Detection of human papillomavirus DNA in colorectal carcinomas by polymerase chain reaction

Human papillomaviruses (HPVs) are associated with a number of benign and malignant neoplasms. To substantiate the relationship between HPV DNA and colorectal carcinomas, 70 carcinomas and 37 adenomas were analysed in this study. Specific types of HPV DNA in colorectal tumours were detected by polymerase chain reaction (PCR) and Southern blot hybridisation. HPV DNA was detected in 11 of 37 (29.7%) adenomas and in 52.9% 37 of 70 (52.9%) of carcinomas. The expression of HPV DNA in adenomas and carcinomas, especially that of HPV 16 in HPV positive cases (4 of 11 v 26 of 37), was significantly different (p < 0.05). There was no correlation, however, between HPV and the location, differentiation, stage, or survival of malignant neoplasms. These data suggest that HPV DNA, especially type 16, is associated with colorectal carcinogenesis.

Optimal dose of garlic to inhibit dimethylhydrazine-induced colon cancer

This study was designed to investigate the optimal dose of garlic during long-term feeding and its preventive and therapeutic effects on colon cancer in rats induced by 1,2-dimethylhydrazine (DMH). A total of 240 male Sprague-Dawley rats were grouped and fed with either a basal or a garlic diet of different concentration, and some groups were subcutaneously injected with DMH 20 mg/kg once a week for 20 weeks. The incidence of colon tumor was significantly decreased in the groups fed with 2.5%, 5%, and 10% garlic diets (p < 0.001). There was no distinct difference among these concentrations (p > 0.05). Therefore the minimal optimal dose of garlic to inhibit colon cancer was 2.5%. The equivalent dose of this concentration in humans is 4.76 g/m2 body surface/day. In a therapeutic study, the tumor-inducing interval in nude mice subcutaneously injected with colon cancer cells (CC-M2) was prolonged by a 2.5% garlic diet (p < 0.01). Thus smaller tumor volume and longer survival time were found in the garlic group than in the controls (p < 0.01). However, the growth rate of tumors was not markedly inhibited by garlic. All rats finally died within 18 weeks. This study suggested that a 2.5% garlic dose may be used mainly as an inhibitor to prevent colon cancers and improve survival time.

Vertebral artery dissection complicated by cervical manipulation: a case report

A 32-year-old healthy man developed vomiting, blurred vision, and consciousness disturbance following cervical manipulation. Physical examination showed stuporous consciousness and spontaneous horizontal nystagmus. Computed tomography (CT) and magnetic resonance (MR) imaging of the brain revealed infarction in the territory of the basilar artery. Studies of MR angiography and vertebral angiography disclosed dissection of the right vertebral artery at the atlantoaxial segment. Antiedematous drugs were prescribed and the patient gradually improved. Neurologic examination six months later demonstrated mild cerebellar ataxia. Physicians and patients should be aware that vertebro-basilar dissection may follow cervical manipulation, and, more importantly, should attempt to prevent progressive infarction.

Neoadjuvant chemotherapy for advanced nasopharyngeal carcinoma

Between October 1990 and November 1991, a total of 16 male patients with advanced nasopharyngeal carcinoma were treated by neoadjuvant chemotherapy before conventional radiotherapy. They belonged to the AJCC stage IV with multiple bulky neck nodes metastases. The chemotherapy consisted of bleomycin, epirubicin, and cisplatin. Six patients completed 3 cycles, 9 patients finished 2 cycles, and 1 patient received 1 cycle of chemotherapy. Seven of the 16 patients (44%) were in complete response, and 50% (8/16) achieved partial response. The overall response rate was 94%. The major toxicities consisted of leucopenia (12/37 cycles had grade III-IV), nausea/vomiting, alopecia. Aplastic marrow developed in 1 patient, and one died of bleomycin-induced pneumonitis. Subsequent radiation therapy was well tolerated. After a minimal follow-up time of 24 months, the 2-year actuarial survival rate was 56%. Although we confirmed the impressively high response rate of this regimen, the toxicities were high and most patients failed at distant site(s). The efficacy of neoadjuvant chemotherapy for advanced nasopharyngeal carcinoma is doubtful and should be further studied in prospective randomized trials.

