Impact of the COVID-19 pandemic on the incidence of intussusception: a systematic review

OBJECTIVE

We aimed to assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on the incidence of intussusception.

MATERIALS AND METHODS

Literature search of the PubMed and EMBASE databases was conducted for articles published in English until August 5, 2022.

RESULTS

Overall, 127 articles were retrieved, and five studies from South Korea (n=4) and the United States of America (n=1) containing clinical data from single-center medical records to nationwide databases were ultimately included in the systematic review. All the included studies reported that the incidence of intussusception decreased significantly during the pandemic period compared with the pre-pandemic period. The communicable disease incidence tended to decrease even as the incidence of non-communicable diseases did not significantly change. There was no significant difference in the time to diagnosis between the pre-pandemic and pandemic periods; however, the time to radiologic reduction was significantly longer or not depending on the study.

CONCLUSIONS

The COVID-19 pandemic significantly reduced the incidence of intussusception in children, supporting the hypothesis that infection plays a major role in the etiology of intussusception. Future studies in the late pandemic or post-pandemic era, which would represent the level of implementation of non-pharmaceutical interventions and social distancing as well as additional data from various countries will be needed.

Incidence and predictors of toxicity in the management of vulvar squamous cell carcinoma treated with radiation therapy

Purpose/Objective

Given the rarity of vulvar cancer, data on the incidence of acute and late severe toxicity and patients' symptom burden from radiotherapy (RT) are lacking.

Materials/Methods

This multi-center, single-institution study included patients with vulvar squamous cell carcinoma treated with curative intent RT between 2009 and 2020. Treatment-related acute and late grade ≥ 3 toxicities and late patient subjective symptoms (PSS) were recorded.

Results

Forty-two patients with predominantly stage III/IV disease (n = 25, 59.5 %) were treated with either definitive (n = 25, 59.5 %) or adjuvant (n = 17, 40.5 %) external beam RT to a median dose of 64 Gy and 59.4 Gy, respectively. Five patients received a brachytherapy boost with a median total dose of 84.3 Gy in 2 Gy-equivalent dose (EQD2). Intensity-modulated RT was used in 37 (88.1 %) of patients, and 25 patients (59.5 %) received concurrent chemotherapy. Median follow-up was 27 months. Acute grade ≥ 3 toxicity occurred in 17 patients (40.5 %), including 13 (31.0 %) acute grade 3 skin events. No factors, including total RT dose (p = 0.951), were associated with acute skin toxicity. Eleven (27.5 %) patients developed late grade ≥ 3 toxicity events, including 10 (23.8 %) late grade ≥ 3 skin toxicity events. Patients with late grade ≥ 3 skin toxicity had a higher mean body-mass index (33.0 vs 28.2 kg/m²; p = 0.009). Common late PSS included vaginal pain (n = 15, 35.7 %), skin fibrosis (n = 10, 23.8 %), and requirement of long-term opiates (n = 12, 28.6 %).

Conclusion

RT for vulvar cancer is associated with considerable rates of severe acute and late toxicity and PSS burden. Larger studies are needed to identify risk factors, explore toxicity mitigation strategies, and assess patient-reported outcomes.

[Metastatic renal cell carcinoma: a clinicopathological analysis of 196 cases]

Objective: To analyze the clinico pathological features, differential diagnosis and prognosis of metastatic renal cell carcinomas. Methods: The clinical data, histology, immunophenotype and follow-up data of 196 patients with metastatic renal cell carcinoma diagnosed from 1994 to 2017 at the Department of Pathology, Changhai Hospital, Naval Military Medical University, Shanghai, China were analyzed retrospectively. Results: There were 142 males and 54 females, with a median age of 61 years. The top three metastatic sites for the 196 cases of metastatic renal cell carcinoma were lung (31.1%, 61/196), bone (29.1%, 57/196) and digestive system (19.4%, 38/196). Among the pathological subtypes of metastasis, the proportion of clear cell renal cell carcinoma was 94.4% (185/196) and that of type II papillary renal cell carcinoma was 3.6% (7/196). The TFE3 translocated renal cell carcinoma and congestive tubular carcinoma were rare, with 3 cases and 1 case, respectively. CK, vimentin, CAⅨ and CD10 were expressed in all metastatic clear cell renal cell carcinomas. CK7, CD10 and P504s were expressed in papillary renal cell carcinomas. TFE3 was expressed in TFE3 translocated renal cell carcinoma. The collecting duct carcinoma was positive for HCK. Conclusions: Lung metastasis and bone metastasis are still the most frequent metastatic sites of renal cell carcinoma. Five years after primary lesion resection may be the high risk time for metastasis. Most of the metastases are solitary when they are first identified. To better diagnose and identify the renal origin of a metastatic renal cell carcinoma, one should consider morphological characteristics, clinical history information of the metastasis and the combined immunohistochemistry of CK, vimentin, CD10, CK7, TFE3, PAX2 and PAX8.

Long-term mortality of patients with tuberculosis in Korea

BACKGROUND: Long-term mortality following tuberculosis (TB) diagnosis in Korea remains unclear.METHODS: The present study used data from the National Health Insurance Service database, an extensive health-related database including most Korean residents. TB patients were identified using International Classification of Diseases, Tenth Revision coding (A15-19, U88.0-88.1) and the type of anti-TB drug(s) between 2003 and 2016. Long-term mortality and causes of death in TB patients were analysed.RESULTS: A total of 357 211 individuals had TB over the period from 2003 to 2016 and 103 682 died. The mean age of the cohort was 54.7 ± 20.7 years, and 59.8% were male. The survival probability of TB patients at 1, 5, and 10 years after diagnosis was 87.8%, 75.3%, and 63.3%, respectively. High mortality and TB-related death rates were especially prominent in the early stages after TB diagnosis. The overall standardized mortality ratio of TB patients to the general Korean population was 3.23 (95% confidence interval 3.21-3.25).CONCLUSION: Mortality in TB patients was especially high in the early stages of disease after TB diagnosis, and mostly due to TB. This figure was approximately three-times higher than the mortality rate in the general population.

Oxidative stress induced necroptosis activation is involved in the pathogenesis of hyperoxic acute lung injury

Necroptosis has been found to be involved in the pathogenesis of some lung diseases, but its role in hyperoxic acute lung injury (HALI) is still unclear. This study aimed to investigate contribution of necroptosis to the pathogenesis of HALI induced by hyperbaric hyperoxia exposure in a rat model. Rats were divided into control group, HALI group, Nec-1 (necroptosis inhibitor) group and edaravone group. Rats were exposed to pure oxygen at 250 kPa for 6 h to induce HALI. At 30 min before hyperoxia exposure, rats were intraperitoneally injected with Nec-1 or edaravone, and sacrificed at 24 h after hyperoxia exposure. Lung injury was evaluated by histology, lung water to dry ratio (W/D) and bronchoalveolar lavage fluid (BALF) biochemistry; the serum and plasma oxidative stress, expression of RIP1, RIP3 and MLKL, and interaction between RIP1 and RIP3 were determined. Results showed hyperoxia exposure significantly caused damage to lung and increased necroptotic cells and the expression of RIP1, RIP3 and MLKL. Edaravone pre-treatment not only inhibited the oxidative stress in HALI, but also reduced necroptotic cells, decreased the expression of RIP1, RIP3 and MLKL and improved lung pathology. Nec-1 pretreatment inhibited necroptosis and improved lung pathology, but had little influence on oxidative stress. This study suggests hyperoxia exposure induces oxidative stress may activate necroptosis, involving in the pathology of HALI, and strategies targeting necroptosis may become promising treatments for HALI.

