Study of the role of retinoblastoma protein in terminal differentiation of murine erythroleukemia cells

Hexamethylenebisacetamide-induced terminal differentiation of Friend virus-transformed murine erythroleukemia (MEL) cells can be inhibited by okadaic acid, an inhibitor of type 1 and type 2A protein phosphatases. The inhibition is shown to be correlated with prevention of dephosphorylation of retinoblastoma protein (pRB) in cells and bypass of G1 prolongation in the cell cycle. These results suggest that pRB-mediated G1 prolongation is necessary for MEL cells to commit to terminal differentiation. However, further experiments demonstrate that the simple cell cycle exit is not sufficient for commitment to terminal differentiation. Induction of dephosphorylation of pRB and subsequent G1 prolongation by forskolin does not lead MEL cells to differentiate. Additional pRB has been expressed in MEL cells by transfection with a neo-resistant plasmid containing RB cDNA under the control of a cytomegalovirus promoter. Exogenously expressed pRB is hyperphosphorylated in logarithmically growing MEL cells without any noticeable change in growth rate between the transfected cell line and the parental cell line. This result suggests that pRB in MEL cells is regulated by protein kinases and protein phosphatases and not by transcription.

Disruption of p53 function sensitizes breast cancer MCF-7 cells to cisplatin and pentoxifylline

The possibility that appropriately designed chemotherapy could act selectively against p53-defective tumor cells was explored in MCF-7 human breast cancer cells. These cells were chosen because they have normal p53 function but are representative of a tumor cell type that does not readily undergo p53-dependent apoptosis. Two sublines (MCF-7/E6 and MCF-7/mu-p53) were established in which p53 function was disrupted by transfection with either the human papillomavirus type-16 E6 gene or a dominant-negative mutant p53 gene. p53 function in MCF-7/E6 and MCF-7/mu-p53 cells was defective relative to control cells in that there were no increases in p53 or p21Waf1/Cip1 protein levels and no G1 arrest following exposure to ionizing radiation. Survival assays showed that p53 disruption sensitized MCF-7 cells to cisplatin (CDDP) but not to several other DNA-damaging agents. CDDP sensitization was not limited to MCF-7 cells since p53 disruption in human colon carcinoma RKO cells also enhanced sensitivity to CDDP. Contrary to the other DNA-damaging agents tested, CDDP-induced DNA lesions are repaired extensively by nucleotide excision, and in agreement with a defect in this process, MCF-7/E6 and MCF-7/mu-p53 cells exhibited a reduced ability to repair a CDDP-damaged chloramphenicol acetyltransferase-reporter plasmid transfected into the cells. Therefore, we attributed the increased CDDP sensitivity of MCF-7 cells with disrupted p53 to defects in G1 checkpoint control, nucleotide excision repair, or both. The G2 checkpoint inhibitor pentoxifylline exhibited synergism with CDDP in killing MCF-7/E6 cells but did not affect sensitivity of the control cells. Moreover, pentoxifylline inhibited G2 checkpoint function to a greater extent in MCF-7/E6 than in the parental cells. These results suggested that, in the absence of p53 function, cancer cells are more vulnerable to G2 checkpoint abrogators. Our results show that a combination of CDDP and pentoxifylline is capable of synergistic and preferential killing of p53-defective tumor cells that do not readily undergo apoptosis.

Selective sensitivity of macrophages to cytotoxicity by inhibitors of macromolecular synthesis: induction of apoptosis

Initial studies designed to measure the effect of inhibiting RNA synthesis by dactinomycin on macrophage functions revealed that the cells were uniformly killed at concentrations that have been routinely used to inhibit RNA synthesis in other cell types. We, thus, determined the dose curve for the cytotoxicity of dactinomycin for macrophages and two other cell types, L929 cells and splenic lymphocytes. Macrophages were extremely sensitive to the cytotoxicity of dactinomycin compared to the other cell types. Submicromolar concentrations that induced 100% cytotoxicity in macrophages caused little death in L929 cells or lymphocytes. Concentrations of dactinomycin that inhibited RNA synthesis by 40% in macrophages induced almost complete cell death but inhibition of over 80% of RNA synthesis in L929 cells or lymphocytes induced no measurable cytotoxicity. Macrophages did take up more dactinomycin than other cells but the amount was not sufficient to account for the large differences in cytotoxicity. We next tested the effects of doxorubicin and cycloheximide and found that macrophages were also extremely sensitive to killing by these compounds, and there was a very close association between the amount of inhibition of protein synthesis and the amount of toxicity. The morphology of macrophages exposed to these agents was consistent with death by apoptosis. This was further supported by assays measuring membrane integrity and DNA fragmentation. These data demonstrate that inhibition of macromolecular synthesis in macrophages, by different mechanisms, causes macrophages to undergo apoptosis. They further suggest that, in contrast to other cell types that require protein synthesis for apoptosis, macrophages require the synthesis of certain proteins to avoid apoptosis.

A mutant p21 cyclin-dependent kinase inhibitor isolated from a Burkitt's lymphoma

The growth arrest mediated by p53 is caused at least in part by the p53 mediated expression of p21 (p21waf1/Cip1). Since only one-third of primary Burkitt's lymphomas (BL) demonstrate mutations in the p53 gene, we examined the structural integrity of the p21 coding region by single-strand conformational polymorphism and DNA sequence analysis to determine the extent to which this gene is mutated in BL. Of 34 BLs analyzed, a frequent change (38%) at codon 31 that replaced Ser with Arg was found in 13 samples, 10 of which were from Africa. This change at codon 31 is also detected in peripheral blood DNA from normal subjects and may thus represent a polymorphism. One BL cell line, DH978, carried a change at codon 63: Phe to Leu. This mutation was heterozygous, and both the wild-type and the mutated p21 mRNA were expressed in the tumor cell line. By transfection experiments, the mutant p21 was less efficient in suppressing clonogenicity than wild-type p21. To our knowledge, this is the only mutation described in p21. The availability of this mutant p21 should further help in functional studies of p21.

Cytogenetic studies in de novo acute nonlymphocytic leukemia

BACKGROUND

There is currently considerable interest in the cytogenetic analysis of leukemia. The improvement of banding techniques has made it possible to rather precisely identify deletion, translocation, inversions, and other structural chromosome abnormalities. Specific recurring chromosome abnormalities associated with distinctive morphologic features are thus increasingly recognized in acute nonlymphocytic leukemia. For example, uneven geographic distribution of nonrandom specific chromosome aberrations has been reported. We herein report the results of chromosome studies on 30 Chinese patients with de novo acute nonlymphocytic leukemia.

METHODS

Cytogenetic studies were performed at Veterans General Hospital-Taipei, from 1988 to 1993, on unselected samples of 30 patients with de novo acute nonlymphocytic leukemia. Chromosome analysis was performed by short-term culture techniques on bone marrow material obtained from patients at diagnosis. Metaphase chromosomes were banded by the conventional trypsin-Giemsa banding technique and then karyotyped according to the International System for Human Cytogenetic Nomenclature (ISCN). Classification of leukemia was based on the criteria of the French-American-British cooperative group.

