SaBrcada: Survival Intervals Prediction for Breast Cancer Patients by Dimension Raising and Age Stratification

(1) Background: Breast cancer is the second leading cause of cancer death among women. The accurate prediction of survival intervals will help physicians make informed decisions about treatment strategies or the use of palliative care. (2) Methods: Gene expression is predictive and correlates to patient prognosis. To establish a reliable prediction tool, we collected a total of 1187 RNA-seq data points from breast cancer patients (median age 58 years) in Fragments Per Kilobase Million (FPKM) format from the TCGA database. Among them, we selected 144 patients with date of death information to establish the SaBrcada-AD dataset. We first normalized the SaBrcada-AD dataset to TPM to build the survival prediction model SaBrcada. After normalization and dimension raising, we used the differential gene expression data to test eight different deep learning architectures. Considering the effect of age on prognosis, we also performed a stratified random sampling test on all ages between the lower and upper quartiles of patient age, 48 and 69 years; (3) Results: Stratifying by age 61, the performance of SaBrcada built by GoogLeNet was improved to a highest accuracy of 0.798. We also built a free website tool to provide five predicted survival periods: within six months, six months to one year, one to three years, three to five years, or over five years, for clinician reference. (4) Conclusions: We built the prediction model, SaBrcada, and the website tool of the same name for breast cancer survival analysis. Through these models and tools, clinicians will be provided with survival interval information as a basis for formulating precision medicine.

Using Machine Learning Approaches to Predict Target Gene Expression in Rice T-DNA Insertional Mutants

To change the expression of the flanking genes by inserting T-DNA into the genome is commonly used in rice functional gene research. However, whether the expression of a gene of interest is enhanced must be validated experimentally. Consequently, to improve the efficiency of screening activated genes, we established a model to predict gene expression in T-DNA mutants through machine learning methods. We gathered experimental datasets consisting of gene expression data in T-DNA mutants and captured the PROMOTER and MIDDLE sequences for encoding. In first-layer models, support vector machine (SVM) models were constructed with nine features consisting of information about biological function and local and global sequences. Feature encoding based on the PROMOTER sequence was weighted by logistic regression. The second-layer models integrated 16 first-layer models with minimum redundancy maximum relevance (mRMR) feature selection and the LADTree algorithm, which were selected from nine feature selection methods and 65 classified methods, respectively. The accuracy of the final two-layer machine learning model, referred to as TIMgo, was 99.3% based on fivefold cross-validation, and 85.6% based on independent testing. We discovered that the information within the local sequence had a greater contribution than the global sequence with respect to classification. TIMgo had a good predictive ability for target genes within 20 kb from the 35S enhancer. Based on the analysis of significant sequences, the G-box regulatory sequence may also play an important role in the activation mechanism of the 35S enhancer.

Cancer risk in patients aged 30 years and above with type 2 diabetes receiving antidiabetic monotherapy: a cohort study using metformin as the comparator

INTRODUCTION

Accumulating evidence suggests that metformin reduces incident cancer development. Few cohort studies have evaluated the risk of subsequent cancer development in diabetic cohorts receiving antidiabetic monotherapy. We conducted a population-based study in patients with new-onset type 2 diabetes treated with antidiabetic monotherapy.

METHODS

We identified a cohort of patients with type 2 diabetics aged ≥30 years receiving hypoglycemic monotherapy (n=7,325) from the 1998-2007 Longitudinal Health Insurance Dataset. Patients were grouped according to the antidiabetic therapy they received into metformin (n=2,223), sulfonylurea (n=3,965), glitazone (n=53), meglitinide (n=128), acarbose (n=150), and insulin (n=806) groups. Patients with preexisting cancer were excluded. All patients were followed up until cancer development, dropout, death, or until December 31, 2008. Cox's model was used to estimate multivariable hazard ratios (HRs) adjusted for age, sex, Charlson comorbidity index, smoking-related comorbidities, alcohol use disorders, morbid obesity, pancreatitis, hypertension, monthly income, and urbanization level. The log-rank test was used to compare cumulative cancer incidence. Two-sided P-values <0.05 were required to reject the null hypothesis.

RESULTS

The overall median follow-up duration was 2.5 years (interquartile range, 3.6 years). Totally, 367 and 124 cancers developed in the sulfonylurea and metformin groups, respectively, representing an adjusted HR of 1.36 (95% confidence interval [CI], 1.11-1.67; P<0.005). No significant differences were observed between other groups. Increased adjusted HRs were observed for colorectal cancer (adjusted HR, 1.94; 95% CI, 1.15-3.27; P<0.05) and lung cancer (adjusted HR, 1.76; 95% CI, 1.00-3.07; P<0.05).

CONCLUSION

Metformin monotherapy may be associated with a reduction in the risk for cancer development compared with sulfonylurea monotherapy. Moreover, the use of an average defined daily dose of >0.25 of metformin when compared to lower dose will contribute to a reduction of 80% risk.

Mifepristone acts as progesterone antagonist of non-genomic responses but inhibits phytohemagglutinin-induced proliferation in human T cells

BACKGROUND

Progesterone is an endogenous immunomodulator that suppresses T cell activation during pregnancy. The stimulation of membrane progesterone receptors (mPRs) would seem to be the cause of rapid non-genomic responses in human peripheral T cells, such as an elevation of intracellular calcium ([Ca(2+)](i)) and decreased intracellular pH (pH(i)). Mifepristone (RU486) produces mixed agonist/antagonist effects on immune cells compared with progesterone. We explored whether RU486 is an antagonist to mPRs and can block rapid non-genomic responses and the induction by phytohemagglutinin (PHA) of cell proliferation.

METHODS

Human male peripheral T cell responses in terms of pH(i) and [Ca(2+)](i) changes were measured using the fluorescent dyes, 2',7'-bis-(2-carboxyethyl)-5-(and-6)-carboxyfluorescein (BCECF) and fura-2, respectively. Expression of mPR mRNA was determined by RT-PCR analysis. Cell proliferation and cell toxicity were determined by [(3)H]-thymidine incorporation and MTT assay, respectively.

RESULTS

The mRNAs of mPRalpha, mPRbeta and mPRgamma were expressed in T cells. RU486 blocked progesterone-mediated rapid responses including, the [Ca(2+)](i) increase and pH(i) decrease, in a dose related manner. RU486 did not block, but enhanced, the inhibitory effect of progesterone on PHA induced cell proliferation. RU486 alone inhibited proliferation induced by PHA and at >25 microM seems to be cytotoxic against resting T cells (P < 0.01).

CONCLUSIONS

RU486 is antagonistic to the rapid mPR-mediated non-genomic responses, but is synergistic with progesterone with respect to the inhibition of PHA-induced cell proliferation. Our findings shine new light on RU486's clinical application and how this relates to the non-genomic rapid physiological responses caused by progesterone.

Antiproliferative effects of 2-methoxyestradiol alone and in combination with chemotherapeutic agents on human endometrial cancer cells

OBJECTIVE

2-methoxyestradiol (2-ME), an endogenous estradiol metabolite, has potent antiproliferative effects on cancer cells. However, its usefulness for treating endometrial cancer has not yet been fully explored. We investigated for the first time whether in vitro combinations of 2-ME with various chemotherapeutic agents might result in a synergistic inhibitory effect on the proliferation of human endometrial cancer cells.

METHODS

As a model, two different human endometrial cancer cell lines, HEC-1-A and RL95-2, were used. These cells were treated with 2-ME alone or in combination with paclitaxel, cisplatin, or doxorubicin. Measurements to detect an antiproliferative effect were performed after 24, 48, and 72 hours using the MTT assays.

RESULTS

In both endometrial cancer cell lines a significant synergistic effect of 2-ME with paclitaxel was observed. The combination of 2-ME and cisplatin was not synergistic and provided only additive effects. The antiproliferative effect of 2-ME was somewhat antagonized by doxorubicin.

CONCLUSIONS

Our study shows that 2-ME has a direct antiproliferative effect on endometrial cancer cells. Our results also show a potential anticancer synergy between 2-ME and paclitaxel in vitro. On the other hand, no remarkable synergistic actions were observed between 2-ME and doxorubicin, suggesting that 2-ME may selectively enhance the anticancer actions of certain chemotherapeutic agents in human endometrial cancer. Therefore, combination therapy should be investigated further as an additional therapeutic option for advanced or recurrent endometrial cancer.

Improved field emission properties of thiolated multi-wall carbon nanotubes on a flexible carbon cloth substrate

In this paper we report the observation of enhanced field emission properties from thiolated multi-wall carbon nanotubes (MWCNTs) produced by a simple and effective two-step chemical surface modification technique. This technique implements carboxylation and thiolation on the MWCNTs synthesized by microwave plasma chemical vapor deposition (MPCVD) on the flexible carbon cloth substrate. The resulting thiolated MWCNTs were found to have a very low threshold field value of 1.25 V µm(-1) and a rather high field enhancement factor of 1.93 × 10(4), which are crucial for applications in versatile vacuum microelectronics.