Renin-angiotensin system and its role in hyperoxic acute lung injury

Oxygen is essential to sustain life, but at a high partial pressure oxygen may cause toxicity to the human body. These injuries to the lung are known as hyperoxic acute lung injury [HALI]). To date, numerous studies have been conducted to investigate the pathogenesis of HALI, for which some hypotheses have been proposed. Accumulating evidence indicates that the renin-angiotensin system (RAS) plays an important role in the pathogenesis of some lung diseases, including acute lung injury (ALI), chronic obstructive pulmonary disease (COPD) and HALI. In this review, we briefly introduce the classic RAS, local (tissue) RAS and intracellular RAS, and we summarize findings on the relationship between local/classic RAS and HALI. The importance--and ambiguity--of the results of these studies indicate a need for further investigations of the RAS and its role in the patho- genesis of HALI.

Roles of transforming growth factor β in hyperoxia-induced lung injury

Hyperoxia induced lung injury (HILI) refers to the acute lung injury secondary to prolonged exposure to hyperoxia at elevated partial pressure. With the advent of efficient systems for delivery of high concentrations of oxygen in hospitals, the population at risk for this condition has been markedly increased. Although numerous studies have been conducted to investigate the pathogenesis of HILI, the specific mechanism is still poorly understood and some hypotheses have been proposed. Transforming growth factor β (TGF-β) is a secreted protein that controls proliferation, cellular differentiation and other functions in most cells and is a type of cytokine that plays a role in many diseases. In this mini-review, we summarize the role of TGF-β in HILI according to its relationships with reactive oxygen species (ROS), pro-inflammatory cytokines, cell apoptosis and pulmonary fibrosis. We hope it may help the understanding of pathogenesis of HILI and provide a greater understanding for the target therapy of HILI.

Effects of Polycan, a β-glucan, on experimental periodontitis and alveolar bone loss in Sprague-Dawley rats

BACKGROUND AND OBJECTIVE

Polycan is a promising candidate for the treatment of periodontal disease. This study was undertaken to examine whether Polycan, a type of β-glucan, has a protective effect on ligature-induced experimental periodontitis and related alveolar bone loss in Sprague-Dawley rats.

MATERIAL AND METHODS

 Polycan was orally administered, daily, for 10 d, at 21.25, 42.5 or 85 mg/kg, beginning 1 d after ligation. Changes in body weight and alveolar bone loss were monitored, and the anti-inflammatory effects of Polycan were determined by measuring the levels of myeloperoxidase (MPO), interleukin-1beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) in gingival tissue. We also evaluated inducible nitric oxide synthase (iNOS) activity and malondialdehyde (MDA) concentrations as a measure of the antioxidant effect.

RESULTS

Ligature placement led to a marked decrease in body weight, increased alveolar bone loss and increased concentrations of MPO, IL-1β, TNF-α and MDA, as well as increased iNOS activity and inflammatory cell infiltration and decreased collagen-fiber content. Histological examination revealed increases in the number and activity of osteoclast cells, decreases in alveolar bone volume and elevated percentages of osteclasts on the alveolar bone surface. Daily oral treatment with 42.5 or 85 mg/kg of Polycan for 10 d led to significant, dose-dependent inhibition of the effect of ligature placement.

CONCLUSION

Taken together, these results suggest that 10 d of oral treatment with Polycan effectively inhibits ligature placement-induced periodontitis and related alveolar bone loss via an antioxidant effect.

Chemotherapy-induced reversible posterior leucoencephalopathy syndrome

Reversible posterior leucoencephalopathy syndrome is a neurological condition seen in various areas of acute medicine, including the administration of antineoplastic therapies used in haemato-oncology patients. It is a rare complication that has been increasingly recognized. It is characterized by altered mental status, visual disturbance, headache and seizures. Magnetic resonance imaging typically shows vasogenic oedema in the posterior regions of the brain. Although its name suggests reversibility, it may result in an irreversible brain injury without prompt treatment. Therefore, it is vital for treating clinicians to recognize this syndrome. We describe the case of a 55-year-old woman with advanced pancreatic adenocarcinoma, who developed clinical and radiological manifestations consistent with this syndrome as a complication of gemcitabine monotherapy.

Methanolic extract of Pterocarpus santalinus induces apoptosis in HeLa cells

Ptercarpus santalinus (Fabaceae) has been used as a folk remedy in Korea, and it has been shown to exhibit antiinflammations, antiulcers and anticancer effects. In this study, therefore, we report the cytotoxic activity and the mechanism of cell death exhibited by the methanol extract of Ptercarpus santalinus (MEPS) against human cervical adenocarcinoma cell line, HeLa. Treatment of HeLa cells with various concentrations of MEPS resulted in growth inhibition and induction of apoptosis in a dose-dependent manner as determined by cell viability, chromatin condensation, DNA fragmentation and sub-G1 phase accumulation. In Western blot analysis, apoptosis in the HeLa cells was associated with the release of cytochrome C from mitochondria into the cytosol, activation of caspases-3, -8, -9 and proteolytic cleavage of PARP. These results suggest that MEPS exhibits antiproliferative effect on HeLa cells via apoptosis, and it may be a potential candidate in field of anticancer drug discovery.

A novel homodimeric lactose-binding lectin from the edible split gill medicinal mushroom Schizophyllum commune

A homodimeric lactose-binding lectin with a molecular mass of 64kDa was isolated from fresh fruiting bodies of the split gill mushroom Schizophyllum commune. The N-terminal sequence of the lectin is similar to a part of the sequence of the cell division protein from Gleobacter violaceus. The lectin was isolated by using a procedure which involved ion exchange chromatography on DEAE-cellulose, CM-cellulose, and Q-Sepharose, and gel filtration by fast protein liquid chromatography on Superdex 75. The hemagglutinating activity of the lectin was stable at temperatures up to 40 degrees C, and in concentrations of NaOH and HCl solution up to 125 and 25mM, respectively. The lectin exhibited potent mitogenic activity toward mouse splenocytes, antiproliferative activity toward tumor cell lines, and inhibitory activity toward HIV-1 reverse transcriptase. It was devoid of antifungal activity.

Failure of intertrochanteric fracture fixation with a dynamic hip screw in relation to pre-operative fracture stability and osteoporosis

We have reviewed 178 intertrochanteric fractures treated by dynamic hip screw (DHS) fixation between March 1995 and December 1999 and followed for a minimum of 1 year. We used Singh's classification of the trabecular bone structure in the proximal femur as a measure of osteoporosis and also classified the fractures according to three different systems (Boyd-Griffin, Evans, AO). The postoperative radiographs were examined for loss of reduction, i.e. varus angulation >100, perforation of the femoral head, more than 20-mm extrusion of a lag screw or metal failure. We found 49 cases which showed radiographic failures. Two were stable fractures and 47 unstable fractures (Evans' classification). Unstable fractures with osteoporosis had a failure rate of more than 50%. In such cases DHS should not be the first choice for treatment.