RESULTS

Of the 30 patients with adequate specimens, 17 (56%) demonstrated clonal chromosome abnormalities. Six patients were found to have structural rearrangements and seven patients have a numerical change as the sole abnormality. Four patients showed both structural and numerical anomalies. t(8;21) was found in 1 of the 8 M2 type ANLL patients and two of them had monosomy 21. Four of the 6 patients with acute promyelocytic leukemia (APL; M3 subtype) showed t(15;17). Two patients with M4 type leukemia and abnormal bone marrow eosinophils showed inv(16)(p13q22). One patient with M4 type leukemia demonstrated the loss of chromosome #7 and none showed the loss or deletion of chromosome #5.

CONCLUSIONS

This study revealed a consistent finding of t(15;17) in APL; however, a low incidence of t(8;21), -5/5q- and -7/7q- in our patients demonstrated the possible difference in the incidence of chromosomal abnormalities in ANLL between the oriental peoples and the whites.

Factors related to long-term effects of thymectomy on myasthenia gravis

The authors report the results of long-term follow-up after thymectomy on 92 cases with myasthenia gravis (MG), including 22 cases of thymomatous MG. These patients were followed up for 6-73 months with an average of 23 months. The surgically effective rate was 88.0% and the late mortality, 6.5%. The sex of the patients and the durations of disease were not obviously related to the prognosis, however the effect of thymectomy was much better in patients aged 10-39 years than in other age groups. The modified Osserman's clinical classification, acetylcholine receptor (AchR) antibodies and citric acid extract (CAE) antibodies titers in plasma and pathological patterns of the surgical specimens of thymus including immunohistochemical observation play an important role among various factors related to the long-term effects.

Avoiding acyclovir neurotoxicity in patients with chronic renal failure undergoing haemodialysis

Acute neurotoxicity following the administration of the recommended oral dose of acyclovir (800 mg twice daily) to dialysis-dependent patients is increasingly recognised. This suggests that the recommended dose is too high. Little is known of the pharmacokinetics of oral acyclovir in dialysis patients. We studied 7 patients with oliguric end stage renal failure receiving haemodialysis. Following haemodialysis, each patient received a single 800-mg tablet of acyclovir. Plasma acyclovir levels were monitored over the next 48 h as well as before and after the next routine dialysis. Peak plasma levels were achieved at 3 h (12.54 +/- 1.76 microM, range 8.5-17.5 microM) with the half-life calculated to be 20.2 +/- 4.6 h. Mean plasma level of 6.29 +/- 0.94 microM were within the quoted range to inhibit herpes zoster virus (4-8 microM) at 18 h. Haemodialysis (4-5 h) eliminated 51 +/- 11.5% of the acyclovir which remained at 48 h. Computer modelling of various dose modifications suggests that a loading dose of 400 mg and a maintenance dose of 200 mg twice daily is sufficient to maintain a mean plasma acyclovir level of 6.4 +/- 0.8 microM. A further loading dose (400 mg) after dialysis would raise the residual acyclovir concentration by 6.1 +/- 1.0 microM. Such a dose modification should prevent neurotoxicity, whilst the rapid elimination of acyclovir by a single haemodialysis treatment provides both a diagnostic and therapeutic tool when toxicity is suspected.

[Clinical characteristics of hepatic tuberculosis]

The clinical characteristics of hepatic tuberculosis in 52 cases diagnosed pathologically were analyzed. Fever, abdominal pain and hepatomegaly were the major clinical manifestations; they were present in 96.2%, 42.3% and 88.5% of the patients respectively. The fever had no consistent pattern and the abdominal pain was usually localized to the right hypochondrium and not related to overwork. Hypergrammaglobulinaemia, elevated alkaline phosphatase level and increased ESR were noted in most of the patients (76.9%, 75.0%, 76.5% respectively). 62.5% of the 52 patients was diagnosed by percutaneous liver biopsy. Since there is no consistent clinical pattern in patients with hepatic tuberculosis, the diagnosis should be considered in patients with unexplained fever associated especially with hepatomegaly or hepatosplenomegaly, elevated alkaline phosphatase level, hypergrammaglobulinaemia and increased ESR, Liver biopsy is the most valuable method to confirm the diagnosis of hepatic tuberculosis.

CGRP in the serum of endotoxin-treated rats suppresses lymphoproliferation

Mouse mesenteric lymph node cells were incubated with concanavalin A (Con A) with or without the rat form of calcitonin gene-related peptide (rCGRP) (0.1 fM-1 microM) +/- human (h)CGRP8-37 (1 microM) for 48 h. DNA synthesis was assessed by [3H]thymidine incorporation. Con A-stimulated DNA synthesis was suppressed by 13, 20, and 30% at 10 fM, 1 pM, and 100 pM of rCGRP, respectively. hCGRP8-37 (1 microM), a selective blocker of CGRP1 receptor, completely inhibited the suppression of DNA synthesis by rCGRP (10 fM-100 pM). rCGRP caused concentration-dependent elevations of cAMP levels, which were potentiated by pretreatment with 3-isobutyl-1-methylxanthine (0.3 mM, 10 min), an inhibitor of cAMP-phosphodiesterase. hCGRP8-37 (1 microM) significantly inhibited cAMP elevations induced by rCGRP at the lower concentrations, but not at the highest concentrations of rCGRP. These data suggest that rCGRP, at circulating levels (1-10 pM), appears to directly interact with receptors on mouse mesenteric lymph node cells that are coupled to cAMP generation, ultimately inhibiting lymphocyte proliferation. To test the involvement of CGRP in suppression of lymphocyte proliferation by serum from endotoxin-treated rats, mouse mesenteric lymph node cells were stimulated with Con A with or without dilutions of endotoxin treated rat serum. At a 1:20 dilution, DNA synthesis was suppressed 30%, at a 1:40 dilution, DNA synthesis was suppressed by 34%, and at a 1:80 dilution, DNA synthesis was suppressed 25%. At all serum dilutions, coincubation with hCGRP8-37 (1 microM) significantly inhibited the suppressive effect of the endotoxin treated rat serum. These data suggest that the immunosuppression observed during endotoxin shock may be due, at least in part, to CGRP in serum.

Induction of bax by genotoxic stress in human cells correlates with normal p53 status and apoptosis

DNA-damaging agents such as ionizing radiation (IR) activate the tumor suppressor p53 and in some cases can cause apoptosis. M1 cells, which do not express the endogenous tumor suppressor gene p53, undergo apoptosis following activation of a temperature sensitive p53 transgene, where it has been shown that bax, an important mediator of apoptosis, is a p53 target gene (Selvakumaran et al, Oncogene 9, 1791-8, 1994). Since p53 can function as a transcription factor after activation by IR, the genetic response to this stress was examined in a panel of human cells with defined p53 status. Like the p53-regulated gene gadd45, bax was rapidly induced, as measured by increased mRNA levels, in the p53 wt (wild type) human myeloid line ML-1, and it was not induced in cells lacking functional p53. However, unlike other p53-regulated genes, bax was only induced in p53 wt cells in which IR also triggered apoptosis. In the case of bcl2, which opposes bax function, mRNA levels were reduced in ML-1 cells after IR. Thus, bax appears to be an unique p53-regulated gene in that its induction by IR not only requires functional p53 but also requires that the cells be apoptosis "proficient."

p53 gene mutations are associated with decreased sensitivity of human lymphoma cells to DNA damaging agents

