Serotonin modulates ethanol-induced depression in cerebellar Purkinje neurons

In the present study, we found that local application of serotonin (5-HT) potentiated ethanol-induced depressions of the spontaneous activity of Purkinje neurons in urethane-anesthetized rats. 5-HT also potentiated depressions induced by gamma-aminobutyric acid; however, this modulatory response was quantitatively smaller than 5-HT-induced potentiation of ethanol depression. Previous reports suggested that the release of 5-HT can be regulated by presynaptic 5-HT autoreceptors. We found that local application of methiothepin, which may induce 5-HT overflow through the inhibition of presynaptic autoreceptors, facilitated ethanol-mediated responses. This methiothepin effect was greatly diminished in neonatally 5,7-dihydroxytryptamine-lesioned animals, suggesting a presynaptic mechanism was involved. We also found that the 5-HT1A antagonist UH301 did not attenuate 5-HT-facilitated ethanol reactions. On the other hand, local application of 5-HT1B agonist CGS12066B potentiated ethanol-induced depression. Taken together, our data suggest that 5-HT can modulate ethanol-mediated electrophysiological depression, possibly mediated through 5-HT1B receptors in the cerebellum.

Antioxidant-sensitive regulation of inflammatory-response genes in Kaposi's sarcoma cells

Kaposi's sarcoma (KS) is a multifocal vascular lesion characterized by abnormal proliferation of endothelial-like KS cells linked to a pronounced leukocyte infiltration. KS lesions contain novel herpes-like DNA sequences, KSHV, hypothesized to originate from the viral pathogen for KS. Using cultured KS cells that retain the KSHV sequences, diverse signals, including tumor necrosis factor alpha, interleukin (IL) 1 beta, polyinosinic acid/polycytidylic acid and lipopolysaccharide, induced the expression of the cytokine IL-6 and cellular adhesion molecules involved in leukocyte recruitment, including vascular adhesion molecule 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1). The thiol-antioxidant pyrrolidine dithiocarbamate (PDTC) selectively inhibited > 90% of the activation of nuclear factor kappa B-like DNA binding activity in KS cells. PDTC also reduced by > 85% induced levels of VCAM-1 and IL-6 at the mRNA, protein, and functional levels in KS cells. In contrast, PDTC did not inhibit the induced expression of either ICAM-1 or E-selectin. These studies show that PDTC differentially modulates the expression of inflammatory response genes in KS cells that contain KSHV, suggesting that reduction-oxidation-sensitive events are involved in the regulation of these genes. These studies also suggest that thiol-antioxidants such as PDTC may play a potentially therapeutic role in the treatment of KS by preventing induction of specific inflammatory response genes that may be involved in the pathogenesis of KS.

Cost of patient follow-up after potentially curative lung cancer treatment

The two objectives of this study were to determine the range of recommended follow-up strategies for patients with lung cancer treated with curative intent and to estimate the cost of such follow-up. Ten articles delineating eight specific follow-up strategies were identified from a Medline search of the literature for 1980 through 1995. An economic analysis was done of the costs associated with the identified strategies. Charge data obtained from the Part B Medicare Annual Data file and the Hospital Outpatient Bill file were used as a proxy for cost. Follow-up intensity varied widely across strategies for 5 years of posttreatment follow-up. Medicare-allowed charges for 5-year follow-up ranged from a low of $946 to a high of $5645. When Medicare-allowed charges were converted to a proxy for actual charges by a conversion ratio of 1.62, the range was $1533 to $9145, a fivefold difference in charges. There was no indication that more intensive, higher-cost strategies increased survival or quality of life. The published literature, including textbooks, holds few answers in this area.

Effect of acupuncture on cardiopulmonary function

OBJECTIVE

To evaluate the relationship between acupuncture and cardiopulmonary function in healthy people.

SUBJECTS AND METHODS

Healthy male volunteers were divided into 3 groups, 16 of persons each Group 1 was treated with acupuncture at points Neiguan (PC6) and Zusanli (ST36): Group 2 was treated with acupuncture at non-acupoints, and Group 3 was taken as control. The effects of resting cardiopulmonary functions were measured with gas analysis system. The resting heart rate (HR), oxygen consumption (VO2), and carbon dioxide production (VCO2) were recorded over a thirty-minute period at intervals of five minutes, 15 minutes, and 25 minutes. Electroacupuncture was given to Groups 1 and 2. The analysis of variance and t test were used in data analysis.