A fusion protein between rac and p67phox (1-210) reconstitutes NADPH oxidase with higher activity and stability than the individual components

Activation of the phagocyte NADPH oxidase, a superoxide-generating enzyme, involves assembly of cytosolic p47(phox), p67(phox), and rac with the membrane-associated cytochrome b(558). Following cell-free activation, enzymatic activity is highly labile [Tamura, M., Takeshita, M., Curnutte, J. T., Uhlinger, D. J., and Lambeth, J. D. (1992) J. Biol. Chem. 267, 7529-7538]. In an attempt to stabilize the activity and to investigate the nature of the complex, we have produced fusion proteins between rac and a C-terminal truncated form of p67(phox) (residues 1-210, 67N), which is a minimal active fragment. In a cell-free system, a fusion protein 67N-rac had higher activity and a 3-fold higher affinity than the individual cytosolic proteins, and 67N-Ser3-rac, which has a longer linker, showed a similar activity with the individual proteins. In contrast, rac-67N, a fusion in the opposite orientation, showed considerably lower activity. The enzyme activity reconstituted with 67N-rac showed a 10-fold higher stability and a lower K(m) for NADPH than the individual components. In the absence of p47, 67N-rac fusion protein at a high concentration showed nearly full activation, which was higher than that with the individual components. These results indicate that covalent binding between p67N and rac in the correct order produces a more stable complex than the individual components, suggesting that interactions among the subunits significantly influence the duration of the oxidase activation. On the basis of these findings, we propose a model for the topology among rac, 67N, and cytochrome b(558).

Effects of ion beam-assisted deposition of hydroxyapatite on the osseointegration of endosseous implants in rabbit tibiae

The aim of this study was to evaluate the effects of coating implants with hydroxyapatite (HA) by an ion beam-assisted deposition (IBAD) method and to compare them with implants prepared with sand-blasted and machined surfaces. Examination of osteoblast cultures displayed no difference in the secretion of alkaline phosphatase (ALP) between the various surfaces, but the IBAD-HA specimen showed low ALP secretion (P < .05). Removal torque tests showed that implants coated with HA by the IBAD method had values similar to the implants with a sandblasted surface, but values for the machined-surface implants differed. Implants placed in a group of ovariectomized rabbits showed lower mechanical test values than implants placed in sham-operated rabbits (P < .05). Implants coated with HA by the IBAD method demonstrated the highest mean bone-to-metal contact ratio on all threads and on the 3 best consecutive threads, followed by the implants with a sandblasted surface and implants with a machined surface (P < .05). Hydroxyapatite-coated implants showed a slightly higher bone-to-implant contact ratio than sandblasted implants, but no statistically significant difference was seen between the 2 materials. The implants placed in ovariectomized rabbits showed lower amounts of bone-to-metal contact than the implants placed in sham-operated rabbits, but no statistically significant difference was seen between the 2 groups. Evaluation of bone volume on all threads and the 3 best consecutive threads showed no statistically significant difference among the different surface treatment groups, but lower bone volume was seen in the ovariectomized rabbits than in the sham-operated animals (P < .05).

Antioxidant activities of dioscorin, the storage protein of yam (Dioscorea batatas Decne) tuber

Dioscorin, the storage protein of yam (Dioscorea batatas Decne) tuber (which is different from dioscorine found in tubers of Dioscorea hirsuta), was purified to homogeneity after DE-52 ion exchange column according to the methods of Hou et al. (J. Agric. Food Chem. 1999, 47, 2168-2172). A single band of 32 kDa dioscorin was obtained on a sodium dodecyl sulfate-polyacrylamide gel electrophoresis gel with 2-mercaptoethanol treatment. This purified dioscorin was shown by spectrophotometric method to have scavenging activity against 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical in a pH-dependent manner. There is a positive correlation between scavenging effects against DPPH (8-46%) and amounts of 32 kDa dioscorin (5.97-47.80 nmol) added in Tris-HCl buffer (pH 7.9), which are comparable to those of glutathione at the same concentrations. Using electron paramagnetic resonance (EPR) spectrometry for DPPH radical detection, it was found that the intensities of the EPR signal were decreased by 28.6 and 57 nmol of 32 kDa dioscorin in Tris-HCl buffer (pH 7.9) more than in distilled water compared to controls. EPR spectrometry was also used for hydroxyl radical detection. It was found that 32 kDa dioscorin could capture hydroxyl radical, and the intensities of the EPR signal were significantly decreased dose-dependently by 1.79-14.32 nmol of 32 kDa dioscorin (r = 0.975) compared to the control. It is suggested that 32 kDa dioscorin, the storage protein of yam tuber, may play a role as antioxidant in tubers and may be beneficial for health when people take it as a food additive or consume yam tubers.

Role of scavenger receptors SR-BI and CD36 in selective sterol uptake in the small intestine

The serum lipoprotein high-density lipoprotein (HDL), which is a ligand of scavenger receptors such as scavenger receptor class B type I (SR-BI) and cluster determinant 36 (CD36), can act as a donor particle for intestinal lipid uptake into the brush border membrane (BBM). Both cholesterol and phospholipids are taken up by the plasma membrane of BBM vesicles (BBMV) and Caco-2 cells in a facilitated (protein-mediated) process. The protein-mediated transfer of cholesterol from reconstituted HDL to BBMV depends on the lipid composition of the HDL. In the presence of sphingomyelin, the transfer of cholesterol is slowed by a factor of about 3 probably due to complex formation between cholesterol and the sphingolipid. It is shown that the mechanism of lipid transfer from reconstituted HDL to either BBMV or Caco-2 cells as the acceptor is consistent with selective lipid uptake: the lipid donor docks at the membrane-resident scavenger receptors which mediate the transfer of lipids between donor and acceptor. Selective lipid uptake implies that lipid, but no apoprotein is transferred from the donor to the BBM, thus excluding endocytotic processes. The two BBM models used here clearly indicate that fusion of donor particles with the BBM can be ruled out as a major mechanism contributing to intestinal lipid uptake. Here we demonstrate that CD36, another member of the family of scavenger receptors, is present in rabbit and human BBM vesicles. This receptor mediates the uptake of free cholesterol, but not of esterified cholesterol, the uptake of which is mediated exclusively by SR-BI. More than one scavenger receptor appears to be involved in the uptake of free cholesterol with SR-BI contributing about 25% and CD36 about 35%. There is another yet unidentified protein accounting for the remaining 30 to 40%.

Characterization of the flavoprotein domain of gp91phox which has NADPH diaphorase activity

A series of truncated forms of gp91phox were expressed in Escherichia coli in which the N-terminal hydrophobic transmembrane region was replaced with a portion of the highly soluble bacterial protein thioredoxin. TRX-gp91phox (306-569), which contains the putative FAD and NADPH binding sites, showed weak NADPH-dependent NBT (nitroblue tetrazolium) reductase activity, whereas TRX-gp91phox (304-423) and TRX-gp91phox (424-569) were inactive. Activity saturated at about a 1:1 molar ratio of FAD to TRX-gp91phox (306-569), and showed the same K(m) for NADPH as that for superoxide generating activity by the intact enzyme. Activity was not inhibited by superoxide dismutase, indicating that it was not mediated by superoxide, but was blocked by an inhibitor of the respiratory burst oxidase, diphenylene iodonium. In the presence of Rac1, the cytosolic regulatory protein p67phox stimulated the NBT reductase activity, but p47phox had no effect. Truncated p67phox containing the activation domain (residues 199-210) [C.-H. Han, J.R. Freeman, T. Lee, S.A. Motalebi, and J.D. Lambeth (1998) J. Biol. Chem. 273, 16663-16668] stimulated activity approximately 2-fold, whereas forms mutated or lacking this region failed to stimulate the activity. Our data indicate that: (i) TRX-gp91phox (306-569) contains binding sites for both pyridine and flavin nucleotides; (ii) this flavoprotein domain shows weak diaphorase activity; and (iii) the flavin-binding domain of gp91phox is the target of regulation by the activation domain of p67phox.

