectal lesion. Atypical spasmus nutans is discussed and clinicians are alerted to a spectrum of possible etiologies.

Acute monocytic leukemia recurring as bilateral perilimbal infiltrates. Immunohistochemical and ultrastructural confirmation

A 28-year-old woman developed leukopenia and slight cervical lymphadenopathy. Bone marrow aspiration and special stains established the diagnosis of acute monocytic leukemia. Following chemotherapy a complete hematologic remission was elicited. Seven months later, she consulted an ophthalmologist because of bilateral conjunctival lesions. Ophthalmologic examination showed subconjunctival, perilimbal grayish-pink infiltrates. A conjunctival biopsy disclosed sheets of mononuclear cells consistent with acute monocytic leukemia. Four months later, she developed cutaneous lesions in the face and chest wall. Subsequent biopsies of conjunctiva and skin and immunohistochemical demonstration of muramidase in the tumor cells supported the diagnosis of monocytic leukemia. Electron microscopic studies were particularly valuable and disclosed that more than 80% of the leukemic cells contained two types of cytoplasmic complexes of rough endoplasmic reticulum that displayed both tubular and helical configurations. These complexes differed morphologically from the ribosome-lamellar complexes observed in hairy cell leukemia and other hematologic disorders.