Persistent ∆FosB expression limits recurrent seizure activity and provides neuroprotection in the dentate gyrus of APP mice

Recurrent seizures lead to accumulation of the activity-dependent transcription factor ∆FosB in hippocampal dentate granule cells in both mouse models of epilepsy and mouse models of Alzheimer's disease (AD), which is also associated with increased incidence of seizures. In patients with AD and related mouse models, the degree of ∆FosB accumulation corresponds with increasing severity of cognitive deficits. We previously found that ∆FosB impairs spatial memory in mice by epigenetically regulating expression of target genes such as calbindin that are involved in synaptic plasticity. However, the suppression of calbindin in conditions of neuronal hyperexcitability has been demonstrated to provide neuroprotection to dentate granule cells, indicating that ∆FosB may act over long timescales to coordinate neuroprotective pathways. To test this hypothesis, we used viral-mediated expression of ∆JunD to interfere with ∆FosB signaling over the course of several months in transgenic mice expressing mutant human amyloid precursor protein (APP), which exhibit spontaneous seizures and develop AD-related neuropathology and cognitive deficits. Our results demonstrate that persistent ∆FosB activity acts through discrete modes of hippocampal target gene regulation to modulate neuronal excitability, limit recurrent seizure activity, and provide neuroprotection to hippocampal dentate granule cells in APP mice.

Role of serum eosinophil cationic protein in distinct endotypes of chronic rhinosinusitis

BACKGROUND

Serum eosinophil cationic protein (ECP) levels affect the surgical outcome of chronic rhinosinusitis (CRS) with nasal polyps. Primary CRS can be classified into type 2 (T2) and non-T2. We aimed to differentiate the role of serum ECP levels in surgical outcomes between the distinct endotypes of primary CRS.

METHODS

We prospectively enrolled patients with bilateral primary CRS who underwent surgical treatment with postoperative follow-up for at least 12 months. Endotyping and serum parameter measurements were completed within 1 week before surgery.

RESULTS

In total, 113 patients were enrolled, including 65 with T2 CRS and 48 with non-T2 CRS. Patients in the T2 CRS group with uncontrolled CRS had significantly higher serum ECP levels than those in patients in the non-T2 CRS group. An optimal cut-off value was obtained at 17.0 μg/L using the receiver operating characteristic curve, attaining a sensitivity of 91.7% and specificity of 56.6%. Multivariate logistic regression analysis showed that a higher serum ECP level was an independent factor for postoperative uncontrolled disease. The hazard ratio was 11.3 for the T2 group, with serum ECP levels over 17.0 μg/L. In the non-T2 group, no parameters were significantly correlated with postoperative uncontrolled CRS.

CONCLUSIONS

Serum ECP levels appear to be a feasible predictor of postoperative uncontrolled disease in patients with T2 CRS as preoperative serum ECP levels >17.0 μg/L in these patients have an approximately 16.7-fold increased risk of postoperative uncontrolled disease and should be closely monitored.

Hippocampal ΔFosB expression is associated with cognitive impairment in a subgroup of patients with childhood epilepsies

Epilepsy is a chronic neurological disorder characterized by recurrent seizures, and is often comorbid with other neurological and neurodegenerative diseases, such as Alzheimer's disease (AD). Patients with recurrent seizures often present with cognitive impairment. However, it is unclear how seizures, even when infrequent, produce long-lasting deficits in cognition. One mechanism may be seizure-induced expression of ΔFosB, a long-lived transcription factor that persistently regulates expression of plasticity-related genes and drives cognitive dysfunction. We previously found that, compared with cognitively-intact subjects, the activity-dependent expression of ΔFosB in the hippocampal dentate gyrus (DG) was increased in individuals with mild cognitive impairment (MCI) and in individuals with AD. In MCI patients, higher ΔFosB expression corresponded to lower Mini-Mental State Examination scores. Surgically resected DG tissue from patients with temporal lobe epilepsy also showed robust ΔFosB expression; however, it is unclear whether ΔFosB expression also corresponds to cognitive dysfunction in non-AD-related epilepsy. To test whether DG ΔFosB expression is indicative of cognitive impairment in epilepsies with different etiologies, we assessed ΔFosB expression in surgically-resected hippocampal tissue from 33 patients with childhood epilepsies who had undergone Wechsler Intelligence Scale for Children (WISC) testing prior to surgery. We found that ΔFosB expression is inversely correlated with Full-Scale Intelligence Quotient (FSIQ) in patients with mild to severe intellectual disability (FSIQ < 85). Our data indicate that ΔFosB expression corresponds to cognitive impairment in epilepsies with different etiologies, supporting the hypothesis that ΔFosB may epigenetically regulate gene expression and impair cognition across a wide range of epilepsy syndromes.

[Correlation between serum autotaxin level and pulmonary ultrasound score with the disease severity and 28-day mortality in patients with acute respiratory disease syndrome]

Objective: To investigate the relationship between serum autocrine motor factor (Autotaxin) level and pulmonary ultrasound score (LUS) and the disease severity and 28-day mortality of patients with acute respiratory distress syndrome (ARDS). Methods: Totally 142 ARDS patients admitted to Danzhou People's Hospital from January 2019 to December 2021 were selected, and serum Autotaxin level and LUS score of ARDS patients on the day of onset were detected. According to the survival within 28 days after entering the intensive care unit, ARDS patients were divided into survival group (86 cases) and death group (56 cases). According to the oxygenation index, ARDS patients were divided into mild group (200 mmHg<oxygenation index≤300 mmHg, 36 cases), moderate group (100 mmHg<oxygenation index≤200 mmHg, 61 cases) and severe group (oxygenation index≤100 mmHg, 45 cases). The receiver operating characteristic curve (ROC) was performed to analyze the value of serum autotaxin level and LUS score to predict the death of patients with ARDS. Kaplan-Meier method was used to draw the survival curve, and Log-rank test was used for comparison between groups. Cox multivariate regression analysis was used to analyze the risk factors of death in patients with ARDS. Results: The LUS score [(26.50±5.20 vs 13.45±3.70, t=11.974,P<0.01] and serum Autotaxin level [(54.83±16.28)μg/L vs (32.70±11.85) μg/L,t=13.842,P<0.01] in the death group were significantly higher than those in the survival group, the difference is statistically significant. The serum autotaxin level and LUS score in severe group were significantly higher than those in mild group and moderate group (all were P<0.001). ROC curve showed that the combino ation of autotaxin and LUS score had the largest AUC to predict the AUC of death in patients with ARDS (0.904, 95CI:0.847-0.962), with the highest accuracy of 88.2%. Survival curve analysis showed that the survival rate of high autotaxin group was significantly lower than that of low autotaxin group (44.1% vs 75.7%,P<0.001), and the survival rate of high LUS score group was significantly lower than that of low LUS score group (49.4% vs 73.8%,P=0.003). Cox multivariate regression analysis showed that elevated LUS score (HR=1.983, 95%CI: 1.402-4.715,P<0.001) and Autotaxin level (HR=2.604, 95%CI: 1.853-6.317,P<0.001) were risk factors for death in patients with ARDS (P<0.05). Conclusion: The increase of serum autotaxin level and LUS score is related to the severity and death of patients with ARDS, which are risk factors for 28-day death in ARDS patients, and can be used as a reference mdicator to predict death in ARDS patients.