Calcified subcutaneous fat necrosis induced by prolonged exposure to cold weather: a case report

We present a 22-day-old infant with extensive subcutaneous calcifications due to subcutaneous fat necrosis caused by prolonged exposure to cold.

[Changes of the certain functions of mitochondria induced by acute exercise and the protective effect of bilirubin]

AIM

To study the mechanism of fatigue induced by acute exercise and the protective effect of bilirubin.

METHODS

41 Wistar male rats were divided into five groups: control group, exercise group, exercise recovery group, bilirubin-treated exercise group and bilirubin-treated exercise recovery group. The rats were administrated with 1 micromol/kg body weight of bilirubin or saline once every day for 4 weeks, after swimming with load for 2 h, all of the rats were killed and several index were determined.

RESULTS

Acute exercise could induce the increase of Ca2+ content in cytoplasm and mitochondria of gastrocnemius, Ca2+ content increased continuously after 12 hours in mitochondria. The Ca2(+)-Mg2(+)-ATPase activity decreased obviously after acute exercise, and the activity increased again after 12 hours. Bilirubin could inhibit these changes. The change of Mg2(+)-ATPase activity in mitochondria had little difference between bilirubin-treated and untreated groups, both of which were lower than that of control group, but the recovery was faster in the bilirubin-treated group than that in untreated group.

CONCLUSION

Bilirubin could protect muscle fibers from injury induced by acute exercise and delay the development of fatigue and promote the recovery through inhibiting the disturbance of the certain function of mitochondria.

In vitro maturation, fertilization, and development of human germinal vesicle oocytes collected from stimulated cycles

OBJECTIVE

To evaluate whether germinal vesicle (GV) oocytes from stimulated cycles can be a source of embryos.

DESIGN

In vitro model study.

SETTING

Specialized laboratory of women's clinic.

PATIENT(S)

Women in whom oocytes were retrieved at the GV stage.

INTERVENTION(S)

After culture of GV oocytes in the modified TLP medium with human follicular fluid, oocytes that reached the metaphase II stage underwent ICSI. Potential of fertilization and subsequent cleavage of in vitro-matured oocytes was compared with that of an in vivo-matured control.

MAIN OUTCOME MEASURE(S)

Maturation rate, rate of pronuclei formation, and developmental activity.

RESULT(S)

The maturation rate of GV oocytes from follicles primed with gonadotropin was not affected by the presence or absence of cumulus. However, the maturation was more synchronous in oocytes with cumulus than in those without cumulus. Proportions of oocytes with two pronuclei and embryos cleaved to the 16-cell stage after ICSI were significantly lower in the oocytes matured in vitro than in the oocytes matured in vivo.

CONCLUSION(S)

Human GV oocytes from stimulated ovaries can be matured, fertilized, and developed in vitro. Production of embryos from GV oocytes will increase the opportunity for achieving pregnancy.

Intestinal sterol absorption mediated by scavenger receptors is competitively inhibited by amphipathic peptides and proteins

Exchangeable serum apolipoproteins and amphipathic alpha-helical peptides are effective inhibitors of sterol (free and esterified cholesterol) uptake at the small-intestinal brush border membrane. The minimal structural requirement of an inhibitor is an amphipathic alpha-helix of 18 amino acids. The inhibition is competitive, indicating that the inhibitor binds to scavenger receptor class B type I (SR-BI) present in the brush border membrane and responsible for sterol uptake. Binding of apolipoprotein A-I to SR-BI of rabbit brush border membrane is cooperative, characterized by a dissociation constant K(d) = 0.45 microM and a Hill coefficient of n = 2.8. The cooperativity of the interaction is due to binding of the inhibitor molecule to a dimeric or oligomeric form of SR-BI held together by disulfide bridges. Consistent with the competitive nature of the inhibition, the K(d) value agrees within experimental error with the IC(50) value of inhibition and with the inhibition constant K(I). After proteinase K treatment of brush border membrane vesicles, the affinity of the interaction of apolipoprotein A-I expressed as K(d) is reduced by a factor of 20, and the cooperativity is lost. The interaction of proteinase K-treated brush border membrane vesicles with apolipoprotein A-I is nonspecific partitioning of the apolipoprotein into the lipid bilayer of brush border membrane vesicles.

Arthroplasty of the hip in patients with aplastic anemia

BACKGROUND

Patients with aplastic anemia are now living longer and therefore are at increased risk for the development of osteonecrosis of the hip. However, studies on the results of arthroplasty for the treatment of osteoarthritis of the hip in patients with aplastic anemia are lacking.

METHODS

Twenty-six primary hip prostheses (one bipolar prosthesis fixed with cement, two bipolar prostheses fixed without cement, three hybrid total hip prostheses, and twenty total hip prostheses fixed without cement) were implanted, between March 1990 and May 1992, in nineteen patients who had been diagnosed with aplastic anemia. A specific prospective protocol was followed for the perioperative transfusion of platelets and blood. Twenty-five hips were replaced because of osteonecrosis of the femoral head, and one was replaced because of a femoral neck fracture. The patients were followed prospectively, with preoperative and serial postoperative Harris hip ratings as well as radiographs, for a minimum of six years or until death.

RESULTS

No patient had excessive perioperative bleeding or a postoperative infection. After a mean duration of follow-up of seventy-nine months (range, seventy-two to ninety-five months), two patients had died with the original implant in place. No patients were lost to follow-up. The mean Harris hip score was 55 points (range, 42 to 68 points) preoperatively and 87 points (range, 56 to 95 points) at the time of the latest follow-up. At the time of this writing, no hip had been revised. One patient with a bipolar prosthesis had radiographic evidence of femoral loosening and will probably require revision. A second patient had some medial protrusion of a bipolar prosthesis, with mild symptoms. All of the acetabular components that had been fixed without cement and all of the other femoral components appeared to be stable on radiographs after a minimum of seventy-two months of follow-up.

CONCLUSIONS

Total hip arthroplasty can be performed safely in patients with aplastic anemia. In the present intermediate-term study, the durability of implant fixation was maintained and the clinical results demonstrated a sustained increase in function of the hip.

Expression and characterization of the flavoprotein domain of gp91phox

Truncated forms of gp91(phox) were expressed in E. coli in which the N-terminal hydrophobic transmembrane region was replaced with a portion of the highly soluble bacterial protein thioredoxin (TRX). TRX-gp91(phox) (306-569), which contains the putative FAD and NADPH binding sites, showed NADPH-dependent NBT (nitroblue tetrazolium) reductase activity, whereas TRX-gp91(phox) (304-423) and TRX-gp91(phox) (424-569) were inactive. Activity saturated at about a 1:1 molar ratio of FAD to TRX-gp91(phox) (306- 569), and showed the same Km for NADPH as that for superoxide generating activity by the intact enzyme. Activity was not inhibited by superoxide dismutase, indicating that it was not mediated by superoxide, but was blocked by an inhibitor of the respiratory burst oxidase, diphenylene iodonium (DPI). In the presence of Rac1, the cytosolic regulatory protein p67(phox) stimulated the NBT reductase activity, but p47(phox) had no effect. Truncated p67(phox) containing the activation domain (residues 199- 210) stimulated activity approximately 2-fold, whereas forms mutated or lacking this region failed to stimulate the activity. Our data indicate that: 1) TRX-gp91(phox) (306-569) contains the binding sites for both pyridine and flavin nucleotides; 2) this flavoprotein domain shows NBT reductase activity; and 3) the flavin-binding domain of gp91(phox) is the target of regulation by the activation domain of p67(phox).