SHENG MAI SAN, A CHINESE HERBAL MEDICINE, PROTECTS AGAINST RENAL ISCHAEMIC INJURY DURING HEAT STROKE IN THE RAT

1. There is evidence that the induction of inducible nitric oxide synthase (iNOS) and peroxynitrite by ischaemia/reperfusion may lead to renal cell injury. Herein, we investigated whether Sheng mai san (SMS), a Chinese herbal medicine, protects against renal ischaemic injury during heat stroke by reducing iNOS-dependent nitric oxide (NO) and peroxynitrite formation. 2. Urethane-anaesthetized rats were exposed to heat stress (ambient temperature 43 degrees C) to induce heat stroke. Control rats were exposed to 24 degrees C. Mean arterial pressure and renal blood flow after the onset of heat stroke were significantly lower in heat stroke rats than in control rats. However, both colonic temperature and renal damage score were greater in heat stroke rats compared with control rats. Similarly, plasma NO, creatinine and blood urea nitrogen (BUN), as well as the renal immunoreactivity of iNOS and peroxynitrite, were significantly higher in heat stroke rats compared with their normothermic controls. 3. Pretreatment with SMS (1.2 g/day per rat for 7 consecutive days before the initiation of heat stress) significantly attenuated the heat stroke-induced arterial hypotension, hyperthermia, renal ischaemia and damage, the increased renal immunoreactivity of iNOS and peroxynitrite and the increased plasma levels of NO, creatinine and BUN. Pretreatment with SMS resulted in a prolongation of survival time in heat stroke. 4. The results of the present study suggest that SMS protects against renal ischaemic damage by reducing iNOS-dependent NO and peroxynitrite production during heat stroke.

Multiple colonic ulcers caused by Churg-Strauss syndrome in a 15-year-old girl

Churg-Strauss syndrome (CSS), or allergic granulomatous angiitis, is an uncommon vasculitic syndrome that is found mainly in middle-aged adults. We describe a 15-year-old girl with CSS, diagnosed by histological findings and characteristic clinical features. The patient experienced two episodes of catastrophic gastrointestinal vasculitis, resulting in resection of 150 cm of small intestine and right hemicolectomy. Colonoscopic examination showed multiple colonic ulcers with active bleeding. The clinical course of the patient was grave and refractory to the therapy of steroid and cytotoxic drugs. In the world literature only two patients with multiple colonic ulcers caused by CSS have been reported, and very rare cases of childhood-onset CSS have been published. We reviewed CSS in children and found that the prognosis was poorer than that in adults.

Cell cycle analysis and detection of proliferative cell nuclear antigen of the endometrium after hormone replacement therapy

BACKGROUND

To understand the effect of sequential combined hormone replacement therapy (HRT) on the postmenopausal endometrium.

METHODS

Sonographic endometrial thickness, endometrial histopathology, flow cytometric cell cycle analysis and the level of proliferative cell nuclear antigen (PCNA) were studied.

RESULTS

One hundred and thirty-eight postmenopausal women were enrolled in this study. Among which, 97 women had their endometrium being adequately obtained; the most frequent type of histopathology was normal endometrium (91.8%). Endometrial hyperplasia was found in seven patients (7.2%), including typical simple hyperplasia (n=1, 1%), focal simple hyperplasia (n=5, 5.2%) and complex hyperplasia without atypia (n=1, 1%). The proliferative fractions (PF; S plus G2-M phase) of cells from normal and hyperplastic endometrium of menopausal women after HRT were 8.18 and 8.95%, respectively, which were lower than those from 29 premenopausal women without HRT. The level of PCNA of normal and hyperplastic endometrium in postmenopausal women after HRT was about 80 and 84%, respectively, of that from premenopausal endometrium.

CONCLUSIONS

Our study showed the PF of the cell cycle and the level of PCNA were not increased in the menopausal endometrium under HRT as compared to the premenopausal controls.

The protective effect of hypervolemic hemodilution in experimental heatstroke

The authors tested the hypothesis in a rat model that hypervolemic hemodilution during heatstroke affected the mean arterial pressure (MAP), striatal dopamine (DA) release, and local cerebral blood flow and neuronal damage score in different brain structures. The heatstroke was induced by exposing the urethane-anesthetized rats to an ambient temperature of 42 degrees C. Hypervolemic hemodilution was produced by intravenous administration of 10% human albumin. Relative and absolute blood flow in the corpus striatum were determined using the laser Doppler flowmetry and the autoradiography diffusible tracer technique, respectively. The DA release in the striatum was estimated using the in vivo microdialysis technique. After onset of heatstroke, animals with hypervolemic state alone, produced by saline or heparinized blood injection, displayed higher values of DA release, as well as neuronal damage score in the striatum, hypothalamus, or cortex, but lower values of MAP and blood flow in the striatum, hypothalamus, or cortex compared to normothermic controls. However, the heatstroke-induced arterial hypotension, cerebral ischemia, increased striatal DA overload, and increased neuronal damage score were attenuated by induction of both hypervolemic and hemodilution state with 10% albumin either before or after the onset of heatstroke. In addition, constant infusions of a vasopressor agent phenylephrine (2 microg kg(-1) min(-1)) after the onset of heatstroke failed to maintain appropriate levels of MAP and resulted in no protection against heatstroke. Thus, it appears that the observed benefit of the 10% albumin is secondary to hemodilution and/or maintenance of MAP.

Inhibition of testosterone secretion by S-petasin in rat testicular interstitial cells

S-petasin, a kind of sesquiterpene ester, is the anti-inflammatory ann analgesic component of the butterbur (Petasites hybridus). The clinical benefit of S-petasin is the spasmolytic activity, but its side effects on the reproductive endocrinology are not clear yet. The present study was to explore the effects of S-petasin on the secretion of testosterone in vivo and in vitro. We found that single intravenous injection of S-petasin (1 microg/kg) decreased basal plasma testosterone concentration in adult male rats. The enzymatically dispersed rat testicular interstitial cells were incubated with S-petasin (0-4.3 x 10(-5)M) in the presence or absence of human chorionic gonadotropin (hCG, 0.05 IU/ml), forskolin (adenylyl cyclase activator, 10(-5) M), and androstenedione (testosterone biosynthesis precursor, 10(-9) M) at 34 degrees C for 1 h. The concentrations of testosterone in the incubation medium were measured by radioimmunoassay. S-petasin at 4.3 x 10(-7) M was effective to reduce the basal and hCG-stimulated release of testosterone in rat testicular interstitial cells. The stimulatory effects of testosterone secretion induced by forskolin and androstenedione were significantly reduced by S-petasin at 4.3 x 10(-5) M and 4.3 x 10(-6) M, respectively. These results suggest that S-petasin inhibits the production of testosterone in rat testicular interstitial cells in part through diminishing the activities of adenylyl cyclase and 17-ketosteroid reductase.

Glucocorticoids reduce interleukin-1 concentration and result in neuroprotective effects in rat heatstroke

In urethane-anaesthetized rats, we assessed the protective effects of glucocorticoids against heatstroke-induced arterial hypotension and ischaemic neuronal damage. Heatstroke was induced by exposing the animals to an ambient temperature of 42 C. The time at which both the mean arterial pressure (MAP) and local cerebral blood flow (CBF) in the striatum decreased from their peak levels was taken as the onset of heatstroke. Control rats were exposed to a temperature of 24 C. The values of MAP and CBF after heatstroke onset were all significantly lower than those in control rats. However, the neuronal damage score in the striatum and serum levels of interleukin-1beta (IL-1beta) were greater. Systemic pretreatment or treatment with an exogenous glucocorticoid, dexamethasone (4 mg or 6 mg kg-1, i.v.), reduced the heatstroke-induced arterial hypotension, serum IL-1beta levels, cerebral ischaemia and neuronal damage, and resulted in prolongation of the time to death (TTD; the interval between the onset of heat stress and cardiac arrest). Following bilateral adrenalectomy, MAP, CBF and TTD values were found to be significantly lower in the adrenalectomized (ADX) rats than in the sham-ADX rats after heat exposure. These changes were attenuated by dexamethasone. The data support the argument that glucocorticoids reduce the plasma IL-1beta concentration and may provide the neuroprotective effects observed in rat heatstroke.