Surface and blood-contacting properties of alkylsiloxane monolayers supported on silicone rubber

Self-assembled monolayers of alkylsiloxanes supported on polydimethyl siloxane (PDMS) rubber were used as model systems to study the relation between blood compatibility and surface chemistry. The inner lumen of PDMS tubes was first treated with an oxygen plasma. The resultant oxidized surfaces were postderivatized by reacting them with alkyltrichlorosilanes to form the monolayer films. The chemical properties of the monolayers were controlled by varying the head-group chemical compositions. Surface derivatization was verified using variable-angle X-ray photoelectron spectroscopy (XPS or ESCA). Blood compatibility was evaluated using a canine ex vivo arteriovenous series shunt model. Surfaces grafted with hydrophobic head-groups as -CH3 and -CF3 had significantly lower platelet and fibrinogen deposition than the surfaces composed of hydrophilic groups such as -CO2CH3, -(CH2CH2O)3COCH3, and -(OCH2CH2)3OH.

Geographic sequence variation of latent membrane protein 1 gene of Epstein-Barr virus in Hodgkin's lymphomas

To assess the role of the Epstein-Barr virus (EBV) latent membrane protein 1 (LMP1) gene in the development of Hodgkin's lymphoma (HL), the polymorphism of this gene in EBV isolates from different geographic locations was analyzed. A 497 bp fragment spanning LMP1 gene exons 1 and 2 was amplified by polymerase chain reaction (PCR), using a primer pair bracketing a Xhol restriction site. PCR products were subjected to Xhol digestion and to DNA sequencing analysis. Twenty-five HL biopsy specimens from the United States and five HL and four non-Hodgkin's lymphoma (NHL) biopsy specimens from Italy were examined. Eighty percent of LMP1-positive samples (12 of 15) from the United States maintained the Xhol restriction site and the remaining 20% partially lost the Xhol site. One of four EBV-positive HL and one of the three EBV-positive NHL specimens from Italy lost the restriction site. The other three EBV-positive HL DNAs were partially cut by Xhol. Direct DNA sequencing analysis revealed that those Italian samples not digested by Xhol were due to a G to C transversion at the first base of codon 18, resulting in the change of glycine to arginine. Those DNA samples partially cut by Xhol were due to a mixture of G/C at the same location. In contrast, those partially digested American HL DNAs had a mixture of G/T at the second base of codon 17.(ABSTRACT TRUNCATED AT 250 WORDS)

Detection of human papillomavirus DNA in colorectal adenomas

OBJECTIVE

To assess the presence of different types of human papillomavirus (HPV) DNA in colorectal adenomas.

DESIGN

The extracted DNA of 109 formalin-fixed, paraffin-embedded tissue sections of colorectal adenomas were analyzed by polymerase chain reaction and Southern blot hybridization. The correlations of HPV types 6, 11, 16, 18, and 33 DNA with the histological patterns of adenomas were also analyzed.

RESULTS

Human papillomavirus DNA was detected in 28% of the adenomas. There were eight (21%) of 38 in tubular adenomas, 13 (33%) of 40 in tubulovillous adenomas, and 10 (32%) of 31 in villous adenomas. All HPV-6/11-positive cases were tubular or tubulovillous adenomas. However, most HPV-16 infections (8/12) were seen in villous adenomas. Human papillomavirus-positive adenomas included three (8%) of 38 that showed mild dysplasia, 10 (25%) of 40 that showed moderate dysplasia, and 18 (58%) of 31 that showed severe dysplasia.

CONCLUSION

The association of the histological type with HPV-16 and the association of the grade of epithelial dysplasia with HPV DNA were highly significant. These associations support the adenoma-carcinoma hypothesis. In addition, the results suggest that HPV infection may be an important factor for the development of colorectal neoplasia.