The present study assessed the role of the p53 tumor suppressor gene in cell cycle arrest and apoptosis following treatment of Burkitt's lymphoma and lymphoblastoid cell lines with gamma-rays, etoposide, nitrogen mustard, and cisplatin. Cell cycle arrest was measured by flow cytometry; p53 and p21Waf1/Cip1 protein levels were measured by Western blotting; cell survival was measured in 72-96-h growth inhibition assays and by trypan blue staining, and apoptotic DNA fragmentation was assessed by either agarose gel electrophoresis or a modified filter elution method. We found that gamma-rays and etoposide induced a strong G1 arrest in the wild-type p53 lines while nitrogen mustard and cisplatin induced relatively little G1 arrest. All agents failed to induce G1 arrest in cells containing mutant p53 genes. The degree of G1 arrest observed with these agents correlated with the rate of p53 and p21Waf1/Cip1 protein accumulation: gamma-rays and etoposide induced rapid accumulation of both p53 and p21Waf1/Cip1; nitrogen mustard and cisplatin induced slow accumulation of p53 and no major accumulation of the p21Waf1/Cip1 protein. Despite differences in G1 arrest and kinetics of p53 or p21Waf1/Cip1 protein accumulation, all agents tended to decrease survival to a greater extent in the wild-type p53 lines compared to the mutant p53 lines. Cell death in the wild-type p53 lines was associated with intracellular DNA degradation into oligonucleosomal sized DNA fragments, indicative of apoptosis. We also observed an inverse sensitivity relationship between nitrogen mustard/cisplatin and etoposide in the mutant p53 lines and this was found to correlate with topoisomerase II mRNA levels in the cells. Our results suggest that p53 gene status is an important determinant of both radio- and chemosensitivity in lymphoid cell lines and that p53 mutations are often associated with decreased sensitivity to DNA damaging agents.

Anti-AIDS agents. 15. Synthesis and anti-HIV activity of dihydroseselins and related analogs

Forty-two dihydroseselins based on the structure of suksdorfin (1) were synthesized in order to evaluate their anti-HIV activity. These synthetic derivatives include 3',4'-di-O-acyl- and 3'- or 4'-O-acyl-cis-dihydroseselins (8-21) and 3',4'-trans-dihydroseselins with O-acyl and/or O-alkyl groups at the 3' and 4' positions (6, 22-43). Two 4'-azido (44, 45) and three 4'-alkylamido (46, 48, 49) derivatives were also prepared. By using optically pure reagents, three pairs of diastereoisomers were synthesized and separated as optically pure compounds (14, 15; 16, 17; 38, 39). Together with the above synthetic derivatives, seselin (3) and (+/-)-cis-(4), (+)-cis- (5), and (+/-)-trans-dihydroseselin-3',4'-diol (7) were also tested for their in vitro anti-HIV activity. An optically pure compound, 3',4'-di-O-(-)-camphanoyl-(+)-cis-khellactone (16), showed potent inhibitory activity and remarkable selectivity against HIV replication. The EC50 value and in vitro therapeutic index (TI) of 16 are 4 x 10(-4) microM and 136,719, respectively, which are better than those shown by AZT in the same assay. In addition, compound 16 is also active against HIV replication in a monocytic cell line and in peripheral blood mononuclear cells (PBMCs). Our in vitro assay indicated that, like compound 1, compound 16 is not an inhibitor of HIV-1 reverse transcriptase. Moreover, the anti-HIV activity of 16 is stereoselective as its three diastereoisomers (17, 38, 39) are at least 10,000 times less active. Since other synthetic dihydroseselin derivatives with different substituents or without any substituents are inactive or are active only at much higher concentration, the antiviral potency of 16 could be associated with the camphanoyl moieties of its structure. Therefore, compound 16 represents a unique coumarin structure with promising anti-HIV activity.

[Clinical study on jiang tang san in treating non-insulin dependent diabetes mellitus patients]

The therapeutic effect of Jiang Tang San (JTS) in 30 cases with non-insulin dependent diabetes mellitus (NIDDM), was observed, whose fasting blood glucose ranged from 11.1 mmol/L to 13.8 mmol/L. The results suggested that JTS has significant effects on NIDDM patients in the lowering of blood glucose, blood lipid and blood pressure levels. The clinical symptoms and blood glucose improved rapidly. JTS promoted the elevation of serum insulin level 1 hour after meal. The total effective rate of lowering blood glucose reached 86.7%. The results showed JTS is better than medication of berberine on lowering blood glucose (P < 0.01) and JTS was still effective when patients failed to respond to other hypoglycemics or on recurrence. There were no significant side-effects during the course of treatment.

Sources of attention-sensitive visual event-related potentials

In a study of the neural processes that mediate visual attention in humans, 32-channel recordings of event-related potentials were obtained from 14 normal subjects while they performed a spatial attention task. The generator locations of the early C1, P1, and N1 components of the visual evoked response were estimated by means of topographic maps of voltage and current source density in conjunction with dipole modelling. The topography of the C1 component (ca. 85 ms post-stimulus) was consistent with a generator in striate cortex, and this component was unaffected by attention. In contrast, the P1 and N1 components (ca. 95 and 170 ms) exhibited current density foci at scalp sites overlying lateral extrastriate cortex and were larger for attended stimuli than for unattended stimuli. The voltage topographies in the 75-175 ms latency range were modeled with a 5-dipole configuration consisting of a single striate dipole and left-right pairs of dipoles located in lateral extrastriate and inferior occipito-temporal areas. This model was found to account for the voltage topographies produced by both attended and unattended stimuli with low residual variance. These results support the proposal that visual-spatial attention modulates neural activity in extrastriate visual cortex but does not affect the initial evoked response in striate cortex.

[Clinical application of cluster analysis in repairing prosthesis ears]

Along with developments and progresses of microsurgery,plastic surgery became very often used method to reconstruct orofacial defects,but for missing ears the prosthesis methods are still a better way comparing surgery The main merits are :no wound,short treatment time,100% success rate,easily figure established.For simplified steps and saving time in the procedure of making prosthesis ears.300 different types ears from recording cases models are analysed and special different type wax-up ears and special models are made to provide different patients as needing for selection.

Extension of the velocity detection range of a tracking novelty filter that uses LiNbO(3) and strontium barium niobate

A method for extending the velocity range of motion detection by an optical tracking novelty filter is described. Separate photorefractive crystals are used as phase-conjugate mirrors in a phase-conjugate Michelson interferometer. Such an arrangement can ensure a significant difference in response times between the two arms of the interferometer, so that the range of detectable velocity is greatly reduced. Also, this implementation of a tracking novelty filter does not require a lossless dielectric beam splitter.