Bacterial lipopolysaccharide activates protein kinase C, but not intracellular calcium elevation, in human peripheral T cells

The increase of intracellular free calcium concentration ([Ca(2+)](i)) and protein kinase C (PKC) activity are two major early mitogenic signals to initiate proliferation of human peripheral T cells. Bacterial lipopolysaccharide (LPS) is nonmitogenic in human T cells. However, in the presence of monocytes, LPS becomes mitogenic to proliferate T cells. The aim of this study was to define the incompetency of LPS on two mitogenic signals in human peripheral T cells. T cells were isolated from human peripheral blood. [Ca(2+)](i) and pH(i) were determined by loading the cells with the fluorescent dyes, Fura-2 acetoxymethyl ester (Fura-2/AM) and 2',7'-bis(2-carboxyethyl)-5-(and 6)carboxyfluorescein acetoxymethyl ester (BCECF/AM). PKC activity was determined by protein kinase assay and cell proliferation was estimated from the incorporation of [(3)H]-thymidine. The results indicated that (1) LPS (10 microg/ml) stimulated PKC activity significantly within 5 min, reached a plateau at 30 min, and maintained that level for at least 2 h; and (2) LPS stimulated cytoplasmic alkalinization but did not affect the levels of [Ca(2+)](i) and [(3)H]-thymidine incorporation into T cells. Moreover, the combination of calcium ionophore A23187 with LPS significantly stimulated [(3)H]-thymidine incorporation into T cells. Thus, the results demonstrate that LPS failed to proliferate T cells, probably because of a lack of the machinery necessary to stimulate the mitogenic signal on [Ca(2+)](i) elevation.

Differential expression of beta-amyloid precursor and Bcl-2 proto-oncogene proteins in the developing dog retina

Previous studies of rat retinas have not only provided evidence that beta-amyloid precursor (APP) and B-cell lymphoma proto-oncogene (Bcl-2) proteins are colocalized in retinal Müller glial cells, but have also indicated that common mechanisms regulate their expression in these cells (Chen, S.T., Garey, L.J., Jen, L.S., 1994. Bcl-2 proto-oncogene protein immunoreactivity in normally developing and axotomised rat retinas. Neurosci. Lett. 172, 11 14; Chen, S.T., Gentleman, S.M., Garey, L.J., Jen, L.S., 1996. Distribution of beta-amyloid precursor and B-cell lymphoma proto-oncogene proteins in the rat retina after optic nerve transection or vascular lesion. J. Neuropathol. Exp. Neurol. 55, 1073-1082; Chen, S.T., Garey, L.J., Jen, L.S., 1997. Expression of beta-amyloid precursor protein immunoreactivity in the retina of the rat during normal development and after neonatal optic tract lesion. NeuroReport 8, 713-717). This investigation attempts to resolve whether or not the pattern observed in rats also applies to other higher mammalian species by examining the expression of immunoreactivity to APP and Bcl-2 in developing as well as mature dog retinas using immunocytochemical methods. Experimental results indicate that the immunoreactivity of both APP and Bcl-2 is located primarily in the inner retina, particularly in the ganglion cells and their axons in late fetal and neonatal stages. From the second postnatal week (the time of eye opening) onwards, immunoreactivity to APP, but not Bcl-2, is localized primarily in the endfeet and proximal part of the radial process of retinal Müller glial cells. Although the findings show both APP and Bcl-2 are expressed in ganglion cells and their processes suggest that the molecules have a role in the differentiation of neurons in the central nervous tissue, the lack of Bcl-2 in the Müller glial cells in dog retinas further suggests that the two molecules may have different biological roles with respect to glial function.

Protein gene product 9.5-immunoreactive neurons in the retina of striped dolphin (Stenella coeruleoalba) and Fraser dolphin (Lagenodelphis hosei)

This study demonstrates immunocytochemically that protein gene product 9.5 (PGP 9.5), a neuronal marker, is expressed by various populations of retinal cells in Stenella coeruleoalba (striped dolphin) and Lagenodelphis hosei (Fraser dolphin): one in the retinal ganglion cells and the other in the inner nuclear layer, resembling horizontal and amacrine cells. The specific distribution of PGP 9.5 in a dolphin closely resembles that in rodents and carnivores; however, some differences arise among these animals. In a dolphin's retina, for example, only a few of giant ganglion cells are immunoreacted while almost all the small ganglion cells are stained strongly. The processes of horizontal cells, identified according to their localization, appear not to connect entirely in a dolphin. Instead, PGP 9.5 positive cells are widely distributed in the small to moderate ganglion cells and have distinct processes which are ramified extensively in the outer plexiform layer in rodents and carnivores. The high levels of PGP 9.5 expressing in the inner part of dolphin retina, including ganglion cells and their axons as well as distinct sublamination in the inner plexiform layer, indicate that this molecule markedly influences the retinal system, possibly in visual connection. Although mammals have various visual behavior, i.e., living marine vs. terrestrial environment, and active during daytime vs. in the night, the retina is a common model to characterize the neurochemical properties.

Effects of prokinetic agents on contractile responses to electrical field stimulation of isolated guinea pig trachea

We investigated the effects of two prokinetic agents, metoclopramide and cisapride, on the contractile response of isolated guinea pig tracheal segments exposed to electrical field stimulation (EFS). Tracheal segments were suspended between two platinum electrodes in organ baths. Frequency-response curves were obtained by increasing the frequency of the stimuli on equilibrated tracheal segments, in a stepwise manner. Metoclopramide potentialed the EFS-induced contraction of the tracheal; the potentiation was more prominent at lower stimulation frequencies (< or = 10 Hz). Cisapride significantly inhibited the electrically stimulated contraction in trachea strips when the frequency of the stimulus was higher than 10 Hz. In the presence of both metoclopramide and cisapride, there was a potentiation of the contractile response at lower frequencies, and this potentiation was reduced when the frequency was higher than 10 Hz. These results demonstrate that metoclopramide enhances and cisapride reduces the airway tonicity elicited by EFS in isolated guinea pig trachea segments. Further studies are needed to verify the effects of these prokinetic agents on EFS-induced contraction of isolated guinea pig trachea and to determine the mechanisms involved.

Regulation of thyroid hormones on the production of testosterone in rats

The effects of a thyroidectomy and thyroxine (T4) replacement on the spontaneous and human chorionic gonadotropin (hCG)-stimulated secretion of testosterone and the production of adenosine 3',5'-cyclic monophosphate (cAMP) in rat testes were studied. Thyroidectomy decreased the basal levels of plasma luteinizing hormone (LH) and testosterone, which delayed the maximal response of testosterone to gonadotropin-releasing hormone (GnRH) and hCG in male rats. T4 replacement in thyroparathyroidectomized (Tx) rats restored the concentrations of plasma LH and testosterone to euthyroid levels. Thyroidectomy decreased the basal release of hypothalamic GnRH, pituitary LH, and testicular testosterone as well as the LH response to GnRH and testosterone response to hCG in vitro. T4 replacement in Tx rats restored the in vitro release of GnRH, GnRH-stimulated LH release as well as hCG-stimulated testosterone release. Administration of T4 in vitro restored the release of testosterone by rat testicular interstitial cells (TICs). The increase of testosterone release in response to forskolin and androstenedione was less in TICs from Tx rats than in that from sham Tx rats. Administration of nifedipine in vitro resulted in a decrease of testosterone release by TICs from sham Tx but not from Tx rats. The basal level of cAMP in TICs was decreased by thyroidectomy. The increased accumulation of cAMP in TICs following administration of forskolin was eliminated in Tx rats. T4 replacement in Tx restored the testosterone response to forskolin. But the testosterone response to androstenedione and the cAMP response to forskolin in TICs was not restored by T4 in Tx rats. These results suggest that the inhibitory effect of a thyroidectomy on the production of testosterone in rat TICs is in part due to: 1) the decreased basal secretion of pituitary LH and its response to GnRH; 2) the decreased response of TICs to gonadotropin; and 3) the diminished production of cAMP, influx of calcium, and activity of 17beta-HSD. T4 may enhance testosterone production by acting directly at the testicular interstitial cells of Tx rats.

Cardiac biopsy of stomach may improve the detection of H. pylori after dual therapy

BACKGROUND/AIMS

To determine whether gastric cardia biopsy may improve the detection of Helicobacter pylori (H. pylori) before and after eradication therapy.

METHODOLOGY

A total of 150 dyspeptic patients with H. pylori infection completing a 2-week course of dual therapy (amoxicillin plus omeprazole) were studied. Endoscopy was carried out at the initial stage and 4 weeks after the completion of dual therapy. During each endoscopy, gastric biopsies were sampled in order from cardia, lower body, and antrum and stored separately to survey the distribution of H. pylori by histology.