Cardiovascular effects of NMDA in the RVLM of spontaneously hypertensive rats

In this study we found that cardiovascular effects were differentially regulated by N-methyl-D-aspartate (NMDA) in the rostral ventral lateral medulla (RVLM) of spontaneously hypertensive rats (SHRs) compared to their normotensive controls (Wistar-Kyoto rats, WKYs). Adult SHRs and WKYs were anesthetized with urethane, cervically vagotomized, and placed in a sterotaxic frame. We found that electrical stimulation or local application of N-methyl-D-aspartate into the RVLM produced hypertension in both strains. Microinjection (3.5-4.0 nmol) of AP5 (2-amino-5-phosphono-valerate), an NMDA receptor antagonist, to the RVLM did not affect resting blood pressure; however, this agent antagonized hypertensive responses evoked by low-frequency electrical stimulation (5-20 Hz) in both strains. The elevation in blood pressure evoked by stimulation at a higher frequency (60 Hz) was not affected by AP5. These results suggest that NMDA receptors are involved in the low frequency, electrically evoked hypertension in both strains. We also found that SHRs had a larger pressor response to microinjection of NMDA and electrical stimulation than did WKYs. AP5 abolished the differences in evoked hypertension between WKYs and SHRs during low-frequency (5-10 Hz) electrical stimulation. These data suggest that the hypersensitivity of RVLM to low-frequency electrical stimulation in SHRs involve NMDA receptors. We previously reported that AP7 antagonizes NMDA and carotid clamping-induced hypertension. In this study, we found that when locally applied to RVLM, AP5 antagonized hypertension evoked by clamping the carotid arteries in SHRs and WKYs. Thus, carotid clamping-induced hypertension may also involve NMDA receptors in the RVLM.(ABSTRACT TRUNCATED AT 250 WORDS)

Microwave ablation of the atrioventricular junction in open-chest dogs

The use of microwave energy for ablation of the atrioventricular (AV) junction was examined in open-chest dogs. Using a specially designed microwave catheter and a 2450 MHz generator, microwave energy was delivered to the AV junction according to one of two protocols. In protocol 1, increasing amounts of energy were delivered until irreversible AV block occurred. In protocol 2, only two applications of energy were used, one at low energy and the other at an energy found to be high enough to cause irreversible AV block. Each dog received between one and six applications of microwave energy. The amount of energy delivered per application ranged from 25.6 to 311.4 J. No AV block was seen at 59.4 +/- 28.3 J. Reversible AV block was seen with an energy of 120.6 +/- 58 J. Irreversible AV block was seen at 188.1 +/- 75.9 J. Irreversible AV block could be achieved in each animal. There was no difference in the energy required to cause irreversible AV block between the two protocols. The tissue temperature measured near the tip of the microwave catheter was correlated with both the amount of energy delivered and the extent of AV block caused. Histologic examination demonstrated coagulation necrosis of the conduction system. Microwave energy is a feasible alternative energy source for myocardial ablation. Since tissue damage is due exclusively to heating and the resulting rise in temperature can be measured, microwave energy may have advantages over currently existing energy sources in terms of both titrating delivered energy and monitoring the extent of tissue destruction.

Growth factor modulation of the formation of a molded vascularized bone graft in vivo

Peptide growth factors are potent regulators of osteoblast differentiation, proliferation, and maturation. Two of these growth factors, transforming growth factor beta (TGF-beta) and basic fibroblast growth factor (bFGF), were used in an attempt to stimulate osteoneogenesis and angiogenesis in a molded vascularized bone graft in the rat. Custom chambers containing cancellous autograft bone and agarose beads and incubated with TGF-beta, bFGF, or a control solution, were closed around the femoral artery/vein pedicle for 2-4 weeks. Control grafts were completely necrotic and without mechanical integrity. TGF-beta grafts demonstrated active osteogenesis around necrotic bone, osteoclastic activity, and limited angiogenesis. Basic FGF grafts demonstrated substantial angiogenesis with limited osteoblastic activity. This study suggests that TGF-beta and bFGF stimulate populations of cells in the formation of a molded vascularized bone graft. TGF-beta induces the proliferation and/or activity of osteoblastic cells, while bFGF stimulates cells involved in angiogenesis. Despite these findings, an insoluble demineralized matrix component may be required for complete transformation and graft consolidation.