Differences in voltage-dependent sodium currents exhibited by superficial and deep layer neurons of guinea pig entorhinal cortex

1. Sodium currents were studied using whole-cell voltage-clamp techniques in neurons acutely isolated from superficial (II/III) and deep (V/VI) layers of guinea pig entorhinal cortex. 2. Sodium currents were larger (peak amplitude) in superficial than in deep layer cells under the same conditions: -1939 +/- 780 (SD) pA (N = 6) versus -307 +/- 257 pA (N = 6). Specific membrane conductance was calculated to be 12.3 +/- 9.6 mS/cm2 for superficial layer cells and 1.4 +/- 0.9 mS/cm2 for deep layer cells. 3. Sodium currents could be activated in superficial layer cells from potentials as depolarized as -20 mV, whereas no significant currents could be activated in deep neurons from potentials more depolarized than about -50 mV. Using a protocol consisting of a 25-ms prepulse and a 20 ms test pulse, the inactivation curves for superficial layer cells were found to be shifted toward more depolarized potentials by an average of 15 mV (V50 = -59.8 +/- 3.8 mV compared with -75.7 +/- 12.0 mV for deep cells). This produced a region of overlap with the activation curves for superficial cells. 4. Over a range of about -50 to -20 mV in superficial layer cells, the region of overlap of the activation and inactivation curves, a sodium current could be activated, which did not fully inactivate during the test pulse (average peak amplitude: -89.5 +/- 48.7 pA; crossover voltage: -39.2 +/- 2.0 mV). Voltage steps to more depolarized potentials, outside the voltage "window", permitted complete inactivation of the sodium current.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical observation of treatment of hypertension with calcium

The effect of oral calcium supplementation (1000 mg/day) on hypertension was studied in 57 borderline and mild-to-moderate hypertensive patients in a randomized, double-blind, placebo-controlled study for 14 weeks. Twenty-five patients from the above groups (11 from the calcium-treated group and 14 from the placebo group) were studied in a crossover fashion for 14 more weeks. The high calcium intake lowered systolic blood pressure by 17 mm Hg (P < .01), and diastolic blood pressure by 11 mm Hg (P < .01). Fifty percent of the calcium-treated patients showed a significant antihypertensive effect and were termed calcium responders. In the crossover study, serum sodium was lower after taking calcium than after placebo intake (P < .05). Pretreatment plasma free calcium content of the calcium-responsive patients was significantly lower (P < .05) than in the calcium nonresponsive patients, and was highly significantly increased (P < .01) after administering calcium. The result showed that oral calcium supplementation can lower blood pressure in a significant fraction of essential hypertensive subjects, and that the free calcium level in plasma may help identify calcium-responsive individuals. While the mechanism by which increased calcium intake lowers blood pressure in hypertension is still undetermined, these data support an underlying relationship between hypertension and calcium and possibly sodium metabolism.

Glutamate receptor gene expression in spinal cord of arthritic rats

Injury to peripheral tissue leads to hyperalgesia that appears to be partly mediated by functional changes at the level of the spinal cord. Glutamate receptors are thought to play a role in acute and short-term (minutes to hours) spinal cord nociceptive responses and may be involved in prolonged or chronic pain (hours to days). We used in situ hybridization to examine AMPA/kainate (GluR1, GluR2, and GluR3) and NMDA (NR1) receptor gene expression in spinal cord following induction of prolonged inflammation by a unilateral intraarticular injection of lipopolysaccharide (LPS; 10 micrograms) into the hindpaw. In control rats, GluR1 expression was prominent throughout the layers of the gray matter of the spinal cord. Microscopic examination revealed labeling of neuronal cell somata in all major nuclei. GluR2 was abundant in substantia gelatinosa and motor nuclei; emulsion-dipped sections exhibited intense labeling over densely packed neurons in the superficial laminae of dorsal horn and individual motoneurons of ventral horn. GluR3 and NR1 were expressed at low levels throughout spinal cord gray matter. One day after LPS injection, when joint swelling was maximal, GluR1 expression was bilaterally decreased by 25% in the substantia gelatinosa at the level of the lumbar cord. In contrast, no significant change was apparent in GluR2, GluR3, or NR1 expression in any nucleus of the cord. At 72 hr after injection, when joint diameter approached control values, all four transcripts were expressed at near control levels. These findings provide evidence for a specific decrease in GluR1 expression in the cord in response to joint inflammation.

Rearrangement of bcl-2 genes in malignant lymphomas in Chinese patients

BACKGROUND

Only a small percentage of Asian patients with non-Hodgkin lymphoma may have follicular type disease. According to molecular analysis done recently, the incidence of rearrangement of bcl-2 gene in patients with follicular lymphoma was lower in Japan than in the United States, suggesting possible geographic or racial differences between Asian and Western populations. The current study was undertaken to obtain data from Taiwan to compare with data from Japan, Hong Kong, and Western countries.

METHODS

Using probes of genomic 5' bcl-2, major breakpoint region (mbr) and minor breakpoint cluster region (mcr) for the breakpoint cluster region of the bcl-2 gene, genomic DNA samples from 55 patients with B-cell lymphoma (17 with follicular type and 38 with diffuse type) were analyzed by Southern blot analysis.

RESULTS

Eleven patients had bcl-2 gene rearrangement, including 9 of 17 (52.9%) patients with follicular lymphoma and 2 of 38 (5.3%) patients with diffuse B-cell lymphoma. Nine patients had the breakpoint located within the mbr, one at both the mbr and the 5' bcl-2 regions, and the other had bcl-2 translocation with involvement of the mcr. DNA fragment of bcl-2 was found to comigrate with JH genes in all patients with follicular lymphoma and diffuse lymphoma who had bcl-2 rearrangement at mbr. The remaining patient who had bcl-2 translocation at mcr had no comigration with JH, Jk, or C lambda genes.

CONCLUSIONS

Despite the low incidence of follicular lymphoma in Chinese patients, the incidence of bcl-2 gene involvement was higher in patients from Taiwan than in those from Japan and Hong Kong, but similar to the incidence of those from Western countries.

Reactivation of hepatitis B virus in two chronic GVHD patients after transplant

We report two cases of hepatitis B virus reactivation following allogeneic bone marrow transplantation (BMT) for severe aplastic anemia and acute myelocytic leukemia. The presence of antibodies to HBsAg, HBeAg and HBcAg prior to transplant indicated previous infection with hepatitis B virus (HBV). These antibodies disappeared 2 and 4 months after the onset of chronic graft versus host disease (GVHD) following immunosuppressive treatment, but HBsAg reappeared in their sera 6 and 10 months later, respectively. This suggests that chronic GVHD and immunosuppressive drugs can reactivate HBV in HBsAb-positive patients, most likely because of the decrease in quality and function of helper T cells and B cells during chronic GVHD to induce clearance of HBV antibodies and reactivation of HBV. Our observation confirms that patients with HBsAb, HBeAb and HBcAb present in their sera should not be considered to have 'immunity' to HBV after BMT.

Biodegradation of trichloroethylene and toluene by indigenous microbial populations in soil

The biodegradation of trichloroethylene (TCE) and toluene, incubated separately and in combination, by indigenous microbial populations was measured in three unsaturated soils incubated under aerobic conditions. Sorption and desorption of TCE (0.1 to 10 micrograms ml-1) and toluene (1.0 to 20 micrograms ml-1) were measured in two soils and followed a reversible linear isotherm. At a concentration of 1 micrograms ml-1, TCE was not degraded in the absence of toluene in any of the soils. In combination, both 1 microgram of TCE ml-1 and 20 micrograms of toluene ml-1 were degraded simultaneously after a lag period of approximately 60 to 80 h, and the period of degradation lasted from 70 to 90 h. Usually 60 to 75% of the initial 1 microgram of TCE ml-1 was degraded, whereas 100% of the toluene disappeared. A second addition of 20 micrograms of toluene ml-1 to a flask with residual TCE resulted in another 10 to 20% removal of the chemical. Initial rates of degradation of toluene and TCE were similar at 32, 25, and 18 degrees C; however, the lag period increased with decreasing temperature. There was little difference in degradation of toluene and TCE at soil moisture contents of 16, 25, and 30%, whereas there was no detectable degradation at 5 and 2.5% moisture. The addition of phenol, but not benzoate, stimulated the degradation of TCE in Rindge and Yolo silt loam soils, methanol and ethylene slightly stimulated TCE degradation in Rindge soil, glucose had no effect in either soil, and dissolved organic carbon extracted from soil strongly sorbed TCE but did not affect its rate of biodegradation.