RESULTS

Before treatment, 88% (132/150) of the study cases had H. pylori found in antrum and 3.3% (5/150) of cases presented with bacteria only in cardia. After treatment, 38 cases had failure of dual therapy. The detection rates of H. pylori by biopsies without cardia decreased after the dual therapy (by antrum only: 88% to 60.5%, p < 0.05; antrum and body: 96.7% to 81.6%, p < 0.05). In contrast, the incidence of patients with only cardia involvement by H. pylori significantly increased from 3.3% (5/150) before to 18.4% (7/38) after treatment (p < 0.01). Among the 7 patients with H. pylori only in cardia after dual therapy, 3 cases had recurrent dyspepsia during follow-up because of no further anti-H. pylori therapy. Two of these 3 cases disclosed diffuse bacterial involvement in antrum and body besides cardia; the last case later had a positive result of urea breath test.

CONCLUSIONS

Biopsy obtained from gastric cardia can improve the detection rate of H. pylori especially after dual therapy, which encounters antibiotics with possible sanctuary sites here. Thus, it will be useful to prevent over diagnosis of H. pylori eradication.

The role of bcl-2 in the progression of the colorectal adenoma-carcinoma sequence

BACKGROUND

The bcl-2 proto-oncogene is a known inhibitor of apoptosis that may allow the accumulation and propagation of cells containing genetic alterations.

METHODS

An immunohistochemical study was performed to examine the role of BCL-2 protein expression in normal colonic mucosa, adenoma, and adenocarcinoma.

RESULTS

BCL-2 was present in the crypt base of normal mucosal glands, while diffuse expression of protein product was observed in 69 cases (65.1%) of adenoma and 29 cases (60%) of adenocarcinoma (p > 0.5). A diffuse expression pattern was often noted in adenomas of the tubular type, solitary lesions, small lesions (< 1 cm), and those with mild glandular dysplasia (p < 0.05, respectively). There was, however, no apparent difference as to location, Yamada type of gross appearance, and gender of patients (p > 0.05, respectively). Patterns of BCL-2 expression did not correlate with the biologic indicators of adenocarcinoma (p > 0.1, respectively).

CONCLUSIONS

Our results support that bcl-2 may play an important role in the early stage of the adenoma-carcinoma sequence. Down-regulation of bcl-2 is associated with the risk of malignant transformation for colorectal adenoma.

Increase of thyrotropin response to thyrotropin-releasing hormone (TRH) and TRH release in rats during pregnancy

Regulation of thyrotropin (TSH) release by thyrotropin releasing hormone (TRH) in the anterior pituitary gland (AP) of pregnant rats was studied. The pregnant (day 7, 14, and 21) and diestrous rats were decapitated. AP was divided into 2 halves, and then incubated with Locke's solution at 37 degrees C for 30 min following a preincubation. After replacing with media, APs were incubated with Locke's solution containing 0, or 10 nM TRH for 30 min. Both basal and TRH-stimulated media were collected at the end of incubation. Medial basal hypothalamus (MBH) was incubated with Locke's medium at 37 degrees C for 30 min. Concentrations of TSH in medium and plasma samples as well as the cyclic 3':5' adenosine monophosphate (cAMP) content in APs and the levels of TRH in MBH medium were measured by radioimmunoassay. The levels of plasma TSH were higher in pregnant rats of day 21 than in diestrous rats. The spontaneous release of TSH in vitro was unaltered by pregnancy. TRH increased the release of TSH by AP, which was higher in pregnant than in diestrous rats. Maternal serum concentration of total T3 was decreased during the pregnancy. The basal release of hypothalamic TRH in vitro was greater in late pregnant rats than in diestrous rats. After TRH stimulation, the increase of the content of pituitary cAMP was greater in late pregnant rats than in diestrus animals. These results suggest that the greater secretion of TSH in pregnant rats is in part due to an increase of spontaneous release of TRH by MBH and a decrease of plasma thyroid hormones. Moreover, the higher level of plasma TSH in rats during late pregnancy is associated with the greater response of pituitary cAMP and TSH to TRH.

[Effectiveness of videotape education for mothers of prematurity]

To investigate the effectiveness of an educational videotape on preterm mothers' knowledge, confidence, perceived stress, and social support, mothers who had given birth prematurely were recruited to participate in this study. Sixty-two mothers were randomly assigned to a control or experimental group. During hospitalization, mothers assigned to the experimental group received additional educational videotape which was designed by researchers for this particular study, regarding the knowledge and skills of caring for premature infants. While mothers in the control group received routine educational care. Both groups of mothers filled out the questionnaire including knowledge of prematurity, maternal confidence, perceived stress and perceived social support at three time periods (before discharge, one week after discharge, and one month after discharge). The findings indicated that mothers who received a videotape education reported having higher knowledge and confidence of caring for their preterm babies than mothers who were in the control group. Moreover, mothers in the experimental group perceived lower stress than the control group mothers when their babies were one month old. The scores of perception of stress, parity, and receiving a videotape education are the best predictors to maternal confidence a week after discharge. Further, the mothers' perception of stress, parity, and the perception of social support can predict and explain 47.1% of the variance of the maternal confidence. These results can apply to clinical practice for nursing mothers who have given preterm births. A convenient videotape education can improve mothers' knowledge and confidence of caring for their premature babies at home.

Neuronal connections between the auricular skin and the sympathetic pre- and postganglionic neurons of the dog as studied by using pseudorabies virus

Pseudorabies virus (PrV) as a neuronal tracer was microinjected into the concave surface of the puppy's left pinna to establish the morphological basis of somato-visceral linkage. The virus infected neurons were detected by FITC conjugated with polyclonal swine anti-PrV serum. Labelled neurons were localized in: (1) the trigeminal, geniculate and superior vagal ganglia; (2) the subnucleus caudalis of the spinal trigeminal nucleus; (3) the intermediolateral column (IML) of the thoracolumbar segments and (4) the sympathetic chain ganglia. Present results suggest that when injected into the peripheral nerves, PrV was retrogradely transported to the nerve cell bodies located in the respective sensory ganglia. From the first order sensory neurons, the virus would self-replicate and was transported trans-synaptically via the brainstem nuclei and IML to reach the neurons in the sympathetic ganglia.

Early postnatal dexamethasone therapy for the prevention of chronic lung disease in preterm infants with respiratory distress syndrome: a multicenter clinical trial

OBJECTIVES

To study whether early postnatal (<12 hours) dexamethasone therapy reduces the incidence of chronic lung disease in preterm infants with respiratory distress syndrome.

MATERIALS AND METHODS

A multicenter randomized, double-blind clinical trial was undertaken on 262 (saline placebo, 130; dexamethasone, 132) preterm infants (<2000 g) who had respiratory distress syndrome and required mechanical ventilation shortly after birth. The sample size was calculated based on the 50% reduction in the incidence of chronic lung disease when early dexamethasone is used, allowing a 5% chance of a type I error and a 10% chance of a type II error. For infants who received dexamethasone, the dosing schedules were: 0.25 mg/kg/dose every 12 hours intravenously on days 1 through 7; 0.12 mg/kg/dose every 12 hours intravenously on days 8 through 14; 0.05 mg/kg/dose every 12 hours intravenously on days 15 through 21; and 0. 02 mg/kg/dose every 12 hours intravenously on days 22 through 28. A standard protocol for respiratory care was followed by the participating hospitals. The protocol emphasized the criteria of initiation and weaning from mechanical ventilation. The diagnosis of chronic lung disease based on oxygen dependence and abnormal chest roentgenogram was made at 28 days of age. To assess the effect of dexamethasone on pulmonary inflammatory response, serial tracheal aspirates were assayed for cell counts, protein, leukotriene B4, and 6-keto prostaglandin F1alpha. All infants were observed for possible side effects, including hypertension, hyperglycemia, sepsis, intraventricular hemorrhage, retinopathy of prematurity, cardiomyopathy, and alterations in calcium homeostasis, protein metabolism, and somatic growth.

RESULTS

Infants in the dexamethasone group had a significantly lower incidence of chronic lung disease than infants in the placebo group either judged at 28 postnatal days (21/132 vs 40/130) or at 36 postconceptional weeks (20/132 vs 37/130). More infants in the dexamethasone group than in the placebo group were extubated during the study. There was no difference between the groups in mortality (39/130 vs 44/132); however, a higher proportion of infants in the dexamethasone group died in the late study period, probably attributable to infection or sepsis. There was no difference between the groups in duration of oxygen therapy and hospitalization. Early postnatal use of dexamethasone was associated with a significant decrease in tracheal aspirate cell counts, protein, leukotriene B4, and 6-keto prostaglandin F1alpha, suggesting a suppression of pulmonary inflammatory response. Significantly more infants in the dexamethasone group than in the placebo group had either bacteremia or clinical sepsis (43/132 vs 27/130). Other immediate, but transient, side effects observed in the dexamethasone group are: an increase in blood glucose and blood pressure, cardiac hypertrophy, hyperparathyroidism, and a transient delay in the rate of growth.