Restoring activity in the thalamic reticular nucleus improves sleep architecture and reduces Aβ accumulation in mice

Sleep disruptions promote increases of amyloid β (Aβ) and tau in the brain and increase Alzheimer’s disease (AD) risk, but the precise mechanisms that give rise to sleep disturbances have yet to be defined. The thalamic reticular nucleus (TRN) is essential for sleep maintenance and for the regulation of slow-wave sleep (SWS). We examined the TRN in transgenic mice that express mutant human amyloid precursor protein (APP) and found reduced neuronal activity, increased sleep fragmentation, and decreased SWS time as compared to nontransgenic littermates. Selective activation of the TRN using excitatory DREADDs restored sleep maintenance, increased time in SWS, and reduced amyloid plaque load in both hippocampus and cortex. Our findings suggest that the TRN may play a major role in symptoms associated with AD. Enhancing TRN activity might be a promising therapeutic strategy for AD.

[Effect of continuous blood purification for acute renal injury after acute Stanford type A aortic dissection]

Objective: To investigate the effect of continuous renal replacement therapy (CRRT) on acute kidney injury (AKI) after acute Stanford type A aortic dissection (ATTAD). Methods: In this study, 120 patients with AKI after ATTAD surgery treat in Gansu Provincial People's Hospital were selected as research objects. Among them, there were 86 males (71.7%) and 34 females (28.3%) with a mean age of (55±5) years. These patients were randomly divided into experimental group (n=60) and control group (n=60) with stratified random sampling. CRRT and intermittent hemodialysis (IHD) were performed in the experimental group and the control group respectively. The therapeutic effect of CRRT on ATTAD patients with AKI was evaluated by blood purification index, renal function index, Sequential Organ Failure Assessment (SOFA) score, inflammatory level, hemodynamic index and fluid infusion volume. Results: The two treatment schemes both had considerable therapeutic effects on the condition of patients, but the therapeutic effect of CRRT was more superior. In the patients treated with CRRT, the levels of serium creatinine (SCr), blood urea nitrogen (BUN) and blood lactic acid (Lac) were all lower than those in the control group (all P<0.05). The time of staying in intensive care units (ICU), the period of oliguria, the times of renal replacement therapy, the time from the first dialysis to the last dialysis and the total hospital stay in the experimental group were all shorter than those in the control group (all P<0.05). The volume of fluid infusion was less and the hemodynamic index was better than that in the control group, but there was no significant difference in hospital mortality between the two groups (P>0.05). The levels of interleukin (IL)-6, IL-8 and C-reactive protein (CRP) in the experimental group were (21.9±1.8) ng/L, (18.6±1.4) ng/L and (22.7±2.2) mg/L, respectively, which were all significantly lower than those in control group ((27.9±3.2) ng/L, (28.3±1.4) ng/L, (60.1±2.5)mg/L, respectively; t=14.527, 13.255, 11.247, all P<0.05). The scores of SOFA at all time points in the experimental group were all lower than those in the control group (all P<0.05). Conclusion: Compared with IHD, CRRT brings no significant reduction in hospital mortality in patients with AKI after ATTAD, but shows better prognosis.

[Screening of phenylketonuria and analysis of phenylalanine hydroxylase gene in 380 996 newborns from Hainan province]

Objective: To investigate the incidence of phenylketonuria and distribution characteristics of phenylalanine hydroxylase (PAH) gene in newborns from Hainan province. Methods: Dry blood spot specimens of heels from 380 996 newborns in Hainan province from January 2017 to December 2019 were collected. Phenylalanine (Phe) concentrations in these dry blood spots were measured by the fluorescence method to screen phenylketonuria (PKU). A second dry blood spot sample will be collected if suspicious samples were detected after initial screening. Tandem mass spectrometry were used to detect the concentrations of Phe and tyrosine. Urine samples of the suspected newborns were sent out for urotrexate spectrum analysis and tetrahydrobiopterin loading test. PCR and flow-through rapid hybridization method were employed to detect PAH gene mutations. Meanwhile, peripheral blood samples of suspicious newborns of PKU and their parents were collected to perform gene sequencing. Results: Among the 380 996 newborns, 39 were suspected and 14 were diagnosed with PKU, including 11 cases of PAH deficiency and 3 cases of tetrahydrobiopterin deficiency. Of 14 confirmed cases, there were 8 male cases and 6 female cases. In the newborn population of Hainan province, the annual incidence of PKU was 1.22/100 000. Thirteen PAH gene mutations were detected in confirmed cases: c.728G>A, c.158G>A, c.1238G>C, c.611A>G, c.1068C>A, c.706+5G>A, c.740G>T, c.1081A>T, c.793T>G, c.1223G>A, c.721C>T, c.331C>T and c.1174T>A. Conclusions: PKU has a high incidence in newborn population of Hainan province in the past three years. The PAH gene has a wide spectrum of mutations. Two rare mutations were also found: c.793T>G and c.706+5G>A.

Genes Bound by ΔFosB in Different Conditions With Recurrent Seizures Regulate Similar Neuronal Functions

Seizure incidence is increased in Alzheimer’s disease (AD) patients and mouse models, and treatment with the antiseizure drug levetiracetam improves cognition. We reported that one mechanism by which seizures can exert persistent effects on cognition is through accumulation of ΔFosB, a transcription factor with a long half-life. Even the infrequent seizures that spontaneously occur in transgenic mice expressing human amyloid precursor protein (APP) lead to persistent increases in ΔFosB in the hippocampus, similar to what we observed in patients with AD or temporal lobe epilepsy. ΔFosB epigenetically regulates expression of target genes, however, whether ΔFosB targets the same genes when induced by seizures in different neurological conditions is not clear. We performed ChIP-sequencing to assess the repertoire of ΔFosB target genes in APP mice and in pilocarpine-treated wildtype mice (Pilo mice), a pharmacological model of epilepsy. These mouse models allowed us to compare AD, in which seizures occur in the context of high levels of amyloid beta, and epilepsy, in which recurrent seizures occur without AD-specific pathophysiology. Network profiling of genes bound by ΔFosB in APP mice, Pilo mice, and respective control mice revealed that functional domains modulated by ΔFosB in the hippocampus are expanded and diversified in APP and Pilo mice (vs. respective controls). Domains of interest in both disease contexts involved neuronal excitability and neurotransmission, neurogenesis, chromatin remodeling, and cellular stress and neuroinflammation. To assess the gene targets bound by ΔFosB regardless of seizure etiology, we focused on 442 genes with significant ΔFosB binding in both APP and Pilo mice (vs. respective controls). Functional analyses identified pathways that regulate membrane potential, glutamatergic signaling, calcium homeostasis, complement activation, neuron-glia population maintenance, and chromatin dynamics. RNA-sequencing and qPCR measurements in independent mice detected altered expression of several ΔFosB targets shared in APP and Pilo mice. Our findings indicate that seizure-induced ΔFosB can bind genes in patterns that depend on seizure etiology, but can bind other genes regardless of seizure etiology. Understanding the factors that underlie these differences, such as chromatin accessibility and/or abundance of co-factors, could reveal novel insights into the control of gene expression in disorders with recurrent seizures.

Distinct patterns of dentate gyrus cell activation distinguish physiologic from aberrant stimuli

Under physiologic conditions, the dentate gyrus (DG) exhibits exceptionally low levels of activity compared to other brain regions. A sparse activation pattern is observed even when the DG is engaged to process new information; for example, only ~1–3% of neurons in the DG granule cell layer (GCL) are activated after placing animals in a novel, enriched environment. Moreover, such physiologic stimulation of GCL neurons recruits young granule cells more readily than older cells. This sparse pattern of cell activation has largely been attributed to intrinsic circuit properties of the DG, such as reduced threshold for activation in younger cells, and increased inhibition onto older cells. Given these intrinsic properties, we asked whether such activation of young granule cells was unique to physiologic stimulation, or could be elicited by general pharmacological activation of the hippocampus. We found that administration of kainic acid (KA) at a low dose (5 mg/kg) to wildtype C57BL/6 mice activated a similarly sparse number of cells in the GCL as physiologic DG stimulation by exposure to a novel, enriched environment. However, unlike physiologic stimulation, 5 mg/kg KA activated primarily old granule cells as well as GABAergic interneurons. This finding indicates that intrinsic circuit properties of the DG alone may not be sufficient to support the engagement of young granule cells, and suggest that other factors such as the specificity of the pattern of inputs, may be involved.