Marked effect of buffers on yield of single- and double-strand breaks in DNA irradiated at room temperature and at 77 K

We have shown that the protocol for handling plasmid (pBR 322) DNA for radiation studies, which normally involves using quite high concentrations of Tris or phosphate buffers, is equally satisfactory in the absence of added buffers provided samples are stored at 0 degree C, or used directly. On exposure of aqueous solutions at 77 K, Tris buffer acts as a weak protecting agent, but phosphate buffers at the same pH act as remarkably effective sensitizing agents, giving ca. 100-fold increases in strand breaks. At room temperature there is again a marked difference between the aqueous and buffered systems, but in this case both the Tris and the phosphate systems are protective. Possible reasons for these contrasting results are discussed, and the advantages of using simple aqueous solutions are stressed.

Quantitative determination of glucose in blood plasma and in fruit juices by combined WATR-CPMG 1H NMR spectroscopy

The quantitative analysis of pure glucose solution < or = 225 mM (< or = 40.8 mg/mL) in 90/10 H2O/D2O was successfully completed in dilute aqueous solution by the WATR-CPMG method whereby the T2 of the water resonance is manipulated by the WATR method followed by elimination of the water peak by the CPMG pulse sequence. The method was applied to the quantitative analysis of total glucose in blood plasma from human subjects undergoing the oral glucose tolerance test in the teaching hospital, and the results were compared to those obtained using a standard glucose oxidase method in a hospital chemical pathology laboratory. The accuracy of the results obtained using the WATR-CPMG method were generally within 5% of the glucose oxidase method. The coefficient of variation was determined to be better than 4% using plasma samples of diabetic subjects. Application to the quantitative analysis of orange and guava juice was also successfully demonstrated.

Liver disease in patients with liver dysfunction prior to bone marrow transplantation

Twenty-two patients with previous hepatic compromise who underwent allogeneic bone marrow transplant (BMT) for treatment of hematologic malignancy or other hematologic disease between 1984 and 1990 were chosen for the present study. After transplant, 19 (86.4%) of the patients developed hepatitis, including six cases (27.3%) of acute hepatitis, 12 (54.6%) of chronic hepatitis and one uncharacterized hepatitis. Nine chronic hepatitis patients were followed-up for 7-56.5 months (medium 35.5 months) with biochemistry studies and ultrasonography. Throughout the observation period, liver cirrhosis or hepatoma were not detected and no patients developed veno-occlusive disease. Furthermore patients who developed hepatitis after transplant had worse prognoses. Based on serial serological survey of the various hepatitis B virus (HBV) antigens and antibodies, we have found that most of the recurrent viral hepatitis in transplant patients could be attributed to the reactivation of the virus. In addition, the use of immunosuppressive drugs, persisting infection by HCV and the development of graft-versus-host disease may also play a role in modulating the course of viral hepatitis in BMT patients.

Bone marrow transplantation for severe aplastic anemia--a study of twenty-one Chinese patients in Taiwan

A total of 21 multiply transfused patients with severe aplastic anemia (SAA) were treated with bone marrow transplantation between March 1985 and September 1990: 20 allogeneic and one syngeneic transplants. A positive response in mixed lymphocyte culture (MLC) was also noted in 7 allogeneic recipients. Pregraft conditioning included high-dose cyclophosphamide (CY) 200 mg/kg over 4 consecutive days, followed by 300 cGy total-body irradiation the day before BMT. Seventeen patients older than 14 years received additional donor buffy-coat cells infusion for 5 days posttransplant. A combination of methotrexate and cyclosporine was used for prophylaxis of graft-versus-host disease. Seventeen patients were alive with a functional graft, and Kaplan-Meier product limit estimates showed a 80.95% probability of survival at 67.7 months. There were 4 deaths: two died of primary graft failure, one from secondary rejection, and the other from chronic GVHD-related complications. Acute GVHD, grade I was noted in only one patient (5.6%). In contrast, chronic GVHD was observed in 10 out of 18 (55.6%) evaluable patients. Venoocclusive liver disease and interstitial pneumonitis were not diagnosed. Our findings indicate that the combination of CY/TBI/BC is well tolerated and results in a low incidence of graft failure/rejection in multiply transfused Chinese patients who received transplants for SAA. The MTX/CsA combination was confirmed as being remarkable in reducing the incidence and severity of acute GVHD. For patients with SAA under the age of 40, with an HLA-identical sibling, we highly recommend BMT as the treatment of choice.

Serum factor(s) induced by restraint stress in mice and rats suppresses lymphocyte proliferation

LACA mice were individually restrained in a specially made cylindrical cage for 10-20 h at room temperature (20 degrees C). Serum obtained from stressed mice was found to suppress normal mouse lymphocyte proliferation induced by concanavalin A, suggesting the presence of a suppressive factor(s) in the stressed serum. Adrenalectomy or injections of naltrexone (1, 10, or 20 mg/kg, ip), just prior to and in the middle of the stress period, did not affect the suppressive activity of serum from mice. However, the suppressive activity was totally abolished by general anesthesia with urethane (1.5 g/kg, ip). These results suggest that adrenal hormones and opiate receptors are not involved in the generation of the suppressive factor(s) and that the central nervous system plays a very important role in this process. SD rats were restrained in a supine position for 20 h at room temperature (20 degrees C) and serum from stressed rats was also found to be able to suppress normal mouse lymphocyte proliferation. A further analysis of "stressed serum" indicated that the suppressive factor(s) was heat stable (56 degrees C, 30 min) and acid stable (pH 3.8), but sensitive to 100 degrees C (3 min), an organic solvent (greater than 60% methanol), and proteinases (trypsin and chymotrypsin). From the measurement of gel filtration (HPLC), the molecular weights of the suppressive factor(s) were 155 and 370 kDa. Taken together, these results indicate that the suppressive factor(s) is a protein with a large molecular weight.

[CA125 in non-Hodgkin's lymphoma]

CA125 is an antigenic determinant recognized by monoclonal antibody CA125 raised against a serous ovarian cancer cell line. Elevation of this antigen has been reported in over 80% of women with epithelial ovarian cancer and many other diseases including both malignant and non-malignant ones. However, in non-Hodgkin's lymphoma (NHL) only a few reports have focused on this topic thus interesting us. In order to exploit its possible role in this field, a total of 61 eligible patients with a diagnosis of NHL were studied. Serum CA125 was measured by radioimmunoassay (RIA) prior to any operative procedures or chemotherapy. Serum CA125 above 35 U/ml was seen in 47.7% of nodal NHL (n = 44) and 70.6% of extranodal NHL (n = 17) with an overall positive rate at 54.1%. The elevation of serum CA125 correlates well with the presence of peritoneal involvement and therefore, with disease extent to some degree. No correlation between it and the histological type or with the B symptom was the rule. Avidin-biotin peroxidase stain by anti-CA125 MoAb was applied to identify the tissue content of this antigen in 15 cases of whom 11 had CA125 well above 35 U/ml. None of the 15 cases examined showed positive result. In conclusion, serum CA125 is probably no more than an indicator of peritoneal stimulation released by tumor invasion rather than a tumor product. The possible role in disease follow-up remains to be elucidated.