CONCLUSIONS

In preterm infants with severe respiratory distress syndrome requiring assisted ventilation shortly after birth, early postnatal dexamethasone therapy reduces the incidence of chronic lung disease, probably on the basis of decreasing the pulmonary inflammatory process during the early neonatal period. Infection or sepsis is the major side effect that may affect the immediate outcome. Other observable side effects are transient. In view of the significant side effects and the lack of overall improvement in outcome and mortality, and the lack of long term follow-up data, the routine use of early dexamethasone therapy is not yet recommended.

Detection of serum transforming growth factor-alpha in patients of primary epithelial ovarian cancers by enzyme immunoassay

Transforming growth factor-alpha (TGF-alpha) is a potent mitogenic polypeptide. It is secreted by a variety of transformed cells and tumors, modifying tumor growth through autocrine or paracrine mechanism. In the present study, serum levels of TGF-alpha were determined by enzyme-linked immunosorbent assay (ELISA) in 27 normal females, 116 patients with benign ovarian tumors, and 42 patients with epithelial ovarian cancers (10 with stage I, 7 with stage II, 19 with stage III, and 6 with stage IV). The ELISA assay could detect a minimum level of serum TGF-alpha concentration at 10 pg/ml. Serum samples were obtained from normal females and from patients with benign or malignant ovarian tumors before initial surgery. The detectable rates were 11% (3/27) in normal females, 28% (32/116) in benign ovarian tumors, and 62% (26/42) in ovarian cancers. The detectable rates in serous and endometrioid ovarian cancers were 71 and 70%, respectively, which were higher than the rate of 33% in mucinous type. However, there was no obvious relationship between the detectability of serum TGF-alpha and the stages of ovarian cancers. The mean concentration of TGF-alpha in ovarian cancer was 159.8 pg/ml, which was significantly higher than 27.7 pg/ml in benign ovarian tumors (P < 0.001) as well as 15 pg/ml in normal females (P < 0.001). The mean concentrations of serum TGF-alpha in stages I to IV ovarian cancers were 133.5, 96.2, 194.8, and 178.3 pg/ml, respectively. The mean concentration of serum TGF-alpha in any two stages of ovarian cancers was not statistically different. In conclusion, measurement of serum TGF-alpha can be used as a supplementary tumor marker to differentiate a malignant ovarian tumor from a benign one. However, the concentration of serum TGF-alpha has no special relation with the stage of ovarian cancer itself. Because of the small number of stage I ovarian cancers with detectable TGF-alpha in the present investigation, it would probably not be feasible to differentiate a stage I ovarian cancer from a benign ovarian tumor based only on the level of TGF-alpha in serum.

Clinical application of gastric histology to monitor treatment of dual therapy in H. pylori eradication

This preliminary study attempted to test whether pretreatment gastric histology of H. pylori infection may affect the success of dual therapy and to identify which parameter of gastric histology could be improved after dual therapy. One hundred forty-five dyspeptic patients with H. pylori infection received a two-week course of dual therapy (Amoxicillin 500 mg every 6 hr plus omeprazole 20 mg twice a day). In each patient, three pairs of gastric biopsies, sampled from the antrum, lower body, and upper body near the cardia, were collected before treatment and four weeks after completion of dual therapy. The density of H. pylori (score 1-5) and parameters of the modified Sydney system were applied to test the severity of H. pylori-related gastric histology in each specimen. The total bacterial load (score 1-15) was a sum of the density of H. pylori sampled from three biopsies. The overall rate of H. pylori eradication rate by dual therapy is 73.1% (106/145). Univariate analysis of parameters in pretreatment histology disclosed that the presence of mucosal atrophy (P < 0.01), lymphoid follicles (P < 0.005), and higher-density H. pylori (P < 0.001) predisposed to dual therapy failure. Multivariate analysis by stepwise logistic regression further confirmed that both the density of bacteria and the presence of lymphoid follicles are the two major factors related to the outcome of dual therapy (P < 0.001). Four weeks after dual therapy was completed, only patients with successful eradication significantly improved in these gastric histology parameters: acute activity, chronic inflammation, eosinophil infiltration, and mucosal atrophy. However, the lymphoid follicle and intestinal metaplasia were not significantly improved during the study period. The eradication rates among three subgroups with different total bacterial loads (group I: 1-5; II: 6-10; III: 11-15) disclosed a downward trend (I: 89.1%; II: 73%; III: 52.7%). It is concluded that dual therapy could improve gastric histology especially among patients with successful eradication of H. pylori. Evaluating pretreatment histologic parameters, including the density of H. pylori and the presence of lymphoid follicles, is valuable in predicting the success of dual therapy.

Lactate and the effects of exercise on testosterone secretion: evidence for the involvement of a cAMP-mediated mechanism

The effects of swimming and lactate on the release of testosterone were examined in male rats. During in vivo experiments, male rats were catheterized via the right jugular vein and blood was collected at 0, 10, 15, 30, and 60 min following the exercise, or they were catheterized via the right jugular vein and the left femoral vein and blood was collected at 0, 2, 5, 10, 15, 30, 60, and 120 min after a 10-min infusion at lactate (13 mg.kg-1.min-1). Trunk blood and blood from the testicular vein were also collected after 10 min of swimming or water immersion. In an in vitro experiment, testicular fragments were challenged with lactate (0.01-10 mM) and/or human chorionic gonadotropin (hCG; 0.5 IU.mL-1), and the mediobasal hypothalamus (MBH) was challenged with lactate (8 mM). The post-exercise levels of plasma lactate and testosterone at 10, 15, and 30 min were higher than resting levels. Plasma luteinizing hormone (LH) was increased following 30 min of swimming. Administration of lactate or hCG increased in a dose dependent manner testicular cyclic adenosine 3':5' monophosphate (cAMP) and testosterone release. Plasma testosterone increased after swimming and lactate infusion. Incubation of MBH with lactate increased the gonadotropin-releasing hormone (GnRH) level in the medium. These results suggest that the increased plasma testosterone levels in male rats during exercise is at least partially a result of a direct and LH-independent stimulatory effect of lactate on the secretion of testosterone by increasing testicular cAMP production. Swim-elevated plasma LH may be a result of a rise of GnRH caused by lactate.

Effects of long-term administration of octreotide on sodium retention and atrial natriuretic peptide in carbon tetrachloride-induced cirrhotic rats

BACKGROUND/AIMS

To realize the roles of peripheral vasodilatation and atrial natriuretic peptide in the formation of cirrhotic ascites, the effects of long-term administration of octreotide on carbon tetrachloride-induced cirrhotic rats were evaluated.

METHODS

Urine sodium excretion, hemodynamics, plasma atrial natriuretic peptide levels, renin activities and aldosterone concentrations were compared between cirrhotic and control rats (protocol 1); and between octreotide- (65 micrograms/kg, twice daily for 10 days, subcutaneously) and placebo-treated (5% dextrose) cirrhotic rats (protocol 2). In an in vitro experiment, right atrial tissue of cirrhotic rats was incubated with different concentrations of octreotide to evaluate the release of atrial natriuretic peptide (protocol 3).

RESULTS

Cirrhotic rats had significantly lower urine sodium excretion and systemic vascular resistance, and significantly higher plasma atrial natriuretic peptide levels, renin activities and aldosterone concentrations than control rats. Compared with placebo-treated cirrhotic rats, octreotide caused increased urine sodium excretion (-10 +/- 4% vs. 13 +/- 8% from baseline values, p < 0.05) and systemic vascular resistance (2.6 +/- 0.1 vs. 3.3 +/- 0.3 mmHg.min.100 g.ml-1, p < 0.05); and decreased plasma atrial natriuretic peptide levels (166.7 +/- 24.8 vs. 234.0 +/- 19.2 pg/ ml, p < 0.05), renin activities (2.45 +/- 0.49 vs. 4.36 +/- 0.53 ng.ml-1.h-1, p < 0.01) and aldosterone concentrations (290.2 +/- 40.0 vs. 483.3 +/- 82.6 pg/ml, p < 0.05). In the in vitro experiment, right atrial release of atrial natriuretic peptide of cirrhotic rats was not significantly changed when incubated with different concentrations of octreotide.

CONCLUSIONS

Octreotide ameliorates renal sodium retention and suppresses plasma levels of atrial natriuretic peptide of ascitic cirrhotic rats with a novel mechanism via, at least partly, the modification of peripheral vascular resistance.

