Management of local residual primary lesion of nasopharyngeal carcinoma (NPC): are higher doses beneficial?

One hundred and eighty-two nasopharyngeal carcinoma (NPC) patients, treated from March 1958 through 1978, received 70 Gy or more and were left with gross residual lesion in the nasopharynx, were retrospectively analyzed. Ninety-two patients were given a boost by reduced portals to a total of 90-120 Gy (boost group) whereas for the other non-randomized 90 patients, the treatment was stopped at 70 Gy (observation group). The local recurrence, distant metastasis and 5-year survival rates of the two groups are: 35% (32/92) vs. 58% (52/90), 20% (18/92) vs. 43% (39/90), and 54% (50/92) vs. 21% (19/90), respectively. The benefit of boost is more apparent in patients with T1-2 than T3-4 lesions (p less than 0.001), at increased risk of radiation encephalo-myelitis from 5.5% to 17%. The authors believe that boost be given to patients with early Stage T or small residual lesion at the primary site of NPC.

Anti-inflammatory and immunosuppressive properties of the bis-benzylisoquinolines: in vitro comparisons of tetrandrine and berbamine

Tetrandrine and berbamine are two naturally occurring analogues with a bis-benzylisoquinoline structure. Comparative in vitro studies show that tetrandrine has significantly greater suppressive effects on adherence, locomotion and 3H-deoxyglucose uptake of neutrophils, as well as the mitogen-induced lymphocyte responses and mixed lymphocyte reactions. Also, tetrandrine displayed anti-oxidant activity while berbamine did not. By contrast, berbamine demonstrated a significantly greater capacity for inhibition of NK cell cytotoxicity. These results show that tetrandrine is superior to berbamine in most aspects of anti-inflammatory and immunosuppressive activity. Since these two alkaloids differ by only one substitution in the side chain of one of the benzene rings, these findings may provide further insight into structure-activity relationships and clues to the synthesis and development of active analogues of this promising class of drugs for the treatment of chronic inflammatory diseases.

Effect of tetrandrine on immunological responses and cardiac transplant rejection in mice

Mice treated with the plant alkaloid tetrandrine have a reduced capacity to mount delayed-type hypersensitivity (DTH) responses. This suppressive effect on DTH was more pronounced when treatment was begun 2 days prior to immunization with sheep erythrocytes. Similar dosage regimens significantly delayed the rejection of cardiac transplants. By contrast, there was significant enhancement of antibody production. These immunomodulatory properties of tetrandrine may account for some of its potential in the treatment of chronic inflammatory diseases, where immunological mechanisms are known to play a major role in pathogenesis.

Suppression of human monocyte interleukin 1 production by the plant alkaloid tetrandrine

The bisbenzylisoquinoline alkaloid, tetrandrine, was shown to affect some important human monocyte functions. The drug caused significant inhibition of random movement, chemotaxis, superoxide anion generation and interleukin 1 (IL-1) production. By contrast, degranulation and hexose-monophosphate shunt activity were unaffected. Tetrandrine may be of value in the treatment of chronic inflammatory diseases where IL-1 has a major role as an inflammatory mediator.

In vitro immunosuppressive properties of the plant alkaloid tetrandrine

Tetrandrine is an extract of the creeper Stephania tetrandra used in traditional Chinese medicine for the treatment of rheumatic diseases. It has recently been shown to retard and even reverse the lesions of silicosis in humans and rats. Data presented in this report indicate that tetrandrine has potent immunosuppressive properties. Mitogen-induced lymphoproliferative responses were markedly reduced even when tetrandrine was added after the initiation of cultures. In vitro antibody synthesis by B cells was also suppressed by tetrandrine, as was the natural killer cell-mediated lysis of K562 cells. It does not interfere with receptor-ligand binding, but does affect the inositol triphosphate second messenger system. These effects of tetrandrine were observed at nontoxic concentrations as shown by lymphocyte viability studies. These results indicate that tetrandrine possesses potent immunosuppressive properties, and may warrant further study in animal models of chronic inflammatory conditions, autoimmune diseases and transplant rejection.