[Normal full-term pregnancy after allogeneic bone marrow transplantation for severe aplastic anemia: a case report]

A 27 year-old woman had a normal full-term delivery 4 years after bone narrow transplantation for severe aplastic anemia. She had received combination regimens of systemic high-dose cyclophosphamide and one fraction of total body irradiation for 300cGy as pre-BMT conditioning regimens. This case illustrates that after regimens incorporating total body irradiation and high-dose cyclophosphamide, recovery of ovarian function and normal pregnancy are still possible.

Activation of macrophages for ADCC in vitro: effects of IL-4, TNF, interferons-alpha/beta, interferon-gamma, and GM-CSF

Macrophages in varying states of activation differ in their ability to perform antibody-dependent cellular cytotoxicity (ADCC) and antibody-independent macrophage-mediated tumor cytotoxicity (MTC). To define further the activation requirements for macrophages to perform various cytolytic functions, we stimulated peptone-elicited peritoneal macrophages, which are only poorly cytolytic, with one of a panel of cytokines and then quantified three distinct cytolytic capacities. The peptone-elicited macrophages, after stimulation with IFN-alpha/beta, IL-4, or TNF, had increased ability to perform both the rapid and slow variants of ADCC but not to perform MTC. Stimulation with high doses of IFN-gamma, however, increased the macrophages' ability to perform all three cytolytic functions. GM-CSF had no effects on any cytolytic capacity. The effects of IL-4, TNF, IFN-gamma, and IFN-alpha/beta on the macrophages' capacity for both forms of ADCC were dose-dependent. IFN-gamma and IFN-alpha/beta increased the macrophages' capacity for both variants of ADCC within 4 hr of treatment, whereas IL-4 and TNF did so only after prolonged treatment. These results suggest that three forms of macrophage cytolytic capacity can be enhanced by cytokine treatment but that the requirements for enhancing each of the three forms of macrophage cytolytic capacity differ.

Clinical and experimental observations on treatment of peptic ulcer with wei yang an (easing peptic-ulcer) capsule

The therapeutic effects of peptic ulcer treated with cimetidine and Wei Yang An were compared clinically and experimentally by the double blind method. Results showed that the effects of the two are similar, but the long-term effect of Wei Yang An was better. Wei Yang An was also good for most cimetidine resistant ulcers, with few side effect. Animal experiment showed that Wei Yang An inhibited the ulcers.

Study of bone marrow cells in non-Hodgkin's lymphoma by DNA analysis

Using Southern-blot analysis, we studied samples of bone marrow (BM) cells from 73 patients with non-Hodgkin's lymphoma (NHL) in various clinical status. The frequency of gene rearrangement was disease-status dependent with a frequency of 65.8% at the diagnostic stage, 81.8% after relapse and 33.3% upon complete remission (CR). BM involvement was evident in a substantial portion of patients with untreated and relapsed lymphoma. The significance of BM involvement by DNA hybridization in relation to conventional clinical staging and histological grade was studied. By Southern-blot analysis, BM involvement was found in 76% of the patients at clinical stages (CS) I-III. The incidence of BM involvement in low, intermediate and high grades of NHL (Working Formulation) was 57%(4/7), 67%(22/33), and 89%(8/9) respectively. A comparative study of conventional BM biopsy vs DNA hybridization in a group of 47 NHL patients showed that all 12 patients (100%) with morphological BM involvement and 25 out of 35 patients (71%) with morphologically normal BM had clonal rearrangements of immunoglobulin (Ig), heavy chain and/or light chain; or T-cell receptor beta chain (TCR beta) genes in BM cells. The false negative rate in conventional BM biopsy was 53%(25/47). Southern-blot analysis on lymph nodes (LN) and BM cells from 37 patients showed that 6 patients (16%) had cross-lineage or different rearranged patterns in the same or different tissues. Southern-blot analysis was found to be highly reliable for the detection of even minimal populations of lymphoma cells in the BM and therefore should be the diagnostic choice for clinical staging of lymphoma.

Remission induction of ANLL with low dose cytosine arabinoside combined with retinoic acid

Fourteen cases of acute non-lymphocytic leukemia (ANLL) were treated with low doses of cytosine arabinoside (LDAra-C 20 mg/m/q12h) and etretinate (all-trans-9-3, 7-dimethyl-2, 4, 6, 8 non-atetraenoate, 75 mg/d). Of which 9 were untreated, 3 were in first relapse and 2 were refractory patients. Five of the 9 patients in the first group, and all 3 patients in the second group achieved complete remission (CR). The 2 cases with refractory ANLL showed no response. The CR rates in untreated, first relapse and refractory patients were 55.6%, 100%, and 0% respectively. In all, there was significant reduction of marrow cellularity in 13 patients, 5 of whom developed bone marrow aplasia with predominantly lymphocyte and plasma cells. Only 2 cases with M5 ANLL showed evidence of differentiating into monocytes and neutrophil in hypocellular marrow phase. The efficacy of this drug combination, however, appeared to be achieved through cytotoxicity rather than differentiation. The side effects in the treated cases included cheilitis, dermatitis, fever, petechiae, and impaired liver function, which soon improved upon discontinuation or reduction of dosage. This combination treatment might be most effective in achieving remission among elderly and severely infected patients with ANLL, and could be appropriate even for patients in first relapse.

Cytokine stimulation of antibody-dependent cellular cytotoxicity (ADCC) enhances cytolytic but not binding capacity of peritoneal macrophages

Macrophages in varying states of activation differ in their ability to perform antibody-dependent cellular cytotoxicity (ADCC). To define further the activation requirements for macrophages to perform cytolytic functions, we stimulated peptone-elicited peritoneal macrophages, which exhibit only a low level of ADCC, with a panel of cytokines and then assayed for the macrophages capacity to effect the rapid and slow forms of ADCC, to bind antibody-coated tumor cells, and to secrete H2O2 in response to immune complex or PMA. All four cytokine preparations, at optimal conditions, enhanced both forms of ADCC, but did not appreciably increase tumor cell binding. Three of the four cytokine preparations (Il-4, TNF and IFN-alpha/beta), however, increased the macrophages capacity to secrete H2O2 in response to either immune complex or PMA, IFN-gamma alone did not affect H2O2 secretion.