Cholecystokinin facilitates methamphetamine-induced dopamine overflow in rat striatum and fetal ventral mesencephalic grafts

The purpose of this study was to investigate the interactions of sulfated (S) and unsulfated (US) cholecystokinin (CCK) and methamphetamine (MA)-induced dopamine (DA) overflow in rat striatum. High-speed chronoamperometric recording techniques, using Nafion-coated carbon fiber electrodes, were used to evaluate extracellular DA concentration. CCK-8S, CCK-8US, MA, and DA were locally applied directly to the striatum of urethane-anesthetized Sprague-Dawley rats. We found that CCK potentiated MA-induced DA release in the anterior striatum. This response is probably mediated through CCK-A receptors because CCK-8S, but not CCK-8US, enhanced MA-induced responses. Replacement of Ca2+ with Mg2+ in the drug barrel antagonized this reaction, suggesting that the modulation of MA-induced DA release by CCK is Ca2+ dependent. Both MA-induced DA release and CCK modulatory effects disappeared in the striatum after unilaterally lesioning the medial forebrain boundle with 6-hydroxydopamine (6-OHDA). We had previously found that the zone of normalized dopamine clearance in 6-OHDA-lesioned rats was considerably larger than that of normalized release in the anterior striatum after fetal ventral mesencephalic (VM) transplantation, which may be a result of partial reinnervation from the transplant. In the present study, we found that the modulation of DA release by CCK was restored only in the zone of normalized release after fetal nigral transplantation; CCK did not increase MA-induced DA release throughout the larger partially innervated area. In conclusion, these findings suggest that not only DA release processes but also CCK modulatory mechanisms are restored in the anterior striatum after fetal VM transplantation.

A strategy for precision of genotyping of Epstein-Barr virus by polymerase chain reaction: application for studying Hodgkin's lymphoma

Previous studies on the genotyping of Epstein-Barr virus (EBV) have been based on the analysis of a single gene locus. The assignment of genotype of an isolate could easily be over-looked with this assay. Our strategy for precision of EBV genotyping has exploited the existence of two families of EBV strains (type A and B) that can be distinguished at three divergent gene loci (EBNA-2, EBNA-3C, and EBER). To precisely determine the genotype of EBV in Hodgkin's disease (HD), we designed primers and simultaneously analysed these three gene loci that distinguish type A and B viruses by the polymerase chain reaction (PCR) technique. The primers designed to amplify these three gene loci encompass either type-specific deletion sequences (EBNA-2 and EBNA-3C) or type-specific point mutations (EBER) that identify the virus strain based on the sizes of PCR-amplified products or the mobility shifts in single-strand conformation polymorphism (SSCP) analysis. The locations of point mutations were identified by direct sequencing of the PCR-amplified DNA. Fifteen EBV-infected cell lines were analysed and a good correlation between EBNA-2 and EBNA-3C typing results was found. In contrast, approximately 33% of the cell lines analysed maintained type A sequences in EBNA-2 and EBNA-3C genes while carrying type B sequences in the EBER region. Data obtained from analysis of cell lines served as a reference for studying HD samples. EBV DNA was detected in about 70% of HD. Among the EBV-positive samples, 56% were associated with type A virus, 13% with type B, and 31% with dual viral sequences.(ABSTRACT TRUNCATED AT 250 WORDS)

Expression of the estrogen receptor in human thyroid neoplasms

The expression and quantitation of the estrogen receptor (ER) in human thyroid tumors were examined by biochemical, immunohistochemical, and reverse transcriptase-polymerase chain reaction (RT-PCR) techniques. For this study, neoplasms, adenomatous goiters and adjacent normal thyroid tissues were obtained from 35 patients which included 10 cases of papillary carcinomas, 17 cases of adenomas and 8 cases of adenomatous goiters. Regardless of the histopathological subtype, ER was detected in 19% (5/27) of the neoplastic tissues with the mean value of ER content of 5.0 +/- 1.3 fmol/mg protein and the mean Kd value of 0.38 +/- 0.28 nM. ER was also detected, but at a lower concentration (2.8 +/- 1.6 fmol/mg protein), in the surrounding normal tissues. There was no significant difference between the neoplasms and adenomatous goiters with respect to the incidence of ER positivity and ER content. Furthermore, ER-positive specimens, as determined by both biochemical and immunohistochemical techniques, also showed the expression of ER mRNA detected by RT-PCR method. These results demonstrate that both ER mRNA as well as ER protein are expressed in thyroid neoplasms. This suggests the possibility that estrogen may affect the tumorigenesis or the progression of some thyroid neoplasms.