RESULTS

In the acupuncture groups, resting heart rate and carbon dioxide production decreased (P < 0.05) and oxygen consumption also decreased slightly, although it was statistically insignificant (P > 0.05).

CONCLUSION

Our results indicate that acupuncture can decrease the resting heart rate and carbon dioxide production, thus lowering the metabolic rate.

Panencephalitic Creutzfeldt-Jakob disease. Unusual presentation of magnetic resonance imaging and proton magnetic resonance spectroscopy

We present serial magnetic resonance imaging (MRI) scans on a biopsy-verified case of Creutzfeldt-Jakob disease (CJD). The initial MRI scan demonstrated increased T2 signal-intensity within the basal ganglia and thalami. Subsequent MRI scans demonstrated a thin cortex, increased T2 signals diffusely within the white matter including U-fibers, and hypointense T2 signals within the basal ganglia, and thalami. Proton magnetic resonance spectroscopy (1H-MRS) study showed an absence of creatine, choline and N-acetylaspartate signals. By these characteristic findings, serial MRI and MRS studies may be helpful in differentiating CJD from other dementing illnesses.

Malignant soft tissue sarcoma of the hypopharynx successfully treated by radiotherapy alone

Sarcoma of the hypopharynx has been reported very rarely in the literature, only six cases having been found among all head and neck malignancies reported to SEER (Surveillance, Epidemiology, and End Results) during 1973-1987. We report a 14-year-old boy with a huge malignant soft tissue sarcoma arising from the hypopharynx. Tracheostomy and feeding gastrostomy were performed as emergency life-saving procedures. Surgical resection had been attempted, but abandoned. Because of the rapidity of tumor growth, we gave the patient a course of accelerated radiotherapy (170 cGy/fraction, two fractions per day) with a total dose of 7140 cGy within one month. A series of endoscopy and imaging studies demonstrated complete regression of the tumor, and the patient is currently alive without evidence of disease 3.5 years after treatment. We conclude that for an unresectable tumor without distant metastasis, radiation therapy may be tried. The time, dose, and fractionation of radiotherapy should be carefully designed and individualized.

The cap-choke catheter antenna for microwave ablation treatment

A matched-dipole type catheter antenna is described for intracavitary and/or transluminal microwave treatment of diseases that may be responsive to thermal ablation therapy. This cap-choke antenna consists of an annular cap and coaxial choke design that can yield SAR distributions in and can produce heating of tissue surrounding the distal end of the catheter antenna. The cap-choke antenna is simple in construction, provides the desired specific absorption rate (SAR) distribution, and is efficient, i.e., the measured power reflection coefficient is 2% in tissue equivalent phantom modeling materials.

Electrophysiological and electrochemical responses of NMDA in the cerebellum: interactions with nonadrenergic pathway

In the present experiments, we measured N-methyl-D-aspartate (NMDA)-induced norepinephrine (NE) release and extracellular action potentials in the cerebellar cortex of urethane-anesthetized rats. The overflow of NE was measured using a Nafion coated-carbon fiber electrode and in vivo chronoamperometry. We found that both NMDA and quisqualate evoked NE release. Our previous work demonstrated that the electrophysiological activity of cerebellar Purkinje neurons could be either excited or inhibited by local NMDA application. It was reported that bicuculline antagonized NMDA-induced inhibition in Purkinje neurons, suggesting that a GABAergic mechanism was activated during NMDA application. We and others previously found that GABA-mediated electrophysiological depressions were enhanced by NE acting via beta-adrenergic receptors while these responses were decreased by activation of alpha-adrenergic receptors. Since NMDA evokes overflow of endogenous NE, the electrophysiological depression induced by NMDA may contain an NE-mediated modulatory component. In this study, we first examined the interaction of NMDA with beta-adrenergic agonist. We found that local application of isoproterenol facilitated NMDA- or GABA-mediated electrophysiological depressions of the Purkinje neurons. Applications of phenoxybenzamine, which antagonized the alpha-adrenergic response of synaptically released NE, also facilitated NMDA-elicited depression. In contrast, the depression induced by GABA, which did not induce NE overflow, was not potentiated by phenoxybenzamine. The facilitation of NMDA-induced depression by phenoxybenzamine was antagonized by the beta-adrenergic antagonist timolol. Taken together, these data suggested that the nonadrenergic pathway is involved in NMDA-induced electrophysiological responses in the cerebellum. NMDA may induce neuronal depression through modulation of GABAergic inhibition via NMDA-evoked NE release onto cerebellar Purkinje neurons.