Antiphagocytic and antioxidant properties of plant alkaloid tetrandrine

The effects of tetrandrine, a benzylisoquinoline alkaloid useful in the treatment of silicosis, on a broad range of human neutrophil activities was examined in vitro. Random movement, chemotaxis and phagocytosis were significantly suppressed. There was minimal but significant inhibition of lysosomal enzyme secretion from specific (secondary) but not azurophil (primary) granules. The same concentration of tetrandrine (10 micrograms/ml) caused marked depression of hexose-monophosphate shunt activity and hydrogen peroxide production, but inhibition of superoxide anion generation was observed even at a concentration of 0.1 microgram/ml. This discrepancy was attributed to the capacity of tetrandrine to scavenge oxygen radicals, as shown by experiments using hypoxanthine-xanthine oxidase to generate superoxide. These potent antiphagocytic and antioxidant properties of tetrandrine may account for some of its remarkable anti-inflammatory effects.

Influx of 5'-deoxy-5'-methylthioadenosine into HL-60 human leukemia cells and erythrocytes

The influx of 5'-deoxy-5'-methylthioadenosine (MeSAdo) into human HL-60 leukemia cells and erythrocytes was characterized in order to determine whether it is facilitated by the nonspecific nucleoside carrier system or by a separate transporter, as suggested by other reports. Initial velocities were measured at room temperature by means of inhibitor-stop and oil-stop assays. MeSAdo influx was strongly inhibited by Ado, dAdo, and nucleoside transport inhibitors including nitrobenzylthioinosine and dipyridamole. Ade was inhibitory only at concentrations in excess of 1 mM. Loss of nucleoside transport capacity during differentiation of HL-60 cells was accompanied by a corresponding decrease in MeSAdo influx rates. These results indicate that MeSAdo influx was mediated by the nonspecific nucleoside transport system. The kinetic data were consistent with a single saturable carrier and yielded Km values of 74 and 184 microM and Vmax values of 424 and 48 pmols/10(6) cells/min with HL-60 cells and erythrocytes, respectively, after correction for a substantial passive diffusion component, which accounted for over 50% of the influx of 1 mM MeSAdo. The passive diffusion of MeSAdo in the presence of a transport inhibitor was not rate-limiting for the salvage of 50 microM MeSAdo to methionine when HL-60 cells were cultured in methionine-deficient medium. The large contribution of passive diffusion to the influx of MeSAdo is consistent with its unusually high octanol/water partition ratio (5.7-fold greater than that of Ado).

Establishment and characterization of a tumorigenic trophoblast-like cell line from a human placenta

A trophoblast-like cell line, TL, was established from a normal-term human placenta. The TL cells were epithelial in morphology with relatively large vesicular nuclei, prominent nucleoli, and numerous microvilli on the cell surface. Cytoplasmic organelles were generally sparse but mitochondria and polysomes were abundant. The cells grew as compact sheets with close membrane approximation interconnected occasionally by desmosome-like junctions. TL cells contained placental alkaline phosphatase, a placenta-associated antigen, cytokeratin, and prekeratin, but not keratin. In parallel, they were negative for factor VIII, vimentin, and fibronectin. Population doubling time was estimated to be about 34 h. TL cells were tumorigenic in nude mice and an increase in tumorigenicity was observed after a certain number of passages in vitro. Chromosome analysis revealed that TL cells were highly heterogenous and had a female aneuploid karyotype with a hypotriploid mode. Unlike trophoblastic cell lines established from neoplastic tissues, TL cells did not synthesize human chorionic gonadotropin or other gonadal hormones, and only a small amount of ferritin (40.3 ng/10(6) cells) could be detected in the cell supernatant and cell extract. Based on various morphological and histochemical criteria, we suggest that the TL cells are derived from the Langhans cells (villous cytotrophoblast), and due to their special features, the cells may be valuable for the study of the differentiation and tumorigenesis of trophoblastic cells.