Ki-ras oncogene activation in transplantable rat thyroid carcinoma induced by N-bis(2-hydroxypropyl)nitrosamine

We have established 17 transplantable rat thyroid carcinoma cell lines from primary thyroid tumors of rats induced by N-bis(2-hydroxypropyl)nitrosamine (DHPN) (Cancer Res. (1993) 53, 4408-4412). The present study was designed to evaluate point mutations in the murine c-Ki-ras gene of these carcinoma cell lines. Using PCR amplification and direct sequencing, we found that the activated form of the Ki-ras oncogene was present in 4 (23%) of a total of 17 cell lines, all the Ki-ras gene mutations being GC-->AT transitions. In three of the cell lines, the mutations occurred in codon 12 (GTP-binding domain), and in the remaining one the first nucleotide of codon 63 was affected. Histologically, three of the carcinomas with Ki-ras mutation were diagnosed as well-differentiated carcinomas, and the other as poorly differentiated carcinoma. Mutations of the ras gene are relatively uncommon in tumors of these histological types. From these experimental results, we suggest that the mutation induced by DHPN is due to damage to guanine in cellular DNA. In addition, Ki-ras activation may play an important role in the initiation of thyroid carcinogenesis.

Functional characterization of partially purified Epstein-Barr virus DNA polymerase expressed in the baculovirus system

The DNA polymerase gene of Epstein-Barr virus (EBV) was cloned into baculovirus transfer vector (pBlueBac). The recombinant baculovirus (AcEBP-15) was obtained by cotransfection of Spodoptera frugiperda (Sf9) cells with infectious DNA from Autographa californica multiple nuclear polyhedrin virus (AcMNPV) and pBlueBac plasmid carrying EBV polymerase gene. Infection of Sf9 cells with the recombinant virus produced substantial quantities of the EBV DNA polymerase protein of the expected size (110 kD). The identity of the EBV polymerase 110-kD polypeptide was determined by (a) immunoprecipitation and Western blot analyses with rabbit polyclonal antiserum specific for a synthetic peptide derived from the coding sequence of the polymerase gene; (b) identification of a polypeptide of identical size (110 kD) from EBV-infected cells; (c) measurement of DNA polymerase activity similar to that of the enzyme induced in EBV-infected cells; and (d) neutralization of the enzymatic activity by the rabbit antiserum and inhibition by phosphonoacetic acid. Our results indicate that the baculovirus expression system provides large quantities of functional polymerase suitable for biochemical and structural analyses, thereby furthering our understanding of the mechanism of viral DNA replication and its inhibition by antiviral drugs.

Flow cytometric DNA analysis of colorectal carcinoid

We analyzed the patterns of DNA ploidy in 31 colorectal carcinoid tumors from paraffin-embedded tissues by DNA flow cytometry and the relationship of the patterns of DNA ploidy to prognosis. Diploid DNA was found in 78% (24 of 31) of carcinoids and tetraploid in 6% (2 of 31). Five (16%) carcinoids were DNA aneuploid, and four of the patients with aneuploidy showing a near-hypertriploid pattern died during the first 5 years of follow-up. The association of aneuploidy with stage, size, and invasion of tumor was significant. However, our data indicated that DNA aneuploidy of a near-hypertriploid pattern was the most precise and reliable parameter for predicting the prognosis of colorectal carcinoid tumors.

Concomitant chemoradiotherapy for advanced epidermoid carcinoma of the uterine cervix: a preliminary report

BACKGROUND

Because the prognosis of advanced carcinoma of the uterine cervix is poor, and has improved very little in the last 20 years, a prospective study was initiated to evaluate the feasibility, response and toxicities of concomitant chemoradiotherapy for such cervical cancer.

METHODS

From May 1992 to December 1992, 22 patients entered the study, 21 of them completed the entire treatment. Their ages ranged from 47 to 72 years, median 57. There were 16 FIGO stage IIIB, and 5 stage IIB. Radiotherapy was administered using 1.8 Gy/day, five days a week, to the whole pelvis (50.4 Gy/28 fractions) with or without parametrial boost according to the tumor response. Intracavitary brachytherapy 5 Gy x five to six times was given after one or two weeks of rest. Chemotherapy consisted of etoposide 100 mg/m2 day 1 + cisplatin 50 mg/m2 day 1 + bleomycin 25 mg/m2/day day 2-3, repeated every two weeks during external irradiation.