Small neuraminidase gene of Clostridium perfringens ATCC 10543: cloning, nucleotide sequence, and production

The small nanH gene encoding a neuraminidase from Clostridium perfringens ATCC 10543 was cloned in JM109 using pUC19 as a vector. Sequence analysis revealed an ORF, nt 310-1455, encoding 382 amino acids that was proceeded by a typical Shine-Dalgarno sequence, GGACGAGA. The nt sequence in the 15-402 region had in vivo promoter activity in an Escherichia coli promoter probe plasmid pKK232-8, which suggested that the small nanH promoter is functional in E. coli. Four regions of amino acids demonstrated great similarity to the "Asp boxes" (-Ser-X-Asp-X-Gly-X-Thr-Trp-) of other bacterial nanH proteins. The small nanH expressing clone, pCPN-1, which was cultured under aerobic conditions resulted in NanH activity which was 203-fold in culture and 211-fold in intracellular fraction compared to that of C. perfringens which has to be cultured under anaerobic conditions. Production of small NanH was also induced by adding sialyllactose to the culture medium of JM109 [pCPN-1]. The enzyme activity could be detected in the periplasmic fraction and the culture medium of JM109 [pCPN-1] after culturing to the stationary phase. The molecular weight, K(m), and optimum pH and pI of the cloned enzyme are identical to those of the parent strain. The cloned, small nanH could be used to study the structure-functional relationship of nanH, while the pCPN-1 clone could be used in the aerobic production of neuraminidase.

Identification of LDH-ras p21 protein complex and expression of these genes in human ovarian cancer

Normal ovarian and ovarian cancer tissues from 35 patients were tested for LDH-A-ras protein complex formation, as well as for the expression of ras and LDH-A genes. By immunodetection of the immunoprecipitates, LDH-A-ras protein complexes are present in the homogenates of human ovarian tissues (benign and malignant). Two bands of 21 and 36 kDa were demonstrated in affinity-purified LDH active fractions by Western blot analysis, and these two proteins were proved to be ras p21 and LDH-A by immunodetection. By Northern blot analysis, elevated levels of c-Ki-ras and LDH-A mRNA transcripts were noted in 49% (17/35) and 40% (14/35) of ovarian cancers, respectively. Concurrent high expression of both genes was demonstrated in 11 cases (31%). Tyrosylphosphorylation of LDH-A was demonstrated in normal and malignant ovarian tissues, and the extent of phosphorylation was correlated with the stage of ovarian cancer. The concurrent elevated expression of ras and LDH-A in the same ovarian tissue may imply that the increased synthesis of LDH-A is due to increased or amplified signaling of the ras-cascade pathway. The possible biochemical role of the tyrosylphosphorylated LDH-A complexed with ras p21 in cell transformation and progression of human ovarian cancer is worthy of further investigation.

Lactate stimulates progesterone secretion via an increase in cAMP production in exercised female rats

The effect of exercise on the production of ovarian progesterone was examined in female rats. During in vivo experiments, diestrous rats were catheterized via the right jugular vein (RJV), and blood samples were collected before and after 10, 15, 30, and 60 min of swimming. In addition, blood samples were collected from the RJV before and 2, 5, 10, 15, 30, 60, and 120 min after 10 min of infusion of lactate (13 mg.kg-1.min-1) through the left femoral vein. To explore if lactate modulates progesterone secretion by acting directly on rat ovary or on anterior pituitary gland (AP), an in vitro experiment that mimicked the in vivo condition was performed. The ovarian tissue was challenged with lactate (0.01-10 mM) or porcine follicle-stimulating hormone (1 microgram/ml) and 3-isobutyl-1-methylxanthine (1 mM) for 60 min, and the AP was challenged with lactate ranging from 0.1 to 10 mM or 10 nM gonadotropin-releasing hormone for 30 min. The postexercise levels of plasma glucose, lactate, and progesterone at 10, 15, and 30 min were significantly higher than the corresponding basal levels. Plasma luteinizing hormone (LH) did not change after exercise. An elevation of plasma lactate and progesterone was found at 15 and 30 min subsequent to 10 min of infusion of lactate. Lactate ranging from 0.01 to 10 mM significantly increased ovarian adenosine 3',5'-cyclic monophosphate (cAMP) and progesterone production in a dose-dependent manner. LH concentration in plasma was not changed subsequent to lactate infusion. LH level in media samples was not altered after incubation of AP with lactate. These results suggest that the increase of plasma progesterone level in rats during exercise is independent of LH secretion and at least in part is due directly to a stimulatory effect of lactate on the production of ovarian cAMP.

The composition and central projections of the internal auricular nerves of the dog

The cranial components and central terminations of the sensory nerves supplying the concave surface of the puppy's pinna, namely, the rostral, middle and caudal internal auricular nerves (RIAN, MIAN and CIAN) were investigated using horseradish peroxidase retrograde and transganglionic labelling techniques. All the 3 internal auricular nerves received contributions from the vagus. The RIAN received additional fibres from the trigeminal nerve while the MIAN and CIAN contained fibres derived from the facial nerves. In the brainstem, collaterals from the descending fibres of the afferents were given off at all levels to the medially located spinal trigeminal nucleus (SpV) which extended rostocaudally from the principal nucleus of the trigeminal nerve, subnuclei oralis, interpolaris and caudalis of the SpV to C1 or C2 cervical segment. The greatest density of central projections was observed in the subnucleus caudalis and C1. In the latter, the terminal field in the dorsal horn was roughly wedge-shaped, tapering off medially from lamina I towards lamina V. A somatotopic organisation was observed in the spinal trigeminal tract (SpVtr) and spinal trigeminal nucleus (SpV) in which the projection fibres and terminal fields of the RIAN were located lateral to those of the MIAN and CIAN. Some nontrigeminal nuclei, e.g. paratrigeminal and cuneate nuclei, nucleus X and the nucleus of the solitary tract were also labelled following HRP application to the internal auricular nerves. The localisation of the central projections of the internal auricular nerves as well as the 2nd order neurons in some specific nuclei to which the afferent fibres project is consistent with the concept of a brainstem somatovisceral link.

Site-directed mutations of the catalytic and conserved amino acids of the neuraminidase gene, nanH, of Clostridium perfringens ATCC 10543

The small nanH gene encoding the neuraminidase from Clostridium perfringens ATCC 10543 was cloned in JM109 using pUC19 as a vector. Sequence analysis revealed an ORF encoding 382 amino acids without a signal peptide sequence. Four regions of amino-acid sequence, 71-82, 140-151, 208-219, and 255-266 constituted four repeated and conserved sequence motifs-Ser-X-Asp-X-Gly-X-Thr-Trp-, the "Asp boxes." When compared, the nanH polypeptides of C. perfringens ATCC 10543 and Salmonella typhimurium LT12 shared 33% sequence identity and 60% similarity if conservative replacements were included. The homology-modeled structure of C. perfringens NanH showed the same folding topology as the x-ray three-dimensional structure of NanH in S. typhimurium LT12. Amino acid residues Arg37, Arg56, Asp62, His63, Asp100, Glu230, Asp247, Tyr347, and Glu362 located around the pocket of modeled C. perfringens small nanH were superimposed with the active-site pocket of S. typhimurium LT12, nanH. The catalytic amino-acid residues as well as the role of the "Asp boxes" have not been characterized for C. perfringens and S. typhimurium. In this study, Asp100, Glu230, and Asp62 were found to be involved in the catalytic activity of C. perfringens small nanH with immunoreactive properties and site-directed mutagenesis analysis. Four "Asp-box" motifs were found remote from the active-site pocket. Mutational and immunoreactive analysis of the highly conserved amino acids located in the "Asp boxes" suggest that these highly conserved residues are important in maintaining the tertiary structure of NanH. The results of this study provide some knowledge for the design of new inhibitors of small neuraminidase.

Molecular biology of human ovarian cancer

It has been proposed that epithelial ovarian cancers are of unifocal origin and arise from a single cell. Many alterations occur during the multistep carcinogenesis including interaction of peptide growth factors, activation of protooncogenes, and loss of tumor-suppressor genes. Increased activity of TGF-alpha and decreased activity of TGF-beta may contribute to the development of many ovarian cancers. Loss of TGF-beta responsiveness has been associated with the downregulation of c-myc expression in the development of ovarian cancer. Alternative expression of many oncogenes including ras, erbB2 and c-myc, were detected in many studies. p53 mutation was detected in 50% of advanced ovarian cancer, suggesting that loss of tumor-suppressor gene function facilitates transformation. Serum parameters like AFP, CEA, CA-125, IAP, LDH, SA, TGF-alpha, and M-CSF have been used as ovarian tumor markers. None of these biochemical markers is presently consistent and specific enough to be an early detection for ovarian cancers.