Changing of hepatitis B virus markers in patients with bone marrow transplantation

The hepatitis B virus (HBV) infection and its resulting hepatic abnormalities are very high in prevalence among the Taiwan population. They also seem to compose a major problem to patients subjected to bone marrow transplantation (BMT) due to intensive chemoradiotherapy. In this study, the sera of 42 patients were investigated before and after BMT to detect the presence of HBV markers and to test their liver function (LF). Being followed-up for 3-12 months after BMT, 12 out of 27 were found to have altered HBV markers according to the classification of the following: seroconversion of HBsAg, clearance of HBsAb, appearance of HBeAg, clearance of HBeAb, and acute hepatitis. Thirty-seven out of 42 patients (88.1%) were found in routine LF test to develop one or more abnormality; however, 90% of them turned normal within one year after BMT. Only one patient died of complications associated with fulminant hepatitis. In conclusion, the previous hepatic damage from HBV infection appears unlikely to increase the risk of posttransplant morbidity and mortality.

Generation of lymphokine-activated killer (LAK) cells and possible implications in autologous bone marrow transplantation--a preliminary report

Lymphokine-activated killer (LAK) cells were generated successfully without mitogen from blood mononuclear cells obtained from 14 patients with varying malignancies and 2 normal donors. Cells from both groups showed a positive cytotoxicity by a 4-hour 51-Cr-release assay against a variety of target cells including natural killer (NK) sensitive K562 myeloid leukemia, NK-resistant Raji lymphoma cell lines, and fresh/cryopreserved leukemia cells from patients refractory to standard chemotherapy but not normal blood cells. Higher cytotoxic activity was obtained with a higher effector:target ratio at 100:1 greater than 50:1 greater than 25:1 (P less than 0.01) in each setting of different targets. Experiments involving cocultures of the LAK cells with either allogeneic (9) or autologous (3) bone marrow cells disclosed no detrimental effect on the committed hemopoietic stem cells by semisolid agar colony forming unit (CFU-GM) assay. The findings suggest that LAK cells may have a potential role for the in vitro purging of the residual leukemic cells from the marrow inoculum prepared for autologous bone marrow transplantation.

Complications of bone marrow transplantation in Chinese

Forty-three patients with hematopoietic disease were treated with intensive chemotherapy and radiotherapy, followed by allogeneic bone marrow transplantation (BMT) from 28 HLA-identical and 10 one to two antigen haploidentical sibling donors and autologous BMT (5 cases). Of these cases, there were 21 with acute nonlymphocytic leukemia (ANLL), 5 with acute lymphocytic leukemia (ALL), 6 with chronic myelocytic leukemia (CML), 2 with Hodgkin's disease (HD), 8 with severe-form aplastic anemia (SAA) and 1 with thalassemia. Complications of BMT were evaluated including acute graft-versus-host disease (GVHD), interstitial pneumonia (IP), veno-occlusive liver disease (VOD), abnormalities of liver function (LF), and alteration of hepatitis B virus (HBV) markers. In thirty-three patients who were followed up for more than 3 months, we found that the incidence of moderate to severe acute GVHD (9.1%) and IP (two cases, 4.7%) were low. No VOD occurred in our series. During the follow-up period, 27 out of 35 patients (77%) had high alanine aminotransferase (ALT)/aspartate aminotransferase (AST) levels, even up to 1000 U/liter; however, only one patient succumbed to a hepatitis-related complication. Previous hepatic damage from HBV infection before BMT does not appear to increase the risk of posttransplant morbidity and mortality.

Adaptive response to 2 low doses of X-rays in human blood lymphocytes

Human peripheral blood lymphocytes exposed to a single adaptive dose of 1 cGy X-rays or 2 adaptive doses, each of 1 cGy, were found to be equally resistant to the induction of chromosome damage by subsequent challenge with a high dose of 1 Gy X-rays, as compared to cells that were not pre-exposed. They responded with a significantly reduced incidence of chromatid and isochromatid breaks. These results indicate the presence of an inducible chromosomal repair mechanism in human blood lymphocytes and confirm the observations made by earlier investigators. The incidence of chromosome damage was found to be similar in the lymphocytes pre-exposed to a single or 2 adaptive doses, suggesting that, under the conditions tested, the second adaptive dose did not offer any additional protection against the chromosome damage induced by the challenge dose.

[Second primary cancer in hematological malignancy experience in VGH-Taipei]

Seven patients of hematological malignancy with second primary cancer had been found at Veteran General Hospital from 1983 to 1988. The second primary cancers either developed subsequently or concurrently with the hematological malignancies. Four patients were diagnosed to be non-Hodgkin's lymphoma and three of them developed squamous cell carcinoma of lung(2) and hepatocellular carcinoma (1) at 44, 20 and 45 months after the initial diagnosis of on-Hodgkin's lymphoma. All three had received chemotherapy and/or radiotherapy. Another one was found to have liposarcoma in the retroperitoneum concurrently. Three patients had chronic lymphocytic leukemia (CLL). Two of them were found to have skin squamous cell carcinoma at the same time. Another one developed cervical squamous cell cancer ten months after treatment with oral leukeran and prednisolone. Literature about synchronous and metachronous neoplasms was reviewed.

Phosphorylation of cytoskeleton-associated proteins, pp58 and pp60, in tumouricidal murine peritoneal macrophages

Two highly phosphorylated vimentin-like proteins, pp58 and pp60, are expressed in macrophages activated in vivo to tumouricidal activity. Resident and elicited, non-tumouricidal peritoneal macrophages displayed low and intermediate levels of phosphorylated pp58 and pp60, respectively. C3H/HeN macrophages became tumouricidal after incubation with 0.1 micrograms/mL A23187 plus 10 nmol/L 12-phorbol 13-myristate acetate (PMA), or 0.1 micrograms/mL A23187 plus 100 ng/mL lipopolysaccharide (LPS), and displayed increased phosphorylation of pp58 and pp60. LPS non-responder C3H/HeJ macrophages were not tumouricidal nor did they show increased phosphorylation of pp58 and pp60 after incubation with LPS plus A23187 in vitro. C3H/HeJ macrophages, however, did become tumouricidal and expressed increased phosphorylation of pp58 and pp60 after incubation with A23187 and PMA. Addition of PGE2 (10(-8) mol/L), resulted in down-regulation of macrophage tumouricidal activity and decreased pp58 and pp60 phosphorylation, which was reversed by addition of indomethacin (10(-6) mol/L) to cultures with PGE2. Phosphorylation increased within 5 min after adding activating stimuli while incorporation of [35S]-methionine into a 58 kD protein did not occur until 6 h later. No 60 kD protein synthesis was detected during the first 8 h after adding activating stimuli, indicating that previously synthesized proteins were phosphorylated during macrophage activation. These results signify a physiological role for the phosphorylation of cytoskeleton-associated pp58 and pp60 during macrophage activation to tumour cytotoxicity.

The many faces of neuroblastoma

Neuroblastoma is a common tumor in childhood. It arises in the adrenal gland or in various extraadrenal primary sites of the sympathetic chain. Clinically, it may present as an abdominal mass or as disseminated metastatic disease. We studied 52 patients with neuroblastoma, and the typical and unusual radiographic features of the disease are presented.