RESULTS

All 21 eligible patients achieved complete response, sustaining during a median follow-up time of 12 months. All the initially elevated tumor markers (SCC, CEA, CA-125) returned to normal range after treatment. The toxicity was well tolerated.

CONCLUSIONS

Concomitant chemoradiotherapy for advanced cervical carcinoma is both feasible and effective, with acceptable toxicities. Long-term follow-up is mandatory, and a randomized trial to confirm the superiority of this protocol will be started soon.

Pain on injection of propofol

A controlled randomized double-blinded clinical study was undertaken to evaluate and compare the efficacy of three methods of preventing pain during injection of propofol on induction of anesthesia. Patients were randomly allocated to six groups: saline pretreatment, followed by induction with propofol at room temperature plus saline; lidocaine pretreatment, followed by induction with propofol at room temperature plus saline; saline pretreatment, followed by induction with propofol at a temperature of 4 degrees C plus saline; lidocaine pretreatment, followed by induction with propofol at a temperature of 4 degrees C plus saline; saline pretreatment, followed by induction with propofol at room temperature plus lidocaine 40 mg; saline pretreatment, followed by induction with propofol at a temperature of 4 degrees C plus lidocaine 40 mg. Pretreatment with lidocaine reduced the incidence of pain and discomfort significantly compared with unpretreated groups. Groups which received propofol mixed with lidocaine also showed a significant reduced incidence of pain. induction with cold 4 degrees C propofol showed no significant difference in reduction of injection pain.

Mycobacterium smegmatis keratitis after radial keratotomy--a case report

A 42-year-old woman who developed a corneal ulcer in the left eye after radial keratotomy. The acid-fast stain showed that numerous clusters of acid-fast bacilli and Mycobacterium smegmatis were isolated on the culture. To the best of our knowledge, this is the first documented case of Mycobacterium smegmatis keratitis in the world literature. The sensitivity test showed that this organism resistant to all the anti-tuberculous agents and antibiotics we test. An initial response to amikacin and kanamycin was found, but relapse of infiltrate was noted one month later. The regimen was therefore changed to a combination of amikacin with ofloxacin. This patient had a favorable response to the topical therapy with amikacin and ofloxacin.

Concomitant chemoradiotherapy for advanced head and neck cancer

Head and neck cancer is mostly curable in the early stages by either surgery or radiotherapy alone, but the control rate for advanced stages is low, even with combined surgery and postoperative radiotherapy. From September, 1990, to January, 1992, 35 patients with locoregionally advanced head and neck cancers were entered in a prospective study of concomitant chemoradiotherapy. Thirty-three completed the treatment. There were 29 males and four females with a median age of 53 years. All except one patient were in stage IV. Radiotherapy was delivered using a telecobalt unit and by conventional fractionation (1.8 Gy/fraction, 5 fractions/wk). Chemotherapy with cisplatin (10 mg/m2/day, daily, days 1-5) and 5-FU (500 mg/m2/day continuously infused for five days) was given concurrently during the first and fifth weeks of radiation. Twenty-four among 31 eligible patients achieved complete response (77.4%) and the other seven (22.6%) partial response, resulting in a 100% response rate. The toxicities experienced were increased compared with those caused by radiotherapy alone. The most common side effects were gastrointestinal and hematologic toxicities but the whole treatment was well tolerated. The two-year actuarial survival rate is 45%. We found the primary origin and overall treatment time to affect survival significantly. The survival rate for tumors arising from the nasopharynx or paranasal sinus is better than for those arising from other regions of the head and neck. The shorter treatment times (within eight weeks) had a better survival rate. Our preliminary experience suggests that concomitant chemoradiotherapy is both feasible and effective for head and neck cancer. The optimal scheduling and dosage of concomitant chemoradiotherapy should be further researched.

Endogenous Candida endophthalmitis: a case report

We experienced a 63-year-old male with a typical finding of endogenous Candida endophthalmitis. Candida albicans was cultured from the vitreous tapping. The patient received oral fluconazole treatment and the symptom improved. In this report, the clinical manifestations of endogenous Candida endophthalmitis and the experience of fluconazole treatment were reported.