Combined treatment of IL-1 alpha and TNF-alpha potentiates the antitumour effect of hyperthermia

Vasoactive cytokines, such as IL-1 alpha and TNF-alpha, modulate the homeostatic state at the endothelial surface and cause various types of pathological damage in vascular systems. We investigated the potential therapeutic effects of IL-1 alpha and TNF-alpha in combination with hyperthermia on SCK tumours grown in the legs of A/J mice. We first determined the effect of cytokines on tumour blood perfusion with the (86)Rb uptake method. When the host mice were given an i.p. injection of 25 mu g/kg IL-1 alpha or 50 mu g/kg TNF-alpha, the tumour blood perfusion markedly declined to 46 and 82% of control, respectively. The combination of IL-1 alpha and TNF-alpha reduced the 86Rb uptake to 41% bf control. Hyperthermia at 42.5 degrees C for 1 h reduced the tumour blood flow to 71% of control. The tumour blood perfusion decreased further to 20% of control when the tumours were heated for 1 h at 42.5 degrees C starting 4h after the injection of both IL-1 alpha and TNF-alpha. The changes in clonogenic cell numbers in SCK tumours, as determined by the in vivo-in vitro assay, following various treatments was also investigated. At 4 h after an i.p. injection of 25 mu g/kg IL-1 alpha or 50 mu g/kg TNF-alpha, the clonogenicity of SCK tumours significantly decreased to 29 or 37% of control, respectively. Heating at 42.5 degrees C for 1 h caused a decline in the clonogenic cell number to 30% of control. When both IL-1 alpha and TNF-alpha were given and tumours were heated 4h later at 42.5 degrees C for 1 h, the clonogenic cell number markedly declined to 0.4% of control. The time needed for control tumours to reach 4 x their initial volume was about 3 days, and treatment with IL-1 alpha or hyperthermia alone induced a tumour delay growth by about 1 day. The combined injection of IL-1 alpha and TNF-alpha followed by a heating at 42.5 degrees C for 1 h delayed the tumour growth by 6 days. The results in this study suggest that prior impairment of blood circulation by the combined treatment of IL-1 alpha and TNF-alpha potentiates hyperthermic damage in tumours.

High complete response rate of concomitant chemoradiotherapy for locally advanced squamous cell carcinoma of the uterine cervix

A prospective study with a newly designed schedule of concomitant chemoradiotherapy was initiated for 42 patients with previously untreated squamous cell carcinoma of the uterine cervix. Their ages ranged from 34 to 77 years, median 57 years. There were 13 FIGO stage IIB, 1 IIIA, 27 IIIB, and 1 IVA. Radiotherapy was administered using 1.8 Gy/day, 5 days a week, to the whole pelvis (50.4 Gy/28 fractions) with local boost if indicated. Intracavitary brachytherapy of 5 Gy for five times was delivered after 1-2 weeks of rest. The first 21 patients received concomitant chemotherapy of biweekly PEB regimen (100 mg/m2 etoposide + 50 mg/m2 cisplatin + 50 mg/m2 bleomycin) for two to three cycles during external irradiation. The chemotherapy for the latter 21 patients was modified to weekly PEBF (50 mg/m2 etoposide + 20 mg/m2 cisplatin + 10 mg/m2 bleomycin + 800 mg/m2 5-FU, mixed in normal saline, 24-hr continuous iv infusion) for five to six cycles. All except 1 patient achieved complete response (97.6%) and sustain so after a median follow-up time of 30 months. There were three relapses--one with persistent pelvic disease and two with distant metastasis. Two-year overall survival and disease-free survival rates were 97.6 and 92.9%, respectively. Myelosuppression was moderate but fully recovered. Other acute toxicities were tolerated except for 1 patient who encountered grade IV radiation colitis with cecum perforation and required surgery. As to late morbidity, the incidence of radiation proctitis was high (21.4%) but of a mild degree, with 1 patient needing repeated transfusion. One patient developed chronic cystitis with an acontractile bladder. Our preliminary results show that concomitant chemoradiotherapy for advanced cervical carcinoma is both feasible and effective with acceptable toxicities. Further follow-up is mandatory to ensure whether this high complete response protocol will translate into long-term local control and survival.