Early Seizure Activity Accelerates Depletion of Hippocampal Neural Stem Cells and Impairs Spatial Discrimination in an Alzheimer's Disease Model

Adult hippocampal neurogenesis has been reported to be decreased, increased, or not changed in Alzheimer's disease (AD) patients and related transgenic mouse models. These disparate findings may relate to differences in disease stage, or the presence of seizures, which are associated with AD and can stimulate neurogenesis. In this study, we investigate a transgenic mouse model of AD that exhibits seizures similarly to AD patients and find that neurogenesis is increased in early stages of disease, as spontaneous seizures became evident, but is decreased below control levels as seizures recur. Treatment with the antiseizure drug levetiracetam restores neurogenesis and improves performance in a neurogenesis-associated spatial discrimination task. Our results suggest that seizures stimulate, and later accelerate the depletion of, the hippocampal neural stem cell pool. These results have implications for AD as well as any disorder accompanied by recurrent seizures, such as epilepsy.

ΔFosB Regulates Gene Expression and Cognitive Dysfunction in a Mouse Model of Alzheimer's Disease

Alzheimer's disease (AD) is characterized by cognitive decline and 5- to 10-fold increased seizure incidence. How seizures contribute to cognitive decline in AD or other disorders is unclear. We show that spontaneous seizures increase expression of ΔFosB, a highly stable Fos-family transcription factor, in the hippocampus of an AD mouse model. ΔFosB suppressed expression of the immediate early gene c-Fos, which is critical for plasticity and cognition, by binding its promoter and triggering histone deacetylation. Acute histone deacetylase (HDAC) inhibition or inhibition of ΔFosB activity restored c-Fos induction and improved cognition in AD mice. Administration of seizure-inducing agents to nontransgenic mice also resulted in ΔFosB-mediated suppression of c-Fos, suggesting that this mechanism is not confined to AD mice. These results explain observations that c-Fos expression increases after acute neuronal activity but decreases with chronic activity. Moreover, these results indicate a general mechanism by which seizures contribute to persistent cognitive deficits, even during seizure-free periods.

Common and distinct patterns of grey-matter volume alteration in major depression and bipolar disorder: evidence from voxel-based meta-analysis

Finding robust brain substrates of mood disorders is an important target for research. The degree to which major depression (MDD) and bipolar disorder (BD) are associated with common and/or distinct patterns of volumetric changes is nevertheless unclear. Furthermore, the extant literature is heterogeneous with respect to the nature of these changes. We report a meta-analysis of voxel-based morphometry (VBM) studies in MDD and BD. We identified studies published up to January 2015 that compared grey matter in MDD (50 data sets including 4101 individuals) and BD (36 data sets including 2407 individuals) using whole-brain VBM. We used statistical maps from the studies included where available and reported peak coordinates otherwise. Group comparisons and conjunction analyses identified regions in which the disorders showed common and distinct patterns of volumetric alteration. Both disorders were associated with lower grey-matter volume relative to healthy individuals in a number of areas. Conjunction analysis showed smaller volumes in both disorders in clusters in the dorsomedial and ventromedial prefrontal cortex, including the anterior cingulate cortex and bilateral insula. Group comparisons indicated that findings of smaller grey-matter volumes relative to controls in the right dorsolateral prefrontal cortex and left hippocampus, along with cerebellar, temporal and parietal regions were more substantial in major depression. These results suggest that MDD and BD are characterised by both common and distinct patterns of grey-matter volume changes. This combination of differences and similarities has the potential to inform the development of diagnostic biomarkers for these conditions.

Clinical analysis of submucosal Medpor implantation for empty nose syndrome

BACKGROUND

Empty nose syndrome (ENS) describes symptomatology and radiographic findings after surgeries on turbinates.The treatment of ENS is still debatable.

PURPOSE

To analyse clinical outcomes of submucosal Medpor® implantation for ENS.

METHODS

A total of 18 patients underwent submucosal Medpor® implantation from 2006 to 2011. We applied SNOT-22 (SinoNasalOutcome Test) for statistical survey of the patients' symptoms before and after surgery.

RESULTS

Two patients were lost to follow up after the surgery. Most of the patients developed ENS-related symptoms gradually within 2 years to 16 years after the previous nasal surgery or treatment. The sites of submucosal implantation are mainly septum and nasal floor, unilaterally or bilaterally. There is a significant improvement of SNOT-22 pre-operatively to one year post-operatively.

CONCLUSIONS

The symptomatolgy remains the most important point when dealing with patients with ENS. Submucosal implantation of Medpor® is a feasible surgical treatment to ENS. A positive cotton test is suggested for the surgical indication and planning.

Puerarin protects against damage to spatial learning and memory ability in mice with chronic alcohol poisoning

We evaluated the effect of puerarin on spatial learning and memory ability of mice with chronic alcohol poisoning. A total of 30 male C57BL/6 mice were randomly divided into model, puerarin, and control groups (n=10 each). The model group received 60% (v/v) ethanol by intragastric administration followed by intraperitoneal injection of normal saline 30 min later. The puerarin group received intragastric 60% ethanol followed by intraperitoneal puerarin 30 min later, and the control group received intragastric saline followed by intraperitoneal saline. Six weeks after treatment, the Morris water maze and Tru Scan behavioral tests and immunofluorescence staining of cerebral cortex and hippocampal neurons (by Neu-N) and microglia (by Ib1) were conducted. Glutamic acid (Glu) and gamma amino butyric acid (GABA) in the cortex and hippocampus were assayed by high-performance liquid chromatography (HPLC), and tumor necrosis factor (TNF)-α and interleukin (IL)-1β were determined by ELISA. Compared with mice in the control group, escape latency and distance were prolonged, and spontaneous movement distance was shortened (P<0.05) by puerarin. The number of microglia was increased in both the cortex and hippocampal dentate gyrus (P<0.01), and neurons were reduced only in the hippocampal dentate gyrus (P<0.01) in puerarin-treated mice. In the model group, Glu and GABA levels decreased (P<0.05), and Glu/GABA, TNF-α, and IL-1β increased (P<0.01) with puerarin treatment, returning to near normal levels. In conclusion, puerarin protected against the effects of chronic alcohol poisoning on spatial learning and memory ability primarily because of anti-inflammatory activity and regulation of the balance of Glu and GABA.