Activation domain in P67phox regulates the steady state reduction of FAD in gp91phox

An activation domain in p67(phox) (residues 199-210) is critical for regulating NADPH oxidase activity in cell-free system [10] To determine the steady state reduction of FAD, thioacetamide-FAD was reconstituted in gp91(phox), and the fluorescence of its oxidised form was monitored. Omission of p67(phox) decreased the steady state reduction of the FAD from 28% to 4%, but omission of p47(phox) had little effect. A series of the truncated forms of p67(phox) were expressed in E.coli to determine the domain in p67(phox) which is essential for regulating the steady state of FAD reduction. The minimal length of p67(phox) for for regulating the steady state of FAD reduction is shown to be 1-210 using a series of truncation mutants which indicates that the region 199-210 is also important for regulating electron flow within flavocytochrome b(558). The deletion of this domain not only decreased the superoxide generation but also decreased the steady state of FAD reduction. Therefore, the activation domain on p67(phox) regulates the reductive half-reaction for FAD, consistent with a dominant effect on hydride/electron transfer from NADPH to FAD.

Synthesis and cytotoxic evaluation of a series of gamma-substituted gamma-aryloxymethyl-alpha-methylene-gamma-butyrolactones against cancer cells

PURPOSE

The main objective of this investigation was to explore the cytotoxic structure-activity relationships of gamma-substituted gamma-aryloxymethyl-alpha-methylene-gamma-butyrolactones against cancer cells.

METHODS

The target compounds were synthesized in two steps commencing with aryl-OH which was treated with a bromomethyl ketone followed by the Reformatsky-type condensation.

RESULTS

Seven types of alpha-methylene-gamma-butyrolactones were evaluated in vitro against 60 human cancer cell lines derived from nine cancer cell types. The average values of log GI50 indicated that for the aryl portion, potencies of these alpha-methylene-gamma-butyrolactones are in a decreasing order of quinolin-2(1H)-one (or 2-hydroxyquinoline, 21, -5.89) > quinoline (19, -5.79) > 2-methylquinoline (20, -5.69) >8-hydroxyquinoline (17,-5.64) > 2-naphthalene (16, -5.59) > benzene (15, -4.90). The same order was obtained for both log TGI and log LC50. However, for the gamma-substituent, the potencies are in a decreasing order of biphenyl (16f-21f) > phenyl and 4-substituted phenyl (16b-e-21b-e) > methyl (16a-21a).

CONCLUSIONS

Unlike cardiovascular activities of alpha-methylene-gamma-butyrolactones in which a gamma-methyl substituent is necessary for vasorelaxing effect while a phenyl or a halogen-substituted phenyl is prefer for the antiplatelet activities, a gamma-biphenyl substituent proved to be the best for their cytotoxicities against various cancer cell lines tested.

Comparison of acquired cystic kidney disease between hemodialysis and continuous ambulatory peritoneal dialysis

OBJECTIVES

ACKD has been described mainly in patients treated with hemodialysis(HD), and there are only a few reports about the prevalence of ACKD in continuous ambulatory peritoneal dialysis (CAPD) patients. Therefore, we compared the prevalence of ACKD in patients receiving HD and CAPD, and evaluated the possible factors which may affect the development of ACKD.

METHODS

Forty nine HD and 49 CAPD patients who had received dialysis therapy for at least 12 months were enrolled in this cross-sectional study. Patients who had a past history of polycystic kidney disease and had acquired cystic kidney disease on predialysis sonographic exam were excluded. Detection of ACKD was made by ultrasonography and ACKD was defined as 3 or more cysts in each kidney.

RESULTS

The prevalence of ACKD was about 31% (30/98) and there was no significant difference between HD and CAPD patients(27% vs. 34%, p > 0.05). The prevalence of ACKD was not associated with age, sex, primary renal disease, the levels of hemoglobin, BUN, and serum creatinine. However, the duration of dialysis was significantly related to the development of ACKD (presence of ACKD, 74.4 +/- 42.4 months vs. absence of ACKD, 37.8 +/- 24.1 months, p < 0.05).

CONCLUSION

The prevalence of ACKD is not different according to the mode of dialysis, and the major determinant of acquired cyst formation is duration of dialysis.

The p67(phox) activation domain regulates electron flow from NADPH to flavin in flavocytochrome b(558)

An activation domain in p67(phox) (residues within 199-210) is essential for cytochrome b(558)-dependent activation of NADPH superoxide (O2(-.)) generation in a cell-free system (Han, C.-H., Freeman, J. L. R., Lee, T., Motalebi, S. A., and Lambeth, J. D. (1998) J. Biol. Chem. 273, 16663-16668). To determine the steady state reduction flavin in the presence of highly absorbing hemes, 8-nor-8-S-thioacetamido-FAD ("thioacetamido-FAD") was reconstituted into the flavocytochrome, and the fluorescence of its oxidized form was monitored. Thioacetamido-FAD-reconstituted cytochrome showed lower activity (7% versus 100%) and increased steady state flavin reduction (28 versus <5%) compared with the enzyme reconstituted with native FAD. Omission of p67(phox) decreased the percent steady state reduction of the flavin to 4%, but omission of p47(phox) had little effect. The activation domain on p67(phox) was critical for regulating flavin reduction, since mutations in this region that decreased O2(-.) generation also decreased the steady state reduction of flavin. Thus, the activation domain on p67(phox) regulates the reductive half-reaction for FAD. This reaction is comprised of the binding of NADPH followed by hydride transfer to the flavin. Kinetic deuterium isotope effects along with K(m) values permitted calculation of the K(d) for NADPH. (R)-NADPD but not (S)-NADPD showed kinetic deuterium isotope effects on V and V/K of about 1.9 and 1.5, respectively, demonstrating stereospecificity for the R hydride transfer. The calculated K(d) for NADPH was 40 microM in the presence of wild type p67(phox) and was approximately 55 microM using the weakly activating p67(phox)(V205A). Thus, the activation domain of p67(phox) regulates the reduction of FAD but has only a small effect on NADPH binding, consistent with a dominant effect on hydride/electron transfer from NADPH to FAD.

Biological effects of man-made mineral fibers (II)--their genetic damages examined by in vitro assay

In order to study and compare genetic damage induced by 10 kinds of man-made mineral fibers (JFM fibers) in cells, human lung epithelial cells (A549) were exposed to JFM fibers and chrysotile for 1 h, then single-cell gel electrophoresis (SCGE) assay was used to detect DNA strand breaks, DNA-DNA interstrand crosslink and the ability of DNA to repair; The results showed that all 10 JFM fibers could induce DNA strand breaks, DNA-DNA interstrand crosslinks and inhibit the ability of DNA repair. When human embryo lung (HEL) cells were exposed to JFM fibers and chrysotile for 24 h respectively, the chromosomal aberration was analyzed and the results showed that chrysotile and most of JFM fibers at 5.0 micrograms/ml induced structural chromosomal aberration, but all of these effects were lower than that of chrysotile and were different among them, suggesting that 10 types of JFM fibers had genotoxicity with different degree in vitro, but all of them were lower than that of chrysotile.