Inhibition of human purine nucleoside phosphorylase by acyclic nucleosides and nucleotides

In an effort to develop more potent inhibitors of human purine nucleoside phosphorylase (PNP) as immunosuppressive and cancer chemotherapeutic agents, the affinity of the erythrocytic enzyme for 30 acyclic nucleosides, nucleotides and related compounds was determined. Among the acyclonucleosides, 2'-nordeoxyguanosine [2'NDG, 9-(1,3-dihydroxy-2-propoxymethyl)guanine] had a 3-fold greater affinity than acyclovir, and 8-amino-2'NDG was the best inhibitor with Ki = 2.6 X 10(-7) M. The ether moiety of the acyclovir and 2'NDG side-chains was not important for binding. Phosphorylated 2'NDG analogs appeared to act as multisubstrate analogs with optimal binding at low (1 mM) phosphate concentration. The 2'NDG mono- and triphosphates had higher affinities than those reported for the phosphorylated acyclovir derivatives but the diphosphate had a similar Ki value of 9 X 10(-9) M. Poor affinity, independent of phosphate concentration, was found for 9-(2-phosphonoethyl)guanine. The 3'-phosphate derivative of 8-(3-hydroxypropyl)-9-methylguanine inhibited with a Ki = 2 X 10(-5) M in 1 mM phosphate. The chemical syntheses of new analogs are described.

Inhibitory effects of tetrandrine on human neutrophil and monocyte adherence

Tetrandrine is a plant alkaloid useful in the treatment of silicosis. Its mode of action is unknown, but results of the present study show dose-dependent inhibition of human neutrophil and monocyte adherence at concentrations (0.1-10 micrograms/ml) easily achieved in plasma during drug therapy. Monocytes were shown to be more sensitive to tetrandrine than neutrophils. Dye-exclusion experiments indicate that tetrandrine is non-toxic to these cells at 10 micrograms/ml concentrations. Suppression of adherence was reversible by washing, suggesting that the drug does not bind tightly to membrane components. Enhancement of adherence by the tumour promoter, phorbol myristate acetate, was abolished by tetrandrine. The uptake of deoxyglucose by neutrophils and monocytes was suppressed by tetrandrine. These results indicate that tetrandrine may act by interfering with the recruitment of these cells into silicotic lesions.

Effects of cyclosporin A on the production of experimental anti-erythrocyte autoantibodies in mice

Mice were treated with cyclosporin A (CsA) (25-100 mg/kg daily, by mouth) during the induction of autoantibodies to erythrocytes by means of injections of rat erythrocytes. A high dose of CsA inhibited autoantibody production whereas a low dose temporarily potentiated it. Cell transfer and anti-Thy 1.2 treatment indicated the presence of suppressor T cells in the spleens of immunized mice. Their formation was inhibited by treatment with high dose CsA and potentiated by low dose CsA. In the CBA/H mice used, CsA treatment after immunization had no effect on autoantibody titres.

Acetylspiramycin and the immune system--II. Effects on lymphocyte proliferation, lymphokine production, delayed-type hypersensitivity and antibody production

The effects of the antibiotic acetylspiramycin (ASPM) on lymphocyte function were studied in vitro and in vivo. When added to lymphocyte cultures in vitro, ASPM inhibited splenic lymphocyte transformation induced by phytohemagglutinin (PHA), lipopolysaccharide (LPS) and antigen. It also depressed production by spleen cells of the lymphokine inducing procoagulant activity in mouse macrophages. Spleen cells from mice given ASPM orally showed enhanced responses to PHA, but normal responses to LPS. The capacity to produce lymphokine was increased early after oral ASPM and slightly decreased after prolonged administration. Oral ASPM had no effect on the production of antibodies and a very slight enhancing effect on the development of delayed-type hypersensitivity to sheep red blood cells.

The use of scrotal septal neurovascular pedicle island skin flap in one-stage repair of hypospadias

A scrotal septum neurovascular pedicle skin flap was successfully used in one-stage repair of hypospadias in 30 patients with encouraging results. The hairless median scrotal skin flap, with the scrotal septum attached, rich in neurovascular plexus and with the flap tip continuous with the external urethral orifice, is ideal material for creating a new penile urethra without interference to its blood supply. Operative technique and clinical analysis are detailed.