First Report of Southern Blight of Mexican Petunia (Ruellia brittoniana) Caused by Sclerotium rolfsii in Taiwan

Mexican petunia (Ruellia brittoniana) is an herbaceous flowering perennial with strikingly colored flowers, widely cultivated commercially as a potted plant and a popular garden plant. In July of 2010, root and stem rot that caused death was observed on Mexican petunia at the flower nursery of the Council of Agriculture & Chiayi County in Taiwan. Plants had rotted and girdled stem bases. Necrotic areas were covered with fans of white mycelium as well as abundant spherical sclerotia. A fungus was isolated from infected tissue and sclerotia, and maintained on potato dextrose agar (PDA) plates incubated at 25°C without light. Colonies were white, cottony, often forming fans; pure cultures were prepared by transferring hyphal tips to PDA. Sclerotia formed after 10 days, initially white becoming dark brown with age, and 0.5 to 0.6 mm in diameter. To confirm identity of the causal fungus, the complete internal transcribed spacer (ITS) rDNA region of the causal fungus was amplified using the primers ITS4 and ITS5 (2) and sequenced. The resulting sequence of 687 bp was uploaded in NCBI. The sequence was 98% similar to sequences of Athelia rolfsii (Sclerotium rolfsii) in NCBI (Accession No. JN543691.1). Koch's postulates were performed using two inoculation techniques. The soil near the base of healthy Mexican petunia plants (four plants per pot) were exposed to recently matured sclerotia (10 sclerotia per plant) developed from pure fungal cultures or 10-mm-diameter agar plugs of mycelium (one plug per plant). Noninoculated plants, in a separate pot, were used as a control. All plants were incubated in a growth chamber at 28 to 33°C. Disease symptoms occurred on all inoculated plants by 5 to 7 days and included yellowing of leaves, basal stem rot, and wilt. Ten days after inoculation, inoculated plants were dead whereas control plants remained healthy. The pathogenicity test was repeated twice with similar results and S. rolfsii was reisolated from infected plants in each test. The pathogen has been reported to cause substantial loss of Mexican petunia in Louisiana (1). The disease is becoming more common in Taiwan and could cause losses in Mexican petunia production. To our knowledge, this is the first report of disease on Mexican petunia caused by S. rolfsii in Taiwan. References: (1) G. E. Holcomb. Plant Dis. 88:770, 2004. (2) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. M. A. Innis et al., eds. Academic Press, 1990.

First Report of Southern Blight of Iresine herbstii Caused by Sclerotium rolfsii in Taiwan

Widely cultivated commercially, Iresine herbstii Hook is a potted herbaceous plant popular for its foliage, which varies from a dark red to brownish maroon. In the summer of 2010, a sudden wilt of I. herbstii plants was observed at a recreational farm in Taipei City in northern Taiwan. The initial symptoms were water-soaked lesions that became soft and then rotted. Necrotic areas on the stems were covered with fans of white mycelium as well as abundant spherical, brown sclerotia. A fungus was isolated from both infected tissue and sclerotia and maintained on potato dextrose agar (PDA) plates incubated at 25°C without light. Colonies were white and cottony, often forming mycelial fans. Pure cultures were prepared by transferring single hyphal tips to PDA. Sclerotia formed after 7 days. Sclerotia were initially white becoming dark brown with age and were 0.8 to 1 mm in diameter at maturity. These are typical features of Sclerotium rolfsii. Koch's postulates were performed by inoculating five healthy, potted I. herbstii plants with 10 fresh sclerotia placed on the soil surface around the base of each plant. In a second test, five healthy potted plants were inoculated with a single 10-mm-diameter mycelial agar plug placed at the stem base of each plant. Five noninoculated plants served as controls. All plants were incubated in a growth chamber at 25 to 35°C. Basal stem rot and wilt developed within 4 days on plants inoculated with sclerotia or mycelial plugs. All plants were dead by 7 days after inoculation whereas the controls remained healthy. The fungus was reisolated from the symptomatic tissue and produced sclerotia and mycelium consistent with S. rolfsii. To confirm identity of the causal fungus, the complete internal transcribed spacer (ITS) rDNA region of the causal fungus was amplified using the primers ITS4 and ITS5 (3) and sequenced. The resulting sequence of 687 bp was uploaded in NCBI (Accession No. JN543691.1). The sequence was 98% similar to sequences of Athelia rolfsii (anamoprh S. rolfsii). This disease has been observed on many species of plants (1, 2). To our knowledge, this is the first report of I. herbstii caused by S. rolfsii in Taiwan or any other part of the world. References: (1) T. T. Chang. Bull. Taiwan For. Res. Inst. 9:191, 1994. (2) Y. N. Wang et al. J. Exp. For. Nat. Taiwan Univ. 20:45, 2006. (3) T. J. White et al. PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, 1990.

First Report of Zonate Leaf Spot of Cinnamomum kanehirae Caused by Hinomyces moricola in Taiwan

Cinnamomum kanehirae, a native tree of Taiwan, is an important tree that hosts popular medicinal fungi. In the winter of 2011, zonate leaf spots were observed at a nursery garden in Wu-Lai, Taiwan. Initial symptoms included small brown lesions on leaves that became larger leaf spots after expanding or fusing together, causing a leaf blight and eventually defoliation. Sporophores on the host were generally hypophyllous but sometimes amphigenous, solitary, erect, easily detachable. The upper portion of the sporophore was considered an individual conidium and consisted of a pyramidal head that was fusiform to ventricose, 320 to 580 μm long and 100 to 130 μm wide at the broadest point. Branches within the pyramidal head were short and compact, and dichotomously or trichotomously branched. The sporophore initials were hyaline, broad, septate, tapering toward an acute apex, and sometimes constricted at the basal septum. Sclerotia were observed in older lesions, grey or black, spherical, and 1 to 2.5 mm in diameter. The fungus was isolated from infected tissue and sporophores, maintained on potato dextrose agar (PDA) at 20°C in darkness. Sclerotia were produced on PDA after 4 to 5 weeks and were irregular or spherical, but sporophores didn't develop on agar medium. The fungus was identified as Hinomyces moricola on the basis of morphological characteristics (1). Koch's postulates were performed by inoculating four 1-year-old, asymptomatic, potted C. kanehirae plants; every plant was inoculated with sporophores from infected leaves on each of five leaves. Four noninoculated plants were kept in separate pots and served as controls. All plants were covered with transparent plastic bags individually and incubated in a growth chamber at 18 to 20°C. Symptoms were observed after 2 to 4 days on every inoculated plant but not on uninoculated plants. The leaf spots were similar to those originally observed. The pathogen was reisolated from spots of inoculated plants. The pathogenicity test was repeated once. H. moricola is known to cause severe defoliation on woody and annual plants, including at least 73 host species and 36 families distributed in the eastern United States and Japan (2). References: (1) N.-S. Tomoko et al. Mycoscience. 47:351, 2006. (2) J. C. Trolinger et al. Plant Dis. Reptr. 62:710, 1978.

First Report of White Root Rot of Japanese Serissa Caused by Rosellinia necatrix in Taiwan

Japanese serissa (Serissa japonica (Thunb.) Thunb.) is a very popular ornamental in Taiwan. During the summer of 2005, serissa plants in a central Taiwan nursery had decaying roots, leaf yellowing, and were wilting. Wilted plants had white fan-like mycelium under the bark. The disease caused 70% loss of seedlings at the nursery. Associated synnemata were rigid, erect, dark, setaceous, 0.8 to 2.1 mm long, 90 to 200 μm wide, and tapering to enlarged whitish gray heads composed of geniculate conidiophores and conidia. Conidia were 3.1 to 5.8 × 2.6 to 3.4 μm, unicellular, hyaline, and subglobal with a truncated base. Root rots were washed, disinfested for 1 min in 0.5% NaOCl, cut into 3 mm³ pieces, plated on Merck (Darmstadt, Germany) potato dextrose agar (PDA) amended with 100 ppm of ampicillin (Sigma, St. Louis, MO), and incubated at 24°C in the dark until hyphae emerged. Single hyphal tips were transferred to PDA, and two isolates were established as pure cultures. Mycelia were cut, stained with 1% cotton blue in lactophenol, and pear-shaped hyphal swellings adjacent to the septa were observed. According to these hyphal, synnematal, and conidial characteristics, the fungus was identified as Dematophora necatrix Hartig, the anamorph of Rosellinia necatrix Prill. Inoculum for pathogenicity tests were produced on oat-wheat medium composed of 20 ml of oat grain and 20 ml of wheat grain, mixed, and soaked in water for 3 h. The grains were placed in 200-ml flasks, autoclaved at 121°C for 30 min, inoculated with two isolates of D. necatrix separately, and grown for 14 days. Six 3-month-old Japanese serissa seedlings were grown in pots. The grain inoculum was added to unsterilized field soil and the plants were transplanted into this mix. Control plants were transplanted into a similar mix without the inoculum. Two replicates were used for a total of 24 inoculated plants and 24 control plants. All plants were kept in a growth chamber at 25 to 35°C with 20 min of irrigation per day, 12 h of irradiation, and relative humidity at more than 95%. Inoculated plants developed root rots after 1 month, and after 4 months, all plants were dead, while control plants remained healthy. D. necatrix was reisolated, hyphal characteristics confirmed, and synnemata were observed on collars of dead plants. The teleomorph was not formed by our cultures, and the identification of Rosellinia necatrix was confirmed by molecular studies. The nuclear ribosomal internal transcribed spacer (ITS) amplified with two primers, ITS1 and ITS4, from our representative isolate demonstrated 99.63, 99.81, and 99.27% similarity to two R. necatrix isolates from Japan and one R. necatrix isolate from Italy, respectively. This disease has been reported on many species of plants (1), but to our knowledge, this is the first report of white root rot of Japanese serissa seedlings caused by R. necatrix in Taiwan. Reference: (1) S. T. Su et al. List of Plant Diseases in Taiwan. The Phytopathological Society of the Republic of China, 2002.