The influence of incubator wall on the irradiation intensity of phototherapy

A clear dose-response relationship has been demonstrated between the irradiance and the effectiveness of phototherapy. This study is designed to detect if there is any difference in irradiance between the inside and outside of different types of incubators. Forty-four incubators of two different types and with ages up to 18 years were included. In comparison with the measurement taken outside an incubator, the mean spectral irradiance detected within a single-walled incubator was significantly decreased (p < 0.001) while that detected within a double-walled incubator was slightly increased (p = 0.014). The reduction of spectral irradiance within an incubator correlated with the degree of incubator wall damage with a maximal loss of 15%. However, the irradiance did not correlate with the age of the incubator. In conclusion, the spectral irradiance received within an incubator was influenced by the type of incubator and the wall damage. Measuring the irradiance within an incubator prior to phototherapy should be emphasized, especially for those incubators with severely damaged walls.

Clinical characteristics of and response to combination chemotherapy and subsequent application of international prognostic index in non-Hodgkin's lymphoma--an experience from a medical center in Southern Taiwan

A retrospective analysis was performed of 117 non-Hodgkin's lymphoma (NHL) patients (72 male and 45 female, mean age 55 years) treated at NCKUH between July 1988 and December 1993. Of the 115 patients who could be classified by Ann Arbor staging system, 26 patients (22.2%) were in stage 1; 23 (19.7%) in stage 2; 29 (24.8%) in stage 3; and 37 (31.6%) in stage 4. According to the International Working Formulation, three patients (2.6%) were low grade NHL, 90 (76.9%) were intermediate, and 8 (6.8%) were high grade NHL. Histologically, diffuse large cell NHL accounted for 52.1% of cases, followed by 16.2% of cases exhibiting diffuse mixed NHL. Immunophenotype analysis was available in 95 cases, which revealed 76 (80%) cases exhibiting B-cell origin, 17 (18%) cases exhibiting diffuse mixed NHL. Immunophenotype analysis was available in 95 cases, which revealed 76 (80%) cases exhibiting B-cell origin, 17 (18%) cases exhibiting T-cell origin and 2 (2%) cases were of null cell type. All patients underwent two groups of induction chemotherapy, either CHOP (Cyclophosphamide, Epirubicin, Oncovin, and Prednisolone), or "modified" COPBLAM (Cyclophosphamide, Epirubicin, Oncovin, and Prednisolone), or "modified" COPBLAM (Cyclophosphamide, Epirubicin, Oncovin, Vinblastine, Bleomycin, Procarbazine, and Prednisolone). Seventy-two cases treated through COPBLAM and 45 cases treated through CHOP were evaluated. The response rate (RR) to COPBLAM treatment was 72.2% and was 68.9% for the CHOP group (P = 0.51). The 5-year overall survival rate (OAS) was 44.1% for COPBLAM, versus 40% for CHOP (P = 0.15). The disease-free survival (DFS) was 72.6% at 63 months for COPBLAM and 58% at 51 months for CHOP (P = 0.16). Neither B cell nor T-cell lineages of NHL showed any statistical difference in RR (P = 0.53, DFS (P = 0.58) or OAS (P = 0.97) to the different treatments. Using multiple logistic analysis, two independent factors, high LDH and advanced stage, were found to adversely affect the rate of complete remission. The application of the International Prognostic Index to our patients needs modification, which suggests the necessity of more evaluation before it can accurately be applied to all international series of NHL.

Prolonged fever in children

During a four-year period, 86 children with fever lasting for at least 6 days without diagnosis at admission after initial physical examination and preliminary laboratory tests were included in a retrospective analysis. Their ages ranged from 2 months to 16 years, and there were 55 males and 31 females. Bacterial infections occurred in 19 patients (22%), viral infections in 17 (20%), mycoplasmal infections in 3 and malaria in 1. Collagen vascular diseases were diagnosed in 13 children (15%), including 7 juvenile rheumatoid arthritis and 5 systemic lupus erythematosus. Thirteen children (15%) had neoplastic or hematological diseases, including leukemia, lymphoma, myelodysplastic syndrome, and neuroblastoma. The fevers of the other 14 patients (16%) were attributed to central fever. The overall diagnostic rate was 98%. Twenty-two children had a poor outcome, including 6 children with collagen vascular diseases and 12 with neoplasms. Diagnoses were made mainly through a complete medical history, meticulous physical examination, regular laboratory tests, and an observation of clinical course. Invasive tissue studies can be fruitful when used appropriately and should be considered for specific indication only.

Successful resection of a minute icteric hepatocellular carcinoma--case report

A 38-year-old male was admitted to our department with jaundice. Imaging studies including ultrasonography, ERCP, PTC and computed tomography (CT) revealed a hilar lesion. Right hepatic lobectomy, caudate lobectomy, excision of CBD and restoration of biloenteric continuity was performed. Pathological examination showed an icteric hepatoma (1.2 x 0.8 x 0.8 cm in size) originating in the caudate lobe. The tumor thrombus occupied the common hepatic duct and the right intrahepatic duct. The postoperative course was fairly unremarkable, and the patient has remained in good health for four years after surgery without any sign of recurrence.

Calcitonin inhibits testosterone and luteinizing hormone secretion through a mechanism involving an increase in cAMP production in rats

Effects of calcitonin peptides, including human calcitonin (hCT), salmon calcitonin (sCT), and calcitonin gene-related peptide (CGRP), on the secretion of testosterone and luteinizing hormone (LH) in male rats were studied. Male rats were injected intravenously with human chorionic gonadotropin (hCG), calcitonin peptides, or hCG plus calcitonin peptides. Blood samples were collected at several intervals following hormone challenge. In an in vitro experiment, testis blocks were incubated with hCG (0, 0.05, 0.5, or 5 IU/ml) or hCG (0.5 IU/ml) plus calcitonin peptides (0-10(-9) or 10(-6) M) at 34 degrees C for 30 minutes. Both medium and plasma samples were extracted by ether and analyzed for testosterone by radioimmunoassay (RIA). The concentration of calcium in each plasma sample was measured by an automatic calcium analyzer. The anterior pituitary gland (AP) was incubated with or without calcitonin peptides (0-10 nM) at 37 degrees C for 30 minutes. They were then incubated with gonadotropin releasing hormone (GnRH, 10 nM) for a further 30 minutes. The concentration of LH in AP medium was measured by RIA. The accumulation of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) in both testicular tissues and APs were measured by RIA. A single intravenous injection of calcitonin peptides decreased the basal and hCG-stimulated levels of plasma testosterone gradually from 60 to 180 or 360 minutes after challenge. The plasma calcium was not altered by the injection of calcitonin peptides and/or hCG. Administration of calcitonin peptides in vitro resulted in a dose-dependent inhibition of both basal and hCG-stimulated release of testosterone.(ABSTRACT TRUNCATED AT 250 WORDS)

Correlation between angiogenesis and basic fibroblast growth factor expression in experimental brain infarct

BACKGROUND AND PURPOSE

Cerebral endothelial cells are quiescent under normal conditions; they are stimulated to proliferate around an infarct, although the mechanism is unclear. In the present study we explored the relation between angiogenesis and the expression of basic fibroblast growth factor (bFGF) by participating cells in brain infarct.

METHODS

Brain infarct was created in rats by ligation of a branch of the left middle cerebral artery followed by permanent occlusion of the left common carotid artery and temporary occlusion of the right common carotid artery. The brains were removed after 1 to 14 days and studied with histological and immunohistochemical methods. Bromodeoxyuridine (BRdU) was used as an S-phase marker for the proliferative cells.

RESULTS

Enhanced bFGF immunoreactivity was observed in neurons adjacent to the infarct after 1 day, and the change subsequently spread to distant neurons in the ipsilateral hemisphere. After 2 days blood vessels and glial cells around the infarct began to incorporate BRdU. During the first week new capillaries accompanied by macrophages extended into the infarct. The macrophages, endothelial cells, and reactive astrocytes expressed mild to moderate bFGF immunoreactivity.

CONCLUSIONS

The spatial and temporal correlation between bFGF expression and angiogenesis in conjunction with the well-known biological properties of bFGF suggest that bFGF produced by neurons, macrophages, and glial cells may participate in angiogenesis in brain infarct.