Chemical transformation of eremofortin C into PR toxin

The natural products of both eremofortin C (EC) and PR toxin are secondary metabolites of Penicillium roqueforti. Because the chemical structures of EC and PR toxin are closely related to each other and differ only by a hydroxyl functional group in EC and an aldehyde functional group in PR toxin at the C-12 position, the chemical transformation of EC into PR toxin was investigated. Oxidation with a chromic anhydride-pyridine complex was found to be the most satisfactory method.

X-ray photoelectron spectra study on the derivatives of N-beta-phenethyl amine and N-beta-phenethyl glycine

The X-ray photoelectron spectra of sixteen derivatives of N-beta-phenethyl amine and N-beta-phenethyl glycine have been studied. The effect of different structures on N1s binding energy and that of their Pauling's atomic charge density on the nitrogen atoms are investigated. The experimental binding energy of N1s is proportional to the calculated Pauling's atomic charge density. It shows that the phosphoryl group is the strongest nitrogen lone pair electron localizing group as compared with the corresponding sulfonyl and acyl derivatives. The XPS results agree with the data that there is no decarbonylation during the synthesis of N-dialkylphosphoryl-tetrahydro-3-benzazepin-1-one. In addition, since the N1s in P-N bond is smaller than that in S-N and C-N bonds, the phosphoryl group can be removed under much milder conditions. These results provide a semi-empirical evidence for the synthesis of the skeleton of the cephalotaxine. It also differentiates the reaction paths for these three different amino protecting groups.

Acetylspiramycin and the immune system. I. Effects of acetylspiramycin on phagocytosis by mouse macrophages in vitro and in vivo

A study was made of the effect of acetylspiramycin (ASPM) on the phagocytic activity of mouse macrophages in vitro and in vivo, using opsonized, 51Cr-labelled sheep red blood cells (SRBC) as test particles. Resident mouse peritoneal macrophages cultured with ASPM (25-100 micrograms/ml for 18 h) showed a 62-92% reduction in phagocytosis. This was due to decreases in both attachment and ingestion of SRBC and was additional to the detachment of some macrophages from the surface of the culture chamber. Morphologically the macrophages were vacuolated, with some nuclear condensation. When the cells were cultured for a further 48 h after removal of ASPM there was almost complete functional and morphological recovery. When mice were treated with ASPM (50-100 mg/kg orally for 7 days) their peritoneal macrophages showed increases of 57-121% in phagocytic activity in vitro. In mice treated with ASPM (200 mg/kg orally for 7-21 days) the clearance of i.v. injected opsonized SRBC was significantly accelerated. Thus, although ASPM is reversibly toxic to macrophages in vitro, it is not toxic in vivo, but actually stimulates the mononuclear phagocyte system. It is possible that metabolites of ASPM, such as neospiramycin, produced in vivo but not in vitro, are responsible for the stimulation.

Effect of 24 antimicrobial drugs on polymorphonuclear leukocyte adherence

The effects of 24 antimicrobial agents on the adherence of human neutrophils to nylon fibre microcolumns were studied. Neutrophil adherence was found to be remarkably resistant to antimicrobial agents. No effect was observed with penicillin G, nafcillin, cephalothin, vancomycin, bacitracin, tetracycline, minocycline, doxycycline, chloramphenicol, erythromycin, lincomycin, neomycin, streptomycin, acetylspiramycin, 5-fluorocytosine, sulfisoxazole, tinidazole and primaquine. Only 2 enhanced adherence - oxytetracycline and rifampicin - and only 4 suppressed adherence - colistin, polymyxin B, quinine, chloroquine - and then only at high concentrations.

Synergistic activation of rat hepatocyte glycogen phosphorylase by A23187 and phorbol ester

The combination of 1.6 microM 4 beta phorbol, 12 beta myristate, 13 alpha acetate (PMA) and 1 microM A23187 produced a five-fold greater stimulation of rat hepatocyte glycogen phosphorylase activity than was seen with PMA alone. Vasopressin activation of glycogen phosphorylase was comparable to that seen with PMA plus A23187. Glycogen phosphorylase activity due to PMA plus A23187 was increased significantly after 30 sec, maximal at 120 and sustained at elevated levels for 240 sec. In contrast, activation due to vasopressin was maximal at 30 sec followed by a decrease. The addition of PMA 5 min prior to the A23187 abolished the synergism between these two agents. These data are compatible with the hypothesis that diacylglycerol and Ca2+ synergistically increase glycogen phosphorylase activity in rat hepatocytes.