First Report of Southern Blight of Silvery Messerschmidia Seedlings in Taiwan

Silvery messerschmidia, Messerschmidia argentea (L.) Johnston, of the Boraginaceae, is indigenous to Taiwan and grown as an ornamental, for windbreaks, or as a shade tree. During the summer of 2005, a sudden wilt of 1-year-old plants was observed in a nursery in central Taiwan. Initial symptoms included stem necrosis at the collar, leaf yellowing, and tan discoloration of leaves. As stem necrosis progressed, infected plants wilted, defoliated, and died. Necrotic tissues were covered with whitish mycelium with clamp connections that formed reddish brown spherical (1 to 2.2 mm in diameter) sclerotia. A fungus was consistently recovered from the interface of diseased and healthy stem tissue, disinfested for 1 min in 0.5% NaOCl, and plated on Difco (Sparks, MD) potato dextrose agar (PDA) amended with 100 ppm of ampicillin. Pure cultures were prepared by transferring single hyphal tips to PDA, and Sclerotium rolfsii (Sacc.) was identified (1). Pathogenicity of two S. rolfsii isolates was confirmed by inoculating 3-month-old silvery messerschmidia seedlings grown in pots. Inoculum consisted of a single agar disk of a 7-day-old culture used per pot or a single sclerotium produced in 10 days on PDA and added per pot. Both the mycelium on the 0.5-cm-diameter agar plug and the sclerotium touched the base of the plant stem. Four plants were inoculated with mycelia, four with sclerotia, and four were noninoculated controls. All plants were kept in a growth chamber at 25 to 35°C with relative humidity of more than 95%. Initially, the basal stems were covered by whitish mycelia growth with a fanlike pattern from the inoculum, and brown, water-soaked necrotic lesions developed near the soil line. Inoculated plants developed symptoms within 4 days, wilted gradually in 7 days, and all were eventually killed in 11 days. Plants inoculated with sclerotia developed disease at a slower rate and control plants remained symptomless. Sclerotia developed on diseased tissues and S. rolfsii was reisolated. This disease has been observed on many species of plants (2), but to our knowledge, this is the first report of southern blight of silvery messerschmidia seedlings caused by S. rolfsii in Taiwan. References: (1) R. K. Jones and D. M. Benson, eds. Diseases of Woody Ornamentals and Trees in Nurseries. The American Phytopathological Society, St. Paul, MN, 2001. (2) Y. P. Tsai, ed. List of Plant Diseases in Taiwan. The Plant Protection Society of the Republic of China and The Phytopathological Society of the Republic of China, 1991.

First Report of Southern blight of Formosan Michelia Seedlings in Taiwan

Formosan michelia (Michelia compressa (Maxim.) Sargent) is a native, giant evergreen tree in Taiwan. This species is used for afforestation, provision of shade in domestic situations, used in parks, and also for furniture. During the summer of 2004, a sudden wilt of 1-year-old plants was observed in a nursery of northern Taiwan. Initial symptoms included stem necrosis at the soil line, yellowing, and tan discoloration of leaves. As stem necrosis progressed, infected plants wilted and died. Necrotic tissues were covered with whitish mycelium that differentiated into reddish brown spherical (1 to 2 mm in diameter) sclerotia. Sclerotium rolfsii was consistently recovered from the surface of symptomatic stem sections that were disinfected for 1 min in 0.5% NaOCl and then plated on potato-dextrose agar amended with 100 ppm ampicillin. Pathogenicity of two S. rolfsii isolates was confirmed by inoculating 1-year-old Formosan michelia seedlings grown in pots. Inoculum consisted of mycelium and sclerotia of the pathogen placed on the soil surface around the base of each plant. Noninoculated plants served as controls. All plants were kept in a growth chamber at 25 to 35°C with relative humidity >95%. Inoculated plants developed symptoms within 14 days while control plants remained symptomless. Sclerotia developed on infected tissues, and S. rolfsii was reisolated from symptomatic tissues. This disease has been observed on many species of plants (1), but to our knowledge, this is the first report of southern blight of Formosan michelia seedlings caused by S. rolfsii in Taiwan. Reference: (1) Y. P. Tsai, ed. List of Plant Diseases in Taiwan. The Plant Protection Society of the Republic of China and The Phytopathological Society of the Republic of China, 1991.

First Report of Formosan Michelia Seedling Root Rot Caused by Pythium splendens in Taiwan

Formosan michelia (Michelia compressa (Maxim.) Sargent) is a valuable evergreen tree in Taiwan that is distributed from low to medium (200 to 1,800 m) altitudes. In many nurseries in Taiwan, Formosan michelia seedlings grow poorly or wilt. The etiology of the disease observed in April 2004 in a nursery in Jinshan was investigated. Diseased seedlings with chlorotic leaves and decayed feeder roots lost leaves, died back, and then wilted. The putative pathogen, Pythium splendens Braun, was isolated and identified on a morphological basis (1). P. splendens was isolated from the roots of diseased seedlings on 2% water agar with 100 ppm of ampicillin. Isolates increased daily on potato dextrose agar at 24°C by 27 to 30 mm and on malt extract agar (MEA) by 23 to 25 mm. No zoosporangia and zoospores were produced. The main hyphae were as much as 9 μm wide on MEA. Hyphal swellings were abundant, globose, smooth, terminal, and 33 to 42 μm in diameter, often with dark, densely granulated contents. Attempted matings of four P. splendens isolates in V8 medium failed. To prove pathogenicity, the four isolates were cultured in 300-ml flasks containing 150 ml of 2% malt extract medium at room temperature for 14 days. The mycelia were homogenized in sterile water at 4,500 rpm for 5 min. The suspension was adjusted to 5 × 10⁶ hyphal swellings per ml. Roots of the 2-month-old seedlings were immersed in the suspension for 2 h, whereas the control seedlings were immersed in sterilized water. Five seedlings of each of three replicates were inoculated with one of the four isolates for a total of 60 seedlings. Controls were replicated in the same way. The inoculated plants were transplanted into plastic flowerpots containing sterilized peat and moss and kept in the greenhouse at 20 to 24°C. After 14 days, inoculated seedlings developed symptoms like those of the original plants. The putative pathogen was reisolated from the roots of inoculated plants. Cultures are maintained at the Forest Pathology Lab of the National Taiwan University. To our knowledge, this is the first report of proof of pathogenicity of P. splendens on Formosan michelia seedlings. Reference: (1) A. J. Van der Plaats-Niterink. Stud. Mycol. 21:151, 1981.