Treatment of metastatic colorectal adenocarcinoma with fluorouracil and high-dose leucovorin: a pilot study

In Veterans General Hospital-Taipei, 25 patients with metastatic or recurrent colorectal adenocarcinoma were treated with a 5-day course of 5-FU (370 mg/M2/d) and high dose leucovorin (200mg/M2/d), repeated every 28 days until a progression of disease was evident. Twenty-one patients had evaluate tumor response. Among the 16 patients with measurable disease, three patients achieved partial response (PR), and their response durations were 2 months, 6 months and 6+ months. Five patients had stable disease (SD) for 4,4,6,7, and 10 months before its progression. Among the 5 patients with documented abdominal carcinomatosis, four remained stable without any progression for 5,6,12 and 12 months after treatment. The overall response rate was 57% (3PRS, 9SDs). Seven of the 12 responders had prior 5-FU exposure. Nine patients had progressive disease and 7 of them died within a few months after the start of treatment. The median duration of response was 6.7 months. The median survival for responders was 9.8 months, and for non-responders, 3.7 months. Performance status (PS) was a main determinant of response. Among the patients with PS = 0 (6 patients), there were 2 PRs and 4 SDs and with PS = 1 (8 patients), 1PR and 4 SDs. When PS = 2 or 3 (7 patients), only 2 SDs were noted. All the 25 patients were put into toxicity test to find in a mild to moderate, easily controlled state. There were 3 (12%) patients with grade 2-3 mucositis, 6 (24%) with grade 2 diarrhea, 13 (50%) with nausea and vomiting. Only 3 cases developed leucopenia but without thrombocytopenia.(ABSTRACT TRUNCATED AT 250 WORDS)

Treatment of severe aplastic anemia: comparison of bone marrow transplantation to immunotherapy

Between February 1985 and May 1988, sixteen patients with severe aplastic anemia (SAA) post multitransfusion were treated with either allogeneic bone marrow transplantation (BMT) (9) or immunosuppression (7). The latter group was further divided into two subgroups: horse anti-human thymocyte-lymphocyte globulin (ATG-ALG) (2) and high dose methylprednisolone (HDMP) (5). There were 8 males and 8 females, age ranged from 10 to 35 years for the BMT group and 19 to 56 for the immunosuppression group. As of analysis, 9 patients in the BMT group had been followed from 1 to 31 months after transplant (median,24). Graft rejection was noted in 2, both had positive mixed lymphocyte culture (MLC) index. Seven had full recovery of hematopoiesis. Of these 7 survivals, none developed acute graft-versus-host disease (GVHD), whereas 2 had chronic GVHD which resolved completely after a 9-month treatment with azathioprine and prednisolone. Kaplan-Meier survival probability at 31 month was 75%. In the immunosuppressive therapy group 2, who received ATG-ALG both failed the treatment, died 7 and 29 months later, respectively. There were 3 responders in the HDMP subgroup, 1 complete, 2 partial. The 1-year survival probability for this group was 42.9% compared with 75% in the BMT group (p greater than 0.10). However, the hematologic reconstitution and Karnofsky performance were complete in all 7 transplant survivals vs one of 3 in the immunosuppression group (p less than 0.01). This experience supports that for patients with SAA under the age of 40, BMT is the treatment of choice if an HLA-identical MLC-nonreactive marrow donor is available, if not, immunosuppression is an alternative approach.(ABSTRACT TRUNCATED AT 250 WORDS)

Pharmacologic assessment of regimen chemosensitivity in the soft-agar assay: effect of oxygen on human tumors

The influence of oxygen on the growth and the in vitro chemosensitivity of human tumor cells was studied in the soft-agar assay. Tumor cells of pancreatic and ovarian origin prefer a reduced oxygen atmosphere for colony formation, whereas those of pulmonary origin grow better in 20% oxygen. Depending on the physiologic oxygen tension and the histologic origin of a particular cancer type, the in vitro chemosensitivity of many drug obtained with the conventional culture system could be inadequately assessed. The in vitro responses of tumor cells to combinations of drugs were measured by the regimen efficacy index (REI) method. The REI delineates the possible regimen enhancement or regimen default based on the in vitro chemosensitivity of the individual agents tested in the assay. In vitro regimen enhancement was observed only in ascites incubated in a reduced oxygen atmosphere with two-drug combinations. However, regardless of the oxygen gradients used, regimen default was seen in cancer cells of solid tumors treated with all combinations of drugs tested. This study suggests further investigation on the effects of oxygen in the soft-agar assay, and proposes the novel use of the REI method for evaluating the in vitro regimen chemosensitivity of human tumor cells.

Cooperative evaluation of human tumor chemosensitivity in the soft-agar assay and its clinical correlations

In supporting the human-tumor cloning effort of the Southwest Oncology Group, we conducted an independent retrospective study to evaluate the clinical correlations of the soft-agar colony-forming assay developed by Hamburger and Salmon (1977). This study was made with the cooperation of 76 clinicians and 11 hospitals in Greater New Orleans. In a 10-month trial (July 1982 to May 1983), we received 134 human tumors of 26 classifications and achieved 76% success in colony growth from 122 plated samples. Retrospective correlations between the in vitro chemosensitivity of tumor colonies and clinical drug responses were made possible in 31% of the patients. Evaluation of 45 in vitro and in vivo associations indicated a combined sensitivity of 0.65 and a specificity of 0.68 for the assay. Technical refinements and the selectivity of the assay are discussed.

Sectional analysis of tumor colony growth in the soft-agar assay: effects of oxygen

Soft-agar clonogenicity of L1210 mouse leukemia cells and of xenografts of a human melanoma and a carcinoma of the cervix was studied sectionally by the sizes of the colonies grown under hypoxic gradients and aerobic condition. Soft-agar plating efficiency was increased in cultured L1210 cells with decreasing oxygen concentrations. The growth of both cultured L1210 cells and their BDF1 ascites was better in 5% oxygen than in 20% oxygen. Although soft-agar colony development of both melanoma and cervical carcinoma was significantly better in 5% oxygen, the former has a secondary preference for a hypoxic atmosphere and the latter, for an aerobic condition.

A role for calcium-activated calmodulin in murine nonspecific cell-mediated cytotoxicity

The role of Ca++ in mouse nonspecific cell-mediated cytotoxicity was studied using the calcium ionophore A23187, inhibitors of calmodulin activity, and agents which modulate cyclic AMP concentration. A23187 markedly enhanced spleen lymphocyte cytotoxicity against SV3T3 target cells, suggesting that Ca++ influx enhances cytolytic activity. This conclusion was supported by experiments in which verapamil, a Ca++ channel blocker, inhibited normal and ionophore-induced cytotoxicity. A23187 also enhanced cytolysis of YAC-1 cells in a 16-hr 51Cr release assay, but had little effect in the more typical 4-hr assay. Lysis of BHK, a cell line resistant to murine natural cytotoxicity, could not be induced by A23187. However, hamster effector cells, which can lyse xenogeneic target cells, showed increased against either SV3T3 or BHK. This indicates that the effect of the ionophore was not due to nonspecific release of toxic products from the effector cells. Both normal and ionophore-enhanced lysis were also inhibited by the phenothiazines chlorpromazine and trifluoperazine, which block the activity of calmodulin. A more specific calmodulin activity inhibitor, W13, was also shown to profoundly inhibit cytotoxicity induced by A23187. These results suggest that Ca++ acts as a stimulus-response coupler in cell-mediated cytotoxicity, and that calmodulin mediates the effects of the Ca++. Furthermore, cyclic AMP appears to modulate the action of Ca++ since agents which increase cAMP levels reduce the effects of A23187.