Structural elements within the methylation loop (residues 112-117) and EF hands III and IV of calmodulin are required for Lys(115) trimethylation

Calmodulin is trimethylated by a specific methyltransferase on Lys115, a residue located in a six amino acid loop (LGEKLT) between EF hands III and IV. To investigate the structural requirements for methylation, domain exchange mutants as well as single point mutations of conserved methylation loop residues (E114A, Glu114-->Ala; L116T, Leu116-->Thr) were generated. E114A and L116T activated cyclic nucleotide phosphodiesterase (PDE) and NAD+ kinase (NADK) similar to wild-type calmodulin, but lost their ability to be methylated. Domain exchange mutants in which EF hand III or IV was replaced by EF hand I or II respectively (CaM1214 and CaM1232 respectively) showed a modest effect on PDE and NADK activation (50 to 100% of wild-type), but calmodulin methylation was abolished. A third domain exchange mutant, CaMEKL, has the methylation loop sequence placed at a symmetrical position between EF hands I and II in the N-terminal lobe [residues QNP(41-43) replaced by EKL]. CaMEKL activated PDE normally, but did not activate NADK. However, CaMEKL retained the ability to bind to NADK and inhibited activation by wild-type calmodulin. Site-directed mutagenesis of single residues showed that Gln41 and Pro43 substitutions had the strongest effect on NADK activation. Additionally, CaMEKL was not methylated, suggesting that the introduction of the methylation loop between EF hands I and II is not adequate for methyltransferase recognition. Overall the data indicate that residues in the methylation loop are essential but not sufficient for methyltransferase recognition, and that additional residues unique to EF hands III and IV are required. Secondly, the QNP sequence in the loop between EF hands I and II is necessary for NADK activation.

Biological effects of man-made mineral fibers (I)--Reactive oxygen species production and calcium homeostasis in alveolar macrophages

10 types of standard mineral fiber samples (JFM fibers) were tested for their cytotoxicity in alveolar macrophages (AM) in vitro experiments, in which UICC chrysotile B was used as a positive control. The cytotoxicity included the production of superoxide anion radical and hydrogen peroxide, depletion of glutathione (GSH) and increase of intracellular free calcium. The results showed that chrysotile and most of the 10 mineral fibers could increase the production of superoxide anion and hydrogen peroxide, deplete the concentration of GSH and increase the level of free intracellular Ca2+ in AM. But all the effects of JFM fibers were lower than that induced by UICC chrysotile B. Although the cytotoxicity of JFM fibers were lower than that of asbestos, these mineral fibers should be used with highly care for workers in industries.

[Studies on cytotoxicity of man-made mineral fiber to alveolar macrophage]

OBJECTIVE

To compare the difference in cytotoxicity to human alveolar macrophage caused by ten kinds of man-made mineral fiber.

METHODS

Ten kinds of man-made mineral fiber prepared by Japan Fibrous Materials Research Association (JFM) were used with alveolar macrophage extracted from guinea pigs in vitro as the target cells. Changes in the production of O2- and H2O2, levels of glutathione and cellular free calcium ion (Ca2+) in alveolar macrophage were determined.

RESULTS

Most of the 10 kinds of JFM fiber could cause increased production of O2- and H2O2, reduction of levels of glutathione and increase of cellular free calcium ion (Ca2+) in alveolar macrophage, to a extent less than that caused by chrysotile.

CONCLUSION

In general, the cytotoxicity of JFM fiber was less than that of chrysotile. Although these mineral fiber could be used as substitutes for asbestos, they still could cause certain harm to human bodies.

Regulation of the neutrophil respiratory burst oxidase. Identification of an activation domain in p67(phox)

Superoxide generation by the neutrophil respiratory burst oxidase (NADPH oxidase) can be reconstituted in a cell-free system using flavocytochrome b558 and the cytosolic proteins p47(phox), p67(phox), and Rac. p47(phox) functions as an adaptor protein; it increases the affinity of p67(phox) and Rac in the NADPH oxidase complex, but is not essential when high concentrations of these proteins are used (Freeman, J. L., and Lambeth, J. D. (1996) J. Biol. Chem. 271, 22578-22582), implying that p67(phox) and/or Rac directly regulates enzyme activity. Herein, we describe an activation domain in p67(phox) that is essential for NADPH oxidase activity. A series of C-terminal truncation mutants of p67(phox) showed that residues 211 to the C terminus (residue 526) are not needed for cell-free activity. However, shorter truncations were inactive, pointing to an activation domain within the region spanning residues 199-210. p67(phox) mutated at single amino acid residues within this region showed diminished activity, and p67(phox) V204A was completely inactive. The effects of mutations on activity were independent of p47(phox), and mutations did not affect the binding of p67(phox) to Rac. In the presence of wild-type p67(phox), the V204A mutant was a potent inhibitor of superoxide generation, and inhibition was partially reversed by high concentrations of p67(phox), but not by p47(phox) or Rac. The V204A mutant competed with native p67(phox) for translocation to neutrophil plasma membrane, indicating that p67(phox) V204A assembles to form an inactive complex. The data imply a direct activation of flavocytochrome b558 by an activation domain in p67(phox).

Acute lymphoblastic leukemia with maturation--a new entity with clinical significance

The diagnosis of 'ALL with maturation' (ALLm) is proposed. One hundred and one patients with untreated ALL were entered into this study. The diagnosis of ALLm was made when more than 20% of all nucleated elements in the bone marrow showed maturation beyond prolymphocytes by light microscopic examination. The mature-appearing leukemic cells showed the same immunophenotype to remaining lymphoblasts. The number of ALLm cases was 19 (18.8%). The mean age at presentation of ALLm was 29 +/- 18, older than that of 18 +/- 16 of the remaining typical ALL (ALLt) (P = 0.015). Remission was induced with daunorubicin, vincristine, prednisone and L-asparaginase. Only two of 19 ALLm patients achieved CR after 4 weeks induction chemotherapy. In contrast, 57 of 82 (69.5%) ALLt patients achieved CR after the same induction chemotherapy. There was no significant difference in immunophenotype of ALLm compared with ALLt. Labeling index of DNA topoisomerase IIalpha (TopoLI) was studied by immunohistochemistry. Initial TopoLI of ALLm (221 +/- 147) was much lower than that of ALLt (609 +/- 262, P = 0.005). Furthermore, the remaining leukemic cells after chemotherapy were not labeled with anti-DNA topoisomerase IIalpha. The P53 protein was expressed in nine of 18 ALLm cases (50.0%) and P-glycoprotein was not expressed in ALLm cases. Twelve of 19 ALLm cases were studied for carrying bcr/abl fusion by karyotyping and/or fluorescent in situ hybridization. Only two cases revealed bcr/abl fusion. In conclusion, ALLm is a separate entity of ALL which has a very poor clinical course and is independent of other prognostic factors. The morphologically mature leukemic cells are in resting GO phase.

A quantitative comparison of machined commercially pure titanium and titanium-aluminum-vanadium implants in rabbit bone

Screw-shaped implants made from rods of commercially pure titanium (grade 1) and titanium-aluminum-vanadium (grade 5) were machined, and the implant surface structures were numerically described before being placed in rabbit tibiae for healing periods of 1 months, 6 months, and 12 months. Quantitative comparisons of the removal torque (Ncm) necessary to loosen the implants from the bone bed were performed. Short-term (1 month) observations revealed no significant differences between the two tested materials. However, after 6 and 12 months, the commercially pure titanium implants were significantly more stable in the bone bed, as compared to the alloy samples. After 6 months, the commercially pure titanium had a mean removal torque of 29 Ncm versus 23 for the alloy (P = .01), and after 12 months, the mean removal torque was 38 Ncm for commercially pure titanium as compared to 35 Ncm for the alloy (P = .01). Quantifications of the bone tissue response to the materials did not show any significant differences; however, the commercially pure titanium showed a tendency to have a higher percentage of bone in contact with the implant as compared to the alloy screws. Bone volumes in the threads were similar. The absence of any quantitative light microscopic difference after 1 month following placement may relate to the fact that there was a sparse amount of bone, since the tissue was in the organization/granulation phase. After 6 and 12 months of follow-up, substantial bone formation had occurred, resulting in significantly increased removal torques for the commercially pure titanium samples.