Interrelationship between thyroxine and estradiol on the secretion of thyrotropin-releasing hormone and dopamine into hypophysial portal blood in ovariectomized-thyroidectomized rats

Effects of thyroxine (T4) on the secretion of thyrotropin-releasing hormone (TRH) and catecholamines into hypophysial portal blood and on the concentrations of arterial plasma thyroid-stimulating hormone (TSH) and prolactin (PRL) in ovariectomized and thyroidectomized (Ovx-Tx) rats were studied. Immediately after ovariectomy, rats were Tx or sham Tx. The Ovx-Tx rats were injected subcutaneously with estradiol benzoate (EB, 0.5 microgram/kg b.w.) or sesame oil, and T4 (20 micrograms/kg b.w.) or saline once daily for 2 weeks. The Ovx rats with intact thyroid gland were injected with saline and oil only. The hypophysial portal blood samples were collected and mixed with or without 2,3-dimercaptopropanol before extraction by methanol or perchloric acid, respectively. The femoral arterial blood was also collected. The concentrations of TRH in methanol-extracted portal plasma and that of TSH and PRL in arterial plasma were measured by radioimmunoassay. The concentrations of catecholamines in perchloric acid-extracted portal plasma samples were measured by radioenzymatic assay. Thyroidectomy in Ovx rats resulted in an increase in portal plasma TRH and arterial plasma TSH. Despite the presence or absence of estradiol, T4 replacement in Ovx-Tx rats decreased portal plasma TRH and arterial plasma TSH to euthyroid levels. Combination of the injection of T4 and EB in vivo caused significantly decreased levels of portal plasma dopamine and increased arterial plasma PRL compared with those in vehicle-injected Ovx-Tx animals. Concentrations of neither norepinephrine nor epinephrine in hypophysial portal plasma paralleled the altered concentrations of PRL or TSH in arterial plasma.(ABSTRACT TRUNCATED AT 250 WORDS)

Transcriptional activation of c-myc proto-oncogene by estrogen in human ovarian cancer cells

NIH:OVCAR-3 is a human ovarian cancer cell line that expresses a moderate amount of estrogen receptors, 28 fmol/mg protein. We have found that estrogen at a concentration of 10(-7) M induced a 2.3-fold increase in the growth of NIH:OVCAR-3 cells after 48 h stimulation. A 4-fold increase in c-myc mRNA expression at 30 min and a 7.5-fold increase at 50 min post-induction with estradiol were observed. Nuclear run-on analysis indicated that c-myc transcripts increased 4-fold within 10 min of estrogen addition. The half-life of c-myc mRNA was 64 min +/- 5 min and was not affected by estrogen. Antisense oligonucleotide to c-myc specifically inhibited the estrogen stimulated c-myc protein expression as well as the growth of NIH:OVCAR-3 cells. A control ovarian cancer cell line OC-3-VGH that had few estrogen receptors (1 fmol/mg protein) did not respond to estrogen in growth; however, these cells respond to estrogen with a 1.5-fold increase in c-myc mRNA. The stability of c-myc mRNA of these cells was not affected by estrogen. Our results indicate that transcriptional induction of c-myc expression by estrogen plays a critical role in the proliferation of NIH:OVCAR-3 cells.

An immobilized-enzyme system for the determination of sialic acid using cloned neuraminidase from Clostridium perfringens A.T.C.C. 10543

Neuraminidase expressed by cloned nanH of Clostridium perfringens has been immobilized and employed to determine the concentration of sialic acid in human serum. Two enzyme pairs, cloned neuraminidase-N-acetylneuraminate (NANA) lyase and pyruvate oxidase-peroxidase, have been respectively co-immobilized on to 1,12-aminododecane-agarose with glutaraldehyde. The relative specific activities of the co-immobilized neuraminidase and NANA lyase were 61 and 77%, and those of pyruvate oxidase and peroxidase were 51 and 96% of the corresponding soluble enzymes respectively. The optimal reaction pH at 37% C for each of the co-immobilized enzymes was about 1 pH unit higher than that of the corresponding soluble enzyme. The optimal reaction temperature of peroxidase was increased as a result of immobilization. The thermostability of the immobilized cloned neuraminidase, NANA lyase, pyruvate oxidase and peroxidase were increased 80-, 83-, 115- and 147-fold at 45 degrees C over the soluble forms respectively. The results correlated satisfactorily with those obtained by using a soluble enzyme system. The system is thus a reliable assay method for sialic acid in serum.

Innervation of the ligament of the femoral head in the formosan rock monkey: a retrograde HRP tracing and ultrastructural study

The innervation of the ligament attached to the femoral head of the Formosan rock monkey (Macaca cyclopis, Swinhoe) was investigated by means of the retrograde HRP tracing method and by electron microscopy. WGA/HRP was injected into the ligament of the left femoral head. Numerous neurons labelled with HRP were found in the ipsilateral lumbar sympathetic ganglia, from L1 to L7, with a peak in the L3 to L5 region. Labelled neurons were also found in the ipsilateral spinal dorsal root ganglia, from L1 to L7 and concentrated at L4. Ultrastructurally, the nerve fascicles to the ligament had an average diameter at 32.8 microns. They contained both myelinated and unmyelinated axons and accompanied the blood vessels. Sensory receptors were not found in the ligamentum proprium but free nerve endings were observed in the walls of the blood vessels. The present results indicate that the nerve fibres to the ligament of the femoral head may be involved in regulating blood vessel calibre in addition to having a sensory function.

Point mutation of the ras oncogene in human ovarian cancer

The ras oncogene exists in a variety of human cancers, including carcinomas of bladder, breast, colon, kidney, liver, lung, ovary, pancreas, and stomach. The ras genes acquire transforming activity either by enhanced expression or by a single point mutation. A single base-pair mutation at specific sites within ras genes endows them with the capacity to transform certain cell lines in vitro. In this study, we showed the patterns of point mutations in codons 12, 13, and 61 of ras genes in human ovarian cancer. The experimental procedures were isolation of genomic DNA from normal ovary and ovarian cancer tissue specimens, amplification of a genomic DNA segment (about 100 bp) using different 5' and 3' extension primers in the polymerase chain reaction (PCR), labeling and purification of synthetic mutation-specific oligonucleotide probes, slot-blot hybridization, and autoradiography. The three reaction steps for the PCR cycle were: 96 degrees C for 1 min in step 1, 56 degrees C for 1 min in step 2, and 74 degrees C for 1 min in step 3. The PCR reaction was repeated totally for 30 cycles. In 28 tissue specimens of human ovarian cancer examined, one specimen was found with a c-Ha-ras point mutation at codon 12, two had a c-Ki-ras mutation at codon 12, and one had a c-Ki-ras mutation at codon 13.

Elevation of carcinoembryonic antigen related to biliary malignancy in hepatolithiasis

Bile duct neoplasms occur relatively often in patients with hepatolithiasis in Taiwan. In this study, 49 patients with a positive immunoperoxidase stain for carcinoembryonic antigen (CEA) in the bile duct glands were examined in relation to the concentration of CEA in serum and bile. The bile concentrations of CEA in 15 control patients, 16 patients with hepatolithiasis only, 7 with hepatolithiasis and bile duct carcinoma, and 11 with bile duct carcinoma only were 4.09 +/- 4.12, 70.49 +/- 81.62, 137.73 +/- 66.15, and 144.3 +/- 117.31 ng/ml (mean +/- SD), respectively. A positive CEA stain from the bile duct was seen in 13.33%, 81.23%, 85.71%, and 90.91% of each group, respectively. No strongly positive staining, (2+ or 3+) was found in the control group, but it was found frequently in the hepatolithiasis and bile duct carcinoma groups. The findings of this study therefore suggest the probability of a combined neoplasm in patients with hepatolithiasis if the CEA value is unusually elevated in the serum or bile.

Shone's anomaly: report of one case

A two-month-old female infant presented with intractable congestive heart failure and cyanosis, present since the neonatal period. The echocardiogram and angiogram showed a parachute mitral valve, aortic and subaortic stenosis, perimembranous type ventricular septal defect, mild aortic coarctation and patent ductus arteriosus. Unfortunately, the patient expired two days after surgical angioplasty for coarctation of the aorta. The autopsy proved a typical case of Shone's anomaly.

A Taiwanese with a pair of sternalis muscles

A pair of sternalis muscles have been found on both sides of the chest in an adult Taiwanese male. The muscles are located superficial to the medial part of the pectoralis major, arising from the sternum and are inserted into the sheaths of the rectus abdominis. They are innervated by the intercostal nerve. It should be emphasized that the sternalis muscle is rarely found in Taiwan.

Breast milk beta-glucuronidase in breast milk jaundice

Breast milk jaundice (BMJ) is the most common etiology of prolonged unconjugated hyperbilirubinemia in a newborn infant. The pathogenesis of BMJ has been studied by many investigators, yet the etiology still remains uncertain. A prospective study was done to examine the role of breast milk beta-glucuronidase in BMJ in healthy full-term Chinese newborns. There were 71 infants in the formula-fed group (FF group), 28 in the breast-fed group (BF group) and 27 in the mixed feeding group (MF group). Study infants were followed at the well-baby clinic for at least two months. Enzyme activity in maternal breast milk and infants' stools decreased significantly during the first week postpartum. There was no intergroup difference in fecal enzyme activity for the different age groups. Significantly more infants in the BF group (35.7%) developed prolonged unconjugated hyperbilirubinemia than did infants in the FF group (2.8%) and the MF group (0%). We did not find higher enzyme activity in breast milk or stools of infants with BMJ than in infants without BMJ. We, therefore, conclude that breast milk beta-glucuronidase is not related to the development of BMJ.