Double balanced de novo translocations involving chromosomes 4/15 and 5/12 in a mentally retarded boy

This report describes a compound structural rearrangement containing two apparently unrelated reciprocal translocations, one between chromosomes 4 and 15, the other between 5 and 12. It is suggested that the patient's mental retardation and osteosclerosis may be the result of the loss of a small amount of chromosomal material and/or position effect accompanying these translocations.

Direct stimulation of phosphatidylinositol degradation by addition of vasopressin to purified rat liver plasma membranes

Rat liver plasma membranes were incubated in Ca2+-free buffer plus 0.5 mM ethyleneglycol-bis(beta-aminoethyl ether)-N,N'-tetraacetic acid (EGTA) containing 0.5 mg/ml deoxycholate or 50 mU/ml vasopressin or both compounds. The membrane phospholipids were extracted, separated by two-dimensional chromatography and quantitated by phosphorus analysis. Vasopressin significantly enhanced degradation of phosphatidylinositol in the presence of deoxycholate (21% with deoxycholate alone versus 32% in the presence of vasopressin plus deoxycholate). However, no significant effects of deoxycholate or vasopressin were seen on the degradation of phosphatidylcholine, phosphatidylethanolamine or phosphatidylserine. These results indicate that specific degradation of phosphatidylinositol can be seen after direct addition of vasopressin to a plasma membrane preparation.

Forskolin as an activator of cyclic AMP accumulation and lipolysis in rat adipocytes

Forskolin increased cyclic AMP accumulation in isolated adipocytes and markedly potentiated the elevation of cyclic AMP due to isoproterenol. In adipocyte membranes, forskolin stimulated adenylate cyclase activity at concentrations of 0.1 microM or greater. Forskolin did not affect the EC50 for activation of adenylate cyclase but did increase the maximal effect of isoproterenol. Neither the soluble nor particulate low-Km cyclic AMP phosphodiesterase activity was affected by forskolin. Low concentrations of forskolin (0.1-1.0 microM), which significantly elevated cyclic AMP levels, did not increase lipolysis, whereas similar increases in cyclic AMP levels due to isoproterenol elevated lipolysis. Forskolin did not inhibit the activation of triacylglycerol lipase by cyclic AMP-dependent protein kinase or the subsequent hydrolysis of triacylglycerol. Higher concentrations of forskolin (10-100 microM) did increase lipolysis. Both the increased cyclic AMP production and lipolysis due to forskolin were inhibited by the antilipolytic agents insulin and N6-(phenylisopropyl)adenosine. Hypothyroidism reduced the ability of forskolin to stimulate cyclic AMP production and lipolysis. These results indicate that forskolin increases cyclic AMP production in adipocytes through an activation of adenylate cyclase. Lipolysis is activated by forskolin but at higher concentrations of total cyclic AMP than for catecholamines.

Effects of melittin on adipocyte metabolism unrelated to lysophospholipid accumulation

Melittin addition to rat or hamster adipocytes resulted in inhibition of lipolysis, cyclic AMP accumulation and glucose oxidation. Low concentrations of melittin were not insulin-like with respect to either stimulation of glucose metabolism or inhibition of lipolysis. Higher concentrations of melittin lysed adipocytes. In the presence of melittin, cellular phospholipids were released to the medium and hydrolyzed with little accumulation of lysophospholipids. Only in adipocytes incubated with melittin contaminated with phospholipase A2 was any appreciable accumulation of lysophospholipids seen and this was in the medium. These data suggest that the toxic effects of melittin on adipocytes are not due to the accumulation of lysophospholipids but rather to the loss of membrane phospholipids or alterations in membrane proteins.