Quantitative and qualitative investigations of surface enlarged titanium and titanium alloy implants

Screw shaped implants of commercially pure (c.p.) titanium and titanium-6aluminum-4vanadium (Ti6A14V) were blasted with particles of TiO2 of mean sizes of 25 microns (Group I) and 75 microns (Group II) and inserted in rabbit bone for 3 months. The surface roughness of the implants was examined and quantified with an optical scanning 3-dimensional instrument (TopScan 3D system), revealing the two alloy surfaces in each group had similar surface roughness. Biomechanical (removal torque) tests showed the c.p. titanium implants to be significantly more stable in the bone bed than those of Ti6A14V. In Group I, the c.p. titanium implants demonstrated a mean removal torque of 38 N cm while the Ti6A14V demonstrated a mean removal torque of 27 N cm (P = 0.004). Group II implants revealed a mean removal torque of 70 N cm for the c.p. ti and 50 N cm for the alloy samples (P = 0.003). The removal torque values were converted to shear forces/strengths by three calculation methods, based on (a) the entire length of the implant surface in the cortical region, (b) the thickness of the cortical bone measured in close vicinity to the thread peaks and (c) the bone-metal contact length measured on the non-unscrewed neighbouring implants. Group I: (a) the c.p. ti implants revealed a mean shear force of 4 vs a mean of 3 N/mm2 for the alloy samples. Shear strengths based on (b); were 8 for c.p. ti vs 6 N/mm2 for the alloy. The mean shear strength/force if calculated according to (c) revealed 23 for c.p. ti vs 18 N/mm2 for the alloy. Corresponding numbers for Group II; (a) c.p. ti 8 compared to 6 N/mm2 for the alloy, (b) c.p. ti demonstrated a mean value of 17 vs 11 N/mm2 for the alloy. According to method (c); c.p. ti had a mean shear strength of 26 vs 22 N/mm2 for the alloy samples. Histomorphometrical comparisons were performed on 10 microns thick undecalcified ground sections in the light microscope. In both Group I and Group II, the calculations of the mean bone-to-metal contact demonstrated more bone in contact to the c.p. titanium implants than to the Ti6A14V ones. Whereas comparisons of the bone volume inside the threads demonstrated slightly higher bone volumes around the alloy samples, no statistically significant difference was obtained between the two materials histomorphometrically.

Ionization and solubilization of 4 alkyl benzoic acids and 4 alkyl anilines in sodium taurodeoxycholate solutions

PURPOSE

The aqueous solubility and the extent of solubilization and ionization constant in sodium taurodeoxycholate (NaTDC) solutions of a series of benzoic acid and aniline derivatives were measured as a basis to characterize and thereby help predict the nature of the interaction of drugs with bile aggregates.

METHODS

The aqueous solubility and the solubilization of two series of compounds, 4-alkyl benzoic acids and 4-alkyl anilines, was measured as a function of NaTDC in 0 and 150 mM NaCl. The ionization constants were determined in water and in 50 mM NaTDC at sodium chloride concentration of 0, 75 and 150 mM by spectrophotometric titration. The diffusion coefficients of NaTDC and the solutes were measured by pulsed-field gradient spin echo NMR spectroscopy.

RESULTS

The aqueous solubilities decreased with increasing alkyl chain length in both series, and the aniline derivatives had larger solubilities than the benzoic acid derivatives. The number of moles of solute solubilized per mole of bile salt ranged from 0.17 to 0.31 for the benzoic acid derivatives and from 1.3 to 3.0 for the aniline derivatives. The pKa values of the benzoic acid derivatives in the presence of NaTDC were higher relative to the controls, and the difference in the pKa (delta pKa,obs) increased with increasing chain length. With the aniline derivatives, the pKa values were also shifted to higher values in NaTDC relative to the control but only in the absence of salt. The presence of the solute caused a decrease in the diffusion coefficient of NaTDC, and the diffusion coefficients of the solutes decreased with increasing alkyl chain length. With the hexyl derivative, the diffusion coefficient of the solute was smaller than the diffusion coefficient of the bile salt. The chemical shift of the protons attached to carbon 18 and 19 of the salt were decreased to a greater extent in the presence of the solutes than the protons attached to carbon 26.

CONCLUSION

Both the solubilization and ionization behavior of solutes were affected by the presence of bile salt aggregates. The surface potential and effective polarity of NaTDC aggregates were found to be dependent on the alkyl chain length for these two homologous series of solutes. The solubilization ratio was largely independent of alkyl chain length, but the unitary partition coefficient was dependent on both alkyl chain length as well as ionization state. The derivatives reduced the diffusivity of the micelles suggesting the formation of larger size aggregates and the solutes (hexyl derivatives) appear to favor association with the larger sized aggregates. The phenyl ring of the solutes appears to be oriented parallel to the plane of the steroid frame with preferential positioning near the hydrophobic rings.

Altered methylation substrate kinetics and calcium binding of a calmodulin with a Val136-->Thr substitution

Calmodulin is trimethylated on Lys115 by a specific calmodulin methyltransferase. Previously, it was shown that the cam2 mutant (Ile136-->Thr) of Paramecium has a decreased level of methylated Lys115 [Lukas, T. J., Friedman, M. W., Kung, C. & Watterson, D. M. (1989) Proc. Natl Acad. Sci. USA 86, 7331-7335]. To investigate how this substitution affects calmodulin structure, function and recognition by the calmodulin methyltransferase, a calmodulin with a Thr136 substitution ([Thr136]calmodulin) was expressed in Escherichia coli in an unmethylated form for in vitro enzyme activator, calcium binding and methylation kinetic analyses. [Thr136]calmodulin was indistinguishable from wild-type calmodulin in saturating (1 mM) calcium in its ability to activate calmodulin-dependent enzymes and in its steady-state kinetic properties with isolated calmodulin methyltransferase. However, [Thr136]calmodulin did show two defects: a complete inability to be methylated in the absence of calcium; and defective calcium binding. As a result, an approximate 10-fold shift in the K0.5 values for calcium dependence of enzyme activation (shifted from 1.1 microM to 9.1 microM of Ca2+ for NAD kinase) and methylation (from 0.71 microM to 7.2 microM of Ca2+ in 0.15 M K+, 2 mM Mg2+) were observed. Non-denaturing electrophoresis and Tyr138 spectroscopic measurements suggest a difference in the conformation of the calcium-depleted structures of normal calmodulin and [Thr136]calmodulin. Overall, the results suggest that the mutation in this conserved position in the COOH-terminal hydrophobic core lowers calcium-binding affinity and alters the calcium-depleted structure leading to decreased methylation at physiological Ca2+ concentrations.