GISH, AFLP and PCR-RFLP analysis of an intergeneric somatic hybrid combining Goutou sour orange and Poncirus trifoliata

Intergeneric somatic hybrids combining Goutou sour orange (Citrus aurantium L.) with trifoliate orange Poncirus trifoliata (L.) Raf] were produced by electrofusion and their genetic inheritance analyzed by amplified fragment length polymorphism (AFLP), genomic in situ hybridization (GISH), and PCR-restriction fragment length polymorphism (PCR-RFLP). Sixteen mini-calluses were obtained after 20 days of culture; they all developed into embryoids on EME500 medium. Following several subcultures on shoot induction medium for a total culture period of 6 months, shoots regenerated. The plants grew vigorously with a well-developed root system and exhibited the trifoliate leaf character of P. trifoliata. Ploidy analysis verified that all of the regenerates were tetraploids (2 n=4 x=36) as expected. GISH analysis confirmed that 18 chromosomes came from trifoliate orange and the remaining 18 from Goutou sour orange, as with most symmetric somatic hybrid plants; moreover, chromosome translocations were also observed in one plant. AFLP analysis of 16 regenerates and their fusion parents indicated that all of the somatic hybrids except one were genetically uniform. Analysis of the somatic hybrid cytoplasmic genomes with universal primers revealed that their chloroplast DNA (cpDNA) banding patterns were identical to those of the mesophyll parent trifoliate orange, while their mitochondria (mt) genomes were of the callus parent sour orange. The potential of GISH in Citrus somatic hybrid analysis is discussed.

First Report of Sclerotium rolfsii on Island Ash Seedlings in Taiwan

Island ash (Fraxinus formosana Hay.) is a large, semideciduous tree in Taiwan. It is used for forestation, a shade tree, and producing wood for furniture. During the summer of 2001, a sudden wilt of 1-year-old plants was observed in a nursery in northern Taiwan. Initial symptoms included stem necrosis at the soil line and yellowing and tan discoloration of the leaves. As stem necrosis progressed, infected plants wilted and died. Necrotic tissues were covered with white mycelium that differentiated into reddish brown, spherical (1 to 2 mm in diameter) sclerotia. Sclerotium rolfsii was consistently recovered from the surface of symptomatic stem sections that were disinfected for 1 min in 0.5% NaOCl and then plated on potato dextrose agar (PDA) amended with 100 ppm of ampicillin. Pathogenicity of two S. rolfsii isolates was confirmed on 1-year-old island ash seedlings grown in 12.7 cm- (5-in) plastic pots in a sterilized mixture of peat moss and vermiculite (3:1). Seedlings were inoculated with mycelia and sclerotia of the pathogen grown on PDA. Three plants each were inoculated with four disks (5 mm) of agar with mycelium and three were inoculated with 10 sclerotia that were placed on the soil surface around the base of each plant. Noninoculated plants served as controls. All plants were kept in a growth chamber at 25 to 35°C and >95% relative humidity. The test was repeated once. All inoculated plants developed symptoms within 14 days, while control plants remained symptomless. Sclerotia developed on infected tissues, and S. rolfsii was reisolated from symptomatic tissues. This disease has been observed on many species of plants (1), but to our knowledge, this is the first report of Southern blight of Island ash seedlings caused by S. rolfsii in Taiwan. Reference: (1) Y. P. Tsai ed. List of Plant Diseases in Taiwan. The Plant Protection Society of the Republic of China and The Phytopathological Society of the Republic of China, 1991.

First Report of Anthracnose Caused by Colletotrichum gloeosporioides on Taxus mairei in Taiwan

Taxus mairei (Lemee & Levl.) S.Y. Hu ex Liu is a giant evergreen tree native to Taiwan. T. mairei and the Pacific yew, T. brevifolia, produce taxol, a highly effective antitumor drug. Anthracnose was observed on cuttings and seedlings of T. mairei in nurseries and on larger plants grown in plantations in Taiwan. Circular or irregular, brown leaf spots were associated with defoliation. Stems lesions and tip dieback were also observed. Colletotrichum gloeosporioides (Penz.) Sacc. was isolated from diseased tissues, and this fungus grew well on potato dextrose agar and malt extract agar (MEA), with a growth rate of 6.3 mm per day on MEA at 32°C in the dark. Colonies were white to grayish white and became dark gray with age. Acervuli produced on leaves were 115 to 155 μm in diameter, with one or several brown-to-black setae and pale salmon conidial masses. Conidia were guttulate, straight, cylindrical, obtuse at the apex and truncate at the base, and approximately 12 to 17 × 3.5 to 6.0 μm. The disease was reproduced by spraying T. mairei seedlings with a suspension of 10⁴ to 10⁵ conidia per ml, and the control plants were inoculated with distilled water. Inoculated plants were kept in a transparent moist chamber with a constant humidity near 100% (1). Symptoms appeared within 7 days when the temperature was over 32°C. When the temperature was below 24°C, symptoms were delayed. The fungus was reisolated from the inoculated plants, fulfilling Koch's postulates. To our knowledge, this is the first record of anthracnose on Taxus mairei (2), and anthracnose appears to be the most important disease on this plant in Taiwan. Voucher specimens have been deposited at the Division of Forest Protection, Taiwan Forest Research Institute as TFRIFCH Herbarium specimen 137. References: (1) W. W. Hsiao et al. Taiwan J. For. Sci.17:119, 2002. (2) Y. P. Tsai, ed. List of plant diseases in Taiwan. The Plant Protection Society of the Republic of China and The Phytopathological Society of the Republic of China, 1991.

First Report of Sclerotium rolfsii on Star-cluster (Pentas lanceolata) in Taiwan

Star-cluster (Pentas lanceolata (Forssk.) Deflers) has recently become popular as a bedding plant in Taiwan. During the summer of 2000, a sudden wilt of 60-day-old plants was observed in a nursery in Tainan City (southern Taiwan). Initial symptoms included stem necrosis at the soil line and yellowing and tan discoloration of leaves. As stem necrosis progressed, infected plants wilted and died. Necrotic tissues were covered with white mycelium that differentiated into reddish brown, spherical (1 to 2 mm in diameter) sclerotia. Sclerotium rolfsii was consistently recovered from the surface of symptomatic stem sections that were disinfected for 1 min in 0.5% NaOCl and plated on potato dextrose agar amended with 100 ppm streptomycin sulfate. Pathogenicity of three isolates of S. rolfsii was confirmed by inoculating 90-day-old plants of P. lanceolata that were grown in pots. Three plants each were inoculated with a 5-mm plug of agar with mycelium or two sclerotia of the pathogen. Inoculum was placed on the soil surface against the stem of each plant. Three noninoculated plants served as controls. All plants were kept in a growth chamber at 20 to 30°C with relative humidity >85%. The pathogenicity test was repeated. Inoculated plants developed symptoms within 7 days, while control plants remained symptomless. Sclerotia developed on infected tissues and S. rolfsii was reisolated from symptomatic tissues. Although this disease has been observed on many species of plants (1), to our knowledge, this is the first report of southern blight of P. lanceolata caused by S. rolfsii in Taiwan. Reference: (1) Tsai, Y. P., ed. List of Plant Diseases in Taiwan. The Plant Protection Society of the Republic of China and The Phytopathological Society of the Republic of China. 1991.