Expression of p53 protein in colorectal carcinoids

OBJECTIVE

To determine the frequency and prognostic significance of p53 protein expression in colorectal carcinoid tumors.

DESIGN

Thirty-one paraffin-embedded specimens of colorectal carcinoid tumor were studied by immunohistochemical staining to detect p53 protein expression. The association of p53 expression with tumor site, tumor size, invasion level, tumor stage, DNA pattern, and patient survival were analyzed.

RESULTS

p53 protein was detected in five (16%) of 31 colorectal carcinoid tumors. There was a correlation between p53 overexpression and tumor site, tumor size, tumor stage, and DNA ploidy (P < .05) but not for the depth of tumor invasion (P = .06). In addition to tumor size, invasion, stage, and DNA aneuploidy, p53 protein overexpression was also indicative of a poor prognosis (P < .001).

CONCLUSIONS

The overexpression of p53 protein is uncommon in colorectal carcinoid tumors. However, the expression of p53 protein has a correlation with clinicopathologic-predicting criteria in colorectal carcinoid tumors and may be used as an associated prognostic parameter to assess patient survival.

Radio frequency electromagnetic exposure: tutorial review on experimental dosimetry

Radio frequency (RF) dosimetry is the quantification of the magnitude and distribution of absorbed electromagnetic energy within biological objects that are exposed to RF fields. At RF, the dosimetric quantity, which is called the specific absorption rate (SAR), is defined as the rate at which energy is absorbed per unit mass. The SAR is determined not only by the incident electromagnetic waves but also by the electrical and geometric characteristics of the irradiated subject and nearby objects. It is related to the internal electric field strength (E) as well as to the electric conductivity and the density of tissues; therefore, it is a suitable dosimetric parameter, even when a mechanism is determined to be "athermal." SAR distributions are usually determined from measurements in human models, in animal tissues, or from calculations. This tutorial describes experimental techniques that are used commonly to determine SAR distributions along with the SAR limitations and unresolved problems. The methods discussed to obtain point, planar, or whole-body averaged SARs include the use of small E-field probes or measurement of initial rate of temperature rise in an irradiated object.

Primary sternal osteomyelitis

A case report of primary sternal osteomyelitis, a rare clinical entity, is presented. Treatment of primary sternal osteomyelitis is antibiotics and complete debridement of the infected bone and anterior periosteum. If the posterior sternal periosteum is not involved, it should be left intact. The defect can be covered with skeletal muscle flaps, which improves healing and minimizes recurrence. This approach led to a complete and timely cure.

Is Kaposi's-sarcoma-associated herpesvirus detectable in semen of HIV-infected homosexual men?

We explored a possible route of transmission of Kaposi's-sarcoma-associated herpes virus (KSHV) with nested and unnested PCR techniques. We looked for KSHV DNA sequences in semen of HIV-positive homosexual men and HIV-negative healthy semen donors. With unnested primers we found KSHV sequences in 21 of 33 (64%) homosexual men and in none of 30 healthy donors. With a nested PCR assay, 30 of 33 (91%) specimens from the homosexual men and 7 of 30 (23%) specimens from healthy donors had detectable KSHV sequences. Over 5 years of follow-up, 13 of 30 KSHV-positive homosexual men (43%) developed KS compared with none of the 3 KSHV-negative homosexual men.