A 1-year radiographic evaluation of marginal bone around dental implants

The aim of this study was to report alveolar bone loss during the first 12 months after implant abutment connection. Marginal bone loss around 62 endosseous root-form implants in 62 patients was measured on periapical radiographs. Changes in bone density were measured by the digital subtraction image radiographic method. At 3-month intervals for 1 year, bone loss around the four types of implants used (standard series, mini series, and hexlock implants of the Steri-Oss system; and 3i standard implants) was investigated. Rapid bone loss around all four implant types occurred in the first 3 months. Most of the implants showed resorption of alveolar bone beyond the polished neck at 12 months. The bone level stabilized at the first thread of the implants with no correlation to either the time of exposure of the polished neck or the type of implant. Bone density decreased at the marginal bone and increased at the newly formed alveolar crest.

Phase properties of mixtures of ceramides

Ceramides have been proposed to have a central role in the function of the stratum corneum. Ceramides also influence the phase properties of model skin lipid mixtures, but the relevance of this to the stratum corneum function is controversial. Because the stratum corneum contains several classes of ceramides, the type of ceramides used in model mixtures of stratum corneum lipid lamellae may be important. Thus, the properties of alpha-hydroxy fatty acid containing (HFAC) and nonhydroxy fatty acid containing (NFAC) ceramides and their mixtures have been investigated. Ceramides were obtained by the conversion of purified bovine brain cerebrosides. Isolated, anhydrous HFAC underwent an endothermic solid to liquid transition at 92 degrees C. With hydration, an endothermic transition at 71.8 degrees C was observed which was accompanied by a reduction in the birefringence. The enthalpy increased from 66 to 89 J/g with a 20-d storage time. These thermal properties are very similar to those observed with hydroxy fatty acid containing cerebrosides. In contrast, anhydrous nonhydroxy fatty acid containing ceramides underwent a broad endothermic transition over the temperature range of 50-90 degrees C. When hydrated, the initial endothermic transition was interrupted by an exothermic transition that was followed immediately by a second endothermic transition. During these thermal changes, there was a loss of birefringence, and with completion of the second endothermic transition, a nonbirefringent liquid was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Isolation and kinetic characterization of the calmodulin methyltransferase from sheep brain

The methyltransferase that catalyzes the trimethylation of lysine 115 in calmodulin has been purified from sheep brain. The enzyme is a monomer with an apparent molecular weight of 38,000 on the basis of gel filtration chromatography and SDS-polyacrylamide electrophoresis. In the presence of calcium the methyltransferase exhibited a Km of 100 nM for unmethylated calmodulin and a kcat of 0.0278 s-1. The enzyme was able to use calcium-depleted calmodulin as a substrate, albeit with less efficiency. The methylation of calcium-depleted calmodulin was inhibited by increases in ionic strength, whereas methylation of calcium-saturated calmodulin was not affected. This suggests a difference in the mode of interaction of calcium-saturated and calcium-depleted calmodulins with the enzyme. As with calmodulin's interactions with other calmodulin-dependent enzymes, the oxidation of the methionines of calmodulin by performic acid treatment decreases the ability of the methyltransferase to recognize and methylate calmodulin. A calmodulin-binding peptide based on the calmodulin-dependent protein kinase II sequence and the naphthalenesulfonamide W-7 inhibit the calmodulin methyltransferase-calmodulin interaction in a calcium-dependent manner. Removal of the NH2-terminal lobe (residues 1-77) does not affect the ability of the calmodulin methyltransferase to recognize and methylate lysine 115. Thus, the determinants for calmodulin methyltransferase binding reside solely in the COOH-terminal lobe of calmodulin. Further, structural features within this region, in particular, the hydrophobic cleft, that are manifested upon calcium binding may contribute to the interaction of calmodulin with the enzyme.

Allogeneic bone marrow transplantation for the patients with hemopoietic stem cell disorders: CUMC experience

Bone marrow transplantation from an HLA-identical sibling is increasingly used as a curative therapy for patients with hemopoietic stem cell disorders including acute leukemia, chronic myelogenous leukemia and severe aplastic anemia. Between March 1983 and March 1991, we performed 86 cases of allogeneic bone marrow transplantation (BMT) for the patients with hemopoietic stem cell disorders: 25 acute myelogenous leukemia (AML); 15 acute lymphoblastic leukemia (ALL); 20 chronic myelogenous leukemia (CML); and 26 severe aplastic anemia (SAA). Ten out of 25 AML are in disease free survival (DFS). The causes of death were recurrence of leukemia (12), acute GVHD (3), sepsis (1) and veno-occlusive disease (1). Nine of 15 ALL are in unmaintained remission. Thirteen out of 20 CML are in DFS. Among 26 SAA, 21 are enjoying DFS, but 1 died of engraftment failure, 3 of graft rejection followed by cytomegalovirus (1) and aspergillus pneumonia (1). Comparing the survival between standard [less than or equal to CR1: 9/14 (64%)] and high risk [greater than or equal to CR1: 1/11 (9%)] AML, our data suggest that preparative regimen for high risk AML was not potent enough to eradicate the minimal residual disease in advanced AML. Although our cases are limited and the follow-up period is short, our result of ALL [overall: CCR (60%), standard risk (adult less than or equal to CR1, children less than or equal to CR2; 8/11 (73%) and high risk; 1/4 (25%)] and CML [overall: 65%, CP; 9/10 (90%), AP; 4/6 (67%), BP; 0/4 (0%)] are optimistic. It is of our interest that the incidence of death related with IP (1/33: 3%) and with AGVHD 94/33: 12%) were much less than that of other's observation but the explanation for this still remains to be clear.

Suicide by burning in Korea

Of 2,143 admissions following suicide attempts over a seven year period (1980-1986) in Seoul, Korea, there were 38 cases (1.8%) of suicide by burning. These cases were matched by age and sex with a control group of suicide attempts in general and were investigated for psychosocial differences from other suicide attempters. No significant differences were found in social factors such as education, religion, marital status, seasonal change and occupation. The majority of suicide attempts by burning were in a public place (73.7%) and were eventually fatal despite intensive medical treatment (78.9%). Half (52.7%) suffered from significant mental disorders and marital disharmony.

Immunomodulation therapy for severe aplastic anemia--ALG versus ALG plus cyclosporin A

Immunosuppressive treatment of aplastic anemia has been increasingly used as an alternative treatment to bone marrow transplantation. In this study, the additive effect of Cyclosporin A (CSA) (5mg/kg/day, at least 3 months) for maintenance of immunosuppression after antilymphocyte globulin (ALG) therapy (40mg/kg/day for 4 days) was compared to the previous ALG alone treatment (15mg/kg/day for 10 days). A high dose of methylprednisolone (20mg/kg/day for 5 days and 10mg/kg/day for 5 days) to the ALG group and a low dose of methylprednisolone (2mg/kg/day for 5 days) to the ALG plus CSA group were administered simultaneously. The results were as follows: 1) Sixteen (69.6%) out of twenty-three patients treated with ALG plus Cyclosporin A showed higher responses (CR: 48%, PR: 22%). On the contrary, nine out of nineteen in the ALG group showed lower responses (CR: 21%, PR: 26%). 2) Our data showed a tendency that male patients in age ranging from sixteen to thirty years showed an excellent response to ALG therapy (12/23: 52.2%). 3) The ALG plus CSA group revealed a faster response compared to the ALG alone group (15/16 within 6 months). 4) We speculate that ALG plus CSA therapy might be the treatment of choice for patients with a moderate degree of aplastic anemia. 5) Adding CSA to ALG increased the chance of infection, such as those with URI-like symptoms, but it did not affect the mortality rate. Our data suggest that the ALG plus CSA regimen may be a more useful therapeutic modality for patients with severe aplastic anemia who cannot be candidates for bone marrow transplantation and a randomized multicenter study is needed for confirmation of our preliminary study.