First Report of Zonate Leaf Spot of Artocarpus altilis Caused by Cristulariella moricola in Taiwan

Breadfruit (Artocarpus altilis (Parkinson) Fosberg) is an important landscape and garden tree in Taiwan. During the spring of 2002, zonate leaf spots of breadfruit were observed at a Taipei nursery in northern Taiwan. Initially, several small, brown, zonate lesions developed on leaves. As lesions enlarged, they coalesced, leading to blighting of leaves and premature defoliation. Sporophores on the host were generally hypophyllous but sometimes amphigenous, solitary, erect, easily detachable, and as much as 850 μm long. The upper portion of the sporophore is considered an individual conidium and consisted of a pyramidal head that was fusiform to ventricose and cristulate, 495 to 534 μm long and 210 to 290 μm wide at the broadest point. Branches within the pyramidal head were short and compact, and dichotomously or trichotomously branched. The conidia were hyaline, broad, septate, tapering toward an acute apex, and sometimes constricted at the basal septum. Conidiophores were 400 to 680 × 20 to 100 μm. The fungus was isolated from infected tissue and maintained on potato dextrose agar (PDA). Sclerotia were produced on PDA after 4 to 5 weeks at 20°C without light, but conidia were not observed in culture. The fungus was identified as Cristulariella moricola (Hino) Redhead based on morphological characteristics (1,2). To complete Koch's postulates, three sporophores from infected leaves or three sclerotia from cultures were placed individually on each of 10 breadfruit leaves. The plants were placed in plastic bags and incubated at 16 to 20°C. Symptoms were observed after 2 to 3 days on 100% of plants inoculated with sporophores and after 6 days on 50% of plants inoculated with sclerotia. The pathogen was reisolated from lesions on plants inoculated with sporophores and sclerotia. No symptoms were observed on the control plants. C. moricola has been known to cause a bull's eye or zonate leaf spot and defoliation on woody and annual plants, including at least 51 host species and 36 families distributed in the central and eastern United States (1). To our knowledge, this is the first report of zonate leaf spot and defoliation of breadfruit caused by C. moricola. References: (1) T. T. Chang. Bull. Taiwan For. Res. Inst. New Ser. 10 (2):235, 1995. (2) S. A. Redhead. Can. J. Bot. 53:700, 1975.

Reversal of cytosine arabinoside (ara-C) resistance by the synergistic combination of 6-thioguanine plus ara-C plus PEG-asparaginase (TGAP) in human leukemia lines lacking or expressing p53 protein

BACKGROUND

Sequence-specific combinations of purine analogs, such as fludarabine or 6-mercaptopurine (6-MP), administered prior to cytosine arabinoside (ara-C) have been shown to abrogate ara-C resistance in human leukemia cells in vitro and in patients with relapsed acute myeloid or lymphoblastic leukemias. The two-drug combination of 6-MP plus ara-C results in greater cytotoxicity than that achieved with either ara-C or 6-MP alone. Further preclinical investigations have shown that the addition of PEG-asparaginase (PEG-ASNase) to the combination of 6-MP plus ara-C (6-MP + ara-C + PEG-ASNase) results in 15.6-fold synergism over that achieved with the two-drug regimen. This is due to increased DNA damage leading to apoptotic cell death.

PURPOSE

Since the intravenous preparation of 6-MP is no longer available and since oral 6-thioguanine (6-TG) provides higher levels of intracellular thioguanine nucleotides than an isotoxic dose of oral 6-MP, we investigated the potential drug synergism of 6-TG plus ara-C plus PEG-ASNase (TGAP) in myeloid (HL60/S, HL60/SN3, U937) and lymphoblastic (CEM/0, CEM/ ara-C/B, CEM/ara-C/I, MOLT-4) leukemia cell lines. The CEM clones, MOLT-4 and HL60/SN3 cell lines expressed functional or measurable p53 protein, while the other cell lines did not.

METHODS

The MTT and trypan blue dye exclusion assays were used to determine drug cytotoxicity. In addition, cellular apoptosis and cellular p53, p21/waf-1 and bcl-2 protein concentrations were determined by FACS analysis and ELISA assays.

RESULTS

Sequential exposure to 6-TG (24 h) plus ara-C (24 h) plus PEG-ASNase (24 h) produced 1.3- to 18.3-fold drug synergism over the two-drug combination of 6-TG plus ara-C. The molecular mechanism of synergism was due to the fact that the three-drug combination was capable of downregulating bcl-2 oncoprotein levels in these cell lines even when p53 was absent.

CONCLUSION

These studies strongly demonstrate that the TGAP regimen is highly synergistic in p53-null and p53-expressing leukemia cell lines. We conclude that this combination regimen is collaterally sensitive with ara-C and further evaluation in an investigational phase I trial in relapsed leukemia patients is warranted.

Noradrenergic dysfunction in the prefrontal cortex in depression: an [15O] H2O PET study of the neuromodulatory effects of clonidine

BACKGROUND

Noradrenergic dysfunction has been consistently implicated in depression. Much of the evidence, though, has been indirect, such as an attenuated growth hormone response to the alpha2-adrenoceptor agonist clonidine. To more directly examine central functioning of the noradrenergic system in depression, we have used [15O] H2O positron emission tomography (PET) to measure cerebral blood flow (rCBF) in combination with clonidine as a neuromodulatory probe.

METHODS

Subjects were six depressed and six healthy women, medication free and matched for age and phase of menstrual cycle. Two PET scans were acquired at baseline and two scans at 20 and 35 min following an intravenous clonidine infusion of 1.4 microg/kg while subjects performed a sustained attention task.

RESULTS

The growth hormone response did not show a significant difference between groups. However, PET results revealed a difference in the right superior prefrontal cortex that was resolved as an interaction from decreased rCBF in healthy control subjects but increased rCBF in the depressed group, which was not accounted for by differences in task performance.

CONCLUSIONS

This differential effect of clonidine in the right prefrontal cortex provides in vivo evidence of noradrenergic dysfunction in depression, which we postulate arises from functionally impaired presynaptic alpha2-adrenoceptors as well as regionally "supersensitive" postsynaptic cortical alpha2-adrenoceptors.

Determination of cilostazol and its metabolites in human urine by high performance liquid chromatography

A high performance liquid chromatography (HPLC) method with ultraviolet detection for the simultaneous quantification of cilostazol, and its known metabolites in human urine was developed and validated. Cilostazol, its metabolites and the internal standard OPC-3930 (structural analogue of cilostazol) were extracted from human urine using liquid-liquid extraction with chloroform. The organic extract was then evaporated and the residue was reconstituted in 8% acetonitrile in ammonium acetate buffer (pH 6.5). The reconstituted solution was injected onto an HPLC system and was subjected to reverse-phase HPLC on a 5-microm ODS column. A gradient mobile phase with different percentages of acetonitrile in acetate buffer (pH 6.5) was used for the resolution of analytes. Cilostazol, its metabolites and the internal standard were well resolved at baseline with adequate resolution from constituents of human urine. The lower limit of quantification was 100 ng/ml for cilostazol and all metabolites. The method was validated for a linear range of 100-3000 ng/ml for all the metabolites and cilostazol. The overall accuracy (% relative recovery) of this method ranged from 86.1 to 116.8% for all the analytes with overall precision (%CV) being 0.8-19.7%. The long-term stability of clinical urine samples was established for at least 3 months at -20 degrees C in a storage freezer. During validation, calibration curves had correlation coefficients greater than or equal to 0.995 for cilostazol and the seven tested metabolites. The method was successfully used for the analysis of cilostazol and its metabolites in urine samples from clinical studies, demonstrating the reliability and robustness of the method.