Human ventromesencephalic grafts restore dopamine release and clearance in hemiparkinsonian rats

We and others reported previously that transplantation of fetal ventromesencephalic homograft restores the apomorphine-induced rotational behavior and electrochemical indices of dopamine (DA) depletion in the 6-hydroxydopamine (6-OHDA)-lesioned rat. We found that regeneration of KCl-evoked DA release and tyrosine hydroxylase (TH) immunoreactivity was limited to the graft area even 4 months after transplantation. In the present experiments, we transplanted human fetal ventromesencephalic tissue to the 6-OHDA-lesioned rats. After transplantation, rats received chronic cyclosporin and vibramycin treatment. We found that human fetal grafts from the substantia nigra can restore the effects of DA depletion in 6-OHDA-lesioned rats; these fetal grafts were found to reduce the apomorphine-induced rotational behavior and restore K(+)-evoked DA release as well as DA clearance in the striatum. The area with active DA release is far beyond the transplantation site, unlike that seen in the homografted rats. These electrochemical responses correspond to the extended outgrowth of TH-positive neuronal fibers distal to the graft area. Taken together, our data suggest that rats that received human mesencephalic graft had much greater DA innervation and more complete restoration of function than those that received homografts.

Methamphetamine facilitates ethanol-induced depressions in cerebellar Purkinje neurons of prazocin- or DSP4-treated rats

Methamphetamine (MA) and ethanol (EtOH) are two commonly abused drugs. Previous behavioral studies indicated that MA may synergistically alter EtOH responses. In the present study, we found that local application of MA did not potentiate ethanol-induced depressions of the spontaneous activity of Purkinje neurons in urethane-anesthetized rats. We and others previously found that, in cerebellar Purkinje neurons, EtOH and gamma-amino-butyric acid (GABA)-mediated depressions can be enhanced by norepinephrine (NE) acting via beta-adrenergic receptors while these responses are decreased by activation of alpha-adrenergic receptors. In the present experiment, after blocking alpha-adrenergic receptors with prazocin, MA significantly enhanced EtOH responses in most of neurons studied. It has been reported that MA may directly and indirectly enhance alpha-adrenergic and beta-adrenergic receptor-mediated responses. The present study may suggest that MA can negatively modulate (antagonize) the depressant effects of ethanol via the alpha-adrenergic receptor, which oppose the positive modulatory mechanism (potentiation of EtOH depression) via actions of the beta-adrenergic receptors. We found that lesioning NE neurons with N-chloroethyl-N-ethyl-2-bromobenzylamine hydrochloride (DSP4), a selective noradrenergic neurotoxin, enhance the MA-facilitated ethanol responses, suggesting that this action of MA may not require NE. Since it has been reported that MA increases serotonin (5-HT) and catecholamine release from their nerve terminals, MA may potentiate EtOH depressions by facilitating the release of NE and 5-HT. Taken together, our data suggested that MA may modulate EtOH responses via catecholaminergic and serotonergic mechanisms in cerebellar Purkinje neurons.

Ketamine antagonizes hypoxia-induced dopamine release in rat striatum

The purpose of this study is to investigate the hypothesis that ketamine, a non-competitive antagonist of the N-methyl-D-aspartate (NMDA) receptor, attenuates hypoxia-induced striatal dopamine release in vivo. High-speed chronoamperometric recording techniques, using Nafion-coated carbon fiber electrodes, were used to evaluate extracellular dopamine (DA) concentration in the striatum. KCl and DA were locally applied directly to the striatum of urethane-anesthetized Sprague-Dawley rats, in order to measure release and clearance, respectively, of DA. These anesthetized animals were paralyzed with D-tubocurarine and connected to a respirator to allow controlled respiration. Systemic concentrations of oxygen and carbon dioxide were altered by changing the partial pressure of O2, CO2, N2 of inspired air and the rate of the respirator. Our data indicate that lowering the respiratory rate from 90 to 20 times/min for 5 min, in room air, caused a decrease in blood O2 while increasing the CO2 concentration. These changes in blood gas concentration were reversible and reproducible. We also found that lowering the respiratory rates potentiated K(+)-induced DA release but not DA clearance in the striatum. In an attempt to induce hypercapnia, the room air was replaced with high CO2-containing air (15% CO2 + 20% O2 + 65% N2), and this change resulted in increased blood CO2 levels without lowering O2 concentration. The hypercapnia did not alter K(+)-induced DA release in the striatum. Next, we attempted to simulate anoxic hypoxia in the absence of hypercapnia. Respiration with pure N2 for 30 s resulted in lowering blood O2 without increasing CO2 levels. Both basal and K(+)-evoked DA releases were increased during N2-induced anoxic hypoxia. These data suggested that transient hypoxia facilitates DA release in the striatum. It has been suggested that NMDA is involved in many hypoxia-mediated responses. We also found that systemic application of ketamine, which itself did not affect blood O2 or CO2 levels, antagonized hypoxia-induced electrochemical responses. These data suggest that the increase in DA release in vivo during short-term hypoxia may probably be mediated through NMDA receptors.