Cytosine arabinoside (ara-C) resistance confers cross-resistance or collateral sensitivity to other classes of anti-leukemic drugs

The major limitation of treatment with antimetabolite drugs is that they produce resistant clones both in vitro and in patients who either do not respond to treatment or relapse soon after response has been documented. To better understand the phenomenon of cross-resistance, we developed seven CEM/ara-C-resistant leukemic clones from the CEM/0 (wt) cell line. These clones ranged from 4- to 3.5 x 10(8)-fold more resistant to ara-C than the wt CEM/0 cell line. Using this model, we determined IC50 concentrations to several chemotherapeutic agents and gamma radiation, and we also studied pro- (p53) and anti-apoptotic (bcl-2) proteins, as well as P-glycoprotein (P-gp) and multidrug resistance related protein (MRP). The cell viability assays showed that these clones were cross-resistant to 6-thioguanine (6-TG) or 6-mercaptoguanosine (6-TGuo) from 1.1- to 8.8-fold with ara-C; cross-resistance to vincristine (VCR) was from 200- to 1 x 10(4)-fold with ara-C. Taxotere (TXR) showed cross-resistance with ara-C from 1.39- to 3.03 x 10(3)-fold; dexamethasone (DEX) also showed a significant degree of cross-resistance from 27.4- to 3.87 x 10(7)-fold. Gamma radiation treatments from 0.77 Gy to 12.3 Gy showed a radiation dose-dependent cross-resistance with ara-C from 1.43- to 2.93-fold. Idarubicin was collaterally sensitive with ara-C from 4.6- to 1 x 10(9)-fold in these cell lines. The CEM/ara-C/G resistant cell line was 3-fold more sensitive to 6-TG or VCR than CEM/0 (wt), and 5-fold more sensitive to 6-TGuo. This cell clone expressed p53 and did not overexpress bcl-2 protein. All of the cell lines studied, CEM/0 (wt) and the ara-C resistant clones, showed functional p53 protein. The cell treatment with 0.1, 1 and 10 microM ara-C for 48 hours showed increased p53 protein expression in most of these lines. No increase in bcl-2 protein expression was seen in the wt cell line after ara-C treatment for 48 hours. Three cell lines resistant to ara-C (CEM/ara-C/B, CEM/ara-C/D and CEM/ara-C/I) showed an important increased expression of bcl-2 protein after treatment with 1 microM ara-C, but not after 10 microM. This alteration may lead to resistance to apoptosis and enhanced cell survival. The ratio of bcl-2 to p53 was increased significantly in these three clones, thus favoring an anti-apoptotic drive. All of the cell lines examined were negative for MRP expression and only two, CEM/ara-C/B and CEM/ara-C/J, were positive for MRP functional activity. However, three ara-C resistant cell clones, CEM/ara-C/7A, CEM/ara-C/B and CEM/ara-C/G, were positive for P-gp expression and functional activity. It is apparent that selection for ara-C resistance confers cross-resistance to many other classes of drugs and gamma radiation, probably due to bcl-2 protein overexpression or P-gp and MRP expression, as independent mechanisms.

Functional neuroimaging in psychiatry

Functional neuroimaging is one of the most powerful means available for investigating the pathophysiology of psychiatric disorders. In this review, we shall focus on the different ways that it can be employed to this end, describing the major findings in the field in the context of different methodological approaches. We will also discuss practical issues that are particular to studying psychiatric disorders and the potential contribution of functional neuroimaging to future psychiatric research.

The quantitative determination of cilostazol and its four metabolites in human liver microsomal incubation mixtures by high-performance liquid chromatography

A high-performance liquid chromatography-ultraviolet (HPLC-UV) method for the quantitation of cilostazol and four of its principal metabolites (i.e. OPC-13015, OPC-13213, OPC-13217 and OPC-13326) in human liver microsomal solutions was developed and validated. Cilostazol, its metabolites, and the internal standard (OPC-3930), were analyzed by protein precipitation followed by reverse-phase HPLC separation on a TSK-Gel ODS-80TM (150 x 4.6 mm, 5 microm) column and a Cosmil C-18 column (150 x 4.6 mm, 5 microm) in tandem and UV detection at 254 nm. An 80 min gradient elution of mobile phase acetonitrile in acetate buffer (pH = 6.50) was used to obtain quality chromatography and peak resolution. All the analytes were separated from each other, with the resolution being 2.43-17.59. The components of liver microsomal incubation mixture and five metabolic inhibitor probes (quinidine sulfate, diethyl dithiocarbamate (DEDTC), omeprazole, ketoconazole and furafylline) did not interfere with this analytical method. The LOQ was 1000 ng ml(-1) for cilostazol and 100 ng ml(-1) for each of the metabolites. This method has been validated for linear ranges of 100-4000 ng ml(-1) for OPC-13213, OPC-13217 and OPC-13326; 100-2000 ng ml(-1) for OPC-13015; and 1000-20000 ng ml(-1) for cilostazol. The percent relative recovery of this method was established to be 81.2-101.0% for analytes, with the precision (% coefficient of variation (CV)) being 2.8-7.7%. The autosampler stability of the analytes was evaluated and it was found that all analytes were stable at room temperature for a period of at least 17 h. This assay has been shown to be precise, accurate and reproducible.

A study on women's practice of breast self-examination in Taiwan

METHODS

A questionnaire interview was conducted on a sample of 3,040 women ages 30-59 years in the Taipei area through multistage sampling with probability proportional to size. Excluding mistakes in household registration, there were 2,311 qualified subjects, 1,749 of whom (75.7%) completed the interview. The study framework was set up according to Green's PRECEDE model.

RESULTS

In the results of this study only 8.4% of the subjects performed breast self-examinations monthly, and no single step of the breast self-examination procedure had a correct rate above 30%. The most remarkable associative factor for the correctness of breast self-examination was "source of instruction," a variable of "enabling factors"; other variables with strong associations were "newspaper contact" (contact with health reports in newspapers), which also belongs to the enabling factors category and "knowledge of breast cancer," a "predisposing factor." Demographic factors such as "educational level" and "urbanizational level" were only indirectly related.

CONCLUSION

The authors suggested using all possible routes of health education, such as mass media, hospitals and clinics, and distribution of information in the workplace, to instruct and encourage breast self-examination, especially among women from rural communities and those with less education.

Interaction between propranolol and propafenone in healthy volunteers

The effects of propafenone on the pharmacokinetics and pharmacodynamics of propranolol were evaluated in 12 healthy male subjects. Both propafenone and propranolol were each administered alone for one week followed by concomitant administration for an additional week. Blood samples, obtained at steady-state, were analyzed for propafenone and its two metabolites as well as for propranolol and 4-hydroxypropranolol. Left ventricular function, exercise performance and electrocardiographic intervals were assessed. Coadministration of propranolol did not produce any significant change in propafenone kinetics including peak plasma concentration (Cmax), time to peak plasma concentration (Tmax), elimination rate constant (t1/2), mean steady-state plasma concentration (Css), or area under the concentration vs time curves. However, concomitant propafenone administration significantly increased Cmax (83%), Tmax (55%), t1/2 (30%), and Css (213%) which were accompanied by significant decreases in plasma levels of 4-hydroxy-propranolol. Propafenone and propranolol significantly reduced supine systolic and diastolic blood pressure by 2.5 to 15.4%. The combination did not reduce diastolic blood pressure further (64.0 +/- 2.8 to 59.7 +/- 1.7 mmHg) nor did it produce a supplemental reduction in heart rate (12% reduction with propranolol, 10% reduction with concomitant administration). Propranolol, but not propafenone, significantly decreased end-diastolic volume index (13%), stroke volume index (15%), and velocity of circumferential fiber shortening (19%). The combination did not cause any further changes in echocardiographic measurements. Electrocardiographic intervals were not altered by either drug use alone or in combination.(ABSTRACT TRUNCATED AT 250 WORDS)