Some nucleoside analogs with anti-human immunodeficiency virus activity inhibit replication of Epstein-Barr virus

The effects of (+)-beta-D-dioxolane-cytosine ((+)-D-beta-DOC), (-)-beta-L-dioxolane-cytosine ((-)-L-beta-DOC), (+)-beta-D-oxathiolane-cytosine ((+)-D-beta-OTC), (-)-beta-L-oxathiolane-cytosine ((-)-L-beta-OTC, or 3TC), 3'-azido-2',3'-dideoxy-5-methyl-cytidine (5-Me-AZDC), and 3'-azido-2',3'-dideoxyuridine (AZDU) on Epstein-Barr virus (EBV) DNA replication in vitro were tested in P3HR-1 cells. Two anti-EBV drugs, 3'-azido-3'-deoxythymidine (AZT) and 9-(1,3-dihydroxy-2-propoxymethyl)guanine (DHPG, or ganciclovir), were used as positive controls. The inhibitory effects on EBV DNA synthesis were quantified by membrane filter and Southern blot hybridizations with an EBV-specific probe BamHI-W fragment. The 50% effective doses (ED50) for EBV DNA replication were 0.15, 0.83, 1.5, 8.3, 14, and 7.7 microM for DHPG, (-)-L-beta-DOC, (+)-D-beta-DOC, (+)-D-beta-OTC, (-)-L-beta-OTC, and AZT, respectively. In contrast, 5-Me-AZDC and AZDU were not effective at concentrations as high as 30 microM. These results indicated that both (-)-L-beta-DOC and (+)-D-beta-DOC were more potent than AZT, which has previously been shown to have anti-EBV activity. (-)-L-beta-DOC and (+)-D-beta-DOC have also been previously demonstrated to suppress the infectivity of human immunodeficiency virus type 1 (HIV-1). Thus, (-)-L-beta-DOC represents the first nucleoside analog with L-configuration exhibiting significant antiviral activities against both EBV and HIV.

Surface characterization and ex vivo blood compatibility study of plasma-modified small diameter tubing: effect of sulphur dioxide and hexamethyldisiloxane plasmas

The development of a small diameter artificial vascular graft or prosthesis is limited by rapid thrombus formation and subsequent embolization upon blood contact. Plasma surface modification was employed to modify the inner surface of small diameter low density polyethylene (LDPE) tubing without varying the outer surface chemistry and physical properties of the tubing. A sulphur dioxide (SO2) plasma was used to form sulphonate functionality on the surface. In addition, a hexamethyldisiloxane (HMDSO) plasma and different gas flow ratios of SO2-HMDSO gas mixture plasmas were used to form ultrathin polysiloxane-like coatings inside the LDPE tubing. X-ray photoelectron spectroscopy (XPS) indicated that the inner surface of the tubing can be modified uniformly with this treatment. In addition, XPS results showed that the percentage of sulphur atoms bound to two or three oxygen atoms (sulphone or sulphonate) increased with the SO2-HMDSO mass flow rate ratio. The blood compatibility of the plasma-modified model materials was evaluated using an ex vivo canine arteriovenous shunt model. Similar thrombogenicity was observed comparing the untreated control and the surfaces modified by HMDSO plasma and SO2-HMDSO gas mixture plasmas, despite the differences in surface chemistry. The SO2 plasma-modified surface, which is the most hydrophilic as measured by the captive bubble contact angle measurement technique, was more thrombogenic than the untreated control. This may be attributed to the combined effect of the surface chemistry and surface hydrophilicity.